Re: Six days to SCHIP

On Sat, 17 Jan 2009 17:55:37 -0800, Miss Elaine Eos wrote:

In article <uyp0uaw5ngpj.156bs8dw1ed04$.dlg@xxxxxxxxxx>,
"Alex W." <ingilt@xxxxxxxxxxx> wrote:

Back up to the top: mandatory reversible sterilization. Now those teens
can *** all they want. And when one of them raises their hand "I want
to have/make babies", we'll turn off the micro-valve in her arm or his
testicles.

What sort of cost will you factor in for the inevitable medical
msitakes (either sterilisaitons that didn't take, or those that
turn out irreversible)?

Hopefully, those will be few and far-between enough that we can call
them anomalies and eat the lawsuits.

Please note, btw, that I do *NOT* advocate state mandated surgery. I
said that it had EXACTLY ONE BENEFIT -- the rest is pretty against my
principles...

Or get sneaky and simply add RU-486 to any beverage dispensed or
sold at schools.....

Well, that's a variant. Again, mandatory medication isn't high on my
list, either, but... well, they put flouride in the water, right? ;)

...And the public road system might even benefit at the same time!

Dream on.

Well, it's always annoyed me that governments, and other huge monopolies
couldn't make use of modern technology. I understand some of the
problems faced with the military (wanting everything rad hardened, etc.)
but, for example, I remember when NASA figured out that Pentiums were
available at Fry's for about $30 (vice the $8000 they were paying for
not as powerful chip sets.)

One might think that the government would WANT to learn to make money
efficiently, rather than drag it out of unwilling subjec^W citizenry...

What makes you think so?
Where is the incentive to make and use money efficiently? They
don't have competition. They don't spend their own money. They
dip from a bottomless well. Perhaps most importantly of all,
there is little to no personal responsibility or consequences for
any of the individuals involved. so why should government bother
with the effort to increase their efficiency?

For that matter, I don't think that's possible. When it comes to
government, everybody's a critic....



Roads are a bad example because they are a natural monopoly.
Rather than outright privatisaiton, put out management rights to
tender for a fixed period.

Sure. But that's "privatization", pretty much. I mean, the government
can claim it still owns the roads but, if some private party is paying
to manage & maintain them, and collecting funds for us to drive on them,
then it's pretty much "theirs", for practical purposes.

It's an outsourced and time-limited monopoly. At least until
someone figures out how to build competing interstate roads ....

The problem with this approach is that those very roads are
already ours. The motorist already paid for every damn potholed
yard of tarmac and should not have to be paying for it again.



Oh, agreed. I just think the state should stick to enforcing variations
on "no hitting, no stealing" and stay out of most everything else.

That's where we differ.

Well, yeah. We only have this discussion about as often as we light up
a cigar... ;)

Is this why I smoke so much?
:-)



I do see some role for the state in preserving inviduals from
their own mistakes, and protecting society from its own
collective shortcomings.

FWIW, polluting my air/water supply = "hitting", in my book. "Go
pollute your own air/water, you stinking evil-corporation, you!" ;)

Which, in the end, is everybody's air or water ...



Protecting-from-one's-self is the stuff that bugs me the most. I think
it just leads to the slow evolution of stupider & stupider public, and
that's bad. It's class warfare, really. Kids SHOULD learn not to blow
[another] fingernail off with firecrackers!

That would be fine if we could ensure that it's only a
fingernail. Some of those Chinese grenades will take your hand
clean off, and there are always those morons who think it a
capital idea to aim rockets at a crowd or see what happens when
they stick a Roman candle under their friend's polyester
jacket....



but the benefits in kind which you are able to draw on.

But that's the point of our disagreement. You are saying "I'm happy to
have the government take away half of the money that I earn, because
they give me so much in return" and I am saying "I would much prefer
that the government let me keep my money and present a menu of what
benefits I would like to receive and let me buy them or not at my
option."

...And I'm even giving "ok, they can auto-deduct police & fire*, as that
falls under the 'no hitting, no stealing' thing."

I am happy to do so because it is far cheaper than comparable
services in the private sector, and because it is in fact more
flexible. I may not need any medical care this year, but I may
need $250K's worth next year.

