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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 21 July 2009 at 9:04pm
If I could of got to where I am today by avoiding service in the Army, I may have opted out. Being a cop then Fed Law Enforcement was little better, enjoyed truck driving till I was medically disqualified, so I did work in the "private" sector. And made good money at it, went owner operator and was taxed out of bussiness (along with fuel prices and surcharges not stabilizing), and back to company driver. I would still be working as a company driver, touring the country with my RV with an income along with "Duke" my Basset Hound, and using more private medical care and also paying more in taxes. I actually miss working, now can't even go to school anymore to get that substitute teaching job I was hoping to get. Being disabled is boring.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mbro Quote  Post ReplyReply Direct Link To This Post Posted: 21 July 2009 at 9:10pm
What tax caused you to go out of business? As I recall you stopped driving during the last administration, where was the massive tax hike that caused you to go in the red?

I actually still remember the thread with the pics of the rig you bought.

Don't blame me, I voted for Kodos.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 21 July 2009 at 9:19pm
Originally posted by oldsoldier oldsoldier wrote:

...enjoyed truck driving till I was medically disqualified...


And when that happened, who stepped in to provide disability assistance?

And when you went owner-operator you discovered the joy of self-employment tax, no doubt.  Catches a lot of people by surprise.

Did you also discover that your private health insurance premiums doubled?  Assuming, of course, that you were carrying private health insurance at the time...


"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 21 July 2009 at 9:33pm
Was not carrying health insurance. Highway use and fuel taxes doubled, fuel surcharges did not keep pace so I was making less per mile take home as a O/O than a company driver. With fuel prices climbing, freight rates dropping, fuel surcharges a week or two behind fuel price hikes, tolls no longer re-imbursed on OH/IN/PA Pikes or NYS Thruway. There were a lot of factors leading to decesion to go back to company. Even though large companies liked O/Or's because maintenence overhead was lowered per tractor, they failed to keep pace with pay issues.
IFTA (Interstate Fuel Tax Agreement) taxes also took a steep climb, you had to pay outragous quarterly state fuel taxes (@$500)even if you put 1 or 1000 gal of fuel in your truck in a high fuel tax state. You avoided fueling in Oregon and Missouri if at all possible, NJ never reimbursed on IFTA. There were a lot of factors.

FYI, I paid for my VA benifits with 23 years of military service, a lot more in sweat and blood than cash, and more than many are willing to pay today, but still want the same form of benifits.

Edited by oldsoldier - 21 July 2009 at 9:38pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mbro Quote  Post ReplyReply Direct Link To This Post Posted: 21 July 2009 at 9:38pm
So you couldn't kick it in a capitalist system?

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 21 July 2009 at 9:40pm
Originally posted by oldsoldier oldsoldier wrote:

Was not carrying health insurance.


I think you meant to say that you were not carrying PRIVATE health insurance.  You had health insurance aplenty - the government kind.

Now take your situation, substitute a 30-year-old driver with two young kids at home, but no government safety net.  He can't afford private healthcare insurance any more than you could.  So what happens when the kids get sick?  When the father feels a murmur in his chest?



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Post Options Post Options   Thanks (0) Thanks(0)   Quote FreeEnterprise Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 9:20am
 
 
I can't wait for Obamacare. It will be fun to take tons of days off work to wait for any type of doctor to see you...
 
Months on end to get treatment sounds like a great way to spend the summer... Woot! More lines, less care, the government way...
They tremble at my name...
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 10:53am
Originally posted by FreeEnterprise FreeEnterprise wrote:

I can't wait for Obamacare. It will be fun to take tons of days off work to wait for any type of doctor to see you...
 
Months on end to get treatment sounds like a great way to spend the summer... Woot! More lines, less care, the government way...
 
I don't know about "Obamacare," but if we end up like Canada (which is not among the better systems out there) it would be a massive improvement over the present.
 
Yep.  Longer life expectancy, lower birth mortality, drastically reduced cost, ...  sounds horrible, I know.

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Gatyr Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 11:07am
Originally posted by FreeEnterprise FreeEnterprise wrote:

I can't wait for Obamacare. It will be fun to take tons of days off work to wait for any type of doctor to see you...
 
Months on end to get treatment sounds like a great way to spend the summer... Woot! More lines, less care, the government way...


First, by agreeing that those personal anecdotes constitute an argument against socialized medicine, you should very well agree that Michael Moore's Sicko is a much more convincing and thorough argument.

