there's something particularly barf-worthy about not only renting a mob to advance your political agenda, but paying them with play money into the bargain.
How do they know that the players are actually writing letters? How do they know they don't just click "Yeah, sure, I wrote it. Now, where's my [virtual currency]?"
I suspect the number of people doing this would rather dwarf the number of people who actually bother to write letters.
> Instead of asking the gamers to try a product the way Netflix would, "Get Health Reform Right" requires gamers to take a survey, which, upon completion, automatically sends the following email to their Congressional Rep:
> "I am concerned a new government plan could cause me to lose the employer coverage I have today. More government bureaucracy will only create more problems, not solve the ones we have."
Ugh. I don't support the proposed plan, but protecting "employer coverage" is just about the worst possible reason to oppose it. Why should my employer have anything to do with my health insurance, any more than they do with my housing or auto expenses? In fact, much of my opposition to Obama's plan is that it strengthens that foolish and harmful dependency.
Just a minor nit, there is no such thing as "Obama's" plan. There is a House bill and a Senate bill (currently under review for amendments), and he hasn't endorsed either yet.
If health benefits didn't have tax breaks, employers would probably stop giving them and would be able to pay a bit more in salary (benefit cost - increased taxes). I personally would prefer to be paid more and use that to select my own health plan, that way it would be portable.
Except non-employer health plans rarely cover pre-existing conditions, which ultimately is what ails most people and contributes most to prolonged suffering in quality of life.
I'm of the opposite opinion, having grown up in Canada (now in the US). I'd much rather have a public plan, even if it means worse care for a moderately well-to-do individual like myself.
The whole American health care debate appears to me as a matter of the haves vs. the have-nots, with the added complexity that a lot of have-nots seem to incorrectly identify themselves as haves.
Except non-employer health plans rarely cover pre-existing conditions, which ultimately is what ails most people and contributes most to prolonged suffering in quality of life.
There definitely needs to be a solution for those who are uninsurable, but employer coverage is a lousy mechanism for that. I'd much rather have a "public option" that charges a reasonable multiple of what the premium for a healthy person would be. That would ensure that you could always get coverage, and provide a guaranteed ceiling on your expenses.
The game would be significantly changed if employers stopped offering it as part of a benefit package. I'm sure the housing hazard insurance industry would look much different if it was a standard employment benefit.
Ultimately, insurance of any kind is a financial risk mitigation pool. The financial risks are spread over those in the pool instead of just one. Everyone in the pool shares the cost of everyone else. I don't want the government creating a super large public pool that I am required to pay for, even if I'm allowed to choose not to be a member of it.
> I don't want the government creating a super large public pool that I am required to pay for, even if I'm allowed to choose not to be a member of it.
This may seem innocuous to Americans, but for us Canadians this sentence epitomizes why American health care is in the mess it is today. The lack of concern for your fellow man is disconcerting at best - and based on people I've talked to here in the US people generally don't feel that other people being sick and dying will negatively affect them.
IMHO this is the big difference: in socialized medicine countries we acknowledge that when a large swathe of the population goes without basic medical care, we all lose - lost productivity, general misery, etc. There's at least the general notion of paying up "for the greater good".
In America I get the feeling it's more treated as "meh, maybe you should work harder". The level of apathy demonstrated for people less fortunate is frankly the one thing that has shocked me ever since moving here, and nowadays is part of my "definition" of the American consciousness. It's always someone else's problem, not our collective problem.
I would like to add a comment about your, "meh, maybe you should work harder," observation.
Perhaps you haven't noticed, but we have a serious problem with a lack of frugality here. In regards to the lower working class your comment is referring to, all too often, they'll have no problem spending $2,000 for a awesome TV. Dropping $110 a month for 200 cable channels? Well, that's a necessity. Oh, gotta get a new cell phone every 10 months because it's the latest trend. Get a new (or newer) car for virtually no reason but to look cool? No problem. Eat out every day? You bet! Pay for a dental checkup? HELL NO!
That is where I take issue. Many of these people have no problem buying the fun stuff, but when it comes to the "grown up" things, they balk, and simply don't put up with it. So, I ask, why should I pay for their "necessities," enabling them to go buy fun stuff, while I have to forgo fun stuff for myself to pay for their said "necessities"?
The fact that you are posting on HackerNews means you are minimum ten times the value of the people you are criticizing.
Those people are being brainwashed to do those things because people like you (ie. the strongest and smartest in society) are refusing to stand up and make things the way they should be.
If you and your cohort* would start taking more responsibility for the lower classes they wouldn't behave so stupidly. Where is your brotherly desire to look out for those who are less capable?
