Home Politics Watch The State Of The Union Live Politics Watch The State Of The Union Live By Justin Gardner - Jan 27, 2010 0 27 SHARE Facebook Twitter tweet And away we go… So, what did you think? RELATED ARTICLESMORE FROM AUTHOR Windows 10 Detailed Review – Apps, Menus, Improvements, Features and More WhatsApp vs. Traditional SMS – Is WhatsApp Costly than SMS? 5 Features That Will Disappear in Windows 10 and How to Get Them Back 27 COMMENTS Did the Republicans sit on their hands a bit less than during his health care speech? Did anyone else see what seemed to be mocking looks on Republican faces? I think he just needs to abandon the overt attempts at achieving bipartisanship and just let it happen if the proposals can get some Republican support. But I don’t think there will be much of that, if any. Reply It was, as always, a very good speech. Understanding, unapologetic, clear, poised, funny. Total command. Sounded sincere. Quite a contrast to the response which, though it hit the right notes, was not delivered with the same sort of forceful and sincere-seeming conviction. I think he’ll get a bump in the polls. And then it’ll go right back to being all about jobs. Reply At this point he’s got two possible options on health care. The first is to get the House to pass the Senate bill. That is not likely to happen unless he explicitly pushes it, because political inertia has set in. The House won’t pass it without Senate action, the Senate won’t promise action until the Reps pass it. The second option is to come to the GOP with his tail between his legs and let them write the bill. In that case it’s likely to be a lot worse. The Senate bill is awful close to the one a smart conservative would write if he was asked to write a bill that controlled health costs, and made coverage affordable for every American. If you don’t believe check out the Dole plan from 1994. This indicates the GOP is likely to demand a lot of stuff that sounds good, but is not smart. Tort reform, for example, has been tried in almost every state since the AMA started pushing it in the 60s. It’s not necessarily a bad idea, but it’s pretty clear that if any politician could fix health care simply by reforming torts somebody would have done it a long time ago. In the past other politicians have tried to fix pre-existing conditions clauses without a mandate. It’s called guaranteed issue. What ends up happening is the pre-existing conditions people go in a high-risk pool and pay near-extortionate prices for insurance. Their ideas on making a national insurance market won’t work either because they’re too chicken to actually make any decisions regarding that market. They want the states to license insurance companies, and to give those companies the right to sell insurance anywhere. In other words a product nobody understands will become even more confusing because nobody will know exactly which of the 50 rulebooks their insurance company is following, and even if they did they probably don’t know what that means. Econ: 101 says markets only work when both buyers and sellers have a solid idea of what they’re buying (and selling), so this is probably not a great idea. In other words if we pass the GOP bills we’ll probably screw the lawyers, give finance people a buttload of money as they game differing state’s regulatory regimes, and be in the exact same mess we are today 10 years from now. Only 10 years from now we’ll be spending 1/3 of our economy on health care, MediCare will be nearly broke, etc. Reply I say give up the ghost of bipartisanship. Would the republicans be catering to the democrats if they were in majority? Reply I wonder Chris, if the Republicans held the White House, and had large majorities in the House and Senate…would you be urging THEM to “give up on the ghost of bipartisanship”? Reply Give up the takeover – eliminate inept waste & fraud in existing programs No need for more/new legislation – just sign me up for the existing benefits our “elected elite” enjoy – – Reply @Nick, I’m a conservative myself, and I know lots of smart conservatives. None of them like the Senate bill at all. Is it better than the House bill? Well, yes, but being shot is better than being burned at the stake: neither one is exactly a recipe for a good time. As someone who designs and implements large and complicated systems for a living, one of the things I’ve learned is that it’s better to keep systems simpler rather than more complex at every step of the design process – complexity will come later, in the one-offs and special cases. These pair of bills are both WAY too large and complicated – the likelihood that unintended consequences will swamp noble intentions to me appears to be a certainty. Therefore, I’d like to see them scrapped. I’m totally on board with improvements to the health care systems in the US, but a little bit at a time, please! Make sure that the incentives line up correctly, and then see if they work… Reply The second option is to come to the GOP with his