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The New Moderate’s 2017 Vigilance List

February 26, 2017

Statue of Liberty

What do America’s moderates have to worry about? More than ever, naturally. I’ve been updating this list each year to reflect our current jitters, and 2017 should be more jitter-inducing than most. It’s a long list, so feel free to take a break for food or therapy. Ready? Fasten your seat belts!

  1. A rogue presidential administration. Trump snatched his unlikely victory by exploiting the fears and resentments of Middle Americans. Our first social media president, he can be refreshingly blunt and irreverent. But he’s also divisive, crude, erratic, shamelessly mendacious and recklessly ignorant. A fake populist, he promptly surrounded himself with a pack of plutocrats who must be cackling at the poor dupes who put their team in power. Trump is a flaming narcissist accustomed to running his businesses by fiat, and it shows. He’s railed against the press, issued combative executive orders, alienated allies and cozied up to Putin’s Russia. (The degree of coziness remains to be revealed.) Trump seems determined to favor our business class above everyone else, even if it means ravaging the environment, rolling back social safety nets and stomping on the arts. He’s not Hitler, and he’s not even an ideologue, but there’s nothing remotely moderate about the man. Remedy: Protest the administration’s offenses, join the resistance if you must, but don’t lose your mind. Watch the circus, take restorative walks in nature and wait until 2020 (or until Congress wearies of Trump’s antics and gives him the hook).
  2. Polarization and the hollowing of the center. Extremists at both ends of the spectrum have been battling it out for America’s soul. Worst of all, the middle is losing. (When was the last time one of your Facebook friends posted a moderate political meme?) In an age of sound bites and Twitter tweets, polarization sells. It reinforces our prejudices and bonds us with like-minded folks. But the cost has been prohibitive: we’ve essentially split into two nations. Moderates are the last vestige of objectivity in this sorry spectacle– the last group capable of seeing both sides of an issue. In short, America needs us now more than ever. Remedy: If we moderates have to shout to win attention, so be it: let’s shout. Once we’re noticed, we need to start the hard work of building bridges between the warring factions. Advice to non-moderates: Try to understand the other guy’s perspective. You don’t have to agree; just understand. Don’t borrow your opinions from glib internet memes and biased “amen corners.”
  3. Rampant identity politics and PC. Tribal loyalties have trumped loyalty to country. Every group with a grievance is putting its own interests front and center. Political correctness has crossed the line from a reasonable concern over offending minorities to an almost pathological obsession with white privilege and the punishment of “microaggressions.” Guess what: Now whites are painfully conscious of their whiteness, and millions of them are bonding together as another angry special-interest group. (Nice work, progressives.) Remedy: We all need to take a deep breath, look outside our own demographic boutique, and find common ground with our fellow Americans again. (We’re the United States, remember?) Do we like pizza, baseball, Louis Armstrong? Great. That’s a start.
  4. Worldwide environmental devastation. This shouldn’t be a political issue, but somehow it is. Trump and his henchpeople would like nothing more than to abolish environmental regulations, so they willfully deny the obvious evidence. Climate change denialists, take note: 16 of the hottest 17 years on record have occurred since 2000. The only question is how much of the change is caused by human activity. Whether it’s 25, 50 or 75 percent, we need to take prompt action unless we’d like to see massive crop failures, extensive lowland flooding and seaports that look like Venice. Meanwhile, the world has lost half of its nonhuman animal population since 1970. Developing nations account for much of the destruction when they convert forest to farmland. As they aspire to middle-class status, they’ll be fighting for use of the Earth’s limited resources and driving endangered species to extinction. Eventually we’ll realize that we’ve ransacked a wondrous planet. (And we’re not equipped to start colonizing distant planets just yet.) Remedy: Work with other governments toward establishing and enforcing sensible universal environmental regulations, because the Earth belongs to all of us. And it’s high time that Asian scientists proved the worthlessness of folk medicines derived from endangered species.
  5. The immigrant/refugee crisis. Legal immigrants are fine. Moderate Muslims are fine. Illegal immigrants and militant Islamists are not fine. Why is this so hard to understand? We can’t simply close our borders – or open them to unrestricted immigration; there has to be a sane limit. The rise of American “sanctuary cities” that protect criminal illegal immigrants is the epitome of misguided liberalism. The U.S. and Europe can’t accommodate all the world’s desperate humans. Meanwhile, our rich petro-pals on the Persian Gulf haven’t lifted a finger to help their fellow Muslims. Remedy: A thorny issue with no satisfactory solutions. For now: offer temporary shelter visas for Muslim war refugees and use leverage to force Arab states to accept more of them… impose limits on permanent immigration, enforce them without building walls, and (in the U.S.) make English our official language to encourage assimilation.
  6. Islamic jihad and other forms of terrorism. Terrorists come in all colors and persuasions, but militant Islamists (ISIS, al-Qaeda, Boko Haram et al.) still take top honors in this department. We can’t coexist peacefully with people who believe that God has called upon them to destroy us. Moderate Muslims aren’t succeeding in stifling the jihadists, and the West can’t constantly police the world. Remedy: A massive reformation within Islam to bring it into the 21st century, or at least the 17th or 18th. The bloodcurdling excesses of the terrorists could (and should) trigger such a movement among the majority of decent Muslims.
  7. Right-wing militancy. Yes, this is now a thing. The movement that started among disaffected Obamaphobes has gathered steam with the election of Trump and the inclusion of some choice far-right nutjobs in his inner circle. Now a motley coalition of gun zealots, crypto-Confederates, white supremacists, xenophobes and defiantly un-Christlike Christians has been making trouble for members of racial, ethnic and religious minorities. It ain’t Sarah Palin’s Tea Party anymore. Remedy: Avoid taunting the denizens of the far right and mocking their ignorance; it only inflames them. I know this will be painful for some, but the “nice doggie” approach might be the only way to subdue them. Of course, we still need to prosecute the hell out of them when they actually commit hate crimes.
  8. The rule of moneyed interests. Call it plutocracy or oligarchy or capitalism on steroids — the bottom line is that a self-entitled, deep-pocketed elite is now firmly in charge of our government, our finances and ultimately our lives. The plutocracy is more entrenched than ever despite Trump’s promise to “drain the swamp” and return power to ordinary Americans. Most of our elected representatives are marionettes operated by the powerful interests that fill their campaign coffers. This state of affairs is unacceptable within a representative democracy. Unless we correct it, we’re headed toward a neo-feudal society of latter-day lords and serfs. Jousting, anyone? Remedy: Ban thinly veiled bribes by lobbyists (via Constitutional amendment if necessary), regulate the financial industry, get rid of corporate subsidies and tax loopholes, impose penalties on companies that move jobs away from the U.S. And yes, raise taxes on the rich — especially on income from passive capital gains.
  9. Online amen corners and fake news. Far too many of us gather our news from biased sources that cherry-pick their stories to promote an agenda, distort them with misleading headlines or simply make them up. (Trump isn’t entirely off base about fake news, although of course he blames relatively reliable mainstream media that criticize him.) The comments sections are even worse: echo chambers for opinions that grow ever louder and more extreme as the choir cheers them on. Remedy: Try to fact-check the juicier items before you post them, and don’t restrict your reading to your political home turf. Make an effort to discover moderate and unbiased news sources. (Hey, you’ve already found one!)
  10. Disruptive technologies. You’ve heard the expression, “You can be replaced by a machine.” Well, it’s happening. Within the next twenty years, most of today’s jobs (even doctors and lawyers) could be replaced by automation, the internet and artificial intelligence. How will all those idle citizens survive without work, and how will the nation survive without a substantial tax base? Remedy: We need a new income-generating model desperately. Universal welfare doesn’t suit the American psyche. Maybe we could all sell Girl Scout cookies (or marijuana) to rich technocrats.
  11. Racial animosity. White-bashing has become normalized; nonwhite activists control the dialogue regarding who’s racist (i.e., most whites) and who isn’t (i.e., nonwhites who hate whites). Now white racists emboldened by the Trump revolution are returning the nastiness. Online message boards often teem with vile racial vitriol from both sides. Double standards abound: blacks get roughed up by police and incarcerated more often than whites for the same offenses; on the other hand, blacks are allowed (even encouraged) to criticize whites, while it’s still taboo in polite society for whites to criticize blacks. Sometimes I wonder if we’ll ever be able to coexist amicably. Remedy: Make an effort to see members of other races as individuals instead of symbols. Even better, make friends with them.
  12. American gun culture. Let’s face it: America is a trigger-happy country. The NRA, police, white militias, inner-city gangsters, Second Amendment diehards, lone-wolf lunatics – all seem to revel in the power conferred by lethal weaponry. And their zeal naturally translates to horrific gun fatality statistics. Despite the bloodshed, the NRA crowd still screams whenever anyone mentions tightening access to guns through more extensive background checks. Remedy: Guns don’t kill people, but bullets do. With over 300 million guns already in circulation here, it makes more sense to restrict access to ammunition — especially semi-automatic clips whose only purpose is to dispatch dozens of victims as quickly as possible. As for our police, it’s time they found and used effective non-lethal weapons for stopping unarmed criminal suspects.
  13. Trump derangement syndrome. To say that the left has overreacted to Trump is like saying that Niagara Falls runs downhill. Granted, Trump is a turkey, and the social justice warriors are entitled to resist a rogue president, but let’s be honest: they’ve been even more divisive than Orangeman himself. The Trump opposition has forged a cohesive sub-nation that despises Middle America and uncritically celebrates all the causes favored by elite leftists and their allies. I can already predict the inevitable post-Trumpian backlash, and it won’t be pretty. (Heterosexual white Christian males might want to go into hiding.) Remedy: Try to convince your progressive friends that Trump voters are bona fide humans who simply disagree with them on certain issues (well, most issues) – and that it shouldn’t be taboo to express opinions that dissent from progressive scripture.
  14. Cultural degeneracy. When did Western culture become an exercise in pushing the proverbial envelope? Movies, TV, pop music, video games, high art and everyday behavior have combined to forge a cheap and often loathsome culture that too often celebrates the worst in human nature – the badder the better. Do I believe in having fun? Absolutely. (This isn’t The New Puritan, after all.) But we also need to restore respect for the nobler virtues, or we’ll crumble, as the Romans did, from internal and external assaults that we’re too weak to withstand. Do I sound like an alarmist? You bet. Remedy: Beats me. Sometimes I think Western civilization at its apex was simply too demanding and rarefied for our species to maintain for any length of time. Still, if you have standards, don’t surrender them!
  15. The politicization of EVERYTHING. Art, literature, music, gender, race, families, religion, sexuality, immigration, flags, vaccinations, the environment, women’s bodies – you name it, the zealots out there have politicized it. When we politicize everything, we split into factions. Factions consist of chronically angry people, and chronic anger isn’t good for the nation’s soul (or your own). Remedy: We should all take Voltaire’s advice and cultivate our gardens. It might put us back in touch with the natural world. Politics is an artificial ingredient, and it slowly poisons everything.

Rick Bayan is founder-editor of The New Moderate and author of the recently published Lifestyles of the Doomed, available wherever e-books are sold.

658 Comments leave one →
  1. Anonymous permalink
    February 26, 2017 11:13 am

    Great! Really great! I have a few quibbles but I bow to you oh great Bayan!

    Environmental destruction: Other than the pernicious climate change deniers, and climate change is the mother of all environmental issues besides which the others pale, I can actually see the point of criticizing environmental regulations. They can definitely be over zealous and poorly scientifically grounded. There have been a couple of extreme examples in Vermont lately, one of which, absurd over-regulation of a hydro-electric dam, actually potentially threatens the existence of the Green River reservoir adn the state park surrounding it. This is because, for what sounds to me like greatly oversensitive and over zealous illogic the Agency of Natural Resource, (which was headed until recently by the wife of the leader of a band I used to be in a few years back until we got, thankfully, a moderate GOP governor who sacked her) won’t let the electric company draw down water to the extent that makes the dam economically profitable to run, as they have for a hundred years without any problem. So, in the face of being in violation of their permit the electric company is threatening to remove the dam, period. That would put an end to one of the most beautiful state parks in Vermont, and the wildest. Pure overkill, unreasonableness and stupidity. Another brou-ha-ha involves regulating the levels of a substance found in the no-stick surface on your pans that is not really been shown to be harmful very clearly down to 50 parts PER TRILLION, which is .05 parts per billion. Someone in the neighborhood of a Vermont manufacturing plant has been exposed to that incredibly low level of the flourowhatisis in question and now they are telling all who will listen that their lives have become a “nightmare.”

    The problem with regulations and the regulatory process is that laws and regulations have to be written one size fits all, so that they cannot be abused in either direction and that is Bloody Hard to do. Still, environmentalists frequently do not know WTF they are talking about ( I was an environmental engineer/hydrogeologist for the State of Vermont for 3 years, I met these wackos) and drag the media and environmental agencies into their hypersensitive orbit.

    But, climate change trumps (ouch) all. The denial of the predictions of apolitical international climate science and its smearing is sickening and is contributing to a potential calamity that the perpetrators’ descendents will be the ones to deal with, along with my descendents. Damn those people, literally, damn them. Pompous Al Gore’s big house and flying around is NOT more important than the massive amount of scientific research that has brought us to the dire predictions that are coming true.

    Fake news. Fake news to me really means FAKE news, news that was made up completely by a putin or an outlet like Breitbart as a weapon. It does not mean overblown or incomplete or biased reporting, or reporting something in good faith that turns out to be exaggerated or even almost nonexistent. The perhaps over-excited reporting on the Russian malware code in a Vermont utility computer was NOT Fake News, there was something to the story and the papers ran with it immediately and then the situation may or may not have really been so harmful as was originally implied. trump has really pissed me off with his fake news bullshit, and with Bannon in the WH by his side, an actual fake news specialist. This behavior needs to be destroyed. And it will be. trump-Bannon will be gone sooner or later and the press will remain and people will apply their judgement about who to trust in the news business, just as they did previously.

    Cultural degeneracy “When did Western culture become an exercise in pushing the proverbial envelope?” A very, very long time ago. but trump is a definite warning that we are pushing it to past the point where society will be worthwhile to participate in.

    You touched on one issue in many of your categories, but it could be much more explicit and get its own category: the right-left chasm that will lead eventually to a real civil war and perhaps two separate non-interbreeding biological species, homo leftus and homo rightus.

    • February 27, 2017 3:23 pm

      Roby (I know it’s you): Thanks for the high praise. Funny, I’ve speculated in the recent past that liberals and conservatives, by shunning each other’s company, could eventually evolve into two reproductively incompatible species. I imagine homo leftus to have a large head with an ethereal face, light brown complexion (to reflect racial mixing) and innate allergies to gluten, meat, and John Wayne movies. He takes offense easily and often suffers from nervous prostration. Homo rightus would have smallish eyes (no use for reading or the arts), white complexion (no racial mixing here), bulky build and a susceptibility to paranoia.

      As for environmental regulations, I agree that they can be a pain in the posterior — especially for small businesses. Like you, I’m more concerned about the willful disregard for scientific evidence pointing to climate change and impending extinctions.

      The “fake news” problem points to our incredible polarization. Each side is willing to believe the worst about the other side, even if it’s fabricated. By the same token, each side is unwilling to believe the worst about itself, even if it’s true. (That’s why Trump is so eager to denounce his adversaries in the press as “fake.” He believes he’s great, so he can’t get past the cognitive dissonance.)

      In short, it’s a good time to take up a nice hobby or emigrate to Iceland.

      • March 4, 2017 1:57 am

        Ha!! Love the comment.

  2. February 26, 2017 7:38 pm

    Trump and his “fake news” rants are *really* annoying–and kinda scary. Yes, there is definitely fake news. There is also such a thing as “corporate media”, since about 90% of our media is owned by corporations (which is why I remain skeptical of mainstream media in general). That said, what other ostensibly charismatic (ostensibly, because I find Trump repulsive, but apparently others think he’s charismatic) leader vilified the press? Hitler. Trump’s connections to the so-called “alt right” and thinly veiled (which is apparently enough for many people) fascism is alarming.
    Also, what do you think of protests and riots in order to oppose the aforementioned so-called “alt-right”?

    • February 27, 2017 6:00 pm

      Alex: I’m not sure how much of Trump is actually Trump and how much is Steve Bannon pulling the strings. Either way, we have an administration that’s flirting with fascism. I don’t think you defeat the alt-right mentality by protesting. (They don’t respond to liberal persuasion.) As the saying goes, don’t poke the trolls. Trump may have emboldened the alt-right to some extent, but the left is also to blame for casting conservatives as “deplorables.” So we might start by voting both far-right and far-left politicians out of office. Next, we need to build bridges between the cultural right and cultural left. It won’t be easy, but we need to find some common ground to take the wind out of the hatred on both sides. I’m probably too idealistic, but I can’t think of any other answers.

      • March 1, 2017 2:04 am

        Sadly, I just might have to agree that the alt-right don’t respond to liberal persuasion. Sadly, because I support the notion of peaceful protesting (peaceful until directly provoked). I still support it from the stance that, even if the alt-right does not respond positively, that shows their failing, while we’d still be acting with dignity. I always grew up with the idea of taking the high road, of being the better person and letting the enemy make fools of themselves. I do like your point about how it’s also the left’s fault for vilifying the right. We need to eliminate the extremes as much as possible, kicking them out, although it’s my perspective that humanity deals in extremes, in absolutes, which will always return eventually. I’d love to try building bridges, although I’m also not sure how. The rising fascism in our society, and the way our government keeps leading it on, is truly scary, though. I do have one more point, though: I see your point about Bannon calling at least some of the shots, and I agree with the possibility, but at the same time, I struggle to believe that a guy like Trump would let anyone else call the shots. He’s a narcissist. I was trying to describe him one day and accidentally started using Stark’s depiction of Loki, with similar response: “Loki’s a full-tilt diva. He wants flowers, he wants parades, he wants a monument built in the skies with his name plastered…sonofabitch!” Except that I actually like Stark and Loki better, and not just because they don’t look like Cheetos with a toupee made of corn hair. Would a guy like Trump ever actually let someone else call the shots, control him, usurp his authority?

  3. dduck12 permalink
    February 26, 2017 9:12 pm

    I greatly admire your well thought out list, Rick.
    I don’t know, it hasn’t yet, and if it isn’t too long to appear, on the “fake moderate web site”. I hope it does, they could use the exposure, not that there aren’t some smart folks over there, but tribalism is like a black hole when the other side speaks.

    Your list order, by the way, is probably subject to each of our individual views, circumstances and demographics. Being a NYer I shouldn’t care much about the disappearing water in the rest of the country, but I do. And, the great the NYC air quality nowadays, makes me really feel sorry for places like Mexico City and cities in China. On top of that, the prospect of giant ice cubes the size of Maryland wiping out vast worldwide coastal areas, including Mar A Lago, causes me to elevate your #4 to my #1.

    • February 27, 2017 6:05 pm

      Thanks, dduck. You know, I tried to post the list on TMV, but for some reason my old password wouldn’t work. I know Joe G. had problems with hackers and had to renovate the site, but maybe it’s just as well. Joe is a good guy, but the readers over there tend to get hysterical over the slightest criticism of protected groups (LGBT, blacks, Muslims, etc.).

      As for the environmental issue, it’s undoubtedly the #1 long-term concern. But wouldn’t it be karma if Mar-A-Lago got inundated by rising sea levels?

  4. February 27, 2017 12:46 pm

    Rick, in case my previous message sent on February 26th shows up then this one will be a second comment. Not sure what happened with Word Press or my comment that went into the cloud and never materialized. (Or maybe I am being moderated after my comment to Jay to shut up)
    Looking at your list for 2017, two things stand out to me.
    One, every one of them is based on divisive politics. The President was elected because of division in America and even division in the democrat party. They furthered their division after Perez was elected to head the party and he picked Ellison as his assistant director. How do they bring back the left of center democrats when they keep moving further left and how do they defeat Trump with coastal politics. The middle is not losing out to extremist politics, the middle does not care anymore. You can’t lose something if you don’t care! If you drop a dollar bill, know you dropped it and keep walking, you did not lose it, you didn’t care!When we have the smallest voter turnout in years that creates an electoral college president, middle America does not care. If they did care, we would not have had Clinton nor Trump as candidates. Where are the centrist in both parties willing to challenge the extremes? Immigration, gun control, deforestation in the rain forest, climate change, LGBT bathroom/locker room issues, all are issues based on the polarization of everything in politics and created by the two parties that offered the two worst candidates in history for that office. And those two candidates were a product of middle America not caring.
    Two, there is little in the way of substantial changes to make America strong and financially solvent in your 2017 list. How do we handle healthcare coverage that is going down the toilet under its current makeup. (Republicans can allow it to destroy itself or the can come up with something different, either way they own the outcome). How do we handle tax reform without increasing the deficit? How do we handle China and its monetary manipulation that helps feed the trade imbalance? (for instance, instead of a border tax, how about eliminating the ability to deduct the cost of good sold that comes from a foreign country, while allowing that for any American produced product or products where more than 50% of the cost is due to American manufacturing) How do we continue to protect the environment, but eliminate the idiotic application of regulation like wetland regulations that forbids the moving of rocks or plowing a wet spot in a farmers field that may hold water for a couple days after a rain?
    Middle America does not care! If we did, we would be taking on the extremist on both sides in social media, town hall meetings, demonstrations and other public and social gatherings to make our thoughts known. And there would not be slightly more than 56% of us voting if we cared!

    • Anonymous permalink
      February 27, 2017 1:59 pm

      Excellent. Its a cycle, the uglier it gets the less many Americans care.

      Turning and turning in the widening gyre
      The falcon cannot hear the falconer;
      Things fall apart; the centre cannot hold;
      Mere anarchy is loosed upon the world,
      The blood-dimmed tide is loosed, and everywhere
      The ceremony of innocence is drowned;
      The best lack all conviction, while the worst
      Are full of passionate intensity.

      Yeats, 1919.

      • Anonymous permalink
        February 27, 2017 2:00 pm

        A is Roby. Lost my login password.

    • February 27, 2017 8:24 pm

      Ron: Well said. You’re probably right that most of the items on the list are the result of polarization. What happened to the great, sensible mid-region of American politics? Well, aside from this site and a few others like it, there’s virtually no representation in the media or elsewhere for a strong centrist point of view. No magazines, no famous pundits, and lately, no high-profile moderate politicians. There are fairly neutral, reliable newspeople like CNN’s Wolf Blitzer, but they don’t bill themselves as moderates.

      I wonder if the big split began with the “point, counterpoint” style of public debate in the media. It’s as if Americans can only handle a “binary” style of opinionizing — it’s simple, clear-cut, unambiguous. They don’t want to deal with shades of gray. Plus, it’s so much more fun to rant with one’s ideologically compatible friends.

      You’re right that apathy plays a role in the hollowing of the middle. As non-fanatics, most moderates simply don’t go ballistic over politics the way leftists and right-wingers do. When I started The New Moderate, I was actually hoping that my colorful commentary and impassioned attacks on extremist politics would start a movement. Well, that hasn’t happened. But I’ll keep plugging away.

      • February 28, 2017 1:05 am

        Rick a couple of followup comments. You commented to dduck about the environment being one of the most important issues. What makes me resist the environmental movement in this country (green energy, mileage standards, etc) is the fact the liberals portray the problem as being 100% caused by Americans and Americans are the only ones that need to sacrifice. One only needs to look at China and its rapidly growing dependence on coal for power where CO2 has increased multiple times since the 90’s, central and northern South America as well as other areas of the world where deforestation has had major negative impacts on the climate and other human actions that have contributed greatly to climate change while America has decreased considerably its CO2 pollutants over the same period of time. But this goes to the “fake news” and the liberal leaning news that will not report the complete story and expects Americans to pay for the changes required in the rest of the world to save the environment.

        Your Point #2 “As non-fanatics, most moderates simply don’t go ballistic over politics the way leftists and right-wingers do. ” Most moderates do not give a hoot about Russian hacking, Trumps tax returns or any of the other 101 things the liberal press is attacking Trump with. Moderates care about rising healthcare premiums and the failing Obamacare program, they care about rising taxes and the wasteful spending in government, they care about the failing social security and Medicare programs, they care that the government now calls social security an entitlement program when the mismanagement of assets in the program has led to this failure and they care about the loss of jobs to foreign countries. They care about the failure of our education system, the rising cost of a college degree that puts one in debt for years after graduation and the fact many can not find work once they get the degree. They care about inner city minorities that white folk think need a college degree to succeed causing the removal of trade programs in schools and those programs being replaced by college prep programs for everyone. They care that trade programs that lead to good paying jobs using ones mechanical skills are no longer available. This privileged thinking has lead to increased unemployment within this group since the training for this work they are interested in doing is no longer available which causes more jobs to move overseas.

