Home > General Topics > Economics > Warren Buffett Says America Is "So Rich" It Can Afford Single Payer

Warren Buffett Says America Is "So Rich" It Can Afford Single Payer

  1. America is $20 TRILLION in debt (not counting unfunded liabilities). How in the Hell is that "rich"?

    If America wants a GOOD single payer plan for health insurance, we should copy Taiwan's.
  2. It's another implementation of socialism this will always fail as feedback is not directly connected to the customer or client.. the client is the government and companies will get good at billing the cover government regardless of what happens to the patient... Its destructionism.. it's completely opposite of how the us was established...
  3. You could have the state pay for the unemployed and companies pay for their employees.
  4. As a libertarian/academic economist who came from a medical education family, I am forced to observe that most of the world has found it worthwhile to provide taxpayer-funded education and health services, and while the details differ, the delivery of these things in the United States is fantastically inefficient. Unfortunately, the recipient/consumers (being, the students and patients) tend to be the least heard, while the biggest influences in the process are (generally) price un-responsive, and instead are the largest purveryors/suppliers/suckers-at-the-teat.

    "Our bad" as they say. It's not the fault of a single-payer system -- it's the fault of the United States for (as a collective) being witheringly stupid in execution. There is an entire planet of good practice available; Warren Buffet (no stranger to value, he) knows this.
  5. The "state" can't pay for anything. It doesn't have any money. Its source of funds is "take money from one citizen to give to another". The only function of the state is to collect the "vig" for implementing/regulating transactions.... even when they are harmful.

  6. ya.. its called taxation and taxation is theft

  7. Probably the most sensible and realistic summary of one's position regarding healthcare provision that I've ever seen in a non-medical-economics forum.
  8. On the surface, the notion of "single payer" makes me think of "corruption", "crony capitalism", and "special interest benefit". The notion of "government, single payer" makes me want to barf. However, the notion of a GOOD single payer system has some merit. Years ago, Taiwan decided it would be a good idea to implement a national healthcare system.

    It took a few years of research and analysis.... considering the "pros and cons" of US, Canada, and European systems. Then "pieced together the best of each" while eliminating the "worst of each". It's now claimed that Taiwan has one of the best and lowest cost healthcare systems on the planet. If America were to get behind such a task, I might could get behind it.

    Why can't we do something like that?? Doesn't if follow... that at some point, somebody's (corporations) greed needs to be sacrificed for the good of the majority? Though that doesn't infer that "one greed should be substituted for another".

  9. The UK also urgently needs to, and either de-politicizing the management of healthcare provision or at least trying to resolve it on a cross-party basis would be a good starting point.

  10. For myself, I wouldn't go as far as to say that(!) but there's certainly a very widespread perception, among those "in the trade" but outside the US, that whereas you undeniably have some of the world's best healthcare available, the proportion of the population to whom it's available is strikingly lower than it needs to be. (When you look at these things on a "cost-per-hundred-thousand" basis, of course the provision cost reduces dramatically as the realistic availability increases.)
  11. And, WTH, just to follow up, the cure for ills seen in public education is to follow one simple step: provide for alternative suppliers -- "School Choice" -- private vouchers and all of that. Suddenly, cost discipline and 'student outcomes' are all the rage. And TEACHERS (and not some gum-flapping administrator with 15 certifications after their name) are getting paid! The US is 27th in math/science last time I saw -- our *descent* has stopped, at least. "Phew!" That one, simple, loudly-moaned-about step....

    1) Get rid of the so-called "Employer Mandate" and any employment-related tax benefits or rules of any kind. Tax "health benefits" as regular income.

    2) Get rid of Treble Damages on Malpractice Pain&Suffering damages.

    These two things, stemming from the mid-1980s, gave us the health horror-show we see today. They took over HMOs such that, rather than working for the patients, they became agents Of The Doctors, For The Doctors, By the Doctors, in the doctors' battles with insurance companies. Eventually, the insurance companies bought out the troublesome doctors, too! So now (and for many years), the Hippocratic Oath has been supplanted by Cover-Thy-Ass procedures, tests, and whole office complexes have been built, peopled, and paid-for, by the schmuck who ground his knee on the driveway, and just wants a bandaid. "That'll be $700, Mr. Smith -- that's with your co-pay, of course."

    Just nuking the Treble Damages standard would produce a host of clinics where, upon signing a statement that "I know I can't sue for massive-ass dollars, should my cut get infected...", you could get that 10¢ bandaid for..... $5, with a dash of iodine and a lollipop, thanks. And like a (helpful) infection, these clinics (and then out-patient operating theaters, and then full-service hospitals) would *balloon* into existence across the country.

    And somehow all those other institutions.... "would find ways" {wink-wink; nudge-nudge} to lower their own costs........
  12. "Why can't we do something like that??"
    Only the lobbyists can answer that.
  13. The lobbyists would have no power if the politicians refused the bribes.
  14. Don't buy into the lie.... single payer is already here. once an entitlement gets put into place it never gets taken away... its outright wrong... read any Austrian economist's take on intervention, socialist medicine etc... its a terrible feedback system, central planning fails..
  15. why not make the 3rd ingredient vouchers? to create competition.

    by the way... I agree that the process is very inefficient but isn't some of that inefficiency due to the government.

    for instance CA has all sorts of caps of medical mal practice claims but health insurance is still very expensive here for those people who pay for it.

  16. The state/treasury borrow from the bond market as they never balance the budget with taxation. I am sure the unemployment rate would increase if medicaid was offered to the unemployed but that would justify lower interest rates for longer.
  17. take it from lew rockwell!
  18. printing money comes from future dilution of our purchasing power,,,, inflationary policy by the fed is just like taxtion,, THEFT
  19. Any excuse to "borrow and spend" is wrong-headed. Didn't your mama ever teach you to "not spend more than you earn"?
  20. A politician shouldn't have enough power over anything to be worth bribing.
  21. Pay for your own hospital. Anything less is just lazy bums crying for handouts!
  22. I agree, every community should own their own hospital.
  23. Public hospitals and clinics have always been the provider for the indigent and the uninsured.
  24. So in every other industrialized nation that has a national health care system all the people that pay for it & use it are lazy bums? A deeply flawed argument.
  25. I agree with that conditionally (and actually, have the same practical economic in spite of fundamental economic views generally). I've thought a good way to handle it was to make a two tier system.

    Doctors may shield themselves from liability for continuing damages and pain and suffering, and be subject to a low malpractice lost wages cap. Attorney fees cannot be recovered. The logic here is that with a no additional cost health care system, all future medical care is covered regardless of cause or cost. In order for doctors to opt-in to this system, they must bill so many hours per week / month / year at going hospital (single-payer tier) rates. Patients who wishes to opt-in to the inexpensive system pays for that with their rights to claim certain damages (kinda like an options collar--give up the upside to protect against the downside costs)

    Doctors may have a private practice outside of the single-payer, while preserving the protections from the single-payer system, and may bill at unregulated rates.

    Individuals may purchase supplemental med mal insurance (in much the same way uninsured / under insured motorists coverage works - a first party coverage against third party negligence). This would cover excess lost wages, pain and suffering, and attorney fees.

    Elective cosmetic surgery (with appropriate exceptions for correcting deformities), is not subject to the single payer system, and doctors performing it may not claim the single-payer protections.

    The perverse incentive is removed for doctors to pursue high-paying elective clients. This also gives incentives for doctors to give care to the poorest, while removing the danger of med-mal. With only lost wages in play, and capped at that, mediation is all but certain to be preferred by both patient and doctor.

    I'm guessing there's a lot of attorneys and insurance folks who wouldn't want any of that--but that probably is more of an endorsement of the model then an argument against it.
  26. *Cost discipline*.... lol.
    What we need is *student discipline*.
    Too many brainwashed whining parents raising brainwashed whining (stupid/fat) kids.
    I say bring back the old school nuns and let em have at it. America will be on top again.
  27. I still have the knuckle scars :D
  28. Awwww, Jeez, v-z!
    I was in grad school when all this shiete came down, and we (policy, econ, political science students) would all be sitting around, discussing the (public policy) news of the day -- and it was so often followed by "Really?!? *That* sounds dumb." And then I'd call home, and get the same thing from the (academic/nursing) parents. "But why are they *doing* that, Thomas?" like I was supposed to come up with the sensible economic answer as to why, what they knew to be medically or economically non-sensible, somehow made sense.

    And this is *decades* ago.

    And now my parents are passed on, but as they were "aging" and a lot of palliative care was going on, my father would show me MediCare bills (as long as your arm) of which, one would entail a 30-minute visit, and go $10,000 - $20,000, and the other would involve an overnight inpatient visit or two, and specialists out the wazoo, and run under $5,000. My father's eloquent question, "Thomas, WTF?" Dad..... Dad, I don't know. I just don't know.

    (The Old Man -- a teacher's teacher, knew how to cut to the chase, eh?)

    Anyway -- thanks for the reminder about Sister Mary Discipline -- my folks had many tales to tell about her. Thank The Entity, I don't.....
  29. Not at all. Like billionaires can afford their own hospitals, every individual should aspire to that, or perish like the lazy bums they are. Let's face it, if you can't afford your personal hospitals, doctors, firedepartments and everything else you require, you're trash and get what you deserve when nobody lifts a finger for you! Anything less than full funding, and you're living off on charity.
  30. I had an emergency appendectomy operation last summer. After being in the waiting room for hours they took me in around 7 in the morning on a Saturday. Operation at 9 or 10. Out by Monday. My cost was 54,000 dollars.

    I have health insurance for my family that I pay over a thousand dollars a month for ( it doubled under obamacare) I have a 10,000 dollar deductible. I am very happy to be alive and would have paid the 54,000 up front if I had to. I thank the surgeon for being skilled enough to save my life an allow me a relatively quick recovery.

    My question is... is that price reasonable. I was charged 11,000 dollars for I.V. fluids.

    On one hand I would have mortgaged any amount to live. I was so grateful to be alive. I told my kids to go into medicine... but on the other hand... that system needs to change its cost structures. Not the medical care but the costs. I mean I was already paying over a grand a month for insurance.

    let me be clear though. I am not in way complaining about the medical care. And, I am not really complaining about the insurance. The insurance was much cheaper before obamacare.
  31. Maybe the free market could bear much higher costs, have you thought about that?
    It obviously means nothing to society / other people.

    Being grateful, what does it really help? Only money and lots of it, to fund personal hospitals and police departments will do!
    BE #1, or perish. Amen!
  32. What you didn't know, jem, was that you were one of three appendectomy patients that came in at the same time.

    The first was your Representative to the U.S. House -- they paid not-a-penny out-of-pocket, were seen immediately, and their House-provided insurance was charged $25,000, you know, "cuz." You were the second patient, $11k out-of-pocket, $43k to your "Big Name" insurance company, who'd already negotiated it down to a flat $33,333 -- the hospital "absorbing" the rest -- cuz, like, "'Gee!' they have all those (patient) numbers they can bring, and isn't medicine cheaper when you can do it in bulk?" Yeah. The third patient was a migrant laborer, who lives hand-to-mouth, whose everyday labors put the meal on the (fast food) table in front of themselves and their loved ones. They had a bellyache on their way through town, hurled every meal they tried to eat for the last 18 hours, and shortly (Thank God!) before their belly burst, they rolled themselves into the ER, and got triaged right after you. Their bill -- a flat $60,000 -- will bankrupt them if they have the moral backbone to stick around, and will be laid upon every other patient, along with the Rep's shortage of $30,000, and your own bill's slippage of $10,000, so when the books are tallied, the hospital comes up being short $100,000 per every three appendectomies.

    SO A THIRD CURE, for the falsely-titled "Heathcare Crisis" (when sensibly, it is a Health Care FINANCE crisis...), is to
    3) have SINGLE, POSTED, TRANSPARENTLY-DERIVED, UNIFORMLY-APPLIED A'LA CARTE MENU of healthcare services, which allows price-shopping amongst non-discriminating service providers. An "Expedia.Com of Healthcare," if you will. Maine (and I think another state or two) does this already.
  33. The question is not whether single payer is a great system. The question is whether single payer is better than what we have now. The U.S. does not have too many other easy alternatives:
    * Fixing malpractice won't because malpractice only consumes about 0.5% of total health care spending;
    * Selling insurance across state lines won't, because we already have 6 states that allow this and none has ever had an insurance company willing to do it. Georgia just passed their 5 year anniversary of allowing this, and in the 5 years no insurance company even asked to see the application.
    * Comparison shopping for healthcare is virtually impossible because most hospitals won't give a quote beforehand.

    The only way for healthcare costs to go down is for somebody to get paid less. Either the hospitals, doctors, nurses, pharma, insurance, etc. What single payer does is to say that the insurance companies will be the ones that will be paid less.

    And for those that say this will put us on the road to socialize medicine, you need to wake up. Between Medicare, Medicaid, the VA, federal, state and local employees, 66% of all the people with health insurance, and 62% of all healthcare spending is already provided by the government.
  34. Not quite. The cost of medical malpractice alone is more than 2% of the healthcare sector's share of GDP. But there's also hidden costs, specifically, when a Doctor orders a very expensive and probably unnecessary test not to rule out the possibility of the disease in question, but to rule out the possibility of getting sued. This pushes up health costs across the board because now these unnecessary treatments must be contemplated in the cost of personal health insurance. That means more underwriting, more bureaucracy, more claims potential, more premiums....

    When you consider than only about 60% of health insurance costs go towards treatment (and depending who you ask, 20-40% of that is rolled back into insurance bureaucracy for med-mal), you get a good idea of the actual cost of health care. Compare the L&H insruance sector to the healthcare sector, and remember their earnings are a fraction of the costs of premiums, the picture of the true expense of med-mal starts to fill in quite starkly.
  35. True the cost of medical malpractice is about 2%, but the 0.5% I am referring to is what the insurance companies actually pay out in claims and legal fees. The 2% is what they collect in premiums. A very profitable business.

    As for unnecessary tests, fear of malpractice is not the only reason. More than 50% of the time that a doctor sends a patient for a test, the doctor has a financial interest in the lab or hospital where the he sends the patient to get the test done.
  36. Just my two cents on the situation from the perspective of drug costs, as someone who used to work in the pharmaceutical industry...

    Way back in the year 2000, my former company (prior to me working there) developed and launched a novel treatment for a certain type of cancer that typically affects adults over the age of 55...at the time, 75% of people diagnosed with this form of cancer would die within 5 years of diagnosis, so this particular drug was welcomed by oncologists and went on to prolong numerous lives.

    Part of the problem with the cancer described above is that approximately half of all patients treated with my company's product will eventually go on to relapse at some point, and therefore will require additional treatment in the future if they want to prolong their lives further.

    This reality has not been lost on competitor pharma companies - today there are 9 competing products designed to treat the cancer my company pioneered treatment for. In many cases, competitors were able to gain approval for their drugs from the FDA by showing that their product prolonged life by 2 months vs a competitor.

    So in essence what this has created a situation where we have gone from the following in a twenty year period:

    1999 - minimal treatment available - people died quickly after receiving low-cost subpar generic drugs.

    2000 - my former company launches wonderful life-prolonging drug - people live longer, but payers are now shelling out $60,000 for treatment.

    2017 - 9 competitor products have emerged - people live as if they do not have the cancer, but often receive numerous types of therapy, each requiring payers to come up with $100,000 per therapy.


    So in reading all of the above, it would appear that we have a victim of our own success in terms of advancing medicines and prolonging life (i.e., people not dying from these terrible diseases is wonderful news, but is actually part of the problem in terms of cost.)

    The example I described above is only detailing the patient experience for a cancer that only affects 80,000 Americans annually, but I am sure that similar situations can be found across numerous disease types. When you think of things in those terms, it is no wonder healthcare costs are skyrocketing.
  37. Lets compare healthcare to police or firefighters. Imagine if you had to first pay up front before a cop ran after a bad guy for you, or pay the firefighters before they even put on their suits and started the truck even though your house was already on fire. This would seem crazy!

    Yet, its like this with healthcare in the US. All this bickering back and forth that the politicians are doing is missing the first question, does everyone matter? Its obvious not everyone matters, but they want to make it sound like they do. When you call the cops or the firefighters, they usually don't know who they are going to help. The guy shot on the corner in New York could be a homeless man or some rich broker. (of course in poor cities, its a bit different cause clearly everyone is poor) But nevertheless, for the most part, anyone in need of police or firefighting gets it because its obviously a general good for society as a whole to catch bad guys and put out fires.

    So I think before any major changes to healthcare happen, they need to just put it on the table that some people don't matter and hence aren't going to be included in how healthcare gets fixed. (In some ways, I almost think it costs more money to exclude people than to offer everyone basic services.)

    If the government started with the mandate that everyone will get healthcare, no matter what, industry would find a way to make it work. It would either involve higher taxes, less corruption, smaller wages for overpriced doctors, more pushback on expensive meds or supplies, etc. But you can damn well bet that if you start with a clean slate and state the fundamental factors, that each person will have access to basic healthcare, things would be different. I really do believe it would be cheaper to offer everyone free healthcare and get on with it, than spending so much time and effort trying to figure out who to leave out and how to do it.
  38. Well, "cost of malpractice" is the additional out of pocket to patients. Arguably, this is north of 50% of the cost of medical care.

    Consider one doctor who rather than diagnosing definitively, cheaply treats as though it's the most likely culprit given the symptoms. Compare that to another doctor who rules out every possibility through tests, definitively diagnoses and provides the exact same treatment. The outcome is the same for the majority of patients. For those that have the rarer disease, they only lose out if the disease advances faster than the time between the prescription, and determining it's not reacting to treatment plus the time for the test. For less likely, but severe and fast spreading diseases, you rule these out up front, or treat in parallel with the likely disease.

    In aggregate this will provide effectively the same level of care in either situation, but will be cheaper AND less invasive in the former. Comparing Cuba and the US provide a reasonable jumping off point to consider this dichotomy. The difference in cost (as a percentage of gdp) is about equal to the cost of malpractice as born by the patient.
  39. Except that pharm companies know that pricing in the U.S. is grossly price-insensitive -- argue it eight ways to Sunday, it's still a fact that going outside the U.S. will (DOES) benefit the patient. So who pays? Those who cannot afford to travel -- those who have no viable alternatives -- those who are sickest, those who are poor.

    Again -- an issue addressed by getting intermediaries OUT of the medical service money-flow. Get a freed end-consumer a mouse and a PayPal account, and everyone globally will pay the same price. Again -- the U.S. has constructed this problem over the last decades, by interfering between the consumer/patient, and the doctor/allies.
  40. When it comes to healthcare, you may not want to compare Cuba to the US -- it may make the US look bad.
    Cuba average life expectancy 79.4 years;
    US average life expectancy 78.9 years.
  41. Well, that difference is tiny and modest compared to the cost difference.
  42. It's sad to see that americans are going down that road, just as Europe did. I'm not american. I'm a physician from a shitty latin american country that has it written its constitution: "A saúde é um direito de todos e um dever do estado.."(Healthcare is everyone's right and a duty of the state...). That single sentence destroyed everything from the start. Something that had always been a disaster, got much much worse. I was taught that BS like a mantra all the way through college and the result of this? A health system that is a total catastrophe, with countless people getting horrible services, literally dying and/or getting permanently damaged because of this fairy tail(along with all the other socialist fairy tails that rule here) that sound beautiful, but have monstruos consequences. I have lived in Europe as well, in more than one country there, and despite what people normaly believe, they have "amazingly" the same flaws, only in different proportions, which is in the process of changing too, for the worse, of course. More than 50 years ago, Milton Friedman already spoke of the disastrous path the USA was in. Things like licenciature for doctors, the AMA as the "doctor's Union" and one of the strongest unions in the country, despite most people not regarding it as such. Restriction on immigration(which could bring doctors from abroad to compete with american doctors, lowering prices and making services better, but was a "necessary evil", because of the welfare state...) And the list goes on. Since then, despite all the logic in his arguments, which were based on concepts that made the USA the great country that it was and, in a way, still is, things only got worse. These things I mentioned and from which he spoke are not even brought up anymore, which shows the level of ignorance that rules today, even in a country that was built based on freedom. Here's an interesting video on the subject:
  43. No kidding, once you claim healthcare is a right and people can't get it without government assistance we're not even arguing in the same century anymore.
  44. Is it your right to travel on safe, speedy roads and bridges? No.
    Is it your right to have somebody blasting the atmosphere for meteorological study? Does the Constitution mention "weather"? Space/NASA? Geology?
    Not directly!
    And yet the stretch is not too far, to say how much better our society is, with such things. I used to point my students to early private-sector space efforts, and tell my students, "Within your lifetime, "space" as we know it, will be a *private sector* deal." That was in the eighties -- things have happened a lot faster than I thought!
    If you lived in Tornado Alley, you would definitely observe how much positive impact has come from NOAA.
    And roads! Sheeesh.
    At one point, three of my favorite Nobel Laureates were alive and had one the Nobel -- these three all had time in publicly-funded community colleges as students. Hello.

    But here's the thing you already know:
    Having or claiming "a right" does not make anything into someone else's responsibility.

    Making that conflation is a lie.

