Ron Paul: We Are Reaching A Point Of No Return

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@ Grover

I read through your response and understand what you are saying. Where we diverge is on the fundamental flaw of government, which you think is monopoly. Again, try looking at this from the outside. From the perspective of a citizen living in a distant (functioning) state, the USA appears not to have an honest "government". For one, government offices have revolving doors. And it is not even a republic when the representatives no longer represent the constituents interests. So the libertarian appeal is understandable, but it is an extreme "fix" and that's why libs have trouble getting traction.
There is not a single example I am aware of where a foreign political campaign succeeded platforming on the repeal of a single payer health care system. One reason is that monopolies are powerful and work very well when they represent the interests of the people rather than corrupt politicians, drug and insurance compaies.
You ask for a fix? Well libertarians would have us throw the baby out with the bath water, but that is extreme. Some thoughts: reform campaign financing, adopt single payer health care, put a sensible tax structure in place (I understand the USA used to have a decent tax system, back in the day), stop over-funding “defence”, because just like “government”, the rest of the world knows it’s not really defence.
The US must move ASAP to take advantage of the once in a lifetime confluence of strong dollar and low rates, to invest in decent renewable energy infrastructure, public education and health before the macro scene deteriorates.
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Reducing government interference even more while letting markets determine our fate. Hmmm…sounds like a disaster in the making. No thanks. Like it or not the countries that are the most livable are the ones that tax the heck out of their citizens and redistribute the money in the form of health, education, welfare, respecting the environment and research and development.
Banging the tired old drum of tax reduction, as a way to bring the two Americas together gives me a brain ache. Releasing ‘animal spirits,’ by letting people follow their natural bent without government interference leads to economic fascism. It’s what’s WRONG with America.
Thousands roam the hollowed out core of America, strung out on opioids, subject to death by fentanyl. Ask,them if their problems are due to personal income taxes being too high. Perhaps, it has more to do with a LACK of govt oversight and incentivizing greed on the part of drug manufacturers, waiting for the problem to get out of control and then reimposing regulation.
Lack of regulation in an economy that has already collapsed, in 2008, and is now being held together with bailing wars and tape has caused all kinds of madness.