        No one in government is listening, And that led to Trump with all his baggage. Even with his high negatives, recent polling that was not covered by the press, but was included in the recent polls shows a double digit improvement in how Americans believe the economy is doing and the direction the country is moving. Moderates care, they are just smart enough to ignore the crap on the far left and far right and support the things that really are important. The problem is we are losing the Lieberman’s while gaining Warren’s. This is where we should be scared to death!!!!!!!!!!!!

  5. dduck12 permalink
    February 27, 2017 4:33 pm

    @Ron P, 12:46: Good moderate rant.

  6. dduck12 permalink
    February 27, 2017 4:38 pm

    Rick, I liked your description of the evolved right and left. Which future party would create special camps where interbreeding would be mandated?

  7. Linda permalink
    February 27, 2017 10:23 pm

    Your list is really long but I’m glad to see it went past some of the same old, same old. The Politicization of Everything and the Trump Derangement Syndrome go together for me. Abhorrence of all things Trump–his voters, what they like, eat listen to or any any part of their being, has made life really hard to live in Trumpland. Very tiring.

    Also thank you for providing a remedy for every problem. I’m always reminding people don’t complain unless you’ve thought about a solution.

    • Priscilla permalink
      February 27, 2017 11:07 pm

      “Abhorrence of all things Trump–his voters, what they like, eat listen to or any any part of their being, has made life really hard to live in Trumpland. Very tiring.”

      Yes. I can imagine.

    • February 28, 2017 1:22 am

      Linda,” Abhorrence of all things Trump–his voters, what they like, eat listen to or any any part of their being, has made life really hard to live in Trumpland. Very tiring” .I can say from one that refused to vote for Clinton and did not vote for Trump (but I did vote), it has taken me hours to block sites that liberals are posting to social media and filling my Facebook with anti Trump crap. It is also very tiring to see the rants from the left concerning Trump when there is little they can do for the next 3 years (until the next election cycle). What you are experiencing from a left leaning standpoint, we are also experiencing from the right leaning standpoint. With social media and the nonstop news on cable TV, it is impossible to escape political comments one may agree or disagree with. For everyone that is not a Trump supporter or is a moderate that understands he is president for 4 years, yes it is very tiring.

  8. dduck12 permalink
    February 28, 2017 1:18 am

    @Ron P, 1:05: Sorry. this rant was not so good. Global change is real and I don’t care who or what, or how, I want it slowed down. What moderates think, feel or care about is not all the same for all of us, so your generalizations may be inaccurate.

    • February 28, 2017 1:29 am

      Could be. I think China’s increasing use of coal is leading to climate change. You may not.
      I think making our cars get 45-50 miles per gallon or whatever the new standards will not have any impact on China. You may think it will reduce Chinas CO2 output.

      See next comment since it has another link

    • February 28, 2017 1:34 am

      dduck…2nd comment ,You might not think deforestation has an impact on the climate. Scientific data show it does.

      So what I think is you and I can debate until hell freezes over about environment issues and clean energy in America and it will have the same impact on the sea levels as me peeing in the ocean if the developing nations do not change their ways. What happene in China and other developing nations will have a far greater impact on the climate than most anything we do here.

      • Anonymous permalink
        February 28, 2017 10:14 am

        Ron, first of all your comments imply that you are not a denialist. Second they imply that you realize how large the problem is and how hard it is to change.

        In general, on the right you have large number of denialists, on the left you have a large number of people who think that using better light bulbs will have a noticeable impact on the problem. They are both wrong, but which group is doing the most harm? The denialists are enough to make me scream. But, it won’t do any good.

        When I first really got interested in looking pretty deeply into this issue (2006), the US was still the leading emitter of human caused greenhouse gases, while China was catching up fast. The statement of the climate science community then was that at the rate we were making these gases we needed to cut the entire human output by 50% to achieve a level at which natural sinks for CO2 would bring us down as a species to the pre human impact level over a 100 years, via absorption and conversion . At that date, China and the US together were producing approximately 50% of the total human output. So, you would have had to remove the American and Chinese populations from the earth to hit that neutral point. Clearly, not a possibility. What the left does not realize is that if you Don’t make that truly drastic 50% reduction then you just will achieve the same dismal CO2 levels over time, just a bit more slowly. Yes, Ron, I agree with you, it would take having the entire human race, all the countries making a combined heroic desperate effort to actually avert a steadily increasing CO2 level and all its predicted impacts.

        But I don’t agree with you that it does not matter what the US does or what position we take. We are the largest most powerful country in the world. As such we are in a leadership position. As well, the Chinese are making things for us while they burn their coal. Whatever small chance there is of humans as a species getting a hold of this problem and truly facing it vanishes to near zero when conservatives win control in the US and we go back to the disgusting global warming is a hoax routine.

        Spring is allegedly 21 days ahead of schedule in my part of the country this year. I am driving my convertible again, it was 73 in Burlington on Feb 26. Killer tornados hit PA. Until the effects of global arming/climate change become nearly intolerable, for example, the tornado and hurricane zones become constant weather disaster zones, crops fail, etc. the denialists in the US will win out most of the time and prevent any chance of seriously facing this. It makes my blood boil, but there is little I can do about their phony climate religion and contempt for an inconvenient climate science until nature plays its cards even more clearly.

        Read the whole thing if you have time:

      • February 28, 2017 12:50 pm

        “A”, please see my comment today to dduck. You are right, I am not a denialist. But I guess i am a “common sense realist” that does not exist in the political arena.

        For instance, you can not take 6%+ from employee wages, match that with employer money (13% total), use that to fund the government through an IOU, pay 1%-3% interest on those IOU’s and expect to have enough money to fund retirement when that person retires. Every person with any iota of investment knowledge knows you need close to the stock market returns to have enough in retirement to live. But now we have government saying SS is a “entitlement” program because they pissed way most of the money. Had anyone in a fiduciary position done the same thing to private funds, they would most likely be facing legal issues.

        The same goes for CO2 emissions. What good does it do to reduce 17% in America while China increases over 400% in the same period of time? I agree we needed to reduce, but why give China basically a free pass? That is not using common sense when agreeing to idiotic agreements.

        And the same goes for many other agreements our government gets into. Total incompetence!

      • Anonymous permalink
        February 28, 2017 1:50 pm

        Ron, yes you are a realist on climate change, and I wish we could could get the country as a whole to that stage, it beats the hell out of the war between deniers and naive hippies as I call them. Realism is our best hope.

        Your comments about China make a lot of sense but there is more to the story. Yes, the agreement is asking more of the US in immediate cuts than of China. China is a 3rd world economy regarding most of its population and is expanding its economy full tilt to change that. So, they cannot just stop their economy on a dime, they are going to continue to use coal in the coming years and are not about to call their economic development to a screeching halt. Getting them to agree to modernize their energy types so as to peak in 2030 was not as incompetent. It sounds unfair yes, but you have to look deeper. Climate change will affect China as much as anyone, and Chinese scientists are not skeptics. The Chinese government understands that climate change will hurt them. They have to phase in their efforts, there would be a revolt if they just pulled the plug on coal and their economic growth. The US has a first world economy of a very different nature and has more immediate ways to reduce emissions. We are ahead of them by 50 or 100 years in our economic stage.

        This is a pretty good explanation:

      • February 28, 2017 2:27 pm

        I guess I am not as open to any country increasing their output to where they will be producing themselves in 2030 what the whole world is emitting today. I understand there has to be some allowance for a rapidly growing economy, but there are underlying reasons why China is growing at 7%, while the USA is 2%. (But we can discuss that another time). But I find it very interesting that in the article you shared, there was no mention of “clean energy” such as wind and solar. ( It did mention nuclear) Do they not have sun shining on China or do they not have any wind? Why are we expected to increase our energy cost for consumers while expanding wind and solar, while China can build dirty plants and grow their pollution astronomically, while our government is spending money to fund alternative energies.

        Is it not time that China invests more in clean energy than they are in coal? They have a much cheaper wage base to produce wind turbines and solar panels so their cost to covert to clean energy is much less than ours?

        “The US has a first world economy of a very different nature and has more immediate ways to reduce emissions. We are ahead of them by 50 or 100 years in our economic stage.”….

        This I would like to see more information on. We have coal plants built in areas of the country where wind and solar are not reliable. T Boone Pickens has said he is willing to invest in alternative energy if he can get the transmission lines to where these forms of energy would be produced. All of our transmission lines now are located in areas not useful for wind and solar. China started out with few plants and few transmission lines, so they could have gone with wind and solar now and built transmission lines from those locations. They will have the same problem in 30 years we have today. The distribution system will be in the wrong place for clean energy production.

        Or could it be wind and solar are a brain fart of thinking and will never be able to provide anywhere near the energy the world needs to provide for the world economies?

  9. dduck12 permalink
    February 28, 2017 1:51 am

    Where’s the beef? I believe in all of those things and more. Like fracking draining good water and other uses sucking our aquifers dry and causing earthquakes in Oklahoma. Of course China is a big pollution generators, but we still need to have an attitude that the whole world contributes to the problem. We have to do our part to slow things down in the U.S. Ignoring nuclear energy while continuing fossil fuel use and relying on solar and wind to carry the load.

    • February 28, 2017 12:34 pm

      Maybe I gave the wrong impression concerning environmental issues. Yes, I am concerned about the environment, but when issues arise and immediately we are required to do something in America that the rest of the world is not required to do, it then becomes a political hot potato. We have required our energy providers to spend money and increase costs for consumers through the elimination of coal powered plants, while China has increased the number of plants, that are not even clean coal, and have increased pollutants hundreds of times. This has caused increased cost to Americans, cost jobs in America since manufacturing is cheaper in China because of cheaper energy along with wages and has increased CO2 pollutants since more manufacturing is in China where energy is dirty.

      There is a better way than the knee jerk reactions that some here expect us to jump, while other countries are basically ignored. Just look at some of the agreements. The Paris agreement on CO2 decrease provided a 17% reduction target for the United States based on 2005 levels. That was total CO2 emissions. China, on the other hand was targeted with a 40-45% decrease per unit of GDP from their 2005 per unit of GDP emissions. The GDP of China has grown from $2.286 trillion in 2005 to $11.202 trillion in 2016 or 500%. This means that over this 11 year period, the United States has had to reduce emissions by 17%, while china has been allowed to increase emissions by 455% (500% GDP change less 45% change per unit of GDP).

      All I am saying is we need a level playing field. If the USA has to reduce 17%, then that same percent should apply to all countries. If the GDP increases in America and we have to reduce 17% regardless, then China should have a total reduction amount comparable to America regardless of their growth in GDP.

      As for environmental issues in America, they also need to be revised to address regional and local regulations. Fracking needs to be regulated by the states or by a regional authority, not out of Washington. Fracking in OK may cause earthquakes, but may have no impact in other regions of the country. Water regulations in the west are different than water regulations in the east. how much can farmers use in California is much different than the needs in Florida.

      We need sensible regulations and agreements, not one size fits all.

      • Anonymous permalink
        February 28, 2017 2:29 pm

        This graph looks a bit different:

      • February 28, 2017 4:43 pm

        Somehow we interpret data in different manners. The USA is at about 6000 units (or whatever the measurement). We were at 6000 in 1990 and we have been basically flat for 20 years. China on the other hand was at 3000 units in 1990, was at 11,000 or so in 2016 and is projected to grow to 14000 in 2030. And this is total emissions that include most everything, not just energy production.

        So it appears that China can add 466% to its output since 1990, the USA has added nothing since that period. We are at 50% of the Chinese output today and will be at 40% of the Chinese output in 2030. The fastest growing car market is China with current sales of 12.5million cars and small trucks compared to America with 17M sold. And the Chinese market is projected to increase substantially in the future with the continued growth in the Chinese GDP where they will become the #1 purchaser of cars and truck in a short period of time.

        According to Forbes Sept 6, 2016, “Although China has been widely expected to be primarily a small car market, actual experience so far suggests otherwise. Sales of large cars have been booming, suggesting that many Chinese consumers are more concerned about safety than they are about price and operating costs. Large cars are inherently safer than small cars, and the Chinese have been quick to understand this tradeoff.”

        So here again, we are expected to buy small cars that families can not use for long vacations, are not as safe for families when in accidents, or buy electric that have mileage limits of 300 miles or so before a recharge, all while the faster growing polluter in the world is selling big cars and trucks at a remarkable growing rate.

        So those are a couple of my reasons that I have a negative view on our energy programs and the standards we are placing on our industries and products. Climate standards is a two way street. Today it is a one way street with all the regulations leading right into America for the most part. Make it run two ways and maybe more people will support government regulations that they don’t now.

      • Anonymous permalink
        February 28, 2017 5:08 pm

        You have a real point. However, you are considering the emissions by country, not factoring in population size differences. So, you could also consider emission per country per capita. We are at roughly 25 tonnes per year per person in the US, China, 4 tonnes per year per person. There are many ways you can look at this.

        The 2007 financial panic had a noticeable impact on our emissions. So did the collapse of the USSR on their emissions.

        I don’t know about being expected to buy small cars, who is expecting it? Activists etc. perhaps but that has no legal effect.

        The columns here are sortable:

      • March 1, 2017 1:03 am

        Yes numbers can be used to support many different ways to look at data. What I find unbelievable is china building coal powered plants when it was clearly a high CO2 polluter. They had the opportunity to go with clean energy and not increase their output so substantially. They also have had years to implement vehicle emission standards and they are now just putting them into effect for 2020 . They still have high carbon emissions from factories they do not regulate. Its like someone with a building with severe limitations to fit their needs and the building burns down. They have an opportunity to rebuild with the limitation being eliminated, but they pull out the old plans and have the building rebuilt using bad plans. China had the opportunity to increase energy and clean their air by using new technologies, but they pulled out the old plans and built inefficient and high pollution plants.

        As for the cars we have to purchase, few are anything but mid sized 4 door sedans with small trunks that can hold two large or three small suitcases. Families of four traveling for a weeks vacation have much more than three small suitcases, So they have to buy larger SUV’s. The reduction in car sizes is due to the mileage standards that require cars to get a certain MPG and to accomplish that, car weights and sizes have been reduced. There is no legal requirement to buy smaller cars, but when there is few larger cars on the market like those in the past where 5 people could travel comfortably, the choice is reduced due to regulations indirectly. So now the majority of cars sold are not cars, they are truck (SUV’s) that defeats the mileage standards, but also increases the chance of bad injuries when the collide with smaller cars. And then looking at California with much higher standards, much of any producers sales has to be electric or hybrids. Those have severe power needs or reduced miles. Your lucky to drive from LA to San Francisco in a Chevy Volt without plugging in somewhere along the trip if you can find a place to do that. And then the time for recharge is much greater than filling a gas tank.

      • Anonymous permalink
        February 28, 2017 5:13 pm

        As well the agreement you are talking about did not start in 1990 so it isn’t an appropriate comparison date. Start from the date of the agreement. Illegal immigration BTW has a considerable influence on US emissions, by converting a 3rd world Mexican who’s per capita gas emission is about 5 tonnes per year to an American, at 25 (anyhow in a generation or so) that is not a small factor. Now, there is an issue to confound the left with.

      • March 1, 2017 1:17 am

        2010..USA 6500 units, 2016 USA 6500 units, 2030 USA projected is slightly less than 6500 units.

        2010 China about 8500, 2016 about 12,000 units, 2030 about 14,000 units.

        So the USA is flat and China increases 64%.

        Sorry I have a problem with the largest polluter now being able to increase their pollution by 64% and our politicians are blaming us for global warming and slapping regulation on us without demanding the same from China. I don’t mind paying more for energy or paying more for products as long as other people in the world have the same regulation field to navigate. But right now China is not in the same ball park as we are in.

      • Anonymous permalink
        March 1, 2017 10:05 am

        “2010 China about 8500, 2016 about 12,000 units, 2030 about 14,000 units.”

        So, from 2010 to 2016 their output went up by 43% or roughly 8% per year (as a rapidly growing industrial 3rd world economy) and the projection from 2016 is for a total of 16% growth or roughly 1% per year.

        I don’t mean to sound like an apologist for China, but that to me sounds like they are committed to make a very significant change.

        The cars you are looking for don’t exist any longer not because of politics or lefties or environmentalists but because they were replaced by SUVs, some of which are as enormous as you could want and would handle any amount of luggage, more than an old style Cadillac or Lincoln Continental ever would. This change from luxury enormous sedans to luxury enormous SUVs was driven by consumer demand. There are also gigantic trucks that could haul a platoon and its luggage. All that certainly did not do anything to bring down American energy use and greenhouse gas production.

        Some subset of American politicians may blame Americans for global warming, if so its because of our strong denialist conservative politicians and their denialist base and because Americans are using energy per capita at a fantastic pace, as we saw, 6 times faster than the Chinese for example.

        Ron the important thing to me is that you are not a denialist and are a realist who will gather actual facts and numbers and have a rational discussion. We have found what we agree on and what we don’t agree on (unless I just persuaded you with my numbers) and I am satisfied to leave it there.

      • dduck12 permalink
        March 1, 2017 10:12 pm

        One picture is worth a 1000 words and this was my world growing up. Then, without looking at China, somehow things got better. Improvement starts with attitude from oneself:

      • March 2, 2017 1:12 am

        dduck, I don’t have any problem with sensible regulations. I grew up in LA (before the liberal invasion) and I know what bad air is like. Your lungs burn when you exercise, your eyes water from the burning of the air. There were many times I had to pull off the road when driving home from college daily and wipe my eyes because they were burning so bad and I could not see where I was going. I understand the need for clean air and clean water.

        But I also understand sensible solutions. We have people fined for plowing fields when someone decides a puddle is more than a puddle in a field.
        This is not sensible. It is government run a muck. Then you have water problems like Flint Michigan where the government totally screwed up from the locals to the feds. That is not sensible.

        As for my position on China air pollution and our cutting more than they are, my position is like you and I owning property on a secluded river, with your property in one country and mine upstream from yours in another county. Both have houses and both have septic tanks. Both septic systems are broken and discharging raw sewage into the river. Your county comes by and orders you to fix your septic tank now at a cost of $10K, but mine comes out and says that due to this county being more rural, I have 10 years to fix my system. Remember, you’re down stream getting polluted water from my system and because two counties have different rules, your water is fouled and I can take water above my discharge so I have clean water. That is the same as China discharging more crap into the air just because they are more of a third world country and just now developing. The air is still getting polluted for another 15 years before anything changes. And another 15 years of their growing air pollution will only add to the already severe problems we have based on some scientific data that has been released. If Co2 is really a problem and the polar regions will be ice free in a few short years, the oceans will rise until NYC and Miami are underwater and the temperate climates will be native to New England, then there ARE NO EXCUSES for any country growing their output, regardless of economic development. Right now this is all political and no one in politics really cares. They just run their mouths trying to attract votes from those that support their positions, all while supporting the corporate interest that have plants in China that do not want to clean up their act..

  10. Priscilla permalink
    February 28, 2017 12:15 pm

    Rasmussen today has a poll out, indicating that a substantial majority of Americans( 63%), from both parties, think that it would be better for the country if Democrats would try to work with President Trump. 29% say that it’s better if Democrats oppose every thing that Trump does.

    Even when respondents are broken out by party, only 44% of Democrats say oppose everything, and 46% say try to work with him.

    In a sane world, it would be unnecessary to even have a poll like this. What possible benefit to the American people is there to having a government that does absolutely nothing but have intra party power struggles?

    I think that this narrative all started with Obamacare. Republicans wanted a bigger say in the way that the law was written and passed, and Democrats were in a position to deny them that say. There was a clear message from both parties ~ from Democrats: “We won, screw you and your voters”…..from Republicans “If that’s the way you feel, screw YOU, we won’t work with you at all, and you’ll own this turkey.” And the idea of compromise and consensus became some pie-in-the-sky fantasy from the past.

    Politics is blood sport, but governing shouldn’t be. There is literally no upside to what has been happening for the last 10 years, and continues unabated. Of course both sides are to blame, but the hypocrisy of Democrats who whined and wailed incessantly about the “party of no” now claiming that they will “#Resist” (can’t forget the hashtag) every single damn thing that a newly elected president does is beyond parody. Get over it.

    Again, I’m not letting the GOP off the hook. Trump has been largely opposed by both parties. The Bush’s famously didn’t vote for him (except for young George P., who clearly has national aspirations), the press has been trying to set up a cage match between Trump and Ryan, almost since election day, and it’s obvious that there will have to be accommodation between the two, if anything is to get done. It’s not at all certain that Trump’s own party will support his aagenda.

    But, if this Rasmussen poll is correct, most people don’t give a rat’s behind if Trump is an inarticulate moron, as long as he is able to reassert American influence internationally and, most important, grow the economy more that the anemic 1-2% p/year that it has been growing.

    How does this rant connect to Rick’s essay? Well, I don’t think that it’s extremism that is our main problem. And I think that the center is still holding. But the people in Washington, hungry for power, don’t care, and the news media finds the blood sport of politics more interesting than the nitty gritty work ~ and slow pace~ of governing by consensus.

    • dduck12 permalink
      March 2, 2017 11:49 pm

      Ron P, 1:27. You could have stopped at “I have no problem with sensible regulations” Bam, we are on the same page. 🙂

      • March 3, 2017 12:16 am

        Sorry, sometimes I like to hear myself talk (See what I write).

  11. Priscilla permalink
    February 28, 2017 1:26 pm

    **INTER party power struggles**

    • March 1, 2017 12:46 pm

      “What possible benefit to the American people is there to having a government that does absolutely nothing but have intra party power struggles?”

      Priscilla, I asked myself that time and time again when the Republicans blocked everything Obama did, merely because of the color of his skin. At least Trump has actual massive character flaws to detest.

      It is really hard to “come together” with a party that behaved so despicably.

      • Priscilla permalink
        March 1, 2017 7:45 pm

        Well, Moogie, I can tell you that I opposed Obama based on his ideology and policies, and my opposition had nothing whatsoever to do with the color of his skin. Accusing the Republican party of being a party of racists is what Democrats do because when they can’t defend or argue their case on the merits.

        And, for the record, Obama had two full years in office with a filibuster-proof majority in Congress. The Republicans could not block a single thing that he wanted in terms of legislation. He got a gigantic stimulus bill, which turned out to be one of the greatest boongoggles in history (“the shovel-ready jobs weren’t so shovel-ready), Dodd-Frank, often called “consumer protection for billionaires,” and a law that wiped out many small community-based banks, and helped the big banks get bigger….and, of course Obamacare, the now collapsing government-controlled health insurance plan that has put millions more on Medicaid and driven health insurance premiums through the roof.

        Add to that the ballooning debt and….well, it’s not racism that caused Obama to be unsuccessful.

      • March 14, 2017 5:30 pm

        While I was working at the inner city school, I had to endure many comments from my white friends that were racist – although I’m sure they wouldn’t think so. Sometimes I called them on it, most of the time to keep the peace I didn’t. I now think that was a mistake. I should have talked more, and am doing so now. Extremely few white people do what I did – put themselves as the white minority in a working (or living) situation. You can’t see your own racism until you do – if even then. There is way too much defensiveness from white people.

        Obama was very successful, and those of us who aren’t racist can see that. All you do is keep repeating the same tired BS that conservatives have repeated for 8 years now. Please go find some real news, and quit watching conservative “media”. That is the real joke.

      • dhlii permalink
        March 14, 2017 7:26 pm

        I do not know you and I do not know the situations you describe.

        But far too often when someone today accuses someone else of racism – they are the problem.

        Trump was elected – because exactly that kind of identity politics has gone too far overboard and failed.

        To many of Trumps supporters grasped that when people were calling him Racist, because he wanted to reign in immigration – that those calling him racist, were calling them racist too.

        If I tell you that if we compare the US to the EU by racial groups – that violence in the US is no different than the EU – is that racist ?
        It happens to be fact.

        Charles Murray – a libertarian was chased out of middlebury college and people were assualted and he was identified as a racist – for publishing a book 40 years ago that noted that the IQ’s of different races were disparate – even when adjusted for environmental factors.
        Is that Racist ? It is also a fact.

        When we can not accept unpleasant facts – because those facts might be used in a “racist” way. we make it impossible to address and correct problems.

        I grasp that there is an issue with police violence today.
        And I have two asian children, so I am pretty clued into the fact that they might not be treated the same by the police.
        At the same time – police shootings have DECLINED over several decades.
        What has changed is we are far more likely to have video of them today,
        and from that we are learning that many instances of police violence are either dubiously justifiable or entirely unjustifiable.