Indeed, if our government had anything half as flexible and less than 2x
as expensive as private sector, I think a LOT of American bitching about
it would quiet down. Sure, we'd still grumble that they could do
better, but at least they'd be in the right order of magnitude...

And from the point of consumer demand, you get this flexibility
only with universal coverage. Everybody pays, everybody gets
access, everybody gets to moan and whinge, but everybody gets
what he needs when he needs.

IMO, where our system really works much better than the USaian
way is for the in-between stuff, neither emergencies or
occasional minor troubles nor the really big catastrophic events
but chronic and serious enough to require regular medical
supervision and constant medication. Without going into details
(unlike Paul :-), I am a member of two different mailing lists
for two different complaints that fall into this category, and
two of the most common topics in either group are "where can I
get insurance" and "no insurance won't take me". Some of them
have been without doctors or drugs for years, knowing full well
that they are practically guaranteeing secondary conditions a
decade or two down the line because even though the medication
itself is not terribly expensive ($100/month), having to see a
specialist to get the prescription every six months *is*
expensive. Several of them even tell of job appliations being
turned down or accepted only on condition that they opt out of
the healthcare plan. This is not a problem you face anywhere in
Europe.



Actually, I'm also ok with
some small and unobtrusive bits of "it's just easier to administer if
you let us do things that are 95% supermajority as 100%." So, if 95% of
the populace signs up for fire service, I'd not kick & scream if they
just made it a tax on everyone. "Close enough." As the number of
people tyrannized by the majority climbs above about 5%, my kicking &
screaming increases.

5%?
You're not one for democracy, are you?

Well, I'd much rather a republic, but only if we get good senators, not
the bunch we have now ;)

Even Caesar was a senator ...



IMO, if one guy is told he can't buy cigars because 19 people are
worried about the impact of 3rd hand smoke (that's 5%), I start to get a
little grumbly, although I confess that 19:1 is a bunch. When it goes
18:2 (10%), I grumble louder. By the time we're to 17:3, you'll start
hearing me talk about oppression and tyranny of the majority.

I start fighting LONG before it gets to 11:9...!

I don't ... as long as the strictures are reasonable. As far as
I am concerned, separating smokers from whiners means I get to
enjoy my cigar in peace, and higher prices tend to improve the
quality of the product on offer.



That's great! And, if such a program were made available to me to
voluntarily buy-in, I might do so. I might even pay a premium to cover
the reasonable cost of having "some people buy-in, some don't" paperwork
done. But I object to the idea that I should buy in and pay premiums to
an inefficient and low-quality system (in America, that's nearly
guaranteed) just so you can get your free tests.

You keep saying that it's low-quality. But you never actually
manage to back that up. IMHO, the only meaningful markers by
which to judge any healthcare provider are outcome-based: how
successful are they at keeping people alive and healthy? On that
score, the British system does stand up quite well. So where so
you see the low quality?

You mistook my meaning. Here in America, the system for which I am
increasingly being forced to buy-into is low quality. It it rocked, I'd
maybe not be so noisy about how much it costs.

The concept of "give us half your money for a few decades and let us
work out the kinks" is not one with which I am on friendly terms. I'm
more of a "show me what you can do and, if it's good enough, I'll pay
for it" kind of a guy.

For me, the issue is not so much an ideological fight between
State vs. Private (a foregone conclusion anyway, given your
incoming president -- never bet against the black guy! :-) but of
the ratio between the two, and even more importantly the division
of labour. Many Western countries, for example, when they
discovered just how hard an ever-increasing life expectancy was
going to hit the state pension funds, moved to a mixed system
where the state guarantees a basic pension which the individual
then has to top up (often in cooperation with his employer) using
his own money and private plans. This works beautifully (at
least until politicians decide they can afford to raid private
retirement provisions to patch holes elsewhere, but that's a
different topic). I could see a similar approach working well
for healthcare: offer state-funded universal access for basic
services (emergencies, annual check-ups, inoculations) and
mandate a minimum level of private care, details to be arranged
by the individual or his employer, for the big-ticket stuff.



(Also why I don't own an American car :\)

Oddly enough, I do.
European cars are too stuffed with hi-tech whizzbangery for my
taste.
:-)
.

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