Second, my girlfriend, who is Canadian, tells me that those sorts of long-line-horror-stories are not at all indicative of the average visit to a Canadian walk-in clinic or ER.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 11:55am
Originally posted by Peter Parker Peter Parker wrote:

How about some of that American "can do?"  Surely our government is good at something other than blowing stuff up?
 
Originally posted by PP PP wrote:

I also hate it when government builds roads for me, educates my kids, kills pirates, or provides a system for resolving disputes.  Commie bastards.
 
Thought your kids went to a private school? Surely the government should be able to be trusted to educate your kids?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 1:00pm
Originally posted by oldpbnoob oldpbnoob wrote:

Originally posted by Peter Parker Peter Parker wrote:

How about some of that American "can do?"  Surely our government is good at something other than blowing stuff up?
 
Originally posted by PP PP wrote:

I also hate it when government builds roads for me, educates my kids, kills pirates, or provides a system for resolving disputes.  Commie bastards.
 
Thought your kids went to a private school? Surely the government should be able to be trusted to educate your kids?
 
Merits clarification:
 
1.  I am not suggesting now, nor have I ever suggested, that there is anything inherently wrong with choosing a private option over a public option. 
 
2.  My point in this post was that OS is making broad statements about the incapability of the government to do anything properly - I merely pointed out a couple of things that I think the government does quite well, including education.
 
3.  Just because I think government can and does provide valuable services does not mean that there may not be a better private option - such as private schools. 
 
4.  I will certainly admit that many private schools are superior to many public schools, as is the case where I live now.  But, frankly, there is nothing wrong with the public schools - it just so happens that the local private school is particularly good and within my financial means.  See point 1.
 
5.  Similarly, if we ever get around to true socialized healthcare, I might still choose to supplement with private healthcare, and there would be nothing wrong with that.
 
6.  I think the public schools in America are deeply flawed in some respects and could be vastly improved, but even so they provide what is objectively an excellent education.  It is an amazing service provided by the government for the benefit of all.
 
7.  And lastly - irrelevantly, but perhaps interestingly, my son will start public school this fall.
 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote FreeEnterprise Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 1:16pm
Don't worry, we can afford government health care, since Obama "Rescued the economy"...
 
 
 
 
 
"just keep spending, just keep spending, just keep spending" (spoken in my best Dory voice)
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 1:35pm
Originally posted by Peter Parker Peter Parker wrote:

Originally posted by oldpbnoob oldpbnoob wrote:

Originally posted by Peter Parker Peter Parker wrote:

How about some of that American "can do?"  Surely our government is good at something other than blowing stuff up?
 
Originally posted by PP PP wrote:

I also hate it when government builds roads for me, educates my kids, kills pirates, or provides a system for resolving disputes.  Commie bastards.
 
Thought your kids went to a private school? Surely the government should be able to be trusted to educate your kids?
 
Merits clarification:
 
1.  I am not suggesting now, nor have I ever suggested, that there is anything inherently wrong with choosing a private option over a public option. 
 
2.  My point in this post was that OS is making broad statements about the incapability of the government to do anything properly - I merely pointed out a couple of things that I think the government does quite well, including education.
 
3.  Just because I think government can and does provide valuable services does not mean that there may not be a better private option - such as private schools. 
 
4.  I will certainly admit that many private schools are superior to many public schools, as is the case where I live now.  But, frankly, there is nothing wrong with the public schools - it just so happens that the local private school is particularly good and within my financial means.  See point 1.
 
5.  Similarly, if we ever get around to true socialized healthcare, I might still choose to supplement with private healthcare, and there would be nothing wrong with that.
 
6.  I think the public schools in America are deeply flawed in some respects and could be vastly improved, but even so they provide what is objectively an excellent education.  It is an amazing service provided by the government for the benefit of all.
 
