I like the simplicity. 20% of agi is a lot of money for most to have to come up with. The biggest issue I have and the flaw in all consumer driven health plans is it is extremely difficult for consumers to shop prices for services. So the market forces never push prices to efficiencies

I wouldn't wish Medicaid on my worst enemy, especially since I've actually been on Medicare for the past decade. The difference is like night and day.

When I first moved to NYC in the mid-70's, I was a disabled student and essentially became a ward of the state, so I collected SSI and was on Medicaid. For me, Medicaid was great as I was on my own and suddenly, I didn't have to pay a thing for prescriptions, medical equipment and doctor visits, but even forty years ago, Medicaid doctors were the lowest rung on the MD ladder.

A three or four hour wait at a Medicaid clinic was average. Getting an appt. was always a nightmare and I was instructed early on to say it was an emergency when calling for one. The waiting room was always packed full of screaming, horribly sick children with hacking coughs and their huge obese relatives chomping on chips or Combos. Few spoke English. Old folks sat wearing soiled diapers in wheelchairs - the smell of death and disease hung in the air. You rarely saw the same doctor twice and because most people were there for the common cold or flu, you ended up just getting a 'script for and antibiotic and sent on your way. Perhaps things have improved, but since Medicaid largely caters to the poorest, I'm kind of doubting it.

Medicare on the other hand was designed for seniors living on their retirement SS. Most doctors still take it (although that's dwindling...), you have your own steady stable of physicians, can get an appt. quickly, etc.

Throwing more into Medicaid/Medicare isn't the answer, but aside from single-payer for all, I don't know what is, but I know damn well that whatever the Rethuglicans do next with health care, it will most certainly be aimed at putting profit over people.

> it will most certainly be aimed
> at putting profit over people.

I hate trite rhetoric.

Y'know what's cool? Paying for stuff.

People should create the wealth that they'll need to care for themselves. And no mix of policy, or paperwork, or "insurance," or rhetoric or legislation or compassion will ever do better than earning the money required to encourage smart, decent people to provide good care. All this shit would go away if people paid for what they need.

Putting profit over peeeeeeepulllllllllll.

Raise your hand if you're a gifted, disciplined, highly intelligent person who gave your best effort to people who didn't want to pay you for over a lifetime of work.

?

Capitalism is tragically underrated nowadays. No other system ever did anything for anyone, especially for anyone poor.

Gummint health care.

The problems with healthcare in the U.S. that need to be addressed before any proposed healthcare reform can be successful.

@ Jacquie T - don't take this the wrong way. It's not personal - it's strictly business.

1) You got a wide range of valuable services for free, including great human capital and semi-miraculous drugs - and then you complain about the quality of the service? What, you don't think it's worth what you paid for it?

2) 'Profits over people'? Give me a break. This is tired, unhelpful sloganeering. It also ignores the facts of history, which are that things done for profit generally have the very best effects for people.

You've already remarked on the quality you get when healthcare is provided for free to the user and on a not-for-profit basis - but you think that more of the same will somehow be better? If your own example is not enough, all we have to do is consider things like the VA, or Britain's NHS. They don't put 'profits before people' - but they put just-about-everything-else before people, and people suffer and die as a result. How many times does this have to be shown before it sinks in?

I can go to Costco tonight and buy a 60", high-definition flat-screen TYV for less than $600 - a truly amazing product, a triumph of technology, that I could not have bought anywhere, at any price, just 20 years ago. That amazing TV is not there because Costco loves people and wants everyone to have a big flat-screen TV - it's there because Costco wants to turn a fat profit, and the way to do that is to offer me what I want at a price I want to pay.

Same applies to health care. It's not some magickal special case where normal economic rules do not apply - it's just another necessary service industry. The way to get costs down and quality up is to put it in the same place that Costco is when it tries to sell me a big-careen TV - price transparency, clear consumer information, and plenty of competition. That means getting the stifling and corrupt hands of government out of the provision side as much as is possible and maybe more.

On the funding side - several generations of large parts of the population have become accustomed to healthcare, all healthcare, being essentially free, and they now assume that all healthcare, regardless of quantity or quality, should be free as some sort of basic human right. Primarily because vote-hungry politicians of all parties have sold them on this idea. Until this mindset is altered, all funding approaches are going to have big hurdles to climb. I like Ms McArdle's idea quite well, along with several others. I don't like the part of it which is tied to AGI, which means consumers are always related to their income, their tax position and their relationship to the state. It also means that very rich or highly-paid persons must fend entirely for themselves, since it is very likely that they will never reach the 20% AGI threshold - yet it is their taxes that pay for everybody else. It might be better to find a funding model that works more off actuarial results (the likely healthcare costs of an individual) rather than solely off income - IOW, more like insurance.

But whatever the case, the funding side will work best when it gets closer to the relationship I have with Costco - clear pricing, clear information and lots of competition.

llater,

llamas

I always think Lasik surgery is a good example. It was never covered by insurance and considered an elective procedure. The price dropped to the point where most people could afford it. (Similar to llamas' Costco TV.)

Whenever I hear the old bromide about putting "profits over people," my bullshit meter immediately goes off, because "profits" is really just a code word "other people." I want free stuff, and I expect someone else to provide it and for me not to have to pay for it. If you aren't willing to work for free, I'm going to screech that you are putting profits over people, when really you just want to get paid for working. I want you to put me above yourself.

