Pepper sprayed for public safety.

[sebastian_dangerfield]

Originally Posted by Tyrone Slothrop

Because everyone is better off, in the aggregate, when everyone is insured. E.g., preventative care is cheaper.

Actually, everyone is not better off in the aggregate in this scenario. Those who require care benefit while those who do not are burdened with a cost. I'm not suggesting we shift to a pure Darwinist/Randian model, but when you say, "We all benefit," you are not entirely, or even mainly, correct. There are millions of people who die having consumed minimal amounts of health care during their lifetimes. Those individuals will have been compelled to subsidize millions who consumed far more. Is this an acceptable scenario given the alternative would allow many people to die? Yes. But is it best for all involved? No. It is the best for those who benefit from the subsidy.

Personally, I do not mind subsidizing health care for people with chronic ailments. Even those acquiring them through poor lifestyle choices. What I have a problem subsidizing are people cannot afford yet still choose to have children. If you have barely enough means to support yourself, and choose to bring children into this world who you cannot hope to support, why am I obligated to subsidize them? I know... Because it makes no sense to punish the child for the sins of the parent. I agree. There is no arguing with that logic. But what I don't understand is why we don't have the conversation on this issue we need to have. We should be able to point the finger at those who recklessly reproduce and ask, What the hell is the matter with you? You're worse than an environmental polluter.* Your decision to have a child damages you, the child, and the rest of us. And we should also be able to point the finger at "conservatives" who rail against birth control and abortion and ask, Are you insane? Birth control should be free for every woman earning under 200% of the poverty level.

I'd happily pay an extra $2000k in taxes a year for a national program to give every woman who can't afford it free birth control pills for her reproductive life.
______
* Fracking doesn't approach the cost impact of miserable humans who'll never contribute to society, yet we debate the pollution from that while people bringing hopeless future wards of the state into society impregnate themselves with abandon.

[Tyrone Slothrop]

Originally Posted by sebastian_dangerfield

Actually, everyone is not better off in the aggregate in this scenario.

At the risk of being a grammar Timmy, I was trying to say that everyone in the aggregate is better off, not that every single person will be better off. Analogously, without vaccination, some people who have to get shots would never get sick, but the aggregate sickness (and apprehension of getting sick) is much less.

Those who require care benefit while those who do not are burdened with a cost. I'm not suggesting we shift to a pure Darwinist/Randian model, but when you say, "We all benefit," you are not entirely, or even mainly, correct. There are millions of people who die having consumed minimal amounts of health care during their lifetimes. Those individuals will have been compelled to subsidize millions who consumed far more. Is this an acceptable scenario given the alternative would allow many people to die? Yes. But is it best for all involved? No. It is the best for those who benefit from the subsidy.

(1) It's not just a cross-subsidy, since the aggregate expenditure on health is less. That was my point about preventative care being cheaper.

(2) People benefit not only because they are cross-subsidized, but because they avoid risk -- they are insured, which means peace of mind.

Personally, I do not mind subsidizing health care for people with chronic ailments. Even those acquiring them through poor lifestyle choices. What I have a problem subsidizing are people cannot afford yet still choose to have children. If you have barely enough means to support yourself, and choose to bring children into this world who you cannot hope to support, why am I obligated to subsidize them? I know... Because it makes no sense to punish the child for the sins of the parent. I agree. There is no arguing with that logic. But what I don't understand is why we don't have the conversation on this issue we need to have. We should be able to point the finger at those who recklessly reproduce and ask, What the hell is the matter with you? You're worse than an environmental polluter.* Your decision to have a child damages you, the child, and the rest of us. And we should also be able to point the finger at "conservatives" who rail against birth control and abortion and ask, Are you insane? Birth control should be free for every woman earning under 200% of the poverty level.

I don't think there's a big societal problem with people choosing to have children they believe they cannot afford, but I agree that everyone should have health insurance and that health insurance should include birth control.

[Adder]

Originally Posted by sebastian_dangerfield

Actually, everyone is not better off in the aggregate in this scenario. Those who require care benefit while those who do not are burdened with a cost. I'm not suggesting we shift to a pure Darwinist/Randian model, but when you say, "We all benefit," you are not entirely, or even mainly, correct. There are millions of people who die having consumed minimal amounts of health care during their lifetimes. Those individuals will have been compelled to subsidize millions who consumed far more. Is this an acceptable scenario given the alternative would allow many people to die? Yes. But is it best for all involved? No. It is the best for those who benefit from the subsidy.

Unless you think there might be non-monetary benefits in the world.

And, actually, those who die without consuming much health care get a pretty tangible non-monetary benefit: they are relieved of the well documents stress associated with being uninsured and therefore ever on the brink of a health-induced financial disaster.

