Please visit one of the specific Bimmerpost sites above  

Go Back   BMW 3-Series (E90 E92) Forum > BIMMERPOST Universal Forums > Off-Topic Discussions Board > Politics/Religion

Post Reply
 
Thread Tools Search this Thread
      03-31-2013, 02:50 PM   #23
techietaichi
Captain
 
techietaichi's Avatar
 
Drives: 2006 325i Pre-LCI
Join Date: Aug 2012
Location: Massghanistan, USA

Posts: 777
iTrader: (1)

Both sides of the aisle are FoS! To me you're either a Constitutionalist or a Federalist. One believes in small government, accepts personal responsibility, accountability, and puts into life what they want out of it. The other wants their hand held from cradle to grave, always blames someone else for their woes, believes they are entitled to what everyone else has even though they don't work for it and doesn't do squat to propell themselves into a more comfortable and self reliant position in life. Shephard or sheeple? Choose one.
__________________
techietaichi is offline   United_States
0
Reply With Quote
      04-01-2013, 09:49 PM   #24
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Thought I'd take a shot at discussing some of these points as well:

Quote:
Originally Posted by mmcnulty View Post
Bulldog CFP,

1. The tax code should be progressive to some degree. People who can afford to pay more, myself included, should pay relatively more. The argument is about how much more. The biggest problem here is people who make a lot more than me actually pay a lower effective tax rate than I do, and that is wrong. The graph of effective tax rate by income peaks in my range, and then falls back down for the even-wealthier. I should not be relatively punished because most of my income comes from *working* as opposed to *investing*.

I agree with your last sentence - there should not be different tax rates for investing, as opposed to earning income. Similarly, Hollywood shuld pay the same tax rates the rest of us do.

2. People shouldn't go bankrupt because they get sick. We also shouldn't jeopardize the financial incentive for medical companies to invest in new technology. My suggestion for threading this needle is:

People don't go bankrupt because they got sick - they go bankrupt because they failed to plan for getting sick, by buying insurance (or knowing what kind of insurance they were buying). This is not true in every case (there are a few loopholes that prevent a small group of people from purchasing insurance), but it is true in the majority of medical bankruptcies.
2a. The government should provide a base level of medical coverage. Nothing fancy, nothing extreme. All preventative care because this costs less than it saves. Highish caps on out of pocket for catastrophic problems like cancer. This isn't a "market" in the normal sense because people have no chance of not participating. If you pass out in the street you will be taken to an ER and given care.

Everyone who "passes out in the street" is guaranteed that they will be scooped up, taken to the nearest ER, and given care. These laws have been in place for years. And it includes illegals, and people without insurance - ER's cannot ask insurance or citizen status. Your idea about everyone having a base level of coverage will never work, for a few reasons. Every special interest group will consider their issues part of the "base level." Would your base level include gender re-assignment surgery, and adoption? Orthodontia? Remember, everything comes at a price. Another argument would be that poor people would not have the same access to care as those with private insurance (e.g. 6 hour waits at public clinics, 9 months to schedule a specialty consult).

2b. The private health insurance market should continue to exist but focus on care above that base level. Shorter waits, more exotic and experimental care, non-preventative care.

See above - the people who would be in the "base level" would want access to the private level benefits.

2c. Note that this is somewhat of a "public option", which actually decreases cost. And by not including the more expensive stuff in the public part, it stops the massive increase in spending in medicare/medicaid, and would replace both of those programs.

The reason that more expensive stuff is in the public option today, is because of the special interests and issues of access to care. It would not change in the slightest - we've been down this road, and it's the reason we are where we are today.

3. Free markets are the ideal, but in extreme cases intervention is required. Monopolies. Banks that are so big if they failed they would destroy the economy. Etc. Regulation is a tool that should be used only on these extremes, but is a tool that should be used. For silly things, like airbag warning stickers on sun visors, the government should stay the hell out. One interesting idea here is limiting the # of laws per session of congress. Make em count.

Your idea of silly is another guy's idea of critical.

This means no subsidies for farmers. This means if a kid dies from a defective product, the market should sort that out not the government. Again, both sides have faults here.

4. A base level of education should be free - primary, secondary, and university. We should be tracking kids into more university-track and technical vocational school track earlier on, like Europe does. This should all be free. Advanced degrees probably should stay private. Let the private market handle everything above this base level, ala my healthcare position above. While we are towards the top of education spending per capita, we aren't actually at the top despite what you say, and an *extremely small* percentage of that comes from the federal government. Most comes from local property taxes and then state funding, and is horrifically inequitable and inefficient.

We already have free education through high school - why extend it to University level? Not everyone needs to go to University. And, the University system is out of control - costs have risen at over 6x the rate of inflation. Why aren't Community Colleges private? Do we really need to spend local tax revenue on basketweaving and porn-study classes?

5. Massively more spending on R&D - medical, computers, biology, and yes, NASA - this is stuff that makes us better and more money in the end, and again, is a pittance of the total. All of NASA = 1% of the total budget.

Completely disagree - the Free Market should drive tech investment. The Feds tend to fund things like studying the genital washing habits of African Men, and Robotic Squirrels (fact - google it...).

6. Increased spending on infrastructure. Not stupid high speed rail. But highways, bridges, tunnels, mass transit to keep cars off the road, etc. Again, this is all good and gains us more money than it costs.

Again - completely disagree. The minute you turn this over to government, you have things like carpool lanes, ineffective mass transit, and massive waste. We have huge spending on infrastructure today that is completely mis-managed - it's not going to get better with more money.

7. Decreased spending on the military. Here I get more controversial I bet. We spend more than the next 13 countries combined on defense, including on unnecessary programs the military doesn't even want but are in congressional home districts so pork keeps them around. We spend nearly 2.5x China as a % of GDP. These are many *many* times the spending program amounts you list, and again, the military doesn't even want them. We need to stay ahead of china, and have effective ways to defeat guerilla-style terrorist groups in various countries. We don't need anything more than that.

Not sure you can compare our spending to China's, since in a communist society they have essentially slave labor and artificial prices.

I am not saying we need to avoid conflict like libertarians - we have a duty as the richest people in the world to be the world's cop where required. But we are doing like 5x that right now.

Agreed - what are we doing in Libya and Afghanistan?

8. Social Security. Despite what some like to say, Social Security is *mostly* financially solvent and just needs some minor adjustments based on eligibility age based on the fact that people live longer. Once we get through the baby boomers retiring, it becomes solvent again. People don't save for retirement - this is why this was invented in the first place. Old people were destitute. That shouldn't happen and I don't see a better way to stop it than social security.

I don't disagree - Soc Security is funded from wages, not from taxes. The problem is that Congress has taken money from the SS treasury for many years for non-SS projects. They wrote I.O.U.'s, and there is no money to pay it back. Basically, Congress has raided our pension fund.

9. The gov't should stay the hell out of social issues and people's lives and religions. This again goes both ways. People should marry whom they choose. Priests shouldn't have to be forced to marry anyone.

Agreed - and gov't should keep from forming their own "religions."

If you object to something here, please try and be specific about it. *Both* sides are being vague and it is unhelpful. Tell me which program that totals more than 1% of the budget you would cut and how. Don't just repeat Fox News talking points, and don't just use the other extreme to try and make your point.