tail between his legs and let them write the bill. In that case it’s likely to be a lot worse. The President is everyone’s President. If he really can’t go to Republicans in precisely the spirit he described last night, and ask them what it would take, he doesn’t deserve to be President. If the price is too high, he can say no. Or he can start a public battle. He can challenge the GOP to show that they aren’t “the party of no.” Presuming in bad faith that there are no circumstances in which a useful bill can be passed with a little bit of GOP cooperation leads to a self-fulfilling prophesy. If Obama cares, he should try. That means ignoring the constant whine-meming of liberals that its all the other side’s fault. The Senate bill is awful close to the one a smart conservative would write if he was asked to write a bill that controlled health costs, and made coverage affordable for every American. If you don’t believe check out the Dole plan from 1994. Well, I guess its interesting that the current plan has some similarities to a 16-year-old GOP plan. But like Obama, I am uninterested in litigating the past. I’ll give you the credit of believing you on these repeated claims, in the following sense: you seem to have truly convinced yourself that the current plan is really in accord with republican principles and currently favored approaches. Sadly, few other folks seem to believe this. Republicans and independents who oppose this bill do so because it adds an expensive entitlement, one they are convinced the nation can’t afford. You and the President can keep shopping the “CBO-approved” vibe all you want. Sooner or later, you’ll have to face the problem that the opposition does not believe that this bill will really save money over the long-term. They think that “CBO-approved” is a cynical and misleading talking point. [for reasons we’ve gone over ad nauseum here.] And here’s the thing. Starting with Bill Clinton in 1994, democrats have co-opted some of the economic policy approaches that helped the GOP overtake congress in 1994, ones that the public found compelling. Obama nodded at a bunch of them last night. Your argument rests heavily on the presumptions that come from a liberal’s sense of what it means to be a smart conservative. But the future of healthcare reform does not rest on liberals’ sense of what it means to be a smart conservative. It rests on independents’ sense of what it means to be fiscally responsible. Let’s break that out for emphasis: The future of healthcare reform rests on independents’ sense of what it means to be fiscally responsible. Read that and repeat it as many times as needed for it to sink in. And notice that neither liberal nor conservative is mentioned. Independents want fiscally responsible policy, and don’t believe the current bill is. Independents want fiscally responsible policy, and don’t believe the current bill is. Independents want fiscally responsible policy, and don’t believe the current bill is. Got it yet? If you still think the “CBO-approved” chant is going to work, keep hammering. But account for the fact that a non-dismissable portion of the electorate has looked into it, and doesn’t buy it. They’re informed, and they are sharing their views. Friggin’ internet! Reply Kranky, As always, I think you are spot on. However, I can’t help thinking that the “and don’t believe the current bill is” is a little like “and believe that there are WMD in Iraq”. In other words, a product of a lot of screaming from the right and a general (distrust of government, fear of terrorism), and one that they will change their minds on when actual facts become clear. Or, as my captcha helpfully offers, “free doubts” Reply We had Republican majorities in the last administration. It was essentially the same problem. Whether the “gripe” is fiscal irresponsibility or fixing an area of our society that really needs it (healthcare), the result is the same. Our elected leaders, regardless of political philosophy, are completely beholden to special interests and not responsible to those who elected them. Ideally every single incumbent would be voted out every election. Maybe they’d finally get the message. Obama was Presidential when he was running, but he’s governed like a minority party Senator. The reconciliation process could get some of these pieces of the HC bill passed-but any insurance regulation (essentially any part of the bill not related specifically to the budget) will not be part of it. Reply Guys, You didn’t actually disagree with my statement that this is the bill “a smart conservative would write if he was asked to write a bill that controlled health costs, and made coverage affordable for every American.” Without an individual mandate coverage is not affordable for sick Americans. Period. Without subsidies the mandate is futile. Without taxes the subsidies can’t be paid for. Ergo if you want to “makes coverage affordable for every American” you are stuck with ObamaCare unless you’re willing to do something