  45. What makes you think that doctors in the US are over-priced? Because they make a lot of money? My brother is currently in med school and doing well, but has worked harder for the past 4 years than I have ever had to work in my entire life. Doctors deserve every cent they make. Malpractice risks / high stress, decades of school, decades of debt accumulated before even the first paycheck, several 9-hour qualifying exams, tests every week for the first year, not knowing which medicine one should practice, not knowing for sure whether one will even like being a doctor, working around sick and dying people, working through the night / odd and long shifts, not knowing or always having a choice where one will be placed for residency for several years of one's life...yeh, they earn their paychecks and I would be completely fine with them going on strike every few years for higher pay as many with a small fraction of their work-ethic do to extort higher pay. Doctors have to be pretty sharp. Few smart people would be willing to face such risks when there are many other things that they could be doing which would generate more money for less risk and stress.

    The rich will always have access to better medicine if they are willing to pay cash.
  46. That's the socialist way. One for the people. And a second one for the government, their friends and the people they helped get wealthy. The one for the people will be the bare minimum better than nothing one. The so called private one will be state of the art.
    Buying healthcare could be as simple as buying a muffler for your car because most muffler repairs are not covered under car insurance. There is no reason I can't get a check up in about an hour at the mall. I can get an eye exam and glasses there. Oh, most eye care is not covered under insurance. Now they charge an arm and a leg for bodywork, and everybody knows it is not priced right, and before they even look at the damage to give you an estimate they ask what your deductible is.
  47. Perhaps it's never too late to start right now, since that should have been implemented long long time ago. Needs a systemic long-term vision.
  48. Amazing to watch from afar how the US manage to tie itself in knots over healthcare.

    Currently you have some of the highest healthcare costs and yet lowest life expectancy of developed nations. A unique hatred of governments seems to prevent what other developed nations have and yet ironically you don't even have free markets due to corrupt paid for politicians (big pharmacy etc).
  49. Amazing you can't understand why we don't want to live like you.
  50. Lol - you said that without even knowing how I live.
    And who do you mean by 'we' just yourself or all Americans?
  51. I like to think that he meant we as in "the people who have personal responsability and don't like the idea of living at the expense of anybody else, just as we don't like that others live at our expense either".:D
  52. The US doesn't have a monopoly on personal responsibility..... and with regards healthcare just look at how less fat, sorry obese, other countries are.
  53. You're right. That's why I didn't say "the US.. or the americans"... As I said in a previous post, I'm not even american. I'm brazilian. What I meant by "we" was us, individuals, regardless of nationality, that have personal responsability. These individuals are still more numerous in the US than any other country, but unfortnately, there are few of them, compared to decades ago. The rest of the world has an inverted "balance" in this. I have lived in Austria and Italy and they are a great example of how Europe is. Austrians, just as the rest of Europe, look up to Sweden and in none of these countries, personal responsability is something highly regarded.
  54. It's not so much a hatred of government -- we have some of the most idiotic governmental structures and strictures as you can imagine! (Think back to tales of medieval Europe and ring-kissing and such -- it's *that* bad in places.) But it is more a profound lack of civility amongst -- get this[!] -- our civic leaders! Visible right here on ET, and right here in this thread -- dyspeptic disphoriacs (or is that, "disphoric dyspeptics"?? I don't know.) of either party *attack* "The Other Side" as unpatriotic ne'er-do-wells whose political *rantings* will bring down Civilization As We Know It. How did Our Current Preside -ent get elected? Ruppurt Murdrock and his ilk, fanning ignorance while the FCC (which abandoned any Public Good goals many years ago) looked away.

    I think, for every 10 years, we should declare ANY political party to be illegal and a capital crime, for the ensuing 10 years. Just flush it all out, every other decade.

    Thems my thoughts.
    I need a beer.
    10:30 on a Wednesday morning.
  55. There is nothing which I dread so much as a division of the republic into two great parties, each arranged under its leader, and concerting measures in opposition to each other. This, in my humble apprehension, is to be dreaded as the greatest political evil under our Constitution.

    JOHN ADAMS, letter to Jonathan Jackson, October 2, 1789
  56. However [political parties] may now and then answer popular ends, they are likely in the course of time and things, to become potent engines, by which cunning, ambitious, and unprincipled men will be enabled to subvert the power of the people and to usurp for themselves the reins of government, destroying afterwards the very engines which have lifted them to unjust dominion.

    GEORGE WASHINGTON, Farewell Address, September 19, 1796
  57. All this talk about personal responsibility is a little much. There really aren't that many people who just sit around all day and say "let someone else take care of me". For the most part, many poor people try their best and work hard. They may not be as smart or conniving as the top 1% or top 10%, and that is why they have problems.

    The lucky people who have done well in life just don't realize how lucky they are, and how much they owe to governments that run a stable society and provide all these poor lemmings for rich business to feed off of.

    Lets put it like this. Separate out the top 10% of earners and give them their own country. What will happen? There will be nobody to do the shit jobs! Heck, maybe even give them the top 20% of earners so that you include well paid public servants like police and firefighters and road construction guys, etc.

    We could go even further and take every nice suburb in every city of every state, anyone who owns a nice house, and lets put them all together. All the so called hard working people who supposedly have lots of personal responsibility and have everything they have from hard work. What will happen? They would very quickly lose their quality of life.

    Nice communities rely on poor people travelling long distances to work in shops that the well off people like to shop at.

    Companies like Walmart rely on government subsidies for their poor employees so they get to pay them less.

    Most financial institutions, be it big banks or shit money lending outfits rely on gouging poor people who don't have the knowledge or ability to get either cheap credit, or free services by having big accounts with said institutions.

    Technology companies wouldn't be who they are without scores of poor people buying up cell phones and cell phone plans.

    Google and Facebook make what they do via advertising because billions of people are seeing ads, the poor people, those same people with supposedly little personal responsibility. Their simple existence is what allows rich people to have what they have. Businesses make lots of money from poor people, and government spending is based on populations of poor people, and this money spent is money earned by both corporations and well off public servants.

    The rest of the county, the 80% or 70% who is poor will do just fine if given their own country. They will support each other, and although they may not have fancy cars, fancy houses, fancy things, they will work hard in life, plow their fields, raise their livestock, and perhaps die at an early age without fancy healthcare, but at least they won't have been taken advantage of by the rich fuckers who lie to them and tell them they should be grateful for what little they have and not even include them in the healthcare system when they get sick, even though they continue to enrich the lives of rich people every day both directly and indirectly.
  58. Yeah the US government and political system does seem designed to feed itself and serve whoever pays it the most rather than the people. Had a discussion once with a US republican about 'free speech' I tried to describe it as what comes from my mouth, writings etc.... he tried to extend it to being able to give donations to politicians to amplify such a voice. He also got a bit annoyed when I said they only have one more political party than China :)
  59. We have one bad party, and then there are other parties. I am not in anyway in favor of the other parties. In most cases no matter how stupid the bad party is the other party can figure out a way to be more stupid. But there is no getting along with the bad party, and most of the time they will be in power because their message is You will get more than you will give.
  60. %%
    Exactly CD;
    let him pay for that TRAINWRECK==============================================================================. I'm not getting on that trainwreck
  61. Just a hypothetical question here. How is it financially responsible to purchase insurance coverage you're highly unlikely to use? Certainly in considering 1,000 24-35 year olds in aggregate, this is unquestionably poor financial responsibility. Especially when you consider that the medical bankruptcy you're likely to face if it hits the fan will place you solidly within medicaid qualifications.

    It makes about as much sense as a poor traveler purchasing kidnap and ransom insurance.
    Or about as much sense as someone who doesn't own a car purchasing auto insurance (I'm actually the exception to this rule--but that's a different story).

    The personal responsibility argument as applicable to health care is bull shit. It doesn't hold up to even the most superficial scrutiny.
  62. Well, here I'll whip out my ("Oh, noooo! He's going to whip it out!!! Shield the children!") libertarian card and observe that the way to guarantee free speech is not to stifle one side of an argument. Is our contemporary environment at all "fair and balanced"? No -- you're completely correct that, for the most part, Money = Volume, and that that is an unsought aberration to what the Founding Fathers intended.

    But Citizens United [Citizens United v. Federal Election Commission 558 U.S. 310 (2010)] did not say that the marketplace for ideas could not be improved. What if we had a federal-level body, commissioned to act only within its enabling legislation, to observe and even *regulate* the free speech/media vehicles using national bandwidth to route communications in this country? What would we call such a thing? "Anybody? Anyone? Bueller?"

    (If you're wondering, then "Yes, a self-described libertarian just proposed that an existing government entity do its job.")
  63. Please don't confuse health insurance with healthcare. They are not interchangeable. All countries have healthcare. Some have government health insurance.
  64. Well, DSF/MSF notwithstanding, the fate of healthcare is inseparable from its cost. In a thread about single payer, all the more.
  65. yes, so we are just debating on the definition of single. If single can pay for it without taking any money from me that's just fine. If I am one of many single payers paying single to pay my single bill no thanks. I have already seen how single pays things. And in the end I am the only single payer left.
  66. That makes you one of many payers. That's the exact opposite of single payer.
  67. Who is this "single" payer? Where does he get his money? Do I have to pay him anything to pay my bill?
  68. That's because he doesn't understand the economics of the situation. He wants to simultaneously avoid the responsibility to pay for the debt accumulated by past generations of Americans yet also fail to pay for the future risks of his own health when he's older. This kind of short term vision destroys economies. Many young men only fend for themselves and feel invincible against things like health care problems, sudden black swan events in their life, or family responsibilities. It's not a realistic outlook.
  69. You don't understand actuarial science. Your own personal experience is irrelevant; it's the pool of people you are in and there will be people just like you who get cancer or other unforeseen illnesses and need medical care. Just because you personally didn't experience it doesn't make it irrelevant. What you seem to want to do is roll the dice of your chances knowing if it doesn't work out the state won't let you die on them and they'll somehow make up for your recklessness at that point. How much money have you saved up personally to cover catastrophic illness or disability, and have you researched the real costs of your care in those cases ?
  70. With regards to healthcare this is total bullshit - look at the data from socialist countries some have over half a century of national healthcare systems. Lower healthcare costs and healthier populations compared to US. Just stop electing stupid governments who are manipulated by US corporations...

    And who cares how the US or any other country was established. How's that relevant to today's challenges ?
  71. If you want to gather like-minded people and do that yourselves, fine by me. You have every right to think this and do it. Where you and the other people that think like you get wrong is when you start to think that you have the right to force me to participate in this. Who are you or anybody else to say how I or the other guy should live our lives? How do you know my or his motivations if you have no idea who I am or who he is? What destroys economies is people letting governments take over it, always basing themselves on the same old mistake: judging policies from their intentions, rather than their results.
  72. I think judging policies by results rather than intentions is exactly where the support for single-payer healthcare comes from (for example ACA is more popular than ever in the last 48 hours). In addition to me, there's at least one more libertarian on here making the pragmatic argument in spite of fundamental economic beliefs to the contrary.

    I suppose you believe police are a fundamental evil too?

    I think the counter argument here is, who are you to say how the other guy should die? Not particularly compelling as a rational, logical thought experiment, but compelling from a evidence based, comparative observation.
  73. %%
    Exactly; Cuba gives you a choice-cut cane or go to jail. NOT that excercise is best demanded by a commie country LOL. John Adams -speedo is good speed
  74. Move to Brazil. Here you'll have a chance to experience real results of your beloved policies. Use only our "SUS" - Sistema Único de Saúde(Sole Healthcare System). The same goes to countries like the Netherlands. My sister-in-law is dutch, she has relatives that come to Brazil(to São Paulo, Curitiba and other cities where there's some capitalism, real competition in Brazil) to get dental and general health treatment when they can. But they use the private parallel system, of course, where they can get quality and speed. In addition, where do you think brazilian politicians, presidents and government officials, the very people that promote this "beautiful" public system, get their treatment? You guessed it: in the few private hospitals that don't accept patients from the public system, hospitals like "Hospital Sírio-Libanês" and "Hospital Albert Einstein" in São Paulo.

    You evaded my questions. But answering yours, it is not my problem how the other guy dies, and it is not his problem how I die, that is my problem, my responsability, nobody else's. But you can be sure that if he can make me pay for how he dies, he will spend my money to the last penny without taking in consideration any issues that will cause me. Nobody spends other peoples's money as they spend their own money.
  75. A fair system will ask that all citizens share in the costs of public services regardless of their level of selfishness, political/economic beliefs, or ability to understand those costs. That includes the cost of present and future risk to need medical care. You choose the nation you want to live in ( the "like minded" people of your choice ), and that's nothing to do with me. But if you are going to whine about costs you must pay and show no ability to understand why those costs exist, be prepared to hear from others why you must pay those costs. I didn't address your intentions, but I addressed "Java"'s intentions because he's a frequent poster who made his beliefs clear in his posts. US national debt and future health care costs are REAL. You can't close your eyes and say hey not my problem. If you choose the US to live in, it is your problem and your responsibility. Pulling a Trump and saying "who knew health care was so complicated" doesn't solve the problem or eliminate the responsibility to pay for it.

    I made my choice, Canada has decent health care at a much lower cost then the US. People can pretend that isn't the case on here ( and many do ), but somehow I've managed to get by fine in our system and it works for me and the majority of Canadians. This is not the case for millions of Americans, and "Java" complains about health care insurance a lot on this site. My comments on Canadian health care are pretty positive.

    I am not "forcing" you to move to Canada and I am not "forcing" you to be an advocate for any health care system.
  76. That's an absurd theory that only ends up transferring the risks you personally wish to ignore or under service to the government or the rest of society should those risks come to bear. It's also totally impractical. At different stations of life, even successful and driven people can be broke ( e.g. going to college or children with poor homes; people suffering catastrophic illnesses ).
  77. I've stated this before, but I do feel for Americans who are stuck paying the price due to the bad decisions many Americans are making for their country in recent years. Some of the posters like "Java" are posting absurd themes that solve nothing. My conclusion is sure, it's the business of US citizens to choose how their country will run, and the choices made must be paid for. Which means things like higher personal taxes for maybe a decade is coming in some form. And if health care remains this muddled mess of political infighting and the inefficient invisible hand of capitalism and special interests, just pay the premiums they are your chosen path. I'm fine with it all, I do think studying Canada's social systems would be helpful but word on the street is most Americans aren't interested. So be it.

    Even more interesting is the upcoming trade wars between the US and Canada. Seems inevitable under Trump. He's already fired shots and ready to tariff the hell out of everything Canadian. Shots will be fired back soon, and many US trade reps are already extremely nervous that Trump and his people are going to deeply damage their industries. Both our economies will hurt as a result, but the one good thing is that will help educate many American voters why Trump has to go. Might take a couple of years for most voters to connect the dots and understand why their jobs are diminished or gone, why their consumer prices are going up. I see everything as a messy short term issue for Canada but a very good long term trend for Canada ( more talent moving here, certain industries relocating here, less reliance on the US for trade, strong housing market as immigration remains strong ). I suppose clearer heads could prevail and the pain could be averted. But Trump's stated ideas and how messed up US health care is suggests otherwise.
  78. How do you know what a "fair system" is? How does anyone know that? What is fair for one, may not be fair to others. US public debt is indeed a real problem, a problem created by waste and stupid ineficient socialist policies such as the one being discussed in this thread implemented over the years in the US. In order to create your so called "fair system", someone will have to define "fair", that will demand centralized power and as you said, it will demand "forcing people" to pay what a very small group of people demands they pay. That is communism, something that has been proven to not only not accomplish its theoretical goals, but also to take people's liberties, resulting in catastrophies such as nazism and movements of the kind. I recommend a book called "The Road to Serfdom" by Friedrich Hayek. It explains this very clearly.
    As for the costs, prices in the US could be lower for sure, but not through socialization of medicine, which always result in inefficiency and higher costs. As for any other economic subject, free markets and the resulting competition from them are the way to go. But for that to happen, a lot of other stupid policies must be reversed. The US is less down the road as other countries, but it has gone really far in this destructive path.
  79. That's comparing apples and oranges. Keep in mind the topic of this thread is not just that Buffet supports a single payer system, but that America is so rich it can afford...a single payer system.
    A fair point. But on health care, it's demonstrable that government spends less of other people's money than other people themselves will spend. Of course there's a class war argument that can be made against this. But as one of the economic losers in a single payer system, I find rich folk saying keeping poor people healthy is too expensive to be inconsiderate at best.
  80. You raise some good points -- buying a no-deductible insurance plan that covers everything for a healthy 25 year old who has never had any health issues and paying the same rate as an unhealthy 60 year old does not make financial sense. However, it doesn't have to be that way. A catastrophic-only health insurance plan for a 25-year old with no health issues and $10k deductible should be dirt cheap. But that plan would only cover catastrophic issues, not dental visits or annual checkups. Sure, the cost of the health insurance would go up over time, but so would the risk that the insurer would have to pay out a claim. That's fair. Over time, the person would have had the opportunity to save up for his or her own medical costs. That would be considered personal responsibility.

    The Elizabeth Warren types that try to discredit all successful people as simply being lucky really annoy me. Maybe you were born with a large inheritance and maybe you did not have to do anything in your life to earn your wealth, but not everyone was as lucky as you. For most people, success comes as a byproduct or sacrifice, delayed-gratification, and substantial risk.

    Supply and demand would not die. At some wage, people would be willing to perform the shitty jobs, but more likely they would try to figure out a way to automate as much of the shit jobs as possible. Higher wages encourage automation because potential cost savings from automation increase with wage.

    If that was true, there would be no 3rd world countries. Standards of living would not vary greatly from one area to another. I suspect that culture and historically access to natural resources has the greatest influence over that.

    Who is forcing them to buy those cell phones? If I was poor, I would not have a cell phone. I'd buy an old cell phone, not pay for service, and rely on wifi-calling.

    That's true. But it comes back to supply and demand. What do you propose doing? Maybe Walmart should pay all employees $20. Fine. What would happen? Walmart might as well hire college graduates since there is enough college-educated labor at that rate and then focus on automation. All cash registers could be automated checkout like Amazon's Fresh store in Seattle. That's where things are going.


    We can talk about the way things should be all day, but it has no effect on what will happen. The laws of economics will ultimately prevail.
  81. Yes, we are not socialists. We don't like socialists. That's why we don't like their single payer systems. We are the single payer. Otherwise known as the taxpayer. We pay for EVERYTHING!!!!!!!!! You talk about single payer like there is just a payer sitting around out there looking for something to pay for. As soon you as you communists start talking about how much WE spend on healthcare I know you are just another socialist robber talking about MY money like it is OUR money and keep YOUR greedy hands out of MY pocket.
  82. Your rants suggest you don't like to pay for the services you require now and in the future, and you need to grow up and pay them. I suppose if the world was a nasty place and we could design a waiver for you that says you will decline any medical treatment for the rest of your life unless you can pay in cash within 24 hours, we could satisfy your extreme views and prevent the country from paying for the risks you refuse to acknowledge. At this point, the US doesn't accept this scenario that arrogant young men should be able to put their health or life on the line to save money. Society has said not everyone can be sensible about these things and you are a good working example of this.
  83. Don't worry my assets are protected. They don't yet sell health insurance. If they did I would buy some to protect my health.
  84. I can't speak for Java, but I'm not so sure that he hates paying for services that he requires now and in the future. I pay for auto and home insurance. I have been paying both for years and have never filed a claim. I don't mind doing so because I set my deductibles high and consider the premium to be a bargain relative to the risk that it is insuring. So I ask, why can't health insurance be like that? Why can't we buy a plan that only covers the catastrophic stuff. A plan that does not cover regular doctor visits, preventative check-ups (although the catastrophic insurance could give discounts for getting annual check-ups, being healthy, etc, just as auto and home insurance providers offer discounts for having equipment that reduces their risk). But today health insurance isn't like that. We don't have an option of just covering the catastrophic stuff and young people like me are forced to subsidize old people, many of whom are not paying a premium to cover the risk that they impose on their insurers. The situation is similar to forcing auto insurers to cover 90% of fuel costs. I drive an SUV that gets about 17 mpg. Why can't others subsidize my fuel costs? My vehicle's fuel consumption sounds like a pre-existing condition to me.

    The only way to solve the healthcare crisis is through better medicine. Fix the root of the problem.

  85. A car isn't necessary to live a decent life. It's a choice you make with discretionary income. Medical care is often required to maintain your life, prevent serious illness, and maintain quality of life. Those who don't drive are still paying taxes to pay for the roads you drive on; they can't opt out on those costs either.

    Canada hasn't had a healthcare crisis and we have had a national plan covering everyone since the 1970s. So better medicine isn't needed to provide this. Some Americans like to pretend we have a lower quality system, but in reality Canadians live around 2 years longer then Americans, and on average Canadians are healthier then Americans ( see obesity rates ).
  86. Perhaps, but they have to live those extra two years in Canada!
  87. Further to Nine_Ender's post, here's a chart for y'all:
    [​IMG]Maternal mortality rate (deaths per 100,000 live births; Source: The Lancet)

    'nuff said.
  88. Can you post the link for that graph, Martin? It doesn't jive with what I find anywhere on the net in regards to US ranking for mortality rate.
  89. It is also there in today's Daily Shot.