What's with the "Fox News" issue? The exact same could be said for MSNBC, ABC/CBS/NBC, and any other mainstream media organization.
One question - were you born in the US? I'm thinking you are either Canadian or English, based upon language used and approach?
bbbbmw is offline  
0
Reply With Quote
      04-02-2013, 12:25 AM   #25
Ahmed
Private First Class
 
Ahmed's Avatar
 
Drives: 2013 C63 AMG
Join Date: Mar 2013
Location: Bahrain

Posts: 130
iTrader: (0)

Garage List
1999 BMW M5  [0.50]
You should ask that in private! Don't know what you're trying to get at!
__________________
2013 Mercedes Benz C63 AMG
2009 Lexus GS460

Ahmed is offline   Bahrain
0
Reply With Quote
      04-03-2013, 10:49 PM   #26
Andy H.
Second Lieutenant
 
Andy H.'s Avatar
 
Drives: 2012 535i M Sport
Join Date: Aug 2012
Location: San Antonio, TX

Posts: 298
iTrader: (1)

Quote:
Originally Posted by Ahmed View Post
You should ask that in private! Don't know what you're trying to get at!
How do you justify telling him to ask that in private if you don't understand what he is trying to get at?
__________________
LIVE FREE OR DIE
Andy H. is offline  
0
Reply With Quote
      04-03-2013, 10:58 PM   #27
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by bbbbmw View Post
One question - were you born in the US? I'm thinking you are either Canadian or English, based upon language used and approach?
OK, that's fairly hilarious, but yes. Born and raised and never lived in any other country. Just because I was avoiding trigger words for both sides and am advocating a centrist approach does not mean I'm somehow not American.

Feel free to go after the substance though.
mmcnulty is offline   United_States
0
Reply With Quote
      04-03-2013, 11:01 PM   #28
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by techietaichi View Post
Both sides of the aisle are FoS! To me you're either a Constitutionalist or a Federalist. One believes in small government, accepts personal responsibility, accountability, and puts into life what they want out of it. The other wants their hand held from cradle to grave, always blames someone else for their woes, believes they are entitled to what everyone else has even though they don't work for it and doesn't do squat to propell themselves into a more comfortable and self reliant position in life. Shephard or sheeple? Choose one.
You're making my point - your argument is what is called a false dichotomy - a false choice. 60-70% of the country is not on either fringe. You are just repeating talking points of the right fringe, which makes it so that you are not contributing to the conversation or providing any solutions whatsoever. Think. Offer ideas. Don't just denigrate.

Based on the approach I outlined, which fringe do you think I am member of? Neither.
mmcnulty is offline   United_States
0
Reply With Quote
      04-03-2013, 11:10 PM   #29
Eagle1oh7
Captain
 
Eagle1oh7's Avatar
 
Drives: '11 328i Sedan
Join Date: Oct 2012
Location: Chula Vista CA

Posts: 661
iTrader: (0)

Quote:
Originally Posted by mmcnulty View Post
OK, that's fairly hilarious, but yes. Born and raised and never lived in any other country. Just because I was avoiding trigger words for both sides and am advocating a centrist approach does not mean I'm somehow not American.

Feel free to go after the substance though.
Remember, there is no such thing as being a centrist in America without being accused of being an evil foreigner. You're either with me or against me!
__________________
DONE: Seibon CF Hood, M3 Rep, MSport rear w/Duke Dynamics CF Diffuser, Rieger Rep Skirts, aFe Stage 2 PRO-R Intake, Seibon CSL trunklid, Forgestar F14 18s w/Michelin PSS

FUTURE MODS: Eisenmann Full Cat-back Exhaust, OETuning ECU, MMW Headers, CF mirror caps, Bi-Xenon headlights, CF rooftop, CF lip
Eagle1oh7 is offline   United_States
0
Reply With Quote
      04-03-2013, 11:14 PM   #30
Mr Tonka
says, Drastic times call for drastic measures
 
Mr Tonka's Avatar
 
Drives: Exceptionally well :)
Join Date: Feb 2009
Location: Tampa, FL

Posts: 1,136
iTrader: (0)

I have a friend who works for the government. His trademark phrase is Waste-Fraud-Abuse, mainly because he sees it every day.

Eliminate even just 50% of the waste and the fraud the abuse and we're in a much better place than we are now.
__________________
-Joe


"Government is the great fiction, through which everybody endeavors to live at the expense of everybody else." — Frédéric Bastiat
Mr Tonka is offline   United_States
0
Reply With Quote
      04-03-2013, 11:51 PM   #31
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Apologies - I've been away for a week. It's also *super* hard to respond inline on this forum because quotes only go one level deep. I'm going to cut some stuff out - sorry if I edit out some of what you feel is important - considering you cut out the entire substance of my budget priorities in your reply, it's probably ok.

I'd appreciate it if you'd take a moment to spell my name correctly. It's disrespectful. Feel free to call me Matt from now on if that's easier. Please be respectful - I am trying to be.

Quote:
Originally Posted by Bulldog CFP View Post
Our gross debt to GDP Ratio is 106%. http://www.usdebtclock.org/
The topic of this conversation is federal debt, not state and local. So it is actually 67.8%, or 38th highest in the world. http://en.wikipedia.org/wiki/Nationa...mestic_product

I am not suggesting this isn't a problem - in fact I repeatedly refer to it as a problem. We disagree about both the scope and relative priority of it. I listed out a whole set of things that I think both sides could agree on that would also eliminate the deficit - I am not saying it is not something that should be solved.

Quote:
Originally Posted by Bulldog CFP View Post
Obama has added more to our national debt than all presidents before him combined. This is a fact. So, you are diminishing this by SPECULATING that it’s okay because the next president will spend even more? Wow! It is evident that you believe the BS line, that all the liberal progressives spew to their ignorant constituents for support, “we need to invest more in…”. Liberal translation for investing: Borrow and spend.
I believe we need to invest more in education, R&D, health research, etc. Yup. These things represent a tiny % of the total budget, and even if 0 would not solve the problem. I gave specific programs I would increase spending on, and did not suggest borrowing. What is your alternative if eliminating them altogether doesn't solve the problem?

Quote:
Originally Posted by Bulldog CFP View Post
I need a shovel. It’s getting really deep in here!
Being hyperbolic doesn't solve anything or add to the conversation.

Quote:
Originally Posted by Bulldog CFP View Post
You are actually equating all the Federal Government waste as though it’s inconsequential minutia or to that of leaving a light on when no one is occupying the room. Wow! Really? Mmcnutly, help us all out here and specify any government entity that is running lean, mean, profitable, offers value to the folks and isn’t broke.
No, I am stating that the ridiculous programs you plucked out, even if eliminated entirely, barely make a dent, so are irrelevant to the larger problem we are discussing. Do you dispute this factually?

Quote:
Originally Posted by Bulldog CFP View Post
Okay, here we go with the liberal progressive talking points of bashing the oil companies. And I bet you aren’t driving an electric car either! If you don’t like it then stop using petroleum based products. Or, don’t invest in a hedge fund. You make the choice!
Actually I drive a BMW M3 V8 that gets about 15MPG of ground up forest creatures. I invest in the market, though I don't think any of it is in hedge funds at the moment - my money manager handles that.

Since you aren't quoting me, I have to speculate that you are referring to the fact that I think there are tax breaks and loopholes on both sides of the spectrum that should be eliminated. I am not being one-sided at all, though your response certainly is. Are you suggesting that oil companies need our financial assistance at the moment?


Quote:
Originally Posted by Bulldog CFP View Post
But it is okay, from your perspective, that California Alameda County executive Susan Muranishi will be doing just fine when she retires on $470,000 a year for life and even getting performance bonuses to boot when she’s no longer performing! At least the folks are getting something for what they are paying for from the oil companies. Oh, here’s one, I wonder why California Berkeley City Councilman Gordon Wozniak wants to tax emails. Suggesting that the money collected, which would be part of a wider-reaching internet tax, could be used in Berkeley’s case to save the local post office!?!
Honestly I have no idea what you are doing here. You are plucking weird examples out of the fringe and suggesting that somehow helps your argument? You are aware, are you not, that I am not some liberal extremest, right? I mean look at what I suggested...

Quote:
Originally Posted by Bulldog CFP View Post
Hey Mmcnutly, why is the U.S. Post Office broke in the first place? Why is UPS, DHL, FedEx, etc. profitable? Mmcnutly, please enlighten us on why you think/feel/speculate that California is $164 billion dollars in Debt?
I've engaged in no speculation. The post office is broke because mail became obsolete, and congress manages it bizarrely. Frankly I think it should go away.

