Libertarianism

While any of that is possible, we made the simplest conclusion under the circumstances.

But, for the record Satchel's Pizza always brags about how they pay their employees a living wage.

Don't get me wrong, I see your point, I just don't agree.

Similar to the weak conclusion that people don't like Obama because they are racist. Race isn't the only factor.

Or that climate change MUST be caused by man. Sure man could play a part, but that doesn't mean it's the only logical
conclusion. Man is not the only factor.

Simple conclusions will always be debated.

Also, I stated that it was my wife's cousin. I don't have a sister, other than Sisters-in-law.

 

1. Interesting what happened here, in light of your point two. When you felt someone put words in your mouth and assigned you thoughts/motivations, you got angry and decried it as unfair. Yet you show no hesitance to do so for this waitress. Most would qualify that as hypocritical.

She could've had a number of reasons to act as she did. Maybe she thought she could earn more money by giving exceptional service to more smaller tables than adequate service to your one larger party. Maybe she was tired or feeling under the weather. Maybe she is trying to reduce her intake of all liquids other than water in order to improve her health, and doing lots of drink refills is too much of a temptation. Maybe she simply found you so unpleasant that you literally couldn't pay her to come over and do better with the refills. Or maybe it was something entirely different. Who knows? The correct answer is "None of us debating in this thread." Which makes it inappropriate for you to use it as an example, just as you rightly said it was wrong of us to assign motivations to your statements and behavior.

2. I ought to apologize here. While I started that point talking about "you" in particular, I ended with a more generalized "you" that more properly addressed the more incentive-based education reformers that you seemed to be expressing sympathy with. I should've been clearer that it wasn't meant personally.

3. Pollution: "Where monitoring data are available, low income and minority communities tend to experience higher ambient pollution levels." Overall health: "Lower Poverty-income ratio was associated with mortality after adjustment for lifestyle, clinical risk factors, and self-rated health in all racial-ethnic groups (P-trend <0.005)."

4. You said you "disagree" about the existence of a vicious circle. That doesn't mean anything. What do you actually disagree with? If you think one of her factual claims was wrong, say that. Or if you think one of assertions based off those facts was faulty, say that. We can then examine whatever specific point you actually disagreed with, and if you are in fact wrong (eg if you thought poverty wasn't associated with higher mortality, when in fact, as I have just shown, it is) then you ought to concede you were wrong.

5. Are you being serious or sarcastic here?

6. You've yet to give one that offers good support for your position.

 

Really? let's look at what was posted.

I never said that I would or wouldn't engage in that discussion.
I was responding to Matt Damon's nonsense, and I was responding to is specifically because Fire_Ice_Death posted how he "smacked down" a question. That's why I was talking about incentives, so yes the debate (the one I was addressing) was actually about incentives, I was specifically addressing his statements that the "ONLY" reason someone would take a job teaching is because they want to teach.
I never posted any comment on those specific proposals.
I never stated that teachers are lazy.
YOU put those WORDS in my mouth.


Which is completely unlike, taking notice in the two differences in treatment by customer service and observing that groups A, B, and C get one type of service, while group Y gets another type of service. All from the same individual server.
Then comparing what the differences in those 4 groups, and coming to a logical conclusion.
In fact that's what people do all the time, find a correlation then hypothesize a causation.
This is the point where I have to wonder if this thread is just one big trolling session.

I'll have to take a look on the pollution data, and the mortality data. Interesting for sure, but not really what I was getting at if I remember correctly.

about the viscous cycle
again let's look at what was posted.

Specifically I don't agree with comments on who is more profitable. (I tho

 

In answer to your point about profitability, it's quite simple, really. Are you familiar with the concept of "cost shifting?" Government payers (Medicare, Medicaid) are guaranteed the lowest rate for any medical services provided. Here is an article on the concept.

The impact is pretty straightforward. If a physician has a choice between seeing two patients, both with exactly the same problem, of exactly the same complexity, and requiring exactly the same amount of time spent/work done, they will make more for the one with private insurance than the one on a government program. Which is to say, in the most literal sense possible, it is more profitable to see wealthier people (eg, people who can afford to have insurance) than it is to see poorer people (who are uninsured, or use a government-provided health insurance program).

EDIT: Didn't see you saying you wanted to repeal EMTALA. Let me just ask more bluntly then, like anakinsgirl did, because I don't want to misinterpret you on something so fundamental. Do you think all people should be means-tested before receiving care of any sort, even in emergency situations where the time it took to make such a check could cost them their life? If so, that's. . .wow. If not, please explain whatever alternative you have to replace EMTALA and related measures.

 

In Florida, Medicaid is never a simple yes or no question. To get Medicaid to pay for nicotine patches or gum a patient must be enrolled in a 12 step program. However that might be going away since the Florida Quitline will mail patients the patches or gum for free as long as they keep on track with there phone call sessions. Currently Medicaid does not cover drugs like Chantix for smoking cessation, although they might cover off-label use of certain anti-depressants like Bupropion.

