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Tuesday, October 17, 2017
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  • Writer Login


    Put the oxygen mask on yourself, first

    by | 41 | Aug 31, 2009

    An open letter to people who will show about $150,000 gross or less on their tax form this year.

    tombstone: He was a priority for a whileThe present poverty line for a family of four is $21,834, but that doesn’t tell the story anymore. You make a lot more than that. You also have credit card debt and/or equity lines or ARM’s or contracts for services that can’t be canceled. One of you is not making the same as last year. A sane accountant looking at your situation would tell you that you that you no longer have “disposable income.”

    Sure, you have a job. Sure, your house is worth more than you can sell it for. Sure, you have assets. You’re vested in your career. But once you pay the what-you-got-to’s, there’s nothing left. You have become the middle class poor. You are the responsible, tax-paying, hardworking, never quit household that is the backbone of our country. You are better off than the unemployed of your same caste, but you are one crisis from being equal to all those other people.

    You are going to achieve. Whatever it takes. You pay your bills. You’ve cut back. No more e-bay. Wine at dinner is a memory or an infrequent special occasion. The boutique shopping for the kids has been replaced by trading clothes with friends and family, charity store visits or Walmart. You haven’t been to the dentist in a while and won’t go anytime soon. That 401-k won’t be matched this year. Your hair is longer and a color you haven’t seen since high school. If they say change your oil every 5,000 miles, it’ll probably be okay for 15,000 or so. You are one straw away from total meltdown. You, the admired among the admired, are one late fee and rate change — or, god-forbid, a medical crisis — from the poverty line. Those triple credit score dot com commercials are singing to you in every television break.

    This healthcare debate is about you. Forget the poor. Save you.

    This debate is framed by spin from all sides, none, not a one, is talking about you. You have healthcare insurance, but please, I beg you God, don’t let me get sick. Don’t make me spend the deductible. I can do a copay today, but a hospital stay? No, save it for the kids. I can’t. There’s a little room on that VISA; what the hey, I can afford to be against healthcare reform. After all, it will bust the budget. Won’t inflation take everything I’ve worked for away?

    No. Not like one pain in the abdomen. Or lump in the breast. Or a little blood in your urine. “It won’t happen to me,” you say. “I’m young.” Don’t dance with that devil. He’ll win. It won’t be long before you or yours will hear it. The age of 65 is longer away in medical insurance terms than your mortgage payoff.

    Healthcare reform is about you. About that moment, perhaps it is today, when your copay at CVS will mean you don’t have lunch money for the kids. About that moment when you have that follow up appointment you’ve been waiting three months for and your child needs medicine.

    Healthcare reform is about what happens to priorities. Your priority list a year ago could go twenty deep. Now it is a list of two. All it takes is a little chest pain to make your priority list a list of one.

    You may want to be a bleeding heart: Charity first, save the person on the phone, screw your health, whatever for the other, I’ll make time, I can match that, run for the other and walk for everything important. This is your moment to do something really important for yourself. For your family. For your friends. Because one of you, maybe not today, but certainly a day very soon, will be, for all practical purposes, poor. The working, hard-working, desperate, no place to turn, poor. The I can over achieve because I believe in capitalism and the American way gone wrong, poor. The I haven’t failed, just ran out of money at the wrong time, poor.

    This debate, is about you. Your priority needs to be, call your congressperson and senators and light a fire up their asses. Read the bills that are being debated. Decide what makes sense to you for you and tell them. Don’t listen to Fox, CNN, MSNBC or anyone else. They don’t take the crisis calls from your family. Only you can decide. This is your moment.

    ###
    Lee Leslie

    Lee Leslie

    I’m just a plateaued-out plain person with too much time on his hands fighting the never ending lingual battle with windmills for truth, justice and the American way or something like that. Here are some reader comments on my writing: “Enough with the cynicism. One doesn’t have to be Pollyanna to reject the sky is falling fatalism of Lee Leslie’s posts.” “You moron.” “Again, another example of your simple-minded, scare-mongering, label-baiting method of argumentation that supports the angry left’s position.” “Ah, Lee, you traffic in the most predictable, hackneyed leftist rhetoric that brought us to the current state of political leadership.” “You negative SOB! You destroyed all my hope, aspiration, desperation, even.” “Don’t you LIBERALS realize what this COMMIE is talking about is SOCIALISM?!?!?!” “Thank you for wonderful nasty artful toxic antidote to this stupidity in the name of individual rights.” “I trust you meant “bastard” in the truest father-less sense of the word.” “That’s the first time I ran out of breath just from reading!” “You helped me hold my head a little higher today.” “Makes me cry every time I read it.” “Thanks for the article. I needed something to make me laugh this mourning.” “If it weren’t so sad I would laugh.” "... the man who for fun and personal growth (not to mention rage assuagion) can skin a whale of bullshit and rack all the meat (and rot) in the larder replete with charts and graphs and a kindness..."“Amen, brother.”

     

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    • Myra

      Lee, you hit it right on the head. We figured up tonight that with excellent UGA insurance and my husband on medicare, our out-of-pocket medical expenses are about $8,000 a year. And we’re pretty healthy! We can afford it now, but we can’t help our kids much if they run into trouble.

      One of them navigates between two seasonal careers, one of which is lucrative but self-employed, the other of which barely covers the light bill, but includes some nominal insurance. With one visit to the emergency room, complete with cardiologist and near heart failure, they blew out the insurance and ended up with a bill close to half of last year’s income. They pay their bills, take responsibility for their child, scrimp and save. But after a c-section and the heart episode, mom is probably uninsurable. You’re damn right about lighting a fire under their asses. But it may take dynamite to move Paul Broun and our two senators.

    • Terri Evans

      Absolutely no one has pointed out this reality in the healthcare debate. Rather, as these things go, the arguments have been polarized. Thank you for reminding us “other folk.”

