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What new or revised public policy/law would make it easier for people to maintain a healthy weight?
Replies
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https://ceoworld.biz/2018/02/14/the-top-25-countries-with-the-best-healthcare-systems-the-world-in-2017/
The U.S. is not on this list.
https://www.internationalinsurance.com/health/systems/
On this list the U.S. is 11th but costs 1.5 the amount per person of the 2nd most expensive country Norway that is ranked 7th.
http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/
W.H.O. Ranks the U.S. 37th of all nations including non industrialized.
This has nothing to do with the ACA. And it has nothing to do with any agenda of The Commonwealth Fund. The data from various sources all points to the same thing. Highest cost. Not the best patient outcomes. Denial is not just a river in Egypt. So many other countries have accomplished better outcome. Why can't the U.S.?
I also find it an error in logic to conflate healthcare costs with a website promoting personal responsibility. There is much more that goes into to healthcare costs. Public policy can play a role in encouraging healthy lifestyles including weight management. I don't see the U.S. system addressing that in any holistic way. For the most part the U.S. system is set up to treat symptoms with drugs instead of addressing root causes of health issues. That is my editorial opinion of course.8 -
I'm unclear exactly what you mean by the bolded. Are you saying the U.S. is subsidizing the healthcare of the other top industrialized nations? And if so, please substantiate this claim.
http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/?fbclid=IwAR0Ar_moC2NR1sbjrt6-AkA2CGJSJjJUK9m9ystJtSdpRNrVJLQaZtbShTotbright1965 wrote: »Nor do you fix it by paying for them.
You just pass the costs on to those who choose to take a more proactive approach.
Stop passing along costs to others and the costs for those no longer having the costs of others passed to them will go down.
If people wish to voluntarily take on those costs, I'm all for it.
I'm not in favor of someone, especially those who buy votes with other people's money, choosing to pass costs on to me and my family.
That is not equal to not wishing to help. I simply think using government fiat is the worst way to make any real, lasting, and meaningful change.tbright1965 wrote: »It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
To your point, medical costs in the U.S. are the highest by a factor of 1.8 and the worst quality of care in the developed world. I think there is something broken in a society that does not make the health of its people an affordable priority. Not every one of the other countries has socialized medicine either. But the fact remains they deliver higher quality of care at a substantially lower cost. Why can't the U.S. figure this out? We also have the highest rate of medical expense related bankruptcy. What is wrong with this picture?
The substantially lower cost originates from subsidies provided by the US.
We don't figure it out because there is no incentive for those in power to do so. They are making profit off of the existing system and will make more under single payer. All they have to do is promise to do something, do nothing, but hold the pretense of compassion. Verba non facta rules the day, but the same personalities and families remain in office.
Anyone else finding the irony of a debate advocating for collective control of health on a site where success is solely achieved through personal responsibility and accountability?
Governments other than the US set drug prices. The US does not. Through congressional action the US bargains with innovators in establishing price, so the ~2.6 B investment to bring a drug to market can be recomped, typically at a 5% industry margin.
Not all drug companies are located in the U.S. This doesn't represent a "subsidy" to other countries and there is much more that goes into the costs of healthcare delivery than just drug prices. Did you take time to read the article? It talks specifically about patient outcomes and satisfaction.
The vast majority of innovations originate via the US regulatory pipeline, both in pharmaceutical and medical device. Note that even many European innovators are opting for the US pipeline.
Of course there is much more in determining the cost of any product group, but deliberate insertion of middle men can only increase the cost, so your hope in either reducing cost or increasing access has no chance of success.
Not much there to read. I'm sure someone advocating for a collectivized system finds comfort in such an article, but it doesn't offer anything for someone looking for objective data.
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I'm unclear exactly what you mean by the bolded. Are you saying the U.S. is subsidizing the healthcare of the other top industrialized nations? And if so, please substantiate this claim.
http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/?fbclid=IwAR0Ar_moC2NR1sbjrt6-AkA2CGJSJjJUK9m9ystJtSdpRNrVJLQaZtbShTotbright1965 wrote: »Nor do you fix it by paying for them.
You just pass the costs on to those who choose to take a more proactive approach.
Stop passing along costs to others and the costs for those no longer having the costs of others passed to them will go down.
If people wish to voluntarily take on those costs, I'm all for it.
I'm not in favor of someone, especially those who buy votes with other people's money, choosing to pass costs on to me and my family.
That is not equal to not wishing to help. I simply think using government fiat is the worst way to make any real, lasting, and meaningful change.tbright1965 wrote: »It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
To your point, medical costs in the U.S. are the highest by a factor of 1.8 and the worst quality of care in the developed world. I think there is something broken in a society that does not make the health of its people an affordable priority. Not every one of the other countries has socialized medicine either. But the fact remains they deliver higher quality of care at a substantially lower cost. Why can't the U.S. figure this out? We also have the highest rate of medical expense related bankruptcy. What is wrong with this picture?