Put Congress on the same VA based healthcare as our military, strip their ability to go elsewhere (don't like it leave PUBLIC service), and make VA based healthcare the optimum service provider.

I'm expecting of course that the answers to the problems w/doing this mirrors what llams and Pirate Jo said.

Profit is what motivates enterprising doctors to open their own clinics outside hospitals run by Catholics (solved that zombie problem).

More profit means more opportunity for "better service here at MY facility" capitalistic pirates.

Word of mouth (damn long waiting time, just gave me a prescription w/o really listening, etc.) will weed out those that really don't care. (That does not work w/government services does it. See above.)

This is doable and measurable and will benefit a significant portion of our population. MAKE the poor use the same facilities if they want FREE care and MAGIC will happen.

Congress will get their A$$es in gear and do something As LONG AS it affects them.

Sigh. Sounds like an echo - an incomplete one, at that - of this.

I guess my suggestion is too hard to read.

Also, who the hell you think "the government" is?

Fuck that!

This is just another attempt at single payer light. And it will deliver crappy service at inflated costs. So once again, fuck that.

The problem is people are calling healthcare as a right. But healthcare is a service, provided by someone trained and knowledgeable in the field after years of study and training, not something intangible provided by God and inalienable by man.

The right of free speech doesn't mean someone else provides my megaphone. Freedom of assembly doesn't mean someone else is obligated to provide the assembly hall. I have a right to bear arms, but not to have the arms provided to me gratis. No other "right" requires someone else to provide to others the fruits of their labor and hard-won expertise. So, is healthcare really a right?

However, as an advanced society, we don't want sick people sitting on street corners begging for alms while coughing up loads of phlegm and germs onto passersby. We don't want them turned away from hospitals and dying in the streets. We should be willing and able to provide for the poorest among us. We're not Victorian London. Try riding BART (or any other municipal transport system) sometime if you want a picture of what that must have been like.

And, of course, we need to worry about "rights creep." If healthcare is accepted as a right, how soon before housing is a right? Food? Clothing? How many rights do we add to the list? Communism was all about rights: the right to housing (provided in a drab concrete government building), the right to food (if you didn't mind waiting in line for hours and picking through empty shelves for the last loaf of moldy bread), the right to healthcare (if you didn't mind waiting months for drunken surgeon to amputate a gangrenous foot that could have been saved with early treatment), etc.

Before we can reform healthcare (whether the ACA or some other system), we must decide where the line is drawn. What is healthcare, a service to be purchased or a right that cannot be denied?

It's not some magickal special case where normal economic rules do not apply - it's just another necessary service industry. The way to get costs down and quality up is to put it in the same place that Costco is when it tries to sell me a big-careen TV - price transparency, clear consumer information, and plenty of competition. ~ llamas at December 7, 2016 4:15 AM

In principle, I agree with you. However, transparency requires an informed consumer base. Modern medical care is highly specialized and the ability of the average high school graduate to be knowledgeable about the latest advances is pretty slim, even if reliable information is available.

If the TV salesman says I need color correction and I have read Consumer Reports and know I don't, I'm informed enough to dispute him. If the doctor says I need a statin, do I have enough expertise to argue with him? Will reading an article on WebMD be sufficient to give me enough expertise?

Now, should we go to a Costco-like competitive and transparent type medical provider scenario, it is entirely likely that some form of information provider will arise, a Consumer Reports of healthcare. However, that will still require an informed consumer base with at least a rudimentary understanding of science and scientific principles.

Also, I can live for a few days without that flat panel television while I comparison shop. I have alternatives for viewing programming in the interim. Can I live for a few days without that hip replacement while I comparison shop?

And I can comparison shop for televisions in my living room on the Internet. A doctor will need to see my hip and view x-rays before deciding how complex the surgery will be. And that's going to require me to visit his office, a painful journey on a bad hip.

To be sure, a transparent healthcare system would work differently than a Costco direct sales model, but the knowledge base of the consumer is vital to a transparent system. And that will require a better education system, to teach people at least some biology and economics, subjects our current system does not excel at teaching and a large segment of our current populace does not want to study.

Also, let's stop conflating health care and health insurance.

Conan, yes, of course, but that's what it's become.

Also, consider a form of "preventive care" -- and that's how hard they now make it to know the price you'll have to pay for it. That prevents me from getting care.

20% of agi is a lot of money for most to have to come up with.

Given that most people can't even scratch up $400 to bail their asses out, this will be a YUGE! stumbling block.

The problem is people are calling healthcare as a right. But healthcare is a service, provided by someone trained and knowledgeable in the field after years of study and training, not something intangible provided by God and inalienable by man.

Unless you fancy taking a shot at repealing the 13th amendment...

But putting more people on Medicaid creates a whole other problem. I work in the medical industry. California's version of Medicaid, Medi-Cal, doesn't pay providers the complete cost of care. If we send them a claim for $100, they'll send us $20 and say, "That's it. We can't pay anymore." Even if we lowered the cost of office visits to $5, they would send us $1. Any doctor or clinic who takes Medi-Cal is basically doing charity work.

I love reading Megan MacArdle.

She is a very smart lady, and some of her constitutional analysis is spot on.

I think she is lost in the weeds on this one though.

Any payment plan that incentivizes people minimizing their AGI as opposed to shopping around for prices is doomed to failure. It wont reduce prices, it will just pile the cost overruns onto the middle class, which are the same people getting shafted now by the third party payer system.