    • i have to believe that all of this churning is bringing much to the forefront, from discussions on racism to how easily one illness brings poverty. And my fervent hope is that finally…it will finally be “us” who make the difference..who make the phone calls..garner support…we voted in these people..now it is up to us to make them hear us…
      change is very hard…status quo makes for death..the option is really not even one..
      i heard on air america a woman say that iran is seen as one who is killing its people by war..but that no one says that here in america our legislators are also killing us by neglect. when will we finally hear that? when our last child dies for lack of health care?

    • austinmcmurria

      “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”
      Arthur Schopenhauer’s truism has kept me from getting irate/depressed about the unconscious greedy madness spewing from those opposing reform of the medical industrial complex.
      How nice that we are at least past the first stage, i have thought.
      This essay portends stage three, if the horse Lee leads to water will just drink.

    • George

      You are spot on. You describe my situation in alarming detail. I’m 6K out of pocket per year if we stay healthy. Smart guy that I am I responded to a news segment about how to modify my mortgage. I applied to Wells Fargo for a loan modification and I was approved. Bottom line, my monthly payment went up $38.00. I had to pay a $1228.00 fee to process the agreement. Last night my 17 year old woke me at 3am with a toothache. I have had feeling of impending doom all morning. I’ll take your advice and ring up all of my representation here in Florida and the bunch in Washington (all but Senator Nelson are Republican). Wish me luck, and good health.

    • Dallas

      … And breathe deeply. Point well-scored.

    • Brenden

      How in your laundry list of “unjust” expenses did you not include a gov’t that plunders 40-50 percent of your income off the top? And in return we get…? For the middle class, taxes are your largest expense… even bigger than healthcare. Unless of course you are in “poverty” and making $21,834 (!), while those of us paying the 40ish percent tax bills, our own healthcare bills also get to pay yours.

    • Myra, Terri, Ariel, Austin: thanks.
      George: Thanks and good luck.
      Brenden: I left it out because I believe this healthcare debate should be about the interests of the working as-hard-as-I-can majority and how their financial priorities can be destroyed because of healthcare expenses. I left it out because this debate should place the interests of the people over the interests of the insurance companies and provider lobbies. I left it out because I believe that if we fail to fix the system for the able and productive in our society, it will rendered any other benefit moot. I left it out because a healthy and financially stable middle class is good for all of us -- individually, businesses and our government. I left it out because I do not believe the healthcare debate should start with a debate of our tax rates, but with our federal spending priorities -- getting rid of just half the war in Iraq pays the projected tab for the house bill. I don’t argue that the marginal tax rates being applied to the middle class has been devastating (though the marginal tax rate on the wealthy is at almost historic lows). The political games of cutting taxes while increasing spending is putting our government in the same position as my middle class example (priorities rendered meaningless by unaffordable expenses). Properly done, however, healthcare reform is an investment which over time will reduce cost (some parse reduce growth) and while ensuring sustainability. Doing it wrong or not doing it all, will cost all of us more.

    • Brenden

      “getting rid of just half the war in Iraq pays the projected tab for the house bill.”

      Not true, no way, no how. Cutting off spending for a one-time war will not ever offset extending the entitlement program of insolvent Medicare. The present value of projected 10%+ cost increases compounding annually over a lifetime of millions of people living to 80 DWARFS the Iraq war cost. Especially the poor whose entire bill will be funded by Uncle Sam their entire lives.

      I don’t really support tax cuts without spending cuts either. But no one here supports slashing public medical spending — and all gov’t spending (incl. military) — to make existing programs solvent. So we’ll just continue to advocate at cross-purposes. At least tax cuts offer an incentive for individuals/firms to work hard and thus pay more taxes. But the optimal solution is ellusive…

    • Brenden: Not wishing to mis-characterize your comment, but you seem to have the position that any expansion of “entitlements” is unacceptable. Do you have room in your position to allow for reform of entitlements which could make programs more efficient or which could hold down future increases? If yes, at what point does your opposition to a public option collide with a position to limit the costs of “entitlements”? Taking that a step further, why should a taxpaying, productive member of society be denied access to an existing government program assuming that taxpayer does it voluntarily and is willing to pay the full price of admission? This article was not about expanding “entitlements,” but more to the point that the existing healthcare system has much of the middle class one crisis from being poor, bankrupt and out on the street. My argument here was about reform.
      But since we are on “entitlements,“ it is my belief that many of the programs are much more practical than altruistic. The number of poor in this country is now so high (2008: more than 38.8 million), the result of many of the ”entitlement“ programs are in crime prevention; keeping homeless off the streets; giving children of the poor a chance to one day become functioning taxpayers; and rehabilitating the underemployed to higher paying jobs -- all important to society and worth some price. If you agree, perhaps one day we can discuss what is the appropriate price for society to invest for these ends. Or perhaps, a more important subject would be how best to invest to minimize poverty.

    • minimizing poverty? what a novel thought, wait i am trying to catch my breath here, in other words, every person might indeed count?
      talk about entitlement, republicans who have upped the national debt, corporations who thrived on entitlement while bankrupting the american public and others who think that money is not only the answer, but only having money makes one worthy.
      entitlement? is that the same word as illegal thieving?
      lets talk civil rights .

    • Brenden

      No, the only reforms I will allow for are those which limit regulation and reduce spending. That is my standard of reform. Otherwise, as they have done since the 1930s the gov’t will use “reform” as pretense to loot, plunder and transfer the productive resources of the country to buy votes to sustain this cycle. Until they’ve looted us into ruin.