States can't run a debt in the way the federal government is, and that's the point of this conversation. The state budget has to be balanced. You are kind of all over the place here. I haven't looked it up but I assume that figure comes from local and city government pension obligations? No disagreement here - that's a major problem. What is your suggestion for a solution?

Quote:
Originally Posted by Bulldog CFP View Post
They will never be able to pay it back! And while you are at it, please let us know your thoughts on why there is a mass exodus of folks from California to states like Texas (and I pray they do not bring their liberal ideology with them).
That's not happening. I also, again, don't understand what point you are trying to make. I am not suggesting raising taxes nor increasing spending. I am suggesting we don't have to do either. We do lots of ridiculous things we shouldn't be. We should be spending less and taxing fairly. And by fairly I mean if you can afford to pay more, like myself, you should pay more, not less. The graph has to have some slope, not a peak for people making more than a million.

Quote:
Originally Posted by Bulldog CFP View Post
You must not be paying your fair share of taxes, mmcnutly! C’mon, man up! Sheesh!!!! Hey man, we’re only 17 trillion in debt and running a 1 trillion dollar budget deficit. Right, Mmcnutly? No biggy.
I pay the Alternative Minimum Tax, and as such my effective federal tax rate is just shy of 28% of my total income. And that is just federal income tax. What's yours? I think the fact that I pay so much actually gives me some freedom to talk here...


Quote:
Originally Posted by Bulldog CFP View Post
Oh BTW, following your oil company logic, then we should all stop going to the movies because the movie stars are hoarding millions of dollars in profit instead of equally distributing it among all the other folks who were employed to help make the movie. “Apalling”.
I really have no idea what you are talking about here. I think you might have mistaken what I was saying for liberal dogma, and are then suggesting I want to redistribute income somehow. I was suggesting nothing of the sort.


Quote:
Originally Posted by Bulldog CFP View Post
C’mon Mmcnutly, use that space between your ears and think it through. Also, just a helpful tip, if you stop watching the liberal progressive main stream biased news and listening to Nancy Pelosi you will have a better opportunity to think outside the box.
I suggested some very outside the box ideas. And I don't really watch TV news. I read things from both ends of the spectrum. I tend to read The Economist more than anything else, and that's hardly liberal progressive.

Quote:
Originally Posted by Bulldog CFP View Post
Taxes as a % of GDP are at an all-time low because the economy is in the crapper with 8% unemployment (double digit when you factor in all those who have stopped looking). The U.S. has the highest corporate tax structure over any other developed country in the world.
So that's not true. GDP goes down when the economy goes down - that's why that % is the real statistic.

We also have the highest corporate tax rates only on paper. In reality, companies pay in the single digits, including my own. I think we should cut the rates and also make it harder to get around. Do you disagree?

Quote:
Originally Posted by Bulldog CFP View Post
Mmcnutly, why do you think U.S. companies are hoarding cash, running on the least amount of employees and not hiring and growing?
That's a good question. Many companies are hiring and growing. Mine is. My whole industry is. I don't really know the answer as to why they are not reinvesting right now. Productivity is way up, so they are getting more without having to. That's part of the answer.

Quote:
Originally Posted by Bulldog CFP View Post
Obviously tax revenue would be higher if the economy was thriving. C’mon dude, Econ 101.
I think you might need to retake Econ 101. As an absolute dollar amount, sure. As a % of GDP, no. GDP would increase as well if the economy was thriving.

Quote:
Originally Posted by Bulldog CFP View Post
This is simply more meaningless, unsubstantiated and aimless comments. I particularly like the use of, “stuff”. It solidifies your point very well.
Again, respect will get you a long way. You ignored the entire main thrust of my post - my point by point budget priorities, and then say my points are meaningless and unsubstantiated? How about you actually debate the merits?

Quote:
Originally Posted by Bulldog CFP View Post
You are saying that “right-wing peoples” belief in fiscal responsibility, financial independence, freedom from government tyranny is as bad as the liberal progressives who embrace the belief that the Government can do better for you than you can do for yourself? The same folks who want European socialism, entitlement (nanny) state, no budget or spending limits, and ignore fiscal responsibility?
Yes, I am saying both extremes are nonsensical. You are doing a bang-up job of making my point for me.

Quote:
Originally Posted by Bulldog CFP View Post
Take a good hard look at our country, mmcnutly. Do you like what you see?
Yes, actually I do.

Quote:
Originally Posted by Bulldog CFP View Post
The majority embrace smaller government, financial independence and personal responsibility. They enjoy taking the initiative that is reinforced with reward of personal success, achievment and financial freedom. This is the very essence of what made our country so great.
This is meaningless hyperbole. Like I said, people like smaller government in the abstract but also the programs it provides specifically. Can you suggest which programs that make up a real % of the problem that you would cut and now? I did. You have not.

Quote:
Originally Posted by Bulldog CFP View Post
Mmcnutly, what can you glean from Greece, Ireland, Italy, Spain or Portugal? Do they offer you any insight? What about Cyprus?
That if you use a common currency you sure as hell had better also have the means to enforce lending standards and borrowing? And that banks should not be allowed to leverage their portfolios to such a degree? And that banks should not be allowed to get so large that they can't be allowed to fail on the merits?

But really, we were talking about the US budget. So this is totally besides the point.

Quote:
Originally Posted by Bulldog CFP View Post
I’ve been very specific since the inception of this thread. However, you are hypocritical to ask me to be specific when you fail to do the same.
I listed 9 specific budget priorities and changes. You have offered none. I was in fact extremely specific. You have yet to propose anything specific that would have any real effect on the budget in any meaningful way. You can't cut out that entire part of my post, then claim I am not being specific.

Quote:
Originally Posted by Bulldog CFP View Post
Who is repeating Fox News talking points? It doesn’t matter where you get your news as long as you question, challenge and verify everything. Am I wrong?
Go back to my 9 budget principles. What would you change?
mmcnulty is offline   United_States
0
Reply With Quote
      04-04-2013, 12:00 AM   #32
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by MP0WER View Post
I have a friend who works for the government. His trademark phrase is Waste-Fraud-Abuse, mainly because he sees it every day.

Eliminate even just 50% of the waste and the fraud the abuse and we're in a much better place than we are now.
Sure. Eliminate 100% of it and we'd still have a massive debt. Waste is absolutely a problem, and it is absolutely a tiny % of the overall problem.
mmcnulty is offline   United_States
0
Reply With Quote
      04-04-2013, 12:25 AM   #33
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by bbbbmw View Post
Thought I'd take a shot at discussing some of these points as well:

Sorry, due to the inline nature of some of your replies I missed that you had a bunch in there. I'll try and recreate:

Quote:
Originally Posted by bbbbmw View Post
I agree with your last sentence - there should not be different tax rates for investing, as opposed to earning income. Similarly, Hollywood shuld pay the same tax rates the rest of us do.
No disagreement. Hollywood in fact does already. It's people who make their money off investments that are getting off easy at the moment. Though there may be tax avoidance strategies being employed by high-paid hollywood types I am unaware of, like using corporations and such.

Quote:
Originally Posted by bbbbmw View Post
People don't go bankrupt because they got sick - they go bankrupt because they failed to plan for getting sick, by buying insurance (or knowing what kind of insurance they were buying). This is not true in every case (there are a few loopholes that prevent a small group of people from purchasing insurance), but it is true in the majority of medical bankruptcies.
I think you are mistaken about your percentages, but I agree that people are playing the odds, and when they lose, they lose big. My point is that they shouldn't be allowed to lose everything, nor should they be allowed to get everything for free. There's a middle ground.

