D.C. Circuit guts ObamaCare

[DinoDoc]

As a Canadian, I am 'forced' to fund our UHC system out of my taxes. But, truth be told, if I were reimbursed that money and offered the opportunity to 'buy into' our system at that price, I'd be nuts to not accept. Similar with modern Americans and Medicare, it's great value for the money.

As someone who has to take care of a person on that insurance, you are woefully misinformed about the quality of that insurance program.

 

[El_Machinae]

As someone who has to take care of a person on that insurance, you are woefully misinformed about the quality of that insurance program.

No I am not. You're misinformed regarding how much it costs me.
Why don't you ship your loved one to you and just take care of that person using your local medical system?

 

[Timsup2nothin]

As someone who takes care of a person on a different insurance system I have a different point of view.

It is hard, and expensive, and that is that. Would it be absolutely great if it involved dropping her off at curb service at a facility with no lines and getting no bill for it? Ab-so-lute-ly...in conversation I would insert a common use word in place of one or more of those dashes.

I like pie in the sky with ice cream just as much as the next guy.

That doesn't mean that I think I should have it at everyone elses expense unless they have it too, and it doesn't mean I think any of us can afford to pay for all of us to have it. I am satisfied that the government is at least trying to provide what we need, even though there is apparently no way anyone could provide what we want.

 

[DinoDoc]

No I am not. You're misinformed regarding how much it costs me.
Why don't you ship your loved one to you and just take care of that person using your local medical system?

Considering the fact I'm referring to Medicare and not the NHS, I'm pretty sure it costs you nothing.

 

[El_Machinae]

So, is there anything preventing you from just funding your loved one's care out of your own pocket?* I must admit, I thought you were talking about the Canadian system. We're not allowed to buy additional healthcare. Well, we are, but it requires a cross-border flight usually.

*More importantly, do you think she(?) would be able to afford superior care to what is currently being received if she(?) had never paid into Medicare? Could you buy her better care than what she's currently getting if you were willing to part with money equal (or less) than what you're currently paying into Medicare?

 

[Timsup2nothin]

So, is there anything preventing you from just funding your loved one's care out of your own pocket? I must admit, I thought you were talking about the Canadian system. We're not allowed to buy additional healthcare. Well, we are, but it requires a cross-border flight usually.

I thought he was talking about Canada too. When I said I was caring for someone under a different system I was incorrect, it's actually the same system. I'm still eager for the pie in the sky system to come along though.

 

[warpus]

Oh, I choose healthcare. Mainly because it's such a good deal, but I acknowledge the welfare benefit, too. I still recognises the moral dilemma. Again, cheap cures are the solution, because it solves both horns of the dilemma.

I will just never understand people who put the vague notion of "freedom" and "liberty" over every single consideration, before they have even heard it.

Not saying you did or do that, but.. a lot of people in the U.S. seem to. "Freedom" often wins out, even if that means a crappier country after the fact. What good is freedom if it leads to a worse country?

 

[bhsup]

Worse in -your- opinion. Maybe some people think being free to succeed OR fail on their own (among other things) is more important than being spoon fed healthcare and a guaranteed salary for sitting on your butt by the federalies.

 

[Timsup2nothin]

I will just never understand people who put the vague notion of "freedom" and "liberty" over every single consideration, before they have even heard it.

Not saying you did or do that, but.. a lot of people in the U.S. seem to. "Freedom" often wins out, even if that means a crappier country after the fact. What good is freedom if it leads to a worse country?

Many Americans subscribe to 'better a free man in hell than a servant in heaven' and are inclined to produce hell in order to test the concept.

 

[Farm Boy]

No, I was actually intending to come off as 'they provide public schools because we need public schools, not because they are trying to indoctrinate our kids as part of some evil plan'...apparently that was a complete swing and miss. Sorry.

Muh bad then!

I will just never understand people who put the vague notion of "freedom" and "liberty" over every single consideration, before they have even heard it.

Not saying you did or do that, but.. a lot of people in the U.S. seem to. "Freedom" often wins out, even if that means a crappier country after the fact. What good is freedom if it leads to a worse country?

There are legitimate concerns along these lines. We have a proud U.S. tradition of forcing people to behave how we think is good for them. "No, you can't seek death with dignity." "No, you can't smoke the marijuana." "No, you can't drink until you're 21." "No, you can't have the sex it's bad for you, we'll lock up teenagers within a year or two of age from each other."