      Taxpayers should not have access to the public option because there should not be one. The gov’t will destroy healthcare when it takes it over. It will drive doctors out of business. The remaining doctors will have less technology, smaller staffs, etc. because they will be paid less by the gov’t. This is happening NOW! There is nothing voluntary about this program: gov’t will take over the market because its vast market leverage. Well, one aspect will be voluntary: that doctors will voluntarily leave the medical field because they will earn more and work less in other fields. Incompetents will remain in the field. Already insurers are starting to reimburse physicians at Medicare rates — doctors are losing money and going under BECAUSE of gov’t Medicare reimbursements right now. I know, you blame oligopolist insurance companies but these exist only because the gov’t won’t allow insurance firms to compete in a national market. The gov’t SUSTAINS the oligopolists. And gov’ts are killing doctors with medical legal liability costs, and so on.

      You do not acknowledge the obvious tractable economic logic of this argument. I don’t deny many people face economic difficulty — but the fault is largely the gov’t’s for increasing costs (by limiting competition… not to mention consequences of their overall fiscal mismanagement) and decreasing access (by paying below-market reiumbursements, high malpractice fees and limiting competition). You want to foment all this outrage from The Dew, but you’re attempting to direct it toward some nebulous cause of “reform” that basically is a blank check for the gov’t to “DO SOMETHING.” When you invoke needs of endless armies of poor, children, or whatever unlimited victim class you care to name — you set up an infinite claim upon the federal fisc that cannot be paid no matter how noble your intentions. We are now paying the bill for your brand toxic political logic in a crashing dollar, huge deficits, unsustainable entitlements and productive capital fleeing these shores.

      The gov’t needs to “DO NOTHING” or “DO LESS.” It needs to stay the hell away from us and our healthcare.

    • Ariel: It is pretty to think so, but we are in a tragic, though not untypical, stage in this cycle of capitalism. As a nation we have ebbs and flows. Attention and then deficit. Innovation then stagnation. Monopolies rise and fall with wage disparity following. Shoot, we once even had a middle class. Then the game begins again. You might pray for jubilee, but expect less and for it to longer than 50 years.

    • Brenden: As you know, some reforms require investment. Businesses face decision each day whether to invest in re-tooling or continue to waste capital using old methods. We are at that point with healthcare. Your hackneyed description of pretense to ruin would be comical if it weren’t so sad. If we have had so much to fear from the 1930’s (the marginal tax rate was 77% in 1918), the government does an even poorer job of looting than anything else they attempt. If your evidence against the public option is that government will destroy healthcare and drive doctors out of business, then they have failed destroying it since 1966 -- my guess is they will continue to fail destroying for the rest of my life. Some doctors are losing money, but they are doing so in an profession with a median income of over $200,000 a year. If your ”obvious tractable economic logic“ is were true (we’ve had this argument in other forums), what does it matter if the fault is government or the private oligopolists or just that it has evolved under law when circumstances have changed, why not fix it? While I admit my toxic logic carries some blame for where we find ourselves, it was the policies of Bush and Friends who refused to support the dollar, borrowed so extensively, refused to pay for new programs and hid true costs of the government they expanded -- should we just fix that? And finally, just because the last administration built on Newt’s dismantling of the competent parts of government and replaced it with political hacks and underfunded agencies, doesn’t mean we shouldn’t have higher expectations for our tax dollars. Yes, I do want to foment outrage for reform -- if for no higher purpose than to match yours.

    • Brenden

      This is what kills me with your logic, Lee. You don’t differentiate between the private and public sector at all. The whole freakin’ history of Western Civilization has been a bloody fight to limit gov’t’s control and assert individual liberty, dating from the Magna Carta to the U.S. Constitution. That you say so glibly: “what does it matter if the fault is government or the private oligopolists or just that it has evolved under law when circumstances have changed, why not fix it?” This gives the lie to your whole ideology. You are using healthcare as pretense for state confiscation of individual rights, property and liberty. You are the problem. And so the fight continues.

      Ariel: your vision of civil rights is “universal healthcare.” What number amendment is that again? Civil rights USED to mean a limitation of state power over individuals with respect to speech, association, property and guns as described in the Constitution. Now it’s come to mean an economic claim by victim classes to buy votes. You want to trade liberty for economic security, you will get neither.

      I love it when you crybabies indulge your inner angry leftist child by bleating “Newt… Bush… Reagan!” as if your sad sack of worthless Marxist ignorant looting plundering incompetents were any better so “Obama!… Pelosi!… Boxer!… Waxman!” right backatcha… Again an example of your emotive method of argumentation that exhibits the intellectual bankruptcy of your position. Keep it up, you’ve found a great place to display it…

    • Brenden: Diatribe noted. We disagree. I believe the role of government is to serve the people from whom it gets its power. People. Not, we the lobby firms. Nor corporations with their special state-sponsored status. Nor industry or employee groups. Nor religious leaders. Nor stock market indexes. Nor political parties. Nor media conglomerates. Nor polls. We the people. That is a bloody cause worth fighting for.
      History surely gives you cause for your fear, but less often in our republic. Stay vigilant, but for goodness sake, have some perspective, too. Our courts can protect your rights. Our voting booths can let you exercise your power to overthrow. We have had cycles of bad government and abuse of core freedoms, but in my lifetime, our government has seized neither my rights, my property or my liberty. If you and your group of soldiers helped with that, thank you (I hope you will also fight to protect the rights of those not strong enough to fight for themselves). Nevertheless, I still need affordable healthcare or I will lose the one thing that allows me to enjoy all the others: life.
      One last thing, I get no joy bleating the sack of names of your worthless fascist ignorant looting plundering incompetents nor do I call your arguments intellectually bankrupt for using the list you attributed to me.

    • Brenden

      Lee, if you can’t pay your doctor bill, are you then going knock on your neighbor’s door and ask her to pay it for you? And if she says, “No,” what then is your recourse? To petition the state raise her taxes to transfer that amount to you?