If the intelligentsia decided tomorrow that marketers are no longer allowed to force shit food and mindless status-driven consumerism on the lower classes, it WOULD stop. Lower-class behaviour is pretty straightforward. They do what they are told.
*essentially, the elite - weather you measure eliteness by intelligence, money, birth, or simply willpower.
It's fun to assume other people are irresponsible, that their ignorance and stupidity is the only (or primary) reason they suffer.
In my experience that assumption is generally incorrect - and IMHO is really a very simplified, polarized view of the world, where people are dumb or smart, good or evil.
This seems to be especially popular on the internet, maybe nerds are a little bit disconnected from reality, or maybe we just lack empathy.
For what it's worth, I used to have the same opinion of poor people - and then I (accidentally) spent 4 months living on the wrong side of the tracks. Suffice it to say, I now refuse to subscribe to such arrogant notions about the poor. Perhaps you should do the same - spend Christmas with someone living in a bad neighbourhood, befriend some of them, treat them like nuanced human beings instead of caricatured archetypes. You will learn a lot - I know I did.
Indeed. It's easy to criticize from a distance, easy to be disgusted by egregious fraud by a rare few when it's trumpeted left and right by the media, deliberately harming the interests of the great majority. I too have been on 'both sides of the track' at times, and noticed that people who've never known real misfortune are most likely to criticize situations beyond their experience. Many people live with situations that the fortunate can hardly imagine.
What many people can't afford is preventive medicine. As a result, they arrive at the clinic or hospital with advanced disease that costs far more to treat. Anyone can understand this, and it makes perfect humane and fiduciary sense to make preventive visits as affordable as possible. That's the meaning of basic health care - and to deny it to anyone is illogical and mean-spirited.
I grew up in a poor family. We had no TV, used clothes, little food, and very few toys. Don't tell me I don't know what it's like to have little. The difference between my family and most I see today is that we prioritized our purchases to be for what we needed, not wanted, so we could be self sustaining. Today it's the other way around because they know Uncle Sam will step in to take care of the rest.
You've conflated health care with health insurance. Everyone in the U.S. has access to emergency health care and many have access to quite a lot of non-emergency health care for free. It is definitely not all or nothing currently.
I do care greatly for my fellow man, but, many of my fellow men are quite adept at taking advantage of the social welfare programs already in existence. Due to her line of work, my wife has, on numerous occasions, visited the homes of people living off the government. Far too often these people are capable of working, but find the trade off not worth it due to the implicit marginal tax rate. The existence of the social welfare programs not only enables unemployment, it also encourages it. Also, discouragingly, these same families often have greater luxuries than mine (nicer cars, house, tvs, gadgets, etc). While anecdotal, this experience is VERY common in my neck of the U.S.
Just because I am responsible, work hard, and frugal with the money I make, I have to be paying to enable and encourage others to do the opposite? How is that good in the long term for them or myself? At what point should I stop working, because if I do work, the taxes will be so high I won't gain a better living standard than if I didn't?
I accidentally upvoted you, so I feel I have to weigh in here.
I find you greatly oversimplify in order to prevent your own understanding of the greater issues involved.
Let's assume for a moment that every American is totally dedicated to helping his fellow man as much as possible. Would that necessarily result in free public healthcare? It's a perfectly reasonable (yet unpopular view) to think that helping other people means doing the things that result in the greater, longer-term good, and that might mean make life miserable. Humanity that struggles is humanity that innovates, adapts, and evolves. Humanity that stagnates does not. There is a very good case to be made for inaction.
It's also quite ludicrous to think that, given the inclination to take some sort of direct action in my fellow man's affairs that _you_ get to define what the appropriate sort of action might be. Perhaps instead of a free doctor, I feel that a cash stipend might be best, where the recipient gets to choose how it is spent. Or, perhaps because I think poor people have poor spending habits, I choose to provide free shelter. To even start thinking along the lines that one solution would fit all problems is to engage in the most wide over-generalizations. And to think that you (or anybody else) gets to decide what this one solution would be and basically try to shame everybody else into accepting this one answer is a non-starter. Reasonable people are going to tell you to go jump in a lake.
Finally, it's completely disconnected to think that my actions have a direct result on other people's lives. People have a dignity and respect that is part of who they are, foibles and all. My writing a check doesn't make a person into a better one, doesn't necessarily improve their life, and might actually make their problems worse. People are who they are. Even when I'm committed to action, even when I've decided to take direct action, even when I think I know what the best action is, I take action because it is the right thing to do for me, not because I'm expecting some sort of miracle result from it.