It's not such a stretch to think that the moralizing prohibitionists of the 21st century will take heavy government involvement in mandated healthcare to come after fatty fatty mcfatty, "You're costing me money fatty and you don't want to be fat anyways, lardass" and regulate lifestyle choice with the iron of law.

 

[El_Machinae]

I will just never understand people who put the vague notion of "freedom" and "liberty" over every single consideration, before they have even heard it.

Not saying you did or do that, but.. a lot of people in the U.S. seem to. "Freedom" often wins out, even if that means a crappier country after the fact. What good is freedom if it leads to a worse country?

Well, freedom is important. I mean, it's not the highest priority to anyone who's not eaten in a few days, but it's pretty important.

The issue kicks in when there are 'forced' payments into a system you'd have voluntarily bought into anyway. There are subset of government services that people resent, that they'd be nuts to refuse to buy into voluntarily. The military, the NSF, Medicare ... all of these programs are pretty damned awesome for what they cost. The counter-factual ("would you have $50 more per year and no NASA from the time you were born/started working/etc?") is something most people wouldn't choose.

Now, this isn't to say there's no fat to trim. There will always be fat to trim.

And then, there's the subset of gov't programs that people would not voluntarily fund. Social Security 'forces' people to save for retirement at levels where they wouldn't voluntarily, and at rates of return we don't find all that impressive. Foreign Aid consumes levels of the budget people wouldn't voluntarily give. Same with welfare.

The counter-factuals on these are tougher. Would you rather not pay into SS and forgo the business of the majority of senior citizens who come into your store? I mean, sure, I'd prefer to save my own money and at better rates-of-return. So, analysing SS, welfare, foreign aid, etc. is much tougher.

 

[Timsup2nothin]

Well, freedom is important. I mean, it's not the highest priority to anyone who's not eaten in a few days, but it's pretty important.

The issue kicks in when there are 'forced' payments into a system you'd have voluntarily bought into anyway. There are subset of government services that people resent, that they'd be nuts to refuse to buy into voluntarily. The military, the NSF, Medicare ... all of these programs are pretty damned awesome for what they cost. The counter-factual ("would you have $50 more per year and no NASA from the time you were born/started working/etc?") is something most people wouldn't choose.

Now, this isn't to say there's no fat to trim. There will always be fat to trim.

And then, there's the subset of gov't programs that people would not voluntarily fund. Social Security 'forces' people to save for retirement at levels where they wouldn't voluntarily, and at rates of return we don't find all that impressive. Foreign Aid consumes levels of the budget people wouldn't voluntarily give. Same with welfare.

The counter-factuals on these are tougher. Would you rather not pay into SS and forgo the business of the majority of senior citizens who come into your store? I mean, sure, I'd prefer to save my own money and at better rates-of-return. So, analysing SS, welfare, foreign aid, etc. is much tougher.

Let's apply a more realistic look to social security that will make this easier.

The vast majority are not 'forced to save at levels where they wouldn't voluntarily'. The vast majority wouldn't save at all. When you are young, healthy, working full time and still trying to figure out how to get off your brother's couch, saving for retirement is the furthest thing from your mind. When you've gotten a 'good' job so you can afford a hovel of your own, barely, it is still pretty far from your mind. The majority of people live their entire lives with the question of how they are going to keep body and soul together next month as the limit of planning ahead they can afford to do.

So given that, without this forced savings where do we end up? Starving old people. So whether this system is necessary boils down to 'are you willing to watch those old people starve?' I'm not. I'm sure you're probably not. Other than Mitt Romney I can't think of anyone I'm not pretty sure about actually. So at the end of the day we can either force people to save, or find some other way to deal with them when they don't.

By the way, if you look at your SS contributions as going to other people's retirement while managing your own for yourself the unimpressive return is much less painful. I've been retired for years, am not yet eligible for SS, and don't anticipate filing for it when I am, so the rate of returns is totally a non issue for me.

 

[El_Machinae]

No, you've kinda painted yourself into a circle. If people would voluntarily pay SS rates for the wellbeing of other people's parents, then SS wouldn't be a necessary legal construct. It's necessary entirely because people wouldn't, and didn't, do it on their own.

Both SS and Medicare are made palatable under the idea that someone is being 'forced' to lend the gov't money with the understanding that they will be paid back at a future date. It's an illusion, obviously, which is why some people are surprised to learn there is no actual trust fund.