further left like single-payer, or something that’s uncategorizeable ideologically like Wydenn-Bennett. Your argument is that we don’t have the money to make coverage affordable for everyone right now. That’s a defensible argument, and in line with GOP principles. But it does not contradict my statement. I think your argument is short-sighted at best, because I believe that the country has to do that eventually, and with high medical inflation every year we wait medical costs rise. Which means the subsidies necessary to run the program rise. In other words a vote against ObamaCare today is de facto a vote for a $multi-trillion program ten years from now. A proigram that will almost certainly be left of Obama’scurrent proposals because a) it will cost more, and b) it’s impossible to go to the right of ObamaCare and still solve the problem. And David: Do you have an idea, to change the health system, that would save significant amounts of money, and cover everyone, but change less then the Senate bill does? Because if you do I’m all ears. When your health system spends twice what anyone-else’s does per capita, despite the fact 10-15% of your population is uninsured, you’re probably gonna have to make a major change. Reply @Terrence Believe it or not special interests are not the problem with health reform. All of them agreed to the basics of Obama’s bill, and if Kennedy hadn’t died they would have agreed to a final bill already. They don’t all like it, but all of them are convinced some major changes are inevitable and that ObamaCare will be relatively painless for most of them. The problems are two-fold. One is that the right refuses to admit the health problem is a major problem. Thus they get away with claiming the most Conservative possible solution to the problem is, in fact, Communism. And additionally imply that if only tort reform were enacted nationally, and a couple little regulations were changed, everything would be fine. This is partly the fault of the political elite, but it doesn’t help that the Tea Partiers are the major right-wing activists of the moment, and they are simply in denial when it comes to the problems with American health care. The second is that our political system is designed to be inefficient. The founders designed it with multiple opportunities for change to lose. A bill may not come to a vote in committee, it can lose in Committee, lose on the floor, the houses might disagree with the conference report, and the President can veto. Reply @ kranky – You and the President can keep shopping the “CBO-approved” vibe all you want. Sooner or later, you’ll have to face the problem that the opposition does not believe that this bill will really save money over the long-term. The same way Dems keep pushing the “Darwin was right” vibe, and the “vast preponderance of scientific evidence indicates humans are causing global warming” vibe. It’s hard to have an honest debate when the other side has no use for discovering facts, or for even admitting facts when they are staring them in the face. Which brings us to the “honest” part of “honest debate” – How can anyone believe these people are being honest about anything? There’s no evidence of it. But hell, they don’t pay attention to evidence, anyway so fak it – they’re right! One can win any argument with their system – you just have to dismiss altogether the notion that there are any facts – at all. It’s damn genius. Reply @Nick: Sure! 1) Require all medical offices / personnel to post prices in advance (similar to auto mechanics). Obvious exceptions for trauma centers, yada yada. 2) Fix how malpractice is dealt with ala Krauthammer’s approach 3) Open a number of sliding-scale / nominal cost clinics in poor areas to directly care for people who cannot get care elsewhere. Together, those measures would improve access to care, reduce costs, and begin to put the incentives in the right place. They would also stop equating health insurance with health care, which is the disastrous central flaw in most of the discussion at this time. #3 would cost money, but providing more care in fact does cost money. It’s worth it. In any case, those approaches don’t break our existing medical system to the yoke of total government control the way the current plans do. Reply You didn’t actually disagree with my statement that this is the bill “a smart conservative would write if he was asked to write a bill that controlled health costs, and made coverage affordable for every American.” What I said in direct response to your claim is this: Republicans and independents who oppose this bill do so because it adds an expensive entitlement, one they are convinced the nation can’t afford. Unless we believe that these republicans and independents think of themselves as dumb, then I’m describing a literal host of Americans who must necessarily believe that smart conservatives should reject the bill. But if that evades you, then let me explicitly state the following (for at least the 3rd time over the