  90. Italy should tell us their secret.
  91. Single payer healthcare, perhaps? Just sayin'...
  92. Lifestyle and diet, and generations of it. The US average lifespan is reduced much to the unfortunate tendency of urban youth to kill one another.
  93. There is a difference between single payer (UK) and social insurance which Europe use. The outcomes under social insurance are better than single payer as the graphs above highlight.
  94. To be fair, a lot of those young American mothers were probably shot.
  95. Lifestyle and diet certainly do impact maternal mortality. I am not quite sure the same applies to the unfortunate tendency of urban youth to kill one another.
    Sure, fine... The Italian system is very similar to the UK NHS. Let's just call it "universal healthcare", shall we?
    While giving birth?
  96. Sorry, I was referring to average lifespan and not maternal mortality. Taking trades and engaging in a forum is even harder than walking and chewing gum.
  97. Ah, Pregnancy Related Deaths.

    Martin's quoted chart simply said "Mortality Rate".
  99. Addicts are more useful than politicians.
  100. Can we get the story from a reputable news service? It's pretty flimsy when even the article with the (clearly disclosed) political slant acknowledges the courts made the decision based on the interests of the child under the presumption the kid is suffering. Makes for a good headline--for rational debate, not so much.
  101. Fake news is all the rage, agendas trump (no pun intended) reality.
  102. %%
    LOL ;great point.Another dis advantage of the gov running it;if they want to give ''free showers/free trainride'' like the Nazi did, they may do that. And if they want to goof around with vets + they die, like they have already done in USa, they can.ACA is a TRAINWRECK===========================================================================================================================================
  103. My chart said "Maternal mortality rate", I'm pretty sure.
  104. You can read the latest UK Supreme Court full ruling here:

    You can also read the ECHR ruling on the parents' appeal here:
    http://hudoc.echr.coe.int/app/conversion/pdf/?library=ECHR&id=003-5768362-7332860&filename=Inadmissibility decision in the case Gard and Others v. the UK - decisions by UK courts endorsed.pdf

    This is an explanation provided by the Great Ormond Street Hospital which has been treating Charlie Gard:

    This is the original UK High Court decision by Judge Francis:
  105. Good points
    Buffet may help you, for profit of cpourse; he is buying part of oil refiner PSX ......LOL. Maybe get closer to free market later on ; not sure anyone wants ACA= trainwreck, by elections========================================================================================================================================
  106. Where did I claim that owning a car is necessary to live? Where did I claim that those who don't drive don't pay taxes? Why can't you address my argument rather that attacking arguments that I never made??

    My point is that if healthcare only covered the catastrophic stuff, it would not need to be so expensive. Based on your argument, "medical care is often required to maintain your life / quality of life" well shit, that definition includes everything. There are so many things necessary to maintain my quality of life or even just life. Ignoring the necessities for quality of life which for some might include beer, drugs, hookers, and video games, let's just consider the top 2 (and there are many more) basic necessities aside from safety. I need food and shelter. Then by your definition, healthcare / insurance should also provide those as they are basic necessities for life. But an insurance plan that covers food is analogous to my car insurance example that covers gasoline. It's just absurd. Health insurance should only cover unexpected catastrophic events. If it did, then it would be affordable. And also things such as regular doctor visits not covered by the healthcare would become a lot cheaper because the laws of supply and demand would kick in -- people would start shopping around for doctors and young people would often skip going to the doctor effectively lowering the demand for those services and consequently cause prices to drop. Peter Schiff articulates this same point well:

    I also don't dispute that Canadians are healthier than Americans. But I don't think that's due to having more access to doctors or drugs. It's cultural and perhaps influenced by the demographics (race). For example, since Canada is mostly white and Asian, how does the longevity of those races compare to the average longevity of the same races in the US?

    I'm not against helping others out, but I realize that resources are finite and I'd rather spend money on cancer research to help the guy who did everything right in terms of diet and exercise, but ended up getting colon cancer and only has a few months to live vs. someone who made poor life choices, smoked, did drugs, ate crap food, etc. and needs special services to accommodate disability due to type-2 diabetes.
  107. Outlawing insurance companies would drive the costs down on any area. Insurance companies give birth to greed which knows no limits. Scuttle them. Prices will drop amazingly low. Docs will compete to give you their best service at their best rates if you are paying as they know you will just run to another doc if they don't. They now just bill outrageous sums to insurance companies and care less about the patient. They just want more money so what do they do?.. program more visits ..look at you for 5 minutes schedule..bill huge amounts to insurance...schedule another visit in two weeks..fer more money..then bill the insurance companies again. Rinse and repeat. Keeps the money coming in. The insurance companies raise the premiums so they can make money hand over fist while forcing the gov to bail them out when they get in trouble..Do you really think damn iv fluids cost 11,000? Why did you wait so long? Could it be cause they had programmed tons of other visits before you so they could get more money. Could it be they knew you were in "the bag" they had you? You needed them ..not they needed you? Could it be you could wait until they got good and ready to fix your problem ...but in the meantime while you wait they can make more money off scheduled up visits? You ain't going nowhere. Could it be you are truely a sick person ..so you gotta wait? Could it be they will just get to you when they can and want to?

    Do away with medical insurance entirely. That in itself will produce quality healthcare as doctors compete and it will put a damper on greed and only the best will rise thru graduate school to become doctors. Service will get better. Costs will go down. Just visit some other countries. Americans are getting screwed by healthcare costs with its root being greed..pure greed...and a system that foments greed.

    If people have to pay their own medical bill they wont race to the emergency room for a snotty nose and docs bill insurance 3000 dollars to show them how to blow their nose on a tissue paper. Skinned knees will be treated at home with soap and water and triple A antibiotic or iodine..etc. Flu with a little whiskey..lemon..honey..etc....home remedies will abound. People won't run to hospital with a sprained knuckle if they are paying for the visit themselves. Docs will have so few people in waiting rooms they will be praying for more patients to come in and for someone to please get sick so they can make a payday. And when they do get a patient they will take their time and show some darn concern. Of course all this is my opinion only but i think it to be a pretty good opinion.
  108. The doctors and big pharma are using disease as a profit machine and grossly overcharging.
    Doctors are paid too much.
    There are not health providers but disease merchants.
  109. I am all for the single payer system.
    But man "disease merchants"? You are off the rails here. Hope you are not going to be sick in your life. Doctor's spend entire their precious young life in slaving away and studying (4 years of pre med, 4 years of med, 3 years of residency and 3 years of fellowship after highschool), while this community is pointing and clicking away. They are paid probably little higher, but not that high compared to executives of capital america.
    No wonder society has such low opinion of traders and high regard to physicians.
  110. The odds of an ET poster being an actual trader are fairly low. Most of us are aware that there are flaws throughout the health delivery system.
  111. Single payer won't work but it would be better than what we have. Have a friend in Canada who is in the construction business. Worker broke his leg. Friend loads him up and races him to hospital or clinic. They make broken leg person sit while they do nothing. Friend gets really pissed and grabs a wheel chair puts broken leg patient in wheelhair...rolls him out of hospital and races to another hospital. Broken leg more important than snotty nose or skinned knee.
  112. The state system that covers the unemployed could use generic imported drugs to lower the cost and people signed up would not be able to sue for negligence lowering insurance costs for doctors. Companies could utilise the state system, for a fee, for part time and low paid workers. This would provide income for the state system and still allow private insurance for full time employees.
  113. Well if you are going to take away our health insurance, couldn't the government at least give us Medical Savings Accounts? We could have Single Payer pay for some of it. He has all kinds of money for healthcare.
  114. The state "pays" for nothing. Taxpayers confiscated wealth pays for whatever the state arbitrarily decides. And that is mostly whatever gets them reelected.
  115. The state borrows money to be paid back by the yet to be born.
  116. Well if you would let me live longer with Single Payer I could pay it all back before I die!
  117. %%
    Some are, srinir,[ +good rebuke on DM] but as you noted , we don't do broad brushes. I had a network give me free book written by Dr Reginald Cherry MD, one of the more skillful+ studious medical doctors. NOT all doctors study as much as they should.; many do not STUDY AS MUCH AS THEY SHOULD

    Even US senator [Dem]Max of Montana warned ''ACA is TRAINWRECK''============================================================================PS This is to all; calling HEALTH insurance ''health care'' is like calling tow truck insurance ''car care'' LOL. Thanks
  118. For 98percent of the population, lack of health insurance would mean lack of access to health care.
  119. %%
    Possible,New W;
    but let us see .

    All US military+ many vets gets health care[not considered insurance@ all].US Military service estimated @7% so its already not 2%/98%.
    Medical cost sharing[maybe not legal in Montanna,LOL]; not insurance@ all , much better, unless one chooses to live in Montana]. I saw 4 of those first google search.I also cut a loss earlier in the year..... myself; that is much better than the other way.

    Many people know[ from experience] cash is better than insurance; but plenty of non cash moves work , which is beyond my notes here[Dr Reginld Cherry .....others]

    Frankly I could go on + on; but I know how to cut a loss,do you?? >> Let us see??

    And related to that but separate ''ACA is a TRAINWRECK''===========================================================================Thanks for your comment NewW.
  120. It's not just pay. All that time and money that doctors invest in their training as well as the risk they take every day when performing their surgeries, writing prescriptions, administering medicine is all risk. If a CEO botches a company, he can usually get a job somewhere else and continue his career. If a doctor botches a surgery, his or her career is usually over. CEO's and traders don't have to carry malpractice insurance. The risk and opportunity cost alone justifies the higher salary. For all the people who wish that doctors were paid the same as teachers and government workers, I wish that they lived in a society where that was true.
  121. Under a single payer, doctors may not need to carry that risk.

    Perhaps that risk is because we have a fundamentally private sector system where the insurance companies absolve themselves of all potential practice by their "in network" doctors.

    And not all government workers are paid the same.
  122. Then who would carry the risk? How would that work?

    I don't think an insurance company should share liability with doctors. All that would do is shift cost from the doctor to the insurance company which would only make insurance more expensive.

    I never claimed that they were. I was just using that as an example of a low-risk (from an employment perspective...government jobs generally have more job security) career. Certainly there are high-risk (from a survival / life / health perspective) government jobs (law enforcement, military, secret service, etc).
  123. How are all these things handled in every other country in the world with single payer insurance?
  124. I didn't read the entire thread so sorry if I am repeating someone.

    I will take Buffett at his word if he promises to utilize the single payer system for himself and his family. We know the odds of that happening are the same as Nancy Pelosi and her billionaire husband, the Clinton's , the Obama's, the Kennedy's et al using it. They will not sit in crowded waiting rooms full of illegal immigrants and their large families, nor will they be told "sorry, you're too old to warrant a hip replacement" or " you'll have to go on the waiting list for that MRI, expect to get it in 10 or 12 months."

    We all know that will never happen. It's like that moron Katy Perry calling for a world without walls, while she herself lives in a compound surrounded by 15 foot walls.

    The solution to health insurance is a private market for those who want it and some form of government provided insurance for those who can't pay. Why should all of us have to suffer a government system when we know the private sector provided excellent health care for the vast majority of us before Obama tried to destroy it? The only reason is liberals' never changing impulse to punish responsible people in the name of "fairness" and drag everyone down to the lowest common denominator.
  125. %%
    I agree with about 95% of that.
    But we dont need the gov involved anymore- anyone can go to emergency room + get treatment, by law. Or they can join the US military if they qualify.No where in the US constitution is hospital care , [not to be confused with health care] promised. Tow truck insurance is not car care care, any more than health insurance is ''health care''

    Imagine the silliness of some that say car care consists of tow truck insurance. LOL .Health insurance is not heath care @ all. Tow truck insurance is not car care also.
    The gov big enough to give you everything can easily take it away; good shot AAA.

    Mr Buffet is free to give all his money to the US Treasury , but he is known for paying few taxes[on a % basis] LOL
  126. I haven't noticed any mention of Medicaid which provides free health coverage to 74 million low income and disabled people.
  127. %%
    Maybe, Speedo,because it's not free @ all??
  128. Only to the recipients..not to the taxpayer.
  129. There will always be a private market because there will always be doctors who will offer services if you pay them enough.

    Healthy people end up paying for the unhealthy. There is no magic single payer with unlimited resources. Resources that could have funded other things that society needs are instead spent on healthcare. And ultimately, since resources are limited, some decisions will need to be made about what is worth saving -- and it won't depend on how much someone has contributed to society, it will only depend on expected outcome -- how much money for what kind of prognosis / most likely outcome. In such a system, more government money would be invested into reviving a 31 year old drug addict who overdosed on heroin than a 81 year old scientist who cured a rare disease, but now has skin cancer.
  130. There is an incredible amount of price gouging and outright fraud in American healthcare. Before we address anything else, there should be a special commission appointed to expose and completely root it out for all Americans to see. Then we can take the next steps.
  131. With a secondary private insurance market, you continue to have the capitalist model and freedom of choice.

    That's the core of the issue: how do you ration a fundamentally limited resource. I disagree with your belief that our health care market is based on how much someone has contributed. Your hypothetical example simplifies the issue to an absurdity. In your example: the 31 year old drug addict could be the son of a successful personal injury lawyer so he's got his cure. The 81 year old scientist could have been dumped by the insurance company because he's old and thus a burden on their profit margins.
  132. Fundamentally, it's a relatively simple issue...,

    Basic economics tells us that markets are just not good at dealing with public goods. This isn't a controversial conclusion by any means and pretty much everyone seems to agree.

    If your society believes that public health is a public good, the government needs to be involved and provide basic healthcare to all citizens (otherwise, you end up having issues with deciding who is deserving and who isn't). If your society believes otherwise, it doesn't need to provide basic healthcare. Obviously, neither conclusion precludes the existence of a completely independent private healthcare market.

    As a matter of fact (stated without judgement), an overwhelming majority of developed countries in the world have concluded that public health is important and thus treat it as a public good. That said, Americans, through the use of their democratic institutions, are free to make their choice and it should be respected.
  133. The problem with "democratic institutions" begins when they serve to impose something over a relatively smaller group by a relatively larger group and give legitimacy to that. If one group is able to "legally rob" the other, you can be damn sure that it will. Hugo Chavez got to power and even converted his mandate to lifelong through democratic means. Does that make this right? We are all seeing the results of this.
    As Milton Friedman always said: If 51% of the population votes to shoot and kill the other 49%, does that make it right to do it? Of course not. That's why private and free markets are the way to go. Because even though they are not perfect, they are the most effective.
    It is an ilusion to think that you're not choosing "who gets what", if government takes over health services. Government will decide who gets what and it is no secret how inefficient governement is at allocating resources. There is no free lunch. Things will have to be paid, one way or the other.
  134. While the sentiment you express is admirable, the logic of your argument is a double-edged sword. As an extreme example, I can imagine a paedophile would argue that the laws imposed by a larger majority which prevent them from preying on minors are "wrong". They would feel that the majority is "legally robbing" them of their rights. And yet, we do have laws which curb certain freedoms that certain minorities want to enjoy.

    To invert Milton Friedman's argument: if 51% of the population votes to stop the other 49% from owning slaves, does that make it wrong to do it? And yes, private and "free" markets, while not perfect, are, on balance, the most effective at allocating certain resources. However, as I've mentioned previously, it's also a relatively well-known fact that there are certain things that markets don't do so well.

    And yes, things have to be paid, one way or another. Some civilized societies have agreed that certain things are best paid by some sort of a tax. Healthcare could be one such thing, but in a democracy, that's a decision for the people.
  135. You´re confunsing what government should be doing and what it shouldn't. A Rule of Law is the basis in which a free society should operate. This dictates the rules of the game. A pedophile that actually commits a crime should be judged for his actions and it is a funtion of government to do this.
    Slavery is something that goes against a free society and is something that should and is very clear in the same Rule of Law that it isn't something that should even be put to vote. The same thing goes to freedom of speech. This subjects can't be even put to vote, because they go against the very foundation of a free society. These should be the only functions of government, which are indeed important and that make government a necessary evil, because markets can't efficiently deal with these issues.
    However, production and services(such as health service) can and are optimaly provided in a free market system, which makes a mistake to put government to handle these items.
  136. Well, don't you think that rule of law is actually just another service provided by the government? The relevant parts of the three branches of the US government (such as Congress, the courts, the police and other law enforcement agencies) are paid for by the taxpayer, so that every citizen can enjoy the various law services society has to offer them.

    In your judgement, public health is an entirely different type of service than public order and rule of law. I have no problem with that, but I think it's important to realize that the line you have drawn is an arbitrary one. As I keep saying, if your view is shared by the majority, that needs to be respected.
  137. The line is very simple, as I wrote in other words in the previous post: that which the free markets can regulate through forces of supply and demand, should be left for the the free market to regulate.
    The very few areas which cannot be regulated through forces of supply and demand, which are basically national defense(armed forces, against foreign enemies), police(defense of the citizens from other citizens) and reinforcement of the rule of law and contracts signed voluntarily between individuals and/or private companies(meaning the justice system) should be handled by government.
  138. Yes, and I see the point you're making. However, let me again suggest to you that the line you have drawn in the above post is arbitrary. For instance, Friedrich Hayek, one of the greatest economists of the 20th century, who formulated a lot of the intellectual case against "big government", argued that healthcare is one the basic services the government should provide ("Constitution of Liberty", Chapters 19 and 20). There are many more such examples, if you look.

    As I keep saying, I respect the right of any society to draw arbitrary lines, if it's the decision of a majority.
  139. In the preface of his book "The Road to Serfdom", Hayek himself admits that in the first editions of his books, he had indeed such ideas, but he also states that as the time passed, he realized that he should've been yet more "libertarian"(even though he clearly says that he chose to leave The Road of Serfdom as it was, but he clearly says that that was an outdated view).
    The same goes for Milton Friedman, which in the beginning defended the idea that government could have a role in the most basic education and he later on changes that saying that evidence showed that even in the most basic education, government has no role.

    And as I too keep saying, if you simply state that what a majority decides should be accepted, you're going to end up with Hugo Chavez. The point is that matters that can be regulated by free market´s supply and demand, which government should not be involved, should NOT be put to vote. There's no need to. The market itself does the job.
    The only things that require a majority to impose something are the things that can't be regulated by the market. For example, which should be the punishment for murder? Life in prision? Death? 30 years? 50? Each person will have an opinion on this, but there's no way to let a "market" decide what will be applied. So this has to be decided by the majority.
  140. Let me just say that "Constitution of Liberty" is not one of Hayek early works. It was written nearly 20 years after "The Road to Serfdom". Some of the points made are also reiterated in "Law, Legislation and Liberty", which was written even later.

    Other than that, it doesn't appear that we're likely to agree on this, so I'll let a better man like Hayek speak on my behalf. Best of luck to you!
  141. You're changing the subject to the author and not the idea. If that were something worth doing, I could simply state that Milton Friedman disagrees with Hayek and states the opposite and that that would be proof of my point. But that wouldn't make sense too. What one person says, even if that person is someone like Hayek or Friedman is no proof of something.
    These men were logical men and logic dictates that we must look at facts. The fact is that government intervention or nationalization of services that can be regulated by free markets results in high prices and poor quality, compared to a free market system.

    We indeed are probably not going to agree on the subject, but the issue is even more fundamental: The thing is that I have no objection with you living your life the way you stated. You want to live your life in a system which has government dealing with healh services? Fine by me. I wish you the best. The problem starts when you believe that you can force me to be a part of that.
    And that is the fundamental problem with this. While I have no objection to your views and choices, provided you don't attempt to force me to be a part of it, the only way to apply what you are stating is by forcing me to be a part of it.:)
    Best luck to you too!
  142. I agree with the sentiment you express that we should all be able to speak for ourselves. I have certainly attempted to do this, as I'm sure you'd agree.

    Separately, I would also note that Friedman, in his 2001 essay "How to Cure Health Care", advocates some government involvement in public health (he calls it "universal catastrophic insurance"). So neither Hayek nor Friedman suggest that a completely government-free, market-based solution would be viable. I think that's rather telling.
    Well, when you're a part of a particular society, you effectively agree to a contract with your fellow citizens. This inevitably forces you to obey seemingly arbitrary rules, some of which you may disagree with and may find limiting to your personal liberty (I can offer you lots of examples). So, like it or not, the majority already forces you to be part of all sorts of things, some of which may not be to your liking. I don't know why the subject of our discussion is any different.
  143. The fundamental point of the subject is if it is supposed to be handled by government or not. Government is brute force, there is nothing more to it. The only areas in which it must be part of, are areas that have no way of dealing with the subject but to force something. That means that government is and always will be an expedient, not a solution. That being said, the less you use it, the better.
    That is even more valid when considering results of government intervention(high prices and poor quality). High prices and poor quality in something such as healthcare will result in unnecessary deaths, suffering and/or permanent damage to people's lives.
  144. %%
    they need a lot of ads. Rememeber when all the lawyers said ''OH we cant do ads, too professional'', what a change a bunch of ads make.LOL-true
  145. For profit colleges.
  146. I never claimed that our healthcare market is based on how much someone has contributed. It obviously is not. I also never claimed that the 31 year old drug addict should die (although perhaps society would be better off if he did assuming that he and his family are unable to fix him). The debate is who should pay for it. If his family simply paid for his expenses, that would be great...no burden placed on the rest of society, no consumption of finite resources that could be allocated to better causes. As far as the 81 year old scientist, anyone should be able to get insurance for some price. Just as it would be unreasonable to expect ATM Tesla puts to have the same premium as ATM JCP puts with same expiration, it's also unreasonable to expect a healthy 23 year old to have the same risk as a healthy 81 year old. The good news is that this won't come as a surprise. It's not like any of us think that we are immune to aging so we can prepare for increased health costs later in life. We all have decades to plan and prepare for it.
  147. Unfortunately there is no "dislike" button.
  148. Congratulations you have just identified Healthcare as an area that requires government to take charge!!! Nicely done.
  149. Should every body have healthcare or should only certain groups have it?
  150. I did not read this entire thread, so I apologize if someone else has already made this point.