I just got the most thorough professionnal eye exam I have ever had at Walmart for 95 bucks. ( and no, my 18,000 dollar a year insurance plan doesnt cover vision or anything else I actually use on an annual basis).

At least 90 percent of human medical needs can be diagnosed and treated by computer or they are self correcting. People should be paying out of pocket for this primary care.

The other ten percent should be covered by an affordable catastrophic policy.

Add a healthcare savings account that you own. That means it isn't raided by the government every December 31st to empty it out.

I think McArdle's plan has something going for it, although as suggested above it could be linked to actuarial risk rather than income.

What the US needs to get away from is using health insurance to pay for routine, expected costs (check ups etc - and yes, birth control prescriptions).

I don't claim on my homeowner's insurance to clean the gutters, and I don't claim on my car insurance for an oil change. If these things were covered, well I'll be damned, suddenly my premium would be $5k per year.

The Lasik example is a good one. But look at other mundane, non-prescription medical costs. You don't claim insurance for a jar of aspirin or a box of band-aids. They're cheap. If birth control pills were available over the counter (without the middle-man element of insurance companies), they'd be $3 a box too.

Stop expecting "insurance" to cover everything. Limit health insurance to insuring against UNEXPECTED adverse events (as it is in every other sphere), and healthcare costs will come down.

> The problem is people are calling
> healthcare as a right.

☑

> Also, let's stop conflating health
> care and health insurance.

☑ ☑ ☑

> Conan, yes, of course, but that's
> what it's become.

I have no idea what you're being so smirkingly resigned to, but I think it's odious, and I bet if good people stand up it can be resisted.

"In principle, I agree with you. However, transparency requires an informed consumer base. Modern medical care is highly specialized and the ability of the average high school graduate to be knowledgeable about the latest advances is pretty slim, even if reliable information is available."

Irrelevant Conan. Do most shoppers know the ins and outs of the electronics industry? Do they know which products are the most cost effective at accomplishing their task? No. Don't let the perfect be the barrier to the good enough. As others have pointed out, Lasik is a complex procedure that isn't covered by insurance but people still purchase it at increasing quality and decreasing cost. Do people get the absolute best service when they shop for lasik? No. I've heard plenty of horror stories. But it is no worse than most medical procedures and most are quite happy with their outcomes.

The only real solution is to eliminate third party payment. People are lazy. And that isn't a bad thing. So as long as 'somebody else will take care of it' there is no reason for people to become informed. As long as there is no market for that information no one will care to provide it. The only real solution is for people to stat paying their own medical bills and only have catastrophic insurance to cover those rare high cost situation. As for common high cost situations, too bad. You have to pay for it one way or another. You may as well stop paying someone else to spend your money for you.

I appreciate the mention of not being able to comparison shop whatsoever for health care and services. The major medical provider in my area has made it almost impossible to keep personal health care costs down, health insurance racket aside. In my youth, our family physician was able to diagnose and prescribe across a wide range of health issues. Now at my local clinic, my pcp will not prescribe so much as an allergy medication without sending me to see a specialist first. This means, extra wait time, a huge increase in cost and medical bills, and guess who you actually end up seeing if you want to get in with that specialist prior to a three month wait? A gd physician assistant. My pcp is an M.D., yet one must suffer through this type of bullshit only for a simple allergy medication.

I realize that allergy medications are available at the drugstore, but now that we are forced to purchase health insurance, why shouldn't a person try to use it since you are basically forced to pay for it? Even for prescription strength medications? And what if what's available otc isn't working any longer? All valid issues for many.

Also, consider a form of "preventive care" -- and that's how hard they now make it to know the price you'll have to pay for it. That prevents me from getting care.

You'll have to talk to a practice that does concierge medicine. Cash and carry, as it were.

Other practices? good luck with that. There's a reason they don't publish their prices. What they charge will be dependent on who your insurer is, what their payment policies are, and how good your insurance policy is.

Some will pay more than the actual cost of a given procedure, others will pay less. In the end, it averages out and they get what they need to make a profit.

Also, depending on the size of the practice, there are people who work there who's only job is to maximize the payment from the insurers and to deal with the paperwork. They're not contributing one lick to your care. And that cost has to be baked into the pie.

Thought I was being harsh last night, posting those comments. Like I was just being an asshole. Posted them anyway, because bitter middle age.

Pleased to wake up in a cloudy L.A. morning and see so much agreement about "putting profit over people."

PoOteeng pRawfitzz ohvar PEEEEEEEPIL.

Know why?

Beecuzz Republicans, and The Corporations™, are meeeeeeeen.

They don't care about PeeeePull, all they care about is being meen! And turning a profit!

But illiterate and sentimental fuckwads who are demanding that distant strangers take a compassionate financial interest in their own intimate health care are PeEeEePiLlLlL.

Got that, you bigoted jerks?!!!?!??!!

Pay your mutherfucking bills.

And when some dickwaving politicians flatters your fantasies and tells you he's come up with a way for you to avoid this quintessential human responsibility, don't listen to him.

I'm with Isab. Megan McArdle is a smart cookie and she usually nails it, but I think she missed on this one. (She's too worried about what progressives think. I'll tell you what progressives think: they're right and you're evil. Period.) Her proposal doesn't address what I see as being the four biggest problems:

(1) Unequal tax treatment of employer-provided vs. individually or group-purchased plans.

(2) Lack of competition in the health insurance industry. (Caused in considerable part by states limiting policies being sold across state lines.)