course of our various related discussions): NO, I DO NOT AGREE that this is the bill a smart conservative would write if he was asked to write a bill that controlled health costs, and made coverage affordable for every American. I continue to find this declaration of yours preposterous. PREPOSTEROUS. Further, so do the majority of independents and conservatives. Any fiscally literate independent or conservative understands that healthcare is a dynamic of unlimited demand against limited supply. In such a dynamic, the only viable solution involves some form of rationing. Sad ugly news for many, but true nevertheless. Conservatives don’t believe in subsidies, which often cause prices to rise. And they don’t believe that the government can ration more efficiently than a well-functioning market. I don’t necessarily agree with all of those viewpoints, but most smart conservatives do. Let’s review the basic problem with your statement: This is the bill a smart conservative would write if he was asked to write a bill that controlled health costs, and made coverage affordable for every American. If a conservative wrote the bill in question, he or she would no longer, by any reasonable accounting of relevant economic principles, BE a conservative. And I am utterly unable to account for why this evades you. If conservatives come over to your way of thinking, then they are thinking like you. You’re not a conservative, and neither would they be conservatives if they agreed with you. You have ignored on multiple occasions when I have pointed out the obvious conservative economic principles that this bill violates. You’ve even gone so far to make this claim right after I provided a list. This ongoing obtuseness leads me to suspect that you are not discussing this issue in good faith. Instead, you are acting as a blind advocate for existing reform. Shame on you. Reply at mdgeorge As always, I think you are spot on. However, I can’t help thinking that the “and don’t believe the current bill is” is a little like “and believe that there are WMD in Iraq”. In other words, a product of a lot of screaming from the right and a general (distrust of government, fear of terrorism), and one that they will change their minds on when actual facts become clear. Thanks MDG. I agree with your first point here, Undoubtedly, many Americans form their opinions on little or no actual research, and on biased one-sided information. As to the question of whether “they” will change their minds…the public is not a monolith. I expect that Americans who benefit from this bill (should it pass) will indeed come to love their new benefits.(Note that I support the current bill solely on the basis of extending non-emergency coverage to the uninsured poor). But resistance to this bill comes primarily from the substantial majority of Americans who currently are satisfied with the health coverage they receive. These folks expect that they’ll be the ones who pay for extending coverage, and that any cost reductions will flow to low income folks. Or something like that. Let’s face it, the system we have now really owes its enduring form to the fact that it satisfies a big enough majority. Satisfying that majority is what allows the current system to endure without change, despite how poorly it serves the remaining minority. It’s a matter of self-interest, the motivating factor we hate to acknowledge but are always stuck accounting for. Consider a group of 100 people deciding how to split $100. Sadly, you can sometimes get 51 people to vote to split $100 into 51 portions even if it means that 49 people get nothing. I wish it weren’t so, but it happens all the time. Reply kk, It’s frustrating that the costs of the current system are so well hidden. It satisfies everyone who doesn’t get sick enough to realize that their insurance doesn’t actually cover them (recission). Reply @Dave As of right now doing number 1 alone would be a gimmick. The prices they’d post would be useless to the majority of people who use medical services because those prices are just the starting point in negotiations. Moreover it’s difficult to say what systemic effects this would have as nobody, in any country, anywhere, has ever tried it. It could increase overall costs if the “my baby deserves the expensive Doctor” factor is more important then the “this Doctor is a ripoff ” factor. Number 2 is interesting but probably wouldn’t actually make the system any more efficient. The County that costs Medicare the most per capita in the nation has virtually no lawsuits. What happens there is simple: Doctors open up blood test clinics, start ordering unnecesary tests, and blame it all on the lawyers when people start asking why: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande Note that in McAllaen Krauthammer’s tort reforms would actually INCREASE costs. No lawsuits mean minimal malpractice costs in McAllen TX. Under Krauthammer’s idea malpractice victims would get some payment. It’s not a bad idea, and if I was King