But what I don't understand is why we don't have the conversation on this issue we need to have. We should be able to point the finger at those who recklessly reproduce and ask, What the hell is the matter with you?

You really don't understand why we don't have a conversation about whether someone other than the parents involved should have input on questions of reproduction? I think you do.

You're worse than an environmental polluter.*

One could argue you are an environmental polluter, in a way.

* Fracking doesn't approach the cost impact of miserable humans who'll never contribute to society, yet we debate the pollution from that while people bringing hopeless future wards of the state into society impregnate themselves with abandon.

You have strange notions of "contribute to society." Nearly everyone earns enough to cover their lifetime consumption. Doing those two things is a contribution.

[Gattigap]

Originally Posted by Tyrone Slothrop

Mitt Romney: "a Roomba caught in a corner."

Ana Marie Cox

A Kissinger impression? This Romney performance keeps getting better the more I learn of it.

[LessinSF]

Originally Posted by Tyrone Slothrop

Because everyone is better off, in the aggregate, when everyone is insured. E.g., preventative care is cheaper.

Except for the slavery aspect of it.

[Adder]

Originally Posted by LessinSF

Except for the slavery aspect of it.

The notion that taxation is slavery is more than a bit of a stretch.

What's the old line about Tolkien and Rand? Yeah, it takes a deluded 14 year old to think that they'd just get to keep all that money if there were no taxes.

[taxwonk]

Originally Posted by LessinSF

But why should I have to subsidize your, admittedly, poor choices?

You don't have to, Less. I am one of the people who thought ahead while I was employed and I bought and paid for private health insurance and long-term disability coverages. I would hope that some aspects of health care reform, focused on regulating or incentivizing (which economically is pretty much the same thing) certain practices in th industry would reduce my costs over time, just like they will yours.

Health care reform isn't just about the gov't paying for everybody's health care. I know you know that. So, pick another person to throw your straw man in front of, because I don't want to play.

Besides, isn't hitting someone else for making poor long-term health choices kind of a glass house-type thing for you?

[taxwonk]

Originally Posted by LessinSF

To amplify, am I in some way your slave? Do I have to work - upon threat of jail, i.e. not paying taxes - to pay for your, again, admittedly, poor choices?

Snce you chose to push the point. Yes, Less. You are a citizen of these United States. You have, in addition to certain rights which we hold inalienable, certain responsibilities, just as inalienable, to provide for the common welfare and defense. It's funny how quick people are to start crowing about their rights and how taking anything from them forget about the oherr half of the Preamble to the Constitution.

You wander the world, safe and secure in the knowledge that if you get in a tight spot, there's an embassy somewhere not too far away to retreat to for sanctuary and support. When you are here you walk on sidewalks and drive on streets that you didn't personally construct. Pay up, motherfucker.

[taxwonk]

Originally Posted by sebastian_dangerfield

Actually, everyone is not better off in the aggregate in this scenario. Those who require care benefit while those who do not are burdened with a cost. I'm not suggesting we shift to a pure Darwinist/Randian model, but when you say, "We all benefit," you are not entirely, or even mainly, correct. There are millions of people who die having consumed minimal amounts of health care during their lifetimes. Those individuals will have been compelled to subsidize millions who consumed far more. Is this an acceptable scenario given the alternative would allow many people to die? Yes. But is it best for all involved? No. It is the best for those who benefit from the subsidy.

Personally, I do not mind subsidizing health care for people with chronic ailments. Even those acquiring them through poor lifestyle choices. What I have a problem subsidizing are people cannot afford yet still choose to have children. If you have barely enough means to support yourself, and choose to bring children into this world who you cannot hope to support, why am I obligated to subsidize them? I know... Because it makes no sense to punish the child for the sins of the parent. I agree. There is no arguing with that logic. But what I don't understand is why we don't have the conversation on this issue we need to have. We should be able to point the finger at those who recklessly reproduce and ask, What the hell is the matter with you? You're worse than an environmental polluter.* Your decision to have a child damages you, the child, and the rest of us. And we should also be able to point the finger at "conservatives" who rail against birth control and abortion and ask, Are you insane? Birth control should be free for every woman earning under 200% of the poverty level.

I'd happily pay an extra $2000k in taxes a year for a national program to give every woman who can't afford it free birth control pills for her reproductive life.
______
* Fracking doesn't approach the cost impact of miserable humans who'll never contribute to society, yet we debate the pollution from that while people bringing hopeless future wards of the state into society impregnate themselves with abandon.

Let me share some of what I learned through the 23 years or so I spent practicing law and representing a lot of insurance companies, as well as building a US captive insurance program for a client from the ground-up, along with the regular lawyers and the finance wonks.