The substantially lower cost originates from subsidies provided by the US.
We don't figure it out because there is no incentive for those in power to do so. They are making profit off of the existing system and will make more under single payer. All they have to do is promise to do something, do nothing, but hold the pretense of compassion. Verba non facta rules the day, but the same personalities and families remain in office.
Anyone else finding the irony of a debate advocating for collective control of health on a site where success is solely achieved through personal responsibility and accountability?
Governments other than the US set drug prices. The US does not. Through congressional action the US bargains with innovators in establishing price, so the ~2.6 B investment to bring a drug to market can be recomped, typically at a 5% industry margin.
Not all drug companies are located in the U.S. This doesn't represent a "subsidy" to other countries and there is much more that goes into the costs of healthcare delivery than just drug prices. Did you take time to read the article? It talks specifically about patient outcomes and satisfaction.
The vast majority of innovations originate via the US regulatory pipeline, both in pharmaceutical and medical device. Note that even many European innovators are opting for the US pipeline.
Of course there is much more in determining the cost of any product group, but deliberate insertion of middle men can only increase the cost, so your hope in either reducing cost or increasing access has no chance of success.
Not much there to read. I'm sure someone advocating for a collectivized system finds comfort in such an article, but it doesn't offer anything for someone looking for objective data.
Besides that article, I posted other rankings a couple of posts up. The fact remains that the U.S. is the highest cost by far and not in the top 10 in the most favorable ranking of outcomes. You may view this as hopeless but it being done all over the world.
If the U.S. drug development pipeline is the most business friendly in the world, that hasn't seemed to improve outcomes for U.S. residents at all. One could almost swallow it if our costs were the highest but our outcomes were the best. Based on the data that is not the case.
FTR, I am not specifically advocating for a collectivized system. If so many other countries are getting better outcomes at lower costs, I would think that bears some study and emulation of best practices. That would really be making America great again IMHO.8 -
I'm unclear exactly what you mean by the bolded. Are you saying the U.S. is subsidizing the healthcare of the other top industrialized nations? And if so, please substantiate this claim.
http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/?fbclid=IwAR0Ar_moC2NR1sbjrt6-AkA2CGJSJjJUK9m9ystJtSdpRNrVJLQaZtbShTotbright1965 wrote: »Nor do you fix it by paying for them.
You just pass the costs on to those who choose to take a more proactive approach.
Stop passing along costs to others and the costs for those no longer having the costs of others passed to them will go down.
If people wish to voluntarily take on those costs, I'm all for it.
I'm not in favor of someone, especially those who buy votes with other people's money, choosing to pass costs on to me and my family.
That is not equal to not wishing to help. I simply think using government fiat is the worst way to make any real, lasting, and meaningful change.tbright1965 wrote: »It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
To your point, medical costs in the U.S. are the highest by a factor of 1.8 and the worst quality of care in the developed world. I think there is something broken in a society that does not make the health of its people an affordable priority. Not every one of the other countries has socialized medicine either. But the fact remains they deliver higher quality of care at a substantially lower cost. Why can't the U.S. figure this out? We also have the highest rate of medical expense related bankruptcy. What is wrong with this picture?
The substantially lower cost originates from subsidies provided by the US.
We don't figure it out because there is no incentive for those in power to do so. They are making profit off of the existing system and will make more under single payer. All they have to do is promise to do something, do nothing, but hold the pretense of compassion. Verba non facta rules the day, but the same personalities and families remain in office.
Anyone else finding the irony of a debate advocating for collective control of health on a site where success is solely achieved through personal responsibility and accountability?
Governments other than the US set drug prices. The US does not. Through congressional action the US bargains with innovators in establishing price, so the ~2.6 B investment to bring a drug to market can be recomped, typically at a 5% industry margin.
Not all drug companies are located in the U.S. This doesn't represent a "subsidy" to other countries and there is much more that goes into the costs of healthcare delivery than just drug prices. Did you take time to read the article? It talks specifically about patient outcomes and satisfaction.
The vast majority of innovations originate via the US regulatory pipeline, both in pharmaceutical and medical device. Note that even many European innovators are opting for the US pipeline.
Of course there is much more in determining the cost of any product group, but deliberate insertion of middle men can only increase the cost, so your hope in either reducing cost or increasing access has no chance of success.
Not much there to read. I'm sure someone advocating for a collectivized system finds comfort in such an article, but it doesn't offer anything for someone looking for objective data.
Besides that article, I posted other rankings a couple of posts up. The fact remains that the U.S. is the highest cost by far and not in the top 10 in the most favorable ranking of outcomes. You may view this as hopeless but it being done all over the world.
If the U.S. drug development pipeline is the most business friendly in the world, that hasn't seemed to improve outcomes for U.S. residents at all. One could almost swallow it if our costs were the highest but our outcomes were the best. Based on the data that is not the case.
FTR, I am not specifically advocating for a collectivized system. If so many other countries are getting better outcomes at lower costs, I would think that bears some study and emulation of best practices. That would really be making America great again IMHO.