for a day I’d implement it, but it just goes to show you how messed up our health system is. If somebody with actual power supported your third idea I’d be on your bandwagon in a heartbeat. But I have the feeling it would cost a lot more then ObamaCare, and it would be harder politically because the tea party types would see it as a bigger “takeover” then ObamaCare is. @kk So smart’s the wrong word. An informed, intellectually honest, conservative who was told to write a bill containing costs, and creating affordable health care for every American would come up with ObamaCare. If a conservative wrote the bill in question, he or she would no longer, by any reasonable accounting of relevant economic principles, BE a conservative. If that’s the case it is impossible to solve the health care problem and still be a conservative. I’m reluctant to go that far. Especially since conservatives in every other country, and the State of Massachusetts have somehow managed to be Conservative while supporting healthcare systems at least as Progressive as Obama’s proposal. Remember Germany’s system was Bismark’s idea. And nobody called that guy liberal in his lifetime. Reply If that’s the case it is impossible to solve the health care problem and still be a conservative. Almost true. Only one small amendment is needed to make it 100% accurate: It is impossible to solve the health care problem in a manner that is satisfactory to liberals, and still be a conservative. Which is similar to what I’ve been saying all along. Of course, we haven’t even talked about your problematic presumption that a conservative would want the government to take primary responsibility for controlling healthcare costs and making healthcare affordable. I look forward to your views on what a sensible liberal would do if he or she were asked to, say, write a bill that made the government smaller and reduced spending on social programs that created a culture of dependency. Might you say “well, liberals don’t believe in that?” You might, mightn’t you? Reply @mdg Agreed. Big part of the problem. If health insurance hadn’t been so heavily subsidized by employers for so long, we’d already have made serious inroads on cost controls. If most people had been paying $600, $1000, $1500 a month for 5 or 10 years, we’d be talking pitchforked crowds on the white house lawn, right? But the fact is that most people only see or care about their own visible out-of-pocket costs. That’s one reason why I like the idea of taxing such subsidies as income. Make people see the true costs. When they really see and feel the pain, they’ll get the problem. And you know what? Imagine big employers were offered a deal where they’d simply stop subsidizing health insurance while adding the subsidy to each employee’s salary. (Along with, say, people getting access to some privately purchased insurance that included collective bargaining power on cost via access to some big buying pool) Employers would LEAP. All they want is something resembling cost certainty for labor. Meanwhile they’ve been stuck cutting back more and more on wages and raises while trying to conceal the skyrocketing costs of healthcare from employees who don’t trust or believe them. Helluva system. huh? Reply @mike mc Well, I personally don’t go quite that far. IMO. both sides have their own pet blind spots and comfortable pretenses. I am not sure what you mean by the “Darwin was right” vibe. Are you talking about evolution? Evolution is a scientific theory, not a fact. Granted. And it’s an extremely well-supported theory. Intelligent design is a theory, but is not a scientific theory, since it is not falsifiable. So I often find myself troubled by what social conservatives want to include in a science class. I’d be fine with intelligent design as part of some sort of philosophy class, but it’s not science. And I say that as someone who keeps an eye on the repeated attempts to clothe it in science. A theory that doesn’t explain how it can be falsified is not scientific. The discipline of science allows no loopholes there. Een if the practice and politics of science may on occasion fail meet that standard. One thing the history of science shows is that this core ethic about falsifiability allows truth to emerge sooner or later. Global warming? My reading is that there are a variety of vibes with subtle differences on the left. I personally am agnostic on the notion that global warming is caused by human agency. It’s quite possible, but far from proven. And I look askance at those who are convinced that human agency has been conclusively demonstrated. Especially when so many of those folks have not personally examined the evidence, and are taking the word of others. I’m a “show me: guy, so shoot me. Not all liberals shop that version. There are many who confine themselves to more simply declaring that there is pretty strong evidence of warming. And I agree with that. If you take the time and cut through the rhetoric and are mathematically literate