@ Jonnan001...you make some good points.  But your posts are toooooo  long. At least for me.  I have the attention span of a 12 year old.

@psychoack...same thing.

don't mean to enter into your debate, just an observation.

Most of the analyses I've read say #2 wouldn't achieve that objective, not by a longshot.  The idea that we could retire the level of debt contemplated in Obama's proposed budgets by imposing higher taxes on only 5% of our citizens is wishful thinking at best, particularly as the baby boom generation starts leaving the work force in significant numbers (not me, mind you - I can't afford to).

As a fellow physician, I want as many people as possible to have access to the best care possible.  I'm not yet convinced that single payer is a feasible means to that end, let alone the best means.  Putting in a few simple rules to make cherry-picking by insurance companies less profitable and to require insurance companies to resume community rating would go a long way.  Having practiced in a fully government-run healthcare system at one time, I'm not too sanguine about the 'benefits' of single payer.  A look at our current VA system should be enough to give one pause.

Consumption as well, since most of it goes to waste by mass-producing non-renewable goods. Pollution/Recycling relationship causes more damages to economy (in general) than we (internationally, btw) can sustain or detect.

The manufacturing cycle overwhelms the consuming by addiction, so to speak.

'Blow up' implies too much about how it happens.

I concede, we need to get to an even or negative population growth - having a reasonable target of what we need to survive would be a good start - the problem with that is that we are evolutionarily wired to want to produce more with each generation. As a secondary problem, studies of evolution in genetic programming environments suggests that limited resources is itself a driver of evolutionary change, which in turn means doing the 'mature' thing and 'living within our means' may cause a stagnation within the genetic pool - over a thousand years, that may mean nothing, over a million it may mean we haven't gotten as far as we would have otherwise. Given the amount of difference between us and our first forebears - well, in a million years I'd like to see descendents that can look at me wondering how I got along with such a small brain with the same wonder I look at homo erectus - {G}.

Jonnan

Well, we were paying down our national debt w/ budget surpluses under Clinton. I think 2013 (which is right around the corner) was the projected date for the debt to be paid off.

However, we elected George Bush and he lowered the highest marginal rate for the rich and look what happened. Despite him trying to hide the war from the books, we still had high deficits and now we are in more debt than where we started.

Raising the highest marginal tax rate WILL eliminate our budget deficits and our national debt. It's not a matter of if but a matter of by how much you need to raise the top marginal tax rate. Obama's issue is that he just doesn't raise it enough. Basically, he doesn't want to take the political heat. However, we are fighting two wars, in a huge financial crisis, and exporting our manufacturing base overseas. In other times in history (Pre-Reagan), when we are under as much duress we raised the top marginal tax rates as high as 90%. Just google it. Basically, things got paid for. However, w/ Reaganism we ushered in the "greed is good" thing and decided the to 5% of income earners should be able to keep most of their money. I can understand the sentiment but the result is the inability to balance the budget and take care of old people and national defense at the same time.

So, you either have to raise the top marginal tax rate, tell seniors citizens to suffer, slash national defense or live on the borrowed dollar. The only other way is to "grow our way out it" but that has proven vis a vis Reagan and the Bushes NOT to work.

The folks that disagree are from the CATO institute and the Heritage foundation. Both of these are funded by rich people to say what they want them to say. No coincidence or surprise there.

Google highest marginal tax rate over last 100 years and look at hte graphs. Our slipping into massive debt really started w/ Reagan and that's when our the highest marginal tax rate was taken down.

Our financial crisis mirrors that of the 20's and the depression, and look what they did w/ the highest marginal tax rates in the 20's. It's the same thing.

I love capitalism but it's function is to funnel wealth to the rich, there's no two ways about that. It's just the pure and simple truth. The goal of a progressive tax structure is to remedy the ills that befall a society when too few own and control too much.

That's why high marginal tax rates work. Basically, they improve the overall economic health of a country by putting money back in more people's hands.

As for health care, I'd vote for a single payer system but I'd settle for a hybrid system of public/private insurance.

I agree with you, we need to eliminate "pre-existing conditions" and health status as a means for health insurance companies to cherry pick the best cases. We also need a public health insurance option.

As for the "single payer doesn't work" canard....well...that just doesn't hew to the facts.

The US system has the highest per capita health costs in the world compared to any other country. Our privatized for-profit system just plainly doesn't work very well. The systems w/ a large government component in country after country, large and small, rich or not, are just more efficient. The $$$ numbers don't lie.

Now, you may have good reason not to want to practice medicine in a NHS type system. I don't begrudge you. Myself, I like owning my own business.

However, you can't say they aren't more efficient and cost effective than what we have.

As for quality and wait times go, that varies and is largely a function of how much money you put in the system.

However, japan has a gov't based system and their wait times are less than ours and their imaging (mri's and ct's) exceed ours. However, they addressed this by just making mri tests cheaper as just one example.

The big issue for docs in gov't systems as opposed to ours is that although you can make a good living the top end incomes are not nearly as accessible as in the U.S.

But as for U.S. primary care (IM, peds, FP and so on) we don't really do that much better than in some other countries.

I don't think it's good policy to basically give less care for more $$$ per capita just to preserve incomes of subspecialist surgeons, drug, and insurance companies. Because that's what it basically boils down to.

Quoting Daiwa,

reply 11

As for the "single payer doesn't work" canard....well...that just doesn't hew to the facts.


Kinda depends on how you define 'work' don't ya think?

Yeah, it does. So, if you define "work" as in cost effectiveness and providing similar overall health care outcomes at lost cost per capita, then single payer "works" a lot better than the system the U.S. employs now.

However, single payer is just one option and worldwide there many different permutations of universal coverage systems, with varying degrees of private and public insurance.