How does one objectively monitor, track, and trend "favorability"? The only reasonable means of doing so would be to have an individual live under each system and then provide an analysis. Otherwise all we have is a subjective, uninformed collection of opinions.
Americans complain more than any culture, an unfortunate byproduct of affluence. This is a known factor to the extent that regulatory authorities expect that you address this issue when conducting pharmacovigilance and post market surveillance.
Perhaps the outcome isn't linked to drug development? Perhaps the outcome isn't linked to healthcare?
I would hope that expanded care is the goal of everyone. The model evolving out of the enlightenment has provided this by such a magnitude that we often fail to recognize how good things are and that changing things have a far greater chance of making things worse than they do making things better. If you have to utilize force to bring about "greater good", then it should be obvious that "good" was never an intention.
The question I repeatedly pose is that are costs actually lower in these other countries?
I need someone to reconcile how products get cheaper and more available via inserting additional processes and cost.6 -
tbright1965 wrote: »FireOpalCO wrote: »tbright1965 wrote: »I have no problem if universal healthcare is voluntary and optional.
My problem is when you FORCE people to participate or contribute.
Have whatever system you want, as long as it is not mandatory and is funded ONLY with money voluntarily given.
Why? Why does a single payer healthcare system need to be voluntary? What is unique to it that does not apply to everything else that is paid for by taxes? I don't decide how much I pay towards the military each year. Neither do I pick each year my contribution to roads, schools, or a myriad of other government provided services. Where on my tax form do I pick how much I want to contribute to our State Department?
Part of being a democracy is sometimes you pay for things that don't benefit you personally or that you don't value. At certain points in our history we decided that some items that weren't provided by the government should be paid for by tax dollars and funded by everyone, not just the "in the moment need" or the largess of the rich. Public schools, fire departments, police, judges, social workers, etc.
Why not voluntary?
...
VOLUNTARY is key, as it will act as a check on those making the choices. If the care doesn't meet the promises, people should be free to leave the program and not be locked in to endless contributions by law.
The problem would be getting it up and running. Why would the wealthy, who can afford whatever system exists, or healthy people who are able to at least afford insurance premiums, switch right away? They would want to wait and see what happens. The people who would jump right in would be mostly low income or high usage, so there would be no way for it to be financially viable.
Voluntary universal healthcare is a logic trap. You can't show it will be a good deal without knowing who will participate, and you can't convince people to participate if you can't show them it will be a good deal.
I'm not saying single-payer or universal healthcare is the answer, I honestly have no idea what is. I'm just saying I don't think voluntary single-payer/universal healthcare is possible, it would just end up being a high risk insurance pool.12 -
I'm unclear exactly what you mean by the bolded. Are you saying the U.S. is subsidizing the healthcare of the other top industrialized nations? And if so, please substantiate this claim.
http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/?fbclid=IwAR0Ar_moC2NR1sbjrt6-AkA2CGJSJjJUK9m9ystJtSdpRNrVJLQaZtbShTotbright1965 wrote: »Nor do you fix it by paying for them.
You just pass the costs on to those who choose to take a more proactive approach.
Stop passing along costs to others and the costs for those no longer having the costs of others passed to them will go down.
If people wish to voluntarily take on those costs, I'm all for it.
I'm not in favor of someone, especially those who buy votes with other people's money, choosing to pass costs on to me and my family.
That is not equal to not wishing to help. I simply think using government fiat is the worst way to make any real, lasting, and meaningful change.tbright1965 wrote: »It is my understanding that a significant number of the 'emergencies' seen in US hospitals wouldn't have been emergencies had they been treated earlier. But the health insurance model makes people, especially on low incomes, reluctant to seek said early medical treatment.
Maybe, instead of forcing hospitals to absorb the costs of emergency care, the costs are owed by those getting the care. Since patients can ignore the bill for emergency care, you may lower costs by changing the system so the patient is on the hook for the costs, period, making it a better choice for them to get care early, when the costs to them are lower.
When costs are shifted to others, there is no incentive to change behavior.
When costs are borne by those who incur them, they tend to seek lower cost solutions.
Except that people are already trying to avoid incurring costs - by avoiding getting healthcare in the hope that the problem will go away / wait until they can get to a physician that will cost them less.
In other words, people trying to avoid incurring costs is actually the problem. You're not going to fix that by making it worse.
Given that medical costs are much, much higher in the US than they are in countries with socialised healthcare systems, are you sure that you don't fix the problem by paying for people to get preventative healthcare...?
To your point, medical costs in the U.S. are the highest by a factor of 1.8 and the worst quality of care in the developed world. I think there is something broken in a society that does not make the health of its people an affordable priority. Not every one of the other countries has socialized medicine either. But the fact remains they deliver higher quality of care at a substantially lower cost. Why can't the U.S. figure this out? We also have the highest rate of medical expense related bankruptcy. What is wrong with this picture?