    Obviously all the other industrialized nations, and many more, have already figured out how to deliver healthcare to all their citizens at a cost at least 50% less than the U.S. cost, and in most cases much less than that, with better outcomes. The U.S. remains the only industrialized nation that pretends it can't figure out how to do this. Rather embarrassing, if you are an American, I would say.

    Isn't it self-evident that if the U.S can afford what it is doing now, it certainly can afford single payer, since the other nations of the world have already proved that the cost of single payer is much less for better results!

    The fundamental problem is, as I have pointed out ad nauseum, most of medical care pricing is extremely inelastic because the conditions needed for elasticity are inherently absent. Virtually all other reasonably modern countries have recognized this! They have solved the run-away price problem by creating a single payer, the government, with dictatorial power over pricing; or else they have kept insurance companies as the third party payer but given government dictatorial power over insurance coverage and rates (e.g., Switzerland -- the highest cost, naturally, after the U.S.) Will the U.S. eventually join these more civilized countries? One would hope so.
  151. It depends, I suppose, on whether you want to live in a place like East Africa or in a civilized country. The U.S. can not be said to be truly civilized until it provides reasonable access to routine healthcare to all its citizens regardless of means.
  152. Even in the socialized countries, not everyone has access to healthcare if you define healthcare as pursuing all means necessary to continue life even if those options are provided by charity at no cost. All these countries will run cost-benefit analysis at some point. Here's a recent popular case:


    So that poor baby is actually being condemned to death because socialized medicine does not want to run the risk of being embarrassed in the event that public charity and the US healthcare was actually able to save the kid. When the government provides something "free", it usually comes at the cost of your freedom.

    You raise a fundamental question though. My answer would be no: healthcare is not a right. Nowhere in the constitution does it guarantee a right to healthcare. You get life, liberty, and the pursuit of happiness. The rest you have to pay for.
  153. Why did you stop at healthcare? Don't people also need food and shelter to survive? Why should those things also not be provided to all? Basically, just let us know when we can all become parasites and live off of others.
  154. Ha ha ha, do you mean, perhaps, why didn't I act like a politician and answer a question that wasn't asked? Of course I don't know if you live in the U.S., but if you do you would know that the U.S. federal government does provide some assistance to some individuals with regard to food and shelter. I'm passing this information on to you in the event you don't live in the U.S. and did not know that. I do have an opinion with regard to these programs but it would not be as informed as my opinion on healthcare. In any case, this is a forum about healthcare.
  155. Come to Europe, everything is free! Billions currently on the way courtesy of George Soros!
  156. The Charlie Gard case has nothing whatsoever to do with what you have described. It's actually extremely similar to the Terri Schiavo case,
  157. Your argument is stemming from a false premise. When markets operate as they do in textbooks you argument will be slightly better.
  158. The only one holding arguments that are false is you. And the falsity in your arguments is not based in premise or arguments, but facts. The USSR, North Korea, Venezuela, China, Brazil(where I worked as a physician) and every other country that adopted socialist policies are proof that what you are stating is false, never worked and never will. But for people that just don't want to see the truth and accept the reality of facts, there is no logic. Just what they want to see. That is why the US constitution secures the right to keep and bear arms, for the possible event that the tyranny that always results from idiotic socialist ideas such as the one that you defend reach a breaking point and the people that truly believe in freedom and personal responsability fight back. I hope that that day never comes, because it would be a tragedy. But if it comes to that, it is preferable than to be in the present situation of the venezualans. I'm not american, but brazilian and that is precisely why I understand the reality of facts, because I lived them. As for when markets operate freely, the result is the U.S., the most developed country in history and the responsible for the creation and development of the biggest advances mankind has ever seen. Something that, sadly, to a great extend, socialists have done a great job at ruining it.
  159. Looks like the boundary of providing essential goods and services by a government cannot be easily defined.

    Perhaps there has been no any universal agreement on defining the boundary on this issue. By well-known economists, politicians or individuals, historically.

    As the boundary can be very dynamic, otherwise we don't need any political or legal systems, as if things are static and clear-cut.

    I don't know which country would provide only the very theoretically basic and absolutely minimum provisions of government supplied services and goods.

    If yes, I am just wondering who would be very happy living there without thinking for a moment to move to other countries/states for a better living for good, where the governments would provide many more better goods and services beyond minimum provisions.

    Even the poorest country on earth would provide more than minimum set of goods and services by the government. I would try to guess.

    Just 2 cents!

    Cf: Page 127 about Taxation and the Provision of Essential Goods and Services

  160. It may be time for you to return to Brazil. Your compatriots are in power. You'll be able to reports to us first hand how much better things are.
  161. ]
    It seems you ran out of arguments and decided to change the subject. That´s OK.:)
    I am still in Brazil, even though I'll probably leave soon... Again... :) That´s because the people in power here are socialist idiots as well, despite what the headlines say... The opposition of socialist parties in Brazil are other socialist parties...LOL Brazil is not a country, it is a joke... That is because almost everybody here is stupid enough to vote to get more and more socialist policies to drive the country further down the toilet. Maybe someday I'll move to the U.S. and become american.. At least in the U.S. about half the population seems not to be that moronic as brazilians, because they understand and see real facts as they really are and want their country to continue to be great country it once was and, in a way, still is. They still made a very poor choice in choosing the current president, but it is still better than the other choice that would sink the country even further in the socialist path. If the day comes and I become an american, I'll be there, voting for the libertarians and why not, arming myself as well.;):D
  162. I live in the US and I am aware that government does provide food and shelter to individuals that meet some requirements. However, despite the best efforts of the Obama administration, there are some qualifications left to get the food and shelter...income, age, and disability are some of the considerations. But why was my question unreasonable? I'll ask it again. Don't people also need food and shelter to survive? Why should those things also not be provided to all as they are necessary conditions for health? If you want people to be healthy, they also need food and shelter.
  163. It's not the Terri Schiavo case. If it was, no one would have stepped up and wasted the medical resources and funding to save the kid. Some people apparently think they have a shot at saving him. Maybe they are wrong, could be, but regardless, why not let them try instead of condemning the child to death? In this case, the British govt. simply does not want to suffer the embarrassment in the unlikely case that the US healthcare system is able to demonstrate better results than their healthcare system. Either that or some people in their system like playing God.
  164. This is just speculation here, but I think America became great because it started with the right culture. What did it take to become an American in the colonial times? The pioneers had to leave their families behind. They had to sell or give away everything that they had and hop on a boat not completely sure whether the boat would make it to their destination and they all knew that they would never see their families and loved ones again. I can't imagine how sad and big of a sacrifice that must have took. They would be going to a land that they had never seen before. They literally left permanently to a place where they had no home. What's the requirement to do that -- courage and risk-taking. The pioneers were tough and the requirement to get here was a filter. You had to be brave and a risk-taker to come to America. We had a common culture of people willing to give up their lives for freedom. Sadly, that culture is not nearly as strong today as it was back then. If all the citizens in the US had to pass the same test to be an American as those first settlers, we'd have a much smaller country today.

    On the other hand, I do think socialism can work if the right culture is in place. There were strong aspects of charity among the settlers (I was tempted to call it socialism, but that's not correct because government did not force people to sacrifice for others). They did take care of each other. Of course, it was a voluntary choice, a true act of charity and not forced onto them by government. I kinda view the Mormons (I'm not a Mormon, but I had a Mormon roommate in college and know several Mormons) as being internally socialistic. From what I have heard, they tithe a lot (I think there's an expectation to tithe at least 10% of earnings) and seem to take care of each other. But in order for it to work, the culture has to be right. Culture is extremely important and they are not all created equal (cultural relativism is bullshit).
  165. I urge you to read more about the Charlie Gard case... You are just not aware of the facts and are relying too much on what you see in the media.
  166. Temer, is if anything as corrupt as Lula or Dilma, and perhaps more so. One thing he his not, however, is a socialist! So in that regard you are getting what you hoped for. Good luck with that!

    All modern economies are mixed economies. This goes for Brazil as well as the United States. In my estimation Brazil's future is not bright under Temer, but we we see, won't we. Expect to see much civil unrest and a drift toward a police State, with the curbing of individual freedom and the clamping down on free speech and the jailing of dissidents and growth of the prison population. At the same time expect Temer's rhetoric to be increasingly disconnected from reality.

    The United States, in it's current manifestation, is a Plutocracy with fascist, socialist, and strong capitalist, elements. It is the least socialist of all modern nations, particularly so if you disregard its huge Military and the VA components. Come on up and join us. You are welcome.
  167. 9.jpg
    Again, as a typical socialist, you're ignoring reality and just believing what you want to believe. Temer was elected WITH DILMA, he was her vice president... They were allies, elected by the same people. This nonsense about he throwing her out of power is just plain stupid. These are facts. Above there is a picture of her taking power, right next to her is Temer and Lula, all holding hands.
    You speak as if I once defended him or any of the idiots in power... They are corrupt socialists(sorry for the pleonasm:D). I wrote clearly in the last post: "That´s because the people in power here are socialist idiots as well, despite what the headlines say... The opposition of socialist parties in Brazil are other socialist parties..."
    There are no people that don't believe in government intervention in every possible area in Brazil and the parties reflect that. The same goes to Democrats and Republicans... Both want to use government to intervene in areas that government should not take any part in.
    People in Brazil don't even consider the idea of government not taking part in every aspect of their lives, government intervention is just a given, and the misery and corruption that Brazil lives in shows clearly the results of this mindset.
    The U.S., despite having drifted toward this same path, still has a good part of it's population that is skeptical about the concept of government and that makes it a unique country in this world and that is also why it still is the best place(IMHO). And I thank you for welcoming me, if everything works out, I'll indeed move to the U.S.:)
  168. You need defintely to read more! You are one-sided informed and you don´t have the full picture. Try again after reading this FED paper - which is actually released quite frequently:

  169. I searched your email posts and "read" that you are a newsletter receiver of George Soros. Enough said. Not interested in anything you have to say. ON IGNORE!!
  170. You can receive emails from George Soros and be opposed to his opinion and actions.
  171. After all Soros has done and said, why would you want to hear any more of his bilge? (Same goes for Obama, BTW.)
  172. So you know what your opponent is up to?
  173. He's made it plain to the world what he's "up to". And Nighthawk is apparently an advocate.
  174. That's a load of bullshit. You are the one that is uninformed. It's not the Terri Schiavo case as you previously claimed. No one was offering to try an experimental procedure to save Terri Schiavo. Name a single medical professional who offered to try any experimental procedure to save her. You can't come up with a single name. Terri tragically suffered brain damage and had no chance (according to medical professionals) of obtaining a normal life. Whereas medical professionals are putting their reputation on the line and offering to try an experimental procedure on Charlie because other kids in a similar state have survived on similar experimental procedures. And why not try it? If the family wants to do it and there's some very slim chance of survival, what's to lose? At the very least, the medical community would at least gain more medical knowledge regardless of the outcome and the family would feel more at peace knowing that they did everything possible to save their child.

  175. Let me ask you a hypothetical question...

    I appreciate that, in a case where there is nothing to lose, an experimental treatment that has a non-zero chance of success is worthwhile, assuming that it costs nothing. As you suggest, it may be worth it just because it might increase our understanding of the condition. However, what if I told you that Charlie Gard, the subject of these decisions, is in pain and suffering? Would you still consider "experiments" that involve him worth the price?

    And you're clearly not all that familiar with the Terri Schiavo case. The appeal cases known as Schiavo III and Schiavo IV involved a possibility of an experimental "vasodilation" treatment advocated by Dr William Hammesfahr and Terri Schiavo's parents. The Second District Court of Appeals ruled to uphold the decision to take Terri Schiavo off life support and rejected the appeals.

    My point here is not to claim that I know who is right in the Charlie Gard case: the hospital medics or his parents. And God forbid I ever have to face a choice that Charlie's parents are facing. My point is that the Charlie Gard case, much like the Terri Schiavo case, is about an argument between two sets of people who have a different view of what's best for Charlie. Just like with Terri Schiavo, politicians and religious figures are now involved. Please forgive me for being a cynic, but somehow I don't think that it's because they care about Charlie. Rather it's because Charlie's case is a convenient "vessel" for their agenda, whatever it might be.
  176. You are correct about Dr. Hammesfahr. There was actually someone willing to experiment on Terri despite the majority medical opinion being that she was brain dead and had no hope of recovery. I still think this case is different because Charlie still has some shot at a normal life whereas Terri was brain dead so the risk : reward equation appears very different.

    The only person that has the right to answer that question -- whether to kill Charlie or attempt to save him would be Charlie himself. Unfortunately, Charlie can't answer that question. You're also correct in saying that is a similarity between this case and the Schiavo case. So who would be qualified to answer that question? His parents or the courts? And that's the difference between this case and the Schiavo case. In the Schiavo case, the husband wanted to terminate life support whereas in this case, the family of Charlie wants to pursue an experiment that might extend or save Charlie. So therefore, let the family decide. Medical decisions should be as close to personal as possible (if not the individual, then default to family decision). If the situation was flipped and the courts were blocking Charlie's parents decision to end life support, I would support the parents in that case too. As far as the pain and suffering argument, how do we know that Charlie would want to kill himself? How do we know that he would not choose to endure perhaps a few years of pain in exchange for perhaps a wonderful and fulfilling life after that point? If he was near the end of his life, I could see how the risk : rewards would be different. But why assume that everyone would want to die in that situation and so too would Charlie?
  177. Your arguments are reasonable and I certainly can agree with several of your points...

    The issue, however, is a really complicated one. In the US, Canada and the UK (probably others, too), the guiding principle for any doctor providing care to a child is based on the "best-interest standard". What happens in those rare cases when a genuine conflict arises between the wishes of the child's surrogates (in Charlie Gard's case, his parents) and what the doctors perceive as their ethical and legal duty to act in the best interest of the child? Both the parents and the doctors could be wrong, they could have ulterior motives and conflicts, etc. The involvement of courts in such cases is almost inevitable.

    There are some relevant cases in the US. For instance, this is the famous "Baby K" case from the 90s:
    There are a few others:
    http://www.leagle.com/decision/1989832145Misc2d687_1710/ALVARADO v. HEALTH & HOSPS.

    There are lots of discussions of the various issues involved out there. For instance, chapter 8 of the book titled "When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families", which you can find here:

    My point here again isn't to agree or disagree with you. It just seems that sometimes particularly difficult end-of-life decisions end up in courts, where judges have to make the final choice. The UK isn't special in that regard.
  178. I see that you know this issue and similar legal events very well. What I have stated about my belief that medical decisions should be made as close to the patient as possible is just my opinion. I can't prove that it's correct. Part of it is somewhat religious. Regarding your question about what doctors should do when there is a disagreement between parents and them, specifically "what the doctors perceive as their ethical and legal duty to act in the best interest of the child" at what point do doctors say to remove life support? Obviously, one case would be when they see no hope of recovery -- brain death. But if there is some hope that the patient can eventually regain consciousness, unless the patient has consciousness and indicates that they want to die, wouldn't the default action be to attempt to save the patient? I thought this was tied to the Hippocratic Oath, but there have obviously been some exceptions to that -- abortion, capital punishment via lethal injection, and euthanasia so maybe it no longer applies. I'll ask my brother who is a med student about this. As you're probably aware, these end of life issues come up a lot more frequently than most people realize. When two out of my four grandparents "passed away" it wasn't really their decision to go to hospice... A lot of people want to believe that most people pass away peacefully in their sleep. That's not the case. What happens at the end of life is usually quite terrible and hard to watch.
  179. Yes, like I said, I respect your opinion, whether it's based on religious belief or anything else... I understand your arguments.

    I, like yourself, struggle with these issues, because they are complicated, difficult and fraught with emotion and pain. As I've said, god forbid I ever have to be in the position that any of the people involved in Charlie Gard's case find themselves in, especially his parents, obviously.

    That said, I just don't see how else you can handle a rare situation where the various people just cannot agree on what's best for the child. In our setting, such conflicts end up in the hands of the legal system and we have to accept its decisions. I wish I had better ideas, but I don't.
  180. Not according to my many Brazilian friends. And not according to any disinterested party either, because it's rather obvious what's going on. Why did Temer immediately push for higher salaries for the Court? It's pretty obvious. No educated person is fooled by this.
  181. Who cares what your brazilian friends say? Brazilians are idiots. Your friends are the same morons that elected these people, Dilma AND TEMER... As I said: THEY ELECTED DILMA AND TEMER, TOGETHER, THE SAME PEOPLE VOTED FOR BOTH, BECAUSE HE WAS HER VICE-PRESIDENT. This is not something to be "interpreted", this is a fact. And the fact that they were elected together, by the same people, speaks for itself.
    And what do higher salaries for the court has to do with anything? It makes no difference if there were higher salaries or not to the Court. She was thrown out of office by CONGRESS, not by the judiciary system. And the Court, of which you spoke, is going after him now for corruption as well.
    From what I've seen so far,you always fundament everything you believe in what people say or in falacies... Not one thing you said had actual facts backing it up. I recommend using logic and observation of facts to draw your conclusions. Fairy tales and fantasies are for children. Grow up and face the real world, man.
  182. Apparently you're not on the IGNORE list quite yet; he's still responding. Congratulations in advance however. As soon as you're officially on the list you automatically become recognized as one of the sane posters her. And there is another benefit too. You can send him the finger whenever you feel like it, and there will be no insults fired back. Here, i'll demonstrate:

    Scat, your a fucking imbecile! :D
  183. Let's wait and see how that comes out, shall we? :D
  184. Let's not ignore all the facts I mentioned so far, at least once, shall we?
  185. Lotsa discussion here.Lets just cut to the quick. Politicians make the laws at all levels in this country.We have the best politicians that money can buy.Who thinks that lobbiests throw the money they are paid away? If you look closely at our political system and and see how it really works,you will see that personal gain,political party,and getting reelected are paramount.
    Nuff said. heypa
  186. Single payer is just not free market ,it is perplexing to me that traders would take an opposing views to the market
  187. This is an absurdly stupid statement by someone who apparently lives on another planet. The two choices offered (although there are others) are either the hopelessly inefficient, chaotic U.S. medical care delivery system that provides worse results and yields 100% or more higher costs, or what all other industrialized countries in the world do to get better results and drastically lower costs. We can't do worse than we are doing now no matter which version of single payer we were to adopt.
  188. Oh we have a socialist triggered
  189. There is always a worse scenario available. Always.

    Look at Trumpie being the lesser of two evils. Evil Hillary at least is not an Evil Idiot. But I digress.

    Meanwhile I guess it never occurred to you things could be improved by having ... less government of the current f'up system we have? That what we need is less not more government involvement.
  190. Who creates the f'up system you have? Regulators?
  191. That's true in regard to medical care at least, it never occurred to [me] things could be improved by having ... less government of the current f'up system we have? That what we need is less not more government involvement.

    What has occurred to me however is this: there is fundamentally no significant difference in quality between the private and government sectors. Both are made up of individuals drawn from a wide range of knowledge, skills and personalities. Neither the Private nor Government sector is more efficient or capable than the other. some things are best handled by the private sector, while others belong in the government sector.

    Looking at obvious problems to be solved through ideologically tinted glasses does no good if we are talking about the private sector versus the public sector. The answer will never be "more of this" and "less of that". Because the "this" and the "that" are both products of people that are fundamentally the same.

    We will have to think in terms of policy and operational improvement in both sectors. We must start by deciding whether a particular function is best handled by the Private or Government sector, and then figure out how best to do it. With regard to medical care delivery we are fortunate to have a wide range of models to consider and improve on. Each of those models is demonstrably better than our own. We can, therefore, answer the initial question. And we even know why the answer comes out as it has. It's because medical care pricing is highly inelastic by nature, and in the U.S. it has been made even more so by regulatory capture. A satisfactory private sector solution is, of course, impossible without pricing elasticity. Ergo Healthcare must be handled by the Government Sector. This does not necessarily mean however that providers will be on the government payroll -- although that is a possibility in some models -- it simply means that government, not the private sector must determine policy, make the rules, and see that they are uniformly applied and that all citizens are treated equally under the law. So let's just get on with it. Trying to fix a fundamentally flawed model with incremental changes can never work.
  192. You first say:

    "That there is fundamentally no significant difference in quality between the private and government sectors."


    "We must start by deciding whether a particular function is best handled by the Private or Government sector, ..."

    Which is it?
  193. In general I would say this is true. But not when it comes to the insurance market. Health insurance is a very complicated industry and no one actually knows how expensive a procedure is. The doctors who administer care rarely know and the patients who receive the care basically never know. Further there is so much administration between the actual care giving and the bill that overhead and inefficiencies have to be creating price inflation.

    Multiple firms touching an invoice, HIPA rules, and multiple insurance plans create a perfect system price inflation. I believe that if the government were to get more involved in health insurance, you would see costs go down just on transparency and paperwork reduction.
  194. Regulators aka Lawyers.

    Also Politicians and Lobbyists aka Lawyers.

    There are even Doctors who are Lawyers.

    In other words if it is not already plainly obvious too many damn Lawyers.
  195. Yet somehow Auto, Property and Life Insurance (among many others) work just fine.
  196. That's because the consumer of that insurance is you.
    "You" consume medical services, but (in the U.S.) it's been 30+ years since you paid the doctor.

