[RD] Surrender Summit

[Zelig]

The (one) problem with American healthcare is that is a for profit industry. Hundreds of millions of dollars are spent every year on excessive executive salaries and shareholders that could go to reducing costs.

It's a smaller problem than worthless admin jobs: https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html

 

[Bootstoots]

How quickly we forget...

The Ukranian situation was originally a MUCH more ambitious ploy attemped by Moscow. They spent a year talking it up as "Novorossiya", this entirely new political entity that would be created by half of Ukraine erupting in rebellion against the central government in Kiev. It just turned out that there were nowhere near enough takers in Ukraine for that kind of project when they tried it. It really was only the two ethnic-Russian-majority provinces in the east that proved pliable. The ambitions was for all of eastern and southern Ukraine, all the way to Odessa, to go the same way. It's just that it didn't.

It nowhere near worked, and so the whole embarrassing project has been quietly dropped by the Russian government. It's not a thing anymore. It was a dud. So completely so, someone like you has apparently already plum forgotten about. Which is how they like it. The "Novorossiya" gambit however was really fascinating enough, for what it says about how the Kremlin regards borders and nations, to not be forgotten too soon.

Putin et al. still insists on occasion that there's no such thing as a Ukranian nation.

Oh sure, I'll grant that he really wanted to slice off SE Ukraine all the way to Dnepropetrovsk and Odessa, and was rather peeved that he couldn't even get Khark(i/o)v to accede to being part of this Novorossiya breakaway state he wanted, to say nothing of the rest of the attempted Novosossiya. But he failed to get much support outside of Donetsk and Luhansk Oblasts, so it's his loss.

Still, it all depended on public opinion, which he was willing to yield to. Everything involving taking your military and annexing, or setting up a puppet state in, territory outside your original jurisdiction is somewhere on the conqueror spectrum. But compared to what happened in and shortly before WWII, Putin's actions don't even approach a Hitler. Not even a Hit, really. More of a Hi. And even there I feel like I'm being too charitable.

 

[SupremacyKing2]

Too funny not to share.

 

[TheMeInTeam]

The (one) problem with American healthcare is that is a for profit industry. Hundreds of millions of dollars are spent every year on excessive executive salaries and shareholders that could go to reducing costs.

Generally speaking, prices in most for-profit industries haven't gone up what, ~tenfold over the past few decades? It's hard to buy that "for profit is the problem" or even the most significant factor...you're not paying several times more for buying a game on Steam, toothpaste, or vacuum cleaners.

 

[Ryika]

Too funny not to share.

That joke would work much better with the Romulans.

 

[Lexicus]

Generally speaking, prices in most for-profit industries haven't gone up what, ~tenfold over the past few decades? It's hard to buy that "for profit is the problem" or even the most significant factor...you're not paying several times more for buying a game on Steam, toothpaste, or vacuum cleaners.

Steam, toothpaste, and vacuum cleaners are all fundamentally different from healthcare.

 

[SupremacyKing2]

That joke would work much better with the Romulans.

Perhaps, but in TOS, the Klingons were the big baddie and were also stand ins for the Cold War Russians. So since they have Kirk on the left, it fits to have a TOS Klingon on the right.

 

[rah]

Besides, that Klingon was very Putin like in the episode. And that one always made me laugh.
So for me, it was PERFECT. And Kirk looked silly in that one also. Almost trump like.

 

[TheMeInTeam]

Steam, toothpaste, and vacuum cleaners are all fundamentally different from healthcare.

Also from each other.

There is no reason to anticipate that "for profit" is a primary driver for cost disease in some circumstances and not others for no reason. Toothpaste doesn't have insurance providers with heavy decision control on the product, government subsidies, a burdensome malpractice legal setup, or anywhere near the same price gouging risk.

Since you acknowledge that the products are "fundamentally different", it's reasonable to expect that the ways it is "fundamentally different" are better predictors of cost disease than the "for profit" aspect. Otherwise we'd expect cost disease more generally in "for profit" industries where there isn't evidence.

More on topic: pressure on NATO allies to spend according to their signed agreement is likely to have a different motivation than believing it makes the US military influence better. For the really low spenders meeting obligations will require them to nearly double their military expenditure. If the goal is to put financial pressure on some nations without the pretext needed for sanctions/tariffs/trade war then forcing them to honor a treaty-bound obligation to spend resources on something they're unlikely to actually use should be an effective tactic.

Could also be used as scapegoat leverage by pointing out that said nations aren't meeting their obligations despite the reminders. Is this a good tactic? Quite possibly not, but it's a possible explanation for why we're seeing it, especially given the tariff tactics applied elsewhere.

 

[Berzerker]

if the shoe was on the other foot and Putin helped the Democrats, would the media be so upset about Russian involvement in our elections?