23

wharfbanger,
As soon as you can form (or show where someone else has successfully formed) a competing sovereign government inside the US, you’ll convince me that government isn’t a monopoly. It is that simple. I agree that the US doesn’t have an honest government. Power (and the desire for more power) is the most corrupting influence there is. That’s why the founders were so adamant about restricting the government’s power. Over time, politicians and the Supreme Court have interpreted watered down the words to get to where we are today. What makes you think that more government will magically solve the corruption issue caused by too much government?
There are lobbyists in DC who will push any agenda for a price. That’s one of the prime roots of the corruption. Whether politicians are paid directly or implicitly offered post governmental service employment, the underlying corruption is rampant. One of the easiest to implement strategies is subsidies. (That’s why taxes are so complicated. All those deductions are really directed subsidies.) Our government has subsidies running everywhere. From the rest of the world perspective, our gasoline prices are being unfairly subsidized. We subsidize corn ethanol and mandate its inclusion in gasoline. Because corn gets subsidized, too much of it is grown. Well, food companies have figured out new ways to put cheap corn into the food we eat. We LOVE it and eat too much. Did humans evolve eating so many carbs?
We have many diseases at epidemic proportions in this country. Many of them, like diabetes, are directly influenced by diet. Instead of attacking the cause of the problem, doctors prescribe drugs to mask the symptoms. Unfortunately, that approach doesn’t fix the problem - so it is a perpetual money maker for the drug companies. Many of these drugs cause side effects that are severe enough to need treatment. No problem! There’s another drug for that … and more side effects … and more drugs.
If people had to pay the cost for their choices - in this case, paying for the drugs that mask the symptoms of perpetually eating a bad diet - they eventually couldn’t afford to keep masking the symptoms and would have to address the root of the problem. By subsidizing everyone’s insurance costs, we’re still paying the cost, but the cost signal is absent for each individual’s choices. Should we really be surprised that people are consuming more health care when we subsidize it?
How will having a single payer system curb the demand side of the equation? If anything, a single payer system will hide the true cost even more from the consumer. I don’t understand why proponents of this system think this is an acceptable solution. Since it concentrates power more, it puts even more corrupting influence on corrupt members of our government (who want more and more power.) How can it not corrupt government even more?
To complicate the issue even more, we’re just about at the conclusion of the “Age of Abundance.” As you know, fossil fuel reserves are diminishing every day because we keep burning them and the earth isn’t creating them fast enough. Meanwhile, we’ve already harvested the highest quality resources and are working on more and more dilute reserves. It takes more energy to refine and process these ores. That leads to more pollution that our environment needs to absorb. The pollution and chemical -cides are killing the other inhabitants of the world. We need them more than they need us!
So what happens when the earth’s oil spigot starts constricting? Will we be able to afford all the complication and complexity that we now take for granted? With diminished energy available, the economy will contract. All the grandiose plans that seemed so achievable when everything was abundant will become increasingly expensive. You can bet that government won’t want to contract (and lose that delicious power) without a fight. They really only have 3 choices - tax more, cut programs/benefits, borrow to make up the difference.
Would you keep working and banging your head on the wharf if your effective tax rate were 100%? What about 90%? How about just slightly higher than it is worth the effort for? (I hope you can see where I’m going with this line of thought.) It doesn’t matter if the tax is on your wages, your transportation, your purchases, your healthcare, or whatever. What matters is the total amount. When the total exceeds your perceived limit, you’ll throw up your hands and give up. (At least, that’s what logical folks do.) Then, the tax base is slightly smaller and government has to make up the difference by raising taxes on others. Can you guess what happens when you play this out? Right. There’s an upper limit to taxation.
How about if the government just cuts programs or promised benefits? Every program in the government benefits some group. Take Defense for example. The military industrial complex has figured out that by manufacturing components for every military weapon in every US congressional district, that cutting any of these programs will get the locals complaining to the 3 people in congress who they actually can vote out. That’s pretty diabolical … don’t you think? They’ve built a safety net for themselves. So, what do we do with all these weapons if we don’t use them? You’re right. We need to project our power throughout the world - which means we have to get involved in skirmishes that we have no right to be involved in.
That’s just one example of why cutting anything is so abhorrent to the government. So, what’s left? We can continue to borrow money. Great! Borrowing money adds interest costs and delays the actually taxing until some date in the future. If they can kick the can down the road long enough, they’ll be out of office and some other congress critter will be responsible for making it all work. This is actually the preferred solution because most folks get their bennies without seeing the cost on their current tax bill. Screw the future taxpayers!!! Oh, wait … we’re the future tax payers for all the can kicking boondoggles of the past. All of a sudden, that doesn’t seem so fair.
So what happens when any government can no longer borrow money? Well, they can just print the money and monetize the debt. That’s when confidence evaporates, hyperinflation kicks in, and the collapse sequence initiates. You can look at Venezuela as a current example of this action. I certainly wouldn’t want to have to live under those conditions. There’s starvation, violence, death, and despair running rampant there. At least, they still have the basic human right of health care. :wink:
Governments around the world are all faced with the same problems. They won’t all collapse like Venezuela is, but they won’t want to contract to a sane and sustainable level until it is too late. Wouldn’t it be logical to contract to a more sustainable level while it is a choice? Unfortunately, most people believe economists who predict infinite growth and more prosperous times are just around the corner. They can’t (or won’t) consider that prosperity has peaked for this cycle.
I try to see it for what it is. I don’t expect that we’ll be able to salvage the system before it fails (catastrophically.) Shrinking the government … and cutting its obligations … would make the step to the new normal less traumatic. It won’t happen because there is such resistance to this idea. It can’t gain any traction because the big boyz want you to buy more of their stuff (so they can get even bigger.) The easiest defense is to just have the media pooh-pooh the idea as well meaning … but horrendously simplistic. (Even seemingly intelligent people swallow this gambit and subsequently regurgitate it as if it is the truth.) It salves the consumer’s worries and then they go out and buy the newest bling. Everybody wins! What could possibly go wrong?
Grover