    Transparent fees and a'la carte pricing; no treble-damages on malpractice; no employer-related insurance (i.e., recognize "insurance benefits" as regular income).

    All solved.
  197. So lawyers sell medical treatments?
  198. I think that's because there aren't many stakeholders in the middle (none of the beauracracy I mentioned earlier).
  199. Yes because we "buy" health insurance the government way. Not the market way.
  200. Lawyers that are also Doctors or just plain old Doctors sure sell medical treatments. As told how to by Lawyers that are Politicians and/or Lobbyists.

    Come on, its not that hard to grasp.
  201. Bureaucracy - government same difference.
  202. It's not.... That's not the problem... :D
    The problem is that there are people that just DON'T WANT to see it... Because taking responsability for one's own life is just too much for these people, they must believe this crap so that they can justify their living at other people's expense... That's a lost cause...
    "The worst blind man is the one that doesn't want to see.";)
  203. Private sector; because socialized med is a TRAINWRECK============================================================================== :caution::cool:
  204. Both. You can't make that decision based on the quality of people who will carry out a particular function because there is no difference on that basis. The decision has to be based on where best the function fits. Somethings, because of their nature, are best suited to the private sector, others should be handled by government. In general, when prices are inherently inelastic you need government to take over. For the market to operate as desired in a capitalist economy, price elasticity is required.

    We have examples where elasticity isn't as great as desired, but it is not due to inherent inelasticity. It is inelasticity born of regulatory capture, high entry barriers, etc. We can see, for example, both these elements at play in the cable and satellite TV retailing. If you were to judge by the advertising of Dish vs. Comcast, you would think that they were offering different pricing. But it is an illusion created by clever advertising. On close examination you would find only pennies difference in pricing for an equivalent product. Although real price elasticity in this case is an illusion, it is not inherent inelasticity, because you really can choose neither provider. Here the buyer can walk, and if enough buyers did walk, price elasticity would become evident.

    On the other hand, Medical Care pricing is highly inelastic, and inherently so. Of course, as everyone knows, it can vary tremendously with location, the patient's ability to pay and their insurance coverage. But that is not the kind of price elasticity I'm talking about.

    For any given situation in the Medical business, if the buyer is given a price, it is a take it or leave it price. The buyer can't walk! (sometimes that is literally the case :D). We might in fact have a very difficult time pinning the provider down to a specific price! And if we did manage to get a firm price quote and then turned down the offer and walked away, the provider would not lower their price. Even if everyone, given the same price, walked away, the price would not come down. For a variety of reasons, we can't, practically speaking and in general, avail ourselves of a lower price elsewhere. That would be the case particularly for emergency care, but it is also true in general. We say, therefore, that medical care has inherent, inelastic pricing. Pricing will not respond in a normal way to supply and demand, and that's what makes medical care inherently a bad fit to the private sector.* There are also moral reasons why medical care should not be relegated to the private sector, but that is a different discussion altogether.

    *I want to make it clear that when I write ",,,medical care is an inherently bad fit to the private sector," I am not taking a position on, nor am I advocating, totally socialized medicine, such as that offered by the VA Administration. There is little enthusiasm for totally socialized medicine in the United States, despite the inconsistent and inexplicable championing of the VA by those who are otherwise unalterably opposed to government involvement in medicine. Rather I mean to suggest as a remedy for lack of elasticity in medical pricing that the Government must be in charge of setting prices and standards and paying for medical care from tax revenue. Under such an arrangement Providers themselves would remain in the private sector. Accordingly, they would bill the government for services rendered. An example of such an arrangement is U.S. Medicare. One can easily envision variations and improvements on that same theme.
  205. How so when in Europe it's cheaper and better than your system, and why not both?
    Ideology blinds.
  206. What is your individual income tax rate?
  207. Is that with or without an imputed cost of medicine? :wtf::(:mad:
  208. I am assuming Simples is located in the EU?
  209. Simple comparisons like that are silly. You could probably argue that EU tax may even approach 80% if you beancount everything. In practice though, if you don't overspend, it's not hard to save up.

    A system where everyone gets a chance at college-level education, free healthcare (costs are miniscule when you need it) where you don't have to risk your health and life to avoid bankruptcy and being kicked on the street, kid support, lack of foodstamp coporate welfare and everything else we take for granted, yield overall lower costs and payback to society as a whole as well as less serious crime and violence.

    How do you get paid for all those extra hours at the company you work for again, or do you have 2-3 jobs to make enough money? Oh right, being taken advantage of is part of the dream. And when that money moves out of the country or everything is Uber'ized to the point taxidrivers can't be called taxidrivers and can't afford their own vehicles anymore, that's really a good thing!

    So basically, tradeoffs, depending on culture and what is accomplished as a whole, which is a tad different discussion than ego games and gains.
  210. It was a simple question, Simples. Are you in the EU? If so, what is your individual income tax-rate? Didn't mean for it to get all fragged out into a border-wagging contest. Oi!
  211. More games I see. Won't bite. You can look it up yourself.
  212. %%
    OK ; Mr Simples Spain ETF has done real well this year.LOL BUT small samples/socialism never work over the long term. WE [USA] fire/fired air traffic controller before they make$ 500,000.I just read 40% of health care is personal choice like smoking; may be more than 50 +%.

    Let see ,what is that group/region want to leave EU , not the UK, they already are leaving, the region that wants out, in Spain??LOL your gasoline tax is way to high, also.

    I like personal choices, not a TRAINWRECK like socialized medicine==================================================================.A socialist[Sanders] got some votes, but that was mostly uninformed students; social media is not socialism, even though a USA teacher warned me some confuse that LOL.Thanks for you reply; allow much more time if you fly in Europe/Spain:caution::D
  213. What has ETF to do with medical health services?
    Small socialism, aka small tribes, works much better than capitalism, but is beaten by larger tribes, that compete through genocide.
    Much stats about health is bunk, though alot of health problems is lifestyle like eating corporate food, alas the other half can be attributed to genetics as well.
    Europe is not EU.
    US gasoline is subsidized by US gov.
    Thank you as well. Always good to broaden perspectives.
  214. I live in the UK and the health service is collapsing. Its a nice idea but totally affordable. It was created after world war 2 when the country had a tiny population but as population has grown its become more and more indebted. Its also a political weapon, any party that suggests we reduce our debt are called evil fascists that want to kill people because the NHS will lose funding. Its a joke.

    The US version is worse however, we don't have anyone go broke because they get ill. Im about as anti socialism as they come but the thought of having to pay 6 figures for your own treatment is terrifying. There needs to be some support.

    The answer as usual lays somewhere in the middle. If i could overhaul the health systems of UK i would say people should pay the first £500 of their treatment, £20 to see a GP, pay for your own X-Rays etc, this would bring in billions of additional revenue in the case of the UK, but if things get really bad and you get a serious disease or chronic condition its covered by the state.
  215. My insurance just paid six figures for treatment. If I didn't have insurance, it would have been a huge blow. Bankruptcy due to medical bills is so prevalent in the U.S.

  216. A partly insurance-based scheme will address some of those issues (as it does in some EU countries).

    The problem with charging people £20 to see a GP (the New Zealand system, more or less) is that you also effectively have to exempt some very substantial groups of people from the charge (those on benefits, those "poor and with cancer", pregnant women, etc. etc.?) and you end up with the same kind of idea as the exemptions from prescription charges, net of which only about 30% of people actually pay the charge.

    It's also a relatively expensive system to run, administratively.

    For both these reasons, it actually raises comparatively little, in overall NHS-spending terms.

    One of my suggestions would be for the state to offer to pay all medical school fees for students willing to contract to work full-time for the NHS for their first 10-15 years after qualifying: a long-term, gradual, almost "cultural" change in med-economics which would relatively inexpensively boost the ever-rapidly-declining number of GP's, saving a lot of money in the long term by not importing already-qualified doctors through very expensive financial incentives, paying inflated agency fees for locum cover, etc. etc.

    The NHS currently spends a fortune on private medicine and private medical facilities, many of which (surprisingly?) are actually of a qualitatively lower standard than its own resources.

    But until the NHS is completely de-politicized, no successful, long-term changes are effectively available, in my opinion.
  217. People in the U.S. would kill for a £500/650 USD copay.
  218. I have done the numbers. The headline is very different if you tally up everything - federal, state, local, real estate, SS, Medicare. I did not include payroll taxes, but that would make it even more complex. The tax rate for an upper middle class employee in the NYC is not radically different from an upper middle class employee in London or Paris. I can attest to the NYC to London comparison personally, having worked in both places.

    However, what one gets for that money is pretty different. In the US, while paying very similar amount in taxes, you end up paying for a lot of things separately. First and foremost is health care. Then there is higher education, maternity leave, kindergarten etc. Whatever safety net that exists in the US is a joke (unless, of course, you work for the government) so you have to account for that too.
  219. You can see how working for the gov corupts someones perspective, they end up with better health care benefits then anyone...this creates the perspective that the gov is inherently looking out for their best interest..
  220. (a) I never heard of any congressman declaring bankruptcy due to medical costs. Have you?
    (b) I recall reading a paper that for an average elected official in the US, their incomes and net worths tend to go up after they done serving their term.
  221. %%
    I like that the UK sent a ship help US when that last hurricanes hit; but that was free will, not required . Good thing the USA just helped stop the ACA [socialzed med] TRAINWRECK/ Mandate===============================================================================.Private sector does medicine so much better; as far as numbers, i like freedom of 1776 + 4th of July freedom.Thanks; like the private sector doctor noted [ non gov doctor]told me -I'm hypersensitive.:caution::cool:
  222. Ya... Exactly!! How they forever could insider trade is just crazy.. above the law... Meanwhile we have to risk our hard earn savings to race against inflationary monetary policy
  223. It makes perfect sense that government employees are given the most socialist benefits. They are ahead of the curve. Everyone at some point will also get free stuff .... until no one will get free stuff when the giant house of cards collapses.
  224. I think a small co-pay (say, £5) charged for all doctor appointments and treatments would do wonders. The point isn't that it's going to raise a lot of money, but that it will eliminate a lot of wasteful and often abusive practices. I think they were looking at this in places like Australia, but I am not sure how it worked out there.

    As to the state paying medical school fees, those fees aren't as high as in the US in the first place. Besides, it's hard to realistically enforce the requirement for the GP to remain with the NHS for a decade or more.

    IMHO, the big issue with NHS is just its plain inefficiency. That means that, as with so many other things, you need to look at how the really efficient people administer things. As usual, that means you want to look at how the Germans do it.
  225. In Scandinavia you pay something every damn visit to the doctor. It's just not that much and if you have to go alot, it gets tax deductible. Unnecessary or too dicey operations are privately paid. Health system humping along good though never perfect. Most people are interested in good health, and the lifestyle and industrialized food US has is largely frowned upon. Sounds like a nightmare going bankrupt just because of health, but it can happen here as well, as building businesses are never easy. But then it would be health-related, most probably not money-related due to medical bills. When abroad we need insurance and pay them happily, because in many countries getting sick there can bankrupt anybody.
  226. Why doesn’t WB with the help of other limousine liberals set up a non profit insurance company for the uninsured using their own funds?

    Talk is cheap. These guys love to spend other people’s money while growing their own wealth.
  227. Bureaucracy in third world shitholes means several palms get greased keeping the system inefficient. You can replace bureaucracy with shitty crony businesses kept afloat by lobbyists in the US.
  228. I listen closely to Buffett's ideas and opinions because he is beyond savvy and has less of an ax to grind than many as he is giving 99 percent of his wealth to charity.

    No one is always correct but some people consistently produce better food for thought than others.

    The US is awash in abundance and Buffett believes in both capitalism and the ideas that no one should lack opportunity for good education, healthcare, or have to go to bed hungry. He is all for people becoming wealthy through hard work, innovation, and so on.. and even finds this desirable for society.. but he also thinks the wealthy are given too many financial breaks, such as through the tax code. He believes in the benifits to society of technological progress and free trade but does not think hard working Americans should become permanent Road Kill.. and he says we need to work on these things.

    Side Note About Abundance:

    There are 10 boys and 100 apples. One boy has 100 apples... how happy are the other 9 boys?

    We are the only first world country without a one- payer system.

    Well... we have something in the ballpark in the form of Medicare once a worker with 40 quarters reaches 65. And I will note that Medicare returns a larger portion of what they take in than do insurance companies.

    One study ranked US medicine number 18 in the world (behind Cuba) for a prope who are both poor and uninsured.

    Another study found US medicine efficiency to be 46th in the world. Another study ranked the US as 50 put of 55. Another study ranked the US in 11th place out of the 11 highly developed countries examined.

    Of course the US is number one in many areas if you are wealthy or have tremendous insurance.
  229. Buffett takes advantage of every tax clause loophole that he can but then whines he doesn't pay enough taxes. He's worth more money than god (thanks mostly to his Insurance Company megalith money printer) but eats a cheapie meal at minimum wage employer Mickey Dee's.

    He is only cares about making more and more money paying less and less taxes in the process and his "warm, caring, mid-western, folksy, grandfatherly" image - period.
  230. Did you know he disowned at least one grandchild? Totally cut off. She lives on 30- 40 k a year now. Not indentured servitude but still...seems cold.
  231. Another globalist ___
  232. And yet he has pledged over 80% of his net worth to a charitable foundation (and not even his own). Granted, I barely earn in a year what he makes in a couple of hours from the dividend carry (*), but I am trying to follow his example. On one hand, I try to pay as little in taxes as I can (living in the NYC, my marginal tax rate is over 50%) and take advantage of every loophole I can. On the other hand, I donate just shy of 50% of my income to a variety of causes (all the usual liberal stuff such as fighting poverty, various health initiatives, protecting nature etc.).

    PS. Oddly enough, if I just consider his total compensation from Berkshire, it's not that different from an average Wall Streeter like myself
  233. When you (Buffett not you you) are worth gazillions WTF is 80%, 88% or 99.88%. And with one foot in the grave. All well and good but it does not deny the fact he games the system, that he knocks, as good as any other player.
  234. An utterly dumb comment. What's next - "the military is inefficient, so why doesn't Buffett form his own private army to fight for the country"?
  235. I respect him more for that. In all likelihood the grandchild deserved it. I'm against inheritance as a whole though - it only causes problems, ruins lives and creates inequality.
  236. I'm not saying she didn't deserve it either. She "blabbed" about the family. I don't know...it's harsh but sometimes parents and grandparents need to be harsh. I disagree somewhat but I understand the idea behind it.
  237. So we are agreed, Buffet can do what he wants with HIS money.
  238. Haha. Ok, that was funny. Of course...of course. Still, we have a right as Americans to gossip about his family life, gawk and criticize. It is the American way ;)
  239. And Buffett can criticize our tax structure. Which in turn will cause some us to call him out as the hypocrite he is.
  240. Why is he a hypocrite for having an opinion and running his business to the letter of the law?
  241. State-ran health care is one of the few things that I could see tangible benefit from. At the moment I see very little of that from my federal taxes.

    Somehow, there is a bunch of assholes in Washington that make decisions on what to do with my money (and yours too, but somehow I am sure I pay more taxes, unfortunately). And, oddly enough, their decision benefit nobody but their re-election campaigns. I don’t give a shit about fighting terrorism (its a show for people who can’t understand statistics), yet half a trillion dollars a year goes to it. I don’t give a fuck about saving agriculture in the US (cause it’s doomed anyway, we’re just postponing the inevitable) yet another 100bn goes to that. I don’t get any say where my money goes, no matter which party is prevalent at the moment.
  242. Just curious. Is this because younger generations lack desire to continue farming operations? I’m wondering how this impacts the value of farmable land. We have a sizable amount in the corn belt, and the growth/rental income seem to consistently outperform the risk-free rate, not to mention provide many nights of good sleep.
  243. Well, considering that farmers get paid not to grow things, it's a good investment. The more they not grow per acre, the more they get paid :)

    PS. I think US agriculture should be dead by now since (a) cost of labour is so much lower elsewhere in the world and (b) subsidies have created a monoculture monstrosity that is taking over our lives.

    PPS. Actually, it's only 20 yards a year (still a lot, but not 100). It's only 23k per farm on average :)
  244. Single payer has some flaws, but it might be superior and is worth the discussion. As long as premiums are deductible and hospitals get tax breaks based on public service or religious affiliation government is deeply embedded in healthcare already.
    Right now healthcare is provided by medicare, the VA, private insurers and public insurers.
    Medicare is single payer and although not perfect operates as pretty much the lowest cost in terms of prices they've negotiated. The VA has really mixed and some awful reviews, but apparently not for lack of spending and many vets are now being allowed to opt into the medicare system. So the argument there is the money is not well spent. This is probably the biggest argument for the problems with a single payer. Some VA facilities are great, but many are shit. So fix the shit facilities - not an overnight process and it will take time, but they need to be fixed irrelevant of who pays.
    Private insurers - generally paid by corporate premiums which are tax deductible to the employer. They are also capped at 20% retention and their profits are taxable. So they are living with a government subsidy and the taxes they pay go to the government and end subsidizing medicare in the end. So what happens if you close them? People at the firms lose jobs and that is a problem, but you also lose some of the cost. Stockholders become disenfranchised and you can't just convert the property. Many private insurers are also providers - they own hospitals and other facilities. So value their assets and buy out their insurance assets and leave their provider assets.
    Mutual insurance companies like many of the Blue Cross providers and religious affiliated facilities, again a government subsidy through their structure.
    Medicaid and the uninsured. Basically the poor and the uninsured and I think this is point Buffet was driving at. In a country with this much wealth we should find a way to cover everyone.
    Some states expanded Medicaid under the ACA and 18 didn't - this was simply politics and is clearly part of the problem.
    Are their countries that have single payer and do it well. Sure and their are countries that have single payer and do it badly also true. Steal shamelessly from the countries that do it well.
    Doctors are well paid in the US -
    Hospitals have very low ROI and they are consolidating in an effort to get economies of scale, but it is a nonsense model under the current system.
    In the Chicago market - where I live - two of the best hospitals in the area aren't in the system of many private insurers - they are in Medicare and provide millions in benefits to Medicaid and the uninsured. This is nonsense.
    The EU provides healthcare to all of it's residents no matter where, inside the EU, they travel.
    Healthcare is almost 20% of our GDP which almost twice what most countries with single payer spend.

    Single payer doesn't mean free, but it's a crime that at almost 20% of GDP we have millions uninsured.
  245. That is a stupid statement, especially considering where a major amount of people are celebrating the New Year tonight. Oi.

    Enjoy your hamburger. (Some of the ag money goes to saving the world from prions. A prion is the scariest damned thing ever to evolve from the primordial goo. Don't believe me? Look it up.)

  246. Hmm, really? Do the math yourself:
    1. number of Americans that have died from terror attacks from 1975 to 2017: 3,024 (https://goo.gl/Sozrxt)
    2. amount of money the US has spent on the War On Terror since 2001: 4,79 trillion (*)(https://goo.gl/z1d2ZU)
    That amounts to some 7 people per year. At the same time road fatalities kill 300+ thousand people every year in the US (https://goo.gl/yRdns4). Cardiovascular problems kill 630 thousand Americans per year (https://goo.gl/VJI9G2). How much do you think is spent on each issue?

    Would you say that spending money on terrorism is a prudent decision?
  247. @sle, what about the economic damage? IIRC Bin Laden was intentionally targeting the financial centers in NYC to precipitate an economic collapse. We're venturing into the land of what ifs but suppose one of these terrorist organizations procured a nuclear weapon? Just a contra point.
  248. Well, considering that number of people that died from prion exposure of all kinds is ... 1-2 people per million and most of it from Creutzfeldt-Jakob (https://goo.gl/rfDEGx).

    PS. There are plenty of other orphan illnesses with the same occurrence that receive close to zero funding.
  249. Is it worth 4.8 trillion dollars in spending? Sounds like a pretty expensive option to me.

    Have they? Most of them have been around for many years, yet their attacks are very low tech (albeit sometimes high concept, like the 9/11).
  250. Come on ..do you think that current cost per death is a prudent way to illustrate/project the future cost of the end goals of terrorist groups and their agendas if they are not thwarted?
  251. Yeah, of course it is. We spend more than we should. More importantly, we give them a lot of attention and that's exactly what they crave.
  252. TlDr; Leave the Middle East, focus on domestic energy options including drilling in Anwar, build alternative energy tech for the future.

    I'll be candid about my political opinions. The U.S. record in the middle east is abysmal, stretching back into the 70s. There is no clear victory to be had there. The real solution is to withdraw from the solution and focus on domestic sources of energy even if it means drilling in Anwar. And the reason I say that is the environmental damage caused by the Iraq war is catastrophic. Think of all those oil wells that Saddam ignited.
    Once a strategic withdrawal is implemented, the passions that fuel terrorism may diminish with time. And we must not keep military bases in Saudi Arabia. Let the Saudis fend for themselves. They have the money.
    And finally, focus on alternative energy sources for the future. But with the present policy? That spending is a must. The threat of another 9/11 or something worse is always on the horizon.
  253. Wow, totally disagree. Some of the bad guys have much larger ambitions than just getting attention and are not the JV, as our apologetic past Pres thought.
  254. There's always a cost to running an Empire.
  255. Yes, I would. I'm going to give you a pass on this, because you are either

    A. Clueless because of your age.

    B. Clueless because of your ignorance of the world's situation.

    C. Just insensitive to the world and what the heck goes on.

    Go ahead and whine about funding to fight terrorism, and how it is all a waste.