(3) Artificial limits on what kinds of plans people can purchase. (Obamacare made this problem a lot worse.)

(4) Bureaucratic and regulatory inhibits on development of new drugs and technologies.

Her idea about the government picking up the tab for catastrophic care is interesting. I'm not sure what I think of it. I think I'd rather see some kind of industry pool, maybe something like FDIC deposit insurance, that would pick up the top end of catastrophic-care cases and prevent financial disasters, e.g., an insurer being wiped out by a mass-casualty event.

Yeah, and as for Jacquie T: I was kind of with you until the last paragraph. That's where you demonstrated that you are just fundamentally unserious. I will say to you what I say to everyone who insists on shoving their un-seriousness in my face: Fuck off. A response in kind.

I realize that allergy medications are available at the drugstore, but now that we are forced to purchase health insurance, why shouldn't a person try to use it since you are basically forced to pay for it?

And then you wonder why it takes you three months to see a specialist? In a normal market, when demand far exceeds supply, prices go up.

But the market is artificially distorted.

I pay my bills. I also pay other people's bills - through this health insurance market, which is no such thing, it's a racket.

"I think I'd rather see some kind of industry pool, maybe something like FDIC deposit insurance, that would pick up the top end of catastrophic-care cases and prevent financial disasters, e.g., an insurer being wiped out by a mass-casualty event."

Such things already existed CD. Though they protected the insured and not the insurer. Which is how it should be by my mind.

Conan, you are incorrect on every single point.

The right of free speech doesn't mean someone else provides my megaphone.

Free speech doesn't require a megaphone.

Freedom of assembly doesn't mean someone else is obligated to provide the assembly hall.

Freedom of assembly doesn't require an assembly hall.

I have a right to bear arms, but not to have the arms provided to me gratis.

It is called a "right" to bear arms, not an "obligation." If the government required you to bear arms, arguably, they would be required to supply you with one.

When I was in the military, I was obligated to be proficient in the use of an M-16, to own and maintain one. The government not only paid for my training, but gave me one to use while I was in the military.

No other "right" requires someone else to provide to others the fruits of their labor and hard-won expertise.

Actually, there is at least one such right. The government gives you the right to primary and secondary education, and it does indeed provide it to you gratis. And it mandates you to use it, at least up until your sixteenth birthday.

So, is healthcare really a right?

You could argue that minimal healthcare is actually a right, since ERs have to take you in cases of an emergency, regardless of your ability to pay.

> You could argue that minimal
> healthcare is actually a right,
> since ERs have to take you in
> cases of an emergency, regardless
> of your ability to pay.

If you did, if you argued that point, you'd lose. ER policies have more to do with getting sick people out of the way of the rest of us, or the individual compassion of the communities which actually pay for them, than they do with your "rights" of some sickly little weasel who never created the wealth to care for himself.

The rest of us? In America, I mean? We are not your Dad, Patrick.

Well, Doc Baker from "Little House in the Prarie," who would accept a live chicken as payment, doesn't practice in my town, Crid.

So, you're telling me that you pay all your medical bills out of pocket?

BTW, where's that blog machoman 'brian', he of the typically American approach to health care finance? Has he met Jacquie?

> So, you're telling me that
> you pay all your medical bills
> out of pocket?

Let's first take a moment to note that there's no reason for you to ask: "out of pocket" was not a point I made, and I've in fact been commenting on the corruption of the word "insurance" in modern politics, as have others in in this stack. You can quote no wording of mine in these comments —or anywhere else on the planet— as citations for your inquiry.

Mostly, Patrick, this is the kind of topic for which your infantile neediness and teenage self-righteousness blend into your blinding fury. Your just can't imagine that bad things could happen without other people, mean ones, being responsible... Responsible for your needs, and responsible for the needs of uncounted (non-existent) throngs of others, whom you imagined to be empowered by and grateful for your concern.

For twenty-five years I was a freelancer, paying street prices for my insurance. Now I work for an enormous communications company, and insurance is part of my compensation. I pay all premiums, deductibles, and out-of-coverage costs.

Yes, you mouthy little twat, I pay all my medical bills out of my own pocket. Always have. Will do so until the day I die, at any cost.

GFY

After all these years, I still love being right about stuff.

After all these years, I still marvel at how effortlessly I can send Crid off the deep end.

Cosh, just now:

Protest-theatre is a creation of the political left, which uses it in an attempt to endow quotidian political fights with the dignity and importance of genuine popular struggles for fundamental rights. It is designed to endow debates over teacher pensions or hydraulic fracturing with the hysterical romance of revolution. In some cases, it is meant only to show that a movement is numerous enough to make trouble for own its sake.

> effortlessly

Yes, absolutely, there can be no doubt: You haven't a clue what you're saying.

Sorry, Crid, I'm enjoying this meltdown a little too much to not try to sustain it a little longer.

What did you freelance as for 25 years? Apparently something to do with communications. I had no idea there was such a robust market for tedium.

I was creating wealth in perhaps the most famously savage capitalist competition the Western world has ever known, Hollywood: Sell a ticket, sell an ad, or take the train, Babe.

In those years, you were crying yourself to sleep in the isolation of your Mom's tinderblock basement, praying through tears that your childhood patterns of resentful and sarcastic interaction with peers might blossom into a magical protective aura to defend you from eventual illness and present responsibility.

Didn't work, Biscuits.