 

[rah]

I actually think so despite any bias they usually show.

 

[Lexicus]

Also from each other.

The three are far more similar to each other than any of them is to healthcare.

There is no reason to anticipate that "for profit" is a primary driver for cost disease in some circumstances and not others for no reason.

This is a tautology.

There is no reason to anticipate that "for profit" is a primary driver for cost disease in some circumstances and not others for no reason. Toothpaste doesn't have insurance providers with heavy decision control on the product, government subsidies, a burdensome malpractice legal setup, or anywhere near the same price gouging risk.

For-profit health insurance has been the main driver of health costs in the US. For-profit insurance means that the major goal of the insurers is to find reasons to avoid paying claims. And they create bureaucracies with the goal of doing that.Obamacare lessened this problem but didn't totally do away with it, as the only way to do that is to make health insurance a nonprofit sector. Whether by nationalizing it or just regulating the profits of the insurers away, as has been done in several countries e.g. Switzerland.

Incidentally, since you bring up "cost disease"- you yourself claim that Civ 4 is objectively better than Civ 5 which is objectively better than Civ 6. Which one of those games cost the most at the time of release? Which cost the least? Why do you think that might be?

if the shoe was on the other foot and Putin helped the Democrats, would the media be so upset about Russian involvement in our elections?

Not only would they be "so upset," they'd almost certainly be far more upset. I think it's pretty safe to say that if a Democratic President had been at the center of even one of the many, many revelations in the Trump-Russia thing, their Presidency would have been completely destroyed and they'd have been impeached and probably convicted almost immediately.

makes the US military influence better.

What do you mean by this phrase?

 

[REDY]

Its allways same pattern. US potus licking Russian boots, Russians invading neighbour and then US is suprised and angry.
Do you remember how Bush saw Putin´s soul and then was Georgia invaded?
Do you remember how Obama announced big restart of relations, betraying its allies in EE by stoping any NATO infrastructure and then was Ukraine invaded?
Now Trump says there is no reason to not trust Putin. I wonder which small country is the next target. Putin plays well.

 

[Farm Boy]

Otherwise we'd expect cost disease more generally in "for profit" industries where there isn't evidence.

Certain goods and services don't work well on the market. Food is fine until there is too little of it, then the market is broken since people will pay anything. Medically necessary for survival/quality of life is the same way for the same reason.

Insurance is garbage when on the market too. The incentives are all wrong. It's a sharing of risk, but the profit motive involves selling as much coverage for as much possible and then not paying it. It doesn't work with flood insurance, it doesn't work with hurricanes, it doesn't work with crops, it doesn't work well with medicine. Either way, whenever something catastrophic happens in an insurance "market"(like homeowners' insurance and a disaster) it's the public on the hook for the tab because magically, the years and years of profits didn't somehow market up a cushion of cash available to pay out when you get the hell year insurance is "for." It's been pissed away on marketing and salaries and dividends.

 

[Berzerker]

Not only would they be "so upset," they'd almost certainly be far more upset. I think it's pretty safe to say that if a Democratic President had been at the center of even one of the many, many revelations in the Trump-Russia thing, their Presidency would have been completely destroyed and they'd have been impeached and probably convicted almost immediately.

Not by Democrats... The GOP and their media outlets would be screaming bloody murder

 

[Verbose]

Oh sure, I'll grant that he really wanted to slice off SE Ukraine all the way to Dnepropetrovsk and Odessa, and was rather peeved that he couldn't even get Khark(i/o)v to accede to being part of this Novorossiya breakaway state he wanted, to say nothing of the rest of the attempted Novosossiya. But he failed to get much support outside of Donetsk and Luhansk Oblasts, so it's his loss.

Still, it all depended on public opinion, which he was willing to yield to. Everything involving taking your military and annexing, or setting up a puppet state in, territory outside your original jurisdiction is somewhere on the conqueror spectrum. But compared to what happened in and shortly before WWII, Putin's actions don't even approach a Hitler. Not even a Hit, really. More of a Hi. And even there I feel like I'm being too charitable.

That's the problem with relativization-by-comparison-to-Hitler. What Putin's done is absolutely gobsmacking, only topped by what he has TRIED to do. But hey, he's not Hitler, so it's all fine, more or less. Not worth dwelling on really, unless of course you have the misfortune of actually having to deal with the fallout of the actions of this "chui".

 

[Lexicus]

That's the problem with relativization-by-comparison-to-Hitler. What Putin's done is absolutely gobsmacking, only topped by what he has TRIED to do. But hey, he's not Hitler, so it's all fine, more or less. Not worth dwelling on really, unless of course you have the misfortune of actually having to deal with the fallout of the actions of this "chui".