    If only you were there on Sep 11, 2001. Please. Don't spout shit about something you have no clue about, statistics be damned. You'd sing a different tune IF YOU WERE THERE.

  256. We are already a net exporter of oil.....
  257. There are guys on Randalls Island that have grand ambitions. It’s the ability to implement those ambitions that counts and they were not very successful over many many years.

    I was in the NYC. I was watching the towers burn from the Bear Steans trading floor in midtown Manhattan. A bunch of my friends died in the South Tower. So when I “spout shit” I know fair and well what I am talking about. The political establishment used this tragedy to rob us blind.
  258. It may not be enough if we're still importing from OPEC and have to act as peacekeeper in perpetuity.
  259. It's funny how FAST things get dark fast here when we don't have MUCH TO TRADE.
  260. I happen to think that ISIL,Levant,Boko, Hezzbo, etc. have more capability than the guy in Rikers.
  261. ....?? We are a NET EXPORTER.
  262. LOL, OMFG Jesus. Well, there you have it folks.

    "I was in the NYC. I was watching the towers burn from the Bear Steans trading floor in midtown Manhattan. A bunch of my friends died in the South Tower. The political establishment used this tragedy to rob us blind"

    Really? You are going to equate 9/11 with political ambitions about trading? Ug!
  263. About trading? What are you talking about? I said it was a tragedy and that politicians used it as a pretext to crank up the military spending.
  264. So in place of increased military/intelligence readiness, what would you propose in dealing with groups with the stated objective being the destruction of the west ?
  265. Biggest Winner of Famed Buffett Bet? Girls Charity
    Nicole Friedman
    Dec 30, 2017 8:00 am ET

    The real winner of Warren Buffett‘s 10-year bet against hedge funds is Girls Inc. of Omaha.

    Mr. Buffett bet $1 million in 2007 that an index fund would outperform a basket of hedge funds over a decade. The proceeds would go to charity, and Mr. Buffett designated his local Girls Inc. affiliate as the recipient if he won. When the closing bell rang at the New York Stock Exchange Friday, the famed investor locked in his victory.

    Mr. Buffett, the chairman of Berkshire Hathaway Inc., has said throughout this year that he is confident he would win. From the start of the bet through the end of 2016, Mr. Buffett’s S&P 500 index fund returned 7.1% compounded annually. The competing basket of funds of hedge funds selected by asset manager Protégé Partners returned an average of 2.2%.

    And because of a twist in the bet’s history, Girls Inc. of Omaha is likely to get much more than $1 million.Mr. Buffett and Protégé Partners originally put about $320,000 each into bonds that would appreciate to $1 million over the course of their wager. But the bonds appreciated much faster than expected as interest rates fell so the two sides agreed to go for a bigger prize. In late 2012, they agreed to buy 11,200 shares of Berkshire B shares, which cost $89.70 at the end of 2012. They’ve climbed 121% since then.

    After Friday, the last day of trading in 2017, those 11,200 shares are worth $2.22 million.

    “I guarantee you it will be put to good use” by Girls Inc., Mr. Buffett said in a December interview.

    Following Mr. Buffett’s investing advice, Girls Inc. of Omaha plans to invest the donation passively and use the investment proceeds to cover the ongoing expenses for a new project: transitional housing for 16 young women who are aging out of foster care, said Executive Director Roberta Wilhelm. The organization bought a property in 2016 and will renovate it next year, with a goal of welcoming the first residents in 2019, she said.

    “That’s a really life-changing gift for the girls, and it’s certainly a big change for our agency as well,” Ms. Wilhelm said.

    Girls Inc. of Omaha is a local affiliate of Girls Inc., a national nonprofit. The Omaha organization provides after-school and summer programs for girls ages 5 to 18. Its annual budget is about $2.8 million, Ms. Wilhelm said.

    Ms. Wilhelm said she has followed Mr. Buffett’s bet with “anticipation and hopefulness” for the past decade.

    “Of course I had full confidence that he would win, but I thought, ‘10 years, it’s so long. Who knows?’” she said.

    Mr. Buffett has previously auctioned off his car and his wallet to support Girls Inc. of Omaha. One year, he donated 17 ukuleles to the organization and taught a ukulele lesson himself.

  266. It does not have to be an all or or nothing reaction. It’s a scale ranging from doing nothing and allocating a meaningful portion of the GDP, I think the right answer lies with some sort of cost/benefit analysis. Obviously, that’s not what happened.
  267. I think you are correct in a utopian situation, but a cost/ benefit anal of fighting terrorism will never be easy in an open society...anyway Happy New Year to all !
  268. If you have to import oil from the Saudis, you have to secure the region in any case and that costs money. A lot of money. If you need to secure oil fields in Iraq, that costs money. We're involved in that region despite being a NET EXPORTER. That's the point.

    We're hardly independent of the middle east despite being a NET EXPORTER. I import 1000 barrels of oil, export 1001. Voila, I'm a NET EXPORTER. EXPORT MORE, IMPORT LESS, extricate the US from the quagmire of the middle east.
  269. We are very involved in the mid east. It has very little to do with oil.
  270. Of course Mr. Buffett is right, but he did not make his point as emphatic as he might have. He should have said, "America can not afford to delay implementing Single Payer Health Care much longer than it already has."

    Single -payer is not synonymous with UK style health care. The UK has single payer and so does the U.S. in the VA and in medicaid (from the patients viewpoint). The VA is similar to the UK system, whereas medicaid is quite different. Medicaid is single payer but it is not synonymous with the UK healthcare system. These distinctions are important! Medicare, on the other hand, is only 80% single payer. Overall, medicare is multi-payer for most and two-payer for some. True single-payer and what politicians envision as single payer may not be at all the same thing. And certainly "single-payer" does not mean necessarily that providers will be government employees, though effective single-payer systems must have a large element of government price control if providers work in the private sector, otherwise little other than uniformity and convenience in billing is accomplished. So when someone says "single-payer", I say, what exactly do you mean?
  271. This may be the only really sensible thing you have ever posted. Congratulations!
  272. You started well and then you went on to fall into the trap that so many fall(to think that "just this once" we should trust government to do something for the "greater good"(whatever the hell that means...)).
    But again, the greed that you mention is good... The problem is "Regulatory Capture"(which is the situation where you have governments joining forces with private companies and persons, this is the source of problems).
    The systems you quoted are shit.. I've lived in Europe and I can tell you that even though it might be good compared to some countries(third world shitholes), it doesn't work and it is a time bomb because the system cannot sustain itself because of it's costs and inefficiencies.
    You want to lower costs and make better services? Do away with every regulatory agency(such as the FDA, among others) and cut the political power of unions(such as the American Medical Association), let doctors from all over the world come and compete between themselves in the US, end bureaucracy to open up clinics, hospitals, health insurance companies + 0% corporate taxes and see the companies and health care professionals(driven by their greed) compete with each other for the clients/patients... You'll see what this does to the costs and quality of health services(I'll give you a hint: think Uber vs Cabs, it's exactly the same thing:D)...
    I'm telling you this because you really started well and did not strike me as someone who is just like so many morons out there that believe in fairy tails told by communist idiots...:)
    You don't have to believe me, just use logic and see that, just as you suspected, everytime you give power to governments, what you get is higher prices and bad services... And the problems you have now are a direct consequence of this: too much government(FDA, AMA... as mentioned).
    When what you suggested is done, the people that always suffer the most are exactly the ones you are trying to help.;)
  273. No, I didn't "start then fall into a trap". I just posed a question. You presumed much apparently without reading.
  274. Yep, you did. I read the whole thing.
    This is the trap... There is no such thing as "the greater good". Mankind's biggest atrocities have been done in the name of "the greater or the common good". That's because someone has to decide what that means... And in a world with so many different people/ways of life/views that is a recipe for catastrophe, because one view will be imposed on others...(Think Hitler...In his mind, he was doing it for the greater good... And a whole country believed him... The result: WW2)
    What I described is a system where no view is imposed over another and the people decide what views to accept individually, by buying the services they want... But institutions such as the FDA and AMA(which serve the purpose of only strengthening "big pharma" and "american doctors union" kill competition...) This makes services expensive and inefficient... The result: the rich can afford to spend more money then they would if there were more competition and the poor are fucked...
  275. Like I said. You pontificate, but don't listen.

    Your Debate Report Card... "D-"

  276. Absolutely... It should cut both ways as this is the way we decide to throw people off healthcare anyway.
  277. I may have seen a documentary about it. If I recall, none of his offspring get a stipend/inheritance other than get all education and healthcare taken care of. The showcased woman was an artist of sorts.

    Commendable really...
  278. She has grit, that's for sure.
  279. A hypothetical question, pls, if I may...

    All these slogans and theories about "people deciding what views to accept individually" are fine and dandy. What if people voluntarily decided to get together (in order, for instance, to increase their bargaining power) and delegate some decisions to experts chosen from their ranks? Wouldn't this in itself be an expression of their individual free will? Is that allowed?
  280. Of course! The key thing is the word VOLUNTARILY. The people you mentioned may be coming together, but it is the same thing since they INDIVIDUALLY decided to do that. The problem with single-payer or any other government intervention is that one group IMPOSES/FORCES something to the other, in other words: it is NOT VOLUNTARY. It is by definition based on the "collectivist" principle, which is the basis of communism. But in order for that to work, a central power has to administrate all that. That, by definition, is a monopoly and a monopoly is always equal to: low quality and high prices.
  281. Hold on a moment, please...

    Hypothetically, let's take a small community, like a township. The people there come together and decide to elect a mayor or a council, which would deal with the various everyday issues that the community faces (e.g. policing, courts, education, etc). Also, in order to enable and fund the operations of the town's communal infrastructure (including the mayor's/councillors' salaries), residents agree to make regular payments. It seems, based on your comments above, that you're OK with such a setup, correct?
  282. Sure... No problem. As long as ONLY THE PEOPLE who agree to make this payments actually do it. Let's assume that 90% of the town's citizens agree that they want to be a part of this. NO PROBLEM, as long as the other 10% may simply not pay anything, because they don't want to.
    The point is that in this setting, the government system is no different from a private enterprise since people can opt out and choose alternative services. Which means that the "government health insurance" will have to compete with the private. But if that is the case, as in a free market, even the governments health insurance acts as a private one and even though in this setting I would have no problem with this "government" company, it makes very little sense to build one. Then same applies for education that you mentioned.
  283. So how do you intend to deal with the "free rider" problem then?

    Let's say 90% of the townspeople vote to pay for daily garbage collection in public spaces. The holdout 10% get to enjoy clean streets without paying anything. Does that sound reasonable to you?
  284. Nope, just as I wrote on my last post(I added a part), the ones who opt out, simply will hire another service to collect their garbage. The problem is that you're still held up in the principle that if a maggiority votes, then it makes sense to impose this on others. That doesn't work and should be held to a minimum. The criterea is: if it can be self regulated by free markets, it doesn't need and IT SHOULD NOT be put to vote, since private enterprises competing in a free market are the best way to handle these.
    Police, justice department, national defense can't be regulated by a market, so they are a necessary evil (even though there is a great proposed alternative even to these systems, except national defense, in the book called The Machinery of Freedom - David Friedman).

  285. Arguably it's reasonable if it's what the 90% who voted for it accepted as the outcome in their voting?

    Even agreeing that monopolies tend, overall, to lead to low quality and high prices - which doesn't seem contentious to me - if you advance the argument you've stated above enough, you can use it to contend that any democratically-arrived-at decision by a big majority is, by definition, "communist" (and you virtually have).

    Not to mention international relations - kind of relevant, in these days of anti-terrorism co-operation, and maybe climate/energy policy, too? (I say "maybe" for climate policy to allow for the fact that some extreme Libertarians are also global warming deniers).
  286. Not virtually, I literaly stated that. Democracy is simply a tiranny of the majority. It is admitedly slightely better then "typical tirannies", but it is still a horrible system because it incurs in the same errors: forcing people(normally a vey large group) against their will. 10% of a 300.000.000 people country is 30.000.000 people. Only an idiot would believe that forcing 30.000.000 people to act against their will is "right" just because the other 270.000.000 voted so.
    As Hayek said:
    "Democracy is essentially a means, a utilitarian device for safeguarding internal peace and individual freedom. As such it is by no means infallible or certain. Nor must we forget that there has often been much more cultural and spiritual freedom under an autocratic rule than under some democracies and it is at least conceivable that under the government of a very homogeneous and doctrinaire majority democratic government might be as oppressive as the worst dictatorship."
    An interesting view from a true libertarian(in the literal sense of the word, not related to the Libertarian Party) that does not "deny" global warming, if you're interested.
  287. Let's say I am one of the holdouts that just doesn't want to pay anything for any service? What happens then?

    As to your broad comment, "held to a minimum" is a rather vague statement. Can you please explain to me how you think it should work in the specific hypothetical example I've given? How can "private enterprises competing in a free market" help in this particular case?

    As to the choice of areas that are perceived by a particular community to be "necessary evils", isn't that something that should be left to the citizens to decide? For instance, in the most famous example of a direct democracy, people in Switzerland hold pretty regular referendums on a whole variety of subjects.
    Agreed, but do you really think people are happy to accept widespread "free-riding"?
  288. I did explain. You should read the post. I was very specific: National Defense, Police and Justice System. Everything else should be completely privatized(because everything else can be regulated by free markets). If you don't want to pay for any service to collect garbage, your house will just become a big garbage storage, a dump, that is your choice. There is no "free ride", you either pay it or you don't get the service.
    And if the smell starts to bother your neighbors, the necessary evil called "justice system" will have the power to punish you for it.
  289. Firstly, please note that my hypothetical question was about clean public spaces, not your private property. Therefore you haven't actually offered me any specific solutions.

    Secondly, like I said, why do you get to choose what should and shouldn't be public in my community? Isn't that a form of tyranny in itself?
  290. Your community can define whatever it wants, how it wants, as long as EACH AND EVERY person that lives in it agrees(which is praticaly impossible, but let's assume that you managed to make a miracle). In this setting, your very small community may decide whatever it wants regarded to garbage collection and if it accepts "free riders", no problem, they each pay for the free riders voluntarily. If one member does not agree with this, he simply gets out(which makes your miracle increasingly smaller):D.
    If you're not in your community and you throw your garbage in public spaces(which is another matter, since government should hold no property), but taking today's reality, you'll simply be punished by the justice system(again).

  291. Not so much ... but there are one or two examples where they probably are, over issues which (generally for "bad" reasons) have become "sacrosanct" to the popular will - I was thinking of the UK's national health service.
  292. But what if my community decides that we don't want to accept "free riders"? In fact, my community gives you the freedom to choose whether to live in it or not, but if you choose the former, you would have to abide by the rules set by the majority. What is wrong with this approach and how is it worse than what you suggested?
    Agreed... Just another example of how nothing is ever about simple "black and white".
  293. Nothing wrong with it... In fact, that is exactly what I propposed. If you read my last post, you'll see that this is exactly what I said.
    The point is: people can opt out.
    In a single payer system, people can't.
  294. Well, my suggestion, if you read my last post, was actually different to yours... I was saying that if people want to "free ride", they're free to opt out of living in my community. Conversely, if they choose to live in my community, they agree to abide by the rules set by the majority. As far as I can tell, this isn't tyranny, according to your definition.
  295. Let me copy the part of my post that explains exactly that... (That is the second time I'm showing you the same thing, so this is getting kind of boring.)
    "Your community can define whatever it wants, how it wants, as long as EACH AND EVERY person that lives in it agrees(which is praticaly impossible, but let's assume that you managed to make a miracle). In this setting, your very small community may decide whatever it wants regarded to garbage collection and if it accepts "free riders", no problem, they each pay for the free riders voluntarily."
    The same concept applies if they don't accept "free riders", which is what I talked about in the first place: if they don't pay, they don't get the service.
    If the individual chooses to live in a way that he will accept the will of the majority, even if that means accepting things that he thinks would be better otherwise, it's OK, because AGAIN: he CHOSE to do that.
    Even though he is living in a collectivist community, it is his INDIVIDUAL CHOICE to do so, therefore, no problem at all.
  296. Fantastisch! Doesn't this mean you're OK with the will of the majority and democracy as a result?
  297. Boy... you're slow...:rolleyes::confused:
    No, not at all... The system you described states that people can OPT OUT.
    In a democracy, the will of the majority is IMPOSED and you CAN'T OPT OUT.
    That is the problem with a single payer system: The government FORCES EVERYONE to pay, there is NO CHOICE.

  298. There are some possible ways round that.

    For example (i) a voucher system; (ii) a tax rebate for those choosing not to use the service they've paid for through their taxes and using another one instead.

    Both have been suggested but not tested in the UK. They're not administratively easy, they have some complications and anomalies, and they cost something. (And at least in the UK, where there's a cultural assumption of the "right" to a fairly high standard of healthcare that's free at the point of consumption of the service, they're unpopular ideas.)
  299. Firstly, there's no need to get personal...

    Secondly, what are you talking about when you say "NO CHOICE"? Haven't we just talked about it? You're free to opt out of living in my democracy and go somewhere else, if you don't like the rules imposed by the majority. There, you can opt out, there's no problem.
    There are all sorts of arrangements that aren't necessarily "single payer". For instance, Switzerland has universal coverage healthcare w/o a single payer system. The main feature of all of those arrangements, however, is that they're mandatory, i.e. they invariably involve the majority imposing its will on the people.
  300. There is no need to complicate things... These will involve bureaucracy, unnecessary costs and inefficiency... The rebate doesn't work, because what you end up paying for the shitty services, bureaucracy and mismanagement is always way more then the rebate you get and the government will ever increase the "basis" you have to pay...
    The voucher would be a lesser evil, since it would promote competition at least, but it is still a very poor choice because it doesn't allow the type of personalization that health services require.
    These suggestions always address the point that "health care is expensive" trying to dilute costs, but nobody talks about the reasons it is expensive. THAT IS MUCH MORE IMPORTANT QUESTION, one that I addressed in my first post.
    That said, first one has to bring down costs and increase efficiency by freeing the health care market from the the unions, bureaucracy, protectionism... And then begin to really consider additional options, IF NECESSARY(WHICH I HARDLY THINK WILL BE NECESSARY).
    Here is a great lecture on the subject:
  301. Nothing personal, it's a mere reality when you have to keep repeating the same thing to someone: it's a slow person, there are plenty around, nothing new... Don't feel "privileged" by this feature.:D
    Like we discussed: when people OPT IN, they voluntarily accept the rules and if they don't they OPT OUT. If you are born somewhere with these rules, you didn't opt in. In the U.S. there is at least close to half the population of the country that is in this situation. Surely you wouldn't suggest that all these people leave their property, work and everything else just because the other half of the country voted to impose something on them.
    The example you posed was a community of people that each and every individual VOLUNTARILY joined in the first place. This has nothing to do with a whole country, where such unanimity would never happen in the first place.
  302. Firstly, life is full of phenomena where you are born, you didn't opt in, and yet you have to abide by the rules imposed on you by either your family or larger society. I sure hope you won't argue that this is everywhere and always a bad thing (far be it from me to suggest that it's always a good thing).

    Secondly, are you suggesting that what matters is what percentage of the population votes for or against something? So if a decision is a 90:10 split, it's OK for the 90% to impose their will on the 10%, whereas when it's 55:45, it's not?

    Finally, no, the example I have given is a case where people who don't want to voluntarily join are free to opt out of living in the community. I really don't quite see how it's conceptually any different.
  303. Sure I would argue with that. If I don't agree with my parents, I must be free to not abide by the rules they impose me(think radical muslims, it is easy to get the idea). Not only I say that this is a right of the son/daughter, but it is essential to freedom. Being born in a place and having to follow the rules of the place is one of the saddest phenomena in this world. Look at the Middle East, Africa, Eastern Europe and increasingly the west. It easy to see how much pain and suffering not being able to opt out of the rules of the place you are born bring.
    This is the part where again, your speed isn't helping you again... I've stated several times exactly the opposite: it doesn't matter the size of the group... The individual is the smallest minority and this is the only minority that has to be protected against tyranny.
    You, on the other hand, by suggesting that if people don't want to live in "your" democracy, they can "opt out" by leaving it. This is very reminiscent of Hitler, who through "his" regime, decided that the jews and everybody that didn't want to opt in by the rules of his regime, should leave the country or die.
    It's curious that you think that the only way people can opt out of "your" democracy is by leaving their private property behind and leaving the country/community.
    I, on the other hand, stated clearly that everyone can do what he/she wants, including live in communities, as long as they don't force others to do something.
    So there is more than one way to "opt out" and the one I'm defending is presuming that firstly: you ACTIVELY OPTED IN. If you didn't, you have to decide if you want to or not. And if you don't want in, the second essential part is that if you're not living on a tyranny, you can simply not be part of the community and still live in the same place and not be threatened for your choice.
    This is what I've stated again and again, but you seem to choose to ignore.
    You insist in "your" democracy/tyranny, where one doesn't opt in and if you don't accept the rules, you have to move out in order to live the life the way you want.(That is the definition of communism and your ideas are very similar to those of Stalin's or Mao's). :)
    Your example began stating that people get together VOLUNTARILY in a community and now you're stating that people born and not choosing to be a part of it must follow the same rules equally. These are completely opposite situations.
  304. wow... if you can't differentiate between those two types of mortality I don't know where to begin. So I won't.
  305. Interesting view... I'm curious, do you happen to have any children of your own?