Cincerblock. But if it had burned...

"Actually, there is at least one such right. The government gives you the right to primary and secondary education, and it does indeed provide it to you gratis. And it mandates you to use it, at least up until your sixteenth birthday"

This is incorrect. No federal mandates at all for public schooling through the age of 16, so no right to secondary education in the constitution or anywhere else.

State law covers this. Most states require education thru either the 8th grade or until age 16, which ever comes first, but public schooling isn't mandatory for anyone.

I dont know what idiot educator told you this, but they are completely wrong.

Reread it, Isab. I said the government requires education. Perhaps I should have specified which government. And nowhere did I say that the education was required at a public school. Obviously, that's not the case, since private schools and homeschooling exists. And I wouldn't have forgotten that, either, since I went to a private school.

Reread it, Isab. I said the government requires education. Perhaps I should have specified which government. And nowhere did I say that the education was required at a public school. Obviously, that's not the case, since private schools and homeschooling exists. And I wouldn't have forgotten that, either, since I went to a private school.

Patrick at December 7, 2016 2:58 PM

So you are admitting your analogy to prove some kind of *right to medical care* is totally bogus?

Patrick, I was right on every single point. The rights as enumerated in the Bill of Rights are acknowledged as your inalienable rights, not ones the government gives you. And you have the entire responsibility for the exercise of them. In none of them does the Constitution say someone else has to provide you with the means of exercising those rights. You don't have the right to take the fruits of someone else's labor in exercising those rights, whether it's a literal assembly hall or a metaphorical one.

The "right" to healthcare, endows you with right to take the fruits of the doctor's labor (his education and his experience). If you have the right to healthcare, the doctor has no right to deny it to you, even if you refuse to pay or want to pay him in chickens.

So no, you do not have a "right" to healthcare.

And where does it say you have the "right" to an education? Society does have a vested interest in having at least a semi-equated populace. The government may require you to attend a school and may even provide one for you, but that doesn't make it a right. If it were a right, private schools could not deny you your right to an education. And would run into trouble charging tuition. Colleges, too, since you have "right" to an education. BTW, you can be expelled from even a public school for a host of reasons, thus denying you your so-called "right" to an education.

You have the same mindset as the folks calling healthcare a "right." You haven't thought through the implications of your position.

Christ that boy pisses me off. We have to wonder how a person could be old enough to be licensed to drive but still believe in an inherent "right" to all these very practical benefits from the work of others.

No religion teaches such a thing. Nor does any school of meaningful literature or path of worldly investigation. I don't think any parents or family, no matter incessant or willful their indoctrination, could instill a presumption that the world should reward people so greatly for so little.

No, a person comes to believe in fairy-tale rights by spending a lot of time in isolation, thinking of oneself.

This is the prototypical new American voter.

Who am I kidding, human nature has always sucked, even in the voting booth.

When I was in the military, I was obligated to be proficient in the use of an M-16, to own and maintain one. The government not only paid for my training, but gave me one to use while I was in the military. ~ Patrick at December 7, 2016 1:20 PM

I highly doubt you "owned" the M16 that the military provided to you. When you mustered out, did you have to turn it in (give it back)? If so, you didn't "own" it.

Not to mention, the M16 is fully automatic, a variety of weapon that civilians are barred from owning without a special permit from the ATF. I doubt the military sent you into civilian life with a fully automatic weapon. None of my military friends got to keep their M16s or their M9s when they were discharged.

You could argue that minimal healthcare is actually a right, since ERs have to take you in cases of an emergency, regardless of your ability to pay. ~ Patrick at December 7, 2016 1:20 PM

No, you couldn't. You could argue the that ER has a legal obligation to provide a minimal level of care in emergencies, without regard to ability to pay.

You could even argue it has a moral obligation.

But you cannot argue that you have a right to the ER's expertise or labor.

No religion teaches such a thing. Nor does any school of meaningful literature or path of worldly investigation. ~ Crid at December 7, 2016 4:55 PM

Modern Liberalism teaches it. That's one reason modern Liberalism has ceased to be a meaningful or coherent school of thought. Making up "rights" out of whole cloth is not a valid philosophical argument, but it buys votes in politics and sounds "fair."

My nephew just tweeted amazement (disgust) at this (ludicrous) headline from WSJ:

Competition From Chinese Imports Weakened U.S. Innovation, Economists Say


U.S. industries that faced surging Chinese competition invested less in new technology, a new study finds

While I don't care for the joker, I appreciated this joke. (Neither DT nor HRC was/is a believer in free expression.)

And Little Patty thinks health care is a right.

A lot of the stoicism which made America go, a lot of the integration of unpleasant truth into our American character which made our nation into a global refuge and resource appears to have faded.

Crid, grow the fuck up. Seriously. Yesterday.

As entertaining as it is to prod you, I never said I believed healthcare is a right. Raising an argument for a position is not necessarily advocating for one. Mature adults (which you are not and have little hope of ever becoming) have the ability to recognize a valid argument for a position, even if they don't hold that position. We also have the ability to recognize when someone raises a really shitty argument (as Conan just did), even when they're arguing for a position that we ourselves hold.

Conan, remembering the magnitude of incomprehensible thick-headedness you displayed when merely trying to point out to you that Congress can impeach for any reason or no reason (since there is no judicial oversight to determine what is actually "treason, bribery or other high crimes and misdemeanors," it means whatever Congress says it means; therefore they can impeach for any reason they want), I really have no interest in making the necessary numerous wordy posts it takes to get you to understand what is really a very simple concept.