Quote:
Originally Posted by bbbbmw View Post
...
Your idea about everyone having a base level of coverage will never work, for a few reasons. Every special interest group will consider their issues part of the "base level." Would your base level include gender re-assignment surgery, and adoption? Orthodontia? Remember, everything comes at a price. Another argument would be that poor people would not have the same access to care as those with private insurance (e.g. 6 hour waits at public clinics, 9 months to schedule a specialty consult).
Quote:
Originally Posted by bbbbmw View Post
See above - the people who would be in the "base level" would want access to the private level benefits.
I do not disagree that where you draw the line is important here. I think if people had to wait months or in lines it would be morally superior to where we are today where they just die. But again, drawing that line is extremely hard, and critical to the financial viability of the proposal. I don't know enough about the specifics of health care costs to tell you.

Quote:
Originally Posted by bbbbmw View Post
The reason that more expensive stuff is in the public option today, is because of the special interests and issues of access to care. It would not change in the slightest - we've been down this road, and it's the reason we are where we are today.
Not sure what you are talking about here. We have no public option now. We have medicare, in which there are no restrictions at all. But we've never been down the road of public health coverage.

Quote:
Originally Posted by bbbbmw View Post
Your idea of silly is another guy's idea of critical.
Yup. It's a matter of common sense, and that is hard to legislate. Agreed.

Quote:
Originally Posted by bbbbmw View Post
We already have free education through high school - why extend it to University level? Not everyone needs to go to University. And, the University system is out of control - costs have risen at over 6x the rate of inflation. Why aren't Community Colleges private? Do we really need to spend local tax revenue on basketweaving and porn-study classes?
You missed where I said we should be tracking kids into technical vocational schools as well. That's a critical bit - not everyone needs to go to a university.

I left this out but I think there's something to be said for influencing what people study. Art history (or basketweaving) should somehow be a more difficult, but not impossible, path than science and math.

Quote:
Originally Posted by bbbbmw View Post
Completely disagree - the Free Market should drive tech investment. The Feds tend to fund things like studying the genital washing habits of African Men, and Robotic Squirrels (fact - google it...).
The problem is there are things for which the free market does not provide enough incentives. There is no reason for private enterprise to send people to the moon (nor reap the benefits of the scientific research that came from it). There is no incentive for drug companies to come up with vaccines when they make more money from people being sick. There are things that private enterprise does not have the scale to do.

It's also tricky to start picking apart specific scientific research. I suggest you read this http://www.slate.com/articles/health...ervatives.html

Quote:
Originally Posted by bbbbmw View Post
Again - completely disagree. The minute you turn this over to government, you have things like carpool lanes, ineffective mass transit, and massive waste. We have huge spending on infrastructure today that is completely mis-managed - it's not going to get better with more money.
Private enterprise does not have the scale nor incentives to solve these issues generally. They do in specific cases. Government has always built the infrastructure - there is no "turning it over" to the government... Perhaps you could be more specific?

Quote:
Originally Posted by bbbbmw View Post
Not sure you can compare our spending to China's, since in a communist society they have essentially slave labor and artificial prices.
That's valid, but doesn't justify the massive multiplier. We're waaaaaay out in front when we only have to be way out in front, imo.

Quote:
Originally Posted by bbbbmw View Post
Agreed - what are we doing in Libya and Afghanistan?
I'm all for selective intervention when we can tip the scales relatively easily, like Libya. I'm also for bombing the shit out of the taliban and bin laden. But the rest of Afganistan, agreed totally - quagmire.

Quote:
Originally Posted by bbbbmw View Post
What's with the "Fox News" issue? The exact same could be said for MSNBC, ABC/CBS/NBC, and any other mainstream media organization.
My point is both extremes have stupid talking points. I was referring specifically to Bulldog's comments as being from the right fringe.
mmcnulty is offline   United_States
0
Reply With Quote
      04-04-2013, 09:11 AM   #34
Mr Tonka
says, Drastic times call for drastic measures
 
Mr Tonka's Avatar
 
Drives: Exceptionally well :)
Join Date: Feb 2009
Location: Tampa, FL

Posts: 1,136
iTrader: (0)

Quote:
Originally Posted by mmcnulty View Post
Sure. Eliminate 100% of it and we'd still have a massive debt. Waste is absolutely a problem, and it is absolutely a tiny % of the overall problem.
I would disagree. Maybe fraud is a tiny % of the problem, but i believe that waste and abuse is at the root of the problem.

I don't know what your experience is with the government but i have worked with several levels of our government from cities to federal. The consistency i've run into over the last 23 years is waste and abuse.

My most recent endeavor is with the FL department of health. They are reconfiguring their current office. They are constructing a new waiting room, reception, and patient processing room. These areas make up about 5% of the total square footage of their building. Once the contract was awarded they decided to add a change order. New carpet and paint throughout the building including new porcelain tile in the waiting room and all break rooms. My original contract was $11,320. The change order was $142,691. So far it sounds legit. The catch is that this office space was renovated just 3 years ago and they received all new carpet and paint throughout the building. The kicker is that the carpet they are now buying is the exact same carpet they installed 3 years ago, even the same color.

The existing carpet was in such good condition that we have installed it in other locations.

FL is in much better condition that the FED and if that type of waste occurs on a single floor of a single building in just one city of one county of a single state.....
__________________
-Joe


"Government is the great fiction, through which everybody endeavors to live at the expense of everybody else." — Frédéric Bastiat
Mr Tonka is offline   United_States
0
Reply With Quote
      04-04-2013, 03:15 PM   #35
ScarecrowBoat
Zooombie attaaack!!
 
ScarecrowBoat's Avatar
 
Drives: 2012 328i
Join Date: Mar 2011
Location: Iowa

Posts: 855
iTrader: (2)

Garage List
2012 BMW  [0.00]
Quote:
Originally Posted by mmcnulty View Post
Bulldog CFP,

OK, for sh!ts and giggles and because I have some time, I'll bite. For the record, I feel I represent a largely unrepresented swath of the country and operate not from liberal nor conservative dogma. I think there are points people could agree on if they would just step away from their respective dogmas.

Also for the record, I live in liberal San Francisco, but have done quite well in my career.

The problem with your argument is you are dogmatic in the opposite direction of what you are lambasting, in, imo, an equally unrealistic manner.

I think everyone agrees, including the President, that in an ideal world we would have no budget deficit and would in fact be paying down the debt. I think even the progressive caucus believes this, they are just out there on how.

When you throw actual dollar amounts into your argument, you weaken it. Debt is measured by "honest economists" as a % of GDP, and you take into account inflation. Suggesting that the real dollar amount historically is some relatively absurd value is not actually helpful. It's true, it just isn't really what matters. Similar "biggest spending president in history". Guess what? Odds are the next one will be even bigger, regardless of party. The bipartisan budget commission suggested we cut about $4T from the budget deficit through spending and taxes over 10 years and guess what? We're pretty much at that amount of cutting/taxes over the past two years or so.

Anyone can quote absurd federal spending as an argument against waste. I can also claim you should turn off lights in rooms you aren't in in your home - this has about the same % effect on the problem as the programs you describe. One could also quote massive tax giveaways we are giving to hedge fund managers and energy companies that are equally appalling on the other end of the spectrum. This is also not really helpful.

Taxes as a % of GDP are at an all-time low, so that is also not really relevant.

The amount of spending that isn't the military and entitlements could be cut to ZERO and it would not get rid of the deficit. And there's lots of good stuff in that category like medical research that no one would agree we should cut.

The progressive caucus is equally wrong. I live in a city where progressives have gone relatively mad, and it sucks as bad as it would if right-wing people were in charge, just in different ways.

My point is this: Both sides are unclean in this argument. Neither side actually owns a public opinion mandate - americans like smaller government in the abstract, but also like all of the individual programs it provides in the specific, silly edge cases you describe excepted.