One thing that is common to all of them is that they cost less per capita than the U.S. system. Furthermore, most industrialized countries that we think of as "modern" and "Western" like we are get similar or sometimes even better health outcome results.

Now, if you want to define "work" as in patient satisfaction...again, many countries match us or best us for less $$$ per capita.

So, if patient satisfaction is good, outcomes are good, and $$$ efficiency is good...that seems to define a lot of what "working" means to me.

However, if you define "working" by meaning that drug and insurance companies make amazing profits at the expense of everyone else, I guess you are entitled to that.

Jumped on any jingoistic bandwagons lately?

First, despite how much leaders all over the planet (Muslim and otherwise) like the idea of there being "the Muslim world," that thing is no more reasonable an abstraction than is "the Christian world." All three Semitic traditions are riddled with sectarian strife and have spread themselves around the globe, which only mixed other cultural stuff into the basic mess of theological disagreement.

Second, and more importantly, Islamic peoples have no monopoly on overbreeding. Cultures around the world and throughout history have developed traditions that reward overbreeding and undermine or outright proscribe birth control. Some of it might have had survival value back in the very low-tech days, but massive populations and massive industrialization just seem like a very bad combo. Messy at best, poisonous most of the time, and downright nuclear when it gets out of hand...

Good points for basic rhetoric, at least. "If you have no answers, reject the questions."

No, it's not better. You still strongly imply that Muslim peoples are somehow different when it comes to the problem of overbreeding, and that's simply wrong. You have not even bothered to try describing 'them' as worse than other groups you dislike.

Because I was born to Christians in the US and have not read nearly as much as I'd like, the only examples I know of religious groups who formally sought to reduce world population are people like the Shakers. But they were basically the other extreme and so not much help for folks who might really hope that our decscendants in a millenium or ten might be part of a species that peacefully and thoughtfull brought its numbers down to something much more reasonable than the 10 billion we're all likely to live to see. (I'm an SF reader, and I don't include independent off-Terra populations in that goal.)

Fixing insurance would be easy.  You could change three things and probably cut the cost in half for the individual subscriber.  Single payers get screwed right now because company A has two million subscribers through business b and really does't give a shit whether individual c is a customer or not.

Require companies to sell any policy they offer to anyone that fits the bill.  If they give Ford employees coverage at a certain price, they have to give that same plan to individuals as well.

Force competition across state lines on the idiot states that have regulated themselves to death.  It's even constitutional, barring someone from purchasing insurance in another state is a violation of the constitution.  Free, unfettered trade between the states is mandatory.  This would greatly reduce the entry bar to a given market, and increase competition.

Tax the health benefits employees recieve.  A 16 grand insurance policy wont look so nice after it's treated as income.  Costs will come down when it's no longer a write-off for the employer and tax free income for the employee.  This will be particularly effective in combination with the first.

A uniform filing system, actual insurance instead of prepaid medical(you're dumb shits if you pay someone else to pay for your checkups) and ending the nonsense malpractice suits that have turned a wealthy profession into one not worth the educational costs would be nice too.

Sorry Eternal Silence, but you know jack shit about spending levels.  When they were taxing those evil rich bastards at 80%, government spending was around 8% of GDP, it's above 40% now thanks to the current shit tards in office.  We have a deficit because government spending has been above the level of war time spending we had during WW1 since the early 70's.  We're batshit insane.  Classical economics, yes, so called trickle down economics are classical economics, did not lead to deficits, a massive increase in spending relative to gdp growth did, tax revenues went up.

Back to socialism.  Your first accurate post Lieu.  That is exactly what my view is.  Now, go find an encyclopedia and look up socialism so you can stop being wrong and agree with me.  You can't have collective ownership and administration of the economy without actually having collective ownership and administration of the economy, that's what public ownership of the means of production is.  When you read past the first sentence it's rather obvious that they aren't talking about individual infrastructure projects when they say socialism.

The only difference between socialism and communism(not to confuse either of these with the crazy fucking dictator real life examples) is that the market place still exists under socialism.  Communism is the crazy fucking bastard branch of marxism, socialism is the moderate branch.  How anyone ever thought central planning would ever be feasible in anything larger than a very small village is beyond me.  Most people can't even plan their own household.

Jonnan -

You're arguing with me over positions I haven't taken.  The discussion wasn't about what things have the strongest correlation with birth rates.  Furthermore, there's no news in the notion that socio-economic factors influence birth rates.  Even so, the post-WWII 'baby boom' wasn't exactly due to fear that those kids might not make it to 20.

However, the birth rate of Muslims in western countries, where they are comparatively 'wealthy' & don't have the infant mortality issues, is much greater than among non-Muslims, with a difference big enough to result in Muslim majorities in some of those countries within 2 or 3 generations.  I'm not passing judgment on that, simply stating what is happening.  You & Swicord want to call that 'jingoism,' go right ahead.

That aside, the point I originally made was in the context of the comment regarding the 'need' to reduce world population growth.  A couple of you have decided to take it where I didn't, which you are welcome to do, but having gone there with you this far, nothing says I have to stay.

I would consider the possibility that I had misinterpreted your phrasing except - well, for a position you haven't taken, you're going to a lot of trouble to defend it - <G>. Not however, actually enough trouble - I'm going to need to see actual references - I'm an arse that way.

That said, I'm going to pre-emptively mention the exact same 'In two to three generations minority [insert name here] will have taken over' theorpy has been posited for every incoming migration into the United States since (literally) the 1800, so you're in the unenviable position that you not only need to find information backing up your position, but must convince people that the information backing up you decision makes a fundamentally different case than that that has come out of anti-immigrant groups the *other* times it's come up every ten years for 200 years - {G}.

Except of course, you're not making that case, so the whole point is moot, and we can ignore that whole issue.

{G} - Jonnan