and look at the data, there is substantial evidence of warming over the last century, even though it does not appear to be occurring equally at all locations. And it’s worth worrying about and keeping a close eye on. It is QUITE possible that the demonstrated warming is due to a build-up of CO2 from human activity. But even if it is, we really don’t have any sort of good handle on what the long-term trend will be,m or whether all changes will be negative. So that’s another spot where I look askance at the right as well. They harbor a similar contingent of lazy uninformed folks who nevertheless express passionate opinions adopted from others.The folks who think that global warming is no more than a left-wing political conspiracy are just as harmful to the notion of honest dialogue as those on the left. Reply @kk Without cost controls we go bankrupt. That is not a liberal or conservative problem. It’s just a problem.A nd according to you anytone who wants to solve it is (by definition) not a conservative. Without affordable healthcare people die. Due to the adverse selection death spiral more people are unable to afford health insurance every year. This is not a liberal or conservative problem. It is just a problem. And according to you, anyone who wants to solve it is (by definition) not a conservative. I look forward to your views on what a sensible liberal would do if he or she were asked to, say, write a bill that made the government smaller and reduced spending on social programs that created a culture of dependency. Might you say “well, liberals don’t believe in that?” You gave me way too much wiggle room. Shrinking government is a conservative catchphrase, but liberals would prefer it if many government programs were drastically shrunk. And you didn’t say how much you wanted to reduce social spending. So I would write a bill eliminating the entire Department of Defense, cut the pay of the top person administering Welfare $0.01, and do the same to the guy who runs Food Stamps. But your analogy doesn’t really hold water. The government running out of money is a problem period, but lots of people (including me) think government should be bigger and spend more on social programs. As for employers: In theory you’re right. If they were smart they’d devote their entire political budget to getting health care off their backs completely. But they don’t do that. Apparently this is partly ideological and partly a control issue. Reply Without cost controls we go bankrupt. Quite true. The kind of cost controls that conservatives oppose are mandated ones like the government setting prices. Please take care to notice that competition in providing amore adequate supply to meet demand IS a form of rationing, if you understand rationing as meting out resources in a rational fashion. You gave me way too much wiggle room. Not really. I said “sensible” liberal. Perhaps you believe that a sensible liberal really would simply abolish the dep’t of defense. I sure don’t. Maybe you don’t recall that the Iraq war authorization vote was unanimous. Without affordable healthcare people die. Due to the adverse selection death spiral more people are unable to afford health insurance every year. This is not a liberal or conservative problem. It is just a problem. And according to you, anyone who wants to solve it is (by definition) not a conservative. No, according to me, anyone who wants to solve it using the currently preferred methods in the democrat-authored current bill is not a conservative. You regularly and repeatedly restate my arguments while leaving out the most cogent specific point(s). This signals your bad faith in the discussion. But your analogy doesn’t really hold water. It wasn’t composed to pass some sort of “analogy that holds water” test. It is generally a simple task to find some reason why an analogy is inapt, if that’s your goal. Instead my query was intended simply to reinforce my point it’s not especially wise to rely on a liberal’s sense of what a “smart conservative” is. Just as it’s not wise to rely on a conservative’s sense of what a “smart liberal” is. As for employers: In theory you’re right. If they were smart they’d devote their entire political budget to getting health care off their backs completely. But they don’t do that. Apparently this is partly ideological and partly a control issue. Not sure what you mean. But my sense is that employers lack any sort of powerful monolithic lobbying group capable of actually doing this. Probably because most companies doubt they could make it happen,. So they think that it would be foolish to pour resources into some elaborate political crapshoot. One for which they’d undoubtedly be crucified by political opportunists, too. One thing I really try to do in thinking about such situations is to avoid positing malice. I don’t know anyone who can really keep a secret, so I don’t believe in large conspiracies. I think that the current system evolved for a variety of reasons, and can be accounted