    • Brenden: If I can’t pay the doctor (or the hospital or the pharmacist), I don’t go. If I use the doctor’s services and find that I cannot pay, I sell off what I have to do so. If what I sell isn’t enough, I’ll try and borrow from any source I can. If I’m unsuccessful, bankruptcy is the final step and everyone loses (62% of bankruptcies in 2007 were related to healthcare costs -- 80% had health insurance). This is happening every day in America. I am one of the lucky ones. I have medical insurance, I just can’t afford the higher deductibles, co-pays, denied reimbursements and the out-of-network charges.
      When Hillary’s bill was debated, only 2% of the health insurance was managed care requiring these charges (disincentives to get/abuse care). Now it is 97%. Along with it came exploding premium costs and number of Americans uninsured. The government didn’t do that. Consumer’s didn’t have a free-market choice. The system is broken.
      I’m not asking for the government to pay my healthcare costs. I’m asking for them to address and reform the problems in the system which make it unaffordable for most working Americans.

    • likethedew.com has become a wonderful way to voice all opinions…and to listen…
      but when listening becomes merely diatribe for diatribe sake, we flounder in frustration.
      brenden, talking to you is ..as barney frank said…like talking to a dining room table.
      lee…you rock, and bankruptcy is indeed the term of the day,bankrupt morals, bankrupt country, and total ignorant bankruptcy of thought..and less we forget mercy for no one.

    • Brenden

      “I’m not asking for the government to pay my healthcare costs.”

      Well why are you stumping for a public option?

    • Brenden: Is this one of those trick semantic questions? You got me. I should have said, ”I’m not asking the government to pay my insurance premiums, but were I to opt for a public option and pay my premiums, yes, I would expect the government to pay the bills of those who provided healthcare services as called for in my policy.

    • Brenden

      I am questioning your PREMISES! Don’t dismiss that as some point of trick semantic digression — this is the essential point of your argument: that the gov’t is not supporting you. Oh, wait. You have just completely contradicted yourself. “Got you indeed,” said the dining room table.

      And what if you can’t pay your premiums?

    • Bert Roughton III

      Brenden:

      “You don’t differentiate between the private and public sector at all. The whole freakin’ history of Western Civilization has been a bloody fight to limit gov’t’s control and assert individual liberty.”

      I think you need to take a closer and more discerning look. Your view of history is a regrettably narrow one. You are so concerned with this vague, amorphous and, as far as I can tell, meaningless, threat of tyranny from above that you fail to appreciate the actual things that are happening to actual people in this actual society.

      In a world where power and money are so heavily concentrated in tiny, elite segments of the population, this distinction between government entities and private entities matters less and less when we are talking about the protection of liberty and individual rights in America. You want the government to do nothing, you want the government to back away and let us “free” “independent” people compete and work it out amongst ourselves but YOU don’t differentiate between those with money and power and privilege and those without. This is the distinction that matters in this debate. Without some regulating force, without some mediating entity, the former will devour the latter (or at least relegate them to an even more profound state of irrelevance) every time. This isn’t some desperate indulgence. This is fact. What about the confiscation of individual rights, property and liberty by private entities? What about the growing chasm between the rich and poor in this country? These are trends which have led to some miserable consequences for millions of people in this country… and they’ve emerged in the wake of decreased government intervention.

      The issue here isn’t public vs. private. The issue is here is about individual worth -- whether people are able to live their lives with the dignity and opportunity that every human being deserves by virtue of birth alone. Everything else is a matter of semantics.

    • Brenden: You and I both know this is like eating an elephant. There are hundreds of big issues, we’d best start somewhere. My focus in this story is the middle class and a warning that we’d better get involved to make sure our interests are considered. Right now, I think the middle will likely get screwed, but be expected to shout, “Yippee, healthcare reform is here.”

      Should something pass, there seems to be a consensus on a consensus that pre-existing conditions won’t effect insurability, but can affect rate; caps on lifetime coverage will be removed; sick employees won’t lose coverage; -- all desirable, but each increases cost; and it looks like there will be at least some amount of progressive subsidy to help uninsured buy insurance -- nice and feels good, but doesn’t help the middle a bit and they are the ones who have to survive in order to pay for it. The poor already have Medicaid.

      What’s in play are all those little details that make up an elephant -- among many others, whether enough will be done to incent or create better efficiencies and make the industry more competitive (federalizing insurance regulation and malpractice reform among them); and whether employers will be required to offer and employees required to buy insurance. I’d gladly give you deregulation and tort reform for a public option, a level playing field (at least, in regulation) with a sunset law to take the public option private 15-20 years down the road, but there’s not enough fat in that part of the elephant to feed all that are now at the trough.

      Your question: What if you can’t pay your premiums? It looks to me that we’ll end up with another one of those donut bills. If you’re in the middle and can’t pay your premium, you’ll need to sell your possessions, declare bankruptcy, hope you lose your job and can survive until you qualify for Medicaid.

    • The dining room table (nee Brenden)

      Yet more lib naivete, malice and name-calling… love it! Keep it up, Dewers!

      Bert, do you deny the reality of tyranny in this world? Get a map and some darts. And my concern that such tyranny might be perpetrated here is false because I “fail to appreciate the actual things that are happening to actual people in this actual society.” I will not wax eloquent: that statement is idiotic. (Or possibly malicious with the intent of justifying the oncoming tyranny).

      “In a world where power and money are so heavily concentrated in tiny, elite segments of the population, this distinction between government entities and private entities matters less and less when we are talking about the protection of liberty and individual rights in America.”