        The demographics and statistics demonstrate – there is no statistically significant racial component to police shootings.
        Blacks are killed by police in the same proportion as whites – out of the population of raciallly identified crime reports.
        Blacks report blacks committing crimes at about twice the rate of whites.

        When we decide the problem is racism – we preclude other explanations.

        I personally think that the disparate rates of violence by race might have something to do with 70 years of government policies destroying black families and institutions.

        I suspect that Liberal Lion Sen. Daniel Patrick Monihan likely would agree.

      • dhlii permalink
        March 14, 2017 7:39 pm

        Obama was successful ?

        Look he was a nice guy – but successful ?
        By what metric ?

        He presided over the worst recovery since the great depression – in fact by some measures the Obama recovery was worse than that of the Great depression.

        He promised numerous things – and failed at pretty much all of them.
        Gitmo was still opened when he left.
        The federal government was less not more transparent.
        We were engaged in more not less spying.
        Pretty much anything the left thinks Bush did wrong – Obama doubled down on.

        We had an 8 year period with sub 2% growth. I do not think that has EVER happened in US history before.

        PPACA is failing in front of us – whether you are on the left or the right, whether you want it to work or to fail, there is zero doubt it has NOT lived up to expectations.

        The TRUTH is exactly the opposite.
        Obama has faced LESS criticism because he was black, because people did not want to be accused of being racist.

        And I think your inability to see Obama as the poor president that he was demonstrates your inability to make good judgements in a context that involves race.
        That is a complex way of saying – you are a racist.

        I have noted that my kids are asian. My daughter gets infuriated when people say she must be good at math and science – she is chinese.
        She is not good at either. She is very good at some pretty non-asin things – like photography, or people skills.

        She rants about people’s racism – when they decide she must be good at things she isn’t, because she is chinese.

        Obama was a poor president. Not because he was black. But because he allowed his broken ideology to color his choices and he made poor decisions.
        He probably was no worse than George Bush.
        Bill Clinton increasingly appears to be a pretty bad person. But he was a pretty good president.

        It is not racist to accurately assess people who belong to a minority.
        It is racist to inaccurately assess them – either to credit them when they do not deserve or the deprive them of credit they do – both are racist.

  12. March 1, 2017 12:43 pm

    “they’ve been even more divisive than Orangeman himself. The Trump opposition has forged a cohesive sub-nation that despises Middle America and uncritically celebrates all the causes favored by elite leftists and their allies.”

    Lordy, this moderate site leans right. You’re about to fall over.

    I guess it depends on where you live. Here in Appalachia, where Trump has been celebrated as the second coming, 75% of my county voted for him…it is anyone who is not totally right wing that is demonized. Long before Trump I was censored for not being lock-step anti-abortion, anti-Obama (anti-black), anti-gay, anti-tax, anti-regulation. There is no thinking in my area, just lock step with or against us.

    If it wasn’t so heartbreaking I would laugh…to say that the left despises Middle America. A huge portion of Middle America is moderate and left. Hillary won the popular vote. That is where most Americans are politically.

    “Celebrates all causes favored by the left?” Like protecting a woman’s right to choose abortion while encouraging PREVENTION of pregnancy in the first place? (go to any “pro-life” site, they won’t give you any information on birth control.) Like protecting the environment, so our grandchildren will have a clean planet? Like demanding higher wages from corporations we all know can easily afford it? Like making sure everyone gets healthcare?

    Say what you will, but the majority of our problems politically were created by 30 years of conservative “media” dumbing down the population, teaching everyone that only their views are the true ones. I worked during a Fox News takedown at a major satellite company, and talked to literally hundreds of Fox viewers. Fox preaches gospel to them. If we were to return to some evolution of the Fairness Doctrine, or start suing the news for falsities we might get somewhere. There are NO huge numbers of lazy poor people out there. (There are a few) There is NO massive fraudulent voting by illegals. How can you have an intelligent discussion with people who don’t know fact from fiction?

    • Priscilla permalink
      March 1, 2017 7:52 pm

      “Long before Trump I was censored for not being lock-step anti-abortion, anti-Obama (anti-black), anti-gay, anti-tax, anti-regulation. There is no thinking in my area, just lock step with or against us.”

      It’s just you and those Deliverance-types, huh?

      Out of curiosity, why don’t you move?

      • March 14, 2017 5:16 pm

        I have been working class for 15 years now. That means I do not have any money for moving. Moving is extremely expensive: I think we paid around $1500 to move here in ’99. I am lucky that if it absolutely must be done, my mother can lend me the money. But it means leaving her (76 yo and I’m the only one that lives nearby) my children, and my grandchildren. The economy is so bad here selling my house would probably be a big problem. I have a lot of pets. I am over 50 years old, and my friends in the city are also having problems finding good paying jobs if they are like me and have not been fortunate enough to keep the same job for many years. I cannot move to the city to keep working for low pay, and I haven’t really seen much hope me or my husband could get anything significantly better.

        You said they were “Deliverance types” not me. They are FAMILY. ( I moved here from Dallas to be with my Grandpa) I am related to everyone here, but I had the good fortune to also live other places. It opened my mind. I don’t have to live in fear; I taught in an inner city high school and lived in the city, not just the suburbs. There are great people there, as well as a few out here who have been out in the real world.

    • March 2, 2017 11:11 am

      Moogie: Our resident libertarian/conservatives (the two most vocal of whom are gone) used to accuse me of being a “statist” or even a socialist. Bottom line: they thought I was a leftist. Now you’re convinced that I’m too conservative. Well, that means I must be doing my job as a moderate.

      You need to spend a day with my Facebook feed to see all the hysterical, vicious and even borderline-looney posts about Trump from my liberal friends. They just reinforce each other’s prejudices, spread baseless rumors as news and generally add to our national malaise by deepening the divide between the right and the left. (My right-wing friends are only a little less vocal, mainly because their guy is in the White House now.)

      Remember, I said that the Trump resistance “uncritically celebrates all causes favored by the left.” The key word here is “uncritically.” In other words, it’s always knee-jerk approval of everything Muslim, black, Hispanic, feminist, gay, transgender — you name it. They don’t seem to be able to discern any shades of gray; for example, that we should welcome moderate Muslims but guard against jihadists… or that police actually kill more whites than blacks… or that biological men who think of themselves as women could use women’s restrooms but probably shouldn’t be stripping down in girls’ locker rooms. It’s the rigidity of progressive thinking that bothers me… and the implication that they’re morally superior to everyone else.

      • Anonymous permalink
        March 2, 2017 11:59 am

        And I, as a self-described moderate liberal cannot argue with Rick’s characterization of “the resistance”, other than to say that it needs a qualifier or two to sort the most extreme from the rest of us. I’m part of the trump resistance but I am not like that. But many, many lefties are just like Rick wrote and they are the loudest most passionate ones and have taken over in certain arenas, facebook for example. They ain’t helping, they will make trump a success and they just can’t stop themselves, too high on self righteousness.

      • Pat Riot permalink
        March 2, 2017 2:35 pm

        Well said, RB.

        “It’s the rigidity of progressive thinking that bothers me…and the implication that they’re morally superior to everyone else.”

        Well said, Rick.

        And it’s that moral superiority and condescension from progressives (I know it’s SOME, but seemingly MANY or MOST) in which they too often don’t use tactful persuasion or explanation to communicate their positions, but instead assume their infallibility, and instead suggest stupidity in anyone who doesn’t agree, that invites or provokes shallow or lowbrow retaliation from some of the opposition. The message gets lost because the messengers quickly infuriate each other.

        Progressive: “The science is irrefutable on global warming, but some people don’t bother with science or learning the facts.”

        Decent American: “ah, screw you, Einstein!”

        Lol. That’s not helpful communication!

      • Anonymous permalink
        March 2, 2017 3:00 pm

        That word progressive is a hard one. What does it mean? It goes back at least to Teddy Roosevelt. Its one more very poorly defined word that gets people into making generalizations. Are liberals progressives, are progressives liberals? In my state many of them warmly despise each other as there is a progressive party that is considerably left of the liberal dem party. I’m willing to have at progressives with a pretty broad brush, if I understand them as Jill Steins left of left voters. Those people consistently give me a rash. If the term is used to mean anyone left of center, which is how Dave always used it, then I protest. We are not all like that.

        As well, the amount of moral superiority coming from the religious right concedes to no other group in it intensity. Even progressives in the Jill Stein sense did not invent moral superiority, that idea and habit has its roots deep in the history of religion, far before Teddy Roosevelt or even Rousseau and his Enlightenment were born.

        Looking up the progressive era in Wiki I find a set of ideas that seem to fit your (Pat Riot) favorite causes pretty well. The Progressive Era was a period of widespread social activism and political reform across the United States, from the 1890s to the 1920s.[1] The main objectives of the Progressive movement were eliminating problems caused by industrialization, urbanization, immigration, and corruption in government.
        The movement primarily targeted political machines and their bosses. By taking down these corrupt representatives in office a further means of direct democracy would be established. They also sought regulation of monopolies (Trust Busting) and corporations through antitrust laws. These antitrust laws were seen as a way to promote equal competition for the advantage of legitimate competitors.

        Wadaya think Pat, who are these progessives you are going after? The same ones on the left of left that make my teeth itch or is your net wide enough that it catches me too and my liberal parents who are not at all fond of conservatives as well?

        I submit that Liberal and Conservative started to feel superior to each other then moment they knew they were liberals and conservative and they only borrowed the habit form the Federalists and Republicans, who only borrowed the habit from the Tories and the Whigs who only borrowed the habit from the Catholics and Protestants who only…

      • Priscilla permalink
        March 2, 2017 3:27 pm

        Roby, I would consider you part of the Trump opposition, not the “resistance”. Unless you are willing to support any means to remove Trump from office, not restricted to constitutional impeachment, you are not part of the resistance. Those people have given in to irrational anger and hate. They say and believe crazy things.

        Your point that they aren’t helping is well-taken and, I think, understated. Not only are they driving some previously anti-Trump Clinton voters away, but they are creating in many Trump voters, decent people who believe that they voted for change, a bunker mentality that did not previously exist.

        These people are beginning to ask why it was incumbent upon them to peacefully accept the results of the 2008 and 2012 presidential elections, despite their opposition to a candidate who said that he would “fundamentally transform” a country that they did not want transformed…..but now that the candidate of their choice, who promised to return the country back to what they see as its founding principles, has won, it’s perfectly acceptable for the other side to question the legitimacy of the election and call for the overthrow of that president by any means.

        This is some dangerous stuff…..

      • Anonymous permalink
        March 2, 2017 3:47 pm

        Well, I do not know the formal definitions of the resistance, (but I admit that it has a sort of a far left ring and you know how I love the far left.) vs. opposition, you may be right. The dangerous stuff, I saw and not long ago from the right in reaction to Obama. I saw it in the second half of Ws presidency too after the Iraq war began, and as a reaction to Reagan, Nixon, and even Johnson. Is it worse now? I really can’t tell. What is happening today always seems to be worse than what happened in say, 1968, but is it?

        I will be the first to agree that I wish the crazies would shut up, left and right. But its useless, since they are crazies by definition they will riot, burn down their neighborhood or some part of their University, break glass, terrorize African Americans in a drunken parade of pickup trucks, confederate flags, and shotguns, turn purple if someone says queer or deplorable, and generally be the loudest, stupidest, most self-righteous people in the country. No one really knows a cure, but jail is a the best one for people who get caught on film going too far. More cameras on cops and in citizens cars etc. that would help. Throw people who are violent in jail, including political violence, very very fine by me.

      • Anonymous permalink
        March 2, 2017 3:59 pm

        This is how long extreme political reactions to elections have been going on (even with a wildly sleazy man like trump being elected):

        “Our founding fathers had as many beefs with one another as today’s politicians do. George Washington and Thomas Jefferson, for example, would probably be horrified to know that they’re destined to spend eternity stuck side-by-side on a mountain in South Dakota. Though the first and third U.S. presidents were once friends, the relationship soured after the Revolutionary War, especially when some of Jefferson’s rather unflattering, thinly veiled comments about Washington were published.

        Washington himself was guarded about what he publicly said about Jefferson, but his wife was a little more forthcoming, especially after she became a widow on December 14, 1799. Losing George was the worst thing that had ever happened to her, Martha once said—but hosting Jefferson at Mount Vernon was right up there. According to a friend, Martha called Jefferson’s visit the second “most painful occurrence of her life.”….

        …In January 1801, Jefferson, a presidential candidate, decided to visit Mount Vernon to pay his respects to the grieving widow. It probably wasn’t out of the goodness of his heart—Washington had been dead for more than a year, and the trip was highly publicized, likely with the hopes that it would help him win favor with the Federalists.

        Though Martha allowed the visit, she remarked to clergyman Manasseh Cutler that she found Jefferson “one of the most detestable of mankind,” and believed that his election was the “greatest misfortune our nation has ever experienced.” ”

        We ain’t gonna stop it.

      • Priscilla permalink
        March 3, 2017 11:44 am

        Roby, again ~ and as usual~ your point is a well-taken one. And, as I am a sucker for on-point historical perspective, I will take it, with one exception. And that is the mass-media, specifically the mainstream news media.

        Washington and Jefferson never had to deal with the 24 hr news cycle, the advent of political operatives (Karl Rove, Donna Brazile, George Stephanopolous, and many, many others) becoming “news sources” and skewing the facts to their particular persuasion, even sometimes refusing to report the facts at all.

        They never had to deal with Facebook and Twitter ~ I was listening to Dana Perino (another former Bush employee,W’s last press secretary) marvel at the influence of Twitter , saying that it was not really a “thing” during her tenure as press secretary. She said that she could not imagine having to constantly confirm or refute tweets in real time, or having a president who independently tweeted on his own, without her always knowing what he was going to say.

        So, a strong, credible and, most importantly, independent press is both necessary and lacking in our current situation. Yet it is at least as powerful, if not far more so, than any bully pulpit.

      • March 3, 2017 12:47 pm

        “Washington and Jefferson never had to deal with the 24 hr news cycle”

        And when the opposition party learns well from Trump how to use this to their advantage, it becomes even stronger.

        But the winners so far are not the republicans or the democrats. It is the Russians. It does not matter if the Russians interfered with our election, it is the perception that they are trying to create that they interfered. Their whole goal is to make America weak and to show that democracies are not what they are cracked up to be. They do not want America as the worlds leader. They are accomplishing that goal by merely creating instances that make it appear they may have interfered. Russian ambassador asked for meeting with Sessions. They discuss a few things and he leaves. Now the appearance that Sessions met to discuss Russian/ American relations and how to get Trump elected is front and center. Hack into a server and do it so they get caught. Makes it appear that Trump is working for the Russians. Most any 1/2 ass hacker could have hacked the DNC and not got caught!

        And had Hillary won, there may be just as much for them to work with to make it appear that she was involved so that their goal to make our democracy look weak is still accomplished.

        And the 24 hr news cycle has become the Russians best friend in this issue as the democrats, in their desire to trash Trump, have fallen for the Russians trap and are promoting exactly what Putin wanted to begin with. Propaganda was the KGB’s primary means of discriminating false information and Putin knows opposition parties can not sit back without attacking their opponent. He is playing America’s politicians like a fine fiddle.

        I am not saying that Trump and his campaign did everything 100% legal. What I am saying is no political election in this country is 100% legal. But when you have someone as polarizing as Trump, it takes very little for some third party to create a wedge and weaken both parties in the process. I see America much weaker today due to the divisions in Washington than 8 years ago and only getting worse.

      • Roby permalink
        March 3, 2017 12:28 pm

        And yet, even without the press of today, and the press was already tasteless and interfering and biased and unfair by 1800, they managed to turn friendships sour, hurl bitter accusations, scare each other to death with their concepts of America, and then there was the dueling. A blood sport literally. Imagine if we had to deal with dueling instead of twitter? The bodies would be everywhere.

        Posting this link is irresistible to me after your comment on W Bush. I’ll remind you before you read it that I have always spoken well of Bush the man, supported him for the most part as president (including Iraq), given him credit for the things he did well (and strongly criticized his go it alone lack of his fathers coalition building and his cover up of the costs of the two wars) and always spoken well of their family. And Yeah, I am liking him and his opinions these days. Not to spoil the punch line of the article but liberals waxing nostalgic on W after a good dose of trump is fairly amazing.

      • Roby permalink
        March 3, 2017 1:05 pm

        “But the winners so far are not the republicans or the democrats. It is the Russians. It does not matter if the Russians interfered with our election, it is the perception that they are trying to create that they interfered. Their whole goal is to make America weak and to show that democracies are not what they are cracked up to be. ”

        Dead on.

        I prefer saying putin or putin and his KGB than to say the Russians, because, believe it or not, many, maybe most, Russians greatly admire America and many things about American culture, while most do not want our democratic system and want a single power figure instead to stabilize everything.

        But for putin this has been quite a victory, for now. I think it will turn sour in time, putin wins battles and loses wars.

      • March 3, 2017 2:58 pm

        You’re so right. Most everyone says :”Russians”, Iranian’s, Syrian’s” etc when talking about governments and when asked, a large majority of people do not support their governments positions. but since they are dictatorships or almost that, they have no say.

      • Priscilla permalink
        March 3, 2017 1:52 pm

        Yet, when Bush was president, he was an idiot, a war criminal, Bushitler, etc.

        McCain is popular again, too. because he and Trump are sworn enemies. When McCain was the GOP candidate running against Obama, it was a different story. He was senile, or close to it, a bloodthirsty warmonger, in bed with the military-industrial complex, and a loose cannon masquerading as a maverick, who did not have the emotional stability to be the president. And, of course, his attempt to nominate a “rising star” in Sarah Palin as his VP, backfired badly and cast serious doubt even among his former admirers.

        My point being that Bush, McCain and Romney were all savaged by the press when they were the nominal head of the GOP. Now, they’re seen through the soft-focus, golden lens of nostalgia for anyone who is not Trump.

        That’s not journalism.

      • Roby permalink
        March 3, 2017 2:08 pm

        That’s not journalism.

        Now, you know what I am going to say…

        If You had to follow the standards you want journalists to follow these kinds of wicked media posts would take a lot more time to write because you would have to document that all these colorful insults actually came from particular journalists. What you just wrote was a mishmash of words (bushitler?) that mostly sound like they from all kinds of campus activists or hollywood airheads.

        For penance, re-write and use only quotes that you can attribute to a source, like a journalist would have to do. You can come up with some heated opinions for certain but I don’t think you can find a reputable journalist writing bushitler.

      • Priscilla permalink
        March 3, 2017 2:53 pm

        ” Even if “the GOP war on women” – the metaphorical talking point – is dead, as at least one pundit has suggested, the GOP war on women – the real and continuing Republican drive to set back women’s rights and opportunities – remains very much alive.
        And make no mistake: A Romney presidency will only escalate the assault. ”

      • Roby permalink
        March 3, 2017 3:12 pm

        Really, Kieth Olberman and Micheal Moore are the face of Journalism? Rolling Stone?

        Now I’ll come up with the Hannity quotes on Clinton and say he is the conservative MSM.

        Was there any serious fair minded coverage of W Bush by ABC, CBS, NBC, NPR, the NYTimes? Or was it all just like Olberman’s ranting?

        You have not proved a case against journalism, you have found evidence that Kieth Olberman (and perhaps by extension MSNBC) is a cranky red meat thrower.
        If I put ABC, CBS and NBC up against Fox as the most obvious members of the MSM who do you think can find more wild stuff, me to pin on Fox or you to pin on the old networks? I’ll win that competition hands down. The standards of the networks are far higher than Fox.

        Priscilla, if you want to indict journalism you have to come up with a case
        against journalism as a whole entire thing and not some particular red meat throwing jerk. I continue to think that conservatives are wasting their time feeling persecuted by the media, especially when they have their own outlets.

      • March 14, 2017 5:22 pm

        LOL, I see the right wing as far far far more rigid in their thought. I don’t really go to any sites that are far right or left wing. but I lived in Texas for 21 years and now rural Virginia for 18…so you can probably imagine I see more posts that are right wing.

        I’ve not heard any stories of any transgenders stripping in a girls locker room, you will have to send a link for that one. white are a high percentage of the population, so of course more of them get killed.

        Far far far far far far more righties think they are morally superior!!!! I doubt I have EVER met a lefty that thinks they are morally superior, but I can introduce you to plenty of morally superior righties just in my county.

      • dhlii permalink
        March 14, 2017 6:54 pm

        There have been numerous columnists from New York City who have described what living in progressivedom is like for a conservative.

        Sorry the Left is FAR FAR more “morally superior”

        Do right wing thugs do hundreds of thousands of dollars damage to colleges when John Stewart comes to speak ?

        There is a recent column about a left gay journalist who made the mistake of running a neutral column on Milo Yanopolis. He was bombarded by hate mail – often from people he thought were his friends.

        I live in a place Jerry Falwell used to call “the buckle on the bible belt”

        Conservatives and bible thumpers look kind of funny at libertarians.
        But I can talk and they will listen – not agree much but listen.

        I have attended Unitarian, and very left leaning churches – in a very right county.
        I would not dare come out as a libertarian in a left leaning church.
        I would not be tolerated.

        While there are plenty on the right who have an incredible air of moral superiority.,
        the most morally superior and intolerant people are on the left.

        I have been very disappointed by many – not all of my gay friends – and I have ALOT of gay friends. These are people who were persecuted for decades.
        Today that is pretty close to ended. And way to many of them have turned arround and not merely persecuted those who oppressed them in the past, but even people who did not.

        I would strongly recommend Johnathan Haight’s work on moral foundations.
        It is a good place to learn about yourself and others and what makes other ideologies tick.

        Progressives are driven by emotion they are incapable of rational or logical thought regarding right and wrong or values.
        Right is what they feel is right. Wrong is what they feel is wrong.
        They have no understanding that approach legitimizes Jim Crow and Nazi’s

        Conservatives respond to revulsion. They know what is right and wrong by what disgusts them. That is problematic, but it is far less dangerous than emotion.

        Libertarians are substantially more likely to make moral judgements based on reason.

      • dhlii permalink
        March 14, 2017 7:10 pm

        One of the reasons we tend to discount the moral superiority emanating from the left, is that is a kind of robin hood moral superiority.

        We are inclined to give those whose “heart is in the right place” a pass – both for their own immoral acts and for the moral intolerance and judgement they cast on others.

    • Priscilla permalink
      March 3, 2017 3:02 pm

      “This isn’t a joke; if the man had a senior moment in this interview, how many more are ahead of him? I’m beyond terrified that this election is even close.

      An interesting footnote: the guy who just got arrested for phoning in the recent bomb threats to synagogues and JCC’s is a former Raw Story writer. He was fired by Raw Story which has reported the story, ~ credit where credit is due.

      Sorry for the multiple posts, but only one link p/post, or I will go into dreaded moderation!

      • Roby permalink
        March 3, 2017 6:42 pm

        The evidence seems to support media bias against conservatives. Here is one thing I found (note that this was the Post itself that investigated its own bias:

        “After the (2008) election was over, Washington Post ombudsman Deborah Howell reviewed the Post’s coverage and concluded that it was slanted in favor of Obama.[118] “The Post provided a lot of good campaign coverage, but readers have been consistently critical of the lack of probing issues coverage and what they saw as a tilt toward Democrat Barack Obama. My surveys, which ended on Election Day, show that they are right on both counts.” Over the course of the campaign, the Post printed 594 “issues stories” and 1,295 “horse-race stories.” There were more positive opinion pieces on Obama than McCain (32 to 13) and more negative pieces about McCain than Obama (58 to 32). Overall, more news stories were dedicated to Obama than McCain. Howell said that the results of her survey were comparable to those reported by the Project for Excellence in Journalism for the national media. (That report, issued on October 22, 2008, found that “coverage of McCain has been heavily unfavorable,” with 57% of the stories issued after the conventions being negative and only 14% being positive. For the same period, 36% of the stories on Obama were positive, 35% were neutral or mixed, and 29% were negative.[119][120]) While rating the Post’s biographical stories as generally quite good, she concluded that “Obama deserved tougher scrutiny than he got, especially of his undergraduate years, his start in Chicago and his relationship with Antoin “Tony” Rezko, who was convicted this year of influence-peddling in Chicago. The Post did nothing on Obama’s acknowledged drug use as a teenager.”[118].”