The substantially lower cost originates from subsidies provided by the US.
We don't figure it out because there is no incentive for those in power to do so. They are making profit off of the existing system and will make more under single payer. All they have to do is promise to do something, do nothing, but hold the pretense of compassion. Verba non facta rules the day, but the same personalities and families remain in office.
Anyone else finding the irony of a debate advocating for collective control of health on a site where success is solely achieved through personal responsibility and accountability?
Governments other than the US set drug prices. The US does not. Through congressional action the US bargains with innovators in establishing price, so the ~2.6 B investment to bring a drug to market can be recomped, typically at a 5% industry margin.
Not all drug companies are located in the U.S. This doesn't represent a "subsidy" to other countries and there is much more that goes into the costs of healthcare delivery than just drug prices. Did you take time to read the article? It talks specifically about patient outcomes and satisfaction.
The vast majority of innovations originate via the US regulatory pipeline, both in pharmaceutical and medical device. Note that even many European innovators are opting for the US pipeline.
Of course there is much more in determining the cost of any product group, but deliberate insertion of middle men can only increase the cost, so your hope in either reducing cost or increasing access has no chance of success.
Not much there to read. I'm sure someone advocating for a collectivized system finds comfort in such an article, but it doesn't offer anything for someone looking for objective data.
Besides that article, I posted other rankings a couple of posts up. The fact remains that the U.S. is the highest cost by far and not in the top 10 in the most favorable ranking of outcomes. You may view this as hopeless but it being done all over the world.
If the U.S. drug development pipeline is the most business friendly in the world, that hasn't seemed to improve outcomes for U.S. residents at all. One could almost swallow it if our costs were the highest but our outcomes were the best. Based on the data that is not the case.
FTR, I am not specifically advocating for a collectivized system. If so many other countries are getting better outcomes at lower costs, I would think that bears some study and emulation of best practices. That would really be making America great again IMHO.
Part of the issue with US healthcare is the poor quality of its customers. Higher levels of obesity, lower levels of fitness, etc than other developed countries.4 -
tbright1965 wrote: »I have no problem if universal healthcare is voluntary and optional.
My problem is when you FORCE people to participate or contribute.
Have whatever system you want, as long as it is not mandatory and is funded ONLY with money voluntarily given.
I have no problem with people helping one another. I have no problem with insurance.
My problem comes when participation is mandated. When the freedom to opt out is taken away by those acting in the name of their vision of "the greater good."
If something is a great idea, you don't need to FORCE them to do it by passing a law.
Like I've said before, I want people to have freedom. So the guy buying toys is always free to buy toys. If he didn't buy health insurance, why should he be able to demand a portion of my wages to pay his medical costs?
See, that's the difference. I'm willing to be in a voluntary insurance program with him. We are each putting the fruits of our labors into a mutual pool to protect one another.
Keyword is VOLUNTARY.
If the person voluntarily DOESN'T join the pool, why am I still expected to pay?
And none of my views prevent you or anyone else from cutting big checks to Uncle Sam if you think Uncle Sam is the best way to provide coverage for those who don't have it, for whatever reason.
So people should be able to opt out of paying for the military or TSA or police or ICE or the Secret Service if they don't want the government reaching into their pockets for those things?13 -
tbright1965 wrote: »FireOpalCO wrote: »tbright1965 wrote: »I have no problem if universal healthcare is voluntary and optional.
My problem is when you FORCE people to participate or contribute.
Have whatever system you want, as long as it is not mandatory and is funded ONLY with money voluntarily given.
Why? Why does a single payer healthcare system need to be voluntary? What is unique to it that does not apply to everything else that is paid for by taxes? I don't decide how much I pay towards the military each year. Neither do I pick each year my contribution to roads, schools, or a myriad of other government provided services. Where on my tax form do I pick how much I want to contribute to our State Department?
Part of being a democracy is sometimes you pay for things that don't benefit you personally or that you don't value. At certain points in our history we decided that some items that weren't provided by the government should be paid for by tax dollars and funded by everyone, not just the "in the moment need" or the largess of the rich. Public schools, fire departments, police, judges, social workers, etc.
Why not voluntary?
...
VOLUNTARY is key, as it will act as a check on those making the choices. If the care doesn't meet the promises, people should be free to leave the program and not be locked in to endless contributions by law.
The problem would be getting it up and running. Why would the wealthy, who can afford whatever system exists, or healthy people who are able to at least afford insurance premiums, switch right away? They would want to wait and see what happens. The people who would jump right in would be mostly low income or high usage, so there would be no way for it to be financially viable.
Voluntary universal healthcare is a logic trap. You can't show it will be a good deal without knowing who will participate, and you can't convince people to participate if you can't show them it will be a good deal.
I'm not saying single-payer or universal healthcare is the answer, I honestly have no idea what is. I'm just saying I don't think voluntary single-payer/universal healthcare is possible, it would just end up being a high risk insurance pool.