      This is an absolute, crystal clear statement of collectivism that few leftists deign to name publicly. Bert: you see wealth, and presume its unjust creation. You said yourself: “those with money and power and privilege and those without. This is the distinction that matters in this debate. Without some regulating force, without some mediating entity, the former will devour the latter”

      You cannot envision a world where people grow wealth by means of voluntary, uncoerced exchange. Wealth is not a force of destruction, it is a force of CREATION! This is precisely how wealth is created — through voluntary exchange in a market where people to improve upon the existing state of technology by taking risk. Improvement, exchange, education, risk-taking = liberty! Some succeed and others fail. The income distribution reflects the ease of wealth creation through competition and exchange. And success and failure. When the distribution is skewed, as it is in this country, is when competitive forces are constrained.

      What constrains competition in this country? Yes, the gov’t. “What about the growing chasm between the rich and poor in this country?” Yes, the gov’t’s fault!

      And Bert: “What about the confiscation of individual rights, property and liberty by private entities?” When a private entity confiscates property, that is a crime. It’s called stealing. When you and your merry band of noble patriots extort the taxpayers and Treasury to pay for your beloved insolvent gov’t programs — that’s called activism. Whatever, dude.

      OK. You all also need to get some boilerplate verbiage that you can copy and paste into your posting to the effect of “the X need of Y class of unlimited victims justifies ruinous taxation on the productive and wealthy.” Feel free to use that.

      Lee, so my sole purpose in posting on this forum is pointing out the logical fallacies involved in those supporting the public option, and so now we’ve come to the rub.

      You say when confronted with unaffordable medical bills — after you sell off all your possessions, declare bankruptcy, etc. — you will need Medicaid to pay. Your justification of expanding the public option is that medical bills are too high, we can’t afford them. Do you see how this logic irrevocably leads to vast numbers of people (the whole country) ending up on Medicaid? Don’t you realize the country cannot afford this?

      That’s why the Public Option is wrong, false, evil, stupid, destructive, and so on.

    • Brenden: I’m glad you have posted in this forum. Eventhough the context is quite different, as Jack Nicholson said in “As Good As It Gets,” “you make me want to be a better man.”
      Back to the topic at hand, I didn’t say I would need Medicaid to pay. I said I wouldn’t seek treatment if I couldn’t pay. It is stupid. It is happening to tens of millions right now. They aren’t lazy and shiftless. They are hardworking and dedicated. And they aren’t seeking something for nothing. They are just living at the time when the price of a commodity as basic as food and water is unaffordable to most. You let them subsidize corn and oil and highways and cars and banks and tobacco and deny care or discussion of reforms unless you can dismantle government? Your principles defame you.
      I did suggest, however, that Medicaid is the only safety net for those in the middle and squeezed. But I totally disagree with your conclusion. Were vast numbers to end up on Medicaid, the evaporation of the wealth and productivity required would devastate our economy far worse than paying their medical bills. No, this argument is about keeping people healthy and productive (fill in the blank: employees, taxpayers, people). Just what kind of ideal reprobative capitalist world are you wishing for when you are willing to let all your workers and consumers suffer and die to save the medical insurance companies from having to compete and provide an affordable product? No, please don’t answer that. I already have too good an idea: wrong, false, evil, stupid, destructive, and so on.

    • Bert Roughton III

      Brenden,

      Obviously, there is tyranny in other parts of the world (the US has helped to ensure that). The focus in this discussion and my focus when I posted the previous comment was on the reality of what is going on in this country, today.The so-called “oncoming tyranny” that you are so worried about is a red herring and I think you know it. If not, Patrick Henry, I hope you’re on the way to Wasington DC to storm the capitol right now!

      You are right. Wealth is creation. Many people do “grow wealth by means of voluntary, uncoerced exchange.” But how much wealth do most people grow? How is it used? And where does most of it end up? These are the questions that you are ignoring

      This is not a zero sum game. This not a world of unlimited resources where hard work alone is the key to wealth and financial independence. Just as wealth is a force of creation for some, it is undoubtedly a force of destruction for others. So, the question we are dealing with here is not whether wealth itself is evil but whether the few who control most of it give a damn about the majority of people out there who are struggling to get just some of it. As you say, wealth has led to advances in technology and a proliferation of many satisfying conveniences but the increasing concentration of more and more wealth in fewer and fewer hands has left us with an economic model in which more and more people in our society are functionally irrelevant and practically worthless -- no slogan, no abstract theory, no political ideology can justify this appalling “distribution” (if you can even call it that).

      But again, you are right. The government is flawed. Bureaucracies are inefficient and often corrupt. Politicians often lie and ussually care more about their careers than their constituents. But at least they are constrained by common rules which we can all respect and, if we need to, change. At least there is a chance that governments can be held accountable. These oligopolies (to borrow your word) are specifically designed to maximize wealth at any cost without concern for the wider social impact. They are accountable only to themselves and operate according to their own chosen rules with minimal oversight. Over the past 30 years, we’ve gotten to see exactly where decreasing government constraints on competition and exchange have taken us. You blame the government for the skewed distribution of wealth in this country and you are not alone in doing so. But we don’t live in a fairytale land where any hard working Joe can pull himself up by his bootstraps whenever he decides to get off the couch. This is a new complex world which increasingly has less room and less use for many of the people that are in it. It is the role of government (any government) to do what it can to mitigate these forces and provide support where the inhuman forces of the market do not.

    • Bravo Bert! You are a warrior for compassion. Brenden, you should unstrap your ideological weapons of mass destruction and try a little tenderness.

    • The dining room table (nee Brenden)

      “You let them subsidize corn and oil and highways and cars and banks and tobacco and deny care or discussion of reforms unless you can dismantle government? Your principles defame you.”

      Lee, shame on you. You ascribe these false premises to me. I reject them. You know I don’t support such subsidy nonsense but you state it in an effort to discredit me because my arguments frustrate you intellectually. That’s OK; learning is supposed to be hard.