        Another quote I find quite interesting:

        “According to Jonathan M. Ladd, Why Americans Hate the Media and How It Matters, “The existence of an independent, powerful, widely respected news media establishment is an historical anomaly. Prior to the twentieth century, such an institution had never existed in American history.” However, he looks back to the period between 1950 and 1979 as a period where “institutional journalists were powerful guardians of the republic, maintaining high standards of political discourse.”
        A number of writers have tried to explain the decline in journalistic standards. One explanation is the 24/7 news cycle, which faces the necessity of generating news even when no news-worthy events occur. Another is the simple fact that bad news sells more newspapers than good news. A third possible factor is the market for “news” that reinforces the prejudices of a target audience. “In a 2010 paper, Mr. Gentzkow and Jesse M. Shapiro, a frequent collaborator and fellow professor at Chicago Booth, found that ideological slants in newspaper coverage typically resulted from what the audience wanted to read in the media they sought out, rather than from the newspaper owners’ biases.”[18].”

      • Roby permalink
        March 3, 2017 7:08 pm

        My own exposure to media is unusual, almost no TV, just hunting for stories that interest me online. So, I may have missed a lot of the American media experience.

        A media as a whole that has clear bias and is accurately seen to have clear bias is obviously less effective, a loss for us all.

        Does it affect voters choices? I’ll play devils advocate. Its been argued that there is no evidence that putins hacking of the DNC that flooded the US with negative information on Dems and Clinton affected the election. Personally I think it affected the election considerably, but the argument conservatives are making is “show me, prove it.”

        If everyone knows that the media is biased do they change minds? I still say that voters read the media that says what they like to hear. It may or may not change the outcomes of elections but it sure is leading to separate evolution of liberals and conservatives.

        Interesting idea that this situation has been the norm in American history and the period I grew up (roughly) in 1950-1979 was a sort of high point that was lost.

        Hmm, depressing, the more I learn the more I think I want to go back to 1960 and live my life there at the peak of everything American.

  13. Pat Riot permalink
    March 2, 2017 7:08 pm

    Ah yes I did throw that term “progressive” around, didn’t I? The meanings of our words can certainly morph over decades and centuries. I’m not sure about past meanings of “progressive,” but I understand modern progressives to be extremely far left liberals, so that to the left of center moderate we have moderate liberals, then liberals, then maybe “activist liberals” who are very involved but still reasonable people (I realize that’s a judgement), then the far left, and then progressives. Though that’s tricky because even moderate liberals can have some progressive ideas/thinking.

    The progressives I’m most concerned about are the ones who are militantly anti-traditional to the point that most all traditional thinking is not only rejected but ridiculed, so that religion is merely dangerous superstition that should be eradicated sooner than later, national sovereignty is an archaic idea that must be erased in favor of one world central planning, and everything is open to new interpretation including gender, value of human life, etc.

    Listen to the new age hippie militants over at National Progressive Talk Radio and you”ll get a sampling.

    I’m with you Roby in your concern/worry/abhorrence of extremists, left and right.

    • Anonymous permalink
      March 2, 2017 8:03 pm

      “Listen to the new age hippie militants over at National Progressive Talk Radio and you”ll get a sampling.”

      Is there such a thing? If so, why would you do that to yourself (listen to it).

      You don’t just mean NPR talk programs between the classical music by any chance? Last time I heard them (decades ago), they were liberal but not far lefties. Far lefties and classical music are a poor match. Well educated liberals like classical music though.

      The young Turks, that’s new age hippie militants.

      • March 3, 2017 1:08 am

        No, not NPR. NPTR: National Progressive Talk Radio. I expose myself to all manner of thinking to test and hone my own thinking.

        Through a friend of a friend of a friend, I became Facebook friends with one of the guys running NPTR during the earliest days of Facebook. The guy’s FB following was quite an “amen camp.” I had some startling online dialogue battles with this camp. I don’t use FB for that anymore.

  14. March 3, 2017 12:35 am

    Well after 50 or so comments concerning Trump, progressives, a few about Obama and my dissertation on China and air pollution, I am wondering what everyone thinks about the chances of any meaningful legislation getting passed by congress. We have the democrats aligned to block most anything, we have continuing investigations about Russia that seem to be getting more intense and we have a definite split within the GOP on healthcare, taxes and immigration.
    Healthcare: Moderate sensible (IMHO) solution (and establishment solution) includes preexisting conditions, kids on parents plan and a few others. Conservatives will not accept anything “Obama Lite”. My thinking is the GOP will repeal and then come up with plans that will not pass the senate (Cruz, Paul, Lee) voting with democrats to reject anything with preexisting conditions, Medicaid expansion and tax credits to purchase insurance on the open market. With three rejecting, legislation is defeated.
    Taxes: Without a repeal and replacement of the ACA with all its taxes that need to be repealed, any tax legislation will also go down to defeat. Conservative members in the house freedom caucus will not support anything that increases the deficit. Tax legislation most likely will only touch corporate tax reform with little impact.
    Immigration: Wall will not get funded and conservatives will block anything that allows “dreamers” to stay legally even though they are more “USA citizens” by growing up and going to school in America than our former president that grew up in a foreign country and was an immigrant from Indonesia.
    So by the end of this legislative year I suspect nothing substantial will get done, the Democrats will be licking their chops knowing they have a good chance to capture the house and keep what they have in the senate and Trump will be shown to be an ineffective leader even though no one could be able to round up the GOP, even Reagan.
    Compromise is dead, between the left and right, liberals and conservatives AND moderate republicans and conservative republicans.

    • Anonymous permalink
      March 3, 2017 8:13 am

      On Healthcare your problem is that you know what you are actually talking about. It would be great if everyone did.

      Your basic scenarios sound pretty realistic, but I’m not sure that the dems will get the house again in my lifetime, which is OK with me as long as they would hold the Senate by 55-45. That is all I ask, one lever of power in the hands of the opposition. But 2018 does not favor that scenario, More weaker Dems up for reelection.

      I’m not sure why the wall won’t get funded with a GOP congress and POTUS (other than being opposed by about 60 of the voters), but I am not following the nitty gritty detalis of politics you probably do and have a good reason for saying that.

      Some outside event may come along and overwhelm all these expectations, either something that was beyond anyone’s control, or something that is related to trump’s foreign policy.

      There is a trump I could like, Ivanka trump. She may have more influence as time goes on and Bannon less. That could change things.

    • Priscilla permalink
      March 3, 2017 11:29 am

      Ron, I think that your scenario could play out ~ the main domino is the ACA, and if the GOP fractures over that, it will prevent the other dominoes from falling (or cause them to fall….I’m a bit confused by my own metaphor, lol).

      But, I am cautiously optimistic, and I think that the current intra-party struggle of Obamacare will be resolved. It will be up to Trump and Ryan to resolve it. Trump, through political persuasion, and Ryan through political process. The Senate is a bit dicier, because there is not a lot of wiggle room there ~ reconciliation requires only a majority, but the Repubs have only a bare majority, and if Rand Paul isn’t happy, or the McCain/Graham twins, or Susan Collins, etc. they could lose it there. If Trump is an effective executive dealmaker, he should be able to get 50 GOP Senators (Pence would be the 51st vote if necessary), and he can likely pick up a Dem vote or two, in states where Obamacare is very unpopular (Joe Manchin, etc)

      I have seen the both GOP and the Democrats go through a weird change since the Trump election. At the Joint Session speech, Republicans applauded big infrastructure spending, protectionist trade policies, and paid childcare leave, while the Dems sat on their hands. While I know that the Democrats were just being pissy, for the most part, it was still a situation of a GOP president proposing what are essentially Democrat ideas. So, once the Great Red Scare of 2017 simmers down (assuming the FBI doesn’t discover some actual evidence), I think it’s possible that there will be some actual legislation coming out of this session of Congress.

      Signed, Pollyanna 🙂

  15. Roby permalink
    March 3, 2017 11:20 pm

    And then there is this:

    Masked thugs showed up and roughed up the speaker and a professor. No arrests.

    But before judging liberal old wacko Vermont too severely, read the comments, there is hope.

    And before blaming the school administration, Murray’s tweet was: “Report from the front: The Middlebury administration was exemplary. The students were seriously scary.”

    Our little tender snowflakes are turning acidic and poisonous.

    • March 4, 2017 12:01 am

      I blame the parents and grand parents. Had they shared their life stories, or those of people they knew, while growing up and attending college, the kids today would know the history behind free speech on college campuses and the fact the boomer generation went to jail in some instances while demonstrating for free speech, was kicked out of some universities due to demonstrations and in some instances, was injured during the demonstrations. Bet in 30 years kids will be demonstrating for free speech after their parents get this removed from college campuses today.

      • dduck12 permalink
        March 4, 2017 12:36 am

        “The college says Murray and professor Allison Stanger (STANG’-er) were surrounded by a group of protesters and a protester pulled Stanger’s hair, twisting her neck. It says the group climbed onto the hood of their car and threw a traffic sign in front of it.

        Public safety officials cleared a path for the car to leave.

        Stanger was treated at a hospital and released. Murray hasn’t commented.”
        Where are the arrests? Liberal ass______.

      • Priscilla permalink
        March 4, 2017 11:39 am

        This is the problem, dd12. None of these kids get arrested, and when there are large protests/riots, which may involve outside and/or paid agitators, we don’t find out, because they’re not arrested either.

        During the Berkeley “Milo protest,” which was clearly a riot and not a peaceful protest, resulting in the destruction of property and multiple assaults, it turned out that only 2-3 people, none of whom were Berkeley students, were arrested. And, I think they were arrested for not dispersing after the riot, not for any felony vandalism or assault during it.

        And, this was a riot that resulted in something like $100,000 damage, for which I assume the taxpayers of California are on the hook.

      • Roby permalink
        March 4, 2017 1:15 pm

        Priscilla, to tie this to our discussion of the media, how is this for irony. The NY Times and Washington Post both did complete and fair stories on this:

        I found a National Review story, its very brief and incomplete and does not even mention the mob assault.

        If this kind of left wing campus fascism is going to be taken on, it had better actually be altered for the better, otherwise it will be altered for the worse. I remember when something this happened at Dartmouth with the BLM riot, the conservative media did a very partial job of following through on coverage. I thought they would have a field day, I was disappointed, no follow through.

        If trump or the conservative movement want to poke this monster they had better have a real and realistic plan that has a chance to work and they had better pursue it with vigor. Otherwise its like briefly using an ineffective antibiotic that only turns the original bug into a superbug.

        Ironically, the Middlebury President and administration show signs of really getting it, I will follow this in the Middlebury student paper to see what happens in the way of consequences.

  16. Roby permalink
    March 4, 2017 1:18 am

    In response to a well written open letter from the Political Science Department explaining why, with some serious conflicts and reservations, they sponsored the Murray talk

    they received this piece of intolerant pomposity in return from a student in the form of another open letter. Here is the last paragraph. I wonder if this student will have any new thoughts on the matter after the way the protest turned out with violence and injuries. I found these things by looking up the student paper at Middlebury, anyone interested in this situation might find it interesting to follow the paper in the next few weeks as the college reacts to having the speaker roughed up and a professor injured by student protesters. Now, if I were Fox, I’d have someone on this full time. So far, the NYTimes has covered it pretty well (its how I heard about the riot) and Fox, just a thin paragraph taken from a local paper.

    “So that is exactly what we will move toward. The Political Science department’s history of enabling scientific racism and alternative facts requires a broad-based community movement that forces the department to change its policy in sponsoring talks. As a body, Community Council approved an official recommendation that the Political Science department rescind the co-sponsorship of Charles Murray during our Tuesday meeting. However, we will also move to drafting more long-term recommendations to ensure nothing like this happens again. In my capacity as a member of our community, I also encourage students to take a stand to force the department towards a new policy. If the Political Science department does not apologize publicly and announce a revised policy wherein no widely-discredited supremacist speakers will be sponsored, members of our community who feel strongly about inclusivity will move to occupy the Political Science department in a sit-in. All students, staff and faculty that stand in solidarity with an effort for real inclusion on campus are invited.”

  17. Pat Riot permalink
    March 4, 2017 6:15 am

    Humans! The irony of people passionate about “inclusiveness” not allowing someone to speak.

    We must have places/forums for open dialogue of ideas. College campuses should be one of the places for expression of ideas.

    We need people to realize the danger of being so convinced of their correctness that they are willing to be violent against those with a different viewpoint.

    I suggest Colleges and Universities could emphasize the importance of free speech by scheduling some outrageous speeches/presentations. Swift’s “A Modest Proposal” comes to mind.

  18. dduck12 permalink
    March 4, 2017 10:52 pm

    OK, before getting into specific recipes (basting sure helps), I think some real arrests, backed up by the ubiquitous phone videos, of these so-called students would go a long way to slowing this anti-free speech crowd. Real students nabbed would face school type charges and outsiders even harsher charges for any property and human assaults. But, there has to more effort by the schools to nail these people. Then plea bargain the bastards to see if there is any organized outside agitation. I don’t think all parents want there kids to be snowflakes and get narrow minded educations, But I’m not sure, liberals are hard for me to understand, so are conservatives.
    BTW, Howard University is under attack, by other ass______.

    • March 5, 2017 12:25 am

      dduck, in many cases the administration of these universities side with the students. In the late 60’s and 70’s, the administration was opposed to the free speech movement. So unlike the 70’s when students were arrested, kicked out of school and other disciplinary action taken, today, the administration is aligned with the students, so (as you say ) ” Real students nabbed would face school type charges and outsiders even harsher charges for any property and human assaults. But, there has to more effort by the schools to nail these people.” the schools are not going to act the same as they did when the free speech movement was taking place. Most universities are not going to do anything to students that support the administration’s political point of view.

      And that is a sad point in college students development as they are being herded like sheep to one political view point and not exposed to the various points of view that exist in the country today (or even in history). One can not defend or fight against a movement if the true facts behind that movement is not known.

  19. dduck12 permalink
    March 6, 2017 1:40 am


  20. Priscilla permalink
    March 6, 2017 10:44 am

    This was a comment on an article in the Weekly Standard, which sort of summarized the problem that I have with the media coverage going on now:

    “Media – Trump has to be impeached because he’s got these Russian ties that we know are true because we have transcripts of wiretaps.
    Trump – Obama must have wiretapped me.
    Media – Trump has to be impeached because he’s claiming he was wiretapped…”

    While no one is claiming any evidence of anything, it is the Democrat claims of collusion between the Russian state and the Trump campaign that has put this whole thing front and center.

    We happened to have dinner this weekend with a friend of ours ( I think I’ve used him as an “informal source” before) who is retired from a career as an attorney who was certified to, and did argue before SCOTUS, He said that, in order for the DOJ to obtain a FISA warrant to investigate Trump and/or his associates for the kind of collusion that you and Jay talk about, Roby, there would have to be a credible belief that the person, or persons, are willfully engaging in criminal espionage. In order to get a warrant to spy on an American citizen, the FISA court requires the DOJ to allege, credibly, that the person has become a foreign agent and intends to do harm to the US.

    In other words, the US citizen has to be suspected of being a foreign spy. An espionage agent. It’s not about whether Trump did business with the Russians, or whether Paul Manafort was hired to do public relations work for the Russian-backed Ukrainian president, or whether Jeff Sessions had an meeting in his Senate office with the Russian Ambassador who everyone seems to know, or whether Trump said that Putin was a strong leader. In order to get a FISA warrant, there would have to be evidence that one or more of these people are Russian agents, who have knowingly decided to betray their country.

    So, our friend, who is no fan of Trump ~ like Ron, he did not vote for either major party candidate ~ is inclined to believe that, if indeed, there was any kind of surveillance on Trump or his associates, it warrants a serious investigation to determine 1) what is the espionage that was alleged 2) was any evidence of this espionage found and who is guilty of treason, and 3) was there perjury commuted by the DOJ in order to get the warrant.

    We already know that Obama used the espionage act to spy on reporters ~ check out the story of James Rosen from Fox, and the secret pulling of phone records of AP reporters who had reported negative reports of a Mideast raid. I don’t believe that it would be unreasonable to think that the DOJ under Lynch would get a FISA court to order surveillance on Trump, And Obama would technically be “out of the loop” because the order would come from the court.

    • Priscilla permalink
      March 6, 2017 10:47 am

      **committed* not commuted

    • Priscilla permalink
      March 6, 2017 10:57 am

      All of that said (whew, and sorry for the wordiness, dd12!) I don’t believe that Trump was right in alleging this kind of surveillance. And I think it is extremely dangerous for a president to engage in these kinds of inflammatory accusations.

      But, I also think that the neverending accusations of Russian ties between the Trump campaign and the Russian government have been dangerous, in that they have been largely baseless and intended to undermine a duly elected president.

      It amused me to see the media, all of a sudden, demand PROOF of Trump’s claim, when they have largely ignored the fact that there is no proof that Trump is a Russian agent, or is even soft on Russia. My conclusion: everyone involved is guilty of making this a big story, when it is a nothingburger.

      • March 6, 2017 12:40 pm

        Priscilla, the attacks on Trump will not end until his term in office ends. After Benghazi, the GOP knew they had an issue that they could continue to pound into the ground to make Clinton look bad and they did just that. How many nights did we have to listen to some talking mouth on the right harp on what happened in Benghazi, how many congressional investigations took place? Did anything ever get settled or did they just give up after their goal was reached? Not finding the truth about Benghazi, but defeating Clinton.

        The play book in Washington these days is to find one or two issues, blow those issues into major “criminal” investigations, degrade your opponent and hope it all sticks so it takes down the party with the person. And since Trump can not get his assistant directors confirmed in critical DOJ and intelligence positions, Obama holdovers are still there, and probably a good source for the leaks coming out of those departments.

        The dems want a special prosecutor because special prosecutors take years to investigate and issue reports. Watergate took more than two years to complete. So the dems win on either case. One, if a SP is named, it takes this issue right into mid term elections and two, if a SP is not named, any reports from congress are quickly denounced as partisan and demands for SP investigation continues. All to make the ruling party look illegal and criminal.

        And while all of this is happening, nothing gets done with immigration, taxes and healthcare.

      • Roby permalink
        March 6, 2017 12:41 pm

        That is why a believable investigation with the appointment of a special prosecutor is in everyone’s best interests. We all know that the majority GOP voters have lost almost all ability to acknowledge trumps unique set of negatives or understand how they appear to those who are not GOP loyalists, but there are the Dems and independents who also live here to contend with. We haven’t accepted trumps unique deficiencies and we need to see an investigation of this mess. If trump and putin did no wrong, they certainly over-clevered themselves in pressing the limits and have brought this on themselves. As Ron said, the winner is putin, he has weakened our democratic system in the view of the world.

        Now, allowing a special prosecutor would likely enrage trump. But then, letting him twist in the wind as we slowly get incomplete info and in the end probably are headed for a special prosecutor anyhow is having a bad effect on the weak mind of the POTUS.

        Appointing a special prosecutor would protect the GOP members of congress as a whole from being seeming to be complicit in a coverup, if it turns out that trump, say, passed on to putin that he was intending to let the sanctions lapse and consider Ukraine as the Russian sphere of influence in exchange for a good relationship with Russia. In return putin gave the trump campaign a huge piece of help via their hacking and leaking of the dirty linen of only one party. Was it a quid pro quo or just the appearance of one? No sane American presidential candidate should ever have put himself in the position that trump did. I find this scenario quite possible, trump would have believed due to inexperience and his simple view of things that he was within his rights to discuss his future policies with putin’s agents and putin would have been glad to stroke his ego to achieve that.

        So, bite the bullet, a believable investigation by a non partisan presecutor that will put an end to the partisan guessing or let trump and the GOP twist slowly in the wind?

      • Roby permalink
        March 6, 2017 1:01 pm

        Ron, I respect your characterization of this, there is a lot to what you say and you have been pretty even handed.

        After the 2012 election in which Obama defeated Romney and the GOP had control of congress I wrote here that an election had been held and in a sort of political acid-base experiment, both parties got some levers of power, with which I was satisfied. You wrote words to the effect that “may it be ever thus” and you never hoped to see another election like 2008 that left one party in complete charge. Thanks god, you said, for gridlock, it prevents worse things. I think I have your ideas accurately even if not in your exact words.

        So, here we are, 2016, one party has all the levers. Bad, very bad, in itself. On top of it we have a unique POTUS who ran an campaign that made anyone but the true trump supporters ill and shocked and furious.

        I am opposed to one party having all the power, but more than that I am opposed to a man of trump’s character being POTUS.

        Let the investigation continue, its based on an utterly real issue. I’ll cry no river for the situation that trump, the GOP, and its supporters are in.

        If they solve any of the issues you mention it will be by some kind of compromise. If they won’t compromise, they will get nowhere. That is how it should be.

      • March 6, 2017 2:09 pm

        Roby, you are right that I said split government is better than one party having all the power in this day and age. Looking back on the most productive periods, Reagan and Clinton, they had split government and did some wonderful things. They compromised.

        And given the correct atmosphere in Washington, split government is still a good thing in my mind. But with the corrosive cooperation that exist in Washington today, doing what the Russians wanted all along is doing nothing for the country other than to make us weak and weaken us further when nothing happens to fix the economy and healthcare. And it is not only the divide within the GOP and Dem’s, we now have a three legged government where Trump is the outsider fighting both parties.

        I don’t support Trump. I think he is an idiot. I would still not support Clinton, I think she is a bitch with piss poor political views. But I find that investigation after investigation in Washington is not what we elected members of congress to be doing. Maybe a special prosecutor is the best thing. I could forgo all news for the next 2 years as nothing other than SP news would be spread by the press. How much news detrimental to the president would be broadcast by the MSM, while how little the investigation had found by Fox news.

        And then, would we be better off in 2 years?

      • Priscilla permalink
        March 6, 2017 1:28 pm

        A special prosecutor is appointed when there is evidence that a crime may have been committed, and there is no confidence that the DOJ or the Congress can investigate it fully and impartially.

        Right now, there is no evidence that any crime has been committed. The Democrats allege, apparently without evidence, that Trump and his people are Russian spies, who turned the election in his favor. I find that utterly bizarre and ridiculous. But, if there is surveillance that proves it, it needs to be revealed.

        Trump alleges, apparently without evidence, that Obama’s intelligence community illegally spied on him and his staff. I find that less bizarre and ridiculous, but that could just be my own bias. In any case, if it’s true, it needs to be revealed. Not through “anonymous” sources, but by the United States Congress.

        If the Congress discovers high crimes and misdemeanors by Trump, he should be impeached. If they find criminal acts by Obama, or anyone in his administration, they should be arrested and charged.

        Period. Full stop. That is what SHOULD happen.

        Ron is likely correct that it will not.

      • Priscilla permalink
        March 6, 2017 1:51 pm

        We, as a people, deserve Trump, who takes his plays right out of the Democrats’ playbook: throw out a baseless charge, using innuendo and “anonymous” sources, and make the other side prove a negative.

        It’s a never ending game of “when did you stop beating your wife?”

        No one in government seems to ever tell the truth. Benghazi is an excellent example, Ron. Obama and Clinton clearly lied about that stupid video (and they arrested the filmmaker!). Most reasonable people figured that out after about 2 weeks. But the Republicans dragged out their investigation for 2 years, and we STILL don’t know where Obama was that night, or why no one did anything to help those guys even as they fought for 6-7 hours.

        The whole thing became political theater. And, we’re watching it play out now, with this stupid Russia thing.

        Does anyone seriously believe that Jeff Sessions did anything wrong by meeting with Kislyak, in his office, with staffers present? Or that he intentionally lied about it when Al Franken asked him if he knew about “continuing communications between Russia and the Trump campaign”

        No. Just a play to get the AG to resign or recuse. Did Lynch resign after a 20 minute, secret meeting with Bill Clinton, while Hillary was under investigation?

        Political theater, and nothing gets done. No healthcare act reform, no tax reform, no spending cuts, not anything. Ugh.

      • March 6, 2017 2:14 pm

        “Does anyone seriously believe that Jeff Sessions did anything wrong by meeting with Kislyak, in his office, with staffers present? Or that he intentionally lied about it when Al Franken asked him if he knew about “continuing communications between Russia and the Trump campaign”

        Yes, the 35% to 40% of Americans that would vote for a democrat even if Ellison was on the ticket for president.

      • Roby permalink
        March 6, 2017 2:12 pm

        “We, as a people, deserve Trump, who takes his plays right out of the Democrats’ playbook: throw out a baseless charge, using innuendo and “anonymous” sources, and make the other side prove a negative.”

        Your answer to everything is that the democrats started it,(and in this case I can’t even begin to understand who you think the democratic version of the truly unique trump is) they did it first, they are worse. If so, it must have been back when you were supported them with as much one-sided force as you now support the other side. Funny you did notice at that point how relentlessly bad they were and their supporters (jeez, that was you!)

        Nothing the GOP side ever seems to emanate in your world from their own set of characteristics. Politics began when the democrats invented it. Good grief.