But I will say this: you need to learn the difference between a "right" and a "liberty." I admit it's not always clearly defined, since even the Supreme Court conflates the terms, except in those instances where the distinction is necessary.

But there is a reason that the American Civil Liberties Union is not the American Civil Rights Union. Your "rights" and your "liberties" are not the same thing.

Patrick, I've noticed a trend with you. When you find yourself on the losing end of an argument, you retreat to hair splitting arguments about the exact wording your opponent uses or claim you were misquoted.

It ain't the Bill of Liberties, it's the Bill of Rights. So, if I use the term "rights" instead of "liberties" you know what I mean. Don't pretend you've somehow discovered a semantic flaw in my argument, especially when you used the same terms in the same way in your argument.

Civil liberty or civil right, you don't have a God-given claim on the fruits of another's labor.

And claiming the "right" to healthcare is putting a claim on the doctor's labor. By virtue of his oath and public sentiment, the doctor may have an civic and/or moral obligation to treat everyone, but that does not give you a claim on that treatment.

A farmer may have a moral obligation to feed you if you show up starving on his doorstep. But that does not mean you have a claim on the crops he grew.

==============================

Since I don't carry a grudge about every disagreement we have (you just don't mean that much to me), I'll respond to your impeachment cite from a vague memory.

I believe you were arguing that Congress (the House) can impeach a federal official for no reason whatsoever, say because it's Tuesday, and claim anything as a "high crime and misdemeanor."

I didn't disagree. I merely pointed out that for practical purposes having an action or series of actions that the House can reasonably argue are "high crimes and misdemeanors" will speed the process of that impeachment (help to get a majority vote) and induce the Senate to levy a punishment. The House by itself cannot simply impeach an official and expect the Senate to remove him from office or censure him without some kind of reasonable "high crime and misdemeanor" basis for impeachment. The Founding Fathers designed the process that way, to prevent heated political disputes from turning into coups.

Only two presidents have ever been impeached, Johnson and Clinton, and the Senate did not remove either of them from office, both were acquitted. Perhaps if the House had shown evidence of something the Senate could agree was a high crime of misdemeanor instead of a political dispute or if it had a stronger public sentiment behind it, the Senate would have gone along with the House and removed one or both of them.

With Johnson, it was quite obvious the impeachment was based on a political dispute between the Radical Republicans in the House and Johnson, a Southerner (Tennessee). With Clinton, there was very little public sentiment for his removal, so the Senate restricted the impeachment trial evidence rules to try and get the House to drop the matter. 19 federal officials have been impeached, with several being removed from office or censured. The last, a judge in 2010, was removed after being impeached for filing false financial disclosures. See, an actual action of the judge's was cited as the "high crime and misdemeanor" basis for impeachment.

Conan, I was not on the losing end of an argument. I raised a position which I did not espouse and never said I did.

What I said was, "You could argue that minimal healthcare is actually a right, since ERs have to take you in cases of an emergency, regardless of your ability to pay."

I did not say, "You have a right to healthcare..."

Saying that you could hypothetically argue a point if you were so inclined is not the same as espousing one. Although, Crid, with his characteristic "petulant teenage" mentality, and hair-trigger tantrum mechanism will never understand this.

You used this device yourself, when you said, "You could even argue it has a moral obligation [to provide you emergency medical care]."

Gee, I read that and thought, "Okay, he's saying that you could hypothetically argue this point, though he doesn't necessarily agree with it."

I very seldom commit to any position. I prefer to throw out hypothetical arguments that I may have just heard or came up with and see how people respond. If Mr. Meltdown pitches one of his trademarked hissy fits, so much the better. And if certain others I will not name presume to decide for me what I agree with, or demand that I commit myself to a position one way or another, it's a veritable feast for me.

If you're defining "right" as something enumerated in the Constitution, you don't have a "right" to clean air. Or any air, clean or otherwise. But the Bill of Rights define liberties, not rights.

It is not hair-splitting. It's how the Supreme Court defines it. Not my problem if you don't know that.

So, yes, you have a right to education. True, some parents may opt to homeschool or send their kids to private school, but if you are availing yourself of neither of these options, your kids had better be attending public school.

Thus kids have a right to an education that they don't pay for, and they are indeed reaping the fruits of another's labor, free of charge.

People sometimes say that driving is a privilege, not a right. Incorrect. They mean to say it's not a liberty. But driving is a right. If I have jumped through all the necessary hoops, getting a license, insurance, registration, and I haven't committed any of the crimes, such as DUI, which could suspend my license, then yes, I do have the right to drive. The state cannot arbitrarily come in and tell me that despite having met all the requirements, I'm not allowed to drive. Consequently, it is a right.

And I even use the roads. No one ever sent me a bill for my share of them, either. So, I am availing myself of the fruits of another's labor at no charge.

Couple of other minor points. An M-16 is not necessarily a fully automatic weapon. During basic training for example, mine had a setting to fire a three-round burst, but no setting for auto-fire.

And yes, it was called "mine," even though it was kept in storage. I could not retrieve it at will. I could only do so if the commander ordered it, and unit armorer was on hand to give it to me when I signed for it. I couldn't have stored it myself, even if I wanted to. And under no circumstances was an M-16 to be transported in a privately owned vehicle. It goes to and from the shooting range in authorized military vehicles only.