      Bert: “But how much wealth do most people grow? How is it used? And where does most of it end up? These are the questions that you are ignoring.” Bert, do you decide the optimal allocation of wealth? Who then?

      You believe I am ignoring these questions because I put faith in my fellow man. That some who has the work ethic, intelligence and initative to undertake risk ought to keep the reward. That person is responsible for his own failure; the gov’t hazards morally by dumping its failures on taxpayers and bond markets. Who is more likely to reinvest reward productively, grow wealth, innovation and employment: the individual or the gov’t?

      Bert, you insist upon the limitations of your fellow man in order to convince him that he needs protecting: “This is a new complex world which increasingly has less room and less use for many of the people that are in it. It is the role of government (any government) to do what it can to mitigate these forces and provide support where the inhuman forces of the market do not.” I don’t believe the world has less use for us. The need has never been more acute for the assertion of individual freedom, competition and exchange precisely because of increasing complexity and knowledge. In response, Bert, which forces should be mitigated: exchange, competition or innovation? And what about that is “inhuman”? What is MORE human than the desire to compete, excel in an effort to better the world?

      Sure, we need gov’t but only so much as is minimally necessary. No insolvent programs and agencies; No bottomless promises to ill-defined victim classes. These immoral transfers to the unproductive beget unproductivity. Victims beget victims, the “more and more people in our society are functionally irrelevant and practically worthless.” You obviously have much dimmer view of human potential than me. “Try a little tenderness” indeed.

      “This is not a zero sum game.” Bert, I see the arethmetical intuition behind my statements eludes you. Competition, exchange and innovation increase wealth. That is you get MORE outputs with FEWER inputs. Stuff gets CHEAPER and more ACCESSIBLE to the AVERAGE person when we are free of unjust regulation and taxation.

      Why do you object to the term “distribution”? You accuse me of abstracting on theory. Perhaps I am. Is that wrong? Do you deny the need of understanding of economic theory as it relates to the healthcare debate? Why? Do you not understand arethmetic? This, again, is an example of progressive anti-intellectual, collectivist emotive argumentation designed to frustrate reasonable debate and instead demand that it occur in an environment of fear and panic. In such an environment, you seek the upper hand by demanding the reality of the fear and panic necessitates the need for reform at any cost, don’t mind the reason. Clearly you oppose reasonable solutions.

      I am not abstracting. The problem of “more and more wealth in fewer and fewer hands” is the fault of the gov’t that stifles competition and innovation with unjust regulation and taxation. I think I made that point plainly. There, I did it again.

      I will indulge a small abstraction to remind you that the optimal allocation of social welfare is best achieved through competitive markets, not gov’t handouts that actually make everyone worse off. That is, when competitive innovation and uncoerced exchange occur it allows for MORE, CHEAPER outputs with FEWER inputs, then we’re all better off. Perhaps I will explain again. Maybe later.

    • Brenden: I didn’t intend to mischaracterize your position and now understand that you are also against subsidies or “entitlements” for corn and oil and highways and cars and banks and tobacco. Wish to elaborate? For instance, being against subsidies for highways, I presume you are also against government spending on pothole repair. Who should fill those potholes, should road users share the expense, and, if so, should that be voluntary? Going further, should a private business which to access land they own to build a factory, I presume they should build and pay for an exit ramp off the highway and the road to their property -- should exit road construction be regulated and, if so, by whom? Let me add a broader question, what government spending (is all government spending a subsidy?), if any, is appropriate and what regulation? If some is appropriate for the common good, who should decide that common good? Some constitutionally established congress? Not trying to make too much of this, but we elect our leaders to represent our interests in determining what is appropriate to spend our taxes on and to write laws that protect us. We all disagree with some decisions, but the mutual suicide pact our forefathers signed created methods to check and balance and change decisions. Perhaps we would have been better off to just allow the landed gentry to vote. Or just white men. But we didn’t. Democracy is messy and seldom protect the interests of all. Benevolent dictatorships don’t stay that way.

      We have a government program of healthcare for the aged. We have a government program for the indigent. We have a program for children who don’t have insurance. Together, they cover the most expensive healthcare users in our society -- people private insurers had just as soon not have to take. The government programs each deliver services at a per person price that is well less than what those of us in the middle pay for private insurance. What I’m asking, is for our government decide that is in the best interest of our country to allow access to these government programs by the people who pay for them. I’m not asking for a subsidy, just access so I can buy in.

    • Brenden: Now reading your comment to Bert, I realize that your already answered part of my question by saying that you do support government programs that are minimally necessary (not sure who decides that or if you really meant “minimally necessary”) as long as it doesn’t help ill-defined victim classes (which is either ill-defined or you actually mean victims who are ill). Excuse my oversight.

    • Melinda Ennis

      Brenden,
      You really need to refresh you knowledge of history. Unchecked, unregulated capitalism has led to some of the worst abuses in history, right here in the good ole USA. Let’s see—how about child labor, sweat shops, mining camps with “company stores” which operated like feudal fiefdoms? These were all a mere 100 years ago.
      Just like in the good old robber baron days, we now have a system with a shrinking middle class in which big business has manifested an incredible power over the common working man. This time, it’s the insurance and pharmaceutical industries who have us all, and apparently our government representatives, by the balls. We are not talking about entitlements or a “free ride,” we are talking about protection against obscene abuses based on nothing but a profit margin that earns the pharma or insurance CEO that extra few million of bonus. Health reform is for the hard working, tax-paying regular citizen who is one small health problem away from economic disaster. Just as surely as a man, woman or child working in a unheated, firetrap factory for 12 hours a day was abused in 19th century America, we are being abused by the unrestricted “free market” excesses of big pharama and insurance in 21st century America.