      • Roby permalink
        March 6, 2017 2:14 pm

        Funny you didN”T notice. Aaarrg!

      • Roby permalink
        March 6, 2017 2:20 pm

        “Yes, the 35% to 40% of Americans that would vote for a democrat even if Ellison was on the ticket for president.”

        Absolutely true. Both sides start with 40% of the popular vote, no matter who they run or how ridiculously bad. Trump picked up an extra 6, Clinton an extra 8. Someone had to win. We lost.

      • dhlii permalink
        March 8, 2017 2:51 pm


        I would suggest there are a number of reports in the media that back Trump up.

        First the LEFT media – including the WaPo and NYT have PREVIOUSLY run stories – atleast one front page headline in NYT of Trump’s people being wiretapped.

        Unless you beleive that is “fake news” or that it was planted – some as early as june 2016, by Trump people, then either the medias sources were LYING about wiretaps, or Trump’s campaign was being investigated and wiretapped.

        I would particularly suggest Andrew McCarthy’s stories on this and other “legal” matters. McCarthy is a former Cheif Assistant US attorney.
        He understands the law in these areas, as well as procedures, and has numerous contacts throughout that part of government.

        His stories have been well reasoned, detailed and rooted on solid evidence.

        I would suggest paying very close attention to the Anti-Trump attacks in the media.

        One of the problems with leaking stories – is that you often leak more than the purportedly damaging information you intend to get out.
        You have to provide a credible basis for the press to trust what you are reporting.

        The real source of the claim Trump’s campaign was being wiretapped and investigated – is the leakers that have been trying to discredit Trump.

        There is really little doubt at this point that Trump’s campaign was investigated by the Obama administration.
        What is in doubt is the breadth and origens of the investigation.

        And as McCarthy notes – there will be a paper trail.
        Not only will there be records of who was investigated and what was found – which thus far appears to be nothing of substance,
        but the same records will tell us who did the investigation, what were they looking for, who directed them, and what evidence was used as the basis to start the investigation.

      • dhlii permalink
        March 8, 2017 2:59 pm


        There are serious differences between how the GOP handled Clinton/Obama and what is occuring here.

        You can say whatever you want regarding the investigations into Clinton/Obama, but they were done openly, following the law.

        Congress as an example IS allowed to investigate the executive.

        The administration is FAR more narrowly confined in investigating its political opponents.

        Process and rules and law matter.

        Republican investigations primarily demanded the administration to turn over records, and testify to their actions, and they were done int he open.
        These investigations are investigations into administration conduct – not investigations into individual private conduct.
        Congress can not charge someone with a crime, it can merely refer a request for a criminal investigation to the FBI.

        When the administration secretly investigates a private party – even a political candidate, entirely different procedures and due process are involved.

      • dhlii permalink
        March 8, 2017 3:09 pm


        The purpose of divided government and grid lock is to prevent the further EXPANSION of government power which is always at the expense of individuals.

        I am cautiously optomistic regarding Trump because though he is very heavy handed and authoritarian, he is acting unilaterally to tear down, to diminish government power.

        Destroying the unilateral actions of others does not require unified government.

        Reducing government SHOULD not require supermajorities – while expanding it should.

        Gridlock is to prevent the growth of government not its reduction.

        So long as Trump is seeking to deconstruct the administrative state – he has my strong support.

        I am still able to oppose him where he goes wrong.

        But even on those areas where I disagree with him – thus far his actions have been small and minimally threatening.

        Trumps huffs and puffs but does nto seem intent on getting us into a trade war. Though I strongly oppose this “border adjustment tax”

        He is seeking to expand the military – which I oppose.
        But he is also actively seeking to expand missle defense – which I strongly support.

        I want to see broader immigration, but I am not strongly opposed to deporting those immigrants who have been charger with crimes. Nor do I oppose being extra careful vetting immigrants from dangerous war torn countries.

      • dhlii permalink
        March 8, 2017 3:30 pm


        It is not so much about “democrats started it”.
        as about in modern times the effort to silence and shout down opposition – through violence if necescary is uniquely progressive.

        It is the left pushing trigger warnings, safe spaces, and micro agressions,
        it is the left banning speakers, resorting to violence and confusing peaceful protest with silencing oppinions you think you do not like.
        All too often the left does not even bother to know what those it protests are really saying.
        They have been labeled “hateful hating haters” and that is enough.

        The blow back of the intolerance of the left was a major factor in the outcome of this election.

        Post election the conduct of the left has been reprehensible.

        I have zero problems with protesting – I have problems with violence intolerance and insult as a substitute for argument.

        I do not care if you want to organize before a meeting.

        Do what it takes to assure that your viewpoint gets expressed.
        Then you owe those who differ the same respect in expressing theirs.

        Free speech does not mean – only your speech.
        When organizing means assuring that no voice besides yours is heard – that is not free speech tolerance or protest.

        That is censorship, intolerance and violence.

        And people can tell the difference.

    • dduck12 permalink
      March 6, 2017 10:20 pm

      @Priscilla 10:24: For Lynch is an honourable person;. So are they all, all honourable persons”
      ““He did come over and say hello, and speak to my husband and myself, and talk about his grandchildren and his travels and things like that,” Ms. Lynch said at a news conference in Los Angeles on Wednesday, where she was promoting community policing. “That was the extent of that. And no discussions were held into any cases or things like that.”

  21. Roby permalink
    March 6, 2017 2:00 pm

    “The Democrats allege, apparently without evidence, that Trump and his people are Russian spies, who turned the election in his favor. I find that utterly bizarre and ridiculous.”

    Because it is ridiculous. And I have heard no democrat say that although I am sure you can find some democrat in congress foaming at the mouth somewhere saying outrageous things.

    The way I said it above however, is quite plausible.

    Evidence there is in plenty, if by evidence we mean clear signs that trump’s team had an inappropriate level of contact with the Russian Government and got, coincidentally or not decisive dirty trick help. Proof is whats lacking, not evidence. Which is why a real investigation is needed. Imagine the pleasure of saying “I told you so” to me and Jay and others if the investigation comes up dry.

    Priscilla, you must have said at least 5 times here during the campaign that if trump got elected you expected him to be impeached and fine, and the same for Clinton. So, he got elected, and now a fair investigation seems like too much to you, let alone an impeachment, that would be simply overthrowing the legally elected government.

    You and tens of millions of others have been through the four stages from denial to acceptance followed by embracement and dogged defence,

    I and tens of millions of other have been through a different process and it did not come out at embracement.

    We can go on like this for the next 2-3 years, but we will have hard time saying anything new.

    I am willing to just wait and see what the outcome is. I wish I could just fast forward and skip the commercials and all the drama. Damned brain, it won’t stop watching.

    I can’t imagine the dems coming up with a 2020 candidate who will unite us. My best vision of someone uniting us, or at least bring the division down from the stratosphere, is, god help me, Pence.

    Tell me that somehow a moderate conservative with a good and amiable character will become president, with the Senate being 55-45 dem controlled and I will be back in my comfort zone. But that seems like a fairy tale, we will have a GOP debacle followed eventually by a Liz Warren-type dem debacle.

    Worst case scenario, after 4 years of a trump mess, Micheal Moore pulls a trump, runs the table against a field of normal democrats using the populist shtick in the lefty version, and we get a dem controlled congress too. If that happens you won’t see me going through a 5 stage process that ends in embracement, I promise you, and I think you will believe me when I say it.

    • Priscilla permalink
      March 6, 2017 2:38 pm

      I worry about that (not Michael Moore specifically) and, in general, the likelihood that, regardless of who the next president is, the opposition party will do nothing but try and sabotage him/her.

      Obama spent almost the entire transition, setting up “landmines” that would make it difficult for Trump to enact his agenda. As far as I know, no modern president has considered that his role during a presidential transition. The press spent much of last week talking about how he and Valerie Jarrett (his “steve bannon”) will be the leaders of the resisitance to Trump, with the goal of forcing him to resign of having him impeached. What president has done that? And what would you have said if Bush had done that to Obama, stating that he was trying to prevent the transformation of America?

      We are in uncharted waters, with a government that is at war with itself.

      • dhlii permalink
        March 8, 2017 2:36 pm

        GWB reportedly engaged int he most cordial transistion ever.

        Obama is setting the record for the most hostile.

        This is also an incredibly dangerous game.
        There is a significant distinction between resistance and criminal misconduct.

        There have been numerous leaks – from the intelligence community that go beyond the typical policy leaking. These are felonies and Obama agressively prosecuted those in his administrationt that leaked intelligence to the press.

        Trump does not often back down – and he is not backing down here.

        Trump could have chosen to ignore this carping from the wings and let it die eventually on its own.

        He has taken a much more aggressive stance.
        He is either winning or losing.

        Essentially either evidence is going to be produced that results in his impeachment – which increasingly seems unlikely.
        Or the former government officials behind this are going to be hounded, and likely prosecuted.

        I would further note that contra Obama his administration was not the most scandal free. What is true is that the press did not even try to chase any scandals to the whitehouse.

        There are numerous instances during his administration of using the machinery of government to target political opponents.
        From leaks of tax returns to IRS political malfeasance.

        Obama does not come into this with clean hands, and he is no longer president, no longer government, his actions will be viewed quite differently.

        If he wishes to speak out openly in opposition to Trump policies – that is his perogative and right – though it has been very rarely excercised by former presidents.

        If he chooses to lead a covert opposition attempting to essentially run spies inside the administration – the consequences could prove disasterous.

        Obama’s OfA has already been video taped organizing the fake grass roots protests at republican TownHalls.

        Further the country is getting fed up with peaceful protest on the right being called hate speech while those on the left engage in actual disruption, silencing rather than merely protesting opponents and on occasion resorting to violence.

        The Anti-PC movement was a significant factor in Trump’s victory.
        There is building anger of ordinary people at being told to sit down and shut up, by people who resort to violence when any oppinion besides their own is expressed.

    • dhlii permalink
      March 8, 2017 3:41 pm

      You say there is evidence a plenty – so produce.

      This “inapproriate contact” cannard is pure nonsense.

      You are holding Trump to a standard that no other candidate has even been held to.

      We have already been through the Sen. Sessions nonsense.
      I do not agree with Sessions on most anything.
      But I am not so stupid as to beleive that a member of the senate armed forces committee would not shake hands and chit chat for 15 minutes – in the presence of two marine colonels with the russian ambassador at a dinner party.
      The left claimed that was unusual – until video emerged of nearly the entire democratic senate caucus at one time or another meeting with Sislak.

      This is a major problem I have with the left – hypocracy.
      Only others have to conform to your standards.

      What constittutes appropriate varies depending whose conduct we are talking about.

      Obama was caught on an open mike telling the Russians that after the election he could be more flexible with them.

      How is that NOT exactly what Trump is being accused of ?

      Provide actual evidence – not proof that Trump and his people have had contact with Russians – Clinton had LOTS of contact with Russians – far more than Trump.

      You need actual evidence of collusion.

      In FACT with respect to evidence they entire “Russia hacked the election” meme is without solid evidence.

      There is still no evidence that the russians hacked the DNC.
      Wikileaks continues to assert that it was an inside job.

      The recent CIA dump adds credibility to that.

      What there is evidence of is current and former Obama aparatich’s going beyond protest, into criminality to reverse the results of an election.

  22. Priscilla permalink
    March 6, 2017 2:19 pm

    “Evidence there is in plenty, if by evidence we mean clear signs that trump’s team had an inappropriate level of contact with the Russian Government and got, coincidentally or not decisive dirty trick help. Proof is whats lacking, not evidence.”

    I assume that you are defining “evidence” as a lower standard than “proof.” The two words are often used interchangeably, but I agree with you that “proof” is the beyond-the-shadow-of-a-doubt standard.

    I am curious as to what evidence you have seen or read about that shows these inappropriate contacts, because I have seen nothing. Just innuendo. Evidence would definitely be helpful, and if there is none, the Democrats should shut up.

    • Roby permalink
      March 6, 2017 2:37 pm

      I’m sorry, but you sincerely never Are going to see any evidence, its tied up in the psychology of the embracement thing. I’d have a lot more interest in an argument that admitted both sets of evidence, those that support and those that argue against trump’s inappropriate contacts. The “there is not one piece of evidence” line is pure defence lawyer 101. And I, like many Americans, never believe a damn word that a defence lawyer says in public pre trial about his client, and damn little of what they claim in court.

      I see evidence of what I stated, not proof, but evidence. Evidence is any fact that can support the case that trump’s team had an inappropriate level of contact with the Russian government. Its a bit astonishing that you can’t find a single fact that supports what I am claiming about trump, but the mind is an amazing thing. I’ll gladly list five or ten things that support the possibility that he is innocent, if you will agree to open your mind and find things that support his guilt. Not prove it, support it.

      Politics in addition to all the other nasty things it is, also is a game of playing lawyer by partisans, Defence attorney for one’s own side, prosecuting attorney for the other side. FInd me a defence attorney who thinks there is a shred of evidence that his client Billy Madman Jones shot up the local saloon, even if he did it in broad daylight in front of 15 witnesses. Its a game all right. He is completely innocent and I am confident we will prove it. Blah, blah, blah. We just tune it out, its expected BS.

      • Priscilla permalink
        March 6, 2017 2:49 pm

        Roby I was genuinely asking ~ what is the evidence? Evidence has to be something, right? It can’t be just people saying, “oh, I think Trump loves Putin.” Even circumstantial evidence has to be something. For example, where is there a quid pro quo? If Trump is a Russian agent who got assistance from the Russians in defeating Hillary, what did the Russians get from him?

        When I said that after Hillary approved the sale of 20 % of uranium deposits to Russia, and got $150 million in donations to the Clinton Foundation, both you and Jay pooh-poohed it, saying there was no proof. Correct ~ but that was circumstantial evidence.

        I’ve read an awful lot of accusations, but none with even circumstantial evidence. Just anonymous leaks showing “contacts” of “Trump associates.” I don’t find that convincing. There’s no there there.

      • Roby permalink
        March 6, 2017 3:12 pm

        ” If Trump is a Russian agent who got assistance from the Russians in defeating Hillary, what did the Russians get from him?”

        For the $%^&*$th time, I DO NOT BELIEVE THE TRUMP IS A RUSSIAN AGENT.

        I explained above what I think he may have done, not because he is a Russian agent, but because he is a clumsy, ignorant, arrogant fool with no respect for boundaries who is incapable of believing that anything he does is wrong. I suspect that he wowed the putin government by previewing his ideas on foreign policy vis a vis Russia that reversed the western sanctions and allowed putin to believe the former USSR is his rightful possession.

        Priscilla, this game is boring. I am prepared to play a different game with you, we switch sides and you play prosecutor and come up with the best case, and make it convincing, that trump broke the rules and putin favored him in return, whether or not that was explicitly promised. I will then come up with the best case scenario that trump was clumsy, clueless about appearances favoring putin’s actions, but not technically in violation of any US law or policy. You go first, because I already know that I can make a fact based case to defend trump, but I doubt that you can bring yourself to convincingly use facts to impugn the legality of his behavior with putin. Because that would be admitting that your side might have actually done something worth an investigation. If you will not break through that mental barrier I am not going to beat my head against the wall of making an ideologically blinded person see.

        There are GOP politicians with integrity, who I have long admired, who are with me in suspecting trump in this or at least are with me in believing that actual facts give this such a bad appearance that it needs to be investigated. Your position is that they McCain, Lindsey Graham and others, are doing that based on nothing at all. You ought to be able to see that this is not the case.

      • Priscilla permalink
        March 6, 2017 3:47 pm

        I’m not TAKING a side. I am saying, as I believe you are, that there is currently a “Democrat truth” and a “Republican truth” and that we would be much better off if we ignored those “truths” and tried to look for objective evidence of what may or may not be going on.

        There is literally NO evidence that the Trump campaign had inappropriate contacts with Russia. There is literally NO evidence that Obama wiretapped Trump Tower.

        Does that mean that both of these things are false? No….but it CERTAINLY does not mean that they are true, or that there is even a kernel of truth to them. You are likely to believe the innuendo about Trump, I more likely the innuendo about Obama. I’m sorry if you have changed your view of Trump, and I missed it. In the past you have said that you believe that he is guilty of treason, so I was going off that.

        But the never ending media drumbeat is about Trump. And Obama is treated as untouchable, for the most part, except by the conservative press, which tends to be less influential. Much of this is Trump’s own doing, much of it is not.

        What I am saying is that voters should not play the game that the media plays ~ the “when did you stop beating your wife?” game, and the Party Truth game. We should stay focused on our own priorities , i.e. the economy, freedom of speech, immigration, etc. and we should demand evidence from the media when they try to attack or defend a president or a party.

      • dhlii permalink
        March 8, 2017 3:31 am

        Given that my wife is a criminal defense attorney – I take great offense at your remarks regarding what denece attorneys say.

        We have entirely lost the presumption of innocence in much of this country.

        Though interestingly today in my country, a judge just declared a mistrial – after the prosecutors opening remarks – because those remarks had violated the rules of court and the rules of professional ethics.

        In my experience – most lawyers – including defense lawyers are not all that good. But far more so than any other attorney’s defence lawyers do their job out of principle.
        Unless you are defending OJ – criminal defense is near legal poverty.
        Almost no one becomes rich as a criminal defense attorney.

        Despite my assertion about the loss of the presumption of innocense – innocent clients are rare.

        Many criminal defendants are not guilty of what they are charged with.
        But they are still criminals.

        Further we universally overcharge the crap in order to force plea bargains.
        That all sounds good and efficient – except that most criminal defendants are guilty is a far cry from all are.
        Is it moral or ethical to charge someone – who is supposed to have the presumption of innocence – and might actually be innocent with a far more serious crime, to coerce them into pleading ?

        Criminal defense lawyers are standing up for their clients – even the guilty ones, because everyone is entitled to the best defence they can get.
        That is moral.

        BTW the rules of professional ethics forbid lawyers from lying, or misrepresenting.

        And I can assure you that Discipline boards take violations of the rules of professional ethics by defense attorney’s incredibly seriously.
        Though the same violations by prosecutors and civil attorneys are ignored.

        I have seen far far more egregious misconduct by prosecutors than defense attorney’s.

        I would also note that prosecutors are far more ambitious and politically motivated.
        Defense attorney’s are going to lose – nearly all the time. They know that up front, yet like Don Quixote they continue to tilt at windmills.
        Wins are rare and far between.

        Conversely a prosecutors career could be over if they lose – even a case they should lose.
        ADA’s what to be DA’s DA’s want to be judges.

        I have to laugh our local DA is running for a state superior court seat – claiming the superior court needs a Prosecutor as one of its members – there are currently 5 former prosecutors.

      • dhlii permalink
        March 8, 2017 3:47 am

        With respect to Trump and the Russians.

        Sorry, so far there is nothing there.

        First, I still do not buy that Putin wanted Trump to win.
        In nearly every way Trump’s policies are at odds with Russia’s

        Russia is close to Iran – Trump is distancing the US from Iran.
        Russia is in a deep recession due to low energy prices.
        Trump is intenet on doing far more than Obama to drive energy prices even further down.
        Trump is building up the military.
        He is increasing missle defence.

        Aside from Trump’s stupid fawning one way bromance over Putin, there is no good reason for Putin to prefer Trump over Clinton.

        Clinton’s connections to Russia are far far deeper and far far more real than Trumps.

        What purported evidence we have been given is not merely weak, but thus far nothing has been confirmed, and nothing new emerges.

        Ben Rhodes and his gang periodically pop up to restart the echo chamber – but there is nothing new, just the same echo’s getting fainter and fainter.

        And the more we learn the less inappropiate anything turns out to be.

        Incoming administrations always make contact with foreign leaders.

        Obama himself told the russians he would be more flexible AFTER his election.

        Sessions recused himself because he had a few words with the russian ambassador at a public dinner party in the presence of two Army Colonels.

        Yet, nearly the entire senate has apparently done the same.

        Russia does not send diplomats to the US to lock themselves in their embassies. They are here to make contacts, to talk to people inside our government and out – to lobby in essence.

        What we do incontrovertably have is leaks of signals intelligence – that is a felony – much worse than Clinton’s email.

        What we appear to have is an ongoing investigation of a political candidate during an election without the evidence that any actual crime was committed.

        Trump has named Obama, and Obama’s surrogates have issued quite careful “non denial denials”. In other words – there was an administration investigation of Trump without sufficient probable cause to do so, but no means of proving that it was ordered by Obama.

      • Roby permalink
        March 8, 2017 10:11 am

        “I take great offense at your remarks regarding what denece attorneys say.”

        How ironic. You could have merely greatly disagreed with me, but you, poor soul, are yet another example of the great American “I am greatly offended” culture.” You’d fit right in at a modern hypersensitive college campus!

      • Priscilla permalink
        March 8, 2017 10:17 am

        Hey, Dave, good to see you back!

        Regarding the ongoing Russia business ~ I believe that the Democrats could be doing great harm to our foreign policy objectives by publicly treating Russia as an enemy. Jeanne Shaheen, Senator from N.H, actually said that the alleged DNC hacking could be considered an “act of war” That is dangerous, hyperbolic rhetoric. If Trump had wanted to pursue some thawing of relations with Russian, based on a mutual goal of defeating ISIS, he cannot do that now, because any detente with Russia will be called “evidence” of his “secret” pact with Putin.

        I do agree with you that Trump said some stupid things about Putin during the campaign, but when it comes to politics, words are often meaningless, and actions, such as appointing Russia hawks like Pompeo, Mattis and others, and having Mattis go to Europe and reaffirm our ties with NATO should speak to the issue in a far more meaningful way. Loose lips do sometimes sink ships, but this has gotten ridiculous.

        I believe that Julian Assange is in league with Russia, and the most recent WikiLeaks dump, which is tremendously damaging, especially coming after all of the IC leaks that we have seen in the last month, highlights the fact that, apparently we (and I presume Russia, China and others) can make a hack like the DNC one appear to have been done by another country,

        I think that the timing is not coincidental, and that the CIA had better get its act together, before we have a president who must operate without a functional spy agency. Ron has said that this whole political witch hunt has helped only the Russians. And, I believe he is right.

    • dhlii permalink
      March 8, 2017 2:18 pm

      Actually there is a great deal of evidence supporting Trumps claims – from the left Press stories themselves.

      • Priscilla permalink
        March 8, 2017 5:50 pm

        True, but all anonymously sourced. The only thing we do know is that General Flynn was in Trump Tower when he spoke with Kislyak on the phone. People have said that it was Kislyak who was tapped, but we really don’t know that for sure ~ it could have been that the phone Flynn used was bugged. And who, exactly, was tapping the call and why? In either case, Flynn was a private US citizen at the time and if, in fact ,a transcript of the call was made available to the press, using his name, it was a serious crime.

      • dhlii permalink
        March 8, 2017 11:28 pm

        It does not matter whether Flynn was a private citizen at the time.
        He was not a foreign national.

        BTW the mere fact that the information regarding Flynn’s contact got out demonstrates the seriousness of the problem – it is not just that there are leaks. But FISA warants are easy to get BECAUSE they are required to be extremely careful about any part of the execution of the warrant that results in wiretapping a US citizen. The compartmentalization of information is rigid.

        You want permission to WireTap a foreign terrorist – easy peasy.
        But if they end up talking to someone in the US.
        The record of that communication is incredibly strictly controlled.
        Under many instances a recording or transcript of the citizen can not be kept – or another warrant must be aquired targeting that individual.

        The leakers had access to the communications between Flynn and Sislak.

        Either they had access to information that should have been so tightly controlled that it would have never gotten out of the hands of a tiny number of people OR Flynn was the target or the wiretap.

        The intense compartmentalization is the price that is paid for the ease with which FISA warrants are granted.

        A FISA warrant is not even allowed to be an accidental means of bypassing the constitutional protections of US citizens.

        Again I would strongly suggest reading Andrew McCarthy on this.

        There is enough information that the press has reported that there are really only three possibilities.

        1). The press has been lying
        2). The anonymous sources have been lying.
        3). The Obama administration was spying on Trump.

        Further 1 + 2 are actually unlikely as the stories the press has run are highly consistent – and particularly consistent with scenario 3.

        I would note Obama had no problems wiretapping journalists.

        I would also note that there have been stories getting out in dribs and drabs since july 2016. Such as that about the computer in Trump Tower that was constantly contacting a bank in Russia.

        These stories were leaked to the press.
        There is not a way of arranging the stories that does not lead to the conclusion that there was an investigation of Trump going on.

      • dhlii permalink
        March 8, 2017 11:30 pm

        I would also note that Trump does nto look nearly so unhinged accusing the Obama administration of wiretapping him – when WaPo and NYT ran stories nearly two months ago with healines saying Trump staff was caught by wiretaps.