7.  And lastly - irrelevantly, but perhaps interestingly, my son will start public school this fall.
 
 
And one could argue that a lot of European countries have far superior educational systems than here in the U.S. One could also argue that they have better roads and transportation than here. Perhaps, they simply are capable of doing it better... OR, perhaps, they pay exceedingly high taxes to pay for such public services. IMO, you cannot get a quality healthcare system, educational system, public transportation system without significantly higher taxes, and thus lower overall living standards. Americans don't want that. Yes Europeans may have socialized medicine, but they pay for it through high taxes and do without a lot of possessions we consider a necessity. How many Europeans have 2 and 3 car households? How many live in houses that average 1800sqfeet+? How many eat fast food 3-4 times per week or for that matter eat out that often? You keep mentioning longer life spans etc, but what part of that is more related to the fact that they live healthier lifestyles? I have visited Germany, and they are not fat! I am sure they live longer, because they exercise and eat better, not necessarily because they have public health care. Who knows how long they would live if they had our standard of health care. It is a different mind set there. Americans are for the most part highly independent and selfish, we do not want to be told that we have to ride the bus and live in a small house. We want big houses, big cars, and we want it NOW!. Until our mindset is changed, and we are willing to pay higher taxes to afford better public works/services, they will continue to be underfunded and losing propositions IMO.
 
I rambled a bit there, but needing to move onto something else.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 4:41pm
Originally posted by oldpbnoob oldpbnoob wrote:

[
And one could argue that a lot of European countries have far superior educational systems than here in the U.S.
 
I would so argue.  Certainly up through high school.  It's not even close for some countries - foreign students entering universities here frequently get significant college credit for their European high school experience.  The same is true of some Asian countries.
 
The US public schools are nowhere near as good as they could be and should be.  It is still an amazing service, and our country would be far worse off without it.
 
Quote Perhaps, they simply are capable of doing it better... OR, perhaps, they pay exceedingly high taxes to pay for such public services. IMO, you cannot get a quality healthcare system, educational system, public transportation system without significantly higher taxes,
 
In this you are simply wrong.
 
There is obviously a general correlation between the quality of a thing and the price of a thing, but for any given "thing" that correlation breaks down pretty quickly.
 
Two things where that correlation is very poor are healthcare and education.  I have said this before, and I will say it again, louder this time, since apparently it isn't taking:
 
EUROPEANS PAY LESS THAN WE DO FOR HEALTHCARE.  MUCH LESS.
 
The US healthcare system, on a per capita basis, in in the range of three times as expensive as most European systems.  And for only a third (or less) of the cost, they get BETTER healthcare.
 
Yes, taxes would go up to pay for true socialized healthcare - but your private healthcare premiums would go away.  Yes, I know that you and OS don't pay private premiums, because you are already on the healthcare dole, but for the rest of us this is huge. 
 
I pay more than $1,500 each month in healthcare insurance premiums.  That's not including copays and deductibles.  If we suddenly insta-swapped for a Euro system, that $1,500 goes away and is replaced by a $500 tax (illustrative, of course - reductions would not be individualized).  Sure, my taxes went up, focusing on that would be silly.  The big picture is that I am now paying $1,000 LESS each month for healthcare than I was before.
 
This is not pie in the sky - this is what the rest of the industrialized world is doing RIGHT NOW.  And they are getting BETTER healthcare along with their savings.
 
This is objective truth:  Most socialized systems provide BETTER healthcare, and they do it for LESS money.
 
 
Quote ... and thus lower overall living standards.
 
I encourage you to visit Scandinavia and tell them that they have "lower overall living standards."
 
 
Quote How many Europeans have 2 and 3 car households? How many live in houses that average 1800sqfeet+? How many eat fast food 3-4 times per week or for that matter eat out that often? You keep mentioning longer life spans etc, but what part of that is more related to the fact that they live healthier lifestyles? I have visited Germany, and they are not fat! I am sure they live longer, because they exercise and eat better, not necessarily because they have public health care. Who knows how long they would live if they had our standard of health care.
 
Probably not as long.
 
You are right - there are clearly lifestyle/culture issues that go into life expectancy, and life expectancy alone should not be the measure of the quality of a healthcare system.
 
So we look to other measures, like infant mortality.  The US here also lags far behind most other industrialized nations - and this one is tied very closely to prenatal care.  People without health insurance don't get good prenatal care, but show up at the ER when they are about to drop.  That doesn't happen in Europe.
 
And in Europe they also don't kick you out of the hospital 24 hours after the baby is born - you stay for a few days for observation.  With both of my kids we went back to the hospital within a week for problems that would have been discovered and handled had we stayed for three days instead of one.  Wasteful.
 
Americans are obsessed with the idea of some government bureaucrat rationing their healthcare, but seem oblivious to the fact that we are now being rationed by insurance bureaucrats instead. 
 
Other measures:  The US has excellent cure rates for cancer.  Probably leads the world in that category.  I do not want to imply that the US healthcare is bad - every doctor I know here is good.  On a doctor-by-doctor (or nurse-by-nurse) basis, I have no doubt we stack up just fine.
 