I just read "Everyday Millionaires by Chris Hogan which provides some fascinating insight into the wealthy - how they achieved wealth and their habits. Similar to weight loss success and failure is largely an output of behavior. No one is going to voluntarily enter into a contract where there is no chance of success.
Either extreme is a logical fallacy and pure fantasy as the scope is too large and encompasses a swath of people and cultures unlike any other country although objective evidence clearly shows the optimal mean lies more towards free market systems. Anarchocapitalism and socialism work in small groups where people have ideological motivation for success. These would be epic disasters in a country with over 300 M.
I good starting point would be to recognize the incredible success we currently have rather than only focusing on the negative. A better starting point would be to get informed with objective data opposed to listening to political talking points and hyperbole.7 -
Here's a lil' copy/cut/paste from a 2017 National Review interview:
"Morally, you have no right to demand medical care of me. I may recognize your necessity and offer charity; my friends and I may choose to band together and fund your medical care. But your necessity does not change the basic math: Medical care is a service and a good provided by a third party...
[M]edical care is a commodity, and treating it otherwise is foolhardy. To make a commodity cheaper and better, two elements are necessary: profit incentive and freedom of labor. The government destroys both of these elements in the health-care industry. It decides medical reimbursement rates for millions of Americans, particularly poor Americans; this, in turn, creates an incentive for doctors not to take government-sponsored health insurance...
So, what's the solution for poor people? Not to declare medical care a 'right,' and certainly not to dismiss reliance on the market as perverse cruelty. Markets are the solution in medical care, just as they are in virtually every other area. Treating medical care as a commodity means temporary shortages, and it means that some people will not get everything we would wish them to have. But that's also true of government-sponsored medical care, as the most honest advocates will admit. And whereas government-sponsored medical care requires a top-down approach that violates individual liberties, generates overdemand, and quashes supply, markets prize individual liberties, reduce demand (you generally demand less of what you must pay for), and heighten supply through profit incentive."8 -
tbright1965 wrote: »I have no problem if universal healthcare is voluntary and optional.
My problem is when you FORCE people to participate or contribute.
Have whatever system you want, as long as it is not mandatory and is funded ONLY with money voluntarily given.FireOpalCO wrote: »Why? Why does a single payer healthcare system need to be voluntary? What is unique to it that does not apply to everything else that is paid for by taxes? I don't decide how much I pay towards the military each year. Neither do I pick each year my contribution to roads, schools, or a myriad of other government provided services. Where on my tax form do I pick how much I want to contribute to our State Department?
Because we are a nation of free people. We are a Republic, not a Democracy. Majority rules gives you things such as slavery and bans on same sex marriage, and bans on interracial marriage and so on.
This nation was not founded on collective rights. There is no right of the majority. Only INDIVIDUALS have rights. Not even the government has rights. Rights are bestowed only upon individuals.
The only way that is maintained is when we recognize and defend the rights of individuals. If we have majority rules, someone loses their rights.
So any system or scheme proposed by government must be 100% voluntary. There is no right to demand that others fall into line with some view of "the greater good" just because 50% + 1 person votes for it.
Maybe the question to ask is why have we allowed our Federal Government to usurp our rights. The roles of the Federal Government, as spelled out by the Constitution are pretty small. Most things people fight about such as police, fire, roads, and so on if they are the responsibility of any governmental unit, are local or state, not Federal.
Having money go to DC and then to have your representatives in Congress try to bring the money back to the community to build a new fire station is the height of insanity. Like the 535 members of Congress, plus the President and VP know better what you need than the people of your own community is laughable.
It's probably an oversimplification, but the real roles of the Federal Government are: Defense, Foreign Policy, and a Federal Judiciary.
That's pretty much it.FireOpalCO wrote: »
Part of being a democracy is sometimes you pay for things that don't benefit you personally or that you don't value. At certain points in our history we decided that some items that weren't provided by the government should be paid for by tax dollars and funded by everyone, not just the "in the moment need" or the largess of the rich. Public schools, fire departments, police, judges, social workers, etc.
Good thing we live in a Representative Republic that was founded on the idea of individual freedom. If we were following the lead of the founders, you wouldn't be asked to pay for what you don't support.
I think the founders, faults and all, recognized the dangers of concentrated power. How concentrated power erodes freedom.tbright1965 wrote: »
Why not voluntary?
...
VOLUNTARY is key, as it will act as a check on those making the choices. If the care doesn't meet the promises, people should be free to leave the program and not be locked in to endless contributions by law.The problem would be getting it up and running. Why would the wealthy, who can afford whatever system exists, or healthy people who are able to at least afford insurance premiums, switch right away? They would want to wait and see what happens. The people who would jump right in would be mostly low income or high usage, so there would be no way for it to be financially viable.
Voluntary universal healthcare is a logic trap. You can't show it will be a good deal without knowing who will participate, and you can't convince people to participate if you can't show them it will be a good deal.