  23. Priscilla permalink
    March 6, 2017 3:10 pm

    And, in other news, the North Koreans fired 4 missiles into the Sea of Japan.

    • Roby permalink
      March 6, 2017 3:20 pm

      And In a further development, the trump administration sent Steve Bannon to sit in the Sea of Japan just off the Korean coast in a little boat with a high powered megaphone to advice Kim Jong un that he is NOT to do this again, or we will spread rumors about the size of his penis (Kim’s not Bannon’s) on

      Now I am out into the fresh air of the real world for the rest of the day and I can only hope that Lil Kim will see that his position is bleak by the time I come home.

      • Priscilla permalink
        March 6, 2017 3:33 pm


      • Priscilla permalink
        March 7, 2017 9:28 am

        I sometimes listen to John Batchelor, if I’m driving at night. He’s always got guests that tend to be very centrist, as he is (I think he used to be considered conservative, but, now that most conservatives have moved farther right, he’s considered a centrist). The other night, he had a panel on North Korea’s warmongering, and one of them (I never know who they are,but they are generally experts in whatever field is being discussed) said that Trump’s meeting with Abe of Japan, and Mattis’s trip to South Korea were both public indications that the administration was anticipating war drums out of NK, and, further, that NK was doing this as a proxy for China, now that the US has signaled its intention to honor its obligations to SK and Japan,

        So, if Steve Bannon is sitting in a boat, insulting the Nork leader’s manhood, he’s probably gone rogue. 😉

  24. March 6, 2017 5:29 pm

    Excellent article about Manchin and what it means to be a “Centrist”. To bad there are not more like him.

    • Priscilla permalink
      March 7, 2017 9:03 am

      Excellent piece on Manchin. I took note of the fact that he was the only Democrat (or ar least the only one that I noticed) who stayed after the end of Trump’s Joint Session speech, to shake Trump’s hand and congratulate him, as the other Dems were racing for the exits, as if someone had yelled “fire!” lol.

      It wasn’t that long ago that there were the “blue dog” Democrats, who represented the fiscally conservative, socially moderate/liberal wing of the party. Other than Manchin, they seem to be all gone now.

  25. Roby permalink
    March 7, 2017 5:21 pm

    Bravo, now follow up on it, stay on it, what consequences, what kind of effort fo find the thugs? The Middlebury president did pretty well in this mess, will she follow through?

  26. Anonymous permalink
    March 9, 2017 1:48 pm

    Good to see you again. In your case that Putin did not nessaserily prefer Trump over Clinton, you mentioned Russia moving more toward Iran and Trump’s rhetoric showings a move away. I agree that is the direction of both leaders but that doesn’t help your case as in personal relations, if you want to be closer friends with a person, having someone else moving farther away from said person does not diminish, even perhaps increases the chances of your relationship growing. Mike Hatcher

    • dhlii permalink
      March 9, 2017 7:23 pm

      There are multiple levels to this.

      One argument I heard FOR Putin messing with the election is that like everyone else he expected Clinton to win, but he decided to wound her as much as possible so that she took office weak. And that he was as surprised as the rest of us that she lost.

      I am inclined to avoid issues of personal preference. They are immeasurable.
      I do not think it is possible to gauge how Putin feels personally regarding Clinton or Trump.
      More complicated still – how far will Putin take those personal feelings when weighed against his own and russias best interests. ?

      How far will others in Russia allow Putin to go based on personal preference against the interests of the country ?

      We can measure the relations of Trump and Clinton to Russia – Clintons dwarf Trumps, even excluding her tenure as Sec State.

      We can measure the effects of their differing policies.

      If you want to argue that Putin committed the resources of Russia to defeating Clinton because he likes Trump better – I can not address that.

      But if we are trying to gauge the probability of Russia favoring Trump over Clinton based on measurable criteria – Russia interests were overwhelmingly with a Clinton presidency.

      BTW none of the above is “libertarian”. It is just logic. It has no ideological component.

  27. March 9, 2017 5:23 pm

    Dave. Glad to see you have returned. We need the libertarian point of view more represented here. I view myself as being libertarian, but then I find it hard to express those views as well as you do sometimes.

    So now for some issues that are important .
    !.What’s your views on the current healthcare bill as proposed by the house?
    2. If you support the freedom caucus position of no tax credits, do yu think there will be an alternative bill?
    3. If healthcare does not get done, what’s your thoughts on the impact on Trump
    4. And last, if healthcare does not get done, how does that impact the rest of the GOP agenda?

    Once you respond, I will weigh in on my thoughts, but want a starting point for a good conversation.

    • dhlii permalink
      March 9, 2017 7:39 pm

      I do not know that much about the current Bill.

      I heard about some comments from the Freedom Caucus and Heritage that confused me, and did not seem consistent with what I would expect from those.

      I also listented to about 10 minutes of Paul Ryan defending what they came up with and explaining why it is less than someone like me would hope for.

      His defense was elequent, and “mostly” I agreed with it save for one strategic issue.

      Ryan is claiming that what he is doing is part of a 3 step process. The current bill is NOT the GOP Healthcare Plan. It is just what he can get through reconcilliation in the Senate right now.

      That is probably where I part company. Ryan has divided the path to a new Health insurance approach into 3 parts.

      My concern is that once the first passes – the next two steps will likely die.

      For me to get behind the Current Ryan bill, I have to be willing to live with it, if it is all that happens.

      I have to think about that. I do not have an answer. But I am skeptical.
      Right now I am inclined to do nothing. PPACA is failing. Let it fail. I think it will be easier to do right after what we have has failed. A bandaid on PPACA – even a big bandaid, surrenders the ability to actually solve the problem.

      Just to be clear though, I has have repeatedly said – compromise is a tool – not a value in and of itself.

      Again I have not really looked at the Ryan bill yet.
      If I beleive this is actually the best that can be accomplished – I might accept it.

      But compromise measures have other risks too.

      We know – well maybe others don’t but I do and the evidence shows that for nearly all problems free markets provide the best solutions – Ronald Coase got a nobel prize for proving that.

      Half free markets are extremely dangerous. Free markets mostly self regulate – partly free markets can go completely off the rails.

      California dergulated half the energy market and ended up with rolling blackouts.

      Sometimes the unintended consequences of compromise positions are far worse than either extreme.

      Though I think Rick leans further left than he is self aware of.
      Rick and many of the “moderates” here beleive that the middle way is nearly always better than the alternatives.
      I do not think that is MOSTLY true.

      I think it is often better to allow something bad to happen and fail, and learn from that failure, than to produce some intermediate bastard sollution that fails far more slowly.

      • March 9, 2017 9:20 pm

        Dave, i was going to try to answer all of your comments in one message, but decided to do them attached to the comment you made.

        “Right now I am inclined to do nothing. PPACA is failing. Let it fail. I think it will be easier to do right after what we have has failed. A bandaid on PPACA – even a big bandaid, surrenders the ability to actually solve the problem”

        I agree with you 100%. Had they let this awful program die from the leaves down to the roots, then they could have designed one that worked without left and right politics playing into it like they have now. When it is only dead at the branches, there are many who think they can save the whole thing by changing a few regulations here or there.

        Now they own the replacement plan and anything they come up with will be a political hot potato..

      • dhlii permalink
        March 10, 2017 12:31 am

        Ron P;

        One of the problems that PPACA had is also the problem the GOP will have replacing it.

        While near everyone agreed that what we had was broken – just as they do now, there is not and probably can not be majority support for a single solution.

        While this problem is more obvious with PPACA and healthcare, it is a general problem with government.

        It is why the default must always be – to handle the problem without govenrment. There are many requirements to justify the use of force by government. One of those is majority – possibly even supermajority support.

        Legislators tend to engage in log rolling and grease with pork to build support.

        But in the real world you can not get 5 of 9 to screw the other 4, by putting together 3 who want one thing that the other 6 do not and 2 who want another that the other 7 do not – atleast not when you are going to end up using force against the other 4.

        In voluntary arrangements, real compromise comes at our own expense.
        If I compromise to get something I want – I gave up something I wanted to get something I wanted. In politics I agree to screw over someone else for what I want. It is not morally the same.

        Anyway, The only truly moral means of handling healthcare is to get government out of it. That will not be perfect, but the imperfections will be the consequence of our own individual choices, and not imposed by force on others.

        But that is not what we are going to see.

        So one way or another the GOP has been suckered into doing exactly the same thing that Obama did – imposing some plan that at best will have plurality support against the wishes of most people.

        The only hope the GOP has is to do better than PPACA.
        The good news is that is not hard.
        The bad news is it is still being done by politicians

      • March 10, 2017 1:14 am

        Free market forces should be the controls that insure the needs of the people. But greed gets in the way and then you have insurance companies selling products to well people and then when they get sick, the coverage is cancelled. That might be free market forces, but it is not acceptable actions, so a plurality demand changes to control the greed.

        So yes, free market forces is a starting point for everything and then when human nature and greed take over and have significant negative impacts on a good percentage of the population though no bad actions of their own, then regulations need to be in place to reign in the greed that drives the negative influences.

        So to close you say “Anyway, The only truly moral means of handling healthcare is to get government out of it. That will not be perfect, but the imperfections will be the consequence of our own individual choices, and not imposed by force on others.” ………Sorry, but when people pay insurance premiums for years and never have a significant claim and then develop breast cancer and the coverage is cancelled and no other insurance will cover them, that is not a consequence of their own individual choice. It is forces being imposed by others on those that have made all the right moves all their life and due to genetic reasons, they develop an illness that the greedy insurance companies decide is not worth covering and their putting profit before moral choices.

        Free market forces work when corporations and insurance companies act in a moral way. That is what led to this mess. Greed or morals.

      • dhlii permalink
        March 10, 2017 12:40 pm

        First, the fact that the free market is the primary means of regulating conduct, does nto make it the only one. Nor does it mean there is no role for government.

        Too many seem to think that libertarianism equals anarchy.

        That government may have a role does not mean government has any role we choose.

        Government is limited to those three domains I keep repeating.

        In your hypothetical – if an insurance company promises something in return for your premiums, and it fails to deliver, that is breach of contract and it is legitimate for governemnt to enforce the contract.

        Regardless, the plurality do not have the right to use force merely because the demand to.
        Nor even because they see an outcome they do not like.

        The use of force – and all government is force, requires justification.
        Any action you can not morally take as an individual – you can not morally take as a group.

        I try to avoid the word “greed” as it means different things to different people. ‘
        If in your conduct you have not: initiated force or fraud, kept your agreements, and not actually harmed others, then your conduct is no one else’s business.
        If you have profited – that is great, in fact it is great for all of us, because it is not possible to profit and conform to those constraints without benefiting others.

        Free – atleast mildly free markets in China have raised the standard of living of 1.6B people from the bottom of the third world to the bottom of the first world since Mao’s death.

        Mother Theresa has not done so much good. Every charity ever in existance and every social safety net program ever added together have not done so much good.

        If morality is measured by the benefits to “the most vulnerable” no system in existance is more moral than free markets.

        Most of the time when people talk about greed they are really talking about their own envy.

        If the dark side of human nature is your concern – then your focus should be on govenrment. Free markets are subject to self regulation, and to those three legitimate constraints I keep noting. There is no real regulation of govenrment.
        Quis custodiet ipsos custodes?

        Please give me a real world example where gree results in negative impacts on broad segments of the population without bad actions that is not covered by the three constraints I keep repeating ?

        There is none.

        Which raises another issue – what constitutes actual harm.

        Having less choices than you would prefer is not actual harm.
        Having less desireable choices than you want is not actual harm.

        We tend to confuse the freedom to do as we please with the ability to do so.

        I am free to be a concert pianist. I do not have the natural ability to do so, and no one owes me those abilites. Further no one owes me the opportunity. Juliard is not bound to accept me – merely because I want in. If something you think is a right or freedom imposes a positive burden to act on others – then it is not a right.

        Food, shelter, jobs – these are NOT rights. No one owes them to us.

        With respect to your quasi hypothetical.

        I do not care if you have had health insurance all your life, or 5 minutes.

        If an insurance company contracted with you to provide you medical coverage, and it violated that contract then you are entitled to have govenrment compel them to live up to that contract.

        We do not need regulations or a massive federal government for that.

        You seem to think that absent a regulation, there exists no remedy for some problem.

        I assert that you can not come up with an actual real world problem that is not already covered by the three principles I keep repeating.

        The foundation of all morality is liberty.
        There is no system of morality that does not start with free will.
        Absent freedom morality does not exist.
        Restricting freedom outside very narrow justifications is inherently immoral.

        Finally, though this observation comes from economics, I think it has broader application.
        Free people – even attempting to act “immorally” constrained by those criteria I have offered can not ultimately help but benefit others.

      • March 10, 2017 4:10 pm

        Dave ..”Free – atleast mildly free markets in China have raised the standard of living of 1.6B people from the bottom of the third world to the bottom of the first world since Mao’s death.”

        Yes and if an individual is found to do some of the things that someone in America does and gets their hand slapped and a minor penalty, in china you may find yourself in prison for 25 years or even worse, disappeared. They know how to control “greed” differently than we do.

      • dhlii permalink
        March 10, 2017 11:45 pm

        Actually no – the chinese are far worse at “controlling greed” than we are.

        Though the “controlling greed” meme is nonsense.

        Please PRECISELY define what greed is ?

        I do not beleive that you can.

        But more importantly,
        define some actually harmful human conduct that does NOT fall under atleast one of the 3 areas I repeatedly identify as the legitimate role of government.

        You may not initiate force or fraud against others – not to profit, not for any other reason.
        You may not renege on your agreements with others – not to profit, not for any other reason.
        If you actually harm others – you must fix it.

        Tell me something that you can do that would be “greed” that would not be covered by one of those points, that government should prohibit ?

        There is nothing.

        Outside those limits – what you call greed is just “envy”.

        And quite honestly GOOD, not bad.

        It is either impossible or nearly impossible to profit unless you provide far greater value to others, UNLESS you violate one of those strictures.

      • dhlii permalink
        March 11, 2017 12:04 am

        China has 118 people in prison for each 100,000 of population – the US has 737.
        Your chance of being executed in China is about 1:1000000 according to manesty international. While China executes just under 2000 people per year – they have 5 times as many people.

        There are alot of problems with China – including a very poor legal system

        Nor is it likely that the standard of living in China will exceed that of the US – absent very substantial increases in freedom – including political freedom.

        At the same time that total burden of government on the people in China – is about 1/2 that of the USE. China has a 50% smaller government as a portion of GDP.

        If you really want to understand China – particularly since Mao’s death,
        and you want an excellent easy to understand primer on economics from one of the top 4 economists of the past century
        Try “How China became Capitolist by Ronald Coase.

      • Roby permalink
        March 10, 2017 9:11 am

        “Sorry, but when people pay insurance premiums for years and never have a significant claim and then develop breast cancer and the coverage is cancelled and no other insurance will cover them, that is not a consequence of their own individual choice. It is forces being imposed by others on those that have made all the right moves all their life and due to genetic reasons, they develop an illness that the greedy insurance companies decide is not worth covering and their putting profit before moral choices.”

        Yes. An excellent comment from the real world, an escape from blind ideology and a call for common decency and common sense.

        Dave’s ultrapure ideological line has no political chance and Ron has neatly explained why.

        Now, as to what we Should do, Oh boy, that is hard. But you can’t ignore Ron’s perspective from someone with personal professional knowledge and understanding of the problem when coming up with the range of options. In the end the issue that Ron has brought up is too powerful and affects too many people for the ideologues to overcome it. What an ugly mess the politics of this are going to be. Anyone who is trying to actually objectively understand the size of the real problem and honestly find some solution will have many chances to do so during the upcoming battles. Others will remain clueless and howl in ideological rage for their pure solution in their imaginary world and primary their GOP congress person if they show the slightest recognition of reality.

      • dhlii permalink
        March 10, 2017 12:52 pm

        Sorry Robby,

        But Ron is wrong – for obvious reasons in his own argument.

        If you have a contract with another party, and they fail to honor it, it is within the legitimate power of government to enforce that contract.

        You and Ron confuse minarchy with anarchy.

        Even ignoring my libertarian principles – what are yours ?

        Lets look at this hypothetical – without a presumptive ideology.

        What are the principles that you use to define the power of government to use force against one party.

        Why may the government force the insurance company to cover the woman with cancer ?

        May government use force whenever it wishes ?
        What principles – if any define when government may use force – and when it may not ?

        If there are no principles – then can’t government equally easily say – the woman must pay for insurance, but is not entitled to coverage ?

        I have been deliberately vague above – because I am asking YOU to provide the criteria by which we determine when force can be used and when it can not.

        But I ask you to consider – whatever basis you use to justify for – that basis can almost always be used in ways you likely do not want.

      • dhlii permalink
        March 10, 2017 1:01 pm

        I do not thing Ron’s hypothetical is all that powerful or difficult.

        I think it is already well addressed. In fact it is not merely address by my libertarian minarchy, but even anarcho-capitalists can successfully address it.

        The most fundimental problem with Ron’s hypothetical – the common fallacious argument against libertarians or even more generally limited govenrment conservatives, is the false presumption that the choice is between anarchy and unlimited government.

        That is not the case.

        While it is actually the case that Ron’s hypothetical can not occur broadly – even with ONLY free market self regulation – otherwise no one would buy insurance.
        Even accepting that there is some window that insurance companies can find – where they provide some of the coverage they agreed to – enough that people continue to buy insurance, but still violate their agreement with others, government still has a legitimate role in enforcing agreements. ‘

        Regardless, Ron’s hypothtical does not demonstrate the failure of free markets.

      • Roby permalink
        March 10, 2017 10:21 am

        I always have said, and finally even wound up convincing my father, that the democrats made a huge mistake in using their majority after 2008 to tackle health insurance when dealing with the financial crisis should have alone been the target. The bitterness that flowed from that was not worth it.

        On the other hand, if I were one of those or related to one of those with a serious or fatal illness who have been screwed by health insurance companies I might well believe that the democrats were finally doing the right thing and thank god. No one else was about to really follow through.

        So, whether the Obamacare effort to finally deal with tens of millions of uninsurables was great or terrible seems to depend on perspective and health. I don’t think that Obamacare put its conservative ideological opponents to nearly as much pain and cost as the health insurance companies put seriously or fatally ill patients and their families.

        The political process is going to deal with this issue only with the most tremendous upheaval and outrage, mostly because of hardened ideological patterns of thought on the right and left by people who are sure that their pure positions are the answer and who managed to infect the whole process with their oversimplified certainties.

      • dhlii permalink
        March 10, 2017 1:05 pm

        When Obama was elected, the democrats mandate was to restore prosperity.

        At that he failed, and that is why the GOP now controls much of the country.

        That BTW is ALSO the mandate they have – not repealing PPACA, not sealing the borders.
        And ultimately that is what they will be judged on.

      • dhlii permalink
        March 10, 2017 1:20 pm

        With respect to PPACA, one of its failures is contained in the false presumptions of your argument.

        First health insurance is not about health. All insurance is about protecting assets – financial.

        Pre-PPACA the poor had lots of free or very low cost insurance options available to them.
        They refused to sign up for free services. Why ? Because they were getting them anyway.
        Free without filling out paperwork is cheaper than free with lots of paperwork.

        Pre-PPACA any competent financial advisor would tell you that if you have little or no wealth – then insurance is useless.
        If you are young healthy, own little – why pay for health insurance ?

        Rand has been studying the effects of health insurance on health care outcomes for more than 4 decades, it has found NONE.
        More recently the “oregon experiment” on a very large scale using the double blind gold standard of research – came to the same results.

        Even Warren’s famous report – essentially concluded that lack of heatlh insurance sometimes results in a financial consequence – bankruptcy.

        Health insurance is not about health. It is about maeing sure that if you get sick you do not lose everything you own.

        Next, what is “screwed by insurance companies” ?

        If an insurance company agreed to something and failed to do it – there is several centuries of contract law that already makes that not merely illegal, but allows people to seek enforcement of that agreement by government.
        No knew regulation needed.

        Or are you saying that insurance companies should be obligated to do something they did NOT agree to do ?

        Because honestly, the hypothetical being offered is false and deceptive.

      • March 10, 2017 4:26 pm

        Dave you say “Health insurance is not about health. It is about making sure that if you get sick you do not lose everything you own.”

        So is this your position or is this what someone has said health insurance should be?

        If this is your position, then how would you address the situation where a female, divorced, husband long gone and no where to be found, gets breast cancer at the age of 40, reaches the lifetime benefits of the healthcare plan she was on, plan is terminated, has three kids and now they can not get insurance since she has a preexisting condition and the old free market forces did not provide any means for her to get healthcare coverage because she makes too much money to qualify for Medicaid, but not enough to fund any future medical cost.

        I lean libertarian and want government to stay out of our business as much as possible. But I also believe there is a place for government to provide help when it is needed, either through regulations or programs. We no longer live in a country where people in a community provided for those in need within their community. People will walk right past someone passed out on the sidewalk and in need of medical attention because they don’t care.

        So what would you do to help someone like the example above. Or would you let them go without medical coverage, meaning all medical services came through the ER and resulted in bad debts.

      • dhlii permalink
        March 11, 2017 12:19 am


        it is not a “position”.
        It is a fact.

        The health insurance industry has spent the past 40 years trying to prove that health insurance changes outcomes – and it has failed – but not for lack of trying.
        That is the conclusion of the decades long and ongoing Rand study.

        Separately the State of oregon somewhat unintentially created a MASSIVE double blind practically laboratory quality experiment to determine just that.
        Google the “oregon experiment”
        again there is zero health outcome benefit to health insurance.

        But this should not surprise anyone.
        Auto insurance does not prevent accidents.
        Fire insurance does not prevent fires.
        Flood insurance does not prevent floods.

        The purpose of all insurance is FINANCIAL.

        If you do not have sufficient assets to protect, there is zero reason to have insurance.

        The entire concept of universal health insurance is an incredible example of economic stupidity.

        There is a reason that PPACA is in a “death spiral”.

        Because absent a very serious penalty it does not make fiscal sense for the vast majroity of the uninsured to buy insurance.

        Those who do for the most part are those who have a high probability of benefiting – those with assets to lose, no insurance and poor health.

        Yes, other people besides me have said this. Off the top of my head I can not recall who.
        But it does not matter – it is a tautology.

        You do not get healthier because you are insured.

        This is actually loosely tied to another perenial failure – preventive medicine.
        Something that sounds good. But in fact, in study after study the costs of preventive medicine – outside of small things that most of us already do – like brushing our teeth, are higher than the benefits.

        Just to be clear – I am not saying that you should not make choices that are likely to decrease your future health risks or increase your life expectancy. But you are never going to see health insurance coverage for preventive medicine – unless insurance companies are FORCED into it – because economically it is a losing proposition.
        It is cheaper to pay the high cost of caring for the small number of people who develop a problem, than the small cost times a large number of people to reduce those numbers a small amount.

        And now we are getting to some “libertarian” facets.
        It is immoral for a majority of us – or less, to increase the costs to all of us for things that only benefit a few of us, and to an extent less than the cost imposed on all of us.

      • dhlii permalink
        March 11, 2017 12:29 am

        With respect to your hypothetical – it is not complete.
        The simplified version is someone develops some serious problem and they do nto have insurance to pay for it.
        And that is where you end.

        In the real world something happens next.
        I am presuming you think she dies – but you did not say that.
        Probably because in the real world that is not what happens.

        Lots of people die every year of non-treatable cancers.
        We all die eventually.
        A small number of people die from treatable cancers – but not because they do not have insurance. Most commonly because they are not detected until it is too late.
        My mother was incredibly well insured and yet she died of colon cancer.
        The doctors told us that she had it for atleast 10 years.
        She had to have known something but did not get it checked.
        Colon cancer is one of the most slow growing and treatable cancers there is,
        and yet afluent well insured people die from it all the time.

        The fact is that PPACA made ZERO change to any mortality trends.

        AGAIN health insurance is about FINANCIAL security – not health.

        People who seek care do not die from treatable diseases in this country merely because they do not have money.

        They do however go bankrupt. According to Elizabeth Warren’s work (before she became a senator), about 1/3 of all bankruptcies in the US involve health care costs.
        And the average amount discharged in bankruptcy is about 2500.
        This is not a Trillion dollar problem – it is not even a Billion dollar problem.

      • March 11, 2017 1:14 am

        Dave, in my example, the mother takes her kids to the emergency room or she goes to the emergency room for her illness. She gets a bill that is 10 times what a bill would run in a doctors office. She uses resources the hospital has to provide due to regulations that require patients to be treated in a certain way, and due to a tort system that favors plaintiffs in medical cases, so the hospital throws everything at a cold so they can not be sued later when she does not follow doctor orders and develops pneumonia.