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Quote:
Should we really be surprised that people are consuming more health care when we subsidize it?
That's not what actually happens, though. Here in Canada our average life expenctancy for both males and females is more than two years longer than in the US, even though we spend a significantly smaller percentage of our GDP on health care costs. We're clearly doing something right that the US is missing.
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Yoxa wrote:
Quote:
Should we really be surprised that people are consuming more health care when we subsidize it?
That's not what actually happens, though. Here in Canada our average life expenctancy for both males and females is more than two years longer than in the US, even though we spend a significantly smaller percentage of our GDP on health care costs. We're clearly doing something right that the US is missing.
The Canadian health care system is far cheaper than the American and everybody is covered. That says it all. In the case of American health care insurers, Atlas doesn't carry the weight of the less fortunate on his shoulders, he insists they carry him. And forget about shrugging, he's fist pumping and high fiving.
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Yoxa wrote:
Here in Canada our average life expenctancy for both males and females is more than two years longer than in the US, even though we spend a significantly smaller percentage of our GDP on health care costs. We're clearly doing something right that the US is missing.
Yoxa, Congratulations on not having the ugliest horse in the glue factory. You clearly are doing something better than what the US is doing. Now, if you can just control all the variables and isolate the major factors, you'll be halfway there. Then, you need to convince our congress critters that your (Canada's) way is so much better and that the congress critters should forego all the money they're collecting from sick maintenance lobbyists. (That will be a tough sell.) Oh, and you better hurry. It won't be long before it is all a moot point due to oil, resources, debt, or some other limiting conditions like food availability due to us wiping out the pollinators. Enjoy it while you can, Grover
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I have to respond to your statement that, ‘monopolies don’t work,’ Grover. Also to your idea that healthcare should be considered other than a human right.
When there is a general consensus within a society that it IS a human right, all sorts of things are set in motion. A universal system working from this mandate will put pressure on pharmaceuticals to keep their prices affordable through various means.
Much like WalMart, (an unregulated oligopoly)deals with its suppliers. Note how cheap everything is in their store. Of course it is because they are large enough they have clout with their suppliers.
A universal insurer, what you would call a ‘monopoly’ has the power to control costs and has efficiencies of scale and a streamlining of process.
A governmental universal insurer is also more apt to work within other governmental structures, like the education system, to advocate for changes that enhance better health. Through the school system, children are more likely to be indoctrinated in a healthy way, to make healthy choices.
Government isn’t ALL bad everywhere. YOUR government is nasty because it operates from the premise that warfare for profit is more important than welfare for people.