So what do I think? I guess here is where I potentially need to put on a flame suit because both sides will dislike what I say. I do have some principles though:

1. The tax code should be progressive to some degree. People who can afford to pay more, myself included, should pay relatively more. The argument is about how much more. The biggest problem here is people who make a lot more than me actually pay a lower effective tax rate than I do, and that is wrong. The graph of effective tax rate by income peaks in my range, and then falls back down for the even-wealthier. I should not be relatively punished because most of my income comes from *working* as opposed to *investing*.

2. People shouldn't go bankrupt because they get sick. We also shouldn't jeopardize the financial incentive for medical companies to invest in new technology. My suggestion for threading this needle is:

2a. The government should provide a base level of medical coverage. Nothing fancy, nothing extreme. All preventative care because this costs less than it saves. Highish caps on out of pocket for catastrophic problems like cancer. This isn't a "market" in the normal sense because people have no chance of not participating. If you pass out in the street you will be taken to an ER and given care.

2b. The private health insurance market should continue to exist but focus on care above that base level. Shorter waits, more exotic and experimental care, non-preventative care.

2c. Note that this is somewhat of a "public option", which actually decreases cost. And by not including the more expensive stuff in the public part, it stops the massive increase in spending in medicare/medicaid, and would replace both of those programs.

3. Free markets are the ideal, but in extreme cases intervention is required. Monopolies. Banks that are so big if they failed they would destroy the economy. Etc. Regulation is a tool that should be used only on these extremes, but is a tool that should be used. For silly things, like airbag warning stickers on sun visors, the government should stay the hell out. One interesting idea here is limiting the # of laws per session of congress. Make em count.

This means no subsidies for farmers. This means if a kid dies from a defective product, the market should sort that out not the government. Again, both sides have faults here.

4. A base level of education should be free - primary, secondary, and university. We should be tracking kids into more university-track and technical vocational school track earlier on, like Europe does. This should all be free. Advanced degrees probably should stay private. Let the private market handle everything above this base level, ala my healthcare position above. While we are towards the top of education spending per capita, we aren't actually at the top despite what you say, and an *extremely small* percentage of that comes from the federal government. Most comes from local property taxes and then state funding, and is horrifically inequitable and inefficient.

5. Massively more spending on R&D - medical, computers, biology, and yes, NASA - this is stuff that makes us better and more money in the end, and again, is a pittance of the total. All of NASA = 1% of the total budget.

6. Increased spending on infrastructure. Not stupid high speed rail. But highways, bridges, tunnels, mass transit to keep cars off the road, etc. Again, this is all good and gains us more money than it costs.

7. Decreased spending on the military. Here I get more controversial I bet. We spend more than the next 13 countries combined on defense, including on unnecessary programs the military doesn't even want but are in congressional home districts so pork keeps them around. We spend nearly 2.5x China as a % of GDP. These are many *many* times the spending program amounts you list, and again, the military doesn't even want them. We need to stay ahead of china, and have effective ways to defeat guerilla-style terrorist groups in various countries. We don't need anything more than that.

I am not saying we need to avoid conflict like libertarians - we have a duty as the richest people in the world to be the world's cop where required. But we are doing like 5x that right now.

8. Social Security. Despite what some like to say, Social Security is *mostly* financially solvent and just needs some minor adjustments based on eligibility age based on the fact that people live longer. Once we get through the baby boomers retiring, it becomes solvent again. People don't save for retirement - this is why this was invented in the first place. Old people were destitute. That shouldn't happen and I don't see a better way to stop it than social security.

9. The gov't should stay the hell out of social issues and people's lives and religions. This again goes both ways. People should marry whom they choose. Priests shouldn't have to be forced to marry anyone.

If you object to something here, please try and be specific about it. *Both* sides are being vague and it is unhelpful. Tell me which program that totals more than 1% of the budget you would cut and how. Don't just repeat Fox News talking points, and don't just use the other extreme to try and make your point.

We need to trim the big programs - medicare, medicaid, social security, and the military. We also need to tax fairly, by which I mean progressively.

If we did all of this, our deficits would be solved. If you have an alternative that would actually work, by all means illustrate it. But please learn about what you are discussing in a way that depends on facts and not talking points.
I...just...YES
__________________
12 BMW 328i
08 Range Rover Sport SC
ScarecrowBoat is offline   United_States
0
Reply With Quote
      04-04-2013, 05:31 PM   #36
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Quote:
Originally Posted by mmcnulty View Post
OK, that's fairly hilarious, but yes. Born and raised and never lived in any other country. Just because I was avoiding trigger words for both sides and am advocating a centrist approach does not mean I'm somehow not American.

Feel free to go after the substance though.
This was an innocent question - I meant no offense whatsoever. Your use of the word "University", as well as your concepts about government education and healthcare reminded me of interactions with colleagues from those countries. It was not a judgement of any sort - was just wondering if that was your reference point.
bbbbmw is offline  
0
Reply With Quote
      04-04-2013, 06:35 PM   #37
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Thanks for your reply - I will try and do the same to recreate the points:


No disagreement. Hollywood in fact does already. It's people who make their money off investments that are getting off easy at the moment. Though there may be tax avoidance strategies being employed by high-paid hollywood types I am unaware of, like using corporations and such.

Me: Hollywood actually gets some fairly significant Federal tax breaks specific to their industry. This in addition to many tax breaks in various states.
--------------------------------

I think you are mistaken about your percentages, but I agree that people are playing the odds, and when they lose, they lose big. My point is that they shouldn't be allowed to lose everything, nor should they be allowed to get everything for free. There's a middle ground.

Me: They don't lose everything. Most providers will use a sliding scale to collect from people who are un/under-insured, based upon their ability to pay. And, there is Bankruptcy court for those who gambled and lost - you don't lose everything in Bankruptcy court, typically (although state laws differ, of course).
------------------

I do not disagree that where you draw the line is important here. I think if people had to wait months or in lines it would be morally superior to where we are today where they just die. But again, drawing that line is extremely hard, and critical to the financial viability of the proposal. I don't know enough about the specifics of health care costs to tell you.

Me: No one "dies" today, because they don't have access to care. There are many laws in place (and have been for many years) that ensure that people are treated. Instead of base level coverage, most people would probably prefer to be able to choose exactly what coverage they want. States decide what has to be covered, which is one reason there is a huge disparity in the cost of health insurance along state lines. But it's illegal to purchase health insurance across state lines, under current law. This was a strong criticism of Obamacare - for all the talk of making insurance companies compete, Obamacare did not remove the barriers to purchasing coverage across state lines.
-------------------------

Not sure what you are talking about here. We have no public option now. We have medicare, in which there are no restrictions at all. But we've never been down the road of public health coverage.

Me: I was referring to the "public option" of Medicaid (government coverage given to low income people), as well as Medicare. While the purchasing power can decrease costs, the programs are notoriously ill-managed, and subject to endless waste/fraud/abuse. And what is covered is as much politically driven as anything else.
------------------------

You missed where I said we should be tracking kids into technical vocational schools as well. That's a critical bit - not everyone needs to go to a university.

I left this out but I think there's something to be said for influencing what people study. Art history (or basketweaving) should somehow be a more difficult, but not impossible, path than science and math.

Me: Whether University or Vo-Tech, I don't think taxpayers should have to pay for it, or subsidize it. Students need to be on the hook to do something productive with their personal investment in their personal education. Otherwise, the education system gets out of control - no accountability, and unlimited access to government funding/student loans. I'd also be very reluctant to influence what people study - not sure I'd trust anyone with that.


The problem is there are things for which the free market does not provide enough incentives. There is no reason for private enterprise to send people to the moon (nor reap the benefits of the scientific research that came from it). There is no incentive for drug companies to come up with vaccines when they make more money from people being sick. There are things that private enterprise does not have the scale to do.