I'm not saying single-payer or universal healthcare is the answer, I honestly have no idea what is. I'm just saying I don't think voluntary single-payer/universal healthcare is possible, it would just end up being a high risk insurance pool.
If the system was better, wouldn't the wealthy be some of the first to come on board? It's not like wealthy people are against saving money. In fact, I'd argue that they may have a pretty good handle on value. Not all the wealthy are newly minted Instagram Influencers, Rock Stars or Star Athletes with new-found riches in the lottery of life. Many have built companies, often out of what they had in their garage, and now have billions.
Any system that would lower healthcare costs for them and/or their enterprises would be welcomed, right?
Wouldn't bottom line focused CEOs welcome less costly alternatives to health care?
Large companies "self-insure" meaning while there may be an insurance company on the benefits card, they are paying them for access to the network, pre-negotiated rates, and administration. The benefits costs are paid by the company. There may be some re-insurance for catastrophic events. But by and large, day to day benefits are paid by the employer, not the insurance company.
If someone came in saying we can provide even better care for less money, what company wouldn't get on board?
It's not unreasonable to expect they prove they will be lower cost. So while I recognize the chicken and egg nature of things, understand that mandatory participation provides less incentive to actually get better. If your clients are captive through the force of law, do things really get better?
Do you want the same people who architect the IRS, the VA and the DoD to now be in charge of an additional 15% of the economy, healthcare?
The Federal G already accounts for about 20% of GDP and IIRC, healthcare is right around that 15% figure. So great, let's just put 1/3rd of all economic activity under the control of Congress (who cannot get along, but still manages to send pork back to the district) and the President (who knows who you might get. Can you trust this one, or the next one? Probably depends on your political leanings.)
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I’m curious, since your statements seem absolute, if you believe ANY taxes should be mandatory?tbright1965 wrote: »tbright1965 wrote: »I have no problem if universal healthcare is voluntary and optional.
My problem is when you FORCE people to participate or contribute.
Have whatever system you want, as long as it is not mandatory and is funded ONLY with money voluntarily given.FireOpalCO wrote: »Why? Why does a single payer healthcare system need to be voluntary? What is unique to it that does not apply to everything else that is paid for by taxes? I don't decide how much I pay towards the military each year. Neither do I pick each year my contribution to roads, schools, or a myriad of other government provided services. Where on my tax form do I pick how much I want to contribute to our State Department?
Because we are a nation of free people. We are a Republic, not a Democracy. Majority rules gives you things such as slavery and bans on same sex marriage, and bans on interracial marriage and so on.
This nation was not founded on collective rights. There is no right of the majority. Only INDIVIDUALS have rights. Not even the government has rights. Rights are bestowed only upon individuals.
The only way that is maintained is when we recognize and defend the rights of individuals. If we have majority rules, someone loses their rights.
So any system or scheme proposed by government must be 100% voluntary. There is no right to demand that others fall into line with some view of "the greater good" just because 50% + 1 person votes for it.
Maybe the question to ask is why have we allowed our Federal Government to usurp our rights. The roles of the Federal Government, as spelled out by the Constitution are pretty small. Most things people fight about such as police, fire, roads, and so on if they are the responsibility of any governmental unit, are local or state, not Federal.
Having money go to DC and then to have your representatives in Congress try to bring the money back to the community to build a new fire station is the height of insanity. Like the 535 members of Congress, plus the President and VP know better what you need than the people of your own community is laughable.
It's probably an oversimplification, but the real roles of the Federal Government are: Defense, Foreign Policy, and a Federal Judiciary.
That's pretty much it.FireOpalCO wrote: »
Part of being a democracy is sometimes you pay for things that don't benefit you personally or that you don't value. At certain points in our history we decided that some items that weren't provided by the government should be paid for by tax dollars and funded by everyone, not just the "in the moment need" or the largess of the rich. Public schools, fire departments, police, judges, social workers, etc.
Good thing we live in a Representative Republic that was founded on the idea of individual freedom. If we were following the lead of the founders, you wouldn't be asked to pay for what you don't support.
I think the founders, faults and all, recognized the dangers of concentrated power. How concentrated power erodes freedom.tbright1965 wrote: »
Why not voluntary?
...
VOLUNTARY is key, as it will act as a check on those making the choices. If the care doesn't meet the promises, people should be free to leave the program and not be locked in to endless contributions by law.The problem would be getting it up and running. Why would the wealthy, who can afford whatever system exists, or healthy people who are able to at least afford insurance premiums, switch right away? They would want to wait and see what happens. The people who would jump right in would be mostly low income or high usage, so there would be no way for it to be financially viable.
Voluntary universal healthcare is a logic trap. You can't show it will be a good deal without knowing who will participate, and you can't convince people to participate if you can't show them it will be a good deal.
I'm not saying single-payer or universal healthcare is the answer, I honestly have no idea what is. I'm just saying I don't think voluntary single-payer/universal healthcare is possible, it would just end up being a high risk insurance pool.