Having said that, I think there is a strong moral case for some sort of catastrophic health insurance -- mainly because people cannot be allowed to forfeit their life savings because they had the misfortune to die from expensive diseases. However, I respect that others might choose to let each man fend for himself. This country was founded by people braving the wilds, not hanging out at the soup kitchen. As a species, in my opinion, the more comfortable we make our cave, the less likely we ever are to venture out of it (travel to the stars)
This argument could easily be extended to other services. Thus, we should not have fire or police services, because they make us too comfortable and might stop us from reaching for the stars.
If you draw the line so that tax money does fund fire and police services, then why not medical? It's easily as big of a benefit to society, imho.
The major difference between medical services and fire/police services is that the former is a private good (rivalrous and excludible), whereas the latter is a public good (nonrivalrous and nonexcludible).
This means that an unregulated market will yield a shortage of police/fire services, but will provide a market clearing amount of medical services.
Fire service is definitely excludible (not on the subscriber's list -> we're not putting your house fire out) and arguably rivalrous (a team of firefighters cannot be in two places at once).
In most areas, fire spreads uncontrollably. Even if I don't buy firefighting services, I benefit when firefighters put out your house fire and prevent it from burning my house down. That's the non-rivalrous and non-excludible element.
But you are absolutely right under some circumstances - in a sparsely populated desert, firefighting would be a private good.
This argument could easily be extended to other services
If I thought this was some sort of generic argument for anarchy I wouldn't have used it. These questions are long settled: where private property rights intrude, some sort of collective protection of private property is required, whether military, police, fire, etc.
The edges of these arguments -- where they do not apply -- are as important if not more important than the arguments themselves. There's a good reason the police department is not like the social services department. It's not all just sort of the same.
Don't you find it even just a little curious that in every other developed nation, the questions have been settled in a different way?
where private property rights intrude, some sort of collective protection of private property is required
My body is the most important piece of property I own. If the government protects some of my property (e.g. my house, from a fire), why does it not protect the most important piece?
Don't you find it even just a little odd that in every other developed nation, the questions have been settled in a different way?
Gosh no, because I don't mix up discretionary spending with required spending. We spend lots on things we like to do, like sports stadiums, airports, etc. There's no reason we can't choose to spend some money on something like healthcare. I just wouldn't mix expenses like that up with expenses like the local vice squad.
My body is the most important piece of property I own. If the government protects some of my property (e.g. my house, from a fire), why does it not protect the most important piece?
Once again, these questions are long settled. Your body is indeed the most precious thing you own, and the government's obligation to protect your body ends in two places: at your skin (meaning the government really has no business telling you how to treat your body) and at your neighbor's property (meaning your right to live doesn't include stealing food from the neighbor's farm)
Once again, that doesn't mean that we can't help hungry or ill people. Of course we can. It just means that it's not the same kind of necessary invasion of private property as, say, drafting your kid and sending him off to war because the nation is in danger.
I think, at this point, we're just going to have to agree to disagree. I am actually somewhat optimistic that America will one day have a universal single-payer healthcare system, but I can see I'm rather unlikely to ever convince you that's a good thing ;)
How about requiring the states to work it out on a state-by-state basis? The feds could set the standards, define the problem, and let some kind of distributed processing system attempt to solve it (instead of a one-size fits all approach that sits in stone and can't easily be changed)
I've always thought that most people aren't very far apart on most issues -- it's just the politics, emotions, and posturing that keeps screwing conversations up (and I speak for myself as much as anybody else)
But yes, agreeing to disagree is probably a good thing to do. :)
What you described is how Canada works. Most people seem to think we have a federal health care system - we do not.
Each province has its own health system, the only federal requirement is that they have peering agreements (so you can travel freely without fear of health care). I've seen cases where people who are hospitalized in more expensive parts of Canada are transferred back to their home province (paid by the health care system of course).
It works remarkably well - and from the few Brits I've seen comment on both, it's likely better than the NHS in Britain, which is the monolithic approach you fear. For one thing, health care management is handled at a much more local level, where individual voting districts actually matter, and coverage levels better suited to the local environmental, cultural, etc, requirements.
The financial risks are spread over those in the pool instead of just one. Everyone in the pool shares the cost of everyone else. I don't want the government creating a super large public pool that I am required to pay for, even if I'm allowed to choose not to be a member of it.
This uniquely American attitude is honestly one of the very few reasons I occasionally consider moving back to Britain.
Not related to the above post, but can whoever keeps downvoting posts like the above please stop? Everyone in this thread has been civil and articulate - please don't downvote things because you disagree with it.
Except non-employer health plans rarely cover pre-existing conditions, which ultimately is what ails most people and contributes most to prolonged suffering in quality of life.
That's a bug in how the contracts are written. Things don't have to be done that way. Standard insurance pays by the treatment, but a reasonable contract would pay by the disease. In my ideal world, I'd be able to walk into Allstate and say,
"Hi, I'd like an insurance policy against lung cancer."