That's not my point.  My point is that the insurance-based regimes leads to medical inefficiencies that increase costs.  Like kicking us out 24 hours after delivery.  Or letting the mother go nine months without a checkup because she doesn't have insurance.  Those things are direct effects of our system, and those things lead directly to increased cost for all of us, while providing overall inferior care.
 
Which leads me to your lifestyle point.  Very legitimate and important concern.  I point to one of the main drivers of healthcare costs in the US:  Diabetes.  Americans get diabetes at a furious rate, and it is an incredibly expensive disease.  A lifetime full of drugs and doctor visits.  And why do we get diabetes so much?  Almost certainly because of our lifestyle, primarily obesity.
 
And THAT is important.  Any meaningful overhaul of our healthcare system MUST include more preventative care.  Drastically more preventative care.  Here is what SHOULD happen:  Everybody sees a doctor at least once a year for general checkup.  If a doctor notices a child (for instance) gaining a bit of weight, the doc will take action.  Not just tell the parents to stop giving him junk food, but REALLY tell the parents about junk food.  Tell the parents about diebetes and heart disease.  Treat obesity like the disease that it is.
 
And THEN, if the problem doesn't go away right away, set the family up with a dietician, a private trainer, heck even a food service if needed.  THAT is what we need.  We need to prevent and treat obesity, not just tell people to lay off the Big Mac.  Right now some of you are thinking "ZOMG pay for a private trainer with taxes?"  YES, pay for a private trainer with taxes.  Because a year or two with a private trainer is a whole lot - a WHOLE lot - cheaper than dealing with that kid's diabetes for the next 50 years, followed by multiple bypass surgeries, and a giant crane to lift him out of his house.
 
Our healthcare system is inefficient because we wait for the disease to show up and then we cure it.  We do a great job curing, but preventing is a whole cheaper than curing.  Now go check your healthcare policy for how much "wellness" benefit you get, and what is covered.
 
So yes, our healthcare system should focus a whole lot more on prevention and general health.  And that would help our lifestyle, which would help our overall health.  Because you are right - we aren't going to save much money on healthcare if we insist on waiting to follow doctor's order until we keel over.
 
 
 

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 5:24pm
Providing Healyhcare to populations such as europe with @70M per country, and the US with 360M is not going to be a cheap proposition.

The current plan in congress have as disqualifying any pre-exsisting conditions, and an age cap. Read the 1000+ page double speak, government languaged and see if you understand what is proposed and how it will be inacted.

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 5:27pm
I am sure you will bemoan the source, but there are some pretty interesting points in this. Also note that it is written in 2006, prior to the current administration, so it is not an Obama or liberal bashing session.
 
 
In regards to living standards:
Originally posted by excerpt from Heritage article excerpt from Heritage article wrote:

A comparative study by Timbro, a Swedish think tank, found that EU countries would rank with the very poorest American states in terms of liv­ing standards, roughly equal to Arkansas and Montana and only slightly ahead of West Vir­ginia and Mississippi, the two poorest states.[15] 
The Swedes are Scandanavian aren't they?
 
Also somewhat interesting a view of Candadian socialized medicine:
 
 
Especialy noteworthy quote regarding your persistent claim that we pay more per capita :
Originally posted by David Gratzer David Gratzer wrote:

Like many critics of American health care, though, Krugman argues that the costs are just too high: “In 2002 . . . the United States spent $5,267 on health care for each man, woman, and child.” Health-care spending in Canada and Britain, he notes, is a small fraction of that. Again, the picture isn’t quite as clear as he suggests; because the U.S. is so much wealthier than other countries, it isn’t unreasonable for it to spend more on health care. Take America’s high spending on research and development. M. D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does.
Innovation comes at a high cost. Someone has to bear it. It certainly won't be us if we take on Canadas model.
 
Another interesting article:
 
 
I like this quote:
Originally posted by <FONT color=#330099><strong>Lawrence R. Huntoon, MD, PhD Lawrence R. Huntoon, MD, PhD wrote:

The other thing the pro-socialist "crisis mongers" fail to tell people is that only one-third of the uninsured are chronically uninsured.2 For the other two-thirds, it is only a short, temporary condition, "half of all uninsured spells will last less than six-months. Three-fourths of them will be insured within 12 months. Only 18 percent of all last for more than two years."(2)
  and
Originally posted by LRH LRH wrote:

] Those who brandish the "crisis" of the uninsured to promote socialized medicine also often fail to tell people that uninsured doesn't necessarily mean poor. In fact, the National Center for Policy Analysis (NCPA) tells us that "a third of the uninsured households earn more than $30,000 a year and 10 percent earn more than $50,000."(2) That's at least 40 percent of the so-called "uninsured" that could well afford a $45 office visit or health insurance.(2) We need to get away from the concept that "someone else," big government or insurance, needs to take care of our every need.
 