    If you do or you intend to, I think you should definitely attempt parenting by honestly and wholeheartedly applying the rules you have given above and see how far it gets you.
    Firstly, where did I ever suggest that someone who doesn't want to abide by the rules should die or have their private property confiscated? My point was very simple: just like an individual has freedom and rights, so does the larger community. If an individual acts in a way that impinges on the rights and freedoms of the community (e.g. by free riding or by committing an injustice), the community has the right to defend itself. Especially because such an individual has the freedom to reside somewhere else, if they don't like the rules. I don't see how this notion is fundamentally different to the example I've given.

    Finally, why do you insist on all the emotional labels? You've now told me that I am "slow" and compared me to Hitler, Stalin and Mao and you really love the term tyranny. Why not be a little less dramatic? I don't think there's anything all that totalitarian or crazy about the simple statement that one should try to find a place to live where they're comfortable with the rules. If you dislike all rules, you can exercise your right to live off-grid in a forest somewhere.
    Well, no, these are not opposite situations at all, simply because you don't get to choose the circumstances of your birth. When you're a minor, your parents/guardians get to make decisions for you. You can assume that your parents/guardians are in a given community voluntarily (if they weren't, they'd be somewhere else) and therefore so are you. When you're no longer a minor, you're free to make a voluntary choice about staying or going. If you choose to stay, the rules apply.

    Regardless, it doesn't look like we'll agree on this subject, so I am happy to move on...
  306. A "community" is an abstract concept, it doesn't exist and therefore it can't have rights and freedoms, only people, individuals can have that.
    There is no drama. I'm being literal. What you are stating is that "a society, greater good, or anything collective" may have the right to impose something for a given individual, that is simply wrong and that is the basis of every totalitarian regime there was in history.
    I never talked about confiscating anything, you simply said that if people want to opt out, they had to move. That implies that if an american, who was born in the U.S. and never opted in for all the socialist programs that have been implemented in the U.S. along decades should move out, since the majority voted for them.
    I've stated again and again that there is no free riding in a system where everything is private... On the other hand, the system which you defend is full of it... Never in the history of the U.S. there were so many people living at the expense of others, producing nothing and just living like parasites, exactly because of the collectivist ideas that you defend. Yet, the people who sustain all of this cannot opt out e stop paying and sustaining all those parasites. It's easy to see the if a part of the country can vote to make the other part sustain them and get nothing in return, that is exactly what they will do(and did). The problem is that again, this goes directly against the individual freedom of each person that delivers the money under threat of arrest and they never actively agreed to this. So your solution is that people that never agreed to this situation move to another country because of an obligation that they didn't individually sign up for and that was imposed on them by others.:rolleyes:
  308. as to Buffett, I don't listen to his social commentary until he voluntarily pays at a higher tax rate than his secretary.

  309. There are actually a number of other areas at which it's pretty good, in addition to emergencies (much cancer treatment, most ophthalmology, etc. etc. ... it's actually relatively common for highly insured people with some kinds of cancer to be advised by their oncologists - given the choice - to have all their treatment in NHS hospitals rather than in the private sector, but this is never reported in the media; not by The Guardian and not by Fox News either ... I could go on, but it's mostly opinion, ultimately).

    In my opinion, neither The Guardian nor Fox News is anywhere near being a fair, balanced or reliable source for "news" about the NHS: each has its own very different incentive for making out that the NHS is a disaster area, at the moment.

    Hence (in part) my comment many pages back about it not even being possible to discuss it very productively unless and until the thing's completely de-politicized.

    My own view is that in general, over the last few years, the NHS has been doing pretty valiantly, all things considered, in extremely difficult circumstances largely not of its own making (in fact almost entirely not of its own making) and deserves rather more credit than it gets. Again, it's all ultimately opinion only, though. [​IMG]
  310. I totally agree with this...

    Since I've lived in the UK for many years, I have quite a bit of direct experience with the NHS. I also know about other people's experiences. I actually think it's amazingly good at some things (e.g. treatments for serious conditions). At the same time, it's shockingly, inexplicably inefficient and poor at some things which are a lot more basic. Like @Xela says, given the aging of the population and all the other issues, the system has coped pretty well, all things considered.
  311. what about the future? can it continue to obtain nurses and personnel from 3rd world countries, which in itself may raise moral issues in some people's mind.

  312. In the short term, perhaps. In the medium and longer term, they plan to train more (and should probably offer to pay their college fees, to do so, in my opinion).
  313. By that measure, 99% of the population has grit
  314. 20 trillion is also about what our annual GDP is.

    Now just as a small example, suppose that I make $100K per year and that I owe $100K on my house (a 30-year loan, like Treasuries). Is that such a big deal? No, even when you consider that I personally don't have the power to tax or to manipulate the dollar, and that my credit rating, however stellar, still is less impressive than that of the US.
  315. I was referring to her making a living as an artist. Not sure if 99 percent of the population could do that. But she could be waiting tables...
  316. Not a good analogy.
  317. He is not required to NOT pay a dividends to shareholders.

    His accumulated wealth (and those shareholders who do likewise) and pass most of this on to charity avoid income and capital gains taxes. He cries about the rates but then does everything he personally can do to avoid paying them.
  318. EUROPE
    Theresa May Apologizes for Delays in Britain’s Health System

    Continue reading the main storyShare This Page
    • day after denying that the National Health Service was facing a crisis, Prime Minister Theresa May of Britain apologized on Thursday for delays throughout the health care agency as it scrambled to cope with a particularly difficult winter season.

      “I know it’s difficult, I know it’s frustrating, I know it’s disappointing for people, and I apologize,” she said in a television interview after being asked if she would be happy if a relative were put through the delays that patients were facing.

      A flu outbreak, colder weather and high levels of respiratory illness have put an unusually severe strain on the N.H.S. this winter, forcing the service to postpone thousands of nonurgent surgeries and outpatient appointments to free up hospital beds and staff.

      And all that comes against a backdrop of years of austerity-driven budget restraints, as well as staffing shortages that many health experts attribute to the anti-immigrant atmosphere fostered by Britain’s withdrawal from the European Union, which is driving foreign health care workers back to their home countries.

      In several emergency wards across the country, patients are having to wait more than 12 hours before they are tended to by a health professional. Hospital corridors are brimming with patients waiting for wards to be freed up, and nonurgent cases are being referred to pharmacies or general practitioners.

    ***the Socialists are running out of your money
  319. A VERY powerful man called this behavior "smart."

    40,000,000 people agreed with him.

    Further, it's not hypocritical for Buffet to call for a single payer health system and to prudently manage his taxes. Unlike you, he pays a substantial portion of the health insurance for hundreds of thousands of his employees. So by your own logic, you should not be opining on healthcare as you don't pay nearly as much as he does.
  320. We will have to agree to disagree on this one, I'm afraid...

    I suppose this is a debate as old as human civilization itself, so I doubt that I can contribute anything meaningfully new to it. Neither could I hope to convince you that you're wrong, given that so much has been written on the subject by much better people than I could ever hope to be (starting with Aristotle).
  321. We don't have too... I really couldn't care less. And people like you are the reason the famous 2nd Amendment was written. Anticipating that government can always become increasingly tyrannical, if it gets to a point where it is unbearable, people will have the means to fight back.
    "A well regulated militia being necessary to the security of a FREE state, the right of the people to keep and bear arms shall not be infringed."

    I really hope that it never reaches that point, because it would be a tragedy. But if it does, those who really believe in freedom, personal responsability and individuality will be there to stand against all this nonsense that keeps creeping into their lives.

    It happened before and for the same reasons that are being discussed, so if necessary, it can happen again...
  322. I think Buffett has repeatedly proven himself to be a better big-picture guy than anyone you know or have even heard of.
  323. A VERY powerful man called this behavior "smart." - Trumpie the Apprentice?

    40,000,000 people agreed ...... - What nonsense are you referring to?

    As for how many people Buffett pays the health insurance of .. it is none.

    Private company health insurance just like salary are earned not given.
  324. If you look hard enough you'll discover your referenced sentence is the lead into the article. It has nothing to do with my personal views. I post articles for one reason only, in order to judge the temperature of the discussion they generate. ET is a quite adequate social laboratory reflective of disparate points of perception.
  325. My apologies, then. The tenor of the opening comment was dismissive, and I just assumed you concurred since you posted it and did not bother to comment otherwise. I will try to be less presumptuous next time.

    But now that you brought it up, where do you stand on Buffett's position and zerohedge's disparagement of him?
  326. Banjo - To make that clear it would have been better to include the headline banner again in the first post as well. I also mistakenly thought that the thread topic was your sentiment and will keep in mind why it is you posts these articles to begin with.
  327. Donald Trump in the second debate where he said his ability to lower his tax rate to single digits made him smart (and not unqualified to be president). 40,000,000 people voted for him to be president.

    Private company health insurance might be a form of compensation, but it's still health insurance that is purchased and managed. Wouldn't it be better if he could just pay people more instead of having to buy health insurance for them because they can't do it themselves?
  328. 40,000,000 voted against Shillary not for Trumpie the so-called "lesser" of two evils. Yup you are correct if you believe I didn't vote for either. I did write-in vote for another "losing" but actual Republican.

    At one time private company health insurance was a lot more affordable than currently ("life was simpler then") so companies provided it as just another perk but like any other business expense it had to be rationalized. When the free market is allowed to function properly companies compete for workers over time with expanding and contracting salary AND benefits packages. Neither is ever given.

    Of course all things being equal group rates are lower but even so if a company has expenses in running such a group that expense again has to be rationalized (and might tax efficient to boot wink, wink) otherwise they wouldn't do it. Even if they are a mid-western grandfatherly type. Bottom line above all else after all.
  329. As a Libertarian, I used to think as Friedman did. Friedman is talking here of the "free enterprise"* solution to unaffordable medical care costs. He is speaking of the evils of what economists now call "regulatory capture." I think he is correct in regard to regulatory capture. If, in the U.S., we simply moved to Single Payer without addressing the problem of regulatory capture we wouldn't accomplish much.

    His assumption, however, that high cost (~1965) is due to advances in medicine and people demanding more sophisticated medical treatment is on very shaky ground, though it is a popular assumption made by those trying to find excuses for our absurd medical costs.. It ignores today's reality that medical care is just as sophisticated in the other developed nations as it is in the U.S.; yet costs in these other countries are far lower. It is more likely, IMO, that high costs in the U.S. are to a significant extent due to regulatory capture favorable to providers in combination with the buyer, i.e., the patient, not being able to walk away from a deal they don't like. The latter is characteristic of medicine everywhere, but the regulatory climate is far different elsewhere. It is far less favorable to providers. I think Friedman is both right and wrong. He is right about regulatory capture holding up prices, but wrong about the cost effects of advances in medicine. This latter factor should actually reduce costs; not increase them as he seems to have suggested. But in the presence of regulatory capture these advances can not work their magic, which would otherwise reduce costs.***

    In most countries there are prescribing pharmacists (this is a major cost saving feature that regulatory capture in the U.S. prevents, and something Friedman did not mention) and , importantly, regulatory capture, in general, is largely absent from the national health plans of other countries. Absence of regulatory capture, however, should not be confused with absence of regulation, these are two quite different kinds of regulation. Participation in national plans elsewhere is mandatory so there is true cost sharing. The healthy share the costs of the Sick. There are tight cost controls, and if insurance companies are involved, e.g., Switzerland, they are highly regulated in favor of the patient and uniformity, despite different companies being involved. The national health plan is the same throughout the entire country. (There is no opting out of parts of the plan by specific provinces to screw up the works, as in the U.S.)
    And too, while people in other countries sometimes find it advantageous to purchase supplemental insurance that augments their national plan no country other than the U.S. has duel health plans, one private the other public, which must be paid for simultaneously, but can't be used simultaneously. I'm speaking here of our way of paying for medicare our entire working lives and beyond into old age while simultaneously paying for private health insurance during our working years. No one yet has convinced me that this isn't an absurd idea. We offer up to the private, for profit insurers the low risk younger population; then we dump the elderly in their sick and waning years onto medicare that they have also paid for, while letting the private companies off the hook. Of course we wouldn't want to cut the private insurers out entirely of the profitable elderly market, so we generously let them sell supplemental policies to the elderly. In all the sane countries of the world people pay just one health premium for their Uniform National Health Plan,. We are the only country that gets to pay two premiums. This is a plan that only a "stable, genius" might come up with. I think I know where we could find one.

    The weakness in Friedman's 1965 argument, I believe, is his failure to recognize that a critical element for a satisfactory free market solution is missing in many instances of U.S. provider-patient interaction. In those instances the customer cannot shop and walk . Because of this missing component, providers, if allowed, can charge far more than would be the case in a true free market* transaction. Hence the need for regulation!; but not the kind of regulatory capture that exists in the U.S. I think our brand of U.S. capitalism, which is warping more and more toward "corporatism" or fascism with regulatory capture as a prominent feature, makes us incapable of solving our health care problems without a genuine crisis occurring first.**

    * There is a dichotomy of meaning to the phrase "free enterprise". Friedman is using the expression in the noble sense where everyone is free to enter the market on equal terms and the buyer and seller can both walk away from a deal they don't like. The other more pernicious meaning of the same phrase, "free enterprise," is synonymous with laissez faire and refers to the absence of government oversight of business so that businesses are free to do whatever they like, including form Cartels and Monopolies and lobby for regulations that facilitate capture of a market and the shutting out of would be competition. This latter definition is the business man's definition. It has also become, judging by actions rather than words, the definition adopted by certain government operatives, including many in Congress today.

    **There was a time in the U.S. prior to the introduction of Medicare, when medical costs were far more affordable (prior to the 1930s there was no concerted effort to limit the number of new physicians). There was no laws preventing a physician or hospital from turning away a patient. Most physicians, however, considered it their duty to treat the indigent as well as those who could pay. Physicians were almost all in private practice and they varied their charges according to the patients ability to pay. During the depression the attending physician at a birth might receive a freshly plucked chicken in payment! Hospitals for patients who could pay might turn away those who could not. In Cities there were separate facilities for charity patients. There was at that time a vast difference between the standard of care for the indigent and that for those of means. That would not be acceptable today. If one were to pass down the hall of the Cook Country Charity Hospital in the Chicago of the 1930's the scene with gurneys lining the walls would have been vastly different than what you would find in a Chicago Hospital in 2018.

    ***A cost factor that I omitted and Friedman did not mention (it was far, far less important in 1965) is the horrible inefficiency of the U.S. system, with duplication of tests, poor communication among providers to the same patient, mountains of paperwork and layers of personnel between the patient and an actual physician. If one was in a contest to design the most inefficient system possible, this U.S. Health delivery system is the one you would design.
  330. These two sentences are completely opposite. You are not a libertarian...
    Everything you wrote is pure communist nonsense...:)
  331. Since you have diagnosed me as "slow" in your previous posts, please allow me to reciprocate...

    I find your views quite extreme and touchingly naive (given your comment about parenting, I have to guess that you're quite young). Furthermore, your attachment to labels and names (everyone who disagrees with you is a "communist" Hitler/Stalin/Mao) suggests same. In fact, in this thread you have invoked Hitler's name twice without provocation, proving yet again that Godwin's Law is alive and well. Your basic argument is an example of a "continuum fallacy" and you have not bothered to educate yourself even slightly on the topic which many great political philosophers have written on.

    I wish you the best of luck!
  332. I couldn't care less what you think of my opinions... You think mine are naive. I think yours are plain stupid, especially considering reality. So what?
    One example of a parent who has opinions like these is the already mentioned David Friedman.
    The definition of communism is basically power centralization/big government. It's simple logic that anyone who defends any nationwide program (such as single payer) is conceptually a communist(even if he or she is stupid enough not to see it). Hayek explains this concept in "The Road to Serfdom" clearly, that allowing little government where it shouldn't, inexorably leads to huge governments and all it's problems(a look at today's world shows exactly that). So, to me, you're the one who is in great need of educating yourself by looking at the shit the world is in by allowing government growth everywhere.
    And since when must I "wait for provocation" to mention anything or anyone's name for that matter? Stop avoiding the reality and running from the fact that your ideas of allowing government to have increasing power over individuals is any different from the persons whose name I quoted. Each and everyone of them at some point had great support from people that thought that theirs was a "great idea", that's why these names are so well known today. But for some reason, those who refuse to look at history and see the actual consequences of supporting that shit, keep defending the exact same process that lead to catastrophes over and over. To me, these are the real "extreme" views, and they are extreme in many ways, but looking at history, they are particularly extreme in one feature: stupidity.
    "Insanity is doing the same thing over and over again and expecting different results."
  333. Indeed, none of it matters... Like the old adage goes, opinions are like assholes, everybody's got one. We will just have to live with the fact that our opinions differ. I am pretty sure that I should be able to handle that.
  334. Exactly... The difference is, that I have no problem with your opinions(as idiotic as they may be) and in what I describe, there is no problem in you having your opinion and living by your ideas.
    But the only way to make your ideas possible is by forcing others to do things they don't want to do(feed parasites is one of the best examples of this).
    This is the main aspect here.
    And if a point reaches that the ones being explored can't take it anymore, the parasites that live by your rules will have to put their lives on the line to keep living at the expense of others(as it has happened before in the American Revolution).;)
  335. That would be my guess as well.
  336. Who gives a shit? Milton Friedman died at 96 saying these exact same things, David Friedman, his son, who is 72 and a parent, continues to defend even less government than his father to this day.(as I already mentioned)
    (Useless)Attempts to disqualify arguments by addressing "age" or "being a parent or not" are typical of those who aren't able to sustain their arguments through logic and because of that try to change the dicussion from the subject to the opponent.:finger::D
  337. I'm also guessing you can't get enough of the sound of your own voice.
  338. Again: Not being able to sustain your arguments through logic, you attempt to change the topic to me from the subject. I am not the subject here.;)
  339. I wonder how you'd feel about Friedman if you were a Thalidomide baby:


    As for Hayek, http://blogs.reuters.com/macroscope/2011/11/09/how-keynes-beat-hayek/

    You have a penchant for ideologues and dogma. Some people never grow out of it. Whatever faults you think Keynes may have had, he walked the talk and was pragmatic. He understood the economy better than his detractors, put his money where his mouth was, and became rich. He was a fairly active trader in his day who traded in accordance with his own understanding of the economy. Can you say that about either Friedman or Hayek? (Hint: no.)
  340. I don't base my opinion on sensasionalist headlines, only children and morons do that, because they draw opinions on emotions and not logic... The answer to your post is simple:

    Furthermore, again, making it clear how every centralized/big government action is a bad idea. I quote a part of the text from "Free To Choose: A Personal Statement", which speaks about the Consumer Products Safety Commision(it is interesting to note especially the highlighted part of the text at the bottom, which makes it clear how it applies to any product, including thalidomide, and that governments actions, are subject to errors just as companies actions, because they are made by people in both situations, but when government makes a mistake, because of centralization, the consequences are ALWAYS of catastrophic proportions if compared to private companies):
    "In August 1973, only three months after starting operation, it "banned certain brands of aerosol spray adhesives as an imminent hazard. Its decision was based primarily on the preliminary findings of one academic researcher who claimed that they could cause birth defects. After more thorough research failed to corroborate the initial report, the commission lifted the ban in March 1974."15 That prompt admission of error is most commendable and most unusual for a government agency. Yet it did not prevent harm. "It seems that at least nine pregnant women who had used the spray adhesives reacted to the news of the commission's initial decision by undergoing abortions. They decided not to carry through their pregnancies for fear of producing babies with birth defects."16 A far more serious example is the episode with respect to Tris. The commission, when established, was assigned responsibility for administering the "Flammable Fabrics Act," dating back to 1953, which was intended to reduce death and injuries from the accidental burning of products, fabrics, or related materials. A standard for children's sleepwear that had been issued in 1971 by the predecessor agency was strengthened by the CPSC in mid-1973. At the time the cheapest way to meet this standard was by impregnating the cloth with a flame-retardant chemical—Tris. Soon, something like 99 percent of all children's sleepwear produced and sold in the United States was impregnated with Tris. Later it was discovered that Tris was a potent carcinogen. On April 8, 1977, the commission banned its use in children's apparel and provided for withdrawal of Tris-treated garments from the market and their return by consumers. Needless to say, in its 1977 Annual Report the commission made a virtue of the correction of a dangerous situation that had arisen solely as a result of its own earlier actions, without acknowledging its own role in the development of the problem. The initial requirements exposed millions of children to the danger of developing cancer. Both the initial requirements and the subsequent banning of Tris imposed heavy costs on the producers of children's sleepwear, which meant, ultimately, on their customers. They were taxed, as it were, coming and going. This example is instructive in showing the difference between across-the-board regulation and the operation of the market. Had the market been allowed to operate, some manufacturers no doubt would have used Tris in order to try to enhance the appeal of their sleepwear by being able to claim flame resistance, but Tris would have been introduced gradually. There would have been time for the information about Tris's carcinogenic qualities to have been discovered and to lead to its withdrawal before it was used on a massive scale."
  341. No, everything that is written and showed there was pure logic and facts, written by one of the most recognized economists of this world...
    First of all, who are you to tell me when I'm going to talk about something or not?:finger::D

    As for Hayek/Friedman/Keynes/me, again, personal attacks to one or the other has nothing to do with ideas. If one was rich or not is irrelevant, I'm talking about LOGIC, IDEAS here... Not this or that guy, you again attempt to invalidate arguments from one side by performing personal attacks/references, because you cannot sustain your ideas through logic.:D
  342. How's this for an idea:


    Milton Friedman, who has died aged 94, was not the most important economist of the post-war era - that title belongs to the brilliant Paul Samuelson - but he was certainly the most controversial. Yet despite his views being championed by so many politicians on the right, it may come as a surprise that Friedman's career as a policymaker largely ended in failure.