 

[Farm Boy]

It's an illusion, obviously, which is why some people are surprised to learn there is no actual trust fund.

The cake is a lie. But only if we don't force our children to bake it for us.

 

[Timsup2nothin]

No, you've kinda painted yourself into a circle. If people would voluntarily pay SS rates for the wellbeing of other people's parents, then SS wouldn't be a necessary legal construct. It's necessary entirely because people wouldn't, and didn't, do it on their own.

Both SS and Medicare are made palatable under the idea that someone is being 'forced' to lend the gov't money with the understanding that they will be paid back at a future date. It's an illusion, obviously, which is why some people are surprised to learn there is no actual trust fund.

I actually wasn't trying to analyze the mechanism. No matter how you paint the circle, the bottom line is 'do this, or watch old people starve'. So choose.

That does make this

So, analysing SS, welfare, foreign aid, etc. is much tougher.

at least as regards SS pretty simple, which is what I set out to demonstrate.

 

[El_Machinae]

My point is that those are things that people would be more likely to opt out of, if given the choice. It requires definite altruism to view SS as anything other than a retirement plan, and it's a pretty crummy plan. The other things I listed, though, no rational person would opt out of.

 

[Timsup2nothin]

My point is that those are things that people would be more likely to opt out of, if given the choice. It requires definite altruism to view SS as anything other than a retirement plan, and it's a pretty crummy plan. The other things I listed, though, no rational person would opt out of.

Only because they don't acknowledge what they are choosing. You would possibly opt out 'for a better plan'. My neighbor would opt out to catch up on his mortgage. But neither of you would opt for watching old people starve, so it makes it easy to feel a lot less 'forced into a crummy plan' and just rationally decide to participate.

Maybe it takes genuine altruism, or maybe it just takes recognizing that the plan is what it is, a buffer against having to watch old people starve. An altruist would really worry about the old people starving. I'm providing an argument for the people who just wouldn't want to watch.

I also realize we are pretty much in complete agreement on this and I think you know it. But between us we are fine tuning the argument.

 

[DinoDoc]

SS would be better off if we'd just admit it is a welfare program and means tested it. If you want to argue that it is indeed a retirement savings plan, I would indeed like my money back to find a better retirement plan.

 

[Timsup2nothin]

SS would be better off if we'd just admit it is a welfare program and means tested it. If you want to argue that it is indeed a retirement savings plan, I would indeed like my money back to find a better retirement plan.

This is a frightening moment but I agree. Means testing would be a huge improvement.

 

[El_Machinae]

SS would be better off if we'd just admit it is a welfare program and means tested it. If you want to argue that it is indeed a retirement savings plan, I would indeed like my money back to find a better retirement plan.

I think that this reflects the insidious nature of these programs.
Now, let me state upfront that SS is extremely benign. It's not wholly contained within the criticism, because it's so gentle and so easy.

But, here's the thing. There is no getting your money back. It's gone.

DinoDoc implicitly feels like it's 'his' money and he's going to get it back 'later'. Yes. In some ways, that true. He's lending money (involuntarily) and he's gonna get paid back.

But, that money he lent? It's gone. The only way to end SS is to screw someone over from the deal they thought they were in. IF Dinodoc wants his money back, we'll need to tax people to pay him back, and those people will not get anything (or nearly anything) in return. A period of not seeing old people starve, I guess. Slightly higher money velocity for a time, I guess, since the Baby Boomers are retiring.

So, if Dinodoc wants to end SS, he can either swallow the pill and accept his money is gone, or force younger taxpayers to pay him back for the money he lent. In the meantime, in the longrun money velocity will plummet - Dinodoc will have to sock away a lot of that money he 'gets back'. The taxpayers paying him back will also have to save at much higher levels than they currently are. Of course, those taxpayers he's forcing to pay him back now have a harder time not starving when they're old, too.

Now, SS is basically currently really sustainable. Each person effectively 'pays' a small opportunity cost (since the returns on your SS premium ain't great). We have benefits - higher money velocity, fewer starving old people.

That's the insidious nature. SS is great, unless you wanna stop it, and then someone gets screwed. It's not the people who took your money, they've already spent it. So, the insidious question is - who gets screwed? People who complain it's a Ponzi scheme are correct, it IS a Ponzi scheme. It just happens to be a sustainable and ... benign one. Not just benign, it clearly has perks. The perks are wee bit ephemeral and hard to measure, but they're clearly there.