There is this thing called the law of large numbers. It's pretty simple, really. Itg would hae to be or I would never undersand it in a million years (math is hard). The law of large numbers posits that if you sell a sufficiently large number of persons the same health policy, the premium income earned by those who do not make claims (or only make minimal claims) over a lifetime will be sufficient to offset the cost of the claims made by a few policyholders over a lifetime.

Under US federal tax law, as well as the law of all 50 states, Puerto Rico, American Samoa, and all of the other minor US outlying territories and possessions, as well as the UK, Bermuda, Canada, a contract is not an insurance contract unless it satisfies the law of large numbers. So, the very thing about which you complain is one of two things a contract must have or it is not an insurance contract. Do you see the dilemma here?

[Sidd Finch]

Originally Posted by taxwonk

Snce you chose to push the point. Yes, Less. You are a citizen of these United States. You have, in addition to certain rights which we hold inalienable, certain responsibilities, just as inalienable, to provide for the common welfare and defense. It's funny how quick people are to start crowing about their rights and how taking anything from them forget about the oherr half of the Preamble to the Constitution.

You wander the world, safe and secure in the knowledge that if you get in a tight spot, there's an embassy somewhere not too far away to retreat to for sanctuary and support. When you are here you walk on sidewalks and drive on streets that you didn't personally construct. Pay up, motherfucker.

Oh, c'mon. Next you are going to say that the airlines, airports, and jet fuel on which Less relies for his travels are supported by government spending.

[taxwonk]

Originally Posted by sebastian_dangerfield

Actually, everyone is not better off in the aggregate in this scenario. Those who require care benefit while those who do not are burdened with a cost. I'm not suggesting we shift to a pure Darwinist/Randian model, but when you say, "We all benefit," you are not entirely, or even mainly, correct. There are millions of people who die having consumed minimal amounts of health care during their lifetimes. Those individuals will have been compelled to subsidize millions who consumed far more. Is this an acceptable scenario given the alternative would allow many people to die? Yes. But is it best for all involved? No. It is the best for those who benefit from the subsidy.

Personally, I do not mind subsidizing health care for people with chronic ailments. Even those acquiring them through poor lifestyle choices. What I have a problem subsidizing are people cannot afford yet still choose to have children. If you have barely enough means to support yourself, and choose to bring children into this world who you cannot hope to support, why am I obligated to subsidize them? I know... Because it makes no sense to punish the child for the sins of the parent. I agree. There is no arguing with that logic. But what I don't understand is why we don't have the conversation on this issue we need to have. We should be able to point the finger at those who recklessly reproduce and ask, What the hell is the matter with you? You're worse than an environmental polluter.* Your decision to have a child damages you, the child, and the rest of us. And we should also be able to point the finger at "conservatives" who rail against birth control and abortion and ask, Are you insane? Birth control should be free for every woman earning under 200% of the poverty level.

I'd happily pay an extra $2000k in taxes a year for a national program to give every woman who can't afford it free birth control pills for her reproductive life.
______
* Fracking doesn't approach the cost impact of miserable humans who'll never contribute to society, yet we debate the pollution from that while people bringing hopeless future wards of the state into society impregnate themselves with abandon.

(Sorry. Got double-posted for some reason.)

[Sidd Finch]

Originally Posted by taxwonk

Let me share some of what I learned through the 23 years or so I spent practicing law and representing a lot of insurance companies, as well as building a US captive insurance program for a client from the ground-up, along with the regular lawyers and the finance wonks.

There is this thing called the law of large numbers. It's pretty simple, really. Itg would hae to be or I would never undersand it in a million years (math is hard). The law of large numbers posits that if you sell a sufficiently large number of persons the same health policy, the premium income earned by those who do not make claims (or only make minimal claims) over a lifetime will be sufficient to offset the cost of the claims made by a few policyholders over a lifetime.

Under US federal tax law, as well as the law of all 50 states, Puerto Rico, American Samoa, and all of the other minor US outlying territories and possessions, as well as the UK, Bermuda, Canada, a contract is not an insurance contract unless it satisfies the law of large numbers. So, the very thing about which you complain is one of two things a contract must have or it is not an insurance contract. Do you see the dilemma here?

I agree with a lot of what you've said, but you really don't address Sebby's point here -- which is, and I quote, "What I have a problem subsidizing are people cannot afford yet still choose to have children."

Maybe that's not a problem that needs addressing in this context, but if that's your response then say that. It may be that Sebby's point is really more of a philosophical question. Though I think there are broader ways to ask that question that are relevant to the health care discussion. Put differently -- should there be consequences, in terms of the amount of gov't money we will spend to provide health care, to people who make bad choices?