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agitating prop wrote:
I have to respond to your statement that, 'monopolies don't work,' Grover. Also to your idea that healthcare should be considered other than a human right.
Monopolies don't have competition to keep them from getting bloated. There isn't external incentive to keep them focused on the bottom line. As such, your choices boil down to - take it or leave it. It is only when enough people choose the "leave it" option that monopolies have any incentive to reform. If you water down the meaning of "work" enough, I agree that monopolies work - just not very well. Their goal isn't to be the best (because they already are ... monopoly) but rather just to avoid being too bad to encounter deleterious consequences (which is much easier to achieve.) I hope you'll be honest and forthcoming into explaining why healthcare is a human right. I really don't understand this line of thinking. In my world, rights come with responsibilities. If you aren't going to be responsible for your own health, why should someone else be forced to pay to try to make it less bad? That doesn't make sense to me.
agitating prop wrote:
When there is a general consensus within a society that it IS a human right, all sorts of things are set in motion. A universal system working from this mandate will put pressure on pharmaceuticals to keep their prices affordable through various means.
Your general consensus boils down to any amount more than 50% demanding that all the population contribute (via legal enforcement) to the stated cause. In this country, we ended up with Obamacare because the general consensus shoved it down everyone's throats. Although that isn't a "universal" system, it should show the folly of thinking that government sponsorship of this program would actually result in the system you envision. What is going to keep the corrupt government "servants" in congress (who are currently benefiting from drug company largesse) from accepting drug company favors if your system passes?
agitating prop wrote:
Much like WalMart, (an unregulated oligopoly)deals with its suppliers. Note how cheap everything is in their store. Of course it is because they are large enough they have clout with their suppliers.
Walmart has focused on low cost. Of course, everything in their store is cheap. As you say, they dictate to their suppliers. If the suppliers don't comply, Walmart won't buy from them. From the supplier's point of view, that's a good example of "take it or leave it." What would happen if Walmart were the only place the suppliers could sell their products? Then, the seller's only choice becomes "take it." Walmart would keep cutting margins until the suppliers can't afford to stay in business.
agitating prop wrote:
A universal insurer, what you would call a 'monopoly' has the power to control costs and has efficiencies of scale and a streamlining of process.
You are correct that they have this power. What would provide the incentive for them to pursue this lofty goal? On the other hand, there's lots of money in graft and corruption. All the managers of the universal system have to do is look the other way. Surely, they would be eloquent enough to paint a smokescreen for their actions which would be acceptable to the consensus. I'm thinking something like, "we're agreeing with company XYZ that research and development costs for drugs have seen inflation rates much higher than the CPI would suggest; therefore, we're approving the seemingly exorbitant increases." Since it is universal and mandated by government, what the hell would you do in this case? Answer: Take it.
agitating prop wrote:
A governmental universal insurer is also more apt to work within other governmental structures, like the education system, to advocate for changes that enhance better health. Through the school system, children are more likely to be indoctrinated in a healthy way, to make healthy choices.
Wow. Your optimism is scary for us in the real world. What makes you think that bureaucrats work together unless both of them gain from the transaction. Bureaucrats are very resistant to suggestions from outside unless they see a personal win. Non-winning ideas get ground down to nothingness in the bureaucratic maze. Winning ideas cost the taxpayer more. Whenever I go to a function at the school, I notice that all the soda machines carry only coke products or only pepsi products. I never see both types of machines in the same school system at the same time. I wonder if that is just a coincidence? Hmmmm. Which product is the healthier choice? (Answer: Neither.) Remember that there's a LOT of profit in a plastic bottle of flavored sugary water. Wonder if some of those profits are surreptitiously wending themselves into the pockets of the administrators? How would we know for sure?
agitating prop wrote:
Government isn't ALL bad everywhere. YOUR government is nasty because it operates from the premise that warfare for profit is more important than welfare for people.
I agree with you that the government I'm stuck with (ironically, because of all the do-gooders voting for it) has morphed into a warfare state for reasons I enumerated in prior posts on this thread. What makes you think that the type of people who run for office and get themselves in the quagmire can actually reform it? The more power we give them, the worse it gets. I'm also not sure what you mean by "welfare for people." That has lots of flavors ranging from well meaning messages to full care and responsibility for all actions - the nanny state. Frankly, the well meaning messages are worthless to me, and I'd rather be responsible for myself and let you be responsible for yourself. I don't need an overseer telling me that my actions are out of line. Finally, who is going to pay for this? How will it work when the economy falters due to hitting some limit? Is the right for health care dependent on the economy? In other words, does the right disappear as the economy craters? How can a "right" disappear simply because the funding evaporated? I guess that's why I have such a hard time seeing this as a "right" and not just a "benefit." Grover
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Quote:
I guess that's why I have such a hard time seeing this as a "right" and not just a "benefit."
Try thinking of universal health care as an invesment, then.
Quote:
The Canadian health care system is far cheaper than the American and everybody is covered. That says it all.
An investment in the reslilience of your people! One difference to ponder is that a better percentage of Canada's health care costs goes to actual care, and less to administration. The insane bureaucratic burden of insurance company paperwork isn't a feature of our system.
Quote:
I'd rather be responsible for myself and let you be responsible for yourself.
It might make sense to think that way if absolutely everything that happened to us was within our own control.
Quote:
Finally, who is going to pay for this? How will it work when the economy falters due to hitting some limit?
The same people who pay now ... but they'd get better value for their spend. If there was no corruption in the system, that is ... sorry I don't have an answer for that. As for the economy faltering, that is indeed something to think about, but a case can be made that universal health insurance makes our economy more efficient so we have more margin to face ups and downs. Not to mention making individual households more resilient. Here's a big economic faltering that already happens all too often:
Quote:
Medical bills are the biggest cause of bankruptcy in the US: https://www.cnbc.com/id/100840148
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So much that they manufacture a toaster that breaks in a year or two and you can’t get the simple part that broke other than in lots of 10000 from China. Or a microwave that lasts 3 years. Or a kid’s “sippy cup” where they’ve made the plastic so thin that it cracks in a couple of years while the quality ones that cost a bit more last much longer (all of the Walmart ones from when our kids are little were in the trash years ago while the name brand ones are still with us and only now falling from common use when my youngest is now 12). I speak from personal experience and my general impression is that many items from Walmart are like this.