If the system was better, wouldn't the wealthy be some of the first to come on board? It's not like wealthy people are against saving money. In fact, I'd argue that they may have a pretty good handle on value. Not all the wealthy are newly minted Instagram Influencers, Rock Stars or Star Athletes with new-found riches in the lottery of life. Many have built companies, often out of what they had in their garage, and now have billions.
Any system that would lower healthcare costs for them and/or their enterprises would be welcomed, right?
Wouldn't bottom line focused CEOs welcome less costly alternatives to health care?
Large companies "self-insure" meaning while there may be an insurance company on the benefits card, they are paying them for access to the network, pre-negotiated rates, and administration. The benefits costs are paid by the company. There may be some re-insurance for catastrophic events. But by and large, day to day benefits are paid by the employer, not the insurance company.
If someone came in saying we can provide even better care for less money, what company wouldn't get on board?
It's not unreasonable to expect they prove they will be lower cost. So while I recognize the chicken and egg nature of things, understand that mandatory participation provides less incentive to actually get better. If your clients are captive through the force of law, do things really get better?
Do you want the same people who architect the IRS, the VA and the DoD to now be in charge of an additional 15% of the economy, healthcare?
The Federal G already accounts for about 20% of GDP and IIRC, healthcare is right around that 15% figure. So great, let's just put 1/3rd of all economic activity under the control of Congress (who cannot get along, but still manages to send pork back to the district) and the President (who knows who you might get. Can you trust this one, or the next one? Probably depends on your political leanings.)
1 -
rheddmobile wrote: »I’m curious, since your statements seem absolute, if you believe ANY taxes should be mandatory?
Taxes should be rare and the greatest taxes should be local, not federal.
Things like the TSA should be funded entirely by what is collected from passengers (if we are going to have a TSA, that's a whole different argument.)
I am not so Libertarian that I think taxes are theft.
HOWEVER, the way DC is doing it, a solid case could be made that a great deal is being stolen from the taxpayer to fund political power grabs.
Things like Social Security should be optional, and certainly shouldn't have graduated payouts. When you look at how AIME (I think I've mentioned it before) is paid at smaller and smaller values. Some AIME is paid back at 90%, then the payout drops to 32% and finally to 15%.
<snip... I started to write a bunch about AIME and bend points and such, but I put myself to sleep in the wonky details. Suffice it to say that if it is such a good deal for workers, why not let workers decide if they really wish to participate or not and to what extent.>
So we steal from middle class workers, because let's be clear, the uber rich are no longer paying Social Security taxes on wages above about $130K to fund those getting the 90% payout on their wages.
If such programs had to rely on people opting in, they would go away.
So while not all taxation is theft, much of how it is done today, not to mention how it is spent looks a great deal ike theft, or at least a bad deal for the typical taxpayer.
When a middle income worker loses 40% of a marginal dollar earned to Federal Income and Payroll taxes and state income tax, before the remaining bucket of taxes are paid, it's hard to argue that he's not paying more than his fair share when it comes to tax burden.
That was my last paycheck. I had 80 hours of regular labor and about 26 hours of overtime. The overtime wages paid my FEDERAL tax burden.
I'm not a rich man.
So I don't trust that "Free College" or "Free Healthcare" or any of the other "Freebies" are actually going to save me any money.
I did get about a 3% drop in my tax burden for 2018, but that's temporary as Congress wasn't able to pass lasting income tax reform.
And at the same time, after paying all those taxes, Social Security only wants to pay me 15% on about half of my indexed wages when I retire, but will give others 90% of their indexed wages.
So yes, I do feel like I'm robbed at times.
Go tax those who want the freebies at my marginal rates.
Let me forego all the freebies in exchange for the lowest marginal rates.5 -
tbright1965 wrote: »rheddmobile wrote: »I’m curious, since your statements seem absolute, if you believe ANY taxes should be mandatory?
Taxes should be rare and the greatest taxes should be local, not federal.
Things like the TSA should be funded entirely by what is collected from passengers (if we are going to have a TSA, that's a whole different argument.)
I am not so Libertarian that I think taxes are theft.
HOWEVER, the way DC is doing it, a solid case could be made that a great deal is being stolen from the taxpayer to fund political power grabs.
Things like Social Security should be optional, and certainly shouldn't have graduated payouts. When you look at how AIME (I think I've mentioned it before) is paid at smaller and smaller values. Some AIME is paid back at 90%, then the payout drops to 32% and finally to 15%.
<snip... I started to write a bunch about AIME and bend points and such, but I put myself to sleep in the wonky details. Suffice it to say that if it is such a good deal for workers, why not let workers decide if they really wish to participate or not and to what extent.>
So we steal from middle class workers, because let's be clear, the uber rich are no longer paying Social Security taxes on wages above about $130K to fund those getting the 90% payout on their wages.
If such programs had to rely on people opting in, they would go away.
So while not all taxation is theft, much of how it is done today, not to mention how it is spent looks a great deal ike theft, or at least a bad deal for the typical taxpayer.