    • Brenden

      Lee, good questions. The first principle I would consider in optimizing public expenditure is whether it’s Constitutional. Specifically, does the expediture or regulation support/not threaten individual property rights? Two, whether the allocation is toward a defensible “public good.” So yes: roads, schools the military are all properly under the perview of the gov’t. And stop this foolishness that I support agricultural subsidies, etc. I do not and you know better.

      I believe the gov’t does have a duty to allocate/regulate in the interests of “public health,” i.e., with respect to epidemics, vaccinations, etc. Beyond that, I am willing to accept a LIMITED, FULLY-FUNDED allocation to the aged and indigent. However, here is the rub. As soon as the gov’t extends that allocation beyond its ability to pay for it and to a class of ricipients without limit (there will always be an unlimited supply of old and poor people), then that allocation/regulation becomes unConstitutional. why? Because the gov’t is forced to spend that money by raising taxes or issuing debt, foisting an unjust allocation upon the citizen consumer/producer and taxpayer. It undermines property rights because of inflating interest payments and taxes confiscate private funds that could be invested in productive outcomes to expand employment, wealth and innovation.

      This is where my complete utter resistance to the public option comes in. This is an endless guarantee of subsidized access to the already highly-economically-stressed healthcare system. Who pays? Lee, you say: “What I’m asking, is for our government decide that is in the best interest of our country to allow access to these government programs by the people who pay for them. I’m not asking for a subsidy, just access so I can buy in.” I don’t understand how your vision of access does not translate into public expenditure. Again, your justification we need the public option because of increasing prices. Then you say if you cannot pay your premiums: “If you’re in the middle and can’t pay your premium, you’ll need to sell your possessions, declare bankruptcy, hope you lose your job and can survive until you qualify for Medicaid.”

      How do you not understand this is an endless unfunded mandate that will result in confiscatory borrowing and taxation, when it’s already plenty confiscatory?

      I ardently disagree with you on this point: “We elect our leaders to represent our interests in determining what is appropriate to spend our taxes on and to write laws that protect us.” When I elect a leader, my expectation is that he will defend and protect the Constitution, and acquit his duties guided by the wisdom inherent in that document.

      There is not one line in the constitution about universal healthcare, hence it is no right. Quite the opposite, it chucks an anti-competitive anchor to the nation’s economy that will drag us to the bottom of the ocean. It’s a threat to fundemental liberty and opportunity, hence it sucks.

      Melinda, where are all these ” child labor, sweat shops, mining camps with “company stores” which operated like feudal fiefdoms?” You answered your own question: “These were all a mere 100 years ago.” Gov’t rightly intervened to promulgate to rules to protect the entire workforce, which benefits the entire workforce. Now why do we need unions again? The implication here is that I do not support such regulation making me a “robber baron” or an “eviw capitawist.” I do support workplace safety regulations.

      You are so convinced of the justness of your unjust cause that you fail to understand the obvious contradiction in statements like these: “We are not talking about entitlements or a “free ride,” we are talking about protection against obscene abuses based on nothing but a profit margin that earns the pharma or insurance CEO that extra few million of bonus. ”

      Who is paying for “the protection”? You want the allocation paid for by the oligopolist insurance companies. Fine, says I: eliminate ridiculous regulations that don’t allow interstate competition for consumer insurance. Lower medical liability premiums for doctors by supporting tort reform. The oligopolists will suffer and doctors’ fees will fall.

      You denigrate profit as if it is NOT the fundemental driver to improving social outcomes by increasing wealth, employment and innovation. And as I have explained a million effing times, the reason these healthcare companies charge these confiscatory prices is because they’re state supported and regulated monopolies or oligopolies. The lobbyists you all complain about seek to petition the gov’t to pass anti-competitive legislation for legal safe harbors for monopolist practices. The gov’t is the one stacking the deck against the healthcare consumer — and you all want the same gov’t to rescue you by spending us into ruin. This is the very definition of stupidity!

    • in this era of democracy..we are all entitled to freedom of speech…but here’s the catch..when view points are battered by misinformation and reality is totally distorted, we are all at risk for not seeking the truth or even choosing to be mindful of what truly matters. so for once …just once…everyone take off the gloves…sit in your separate corners ..take a breath..and realize we are all living in total misconception…the “founding fathers” based everything on being a white male land owner who belonged to the masons. there has not been a day in this country that the patriarchy has not thrived off the backs of any who was not a rich white male. neglect and abuse..built into the constitution.

    • Lee Leslie

      You may be right about the infinite cost (though you refuse to consider finite solutions). You may be right that infinite or even optimistic growth cannot sustain even healthcare affordability. It may bankrupt us all. So here’s the rub -- as a thinking human, I cannot accept that this problem which means life or death or suffering for tens of millions of Americans is unsolvable. Entrenched beliefs, narrow constitutional parsing, perceived confiscatory borrowing or modified taxation be damned, lets find a solution. I believe the risk to our society of letting another 16 years go by without at least a good attempt to fix this system is more onerous than the fears you propagate.
      My value system cannot allow for your perfect scenario of dismantling regulation to play out where you find yourself one day with your spouse or your child or your grandchild who needs a kidney or an operation and your healthcare version of ebay finds you are the losing bidder. My value system cannot embrace the survival of the richest or most fortunate and the misery or death of all others to prove a theory. It is not a game. It is not about winning. Our republic and our economic system were never perfect philosophy. Now is the time to dispense with rhetoric and platitude. It is a time for solutions and innovation. Thanks for stopping by.