for without focusing on evil or blame. Employers have offered health benefits for a long time, beginning at a time when it was a very affordable additional cost that helped attract quality workers. Rising costs continue to make continued provision more untenable, but there’s a big inertia issue. What is quite possible is that more and more big employers keep decreasing their subsidies, putting that money into wages while offering little more than a variety of options that give workers group purchasing power. If the true costa are revealed, and various options are provided, people will self-ration. As I have repeatedly stressed, cost growth in the 8 to 10% range WILL force a “solution” of some sort. I get that you believe that this bill’s ideas can truly reduce costs. I don’t agree. Increased subsidies generally cause costs to rise. That our government is currently providing training to make more and more healthcare workers is yet another signal that it expects the healthcare industry to keep growing strongly. Neither of those things makes for an optimistic forecast for reducing cost growth. Now, if we were to tax employer subsidies as income, that would reduce costs. Did you notice how that idea went over like a fart in church, and how the unions cynically sought an exemption instead of to kill it? I can imagine some number of sensible conservatives supporting taxing big employer healthcare subsidies as income. Just as I can totally understand how quickly they’d back away from it if unions were given any exemption. Reply @kk Quite true. The kind of cost controls that conservatives oppose are mandated ones like the government setting prices. Please take care to notice that competition in providing amore adequate supply to meet demand IS a form of rationing, if you understand rationing as meting out resources in a rational fashion. Government-mandated prices are not in the bill. Not really. I said “sensible” liberal. Perhaps you believe that a sensible liberal really would simply abolish the dep’t of defense. I sure don’t. Maybe you don’t recall that the Iraq war authorization vote was unanimous. It was a bit of hyperbole But realistically our defense budget is a majority of the world’s military spending, and we’re formally allied to most of the other big spenders (Europe, Japan, and South Korea), so we could probably scrap a significant portion of the defense budget and be no worse off. Certainly 10-20%. And that’s not the only place liberals think the government should pull back. Marijuana busts are another, as are agricultural subsidies, US Foreign Aid is mostly military, etc. No, according to me, anyone who wants to solve it using the currently preferred methods in the democrat-authored current bill is not a conservative. You regularly and repeatedly restate my arguments while leaving out the most cogent specific point(s). This signals your bad faith in the discussion. You are misinterpreting my argument. My argument is that there is no possible way to achieve affordable healthcare/cost controls/etc. for every American that is more Conservative then the approach taken in this bill. It simply does not exist. Note that if I’m mistaken on this point I will gladly admit it. But so far I have yet to see a more conservative approach that would work. In other words you are arguing that conservatives prefer fairy tales to anything that will actually work, and that any conservative who wants a policy that will work is (by definition) not conservative. Reply Without cost controls we go bankrupt. Costs by nature eventually moderate themselves. Socio-economic trends do not continue indefinitely and eternally. Cost/prices are driven by supply and demand, not by immutable laws of physics. And as I have pointed out so very very often for so very very long, the single major driver of health care cost growth in excess of GDP growth (a situation seen in every developed nation, including those with socialistic single-payer systems) is simple aggregate demand. We want more. We are willing to pay for it. Without affordable healthcare people die. News flash: They also die with it. In point of fact, everyone eventually dies, reagardlss of how much health care they receive at any prices, afforable or no. No exceptions. The question-begging term in your statement is “affordable healthcare.” With an unlimited budget you can get everything possible. You’ll still eventually die. With no budget, you’re dependent on the kindness of strangers … and you’ll still eventually die, regardless of how much kindness is shown. Please take care to notice that competition in providing a more adequate supply to meet demand IS a form of rationing, if you understand rationing as meting out resources in a rational fashion. Er, no. Your definition of rationing is wrong. When economists refer to “price rationing” they’re not really talking about rationing at all as it’s generally understood by the lay public, but about the supply/demand market mechanism itself, in which goods and services