The only people comparing him to Hitler are doing so to blow his actions out of proportion. The difference between Hitler and Putin is that Putin and Russia's posture is fundamentally defensive, not offensive. Putin is not going to start an apocalyptic race war, because he doesn't roll like that.

 

[TheMeInTeam]

For-profit health insurance has been the main driver of health costs in the US. For-profit insurance means that the major goal of the insurers is to find reasons to avoid paying claims.

That's a bit more like it. For profit healthcare =/= for profit insurance. The former can have the latter, but it's not a mandatory property. What makes it really bad is that the latter influences legislation to bloat it even more, and actually influences medical judgments (pretty directly depending on what you consider). This also meets the criteria of distancing it from the products I mention - they have no such insurance bloat and nowhere near the influence on policy/law.

This goes with malpractice too - even this is insured, and not cheaply.

Incidentally, since you bring up "cost disease"- you yourself claim that Civ 4 is objectively better than Civ 5 which is objectively better than Civ 6. Which one of those games cost the most at the time of release? Which cost the least? Why do you think that might be?

Actually I pin Civ 4 > CIv 6 > Civ 5. If I ever typed otherwise, it was a definite typo. Civ 5 was trash by design and while I have serious issues with Civ 6 UI and prioritization, it doesn't shoehorn broken incentives and penalize war even for the winning side.

I actually don't remember how much each of these games cost at release; I was late to the party in Civ 4 BTS and beta tested Civ 5, meaning my particular price to access both of those titles was atypical. What were they each on release?

What do you mean by this phrase?

Earlier in the thread, discussion on US pressure on NATO implied that it seemed to be undermining the US own ability to use its relative military strength to influence world politics. It wouldn't surprise me if such posturing (and looking cozy with Russia) is instead intended to squeeze countries financially, regardless of whether such would be effective.

Either way, whenever something catastrophic happens in an insurance "market"(like homeowners' insurance and a disaster) it's the public on the hook for the tab because magically, the years and years of profits didn't somehow market up a cushion of cash available to pay out when you get the hell year insurance is "for." It's been pissed away on marketing and salaries and dividends.

Only possible because of their ability to influence legislation. You're not wrong, but in a more honest system it's put up or bankrupt. Even if the public dime still winds up rescuing people, at least they'd have disincentive at the investor and firm level to piss away this money because the firm would stop existing and so would their own jobs/investments.

If there's anything in markets that needs to be fixed in today's environment, one of the first priorities needs to be on removing all the rigged legal loopholes and overt dishonesty. Pretty hard to do, and also pretty hard to come up with process that blocks people from rigging laws in their favor in the future.

 

[Lexicus]

That's a bit more like it. For profit healthcare =/= for profit insurance. The former can have the latter, but it's not a mandatory property. What makes it really bad is that the latter influences legislation to bloat it even more, and actually influences medical judgments (pretty directly depending on what you consider). This also meets the criteria of distancing it from the products I mention - they have no such insurance bloat and nowhere near the influence on policy/law.

This goes with malpractice too - even this is insured, and not cheaply.

I don't believe hospitals and whatnot should be allowed to operate for-profit either but I don't think that's anywhere near as important as the insurers and the pharmaceuticals.

I actually don't remember how much each of these games cost at release; I was late to the party in Civ 4 BTS and beta tested Civ 5, meaning my particular price to access both of those titles was atypical. What were they each on release?

Civ 4 was lower than Civ 5 and Civ 5 was lower than Civ 6.
And Civ 5 and 6 had a lot of the game content come in the form of paid DLC, which further inflates the price of the game. Civ 4 I paid $29.99 for the game around the time it came out, then $19.99 for each expansion when they came out. I paid more for Civ 5 even given that I took advantage of Steam sales for a lot of the DLC for that game, and I would have paid more yet to get the equivalent content for Civ 6 had I bothered to do that.

Earlier in the thread, discussion on US pressure on NATO implied that it seemed to be undermining the US own ability to use its relative military strength to influence world politics. It wouldn't surprise me if such posturing (and looking cozy with Russia) is instead intended to squeeze countries financially, regardless of whether such would be effective.

I don't think it is effective at all. As I said, the US is best served by making other governments compliant...and the way to do that is "guarantee their security" by effectively making them satellite states. Many of these countries have histories of seriously malignant militarism and should not be encouraged to have their own militaries anyway in my opinion. People talk smack about the US all the time and rightly but compared to the French, Belgians, Dutch, arguably to England, and definitely to Germany we've been downright benign as an imperial power.

 

[metalhead]

This goes with malpractice too - even this is insured, and not cheaply.

Malpractice claims account for less than 1% of healthcare spending in the U.S. This is a non-issue.