    • Brenden

      I don’t know. You can emote, claim universal values, claim the great universal conspiracy of white men. On the white guy point: it demonstrates a profound misunderstanding of history, admits you cannot debate rationally and basically further admits you’re a loser and always will be. People who think like you, Ariel, are losers because they think they cannot advance in society because they’re not white men — ALL evidence to the contrary. The only thing you’re attempting to accomplish is build political support for a economically, intellectually and morally bankrupt healthcare policy. Economically bankrupt because it can’t be paid for; Intellectually bankrupt because its proponents rely on irrational, emotive arguments and false claims; Morally bankrupt because it stifles competition and imposes confiscatory taxation, inflation and debt, Morally bankrupt because it will result in a DECREASED overall supply and quality of healthcare, Morally bankrupt because it plunders the productive to transfer to the unproductive which will decrease overall productivity, growth, innovation, employment, education, opportunity, wealth, etc., Morally bankrupt because these very people you’re hoping to benefit — the serially unproductive — will actually be made worse off because you will have destroyed any incentive to perform in that industry and by definition they will suffer first and the most.

    • I am going to take the higher road on this comment by brenden….because perhaps he is totally shook up knowing that everything we know as Americans, is indeed not the truth. but rather a cover up of the founding fathers so that we would not notice that this country was built on plundering, raping, enslaving and killing anyone who was not white. and because, i am just gandering a guess here, he raises his rifle to shoot first and then ask questions afterwards.
      I am hoping that somewhere in the collective psyche of humanness the sadness of past actions become the hope of each new sunrise. My grandchildren will know not only that they are loved, but that we ALL cared enough to give them the option for both healthcare and education. And the love of freedom of speech and freedom to love each other no matter their political persuasions.

    • Brenden: I don’t know. You can emote, claim universal values, claim the great universal conspiracy of proletariat. On the proletariat point: it demonstrates a profound misunderstanding of history, admits you cannot debate rationally and basically further admits you’re a loser and always will be. People who think like you are losers because they think they cannot allow advance in society because everyone beneath their wealth status is below their worth as a human being — ALL evidence to the contrary. The only thing you’re attempting to accomplish is build political support for a economically, intellectually and morally bankrupt healthcare policy. Economically bankrupt because it can’t be sustained; Intellectually bankrupt because its proponents rely on irrational, emotive arguments and false claims; Morally bankrupt because it stifles competition and imposes confiscatory price fixing, inflation and debt, Morally bankrupt because it will result in a DECREASED overall supply and quality of healthcare, Morally bankrupt because it plunders the productive to transfer to the private insurance monopolies which will decrease overall productivity, growth, innovation, employment, education, opportunity, wealth, etc., Morally bankrupt because these very people you’re hoping to keep down — the serially productive — will actually be made worse off because you will have destroyed any incentive to perform in that industry and by definition they will suffer first and the most.

    • Brenden

      Oh, and one more thing. I do have a solution, but you reject it: yes, deregulation. But whole point of it is that it NOT provide a costless guarantee, there is still risk. But there is reward for taking the risk, that is, providing healthcare to risky patients and offsetting that risk against low-default-risk, healthy patients. You know this is true of anything in life, when you cross the street, buy produce or even choose a doctor. Risk is everywhere, and it requires an understanding of distributions and statistics. Risk management, if you will, which you denigrate as plundering evildoers “of the little guy” when the exact opposite is true: the gov’t is actually the looting plunderers that offers only taxes, inflation and unemployment in return. Your argumentation also admits the most overstated false-polemic hyperbole: “My value system cannot embrace the survival of the richest or most fortunate and the misery or death of all others to prove a theory.” This is ridiculous and demonstrates you totally misunderstand my arguments or consciously misrepresenting them. Stupid or Evil or both? I don’t know which. I’ve ask myself that a lot these days.

    • Brenden

      Ah-ha, you answered my question: stupid and evil: “On the proletariat point: it demonstrates a profound misunderstanding of history, admits you cannot debate rationally and basically further admits you’re a loser and always will be. People who think like you are losers because they think they cannot allow advance in society because everyone beneath their wealth status is below their worth as a human being — ALL evidence to the contrary.”

      You’re the one trying to constrain competition and innovation, Lee, by extending an unfunded gov’t healthcare administration that will consume the productive economic sectors of this country. In a market society, producers wish to transact with as many consumers as possible throughout the dynamic income distribution, which grows social welfare. Your moronic copy paste, “I know you are but what am I” logic is false and you know it. You think you’re defending your position with rhetorical flourish when only further demonstrates its falsity and your ignorance.

      And you accuse private interests of “price-fixing”? That’s the very essence of the “public option” for the gov’t to fix prices at the lowest level affordable by the poorest patient (note: below reimbursement rates for doctors). “Price-fixing” is exactly the outcome you’re after!

      If your going to advance a position to demand an allocation of public money/policy then you must rationally defend it otherwise we have been reduced to an absurdist polity that will admit any cartoonish ignorant dictator to lead us over a cliff. You are the cutting edge of a new generation!

    • Deregulation? Sure, what we did for the banking industry and airlines, yeah, let’s see if we can do it for healthcare.
      Sure, the answer to monopolies in each state is remove regulation -- surely we can trust these executives to do what’s right -- I have faith they would play fair with competitors.
      Sure, let’s deregulate Medicare and Medicaid -- surely our retirees and disabled would happily give up the guarantee of coverage for a system where any provider could charge whatever they wished and the payer would cover only what they wished.
      Great idea. That’s your solution? Boy, that’s got a chance of working.
      Oh, risk management. Yeah, way too complicated for people to understand (isn’t that the same argument used on Wall Street right now to justify their shell games and bankruptcy in real terms?). Hogwash. There’s little risk in a system where you can raise rates with no competition and you are the sole judge as to what you have to pay. And what is risk is remaining, you just sell off to an unregulated hedge fund that gets insured by AIG which is owned by the government. Who is being ridiculous?
      Brenden, with all dew respect to your economic educational credentials, go back to school: If you allow monopolies, they must be regulated. If you desire competition and deregulation, you must first rid yourself of the monopolies.

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