are differently consumed by the individual choices of consumers in response to price levels. Rationining as the term is commonly used means everything BUT consumers making their own free choices, and is what economists refer to as non-price rationing. Rationing in general refers only to the the latter, which is the controlled distribution of scarce resources, goods, or services. As in, controlled by someone other than the actual consumer. Such rationing, at root, is ALWAYS done in an attempt to keep prices below the level that demand would otherwise dictate. The problem being, of course, that such rationing inevitably leads to shortages at any given price on the demand curve below the supply/demand equilibrium point. Reply OK, my definition doesn’t match what economists say. Got it. The reason I gave that definition is because it matches the context in which I’m talking about solutions. If we have a higher demand than supply, then cost is the mechanism by which resources get meted out (whether that meting out matches the def’n of rationing.) So, to be clear ( because I don’t think I’m really arguing with you here Tully), if we as a nation decide that we don’t like cost as a mechanism for the rational meting out of healthcare resources, then we need some other mechanism(s). Not saying any of this to be contentious. I just don’t want anyone to miss the point that in the current supply-demand dynamic (which Tully and I basically agree about ), we’re looking for some sort of substitute for cost as controlling mechanism for the supply-demand imbalance. And leaving aside whether there even is such a substitute, subsidies don’t push costs in the right direction at all. Except from the temporary micro-perspective of the given individual consumer who receives a subsidy from an employer or from the government/taxpayers. Reply @Nick Government-mandated prices are not in the bill. What would you call the cuts to medicare that dictate a low rate of growth in medicare reimbursement, if not price controls? Isn’t this mechanism pretty much the SOLE basis on which democrats contend to make this plan a budget reducer? My argument is that there is no possible way to achieve affordable healthcare/cost controls/etc. for every American that is more Conservative then the approach taken in this bill. It simply does not exist. Note that if I’m mistaken on this point I will gladly admit it. But so far I have yet to see a more conservative approach that would work. That hasn’t been your argument at all. You’ve shifted it, again, to evade my repeated refutations. The previous form of your argument is that smart conservatives should agree with it and support it. And I’ve told you that you’re not a good source of understanding about what smart conservatives believe, because you’re not conservative. Now, since I’ve pushed you, you’re much closer to revealing what you really think, which is simply that conservatives are wrong not to support this bill. And that no conservative ideas absent from this bill will work. You keep trying to shift the basis of the original argument until it turns into one that you can win. But I won’t get drawn into defending an argument that I didn’t make. In other words you are arguing that conservatives prefer fairy tales to anything that will actually work, and that any conservative who wants a policy that will work is (by definition) not conservative. Once again, your frustration at trying to defend your original bad argument has led you to spout a petulant insult while simultaneously mischaracterizing what I;’ve said. I’ve never argued anything resembling this, as you know. Look Nick, I am fine recognizing that you think liberal ideas on this issue are better. What is so troublesome is your utter unwillingness to acknowledge that conservatives, many of whom are extremely intelligent and well-informed, believe differently than you do. In good faith. You’ll never be any better than a partisan tool until you are willing to recognize that there are many conservatives who, upon thinking deeply, differ on some basic principles about this world. Their passion, faith, and sincerity is no different than yours. You should grow up and notice this. President Obama has repeatedly appealed to Americans for a ratcheting down of partisan rhetoric and demonization. And here you are declaring that conservative ideas won’t work and are fairy tales. You’re letting the President down. The bitter partisan divide will never be bridged so long as each side demonizes the other, calling their ideas fairy tales and consistently implying that the majority of their actions are undertaken in bad faith. It’s really no wonder at all that Americans everywhere are walking for the doors and deserting BOTH parties. I think a quickly growing portion of the public is looking at both democratic and republican partisans and wondering how did we all get so FULL of crap? Reply LEAVE A REPLY Cancel reply Notify me of follow-up comments by email. Notify me of new posts by email.