It's also tricky to start picking apart specific scientific research. I suggest you read this http://www.slate.com/articles/health...ervatives.html

Me: I agree with you, but just a little bit... Yes about the moon, but drug companies making more on illness than vaccines is not correct - you can potentially make more by vaccinating everyone than treating the 1.5% that gets ill. Government intervention has skewed this model by artificially reducing the amount paid for vaccines. One aside - the US is the only country in the world that allows drug makers to charge more than the cost of manufacturing a drug. The end result is that the US bears the cost of drug development for the entire world, and it shows up in our healthcare costs. This is never accounted for in the global comparisons of healthcare costs.

Regarding the scientific research, I agree that it's complex. But the author lost credibility when she concluded "the study has the potential to move science forward", and justified the expense with "Most of the grant money was spent on salaries, putting money back into the economy" - she clearly doesn't understand that the money was forcibly taken out of the economy in the first place, from taxpayers...
-------------------------------------

Private enterprise does not have the scale nor incentives to solve these issues generally. They do in specific cases. Government has always built the infrastructure - there is no "turning it over" to the government... Perhaps you could be more specific?

Me: My point was that government built the infrastructure in the first place, with tax money. In the 1950's, our Interstate system was built with tax money, which included funding to maintain it. Over the years, government has dipped into this infrastructure funding, and diverted the money to other areas (like taking gas tax revenue and paying for pet projects). What happened to the money that we are already paying, that should be used for maintenance? Additionally, the infrastructure projects like carpool lanes, mass transit, etc. have failed in many areas, and the incentives to get the Federal funding are often counterproductive - they are more social engineering projects than effective development. And finally, the Big Dig in Boston is a classic example - 25 years, and $14.6B (190% cost overrun). For years they had a sign in the middle of the traffic snarl "Rome wasn't built in a day - if it was, we would have hired their contractor" - sticking their finger in the eye of the taxpaying public.
---------------------------------

I'm all for selective intervention when we can tip the scales relatively easily, like Libya. I'm also for bombing the shit out of the taliban and bin laden. But the rest of Afganistan, agreed totally - quagmire.

Me: We tipped the scales in Lybia, but most likely in the direction of American's enemies. I still don't know what that was about...
bbbbmw is offline  
0
Reply With Quote
      04-04-2013, 06:48 PM   #38
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Quote:
Originally Posted by mmcnulty View Post
Sure. Eliminate 100% of it and we'd still have a massive debt. Waste is absolutely a problem, and it is absolutely a tiny % of the overall problem.
In healthcare, waste/fraud/abuse are truly massive, and driven by several forces:

1. Greed, malfeasance, corruption - yes, people do try and defraud the system.

2. Government payment methodologies - As a doctor, hospital, etc., Medicare and Medicaid will only pay for treatment if you follow certain protocols. Those protocols are often outdated, and rigid to the point of requiring massively wasteful behaviors. But - if you don't follow them, you won't get paid - ask any Physician.

3. Risk of lawsuit - depending upon whose estimate you use, about 15% of healthcare treatment is ordered by docs simply because they are afraid of getting sued. Our legal system encourages this, and Obamacare did nothing to provide for Tort Reform.

Medicare and Medicaid spending are about $1T/yr. If we addressed the above areas, the cost of healthcare would decrease dramatically, as would government spending.

Last edited by bbbbmw; 04-04-2013 at 07:46 PM.
bbbbmw is offline  
0
Reply With Quote
      04-04-2013, 09:24 PM   #39
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by MP0WER View Post
I would disagree. Maybe fraud is a tiny % of the problem, but i believe that waste and abuse is at the root of the problem.

I don't know what your experience is with the government but i have worked with several levels of our government from cities to federal. The consistency i've run into over the last 23 years is waste and abuse.

My most recent endeavor is with the FL department of health. They are reconfiguring their current office. They are constructing a new waiting room, reception, and patient processing room. These areas make up about 5% of the total square footage of their building. Once the contract was awarded they decided to add a change order. New carpet and paint throughout the building including new porcelain tile in the waiting room and all break rooms. My original contract was $11,320. The change order was $142,691. So far it sounds legit. The catch is that this office space was renovated just 3 years ago and they received all new carpet and paint throughout the building. The kicker is that the carpet they are now buying is the exact same carpet they installed 3 years ago, even the same color.

The existing carpet was in such good condition that we have installed it in other locations.

FL is in much better condition that the FED and if that type of waste occurs on a single floor of a single building in just one city of one county of a single state.....
My point is simply one of scale. If you removed every penny of fraud, waste, and abuse from the government, and left current policies in place - you'd still have a debt and deficit. The programs that are actually costing us the large percentages of our budget are enormous. While in any enormous program waste is going to be a problem, and in real dollars appalling, it just pales in comparison to large spending programs in the military, medicare, or medicaid.
mmcnulty is offline   United_States
0
Reply With Quote
      04-04-2013, 09:33 PM   #40
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by bbbbmw View Post
In healthcare, waste/fraud/abuse are truly massive, and driven by several forces:

1. Greed, malfeasance, corruption - yes, people do try and defraud the system.

2. Government payment methodologies - As a doctor, hospital, etc., Medicare and Medicaid will only pay for treatment if you follow certain protocols. Those protocols are often outdated, and rigid to the point of requiring massively wasteful behaviors. But - if you don't follow them, you won't get paid - ask any Physician.

3. Risk of lawsuit - depending upon whose estimate you use, about 15% of healthcare treatment is ordered by docs simply because they are afraid of getting sued. Our legal system encourages this, and Obamacare did nothing to provide for Tort Reform.

Medicare and Medicaid spending are about $1T/yr. If we addressed the above areas, the cost of healthcare would decrease dramatically, as would government spending.
The problem we have with medical costs are vastly greater than you describe. There's an interesting book out - for a summary of some of it I suggest this interview: http://www.thedailyshow.com/watch/th...nterview-pt--1

"Tort reform" is also a misnomer. Limiting damages only hurts *successful* lawsuits. There are of course exceptions but in large part if you lose a lawsuit, you did something to deserve it. We should figure out ways to prevent frivolous lawsuits, but nothing I've seen parading under the guise of "tort reform" has actually attempted to do this.

I think you are mistaken about some of the ways in which medicare specifically is run. Medicaid is very different. My brother is actually a prominent physician, fyi. So I'm not speaking from a place with no grounding.

I appreciate the exchange of ideas on the merits and respectful attitude, btw, and not the insanity of some of the other replies ;-)
mmcnulty is offline   United_States
0
Reply With Quote
      04-04-2013, 09:53 PM   #41
mmcnulty
Enlisted Member
 
Drives: 2013 E93 M3 DCT SSII
Join Date: Oct 2012
Location: San Francisco

Posts: 43
iTrader: (0)

Garage List
Quote:
Originally Posted by bbbbmw View Post
Thanks for your reply - I will try and do the same to recreate the points:


No disagreement. Hollywood in fact does already. It's people who make their money off investments that are getting off easy at the moment. Though there may be tax avoidance strategies being employed by high-paid hollywood types I am unaware of, like using corporations and such.

Me: Hollywood actually gets some fairly significant Federal tax breaks specific to their industry. This in addition to many tax breaks in various states.
--------------------------------
Yeah, the *people* in hollywood pay the same in taxes, though. You are talking about corporations. I was talking about personal income taxes. And I am not sure hollywood gives out more local tax breaks than other areas do to attract businesses, auto factories, sports teams, etc. It's a pretty general problem.

Quote:
Originally Posted by bbbbmw View Post
I think you are mistaken about your percentages, but I agree that people are playing the odds, and when they lose, they lose big. My point is that they shouldn't be allowed to lose everything, nor should they be allowed to get everything for free. There's a middle ground.