But the point was, the military required me to have one and be proficient in it. Consequently, they supplied me with one for my own use (no one else was allowed to use mine) and gave me the necessary training to shoot one. I paid for neither the weapon nor the training. In fact, the military paid me to train on it.

Nicey-nice that the Senate chose to follow the strict rules for high crimes and misdemeanors. The point is, there's no judge on hand to gavel away and insist that mismatched socks are not a high crime or misdemeanor.

But let's say, hypothetically, that the Democrats take the Senate and House next election. We already know they hate Trump and Republicans are not wild about him either. If they wanted to, they could impeach and remove for mismatched socks. If they chose to do that, no one can stop them, nor will they answer to anyone for it.

And, Patrick, I did not say you need an literal assembly hall to peaceably assemble or an literal megaphone to practice free speech. I used a rhetorical device to illustrate my position. You chose to take my points literally. I'm well aware that free speech does not require a megaphone, nor free assembly a hall.

And yes, the M16 was assigned to you and only you, but it was still the US Army's. And it was not provided to you as part of your right to bear arms, it was provided to you as part of your obligation as a soldier. Once you left the Army, it was no longer "yours," the Army no longer had an obligation nor a need to provide one to you.

As for "fully automatic," I believe the M16A2 does not have a fully automatic setting, but the M16A3 does. I don't know about the M16A4. The civilian-model AR-15 does not have a fully automatic setting. The M4A1 also has a fully automatic setting, whereas, I believe, the M4 does not.

If you choose, as a citizen, to go to a gun store and purchase a weapon, you have that right, however, you do not have the right to demand that the gunmaker provide to you the fruits of his labor gratis.

With regard to rights and liberties, you have a right to purchase healthcare (not the right to have healthcare); and the doctor has the right not to treat you. You have the right to pursue an education (not the right to have one); and the teacher has the right to choose not to teach you.

You have the right to move about freely within the country of your citizenship, whether by bus, foot, or automobile; you have the right to not be held prisoner in your own home or neighborhood. You do not have the right to drive. You might have the government's permission to drive, if you pass the requisite test and meet the requirements laid down by the governing authority. We can argue separately about whether the government has the authority to restrict your method of getting around and whether driver's licenses are constitutional (driving on private property and all that).

Your argument, hypothetical or not, argued for the right to the results. The fallacy of arguing rights to positive results is one reason our Founding Fathers were careful in delineating which rights the federal government would be restricted from abrogating (and in the wording they chose).

If they wanted to, they could impeach and remove for mismatched socks. If they chose to do that, no one can stop them, nor will they answer to anyone for it. ~ Patrick at December 8, 2016 7:58 AM

Never argued they couldn't; just that getting the votes necessary to do so might prove difficult without actual malfeasance.

"And I even use the roads. No one ever sent me a bill for my share of them, either. So, I am availing myself of the fruits of another's labor at no charge."

No, you are not. You pay taxes at the gas pump that fund public roads, you pay a tax when you buy the car, and another when you register it.

There is no free lunch, the costs are just hidden.

"But let's say, hypothetically, that the Democrats take the Senate and House next election. We already know they hate Trump and Republicans are not wild about him either. If they wanted to, they could impeach and remove for mismatched socks. If they chose to do that, no one can stop them, nor will they answer to anyone for it.

Patrick at December 8, 2016 7:58 AM"

It is a bit more diffcult that that. Conviction for something that has been alleged in the impeachment proceeding requires a 2/3 majority of the Senate. The Senate Democrats would need to have a rock solid 2/3 majority which doesnt happen often, and of course, if a President is impeached, the guy who replaces him is the Vice President, so it would gain them nothing except the ill will of a lot of voters who supported and liked the President.

Never argued they couldn't; just that getting the votes necessary to do so might prove difficult without actual malfeasance.

It is a bit more diffcult that that. Conviction for something that has been alleged in the impeachment proceeding requires a 2/3 majority of the Senate. The Senate Democrats would need to have a rock solid 2/3 majority which doesnt happen often, and of course, if a President is impeached, the guy who replaces him is the Vice President, so it would gain them nothing except the ill will of a lot of voters who supported and liked the President.

Not necessarily a rock-solid 2/3 majority. Just enough Republicans who hate Trump as much as the Democrats do and are willing to get him removed.

And while I agree my hypothetical situation is (at best) unlikely, my only point is that it's theoretically possible. I just find it very interesting that there is no higher authority to make sure that Congress is only impeaching for true instances of "treason, bribery or other high crimes and misdemeanors."

Consequently, it makes the very provision utterly meaningless. Yes, it would be very nice if Congress were strict adherents of the law and conscientiously made sure that the crimes of the accused were truly an instance of "high crimes or misdemeanors," but seriously, how informed do you judge the lawmakers to be about the nuances of the law and what constitutes a "high crime or misdemeanor"? Have they been properly schooled in common law, which is where the term comes from?

Not bloody likely.

To give another example of what I was saying, during Obama's term, I have engaged with the birther contingent who insist that Obama is not a natural born citizen. Not because they believe he was born in Kenya, but they insist that a natural born citizen relies about some obscure interpretation of the writings of Vattel and requires two citizen parents for a child to be considered a natural born citizen.