 
Regarding my healthcare costs, you still lose me on how you are comparing this to us being on the dole. Let me make it clearer.. My wife gets insurance as part of her compensation for doing a job. This job happens to be working for the school, but it is nonetheless a JOB.  When I worked at previous employer, I also had paid insurance for several years. It is because it was compensation for me working for them and was part of my salary. What is the difference between my wife working at GM and getting paid medical insurance and her working for the county and getting the same benefits? I don't get the distinction. Would it make it easier for you to comprehend if they paid her $12k more per year and than charged her for insurance?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 5:32pm
Originally posted by Peter Parker Peter Parker wrote:

And THEN, if the problem doesn't go away right away, set the family up with a dietician, a private trainer, heck even a food service if needed.  THAT is what we need.  We need to prevent and treat obesity, not just tell people to lay off the Big Mac.  Right now some of you are thinking "ZOMG pay for a private trainer with taxes?"  YES, pay for a private trainer with taxes.  Because a year or two with a private trainer is a whole lot - a WHOLE lot - cheaper than dealing with that kid's diabetes for the next 50 years, followed by multiple bypass surgeries, and a giant crane to lift him out of his house. 
  I have seen overweight people in hospital gowns standing outside the hospital entrance smoking through their trach tubes..... You can't help stupid sometimes. Perhaps what we need to do is thin the herd. Pun intended.
 
Sorry for the double post.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 8:28pm
Warning - long post ahead.
 
 
Originally posted by oldpbnoob oldpbnoob wrote:

I am sure you will bemoan the source,
 
Nothing wrong with the Heritage Foundation, so long as you know what they are.  They obviously write from ideology to some extent, but I would certainly consider them trust-worthy in general.
 
Quote there are some pretty interesting points in this. Also note that it is written in 2006, prior to the current administration, so it is not an Obama or liberal bashing session.
 
 
In regards to living standards:
Originally posted by excerpt from Heritage article excerpt from Heritage article wrote:

A comparative study by Timbro, a Swedish think tank, found that EU countries would rank with the very poorest American states in terms of liv­ing standards, roughly equal to Arkansas and Montana and only slightly ahead of West Vir­ginia and Mississippi, the two poorest states.[15] 
The Swedes are Scandanavian aren't they?
 
 
First, always go to the primary source.  The original Timbro publication can be found here.  Reading that, you will see that the Timbro folks aren't talking about "living standards" at all, but prosperity and wealth.  That whole paper/book is about economic policy and GDP per capita.  Shame on the Heritage Foundation for misquoting.  And after I just finished saying nice things about them.
 
(And, of course, Timbro is basically a Swedish analogue to the Heritage Foundation.  They have a political/economic agenda, and are definitely not representative of the common view in Sweden.  I would encourage you to walk the streets of Stockholm or Uppsala and see what the folks in the bar think.)
 
But that does raise a very legitimate point, driven home by the rest of the Heritage Foundation article:  how to define "standard of living"?  If you measure that by number of cars or average home size, well then you and the Heritage Foundation (and Timbro) are right, and Scandinavia is a horrible place to be, and certainly far worse than, say, Alabama.
 
But if you enclude things like average hours worked per week (with fewer being better), average vacation time taken, proportion of population living in poverty, number of homeless, teen pregnancy rate, average education level, access to internet, crime rate, drug use, access to public outdoor space, access to higher education, vertical mobility - well, then Scandinavia starts looking pretty good.
 
Who's to say which definition is better? 
 
I say neither and both, and I say that the Heritage Foundation is missing the boat here, while you had it right.  The reason why houses in Sweden are smaller than here isn't because they can't afford it.  It is because they don't WANT bigger houses.  It's a cultural difference.  Maybe they would like another car in the family, maybe not.  Other than collectors, you certainly won't find many Swedes in need/want of a 3- or 4-car garage.  Most Swedes would consider that a waste of space and money.
 
So I say boo to the Heritage Foundation for measuring irrelevancies here.
 