Me: They don't lose everything. Most providers will use a sliding scale to collect from people who are un/under-insured, based upon their ability to pay. And, there is Bankruptcy court for those who gambled and lost - you don't lose everything in Bankruptcy court, typically (although state laws differ, of course).
------------------
I was being hyperbolic - I apologize. They don't lose everything, but they lose most everything. And those costs they can't pay are picked up by the rest of us already - instead of taxes, they are in higher premiums and device costs. The costs are already shared.

Quote:
Originally Posted by bbbbmw View Post
I do not disagree that where you draw the line is important here. I think if people had to wait months or in lines it would be morally superior to where we are today where they just die. But again, drawing that line is extremely hard, and critical to the financial viability of the proposal. I don't know enough about the specifics of health care costs to tell you.

Me: No one "dies" today, because they don't have access to care. There are many laws in place (and have been for many years) that ensure that people are treated. Instead of base level coverage, most people would probably prefer to be able to choose exactly what coverage they want. States decide what has to be covered, which is one reason there is a huge disparity in the cost of health insurance along state lines. But it's illegal to purchase health insurance across state lines, under current law. This was a strong criticism of Obamacare - for all the talk of making insurance companies compete, Obamacare did not remove the barriers to purchasing coverage across state lines.
-------------------------
There's two points in here, both of which I disagree with. One, people absolutely die because they lack coverage. Emergency care is one thing - long term chronic untreated conditions are completely another, and cause a lot more death than emergencies covered by laws.

Second, the health care across state lines thing is bogus. States regulate insurance. The regulations are different in every state. If you allowed this, insurance companies would cluster in the least-regulated and cheapest state, offering cheaper coverage that covers a lot less. This doesn't actually save any costs - it just makes it easier for insurance companies to game the system.

Quote:
Originally Posted by bbbbmw View Post
Not sure what you are talking about here. We have no public option now. We have medicare, in which there are no restrictions at all. But we've never been down the road of public health coverage.

Me: I was referring to the "public option" of Medicaid (government coverage given to low income people), as well as Medicare. While the purchasing power can decrease costs, the programs are notoriously ill-managed, and subject to endless waste/fraud/abuse. And what is covered is as much politically driven as anything else.
------------------------
Medicare is not really managed at all, which is why people like it - they go get what they or their doctors want and there isn't really any oversight unless it gets excessive, but that's pretty rare. And see my other response regarding waste/fraud/abuse vs the built-in problems in pricing and payment that are really the root cause, illustrated in Steven Brill's book, if I recall his name correctly.

Quote:
Originally Posted by bbbbmw View Post
You missed where I said we should be tracking kids into technical vocational schools as well. That's a critical bit - not everyone needs to go to a university.

I left this out but I think there's something to be said for influencing what people study. Art history (or basketweaving) should somehow be a more difficult, but not impossible, path than science and math.

Me: Whether University or Vo-Tech, I don't think taxpayers should have to pay for it, or subsidize it. Students need to be on the hook to do something productive with their personal investment in their personal education. Otherwise, the education system gets out of control - no accountability, and unlimited access to government funding/student loans. I'd also be very reluctant to influence what people study - not sure I'd trust anyone with that.
The problem is that isn't working. Relatively few college students pay the total cost of college out of pocket, so that connection is already tenuous, and the system preys on students. I don't see how guaranteeing what is now required to get a real career is out of control. The more we educate our citizens, the more money flows back in the end. It's the long game, so it's more difficult to draw the line from X to Y, but it exists.

I agree with reluctance to influence what people study, but I also think there might be something clever in that realm that I won't rule out.

Quote:
Originally Posted by bbbbmw View Post
The problem is there are things for which the free market does not provide enough incentives. There is no reason for private enterprise to send people to the moon (nor reap the benefits of the scientific research that came from it). There is no incentive for drug companies to come up with vaccines when they make more money from people being sick. There are things that private enterprise does not have the scale to do.

It's also tricky to start picking apart specific scientific research. I suggest you read this http://www.slate.com/articles/health...ervatives.html

Me: I agree with you, but just a little bit... Yes about the moon, but drug companies making more on illness than vaccines is not correct - you can potentially make more by vaccinating everyone than treating the 1.5% that gets ill. Government intervention has skewed this model by artificially reducing the amount paid for vaccines. One aside - the US is the only country in the world that allows drug makers to charge more than the cost of manufacturing a drug. The end result is that the US bears the cost of drug development for the entire world, and it shows up in our healthcare costs. This is never accounted for in the global comparisons of healthcare costs.
We need a system that retains financial incentives for drug companies while preventing gouging, or pricing that has nothing to do with market demand or forces. That market feedback loop is broken, and, imo, is the main problem.

Quote:
Originally Posted by bbbbmw View Post
Regarding the scientific research, I agree that it's complex. But the author lost credibility when she concluded "the study has the potential to move science forward", and justified the expense with "Most of the grant money was spent on salaries, putting money back into the economy" - she clearly doesn't understand that the money was forcibly taken out of the economy in the first place, from taxpayers...
-------------------------------------
Money that goes to salaries is not taken out of the economy. That money pays for things people need, which goes into those people's salaries and companies, etc. There is a multiplicative effect - the money does not disappear. The basic point remains - basic scientific research is on the whole helpful to society and bears economic and other fruit down the line, and it's problematic to pick apart individual studies or programs and ignore the whole.

Quote:
Originally Posted by bbbbmw View Post
Private enterprise does not have the scale nor incentives to solve these issues generally. They do in specific cases. Government has always built the infrastructure - there is no "turning it over" to the government... Perhaps you could be more specific?

Me: My point was that government built the infrastructure in the first place, with tax money. In the 1950's, our Interstate system was built with tax money, which included funding to maintain it. Over the years, government has dipped into this infrastructure funding, and diverted the money to other areas (like taking gas tax revenue and paying for pet projects). What happened to the money that we are already paying, that should be used for maintenance? Additionally, the infrastructure projects like carpool lanes, mass transit, etc. have failed in many areas, and the incentives to get the Federal funding are often counterproductive - they are more social engineering projects than effective development. And finally, the Big Dig in Boston is a classic example - 25 years, and $14.6B (190% cost overrun). For years they had a sign in the middle of the traffic snarl "Rome wasn't built in a day - if it was, we would have hired their contractor" - sticking their finger in the eye of the taxpaying public.
---------------------------------
I lived in Boston through the big dig, and have been there since, and it's a revelation. Sure it was absurdly expensive, but the benefit to both commuters and city dwellers with massive amounts of green space and parks and a waterfront no longer cut off from the rest of the city is immense. Ask someone in Boston whether the big dig was worth it, even at that cost - I don't think many would say no at this point.

I agree that diverting gas tax money and other money earmarked for transportation infrastructure is a bad idea, and we are paying for it now. I don't see how that is a reason why we should not have government still handle that side of things.

Quote:
Originally Posted by bbbbmw View Post
I'm all for selective intervention when we can tip the scales relatively easily, like Libya. I'm also for bombing the shit out of the taliban and bin laden. But the rest of Afganistan, agreed totally - quagmire.

Me: We tipped the scales in Lybia, but most likely in the direction of American's enemies. I still don't know what that was about...
A bad guy killing his own people was brought down. Into the void stepped militias with primarily local agendas and no real global anti-american agenda. 99% of them at least. But we don't really disagree here.
mmcnulty is offline   United_States
0
Reply With Quote
      04-04-2013, 10:31 PM   #42
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Quote:
Originally Posted by mmcnulty View Post
The problem we have with medical costs are vastly greater than you describe. There's an interesting book out - for a summary of some of it I suggest this interview: http://www.thedailyshow.com/watch/th...nterview-pt--1

"Tort reform" is also a misnomer. Limiting damages only hurts *successful* lawsuits. There are of course exceptions but in large part if you lose a lawsuit, you did something to deserve it. We should figure out ways to prevent frivolous lawsuits, but nothing I've seen parading under the guise of "tort reform" has actually attempted to do this.