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Grover-
I’m with you that its not a right.
However, (you had to know that was coming) given the cartel-like nature of our current system, universal healthcare is the best of a bad lot of options.
I’ve actually seen it work in real life. There is corruption, but its “little people” corruption which ends up with people going to the hospital when they have the flu.
Big cartel corruption ends up with generic meds like albendazole at $100 per pill. That, writ large across the whole system, accounts for about 9% of GDP in the US. Institutionalized corruption is vastly worse than the little people corruption.
From my observation, the “little people” corruption doesn’t cost that much money. While there is usually unlimited demand for free services, it does turn out that people don’t queue up for appendectomies that they don’t actually need. Health care isn’t one of those “I want more free stuff” things, except for the “fun drugs” which … are a problem right now anyway.
And - in exchange for free care, there have to be death panels. Some hospitals don’t have surgeons. If you need surgery, you have to go to the big hospital. Hope you make it in time. Then again, its free, so…you really can’t complain too much.
Likewise, if you are having a baby, you get a nurse. One nurse. Usually, it works out. Sometimes, it doesn’t. If you don’t like that - probably a good idea to pay instead of using the free service. Friend of mine is a nurse; delivered over 300 babies first year out of school. How’s that for OJT?
And it also turns out, when there is competition at the lower end, rather than a cartel that institutionalizes corruption, the private hospitals actually have to compete, and so prices and services are actually quite excellent.
I’ve seen it work. It is possible.

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Of a country where health care is not considered, say a fundamental privilege/right, and where it has been successful and it has led to better health in the populace. This is an excellent but in some ways theoretical area and I am a very concrete person at times.
Some of us in healthcare are taught about things you don’t see here much more (like rickets, dying from simple treatable infections, cholera) that are much more common in impoverished or traumatized areas like Haiti, Yemen, etc…
Of course those 2 countries provide how political the delivery of health care can be and how devastating it is when politicians like MBS turn against a populace, go to war, etc…
I am being serious though, not sarcastic. If every man for himself works is there a good example or are we really talking about letting people die for lack of basic funds for care?

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I am with Yoxa on this one. Canada, and even Cuba, are doing basic medical care way better than the USA.
One story:
A mother brought her child into the ED with a complaint of weight loss. They had no insurance and the ED is the only place to get “free” medical care. (Single parent with a minimum wage job, no benes.)
It turns out that the child had moderately severe asthma and the mother did not have enough money to pay cash for the Albuterol rescue inhaler ($80 each) nor the preventative steroid inhaler ($160/month). Without the inhaled corticosteroid (ICS) her asthma was always flared to some degree. She often could not eat due to shortness of breath.
(Kleenex alert) Mom told the story of them lying in bed at night wheezing, short of breath, frightened and crying. Her mom would hear her wheezing and would rub her back and sing her favorite songs to help her settle down and sleep. When that would fail, she would relent and call 911 so that she could get an albuterol nebulizer treatment from the paramedics. Mom hated that the paramedics and the ED staff were “always mad at them for abusing the system.” (Why didn’t they follow up with their regular doctor and use the medicines prescribed?)
Albuterol inhalers used to be $4 at Walmart. But, pharmaceutical companies lobbied the FDA to get chloroflourocarbons banned from inhalers to “protect the ozone layer.” Mother Jones tells the story here:

Well, the ozone layer was the initial cause of all this, so feel free to place some of the blame on environmentalists if you like. But ... they suggested ...just making an exception for asthma inhalers and let well enough alone. At that point, the pharmaceutical companies that had been eagerly waiting for the old inhalers to be banned went on the offensive. IPAC lobbied [the FDA, and] for other countries to enact similar bans, arguing that CFC-based inhalers should be eliminated for environmental reasons and replaced with the new, HFC-based inhalers. The lobbying paid off. In 2005, the Food and Drug Administration (FDA) approved an outright ban on many CFC-based inhalers starting in 2009. This June, the agency’s ban on Aerobid, an inhaler used for acute asthma, took effect. Combivent, another popular treatment, will be phased out .... In other words, pharmaceutical companies didn’t just take advantage of this situation, they actively worked to create this situation. Given the minuscule impact of CFC-based inhalers on the ozone layer, it’s likely that an exception could have been agreed to if pharmaceutical companies hadn’t lobbied so hard to get rid of them. The result is lower-quality inhalers and fantastically higher profits for Big Pharma.
The newly formulated and FDA approved albuterol HFA was now a "new drug" and under patent protection. This "new albuterol" cost $70 - $80. The regulatory apparatus was completely aligned with Big-Pharm against the citizenry. --------------- Mexican migrant farm workers can not afford ICS and would requested a monthly IM injections of Betamethasone, a long acting systemic steroid, to control asthma like they got back home. The systemic steroids are dirt cheap (<$2/month) but have horrendous side-effects when used long term. The outrageous price of the inhaled form forced many to rely on the toxic systemic forms. --------------- When people cannot obtain basic medical care while their richer neighbors can, the pitchforks will be coming out.
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At what date in history did healthcare become a human right/fundamental privelege? This is important to answering the question because we need to know when to start measuring health outcomes.

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At what date in human history did healthcare become a human right/fundamental privilege?
Oh that’s an easy one! It never has but should be! The BETTER question should be is "why is it okay for rapecious companies to bankrupt people, create stifling rules around and limit access to affordable healthcare just so the masses can be controlled and specific entities can get filthy rich?
Here is another question “should people have access to clean water and food and affordable shelter or is it okay to use those as weapons as well”? Or how about this question do we have a right to choose to NOT be vaccinated, chipped, tracked or experimented on? How about - do we have a right to be told the truth and be informed when something effects us? Perhaps we are just property and have no right to any if the above?
Lots of questions.
AKGrannyWGrit

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In a country where we (still) have enough resources to provide basic care to everyone using the modern medical system, and enough humanity to offer emergency care to those whose chronic conditions get out of control because they can’t afford care, it’s simply a good investment to offer basic care to everyon.
It’s also a good investment, to prevent the kind of profiteering and rackets that healthcare is today and to create a system that as much as possible gives people incentive to care for themselves as best they can. We owe it to everyone to eliminate subsidies for corn and other crops that are grown in unsustainable and toxic ways and then find their way into all sorts of unhealthy foods. We owe it to everyone to remove subsidies that encourage a sedentary, isolated lifestyles that damage health so much (I’m thinking all of the hidden subsidies to suburban sprawl among others. We owe it to everyone not to subsidize pollution and to allow corporations to externalize their environmental damage. I could go on …
I’m not saying it’s easy or even possible to do any of these in this decaying and corrupt society we call the United States, just that it’s a good investment.
When we can no longer afford to offer the sophisticated kind of care available today, there will still be all sorts of low cost health care options that will improve quality of life, if not in every every that modern medicine can, then in many of them.