"Okay. At your age, health, and risk level, your risk level is X over six months. We offer a six month contract covering treatment plan A, averaging $Y for $XYProfit or treatment plan B, averaging $Z for $XZProfit."
"Only six months? If I'm still sick after six months, my rates go up?"
"Actually, $Y is the lifetime cost of Plan A. In the event you are diagnosed with lung cancer, we are contractually obligated to pay for the treatment strategy outlined there for the rest of your life."
"Even if I can't keep up with the premiums?"
"It doesn't work that way. This is a one time contract designed to mitigate risk over the coming six months; if you fall ill, you have no further obligation to us."
"Can I change from Plan A to Plan B after I get sick?"
"You can, but it'll cost you $Z - $Y. At that point, though, it's not really insurance -- more like a financing and payment plan, so the cost is much higher. You're best off selecting the level of coverage you want in advance, or arranging financing at the time."
"So, if I do develop lung cancer, my acute injury contract with you is unaffacted?"
"Right."
"Or I could even switch to State Farm for that, and you'd still be obligated to pay for lung cancer treatment."
"Right, though where synergistic treatements are possible, we offer a significant discount if you buy all your health insurance through us..."
This seems to me like the omly mathematically sensible way to do it, and I find it perverse that it's done any other way. Let alone that the other way is standard practice. You buy insurance to mitigate risk. I buy a fire insurance policy that covers the cost of repairs to my house in the event of a fire. I would never buy a fire insurance policy that covered any repairs to be made within a month of the fire's occurance (after which the company might drop me or my rates might go up), nor would I expect a company to offer "insurance" that covered any repairs to be made in the current month as a result of previous fires. That would be mathematically insane.
And yet it is the default case with health insurance. It mitigates the cost of this month's treatments, not this lifetime's diseases.
"So . . . I need to disclose something. I'm actually shopping for lung cancer insurance because I already have lung cancer, and I can't afford the treatment."
"The situation is very different, then, but we can still help you manage the overall cost of treatment. Plan A costs $Y and Plan B costs $Z, and comes with these options--"
"Whoa, whoa, whoa. Those are hundreds of thousands of dollars, and you want it up front? I can't possibly afford that."
"Oh, that's just the total price of the contract. Our financing department typically offers 15 to 30 year payment plans, with some risk premiums."
"Paying for two years of treatment over three decades? It still looks expensive."
"Yes, it's better to have insurance up front, so you can pool risk with others who match your risk profile. But even after the fact, you can still pay for predictability. You may have an easy and successful treatment, or you may suffer a costly and prolonged process followed by even a relapse. The cost to you is $Y either way."
"Okay, well, so . . . not only am I uninsured and already sick, I'm also poor and don't really have any assets. You'd have be crazy to loan me money to cover even the most bare bones treatment plan. Am I just SOL?"
"Well . . . we can't do much for you. At this point, you're not trying to mitigate risk, you're trying to get other people to pay for an already incurred cost. That's not insurance anymore, that's charity, and we can refer you to St. Joseph's Hospital. . ."
If you want to offer universal treatment to the poor, it is a noble charitable goal -- on par with offering universal food or universal education or pursuing world peace. Establish a fund or program for that purpose and go for it.
But leave the people who are buying actual insurance alone!
I want a health insurance contract that is portable, customizable, and that does not give me or the insurer or the doctor perverse contractual or treatment incentives. In particular, I want a plan that actually mitigates the risk I'm trying to mitigate. I want the cost to be reactive to my personal risk level -- I don't want to pay for anyone else's health care, and I don't want anyone else to pay for mine. The lung cancer insurance cost should go up if I smoke. The cost to cover kids against genetic disease should go up if my spouse and I are both cystic fibrosis carriers. The costs in general should go down if I can pass a bi-annual athletic test. I want to be able to self-insure at whatever level I think is financially appropriate, and I want to expect to pay cash for routine or elective procedures. I don't want to be denied vaccination, required to vaccinate, or even vaccinated for free; I want to be offered a $17 tetanus shot in exhange for $4 off my monthly insurance bill.
Right now, employment is insurance and health care is partly charity and insurance is partly charity and charity is largely employment.
I'd love to live in a world where employment was employment, health care was health care, charity was charity, and insurance was insurance.
Well, I doubt that would work too well either. A rash of e-mails of the same general form will probably be attributed to a few spammers spoofing return addresses, rather than to a genuine movement. These people probably get spam about political issues all the time.
Paying for outrage is not new. I used to work in D.C. and almost every week there were ads in the paper for protesters. As I remember, it was relatively good pay if you were of college age.
But virtual money for emails? I have to say I like it. Now everybody can be fake outraged.