I think you are mistaken about some of the ways in which medicare specifically is run. Medicaid is very different. My brother is actually a prominent physician, fyi. So I'm not speaking from a place with no grounding.

I appreciate the exchange of ideas on the merits and respectful attitude, btw, and not the insanity of some of the other replies ;-)
In states that have enacted Tort Reform, their health insurance costs have dropped substantially. Many insurers would rather settle out of court, even if not guilty, because it costs more to defend yourself, and countersuing a sick individual for court costs is a losing proposition. Tort Reform discourages these lawsuits by capping the amount you can sue for, in the absence of malfeasance (e.g. if the Dr. was drunk). If your brother is in private practice, he no doubt pays some pretty heavy malpractice premiums to cover himself - and these get passed on to his patients.

The guy you referenced who was interviewed on The Daily Show actually wrote an article in Time Magazine - it wasn't a book. He makes some assumptions in it that are intriguing, but also often inaccurate:
http://www.forbes.com/sites/chriscon...-costs-part-1/
http://www.forbes.com/sites/chriscon...r-pill-part-2/

One assumption that is often repeated, and completely inaccurate - that the US healthcare system has lower outcomes (performance) than other countries. In fact, other countries don't record statistics like we do - when you adjust for it, we are leading.

Another is that 60+% of bankruptcies are caused by medical bills - deeper analyses have shown that of Americans claiming medical bills as the cause of their bankruptcy only had medical bills as 12-13% of their debt.

I've worked with Doctors, Hospitals, Insurers, and Pharma companies for many years. Our healthcare system has many problems, but it's been over-politicized since the Clinton's were in office, and the "solutions" presented by politicians are intended to gain votes, not solve problems. It's distressing to see what's unfolding - it is exacerbating the problems, not solving them.

I appreciate the debate as well - none of these problems are simple, and I usually learn something from another point of view!
bbbbmw is offline  
0
Reply With Quote
      04-04-2013, 11:03 PM   #43
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Okay - I'm giving up on this "quote" thing - will try to respond to a couple and make sense:

Quote:
Originally Posted by mmcnulty View Post
Yeah, the *people* in hollywood pay the same in taxes, though. You are talking about corporations. I was talking about personal income taxes. And I am not sure hollywood gives out more local tax breaks than other areas do to attract businesses, auto factories, sports teams, etc. It's a pretty general problem.

Me: Yes - sorry - I was speaking of corporate tax breaks - both Federal and State. They get huge breaks, and only employ very few people.

I was being hyperbolic - I apologize. They don't lose everything, but they lose most everything. And those costs they can't pay are picked up by the rest of us already - instead of taxes, they are in higher premiums and device costs. The costs are already shared.

Agree - in an earlier post I mentioned that the high Medical Bankruptcy number is a myth. I've also worked with many hospitals that collect $.03-.09 per dollar, on their uninsured patients. They don't bother to sue, as there are no assets. And we all ultimately share the burden.

There's two points in here, both of which I disagree with. One, people absolutely die because they lack coverage. Emergency care is one thing - long term chronic untreated conditions are completely another, and cause a lot more death than emergencies covered by laws.

Me: If you have assets and choose to roll the dice without insurance, you may lose those assets if you have a healthcare event. If you end up losing your assets, you then qualify for Medicaid, at no cost to you. So no one should end up dying because of a lack of care.

Second, the health care across state lines thing is bogus. States regulate insurance. The regulations are different in every state. If you allowed this, insurance companies would cluster in the least-regulated and cheapest state, offering cheaper coverage that covers a lot less. This doesn't actually save any costs - it just makes it easier for insurance companies to game the system.

Me: It's illegal to live in one state, and buy insurance in another. So if you live in CT and must pay high premiums, you can't buy it from IA, which has low premiums. The law is what prevents insurance companies from clustering in a low-cost state. That law could be changed.

Medicare is not really managed at all, which is why people like it - they go get what they or their doctors want and there isn't really any oversight unless it gets excessive, but that's pretty rare. And see my other response regarding waste/fraud/abuse vs the built-in problems in pricing and payment that are really the root cause, illustrated in Steven Brill's book, if I recall his name correctly.

Me: Medicare is highly regulated - in payment and practice patterns for the Doctors. Which is why many docs no longer accept it - it is too much hassle, and the payments are too low. Same goes for Medicaid.


The problem is that isn't working. Relatively few college students pay the total cost of college out of pocket, so that connection is already tenuous, and the system preys on students. I don't see how guaranteeing what is now required to get a real career is out of control. The more we educate our citizens, the more money flows back in the end. It's the long game, so it's more difficult to draw the line from X to Y, but it exists.

I agree with reluctance to influence what people study, but I also think there might be something clever in that realm that I won't rule out.

Me: I think we are on the same track - about the education system preying on students - that was my point. I'd love to see the Unversity system go to an accountable model - where you pay them based upon getting a job, and perhaps a percentage of your first 10 years earnings - or something like that.

We need a system that retains financial incentives for drug companies while preventing gouging, or pricing that has nothing to do with market demand or forces. That market feedback loop is broken, and, imo, is the main problem.

Me: Agreed. But again, much of the problem is the government. The FDA takes years to get a drug to market, and the process is byzantine and expensive. The legal system allows unlimited lawsuits. These issues could be easily fixed.

Money that goes to salaries is not taken out of the economy. That money pays for things people need, which goes into those people's salaries and companies, etc. There is a multiplicative effect - the money does not disappear. The basic point remains - basic scientific research is on the whole helpful to society and bears economic and other fruit down the line, and it's problematic to pick apart individual studies or programs and ignore the whole.

Me: The first part of your statement reminds me of Nancy Pelosi saying that Unemployment Compensation actually stimulates the economy - I would disagree. I understand your second point.

I lived in Boston through the big dig, and have been there since, and it's a revelation. Sure it was absurdly expensive, but the benefit to both commuters and city dwellers with massive amounts of green space and parks and a waterfront no longer cut off from the rest of the city is immense. Ask someone in Boston whether the big dig was worth it, even at that cost - I don't think many would say no at this point.

I agree that diverting gas tax money and other money earmarked for transportation infrastructure is a bad idea, and we are paying for it now. I don't see how that is a reason why we should not have government still handle that side of things.

Me: Of course they love the Big Dig now - it was billions of Federal dollars, not City of Boston tax dollars! I hope they are enjoying that Lobster Roll on the lawn that we all are paying for, while the traffic flows under their feet. Thanks, Tip O'Neill!

My point about government handling infrastructure is that all the Stimulus money was supposed to be spent on infrastructure repair - whereas it should never have been allowed to disintegrate in the first place. It's becoming yet another overfunded, wasteful debacle...
bbbbmw is offline  
0
Reply With Quote
      04-04-2013, 11:09 PM   #44
bbbbmw
First Lieutenant
 
Drives: 135i
Join Date: Nov 2012
Location: Southwest

Posts: 362
iTrader: (0)

Quote:
Originally Posted by mmcnulty View Post
Sure. Eliminate 100% of it and we'd still have a massive debt. Waste is absolutely a problem, and it is absolutely a tiny % of the overall problem.
Not to beat this to death... but I remember a Congressional Budget Office report that said we could eliminate the Depts of Energy, Commerce, and Education, and save $600B/yr (remember Rick Perry in the debates? He brought this up, but couldn't remember the Dept of Commerce). Since Obama's been in office the debt has risen by $6T - if these had been eliminated in 2008, would the debt have risen by **only** $3.6T? That's not small change.
bbbbmw is offline  
0
Reply With Quote
Post Reply

Bookmarks

Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -5. The time now is 04:46 AM.




e90post
Powered by vBulletin® Version 3.7.0
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
1Addicts.com, BIMMERPOST.com, E90Post.com, F30Post.com, M3Post.com, ZPost.com, 5Post.com, 6Post.com, 7Post.com, XBimmers.com logo and trademark are properties of BIMMERPOST