When a middle income worker loses 40% of a marginal dollar earned to Federal Income and Payroll taxes and state income tax, before the remaining bucket of taxes are paid, it's hard to argue that he's not paying more than his fair share when it comes to tax burden.
That was my last paycheck. I had 80 hours of regular labor and about 26 hours of overtime. The overtime wages paid my FEDERAL tax burden.
I'm not a rich man.
So I don't trust that "Free College" or "Free Healthcare" or any of the other "Freebies" are actually going to save me any money.
I did get about a 3% drop in my tax burden for 2018, but that's temporary as Congress wasn't able to pass lasting income tax reform.
And at the same time, after paying all those taxes, Social Security only wants to pay me 15% on about half of my indexed wages when I retire, but will give others 90% of their indexed wages.
So yes, I do feel like I'm robbed at times.
Go tax those who want the freebies at my marginal rates.
Let me forego all the freebies in exchange for the lowest marginal rates.
wait.
..... does this mean that the government won't be buying me a new motorcycle ?
drat.2 -
Motorsheen wrote: »
..... does this mean that the government won't be buying me a new motorcycle ?
drat.
And neither will I
2 -
I think implementing laws that limit the size of sodas sold at restaurants and fast food places would be beneficial. No one needs a 44oz full sugar soda from the gas station.
Also controlled portion sizes/limits. You go out to eat and you get two meals for the price of one at a lot of places. Instead of offering large portions directly on your plate, restaurants could offer a free take-away box with every purchase, encouraging you to eat it at a later time. Very few people need a 16-20oz steak, or a half-pound burger. Those are way over the recommended daily serving for any gender and most activity levels.
7 -
PineAndSalt wrote: »I think implementing laws that limit the size of sodas sold at restaurants and fast food places would be beneficial. No one needs a 44oz full sugar soda from the gas station.
Also controlled portion sizes/limits. You go out to eat and you get two meals for the price of one at a lot of places. Instead of offering large portions directly on your plate, restaurants could offer a free take-away box with every purchase, encouraging you to eat it at a later time. Very few people need a 16-20oz steak, or a half-pound burger. Those are way over the recommended daily serving for any gender and most activity levels.
Just because "nobody needs" it doesn't follow that "there oughta be a law." Laws are enforced by men with guns - the police. If you wouldn't send a man with a gun to put someone in a cage in order to enforce the idea you're advocating, then it shouldn't be a law.
7 -
autumnblade75 wrote: »PineAndSalt wrote: »I think implementing laws that limit the size of sodas sold at restaurants and fast food places would be beneficial. No one needs a 44oz full sugar soda from the gas station.
Also controlled portion sizes/limits. You go out to eat and you get two meals for the price of one at a lot of places. Instead of offering large portions directly on your plate, restaurants could offer a free take-away box with every purchase, encouraging you to eat it at a later time. Very few people need a 16-20oz steak, or a half-pound burger. Those are way over the recommended daily serving for any gender and most activity levels.
Just because "nobody needs" it doesn't follow that "there oughta be a law." Laws are enforced by men with guns - the police. If you wouldn't send a man with a gun to put someone in a cage in order to enforce the idea you're advocating, then it shouldn't be a law.
Huh? There are bunches of laws we don't routinely send guys with guns out to enforce (laws regulating advertising, food labeling, financial reporting, just to name a few).
I agree with you that laws about soda size are overreach, though.7 -
PineAndSalt wrote: »I think implementing laws that limit the size of sodas sold at restaurants and fast food places would be beneficial. No one needs a 44oz full sugar soda from the gas station.
Also controlled portion sizes/limits. You go out to eat and you get two meals for the price of one at a lot of places. Instead of offering large portions directly on your plate, restaurants could offer a free take-away box with every purchase, encouraging you to eat it at a later time. Very few people need a 16-20oz steak, or a half-pound burger. Those are way over the recommended daily serving for any gender and most activity levels.
Great evil is conducted via the notion "nobody needs".3 -
PineAndSalt wrote: »I think implementing laws that limit the size of sodas sold at restaurants and fast food places would be beneficial. No one needs a 44oz full sugar soda from the gas station.
Also controlled portion sizes/limits. You go out to eat and you get two meals for the price of one at a lot of places. Instead of offering large portions directly on your plate, restaurants could offer a free take-away box with every purchase, encouraging you to eat it at a later time. Very few people need a 16-20oz steak, or a half-pound burger. Those are way over the recommended daily serving for any gender and most activity levels.
Too many loopholes around limiting size. If you want to discourage consumption, just tax it like alcohol.2 -
This is true. Most developed countries have implemented a sugary drink tax, but in conjunction some have also required the amount of sugar in those products to be reduced by a certain percentage. France also implemented a law that refills on sugary drinks are no longer allowed.Theoldguy1 wrote: »Too many loopholes around limiting size. If you want to discourage consumption, just tax it like alcohol.
I hope that the US would eventually follow the example.
4
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