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Thanks to all for responding. The emotional level of this thread tells me that people are firmly anchored in their opinions, but can’t completely explain why. Count me in that group as well. Yoxa moved the goal posts slightly by saying that health care should be considered an investment rather than a right. This position makes more sense to me.
If healthcare is considered an investment, return on investment (ROI) must be top of the consideration list. There are other considerations like humanitarianism and public relations, but if it isn’t profitable, it isn’t a sound investment. There should be cold-hearted metrics to determine whether to invest in a person’s health. (DaveF could probably write a program to do all the heavy lifting.) If the answer (based on ROI) comes up “no” then, public funds can’t be used. If the person, the family, or community isn’t willing to fund the investment, then the treatment won’t be provided.
Imagine an 85 year old with diabetes, beginning Alzheimer’s, and heart disease demanding open heart surgery to repair defects. Should this procedure be authorized? This isn’t a hypothetical case. It actually occurred with a friend’s aunt. She had Medicare and enough supplemental insurance to cover the whole cost without additional co-pays. (From the hospital’s and doctor’s perspective, she was completely covered. They have to pay the salaries and hospital debt somehow.) She had the surgery and lived a little more than a year. I should say that she existed a little more than a year. She never fully recovered from the surgery. Meanwhile, the Alzheimer’s got significantly worse, she remained bedridden, and she required care 24 hrs per day. Toward the end, she had to be strapped to the bed so she wouldn’t try to get up, fall, and hurt herself worse. The aunt had squandered almost all her money over the years, so my friend provided this care out of the sincere goodness of her heart. I respect that!
If this were an isolated case, it would be only a mistake; however, I hear of these stories frequently and that makes it a tragedy. Because the late 70s and 80 somethings (Silent Generation born during the Depression) are such a small generation and many of them are already gone, we can fund their procedures regardless of the real sensibility. Now, the much larger Baby Boom generation is advancing in age and “needing” the same level of care.
It really doesn’t matter if we use Universal Care, Insurance, or direct cash payments out of a person’s savings. The total cost HAS to be paid from some funding source(s). We can see what happens when we rely on insurance to cover the expenses. Insurance costs increase by many multiples of CPI. I really don’t know what the primary causes are - patient demands (like my friend’s aunt,) drug company greed, side effects of previously prescribed medications, or other considerations. Universal Care won’t solve the cost problem without making major changes to the endemic system of corruption in the US government. Actually, since Americans are soaked so much to pay for R&D, other countries (Canada) get the benefits of generic versions of the newer drugs without the price tag - You’re Welcome!
We also have to look at the range of possible future conditions to see if the investment will likely have a return associated with it. Economists only see the economy expanding forever into the future. As an example, if we run out of oil, there will be a huge incentive to develop alternatives to replace oil. In their world, no problem can’t be overcome. If that is the only possibility, then we assign 100% likelihood and move on. But, what happens if the economists are wrong and the future doesn’t pan out as they predict?
To complicate matters, governments sell the cost of their existence as a percentage of a country’s GDP. This makes sense on some level as a gage of the appropriate level of government. In order to hide the true cost, governments lie to us both covertly and overtly. Take public employee pensions as an example. If the pensions were completely covered at the time the work was performed, there wouldn’t be a pension crisis. Unfortunately, we elect people who are very adept at kicking the can down the road. If they funded the pensions adequately, they couldn’t fund all their pork barrel projects without raising taxes. The pension crisis will get worse due to the low interest rate environment we’re in. Even under the economist’s view of the future - green grass and high tides forever, there is a significant risk of systemic collapse.
Unless we can successfully develop an alternative to fossil fuels in time, public pensions alone will defunct the government. Only a cornucopian economist (or a clueless do-gooder) would argue that we need to add more gargantuan obligations to the already overflowing government plate. What could possibly go wrong?
If we follow the message of the 3 "E"s, we know that the future isn’t going to be a straight line continuation of the recent past. Wouldn’t it be better to prepare for a future of less than to close our eyes and run at full speed into a wall (or over a cliff)? I know that Libertarianism sounds too simplistic to work. By the same token, our current government is too complex and corrupt (and expensive) to work for long once the economy tanks due to energy or environmental issues. If the economy collapses and can’t return to former glory, even a spartan Libertarian based government will be too complex (and expensive) to afford. It is a good first step.
Here’s what I wrote in Post #2. It is a good summary of my position:

We may pull through this next recession like we did the last one - doubling down on QE. Will we be able to get through the next recession (or the one after that) the same way? Eventually, the system will fail because all the promises that have been made can't be afforded. At that point, systems will break down - perhaps catastrophically.You won't be able to rely on social security or Medicare or any other of the myriad promises. What will you do? What will help you succeed is your core principles. When others see you adhering steadfastly to these principles, it gains their trust. With trust comes the opportunity for cooperation. Cooperation can lead to mutually beneficial outcomes. That is the currency of the future. Cultivate it now while the status is still quo.
Good luck to all of us! I'll be away from my computer for the next week or so. Don't expect timely responses. Grover
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http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds–from 5 percent to 15 percent–albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen–that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right).

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo...

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<strong>I worked for twenty-three years in health care. First, in public health education at a county clinic in South Carolina. The county clinic provided pre-natal care, contraceptive services, well baby check-ups, a venereal disease treatment and investigation program, wound management, dental treatment, vaccinations, adult walk-in clinic and nutrition counseling for diabetics and children at risk. It was a well run service with specially trained nurses providing most of the care. From this job, I moved to work as a Social Worker (Department of Mental Health, SC) in a half way program for institutionalized psychiatric patients. The goal was to get people who had been in long term care back into the community with help from mental health professionals. Many of these people had had lobotomies or had been in institutional care for decades. They thrived in their own apartments and homes with our back-up. I returned to school in 1981 to become a Physician Assistant and worked for the next 17 years in OB-GYN.                                                                              In 1973, The Health Maintenance Organization Act was passed under the Nixon administration. This made for profit medicine legal. Read <a href="http://www.thecriticalaye.com/2011/08/31/skyrocketing-health-care-costs-thanks" title="www.thecriticalaye.com/2011/08/31/skyrocketing-health-care-costs-thanks" rel="nofollow">www.thecriticalaye.com/2011/08/31/skyrocketing-health-care-costs-thanks</a>, provides excellent information. I observed over the many years since health care became "for profit" the loss of access to quality care for the poor and uninsured. Most of the county clinics have closed. The state mental hospital has closed and the large campus is being developed into luxury apartments, upscale small businesses and a baseball stadium. I have no idea what became of my old psychiatric patients after the half way program lost funding.                                                      I retired in 2000 due to chronic illness. The whole system, at present, seems to be all about prescribing the newest medications, ordering tests and expensive procedures. Providers are all so rushed to see as many patients as possible. When calling for an appointment to see a new doctor, after getting your name and birth date, the scheduler asks what insurance you have. Few will see an uninsured patient. Universal Health Care will remove the profit motive from medicine. Americans were able to get good care at reasonable costs prior to the Nixon era. Doctors, drug companies and hospitals did not spend billions advertising their wares.  The current system promotes drugs not health maintenance.   </strong>
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spotted turtle wrote:
Universal Health Care will remove the profit motive from medicine. Americans were able to get good care at reasonable costs prior to the Nixon era. Doctors, drug companies and hospitals did not spend billions advertising their wares. The current system promotes drugs not health maintenance.
spotted turtle, Thanks for sharing your story. I read your link and agree that our current system is more interested in profits than in public health. Unfortunately, the Medical Industrial Complex has accumulated lots of money over the years that they can use to sway politicians via lobbying. What makes you think that they wouldn't be able to bastardize any legislation (ie Universal Health Care) that promotes good health for us and austerity for them? Grover