Sebby likes the "people pumping out kids they can't afford" illustration, but I can make one that I think fits better with your arguments. You've pointed out that providing prenatal care is way cheaper than dealing with the problems that prenatal care avoids. I'll assume that's true (I think it is), even when you are talking about providing pre-natal care to many, many times the number of people who would actually have the post-natal problem.

But, what do you do about the people who fail to go to pre-natal care, even though it is available and affordable/free? What do you do about the diabetic who continues to eat salami every day and drink 6 beers every night? Maybe your answer is "nothing", because you believe that the carrot of cost-effective solutions is sufficient to attract enough people to cut health costs, and you don't need a stick. (Or maybe you just don't like sticks.)

But, honestly, I'd like to know your answer. Cause I'm torn over these sorts of things.

[taxwonk]

Originally Posted by Sidd Finch

I agree with a lot of what you've said, but you really don't address Sebby's point here -- which is, and I quote, "What I have a problem subsidizing are people cannot afford yet still choose to have children."

Maybe that's not a problem that needs addressing in this context, but if that's your response then say that. It may be that Sebby's point is really more of a philosophical question. Though I think there are broader ways to ask that question that are relevant to the health care discussion. Put differently -- should there be consequences, in terms of the amount of gov't money we will spend to provide health care, to people who make bad choices?

Sebby likes the "people pumping out kids they can't afford" illustration, but I can make one that I think fits better with your arguments. You've pointed out that providing prenatal care is way cheaper than dealing with the problems that prenatal care avoids. I'll assume that's true (I think it is), even when you are talking about providing pre-natal care to many, many times the number of people who would actually have the post-natal problem.

But, what do you do about the people who fail to go to pre-natal care, even though it is available and affordable/free? What do you do about the diabetic who continues to eat salami every day and drink 6 beers every night? Maybe your answer is "nothing", because you believe that the carrot of cost-effective solutions is sufficient to attract enough people to cut health costs, and you don't need a stick. (Or maybe you just don't like sticks.)

But, honestly, I'd like to know your answer. Cause I'm torn over these sorts of things.

To be honest, I treated Sebby's pumping out babies issue as sort of rollingoff the sidewalk. The two are not really related. Your restatement is also a question that doesn't look at the economics of health care so much as what, if any, sanctions can we impose on people for not doing the right thing.

I see that as more of a moral question. To take Sebby's example, we could forcibly sterilize womn who give birth to children they (and we) can't afford, or we could jail them. Of course, that forces us to look at the question really raised? Can you punish people for being "bad" or noncompliant? To take your example, do you take a guy who is 200 lbs overweight ad cut off his insulin if he doesn't meet a periodic weight loss requirement, say 10 lbs a month?

It's a question that troubles us all, but I think I come out this way. We have a safety net. Period. There will always be those people who, for whatever reason or no reason at all, simply refuse to help themselves or take advantage of help that is offered. We owe it to ourselves to help them anyway. The alternative is to kill them or let them die quickly. I'm willing to pay an extra couple thousand a year not to live in that society.

[Adder]

Originally Posted by Sidd Finch

But, what do you do about the people who fail to go to pre-natal care, even though it is available and affordable/free? What do you do about the diabetic who continues to eat salami every day and drink 6 beers every night? Maybe your answer is "nothing", because you believe that the carrot of cost-effective solutions is sufficient to attract enough people to cut health costs, and you don't need a stick. (Or maybe you just don't like sticks.)

But, honestly, I'd like to know your answer. Cause I'm torn over these sorts of things.

You do what you can to educate people about their choices, and make available the information necessary to improve choices.

And once that's done, you sit back and realize that shit happens. People make dumb choices that impose costs on others all the time. And people do perfectly innocent things like try to walk across a street without getting hit by a car, which can end up imposing costs on others too.

The question is whether you prefer a society that says, "well, them's the breaks" to those people (ala Less) or you think that maybe, to borrow a phrase, "there but for the grace of god go I."

We can cure neither randomness nor human nature. Oh well.

ETA: And I'm with Wonk in terms of being willing to pay to not be a part of a society that does otherwise.

[taxwonk]

Originally Posted by Adder

You do what you can to educate people about their choices, and make available the information necessary to improve choices.

And once that's done, you sit back and realize that shit happens. People make dumb choices that impose costs on others all the time. And people do perfectly innocent things like try to walk across a street without getting hit by a car, which can end up imposing costs on others too.

The question is whether you prefer a society that says, "well, them's the breaks" to those people (ala Less) or you think that maybe, to borrow a phrase, "there but for the grace of god go I."

We can cure neither randomness nor human nature. Oh well.

I'm agreeing with Adder more these days. Does that mean he's getting smarter or the oxygen flow to my brain is dropping more than I feared?