But we officially went far afield here, I think.
 
 
Back on point:
 
Quote Also somewhat interesting a view of Candadian socialized medicine:
 
 
Especialy noteworthy quote regarding your persistent claim that we pay more per capita :
Originally posted by David Gratzer David Gratzer wrote:

Like many critics of American health care, though, Krugman argues that the costs are just too high: “In 2002 . . . the United States spent $5,267 on health care for each man, woman, and child.” Health-care spending in Canada and Britain, he notes, is a small fraction of that. Again, the picture isn’t quite as clear as he suggests; because the U.S. is so much wealthier than other countries, it isn’t unreasonable for it to spend more on health care. Take America’s high spending on research and development. M. D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does.
 
First, on the quoted parts - Why should healthcare cost more here just because we are wealthier?  That doesn't compute.  A DVD player costs a lot more in Europe than it does here, as does a meal in a restaurant.  Why should healthcare cost more?
 
As to research, this is a very valid point.  I suspect that any true overhaul of the US system would uncover that we are essentially subsidizing medical research for the rest of the world.  That needs to change.  Either we reprice everything to recover more costs from other countries, or we separate the R&D costs from the healthcare costs so we can have level field competition.  R&D is polluting the data pool.
 
Now, as to the article in general - very interesting.  I am not that familiar with the Canadian system, but I understand that it is an odd public/private hybrid, kind of like the Swiss system, and I believe it also operates at the provincial level rather than the national level, in which case observations about Winnipeg may not be generalizable.  I could be wrong.
 
In any event, anecdotes are always scary (although I have heard far scarier anecdotes about Canada than the lamos this guy picked).  The thing about anecdotes, though, is that everybody has one.  Heck, I don't have to go to the ER to look for anecdotes - I have enough anecdotes from my own life to fill a book.  And I don't think I'm special on this point, I just pay attention to the issue.
 
And this point is made for me by the author in the very first paragraph, when he sets it up like he is talking about a US HMO, and then "shocks" us by saying that he is talking about Canada.  Think about that for a minute... ... ... what does that say about American HMOs and our opinion of them?
 
But the more interesting part of the article comes further down, when the author is discussing the "Americanization" movement in Canada, the UK, and elsewhere:  he is talking about privatization.  I don't see any mention of cutting back from universal coverage.  I don't see any mention of fracturing the system.  I don't see any mention of cutting back on preventive medicine.  Just privatization.
 
And you know what?  I am just fine with that.  I don't give a hoot if my doctor works for the state or a private practice.  Here's what I want:  A rock-solid guarantee (some limitations to be discussed) that when I take my kid to the doctor (a) she will get treatment, and (b) I won't get a giant bill.  In the current US system, neither of those is true.
 
Limitations, of course - not all treatments can always be covered.  There will always be a limit, regardless of the system.  But that isn't my point.
 
My point is that I don't want my daughter declined because I forgot to bring my insurance information.  I don't want to get a giant bill because I filled out a form incorrectly when I changed jobs, or because this doctor is "out of network." 
 
What any good healthcare system needs is these things:
 
1.  Universal coverage and access for most procedures.
2.  Nominal on-the-spot fees.
3.  Full portability, regardless of employment or pre-existing conditions.
4.  Significant emphasis on preventive care.
 
I don't care what means are used to get there.  Single-payer seems logical and obvious, but need not be the only way.  It certainly does not have to be government operated, and does not have to be a monopoly.  It is easy to envision such a system with plenty of competition to keep costs under control.
 
So I don't really have a problem with this article - the guy, as far as I can tell, is annoyed with government management more than anything else, and aren't we all?
 
 
 
Quote  
Another interesting article:
 
 
I like this quote:
Originally posted by <FONT color=#330099><strong>Lawrence R. Huntoon, MD, PhD Lawrence R. Huntoon, MD, PhD wrote:

The other thing the pro-socialist "crisis mongers" fail to tell people is that only one-third of the uninsured are chronically uninsured.2 For the other two-thirds, it is only a short, temporary condition, "half of all uninsured spells will last less than six-months. Three-fourths of them will be insured within 12 months. Only 18 percent of all last for more than two years."(2)
  and
Originally posted by LRH LRH wrote:

] Those who brandish the "crisis" of the uninsured to promote socialized medicine also often fail to tell people that uninsured doesn't necessarily mean poor. In fact, the National Center for Policy Analysis (NCPA) tells us that "a third of the uninsured households earn more than $30,000 a year and 10 percent earn more than $50,000."(2) That's at least 40 percent of the so-called "uninsured" that could well afford a $45 office visit or health insurance.(2) We need to get away from the concept that "someone else," big government or insurance, needs to take care of our every need.
 