    Given his status as a long-standing hate figure, the assumption by many of the left is that his agenda was cemented into place during the Reagan and Thatcher administrations in the early 1980s, especially Friedman's well-known view that inflation is solely influenced by changes in the money supply. But very few of Friedman's most cherished proposals were ever put in to practice. Of those that where - such as monetarism - almost all turned into failure.

    The great irony for Friedman's fans is that the one piece of public policy he was responsible for that was widely and internationally adopted was one that greatly increased the ability of central governments to collect taxes - a policy he later repudiated in disgust.

    Obituaries of Friedman will doubtlessly sing of his successes. But close examination will show them to be few, and none unalloyed. For all his high public profile - thanks to his regular column in Newsweek and series on US television, Free To Choose, which made him into something of a star - today no mainstream academic economist is a monetarist and Friedman left no lasting school of academic heirs. Even the "Chicago school" at the University of Chicago has waned in influence, eclipsed by the mighty MIT army of economists that followed Samuelson.

    Of course Friedman is greatly respected for his theoretical work as an economist, especially on his analysis of the role of money, the importance of inflation expectations in wages and employment, and perhaps his most lasting contribution (it could be argued), the permanent income hypothesis, which suggests that households take a longer view of anticipating their past and future income than previously thought. His award of a Nobel prize in economics was richly deserved - even if he was churlish in accepting it (he said after winning: "I would not want a professional judgment of my scientific work to be those seven people who selected me for the award").

    In terms of the policies he inspired or influenced, however, the report card is not so glowing. His great claim, the idea that "inflation is always and everywhere a monetary phenomenon" may have set off the Monetarist versus Keynesian "econ-wars" of the late 1970s and 1980s. But Friedman's ideas of directly targeting the money supply were tried and rejected as a failure, in both the UK and the US, and Friedman himself backed away from his dogmatic earlier positions. Today, no major central bank directly targets money supply data in setting monetary policy - instead they are far more pragmatic. Even Friedman's great admirer Alan Greenspan never tied himself to the monetarist mast, preferring to keep his options open.

    Friedman also railed long and hard for school vouchers to be adopted, to little avail, and his libertarian leanings provoked him to call for recreational drugs and prostitution to be legalised. He lobbied against environmental protection and regulations of all kinds, the vast majority of which were happily ignored by his friends and enemies. Even the economic reforms in Pinochet's Chile he is said to have inspired have run into trouble.

    Friedman's first big role as a policy advisor came in 1964 to Barry Goldwater - the least successful Republican presidential candidate in the last 100 years. His next gig was for Richard Nixon - an unsuccessful president in a different way - although Nixon ignored him when it mattered, except when he could use Friedman as cover for politically difficult decisions, such as ending compulsory military service.

    And Friedman's one success? In 1942, during world war two, Friedman actually went to work for the US government. While there he helped design the payroll tax that in Britain is known as PAYE, Pay As You Earn, and in the US as withholding tax, the system that allows the government to administer the taking of income tax directly from salaries and pay packets. Unlike everything else he argued for, withholding tax was withstood the test of time and is in use all around the world. It was the best thing that Keynesian-style government could ever have wished for, and Friedman bitterly regretted it. In his memoirs he wrote:

    "It never occurred to me at the time that I was helping to develop machinery that would make possible a government that I would come to criticize severely as too large, too intrusive, too destructive of freedom. Yet, that is precisely what I was doing. [My wife] Rose has repeatedly chided me over the years about the role that I played in making possible the current overgrown government we both criticize so strongly."

    Rest in peace Milton Friedman, big government's best friend.
  343. As for Hayek, his faith-based philosophy is not even internally consistent, and neither are his adherents, as I posted earlier:

  344. Wow, a personal attack from a leftist newspaper to Milton Friedman.:rolleyes: As I told you more than once: personal attacks are the last resort of the person who can't argue through logic. Everything I wrote up there was based on facts, argueing against your thalidomide fact. NOT ONE POINT were you able to counter-argue through logic... Everything you were capable of until now was this: opinions and personal attacks/referrences...
    Let me know when you're up to the challenge of arguing with logic.;)
  345. A chronology of his career is a personal attack? I guess you don't think that highly of his contribution either, then. Who knew.
  346. Fuck his life... All I care about is his ideas, which are based on facts and logic.
  347. As presented in the chronology, his cherished ideas failed and have been largely dismissed even by those who admired him.
  348. As written in the article(one of the few parts that is based on facts): his ideas were not applied... (no surprise, since the ones responsable for applying it are government officials a.k.a. idiots).
    And the ones who were "tried" were distorted to the point that he rejected what was actually put to effect.
    So, again, the point is: these ideas are based on facts and logic, which I showed on the answer to thalidomide, which you still haven't counter-argued. This is what matters.
  349. This is the guy who would not have intervened when the Thalidomide problem surfaced; he would have waited for the company that made it to go bankrupt. You know, the Invisible Handjob.
  350. Monetarism was never applied... He proposed a steady increase in the supply of money in a fixed % related to the GDP, he also proposed to limit by law government spending. None of this was ever put to practice... QE's "packages" and constant approval by government of increases in "debt ceiling" are not the proof that the idea failed, but another proof that they were never applied.
  351. And again: fuck the guy. Your personal attack towards him didn't counter-argue his idea on the thalidomide/FDA subject.
  352. Now you're just being silly... But that's OK, since that too shall pass.
  353. I can just as easily present to you the same arguments and facts that he used that prove that printing money is the real source of inflation. Here is were he shows it(not a matter of opinion, it is all backed up by data):

    In the long run, the quantity of money simply adjusts itself to the quantity of goods and services. The problem is basically surges of money printing which make prices artificially go up, which in turn stimulates business investment and when the lack of real demand is perceived, recession and instability kick in. This, in turn, calls for another money printing spree and the process renews itself. Not to mention the descrease of lack of buying power of the population, considering that salaries take very long or not even are adjusted to compensate the increase in the quantity of money. Brazil's example during the military regime, which he mentions on the video is a great example of that. The government printed tons of money for "faraonic projects" such as Itaipu and Transamazonica, which made such a steep increase in inflation.
    In other words, the quantity of money per se is not as important as the speed.
    Furthermore, interventionist policies are not reduced to money printing. This takes us to the argument of the 2008 crisis, in which, as the crisis of 1929, the "role of savior" from government is well spoken of, but the fact that government was the cause of it is not mentioned in mainstream media. The manipulation of interest by the FED is the main reason for the housing bubble... Had the market been free to adjust the interest rate, such a situation would never have happened in such proportion. All of this is, again, quite well documented in "A monetary history of the United States", which again, makes this arguments backed up by data.

    AND HOW ABOUT COUNTER-ARGUEING my thalidomide/FDA answer to your post with actual facts and logic? I'm still waiting for it, even though I commented it on every post since then.:)
  354. How about a real counter-argument, instead of a meaningless personal opinion?:D
  355. I'm a classical libertarian. Chances are you have what may be termed anarcho-capitalism associated with the current use of the term "libertarian" in the U.S. I am more, I guess you could say, a Bill Weld Libertarian than a Gary Johnson Libertarian. Perhaps if you did some reading you could sort these things out for yourself. Communism is something else entirely. You might profit from reading up on that as well. If you want to understand the classical libertarian viewpoint, I can't think of a better source than Noam Chomsky, who has spoken widely on this topic. In fact the expression anarcho-capitalist is his term for some of those in the U.S. who are wrongly describing their views as "Libertarian".
  356. I think you're obsessed with the term "counterargument." Friedman was an ideologue. His own words bury him, saving me the trouble.

    As it is some pharmaceutical companies are fast and loose with their research. And now you want to do without the FDA? Pound sand.
  357. Use the term you want... It doesn't matter, you're in favor of government controling your and other people's lives: This is SOCIALISM.
    As Ayn Rand said: "Communism seeks to enslave men through force, Socialism seeks the same thing through vote." Therefore, their goal and final result are the same. This is what matters.
  358. ...was an idiot. Have you actually read her books? I have, cover to cover. She was a pseudo-intellectual for the intellectually lazy. Make yourself at home.
  359. Cut him some slack. Every highschool wannabe philosopher dreams of being Howard Roark.
  360. No... This is a mere response to your obsession in making personal attacks/references, due to your lack of arguments based on logic and facts. Stop doing it and I'll stop saying it.;)

    As to the video: WTF?:confused: That is exactly the point... Flawless thinking from Friedman. But again... There's that "speed issue" going on with you apparently...:D
    As the logic in the video shows: YES.
  361. Again with the personal attacks for lack of arguments? :)
    No point in discussing with people who insist on doing that... Waste of my time... I hope you some day become a person who is able to sustain what you say through LOGIC, REASON and FACTS... But I realize it is very unlikely... Oh well... Life goes on... I'm done with you. Bye.;)
  362. I don't know. Didn't Dagny leave him for John Galt? Oh, wait. Wrong book. (In my defense, they're all the same diatribe.)
  363. Seriously, STFU.

  364. He's the architect who rapes the heroine in Fountainhead (I still don't get how Ayn Rand justified that).

    Anthem was a fun book. Especially as I was entering my "Rush" phase.
  365. I didn't read Anthem, but I did read Atlas Shrugged and The Fountainhead. The diatribes that pass for dialogue are interchangeable.
  366. Anthem was much shorter and more science-fiction-y. I was a wanna be philosopher in highschool. I read a lot of her non-fiction essays as well and I agree with you.
  367. I am heartened that you've read Friedrich Heyak's "The Road to Serfdom"; now you owe it to yourself to read Robert Skidelsky's "The Road From Serfdom" as well. And here for you is a beautifully written and finely argued essay by Alan Binder (Economic Advisory Counsel Head, and Fed Governor) that i can't recommend too highly to anyone arguing that "the way to fix things is to reduce the size of government." The essay is in the public domain, so it is free for you to access. At the risk of going overboard, I consider it among the most insightful essays on government written in the past 20 years -- certainly of the ones i've read. The title is: "Is Government Too Political." It can be found here: https://www.foreignaffairs.com/articles/united-states/1997-11-01/government-too-political. I was unaware of Binder's essay until recently when a well-known economist friend put me on to it.

    At a Christmas milk punch gathering (I'll have the recipe for you if you'd like it.) I was chatting with a freshly minted, Brown, political science graduate. He astounded me when he said he'd read John Quiggin's book, "Zombie Economics," as an undergraduate! This is a book I have recommended many times to my ET colleagues with an interest in comparative economics, as you obviously have. There is hardly any better, nor more entertaining, review of late twentieth century economic fads than this. As Chicago "fresh water school" economics comes in for some good-hearted merry making, I know that you, as a stalwart Friedman fan, would enjoy it as much as I did, assuming you've not read it already. And, if you have, please let me know your thoughts.
  368. And while we are all recommending books to each other to read I'd like to add:

    Where Keynes Went Wrong - And why world governments keep creating inflation, bubbles and busts by Hunter Lewis.


    Fed Up - An insider's take on why the Federal Reserve is bad for America by Danielle DiMartino Booth (formerly of the Dallas Fed)
  369. What's curious to me is that our good Dr. Greenspan is (was?) a Rand Devotee. The defects in her "philosophy" seem so painfully obvious that I can't imagine any well-read person lining up with her. Does that mean Alan was not well-read? Perhaps he had no time, what with all that Sax playing. It could explain his need to fall back on mumbo-jumbo. In any case, it seems his faith in Objectivism, and firm belief that markets left alone would self-correct relatively harmlessly was at the bottom of his failure to step in when repeatedly warned of excesses in the mortgage markets, despite his being the Chief Regulator.
  370. I think I am already sufficiently versed on the former topic, but very interested in having a look at the Booth book. Thank's for the recommendation!
  371. WAS.

    I thought I read somewhere that he gave up on all that stuff long ago.
  372. LOL Money Printer Greenspan (also Bernanke, Yellen and soon Powell) went off the track after he .... stopped following Rand, Friedman, Hayek.
  373. I think it is a bit complicated. The Fed does "print". But the decision to do so is largely dictated by combined fiscal and tax policy which is the bailiwick of Congress. The Fed has to respond to economic conditions, sometimes of their own making but far more often Congress'. And occasionally, external factors beyond the control of either Congress or the Fed dictate. The common wisdom has it that the Treasury borrows when its receipts don't match expenditures. But in actuality the Treasury spends independent of both borrowing and tax revenues. I.e., they can spend before they borrow, and do. (The Treasury pays its bills when due regardless of whether the receipts from taxes and bond sales have arrived. Bonds are issued by the Treasury, but are largely a tool of the Fed. Bonds provide both an interest paying alternative to cash and a means of maintaining reserve accounts at their target level. The bottom line is that the Treasury spends money into the economy and taxes it back out. If it spends more in than it taxes out the difference is the deficit. The best the Treasury can do in the long run is to balance spending and taxing, but in reality the U.S. will always run a net deficit over time. Deficits increase the amount of money in the private sector that available for savings and investment. When money grows faster than population and productivity grows the result is usually inflation. However there is another factor, and that is how the additional money is distributed. This I think should play a role in how rapidly inflation advances. The important thing for all of us to understand is that deficits per se are not necessarily bad. They can be both too big and too small. We are probably looking at way too big. But we are blazing new ground because we have seldom had this much stimulus so close to full employment before, with the exception of when the entire nation was on a war footing. In war time, demand is hugely boosted. And too, how do you stimulate an economy where demand is already near peak levels by putting more money on the supply side? The massive Reagan 1981 tax cuts came on the heels of a recession. That's not true of these Trump era cuts. Equities of course move up with inflation. Is the market anticipating outsize inflation down the road, or are we dealing mainly with "irrational exuberance?" The Fed will try to counter by raising the funds rate. It will be interesting to see what happens over the next few years. In any case, monetizing the debt will, in effect, pass a large part of the debt on to Treasury holders. I think this is probably what Lord Skidelsky had in mind when he said, "the people that own the debt pay the debt."
  374. I have offered you a variety of counterarguments already. Moreover, as I mentioned before, better people than I have done the same, if you only bother to look. Since you appear to be a bit of a student of American History, you may want to read what some of the Founding Fathers opined on the subject (e.g. John Adams, Thomas Jefferson, John Jay, etc).
  375. The one's you did, I already answered and you conveniently ignored what you couldn't counterargue.
    which happened after my last post: You were not able to say anything against the fact that your ideas need to force others to go against their will to work and my ideas are compatible with anything, including yours, as long as you are able to convince a certain number of persons to voluntarily join your ideas and the ones who don't want to be a part of it, simply don't and live their lives the way they want without being forced to do nothing.

    Your answer to that was just a meaningless opinion: that I'm being silly, which shows your lack of arguments against the reality of what I said.

    So, like the other guy, there is no point in argueing with people who insist in defending their ideas with mere personal opinions not relating to the subject or other ways to disguise the fact that they can't sustain their ideas through logic, facts and reason. It's just a waste of my time, so I'm done with you too. Bye.:)
  376. No free lunch. Whether the Fed or Treasury provides it.
  377. [​IMG]
  378. And this is from the guy whose last answer was: "Seriously STFU!" :D
  379. My remarks, I had hoped, were more to the matter of who is the cart and who is the horse. The Congress is clearly the horse; not the Treasury and not the Fed.
  380. And why not do it Canadian style?
  381. Then you are ignoring recent history.
  382. According to the BIS Canada is 4th worst - when it comes to debt.

    Or were you referring to how they slice their bacon.
  383. If you are referring to the Fed's role in the Financial crisis, then I will disagree. Even here the Horse was Congress, i.e., it was Congress that passed the Gramm- Leach-Bliley "Financial Services Modernization Act." Yes the fed under a different chair could have nipped the nascent crisis in the bud, but without Gramm-Leach-Bliley there may have been no crisis. At worst the crisis would have involved far fewer institutions.
  384. Remarks by Governor Mark W. Olson
    Before the American Law Institute and American Bar Association, Washington, D.C.
    February 8, 2002

    Implementing the Gramm-Leach-Bliley Act: Two Years Later

    "However circuitous the route the actions by the Federal Reserve and the Comptroller of the Currency helped reduce the final restrictions, other than the ones on insurance underwriting, that had been in the way of full financial-service integration. Thus, by the time the Gramm-Leach-Bliley Act passed through the Congress, in the summer and fall of 1999, it was long overdue."

  385. Note the date of this speech!
  386. I did. Did you read it. It is referencing what THEY, The Fed, did already.
  387. "The Congress has freed financial institutions to follow their markets and has provided the regulators with the ability to let them do so, while still requiring prudential supervision focused primarily on ensuring the safety and soundness of insured depository institutions."

    You'll note the Quote says "Congress", not the Fed. The Congress is clearly the Horse and the Fed is clearly the cart. That's the point I was entirely too subtly making. Both Rubin and Greenspan were on board with G-L-B. The speech was in 2002, 5 years before the shit started hitting the fan. These folks, Gramm, Leach, Bliley, Rubin, Greenspan and the the other Republicans pushing for G-L-B never foresaw the disaster headed for the financial industry. But plenty in Congress did. They said on the floor of the Senate exactly what would happen if G-L-B passed. Their protests were in vain against an onslaught of Republican enthusiasm for loosing the reins of controls on banks. And by god everything the Democrats said would happen if G-L-B passed did happen, exactly as they predicted. Again, Congress is the Horse, the Fed is just the cart. Clinton signed the Act in the waning hours of his presidency and we were off to the races. (The bill had been cut off at the knees numerous times before, but this time, in a "clever" maneuver, it was attached to a must pass omnibus spending bill.)
  388. Yeah, and he is “an ideal man” in Rands own words. I more or less lost any interest in her shit after that book.

    I do want a recipe. As for Zombie Economics, I read it too and felt it was a little to light on analysis, but otherwise OK.

    On topic. Realistically, every self-professed "libertarian" is very happy to reap the benefits that are provided to him by the state (it's rare to meet one that is in the income bracket where he's a net payer). I am also pretty sure none of them refuse to accept Medicare when they reach the right age. So that more or less takes care of the whole "Buffet is a hypocrite" chat.

    PS. Yes, the modern American concept of libertarian has very little to do with the proper free market thinking, just like todays Republican Party has little to do with the original ideas. Blame the shift in the "Overtons Window".
  389. You failed.

    Reread what I previously quoted specifically . "However circuitous the route the actions by the Federal Reserve and the Comptroller of the Currency helped reduce the final restrictions, ........."

    Also a snippet from Wikipedia:

    "At the time of the repeal, most commentators believed it would be harmless. Because the Federal Reserve's interpretations of the act had already weakened restrictions previously in place, commentators did not find much significance in the repeal, especially of sections 20 and 32.[14] Instead, the five year anniversary of its repeal was marked by numerous sources explaining that the GLBA had not significantly changed the market structure of the banking and securities industries. More significant changes had occurred during the 1990s when commercial banking firms had gained a significant role in securities markets through "Section 20 affiliates".
  390. 1) Realistically you don't have a clue, neither do I or anyone else for that matter, what someone else pays in taxes.

    2) Because they are not given a choice. The state has a monopoly in building in roads, except in rare cases, for example. Go down the list from there.
  391. Mary Virginia McKenzie's "Milk Punch":
    (makes 1 quart)
    1/3 cup brandy
    2/3 cup bourbon
    1 teas. freshly grated nutmeg
    1 Tbs. vanilla
    2 cups half and half
    simple syrup to make one quart, ~ 1 cup (simple syrup is one part sugar dissolved in 2 parts water)

    Chill all ingredients before mixing. Can be served over ice or not as the mood strikes you.
    Best poured from a chilled silver pitcher from before the "wah" (The civil wah of course, what evah wah is there?)
    For any respectable gathering a 4-fold multiplication of the recipe will be required. ​
  392. I don't know how many times I have to point this out to you before it sinks in, but this will be my last attempt. The Fed did not weaken restrictions until Congress acted. Citi, i believe it was, you can look it up, had bought Travelers which was illegal under then existing regulations. The Fed gave them some time to divest or otherwise resolve the issue. This threw Gramm and his boys into overdrive. Now, was Greenspan a horrible Fed Chair?, yes he was. If you had to lay fault for the the financial crisis on any one person, any one thing, other than human greed, you would have to lay it on Greenspan. He was the one person who could have intervened to prevent a full blown crisis. He steadfastly refused to because he believed in free markets in the laissez faire sense, and so the "invisible hand" would solve the problem harmlessly if only everything was left up to the market and free enterprise.
  393. I will believe the Fed's own words. Not yours thank you very much.

    As for Greenspan he was a free market believer right up his appointment to The Fed.
    The Fed by its very nature and design is an interventionist.

    Actually make that, Greenspan was never a free market believer. He just talked a good game.
  395. I have the Booth book on order from Amazon..
  396. erick_red

    Do you often add to a quoted post to make it look like someone said something they didn't?

    "But I bet you that your citizens have a better health system than ours ... and the USA is no longer in debt?"