        Hospital raises rates at budget time for the paying patient to cover the cost generated by those using the emergency room for normal medical care.

      • dhlii permalink
        March 11, 2017 1:45 am

        So in your hypothetical – because government has ALREADY screwed things up,

        You beleive it is entitled to screw them up even worse.

        If you have a woman with breast cancer she is being treated at a hospital.
        The ER/DR. Office aspects of your hypothetical are either small or false.

        If you want doctors to start seeing patients with less resources – that is trivial.

        Get rid of the medicare/medicaid rule that prohibits doctors from charging private patients less than medicare/medicaide.

        The govenrment prohibits doctors from engaging in charity.
        As a result – patients end up at the ER.

        I keep trying to tell you – what we had immediately before PPACA was NOT a free market system. It was already a highly regulated thoroughly F’d up government distorted system.

        BTW I have little problem with our tort system.
        In fact I would make it EASIER for people to file tort claims.

        Torts are a legitimate form of “regulation” – and one that businesses fear and respect – otherwise why the tremendous pressure for tort reform.

        I would likely eliminate or reduce mass torts, and class action lawsuits.

        Beyond that though I have no problem with punative damages, I have problems with significant pain and suffering damages.
        And I am going to require plantiffs to demonstrate ACTUAL HARM.

        Regardless, “if I ruled the world” – there would be no regulation, but there would be significantly more torts.

        At the same time I do wish to re-iterate – as a matter of fact, not ideology,

        that the PRIMARY regulating forces in a free market – are the market itself.

        Government – our criminal, contract and tort laws are a critical backstop.
        But they accomplish TWO things:
        They are the means of constraining the few of us in society who are only constrained by law – primarily sociopaths.
        In a system with no govenrment AND sociopaths, everyone quickly degenerates to force, and fraud and the wheels come off.

        BUT it is not govenrment that constrains the conduct of most of us most of the time.
        It is our relations and interactions with others.

      • March 11, 2017 1:03 pm

        “And I am going to require plantiffs to demonstrate ACTUAL HARM.”

        And there is the fallacy of your argument. With our current systems where judges and jurors are allowed to determine if someone was harmed or not, ACTUAL HARM will never be defined. Just look at the Krispy Kreme case in California where a judge has ruled a claim can be made because someone thought jelly filled donuts had nutritional value.

      • dhlii permalink
        March 11, 2017 7:56 pm

        The mess we have made of language is not my fault.
        That is to a large extent driven by political ideology – particularly that of the left.

        I will have zero difficultly obliterating most any argument from someone on the left – if they will agree to use language consistently.

        They can define terms however they please – so long as those terms mean only one thing – in the context of government – if we are writing poetry or fiction you can play all the word games you want. Further they must no define terms such as to preclude there being words to describe those values they do not like.

        Anyway, give me that and it will take very little time to run any left wing argument into massive self contradiction.

        Progressivism only survives based on massive ambiguity in the meaning of words.

        Regardless you are opening up another issue – and that is legal interpretation.

        When Adam’s said that we are a nation of laws not men – that was not to diminish the importance nor control of men.

        What it means is that we make public choices based on law that government scrupulously follows and that has one meaning.
        If we do not like the meaning – we have a process to change the law.
        But those imposing the law – police, lawyers, judges, impliment the law as it is written.
        Not as they want it to be.

        If the law is wrong, the law is wrong – still the courts must impose the law as it is.
        It is the people and the legislatures responsibility to change the law when it is wrong – not the courts.

        Trying to fix things by manglining the meaning of words, moves us from being a nation with some bad laws to a lawless nation.
        A nation where our standard becomes the favor of the judge we appear before.
        Not the law – a nation of men not law.

      • dhlii permalink
        March 11, 2017 12:44 am

        I am not attacking your libertarian bonafides.
        If Cass Sunstein can call himself libertarian you certainly can.

        But I am attacking the premise that if government can help – it should.

        No actually it should not.

        All government action comes at the expense of liberty.
        Further government is the most expensive, and inefficient means of addressing nearly everything – in fact it is expensive and innefficient when it does those things it must do.
        But we have no choice there.

        Nor do we want government to be efficient – the Nazi’s are what efficient govenrment looks like.

        We do not live in a country were communities provide ?

        My family provides about 1000 meals to the “homeless” every year.
        We buy the food, prepare it, bring it to a community center and serve the meals.

        We do so about 6 times a year. But there are meals at that community center every day – and sometimes several times a day. Most of them are provided by local churches.

        In my community the womens shelter is run in the YWCA – and operated by again – volunteers mostly from local churches.

        The government spends alot of money purportedly helping people in need.
        But that money is for the most part wasted.
        Worse still it does not truly improve the lives of those who recieve it.

        Actual charity is hard. It is easy to create dependence. Even charities fail in that way.

        But I want to go beyond charities. While I have no problems with charity and they are far more effective that government. Even charities are deeply flawed.

        I am going to return to China.

        I deliberately compared what happened in China over the past 40 years to private and public charity and found the latter woefully lacking.

        Bill Gates is one of the worlds greatest philanthropists.
        And I do NOT mean the gates foundation.

        Gates and Buffet do far more good – with the money they have privately invested.
        That money creates companies, jobs, and WEALTH for all of us.

        China went from the bottom of the 3rd world to the bottom of the 2st world by creating huge amounts of wealth – through capitalism. Not through charity.

        If you want to weigh the morality of free markets against Charity and measure by the societal benefits, free markets are the most morally positive force in existance. Mother Theresa is a distant second.

        When you start ranting about GREED. Start thinking about the 1.6B people who could still be living on $50/year.

      • dhlii permalink
        March 11, 2017 12:50 am

        So as a society we should pay a couple of trillions of dollars a decade to solve a problem that is not even a billion a year ?

        Yes, the woman who develops breast cancer without health insurance should go bankrupt.
        People go bankrupt all the time. There are about 750,000 people who go bankrupt each year.
        I know people who have gone bankrupt personally.

        Going bankrupt is not dying. It is starting over. It means several years of bad credit.
        It is not good. It is also not something that we should pay a couple of hundred billion a year to avoid.

        Trump went bankrupt 6 times.

      • March 11, 2017 1:24 am

        Dave what you do not understand is everytime this individual walks into the hospital to get medical care they use resources that increase cost. Those cost are passed on to the paying patients.

        When I left healthcare financial management employment, 90% of revenue generated by self pay patients went to bad debt. Medicare covered about 50% of the charges generated for Medicare patients. Medicaid covered about 25% of the charges generated. And these did not cover the actual cost generated by these revenues. Medicare represented 50% of our business, Medicaid about 15% and self pay about 10%. That meant 25% of the patients provided all of the revenues required that a for profit company calls “profit”. Those funds paid for capital equipment for new and replacement technologies.

        That is why medical costs, along with malpractice insurance cost, has risen so drastically in the past 25 years.

        Could GM sell 75% of their cars at costs or below cost and survive on 25% of their customers providing their cash flow without jacking up prices drastically?

      • dhlii permalink
        March 11, 2017 4:48 pm

        Sorry Ron but I understand completely.

        Regardless, the solution to a broken system is not to use its existing problems as justification to break it further.

        Prior to EMTLA hospitals were not required to accept you if you could not pay.
        Catholic hospitals in particular lobbied hard for EMTLA because other hospitals – particularly government hospitals were dumping patients on them – because catholic hospitals on their own chose to accept anyone.

        I approve of the choice of catholic hospitals to take whoever comes through the door.
        I do not support imposing their charitible policies on everyone else by force.

        Ultimately the number of catholic hospitals has declined anyway – because government increasingly makes charity harder and harder. Look at what PPACA attempted regarding Little Sisters of the Poor.

        Anyway MY point is simple – you should be free to choose to provide care to anyone who enters your door. You are not free to force others to do the same.

        Between EMTLA and Medicares rules requiring doctors to charge all other patients the same price the charge medicare we are driving the poor away from doctors and to ER’s,
        Further we have taken what could be Doctors charging different patients based on their ability to afford, to medical care is either free – because someone else is paying or expensive – because you are paying yourself.

        This is a STUPID model.

        There are myriads of reasons you want free markets – you do not get these horrible unintended consequences in free markets.

      • March 11, 2017 5:18 pm

        Dave, I can understand your position about free markets, but your position that medical facilities should be able to pick and choose the patients they provide services to is unacceptable for me. One reason alone.

        Most all hospitals are 501(c)3, not-for-profit organizations. They do not pay property taxes, in most states they do not pay sales taxes and they do not pay federal income taxes. Over the years from about 1990, hospitals took over the majority of physician practices. Those practices owned property, they paid property tax, they paid sales tax on everything they purchased and they paid federal income tax, if they had some kind of corporate license. Just in my town, since 1990, 10’s of millions in property values have been purchased by the healthcare systems and all those properties are now part of the 501(c)3 corporation, thus they took millions off the tax rolls for the state and local government.

        As part of this BENEFIT they get from sheltering these assets and income from taxes, there is a community benefit calculation they go through to show what they return to the community to be able to continue to shelter these assets and revenues from taxes. And that community benefit includes patients that they provide uncompensated care for.

        Now if you want to eliminate EMTALA and let the hospitals choose the patients they provide services to and you accept the fact that someone living 10 miles from one facility may be transported 50 miles to another facility to receive emergency care for , lets say a heart attack, then all the not-for-profit benefits current 501(c)3 hospitals get needs to be eliminated and make them for profit and let them pay billions in taxes nationally. Recommend that to the American Hospital Association and see what response you get.

      • dhlii permalink
        March 11, 2017 9:27 pm

        So again your argument is because government has F’d something up, it gets to F it up more.

        I want a really simple tax code – small government low flat rate applying to everyone.

        If we drop corporate taxes to zero – there is no sane reason to tax corporations.
        Then it does not matter whether a group is a 501(c)3 or whatever.

        Regardless, in the event you actually support tax exemptions – which mostly I do not.
        They can not come with requirements to alter your conduct.

        Can government dictate to a church what it teaches, because it is tax exempt ?
        Can it dictate to a college ?
        Then it should not be able to dictate to a hospital.

        But again as a practical matter corporate taxes should be zero – then the entire corporate tax code goes away.

        The objective is to get government OUT of making choices for us.
        Not to increase the reasons it can.

      • dhlii permalink
        March 12, 2017 12:01 am

        How horrible. Instead of spending billions of dollars and turning our ER’s into very expensive doctor’s offices, people might have to travel a bit ?

        How did Lewis and Clark survive so far from a hospital ?

        You do understand that if you had a heart attack, by the time you have arrived at the hospital you have either already gotten the emergency care you need – or you are dead.

        Regardless, of what we do about corporate taxes, I have no problem with for profit hospitals and non-profit hospitals.

        BTW we have plenty of for profit hospitals today.

        Frankly I want lots of for profit hospitals, because ….

        It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.
        Adam Smith

        The primary driving for for the improvement of everything is self interest.
        I want a better hospital – that means I want hospitals where people are looking to do a better job faster, more efficiently for less.

        Because standard of living ONLY improves by creating more value with less human resources.

      • dhlii permalink
        March 11, 2017 4:55 pm

        The percents I have heard were different – Medicare covers 95% of actual costs, and medicaide about 72%.,

        but it does nto matter, the point is that medicare and medicaid force subsidies from the privates system – which drives prices UP.

        And AGAIN I would note – this is still bad government programs that break the market and make things cost more for the rest of us.

        How strong do you think popular support of medicare and medicaid would be if people understood that not only are they paying taxes to support them,
        but they are paying higher insurance costs to subsidize them ?

        The left seems overjoyed at the difficulty that republicans are having getting a plan together.
        They think this is a march towards Single payer.

        Vermont tried to make Single payer work, they had popular support. But even with a strong left government they could not make the numbers work

        As you note – neither medicare nor medicaid pay their own way.
        Single payer either means the quality of medical care must decline substantially,
        or the cost of government provided medical care must increase substantially.

      • March 11, 2017 5:27 pm

        Dave, not sure where your numbers came from, but either it was from the governments Medicare/caid cost report, some liberal propaganda sheet that was promoting more Medicare and Medicaid, or the numbers covered everything in healthcare, from drugs, doctors and hospitals. I can tell you Medicare and medicaid has never covered that percentage of TRUE costs for hospitals.

        Now we do a report at the end of every year to give our government information of revenues and cost.(Medicare/Medicaid Cost report) They take that data, remove what they don’t like, and come up with a figure as to what their cost is for government patients. It is no where near what the TRUE cost to provide services, but it is a good propaganda tool for the government to use when citing data.

      • dhlii permalink
        March 12, 2017 12:02 am

        Not looking to quible over numbers – yours make my point better than mine.

      • Roby permalink
        March 11, 2017 8:47 am

        “Going bankrupt is not dying. It is starting over. It means several years of bad credit.
        It is not good. It is also not something that we should pay a couple of hundred billion a year to avoid.”

        And then the cancer comes back and she can’t go bankrupt again for 7 years. So she and her spouse lose the house and life savings this time, while she is dying.

        And… the hospital is Still stuck with the bill that it Still passes on, as Ron describes.

        So, your libertarian solution solves everything! Great thinking!

        But its not a problem that we should deal with because libertarian theory says that govt. is a burden than we should remove. Which is why it is good that the stoned guy who could not name any foreign leaders did not become POTUS. (not that we won the POTUS lottery in any case.)

      • March 11, 2017 1:13 pm

        “Which is why it is good that the stoned guy who could not name any foreign leaders did not become POTUS. (not that we won the POTUS lottery in any case.)”

        You may want to check out how this new healthcare law is being introduced. POTUS has nothing to do with it other than 5 issues he wants included and the fact he wants a repeal of Obamacare. Everything is coming out of congress. And he has said he is not going to get involved with the details in the bill (guess he is not going to read it either).

        Being a former governor, maybe Johnson would have had some ideas that might have worked. What we have coming now looks like a bunch of stoner politicians wrote this crap and are now feeding it to us trying to make it look like something other than a $145 billion dollar tax cut for the insurance companies.

      • dhlii permalink
        March 11, 2017 8:00 pm

        Anything that government does that is NOT let the market decide, is going to provide some improper advantage to some group.

        The most likely group will always be big business and the wealthy – because they have something politicians want – money.
        But even if you disempower big business and the wealthy – someone will bend whatever power you give govenrment to their benefit.

      • dhlii permalink
        March 11, 2017 6:23 pm

        Still pushing the without health insurance someone is going to die rot.

        Lets assume you are correct – what are you prepared to give up to maybe extend one persons life a bit ?

        Save the children tells me all the time that for .50/day I can save some child from starvation.
        So can you add 70 years, or even 10 years to the life of your hypothetical woman – for $.50/day ?

        Equally importantly – how can you excoriate others for not “saving” the woman with cancer when you have not given $.50/day to save some starving child elsewhere ?

        The fact is everything we consume is paid for from everything we produce.
        If you spend a Trillion saving a few people from cancer – or even a billion or a million,
        there is something else you have lost.

        In the end your not really changing whether this hypothetical woman lives or dies – you are just changing how the decision is made. Because ultimately someone is going to have to decide who lives or dies.

        The choices are simple – you can let bureaucrats in washington decide.
        It is my understanding that the actuarial value of a human life that HHS uses is about $125K.
        If it costs more than $126K to extend someones life – HHS is not approving it.

        But there is a big difference between HHS deciding and letting people decide for themselves.

        When the government decides – it decides for everyone. It decides for people that could easily afford $125K to extend their own lives, and it decides for those who can not.

        When we decide for ourselves – we get to factor all kinds of things in.

        If I am 80 – do I want to burn through 100K or what might go to my kids in order to live another 3-6 months – and possibly in great pain ?

        If I am your hypothetical women – I may not have $125K – but I might be able to come up with much of it. Regardless, I get to decide.

        If I am the hospital – I get (or should get ) to decide am I willing to put 125K into this patient – and hope they can pay me back.

        When choices are made by government – they MUST be made blind.
        Most of us understand we do not get to say – we will save the white guy, but not the black one. But that also means we do not get to say – we will save the woman with a job and a child – but not the drug addict.

        What those of you on the left do not understand is that ultimately choices are going to be made – they must be made. When government makes them for us – more people do not benefit, that is actually close to impossible, because there really are only so much resources we are going to spend on healthcare, all that happens is the majority of us are relieved/prevented from making choices for ourselves.

      • dhlii permalink
        March 11, 2017 6:30 pm


        I would also prefer if you provided real world examples – actual people with actual names.

        This is important – because hypotheticals always gloss over real world facts.
        Such as the fact that in the real world there are nearly always lots of other choices.

        You can say hypothetically the woman with cancer will die without PPACA,
        and I can say, but hypothetically the Catholic Church, or the Koch Brothers or … will step in and save her.

        In the real world my solution may not be possible, but in the real world your hypothetical is not either.

        We know that PPACA changed the number of people insured – though not by much.
        At the same time we know it did not change the mortality rates or life expectance.

        In otherwords, even if your hypothetical actually proved true and PPACA saved 1000 cancer patients that would have died otherwise. It did so by killing 1000 others.

        Get a clue – everything comes at a cost. And real costs are not in $’s.
        They are in days, months, years of our lives.
        Money is how we measure – what we gain or lose are time with our family, or other elements of our standard of living.

    • dhlii permalink
      March 9, 2017 7:46 pm

      To my knowledge there is no libertarian litmus test.

      I acknowledge that I have become fairly extreme as libertarains go – practically but not quite anarcho-capitalist.

      When I first started posting at TNM I was more moderate than today.
      A few decades ago I would have been called a liberal – though nothing like todays progrssives.

      While I have become more informed on ideology as my views shifted.
      My views shifted because I saw constant government failure and the more deeply I looked the more apparent it was that govenrment rarely gets things right.

      Essentially I became more extreme in a very pragmatic fashion.

      I would like to say that roads, and bridges and infrastruction and schools and ….
      are the legitimate functions of govenrment – but the more I learn the more obvious it is that government does even those horribly, and that free markets will do them better.

    • dhlii permalink
      March 9, 2017 7:53 pm

      I have not heard the Freedom Causes position from the Freedom Caucus.
      What I heard was their position for other sources did not make any sense to me.

      I doubt there will be an alternate bill. Though this bill may get ammended.
      I also doubt Ryan is going to get the 2nd and 3rd steps that can not be done through reconcilliation so I am looking at this bill as having to work standalone.

      I think our choices are this – possibly with amendments – good and bad,.
      or waiting for PPACA to fail.

      I do not think that Healthcare is an issue that Trump will live or die over.
      While he addressed it in the campaign – only in the vaguest terms and not as one of his lead priorities.

      Regardless, the most important factor effecting Trump will be the economy 2 or 4 years from now.

      What Trump has or has not done on Healthcare, immigration, trade, will not matter at all if the economy is experiencing 4% growth. And they will not matter at all if it is experiencing 2% growth.

      The only way that any of these effect Trump’s (or the GOP’s) future significantly, is if they impact the economy.

      • March 9, 2017 9:27 pm

        ” i do not think that Healthcare is an issue that Trump will live or die over.”

        I was just going by the reports that the tax reform bill as big as the GOP has promised and corporate America is banking on requires all the taxes in the PPACA to be repealed before the new tax legislation can be written. Guess they need to know what they are working with before they can write the new legislation.

        And I think they have to repeal the PPACA with 50 senate votes (with the VP breaking the tie). That means if the repeal Obamacare and they have nothing to replace it, the PR problems they are creating by taking away healthcare coverage becomes a political nightmare.

        You and I may believe the government should play no role, but the najority of AMeria will not see it that way.

    • dhlii permalink
      March 9, 2017 8:08 pm

      Just to be clear – I am more likely to be friendly to Republican/Conservative positions. But I am not a republican.

      At best I trust republicans slightly more than democrats – which is not much.

      I think Paul Ryan is a decent person trying to do what he beleives is right, and I will consider what he is pushing seriously.

      But whether I support what is coming out right now depends on whether I beleive this is the best we can do. I will not be deciding based on what Ryan is promising in future bills. I do not think he can deliver those promises. Further I will be considering whether we can do better if we allow PPACA to fail.

      Unlike the moderates here, I am not afraid of failure, and only inclined to compromise if I really do beleive it is the best we can do.

      And again – my distrust of the left should not be presumed to be an endorsement of the right or an indication that I trust them either.

      My criteria is not what is best for the GOP. But what is best for people.

      One of my hopes from this election is that Democrats will become more libertarian friendly.
      Thus far I am not seeing that – but I can hope.
      I have met libertarian democrats.

      Next I do not support the Freedom caucus – merely because they have freedom in their name. I am more likely to trust them than democrats or the rest of the GOP.
      But I presume they are politicians too.

      I would also note that while I consider Trump evil – I argued before he was the lessor evil.

      I am not knee jerk opposing everything he does.

      Overall thus far he has impressed me.
      That still does not mean I support everything he has done.
      I do not think that Sessions is a racist.
      I think Sessions is an honorable man.
      I also think that he is wrong on nearly every issue, and probably Trumps worst nomination.

      I do not support Trumps immigration EO.
      But I am not rioting over it. i think it is less egregious than myriads of hings Obama did.

      I am not sure I would like Steve Bannon as a friend.
      But I am 1000% behind deconstructing the administrative state.

      I am capable of liking someone and disagreeing, and dislikeling someon and still agreeing with some of their positions.

    • dhlii permalink
      March 9, 2017 8:15 pm

      Ron P;

      Just to be clear – I do nto think any of my answers to your questions are particularly libertarian.

      If you wanted to know what I think we should do – which no one is discussing:

      Repeal ERISA, Repeal EMTLA. Repeal all federal health insurance laws and regulations.
      Eliminate any form of tax credit, subsidiy or deduction for healthcare – whether individual or employee.

      In short – get government entirely out of health care, and health insurance.

      Find some way to give back to people the money we have taken from them for medicare – pretty much impossible to do, and end medicare.

      Health Care/Health Insurance is one of those places where it should be crystal clear – free markets and not the problem – government is.

      But none of that is going to happen

      • March 9, 2017 9:42 pm

        ” Repeal all federal health insurance laws and regulations.”

        I am with you on many things, but there is one question. How would you handle insurance companies that take money from subscribers to cover health related issues and then when the subscriber uses those for extraordinary issues, they cancel the plan and the person has no insurance. I know this happens, Lady that worked with me in the 90’s had insurance for 30 years with one company, She had to have a liver transplant. That was provided, but the insurance was cancelled after that. She then had no way to pay doctor followup bills, drug costs for rejection medication and insurance to cover her family with any of their illnesses. Our employer (hospital) had a fund raising effort and raised enough money to establish and fund that earned interest and that with some of the principle paid for her and her families healthcare cost for many years. The funds were designated for health related expenditures only.

        I don’t believe the government should mandate anything, such as healthcare, seat belts, Motorcycle helmets, etc if the only person in harms way is the person who chooses that course of action, but I also believe there are government regulations that are needed to protect people from unscrupulous companies like insurance companies that only have profit in mind regardless of the negative impact it has on customers.

      • dhlii permalink
        March 10, 2017 1:01 am

        Ron P;

        With respect to your scenario:

        Lets not pretend that all humans are kind and fart butterflies.

        Contra the left free markets without government tend to be very effective at punishing bad behavior. They do not do so perfectly.
        But look arround – there is no arrangement that acheives perfection.

        In a free market are some going to try to cheat or otherwise game the system ? Yes, and sometimes they are even going to get away with it.

        About 1 in 30 people are sociopaths. Alot of those are attracted to roles of power in business. Though I would note – even more are attracted to government and politics.

        Something we should always remember when we think of government as the answer to any of our problems.

        “If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary.”

        The same crooks cheats liars and theives that the left fears in business – make up our government. We are not obligated to do business with anyone.
        We get to make our own judgement over who to trust and who not to, and if we are wrong – we get screwed as a consequence of our own error.
        We do not have a choice when the crooks, cheats, liars and theives are our government.

        But with respect to your scenario:

        Insurance is a bit more complex than some exchanges – but the core is still simple – value for value. If you buy insurance that does not cover you when you need it – word of that gets arround and insurance companies have to adapt. Just as when insurance companies write policies that take on too much risk for too little premium – investors get pissed and premiums or policies change.

        If you want to know what free market insurance looks like – go to the cereal Aisle of your grocery store. Dozens of choices from the 3 big companies, and hundreds of choices from dozens of other companies.
        Something for everyone. And no one makes their choices the same way.