 
Very interesting article, and gets to the heart of many of my problems with the US system.  The first part about the tax and premium structure - great example of the kind of unnecessary complexity that introduces inefficiency and waste into the system.  If healthcare were not related to employment in any way, it would be a big improvement.
 
But another interesting part is the part you quoted, about the nature of the uninsured.  Also tells me the writer is a bit checked out, on a couple of points.
 
First, as to the "temporary uninsured."  He says this like that takes care of it - like being uninsured for a couple of weeks is no biggie.  IS HE FREAKING KIDDING ME?  First off, I guarantee it is a big deal if you fall off a ladder, or if your kid starts to run a temperature, or if your wife thinks she feels a lump.  But more importantly, systemically, it is a big deal because even the slightest break in coverage drastically increases the chance that you won't be able to get coverage every again - thanks to the wonder concept of "pre-existing conditions."  In fact, not only is "temporary uninsured" a big deal, it is one of the central problems with the entire system.  Who wants to cover the guy who shows up with a coverage application and stage 3 cancer?  Bueller?  Bueller?
 
This writer pointed to one of the main issues and pretends it is no big deal.
 
Second - the part where most of the permanent uninsured can really afford insurance if they really wanted to.  Again, he presents the income numbers as if they are some grand revelation.  In the meantime, the rest of us are perfectly aware that the biggest chunk of long-term uninsured are employees of small businesses, and solo operators.  Dental assistants.  Truck drivers.  Construction workers.  Also the multi-parters - the guys that work three part-time jobs.  Hard-working people all, but not exactly high earners.
 
And then the writer goes and guarantees to me that he is checked out - according to him, a household with annual income of $30,000 "could well afford a $45 office visit or health insurance.  What planet does he live on?
 
First off, it isn't $45 OR health insurance.  You need health insurance BEFORE you get the $45 doc visit.  So there is that dee-dee-dee moment.  But the cavalier way he declared that they can afford health insurance, that is what really galls me. 
 
For kicks and giggles, I just applied for some private health insurance online.  Healthy couple, two kids, no preexisting conditions (I would have put down some preexisting, but I didn't feel like having a fake medical interview to make a point here).  The cheapest I came up with $220 per month.  Seriously crappy insurance, though - up-front deductible of $5,500 each year.  What kind of insurance is that?  I pay the fist $5,500 each year?  Now, to get the "$45/visit" kind of insurance I had to go up to $550/month - and that wasn't exactly super-duper insurance either.
 
That's $550 per month, after-tax out of pocket, for a family of making $30k per year.  And that's before the costs for the actual doctor's visits and medicine.  And buddyboy MD, there, thinks that this is no big deal, and this family should stop looking for someone else to take care of their every need.
 
Please.
 
 
 
Quote  
Regarding my healthcare costs, you still lose me on how you are comparing this to us being on the dole. Let me make it clearer.. My wife gets insurance as part of her compensation for doing a job. This job happens to be working for the school, but it is nonetheless a JOB.  When I worked at previous employer, I also had paid insurance for several years. It is because it was compensation for me working for them and was part of my salary. What is the difference between my wife working at GM and getting paid medical insurance and her working for the county and getting the same benefits? I don't get the distinction.
 
Given that you just made a lengthy post about the glories of privatization, I find it rather ironic that you don't see the distinction.
 
Quote Would it make it easier for you to comprehend if they paid her $12k more per year and than charged her for insurance?
 
Indeed it would, to some extent - but not really.  Because overwhelmingly today most employer's pay only half of the health insurance premiums, and those premiums scale with family.  Your wife's health insurance is arguably payment for her services, but not yours or your kids'. 
 
Would her salary go up if you died or divorced her, to compensate for lower health premiums paid by the employer?  Would her salary go down if you had more children, to compensate the employer for higher premiums?  No?  I didn't think so.  (I actually don't know about your case, of course, but I know of no state or federal employment that works this way).  My personal healthcare costs went up when I had kids - we considered changing plans to save money.  Your wife's costs were unaffected by children.  And as a result, her employer is  paying 100% of the health insurance premiums for everybody in your family other than your wife.  If her employer were GM, it would be the shareholders.  But she works for the state, which means that the taxpayers are paying for your health insurance (and your kids').  You're welcome.
 