I am well aware of the problems with Government run programs. Recently I had a patient prescribed some Prenatal vitamins, we paid $60 medicaid reimbursed us something like $40. So we had a net loss of $20 plus the usual dispensing costs.
But to me that isn't "the Poor"
That's "the Government"

I understand that you are reading what I am typing, but I don't think you get what I'm talking about. Which is likely my fault as I'm not a wordsmith, but more of a math and science geek. I'm good at explaining drugs to patients, but apparently not good at explaining my personal beliefs in markets.

I watched this vid recently, one of the guests stated that he believed that "if we had a draft there wouldn't have been an Iraq War" . I understand exactly what he meant, but I disagree.

Getting back to medicine, The problem with comparing the "Wealthy" and the "poor" is that there is a huge in-between.
For example let's just say for arguments sake that 25% of all U.S. Citizens are poor enough to qualify for Medicaid.
Now if the top 1% are the wealthy that leaves approximately 74% of people that we are completely ignoring.
I tend to think of the poor as a large group and that many could afford more necessities if they would put down some luxuries,
like the cigarettes or the press on nails and eyelashes. The genuinely poor (the poorest of the poor) would be better aided by charity groups like churches etc. I have no experience with Minute Clinic or Take Care Clinic so I have no idea how they treat cash paying customers. I can say that when it comes to cash paying customers, Walgreen's is trying to get them to sign up for their Prescription Savings Club , this makes it more profitable to fill scripts for them, and cheaper for the patient. But it's not for everyone.

I have had some experience with Solantic Clinics, they are not too expensive, and they even have a 3-day feel better guarantee, they call 3 day

 

I can't do the Youtube videos, but the Libertarian Party platform seems horribly inadequate, especially as a replacement for the present system. For example, in their only real positive policy proposal (things like "decrease regulation" are so general as to have no meaning) is embracing medical savings accounts. This, I think, underestimates how expensive healthcare is. To illustrate, the median cost of a coronary bypass (and associated hospital stay) is $25,140 per a review of patients from 2003-2005. Other studies cite means that run well over $30,000.

This is over half a the mean yearly income for an American worker. Yet this is one of the most common procedures in medicine. It is unrealistic to expect that, even with a tax free savings account, someone could regularly absorb these kind of costs. Likewise, I think it is simply untrue that someone could cover these sort of costs simply by foregoing relatively cheap luxuries like cable television, make-up, or alcohol. The fact that health-related expenses is a leading cause of bankruptcy (even in people who have insurance) speaks to this problem as well. The cost of healthcare far outstrips the ability of most individuals to pay it.

I also think the models being offered don't take enough consideration of societal justice. While, in your hotel example, someone only has to endure discomfort to go without a room for a night, in the case of a heart attack, they literally will not survive being turned down for treatment. Likewise, the Libertarian platform cites laws that mandate coverage of certain conditions as a bad thing. Yet, they don't account for the fact that, absent these laws, health insurance companies would not cover them (they aren't profitable--there are too many guaranteed costs associated with treatment for any premium to make up for it), while the severity of the disease would make it impossible for these individuals to pay their own expenses. The Libertarian "plan" thus asks people with a whole array of diseases to simply suffer, unaided and indefinitely, so that everyone else can have marginally lower rates. That seems terribly skewed to me, and not a solution worthy of our society.

Ultimately, we agree that every community/industry is different, and has to seek out unique solutions. But I think part of that may mean recognizing that healthcare is not simply something handled by an unrestrained "free market." In some situations, regulation makes sense and improves things. Government involvement is at times a positive. Using a one-size-fits-all solution that automatically rejects this is in error, I think.

 

Except that HSAs aren't meant to be a solution by themselves.

HSAs are designed to cover two things: routine medical expenses (doctor visits, occasional prescriptions, minor emergencies, etc), or the deductible for a catastrophic coverage plan.

You aren't expected to pay the full cost of a coronary bypass from your HSA. You're expected to be able to use it to cover all or part of your $5000 deductible on a $100000 catastrophic coverage policy. (All numbers are for example only and are not expected to reflect the terms of any specific policy.)

That's it. It's not exactly fair to take only half of the proposed solution, treat it as the full proposal, and then declare that it's misguided.

Kimball Kinnison

 

There are actually a number of other problems. As Bush demonstrated, it's not the most efficient system by far. (He demonstrated this...by making it less efficient by taking away the right to bargain with the drug companies.) You can also see some cosmetic surgeries finding their ways onto the healthcare system, but until recently, estrogen pills (which might be useful for osteoporosis but tend to rouse the ire of prolifers) were not.

 

The Libertarians are a bit too extreme on liberty there is a reason we have laws of course.