Now, I could go over the SCOTUS decision of United States vs. Wong Kim Ark and point out that according to the common law expert Albert Venn Dicey (who was cited in this ruling) "natural born" means anyone who acquires their citizenship at birth, and according to Queen Victoria's Chief Justice, Alexander Cockburn (also cited in this ruling), a child born within the confines of a nation, even if born to aliens, is a citizen at birth; therefore, Obama, even if born to illegal aliens in the U.S., is a natural born citizen.

Or I could just point out that Congress oversees all elections without judicial oversight, therefore a natural born citizen is whatever Congress says it is.

Say, Arnold Schwarzenegger (who is not a natural born citizen by anyone's definition) did something really mensch and was elected President on an overwhelming wave of popular support, in spite of the fact that he isn't a natural born citizen.

If Congress ratifies the results of the election, then Schwarzenegger is President. There's no judicial oversight to stop this and say, "No, Schwarzenegger is not eligible."

I just find it fascinating that these provisions exist in the Constitution without any means of truly enforcing them. We have to rely on the expertise and ethics of Congress. Ain't that a snort?

Not necessarily a rock-solid 2/3 majority. Just enough Republicans who hate Trump as much as the Democrats do and are willing to get him removed. ~ Patrick at December 8, 2016 12:05 PM

No, a rock solid 2/3 majority. With 100 senators, 67 votes for conviction must be cast. Fewer than 67 and no conviction (no censure, no removal from office, nothing). In Andrew Johnson's case, the Radical Republicans needed 36 votes in the Senate to remove him. They got 35, even after threatening the 7 Republicans who voted to acquit. The House only requires a simple majority to impeach.

I just find it fascinating that these provisions exist in the Constitution without any means of truly enforcing them. We have to rely on the expertise and ethics of Congress. Ain't that a snort? ~ Patrick at December 8, 2016 12:05 PM

If a government official is so unpopular that arbitrarily removing him from office carries no electoral penalty, then Congress is, in effect, doing the will of the people. And the Founding Fathers allowed that to be part of the government they set up.

As an example, Gray Davis was recalled in California less for failure to do his duty than simply for being unpopular, despite being re-elected to the office only months earlier. That and an electricity crisis that Davis had actually already made moves to resolve, fast tracking the first new power plant to be built in California in 12 years. If the legislature had voted to impeach him and remove him from office, there would likely have been few consequences for doing so in the next election.

California's constitution allows recall elections. The US Constitution does not. So, impeachment fills the role of letting the people express extreme dissatisfaction with an elected official's performance or conduct outside of the regular election cycle.

"In Andrew Johnson's case, the Radical Republicans needed 36 votes in the Senate to remove him. They got 35, even after threatening the 7 Republicans who voted to acquit."

An aside, but it's rather breathtaking to realize how close our world, and us, came to never existing here as we know them. Had the Radicals managed one more vote for conviction, Radical Benjamin Wade, the president pro tem of the Senate and an ardent Socialist, would have become President. That IMO probably would have launched a new Civil War with three or four different factions, and this time it would have been a fight to the death, likely resulting in the breakup of the United States.

(BTW: it's not widely known that John Wilkes Booth was not a lone wolf. He was part of a conspiracy that intended to assassinate Lincoln, Johnson and William Seward all the same night. Seward was stabbed but survived; the conspirator assigned to shoot Johnson got drunk and missed his window.)

To get back to the question: I like the plan, for me, at this point in life, if I get to pocket a significant portion of the employer-paid premium reduction. But I think it is way, way too much cost exposure for most people to contemplate.

I grew up in Kaiser. For the first half of my life I went to the same hospitals as Amy. I paid $15 to go the doctor. That's it, the only direct cost paid at all ever. Now you want to take $15 to $15,000!!! I think that would be crazy talk to a lot of people. That's like buying a new car every year. But you know, my Out of Pocket is about 4% AGI and employer-paid premiums are about 17%, so we're basically already there.

Conan:

No, a rock solid 2/3 majority.

What I meant was, the 2/3 majority doesn't have to be entirely of Democrats. The Democrats wouldn't need to have 2/3 of the Senate to remove Trump. Just enough Democrats and Republicans to make up 2/3. The Republicans don't much like Trump either.

Who am I kidding, human nature has always sucked, even in the voting booth.

Crid, are you being ... smirkingly resigned?

BTW: it's not widely known that John Wilkes Booth was not a lone wolf. He was part of a conspiracy that intended to assassinate Lincoln, Johnson and William Seward all the same night. Seward was stabbed but survived; the conspirator assigned to shoot Johnson got drunk and missed his window. ~ Cousin Dave at December 8, 2016 1:54 PM

And this plot was supposedly in retaliation for the alleged plot to assassinate Jefferson Davis and the Confederate Congress.

> are you being ... smirkingly
> resigned?

No, I'm being bitterly overwhelmed, and by cowardly fucktards. They apparently cannot be stopped, and they're going to get the planet they want.

You and I will be compelled to live on it.

Crid:

No, I'm being bitterly overwhelmed, and by cowardly fucktards. They apparently cannot be stopped, and they're going to get the planet they want.

Do you find no encouragement at all in the fact that Donald Trump won the election and that fact alone has reduced to social justice warriors to quivering masses of helplessness?

One of the big problems in today's healthcare market, even Obamacare, is that everyone is playing with house money.

> that fact alone has reduced
> to social justice warriors to
> quivering masses of helplessness?

How would you know? They quiver always, by definition, as by your own continuing example.

MM says I'm wrong, and should probably apologize.

https://twitter.com/asymmetricinfo/status/807350433941516288

Let me think about it.