Originally posted by oldpbnoob oldpbnoob wrote:

Originally posted by Peter Parker Peter Parker wrote:

And THEN, if the problem doesn't go away right away, set the family up with a dietician, a private trainer, heck even a food service if needed.  THAT is what we need.  We need to prevent and treat obesity, not just tell people to lay off the Big Mac.  Right now some of you are thinking "ZOMG pay for a private trainer with taxes?"  YES, pay for a private trainer with taxes.  Because a year or two with a private trainer is a whole lot - a WHOLE lot - cheaper than dealing with that kid's diabetes for the next 50 years, followed by multiple bypass surgeries, and a giant crane to lift him out of his house. 
 
 
I have seen overweight people in hospital gowns standing outside the hospital entrance smoking through their trach tubes..... You can't help stupid sometimes. Perhaps what we need to do is thin the herd. Pun intended.
 
 
Absolutely - but how?  Are you prepared to cut off people from health insurance completely if they engage in certain behaviors?  You may be enough of a hardass, but I don't think the rest of society is.
 
And that, ultimately, is why a purely free-market approach to healthcare fails.
 
Because, ultimately, we already HAVE single-payer universal coverage socialist healthcare.  Anybody walks up to an ER, they will get treatment.  Doesn't matter who or what.  They will get treated, insurance or no insurance.  If they can't pay, the taxpayers eat the bill.
 
Unless we are prepared to act like capitalists and turn away customers who can't pay, then we don't really have a capitalist system.  And the free market does a very poor job of handling matters when it can't turn anybody away.
 
Right now, the taxpayers are the healthcare providers of last resort for everybody in the country.  That's called universal socialized medicine.  We are already there.  The problem is that we have the world's worst socialized medicine, because the social safety net doesn't kick in until you are about to drop, which is the most costly time to start working on a problem.
 
And that is why almost anything would save us money, if it only got us to true universal coverage.  Because then "uninsured" people would see the doctor BEFORE the rash turned into cancer, and we would save millions.

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 10:10pm
Since we are discussing the American HC system, I would think it very relevant to discuss what Americans consider a standard of living. Do American want to live in 1000sq foot home, drive a Yarus or the bus, reduce to 1.5 kids, and have their parents live with them until they die? No.  I get what you are saying about streamlining health care and reducing costs, but I do not think socializing the entire system is the answer. In order to have such encompassing social programs, you must have a government that is huge, and the only way to pay for it is by..... taxes. And I do not beleive the government is good at social programs. Look at welfare, unemployment, child services and yes the school systems. Heck, look at NASA and the military. Most government agencies are filled to the brim with waste and poor spending choices.  And back to the point, Americans do not want to give up their 2.5 kids, 1800 square foot houses, two cars,  boats, jet skis, credit cards and on an on and on.. 
 
Are there problems with the current system? Yes. Is completely socialzing the system the answer? IMO, no. Now granted, I listened to the Obama speech a short time ago and some of what he is saying makes sense. If he is truly trying to push through a system where people with existing coverage can keep it and any new programs will be paid for by savings from streamlining and such, awesome. But anything that increases my overall taxes, I am not in favor of. Period.
 
Last issue regarding my wifes insurance.. To be clear, she works for the local school district, not the state. The insurance is a consortium of the county school districts and is actually private insurance. Also as mentioned before, she took the lower paying job because it offered insurance. Could she have gotten a job that paid more and paid our own insurance? Sure, but why? Could she get a job making 12k more, most likely. If that is the case, and she had to pay 1/2 of her insurance, theoretically, the district should be thanking her for doing the job for 6k less than she is worth. You're welcome.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mbro Quote  Post ReplyReply Direct Link To This Post Posted: 22 July 2009 at 10:18pm
Nit pick: although your wife's insurance is through a private enterprise it is paid for by tax dollars which is what makes it socialized. Sort of like federally subsidized school loans although granted through a corporation they are still a socialist (ick) program because they are being paid for through taxes.

Even better example: The government handing out military contracts to companies like Black Water to provide security detail or whatever other operation at a much higher cost than what it would cost the government themselves to just do the operation themselves. Yeah there's private enterprise involved but it's still a use of tax dollars. They're just used inefficiently because it could have been done cheaper.

Edited by mbro - 22 July 2009 at 10:21pm

Don't blame me, I voted for Kodos.
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