        People are going to make sub-optimal choices in health insurance, but that is still better than being forced to accept sub-optimal choices made by others.

        The argument for free markets is not that they are perfect, or that there is no lying cheating stealing or fraud. It is that nothing else works better, and more importantly – our choices are our own – even if we make them less than perfectly.

        One last point, government can not and should not protect you from making bad choices. But free market does NOt mean that lying, cheating and stealing are acceptable.

        I tend to repeat 3 legitimate roles for government:

        1). to punish the initiation of force or fraud by others – that is the basis for most criminal law. If there is no force or fraud involved it should not be a crime.
        2). To compel people to keep their commitments – that is the basis for most civil law, contracts. It is not governments job to decide what constituties a ‘fair contract” only to enforce contracts that were freely entered.
        3). To compel people to make whole those they actually harm – that is the basis for most tort law.

        In the GOP’s list of policies is tort reform. This is a place I oppose republicans. It is not the role of government to limit how we conduct our lives – economic or otherwise in the hope of preventing harm. I oppose regulation.
        It is the govenrments responsibility to assure that hose that actually harm us – make us whole.
        I do not support regulation – I do support Torts.
        I do not support the NLRB – at the same time I absolutely support the right of workers to negotiate – as voluntary groups or individuals. Again it is not governments business to decide what a contract should look like, only to enforce those that are freely agreed to.

        Back to your initial example:
        If an insurance company actually breaches its contract – there is a role for government in enforcing the contract.

        I would note that for most of us – we can not sue our insurance company when they breach. Why ? Government.
        If you buy insurance for your self and the insurance company breaches – you can sue them. If your insurance comes through your employer ERISA dictates that you do not own your insurance, and the insurance companies contract is with your employer not you, so you have to go through an independent messy system of adjudication, that frankly heavily favors insurance companies.

        One of the good things to come out of PPACA and possibly the GOP plan is an increase in the people buying insurance for themselves. That buypasses ERISA and makes insurance breaches harder.

      • Priscilla permalink
        March 10, 2017 11:31 am

        One of the problems that advocates of a free market healthcare system face, is that the other side can come up with any number of examples of individual tragedies caused by the current health insurance system. Democrats did it and now Republicans are doing it….and then Democrats will do it again.

        The natural response today is to demand that the government, fix, prevent or mandate whatever is wrong with the system, rather than allow the system to right itself, and provide safety nets for those who are truly in need.

        I think that, as a society, we have moved far enough to the left so that the goal of a truly free healthcare market is probably not realistic.

      • dhlii permalink
        March 10, 2017 1:30 pm

        No, there are very very few examples of real tragedies CAUSED by free market health care.

        Most of those produced by the left do not hold up under scrutiny.

        The more famous one used in the anti Romney TV adds was ludicrously false.

        The husband lost his job, and subsequently his health insurance and many years later – with many other intervening factors, his wife became ill.

        Is there someone claiming that if you buy health insurance and pay a single premium that the insurance company owes you healthcare for life ?

        The vast majority of these horror stories boil down to either actual breach of contract – which even minarchy handles with no difficulty,
        or messes created by ERISA – individuals insured through company health insurance can not sue insurance companies as a result of ERISA.
        Or are horrible misrepresentations of the actual facts.

        Completely ignoring government.

        Do you beleive your insurance company is not going to cover you if you develop a serious problem ?

        If you do not – then why are you paying for insurance ?

        As you are paying for your insurance, that means you really beleive you will be covered – enough to spend the money on insurance.

        Even without any government at all, we do not pay for things we do not bleive we are going to receive.

      • Roby permalink
        March 10, 2017 11:54 am

        Those truly in need are a good fraction of 52 million. Your “safety net” will cost a trillion dollars, easily.

        “52 million Americans with pre-existing conditions could become uninsurable if Obamacare is repealed”

      • March 10, 2017 4:04 pm

        Roby, this is NOT my position, but I bet it is to some who won’t say these wordsbut think it and support them!

        “No better way to control rising Medicare cost than to eliminate the preexisting mandate so people with chronic problems under the age of 65 can not get medical help. They die before they reach the age of 65!”

        Now that’s healthcare cost control at it’s finest. And the free market is preserved, corporate profits are maintained for the investors, taxes (due to reduced Medicare costs) can be lowered and we all make out!. WOOHOO, the fix is in!!!!

      • dhlii permalink
        March 10, 2017 11:18 pm

        Were people dying from lack of healthcare before PPACA ?
        All of us will die eventually,
        but no one in the US dies because they can not afford healthcare
        Some of us have gone bankrupt because we can not afford healthcare.

        The rhetoric about people dying is vile false propoganda.

        Health Insurance !- Healthcare.

      • dhlii permalink
        March 10, 2017 10:28 pm

        Medical care is going to cost approximately the same amount whether there is a PPACA, or some republican plan.

        One of the problems with any approach other than free markets is that there is no top down solution that actually expands medical care or actually decreases medical costs.

        That is what free markets do – with everything.
        That is NOT what governments do with anything.

        Your argument about the trillions of costs associated with those with pre-existing conditions – is a red herring. The healthcare needs of people and the cost of those needs are not reduced by insurance, or subsidies or tax credits.
        In fact all of the above tend to INCREASE costs.

        That does not make insurance inherently bad. But lets not kid ourselfs into beleiving that there is any top down arrangement of anything ever anywhere that has ever reduced the cost of anything.

        The only thing that has EVER reduces costs and/or increased value delivered is free markets.

        Nor is this any secret. FDR’s NRA was a system o0f top down economic decision making that had very nearly failed on its own when the courts struck it down.
        Nixon’s wage and price controls made inflation dramatically worse.

        The economic calculation problem – is an economic debate over the viability of socialism that was resolved both in theory and in practice decades ago.

        Please name a single socialist country anywhere int he world that is not impoverished ?
        Chaves took one of the more wealthy south american countries and has destroyed it.

        Even those vaunted european social demoncracies have growth rates about one percent lower than ours and standard of living atleast 20% or more below ours – despite the fact that thye were wealthier than the US not that long ago.

        Socialism does not work. Socialism lite does nto work.

        What is wrong with US healthcare today is that it is not only significantly socialized – it is actually socialized badly.

        One of my fears with regard to PPACA was that the system it replaced was a disasterous quasi socialized mess and it was entirely possible that PPACA could actually outperfrom what it replaced.
        But I should not have feared – never under estimate the ability fo government – particularly left government to make things worse.

        I am not personally all that concerned about pre-existing conditions.
        The lefts selling of PPACA was grossly dishonest. Their criticism of alternatives is no better.

        I tire of this nonsense that PPACA saved X millions of lives or resulted in some other miracle.

        There has been ZERO change in long term trends of life expectance.

        As I have noted elsewhere Health insurance is PURELY about financial security.
        There are really only a very small portion of the uninsured for whom that is a serious problem

        There was almost nothing in PPACA that had anything to do with Health, and probably nothing in its replacement either.

        There are only two significant questions being addressed:

        If we are stuck with quasi socialized healthcare – who and how are we going to pay its high costs ? It is going to cost the same amount no matter what.

        Are we going to pass some change with sufficiently free markets to actually lower the real costs ?

      • Priscilla permalink
        March 10, 2017 12:12 pm

        I tend not to pay much attention to these sorts of stats, Roby. Like any others, they can be easily skewed to any particular position.

        For example, according to the Kaiser study:
        “That means that about 27 percent of all adult Americans under the Medicare age of 65 potentially could have trouble finding new coverage in the future if they lose their existing policies under Obamacare, expanded Medicaid for low-income people or through an employer. ”

        Well, that’s a pretty broad statement! No one, to my knowledge is advocating the loss of Medicaid for those truly in need. Many of those who have been forced to purchase an Obamacare policy will have opportunities to purchase and equal or better policy, and, in many cases, employers provided better healthcare before the mandate than after.

        So, I’m not arguing that everything will be rosy and perfect ~ it never is~ but that this study is very slanted.

      • dhlii permalink
        March 10, 2017 10:37 pm

        Unless we make changes that actually reduce the cost and/or increase the value of healthcare – and the only thing that has ever reduced the real costs of anything over the long run or increased the real value over the long run is free markets – then the entire fight is over who and how are we paying for health care.

        Unless the republican plan significantly increases free market competition it will cost the same and PPACA. The debate will be over who pays.

        I am also NOT that deeply concerned over this.
        I think that the GOP has too strongly walked into the obvious democratic trap regarding Healthcare. Unless they incorporate significant free market processes – any GOP plan will cost the same or more.

        Personally I think republicans shoudl leave PPACA alone.
        It is in its death spiral. Let it fail on its own.
        I think it will be easier to get the country to make a wiser choice when it is clear that neither PPACA nor any other top down solution is going to work.

      • March 11, 2017 1:02 am

        “I am also NOT that deeply concerned over this.
        I think that the GOP has too strongly walked into the obvious democratic trap regarding Healthcare”

        Dave…How right you are on this. The Democrats designed a plan they knew would fail so their next step would be a one payor national system where everyone had the same insurance.

        So now the GOP is dealing with it before it fails and they are paying the price.

        They should back off, let it fail and then most people would be begging for a replacement. Now anything they come up with will be attacked by the democrats where allowing the dems plan to actually fail completely would allow the GOP an open environment for their ideas where the attacks could be headed off using the failed democrats system as the reason they had to come up with a new plan.

        Right now saying the current system is a failure is just words for the majority of voters.

      • dhlii permalink
        March 11, 2017 1:29 am

        Yes, the democrats end game is single payer.

        But if the republicans are smart enough NOT to push forward on “obama care lite”,
        failure is more likely to move us towards a free market system than single payer.

        Single payer is medicaide for all. Few of us are going to be happy with that.

        I beleive Reason contracted for a recent poll on healthcare.

        Every single item of PPACA that is purportedly popular – that the GOP is desparately trying to figure out how to deliver was extremely unpopular when asked
        “would you be willing to pay more to ….”

        Free markets are like voting in a democracy except:
        You vote with money. You can vote for many things and to different extents, but each of us only has so much money.

        This is actually important – and it is better.
        You can not know how important anything is to people – unless you can know what they will pay for it.

        If you beleive in the principles of democracy – you should beleive in free markets more.

        In a political system we at best get to vote yes/no.
        In the market you get to vote how important something is to you.
        In a political system you vote hypothtically on ideas not their costs.
        In a market you vote for actual things and your vote is based on their real cost.

        Markets reflect the true wishes of people and the strength of those wishes.

      • Roby permalink
        March 10, 2017 1:39 pm

        “Well, that’s a pretty broad statement! No one, to my knowledge is advocating the loss of Medicaid for those truly in need. ”

        I am not an expert in this, it goes way over my head in fact, I think that I would need to study this issue for a hundred hours or so just to begin to be able to talk about it with a general understanding.

        But according to what I read it sounds like you are wrong:

        “Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans.

        CNN, meanwhile, is reporting that the Trump White House is negotiating to possibly roll back the Medicaid expansion earlier to appeal to conservatives — counter to Trump’s promise to leave Medicaid alone:

        White House officials are beginning to urge House GOP leadership to include an earlier sunset of the Medicaid expansion funds authorized under Obamacare than the 2020 date set by the current bill. The change comes just days after the bill was unveiled and follows a blitz of activism aimed squarely at the White House and President Donald Trump, who has met with conservative leaders in recent days.”

        So, its already, in fact, cutting medicaid requirements and many conservatives are widely reported to be very disappointed that it does not cut enough and pushing for a much tougher rewrite.

        However, this comes out, there are going to be tens of millions of really outraged people, even within the GOP voters, let alone liberals etc.

        Its over my head, I do not have the huge amount of time it would take me to really understand this. But the outlines are pretty clear, one set of conservative activists wants Obamacare pretty well gutted, while another group in the GOP has some actual understanding of the consequences to millions of people who voted for trump and has an idea of the chaos that can ensue in the insurance industry. The chances that

        “Many of those who have been forced to purchase an Obamacare policy will have opportunities to purchase and equal or better policy ”

        seem to me extremely optimistic unless you add the caveat “that that can in no way afford and won’t actually buy.

        The whole issue completely reminds me of the Act 60 Vermont property tax/school funding bill that I opposed tooth and nail and fought waving a pitchfork for years. But, I understood with Act 60 that once it was implemented, a statewide property tax to fund the schools, no one could ever remove it. I was correct.

        The people who actually completely understand the nuts and bolts of this issue (all 20 or so of them, ha) are most likely waiting in awe for the explosion that is coming.

      • dhlii permalink
        March 10, 2017 10:59 pm

        If we are going to discuss what we really should do – what will work best.

        Then YES, I am advocating completely getting government out of healthcare.
        And that would include ending medicaid.
        Medicare is slightly more complex – because we have lied to people and told them that they were buying medicare from their payroll while they worked.

        I get disgusted by this “truly needy” nonsense.

        Most of you know I am a landlord. I have 5 units. All of my tenants are bottom or 4th quintile.

        Sorry, these are not “truly needy” people.
        I periodically go into my tenants apartments and they are better off than my parrents were in the 60’s – and my parents were 2nd quintile.

        I have a hard time thinking of families many of whom have SUV’s with leather seats, multiple flat screens, smart phones for their kids, laptops and tablets, leather sofa’s …..
        as Truly needy.

        Frankly, I think that it is elitist and stuck up to go arround pretending that these people can not survive but for government assistance.
        Most of my tenants are decent hard working people able to carry their own weight and not in need of the govenrment help some of them receive.
        Those who are not – are not doing any better for the assistance they receive from government.
        And in fact may be doing worse.

        I think it is incredibly stupid for us to take large amounts of money for everyone, and then give it back to them.

        You want to pretend those towards the bottom do not pay much taxes.
        Where do you think the money I have to pay for taxes on my rental properties comes from ?
        Not from me.

        No one would invest in anything, it they had to pay taxes on it and were not receiving money from others.

        How do you think the Waltons pay their taxes – from the money paid to them by the people who frequent Walmart.

        Contra the left – the creation of wealth trickles up. The Walton’s got rich because they created about 20times as much wealth for others.
        But taxes flow down.

      • dhlii permalink
        March 10, 2017 11:12 pm


        You do not need to be an expert.
        Whether PPACA stays or goes.

        Nearly exactly the same number of people will get sick next year.
        Their healthcare costs will be nearly the same.

        All that will change is at the highest level – who picks up the tab.
        Regardless, taxes flow down hill so it will always be those fromt he middle down who end up paying. That can not be changed.

        What we can do is increase the value and decrease the cost of healthcare.

        But government has NEVER been able to do that.

        Only free markets have ever done that.

      • Priscilla permalink
        March 10, 2017 4:02 pm

        The Medicaid expansion was intended to funnel people below a certain income level into the Medicaid program, so that they would not be eligible for a subsidized healthcare plan on the state exchanges. In order to entice states to expand their Medicaid rolls to any family who made less than 140% (that’s my recollection, could be a tad wrong in either direction), the federal government offered funding for Medicaid for 3 years ~ after that, the states would have to find their own funding, through the state budget process. Many GOP governors refused the expansion, on the grounds that it would explode the Medicaid ranks and leave the state taxpayers holding the bag after 3 years.

        Many of the previously uninsured people (most, in some states) who got coverage under Obamacare were included in the Medicaid expansion, not people who purchased coverage on the exchanges.

      • March 10, 2017 4:38 pm

        Priscilla….Roby….Dave.. The medicaid expansion provided minimal healthcare coverage to millions. It was not the panacea the democrats expected.

        I have said this before but will repeat it because it is important. If you are a Medicaid covered individual, you will not get a hip implant, cardiac by-pass surgery or any other high tech medical procedures that people with employer provided health insurance will get. That is because most all specialist that do these high tech procedures do not accept Medicaid as a means of reimbursement. Hell, most all good GP’s don’t accept Medicaid as the Medicaid reimbursement for an average office visit won’t even cover the cost of them having their oil changed at Jiffy Lube. And then they have to pay their staffs for whatever services they provide, so the GP’s limit their practices to better paying patients and fill their schedules so they can get paid more.

        What you will get is a narcotic for pain medication or blood thinners to reduce the clots that will cause a heart attack if your a medicaid patient. Hospitals, doctors and the medical community will not say this, but there financial records by financial class will support what I have written.

      • dhlii permalink
        March 11, 2017 1:20 am

        And again what is it that you expect government to provide as an entitlement to people ?

        Nothing you are describing about medicare says – people die.

        In Canada and the UK – people do die, waiting for government care.

        I beleive I have written about my parents deaths before – but again, as it explains the difference between US and european health care – and the cost difference.

        My mother died of colon cancer – she spent the last year in an out fo the hospitial.
        My father died of vascular dimensia – and he spent the last couple of years in and out of the hospital.

        Both had medicare – and good suplimental coverage. While they were “affluent”, they received the same care that people with medicare and suplimental insurance do.

        In the end they both died – that is what happens to all of us eventually.

        During that last year – the “medical” care they received was maybe a little better than someone on medicaid. No one does major procedures on patients who are not going to live more than a year or two no matter what. They did not get hip replacements or bypasses, or …

        But they did end up in the hospital frequently.
        My mother ended up in the cancer wing several times. My father in the stroke wing.

        These were impressive. They had two nurses – 24×7 shared with one other patient.
        Someone was ALWAYS present.
        The rooms were private and sumptuous – better than the Helmsley palace.
        Terrazo floors wood paneled walls, an entertainment system, giant flat panel, and an alcove for the family – where we could converse privately, sleep, eat ….

        That is why US healthcare is incredibly expensive.

        A ford Focus and a Lamborghini Huracan will get you across manahattan in about the same amount of time. The outcome is the same.
        But no one pretends that a focus is the same as a lamborghini just because the “outcome” is about the same.

        The standard of living in the US is more than 20% higher than nearly all of europe, 30% higher than most of.

        A higher standard of living means we have more wealth (that is literally what it means)
        Many of us can afford the Huracan rather than the focus.

        My parents did not live longer because of US medical care.
        But their last year was better.

        So back to your medicaid patients – and your woman with breast cancer and no health insurance.

        No I do not think it is a crime that medical expenses bankrupt some people.
        I do nto think government must provide medicaid patients hip replacements, or wood paneled suites when they are in the hospital. I do not have a problem with not paying for advance treatments or expensive treatments that MIGHT work better for people who can not afford healthcare.

        But I do have a major problem with government deciding the same things for the rest of us.

        That is what the right tends to mean by “death panels” and that is where we are headed with “universal”.

        When government takes over – it MUST treat everyone equally. That is what we want.
        There are critical moral reasons it can not do otherwise.

        When that happens ALL of us are only going to get the equivalent of medicaid care.

        We certainly do not want government deciding who gets the wood panneled suite and who gets the ward.

        To address outcomes one last time.

        The most critical factors related to a nations people acheiving a life expectancy in the upper 70’s are rooted in the state of the art of medical care in 1950.
        That is when there were few if any private rooms and hospitals had wards with 20 people in them.

        Alot has improved since then. The quality of care is far far better. Hospitals are alot more pleasant. But outcomes are not that different.

        We can trivially afford “universal” healthcare that is the equal to what the US had in the 50’s.
        That is cheap – and will produce nearly the same outcome.
        India has it – and has a booming medical tourism business.
        China has it.

        Hong Kong provides that to absolutely everyone.
        But you can pay extra for better – and almost everyone does.

        And that is how free markets work.

        They increase the value delivered and decrease the human cost to do so.

        But VALUE is whatever we want and need. It is not some pseudo objective measure of outcome.

        Having a wood panneled hospitical suite with an entertainment system and an alcove for family and ….
        That IS a higher standard of living.

        One other thing about free markets – usually in less than a generation – the standard of living of the affluent, becomes the standard of living of the rest of us.

        That does not happen where government controls.

      • dhlii permalink
        March 10, 2017 11:15 pm

        I think you might be wrong about some of the details of medicare expansion.

        But I do not think it matters much.
        We few exceptions red states opted out.

        Those states that expanded medicare will have a problem if the feds quit footing the bill.
        And that is likely.

      • Priscilla permalink
        March 10, 2017 4:07 pm

        Sorry, that was 140% of the federal poverty level. And, I checked ~ it is 138%. For a single person that’s abit over $16K, for a family of 4 it’s about $33,500K.

        Many of those people don’t want to be on Medicaid, which is crappy coverage, but can’t possibly afford Obamacare plans, which are priced high, with big deductibles.

      • dhlii permalink
        March 10, 2017 11:37 pm

        Another big fight is over what the purpose of health insurance is.

        While I have zero problems with someone choosing and paying for a zero deductible gold plated health insurance plan.

        Such a plan is nothing more than prepaid healthcare at a premium price.

        A $200 deductible plan costs about 10,000/year more than a 10,000 deductible plan.
        A smart person would grasp that the high deductible plan is ALWAYS the better value.

        If your yearly healthcare costs are less than 10,000 you win.
        If they are over 10,000, you are no worse off.

        The purpose of insurance is to protect your wealth in the event of a catastrophe.
        It is not to pay exhorbitant sums to third parties so they can pay for basic care for you themselves.

        Insurance for ordinary healthcare expenses is incredibly economically stupid.
        It creates huge moral hazard – and after the housing bubble we should have had our fill of moral hazard.

        Prices will NEVER be controlled when those who consume are not those who must pay for ordinary services.

        Insurance (all insurance) only works when it protects against the unforseen – not the foreseable. And where the beneficiary can not increase the risk to the insurer outside the insurers control.

        If you want essentially prepaid medical – go to provider based systems – the incentives and control are completely different – and these arrangements keep threatening to completely change medicine.

        A way to deal with your basic health needs is to contract with your Doctor.
        To basically buy medical services like you buy cell phone serivce.

        Let your doctor sell a package of basic services that you get for a fixed monthly cost, and you use those you need.

        This presents tremendous cost savings oportunities for doctors – because billing is one of the most expensive parts of a medical practice.

        It also allows them to explore more creative ways of providing service.
        As an example for many many issues I must visit a doctor – because that is our care model.
        But much of the time I do not need to.
        I need to send my Doctor information – and get answers.
        Phone or email communications could substantially improve the efficiency of health care.

        AGAIN remember there is only ONE way to increase standard of living
        Deliver more value at less human cost.

        I can not stress that enough.

        ANYTHING that you are looking at – Minimum wage increases, health care.
        Whatever can be evaluated that way.

        Does it increase the value created ? does it decrease the human cost ?
        If the answer to both is no, then society is at best no better off, and more likely worse off.

        If the answer to both is no – you are fighting over who the loser is. Not about any real improvement.

      • Priscilla permalink
        March 11, 2017 10:45 am

        Ron, yes Medicaid is very low level coverage,with the worst doctors. The whole point of the expansion under Obamacare was to keep the poorest people out of subsidized plans, or else the cost of unsubsidized plans (which were intended to fund the subsidies, along with some additional taxes) would skyrocket even more than they already did. At least that was my understanding.

        The cost of “women’s health” was and is a major sticking point for Obamacare, because “women’s health” has become a euphemism for birth control and abortion. As a woman, I am infuriated by this, and by the feminist movement, which has turned a blind eye to all sorts of abuses perpetrated on women by sharia, yet organizes protest marches over the “right” to free ~ that is government-paid ~ abortion on demand. If the ACA allowed single men and over-50’s of both genders to buy policies that did not include coverage for maternity benefits,newborn and well-child-care, birth control and abortion, they could pay considerably less for a decent plan, but that would defeat the purpose of having those who buy insurance pay for those who are subsidized.

        Dave, I may have misstated the exact details of the Medicaid expansion, but I’m pretty sure that its purpose has been to push more low-income people into government healthcare, for the purpose of getting them out of the paid healthcare market. I am in favor of a total revamping of Medicaid, so that it functions as a true safety net for the truly poor. As it is now, it gives us an idea of what all of our lives might be like under single payer. Democrats like to point to Medicare as the gold-standard of single payer, but Medicare is going bankrupt.

      • dhlii permalink
        March 11, 2017 6:43 pm

        ER visits actually increased after PPACA so that part did not work very well.

        Regardless of whether you label is womens healthcare or something else.

        The absolutely stupidest way to provide ordinary everyday health needs – routine doctors visits, physicals, routine medications, birth control, viagra, ….
        Is through insurance.

        That is like saying “I think I will get an insurance plan to cover my magazine subscriptions” and expecting that magazines will get cheaper.

        You do not ever want to cover ordinary expenses with insurance.
        Not only do you totally destroy the natural forces that drive prices down, but you actually introduce forces to drive prices up.

        Further you NEVER want to provide insurance to cover what is a “choice” of the insured.
        Doing so must be incredibly costly – because you must assume most people will make the choices that cost the insurer the most.

        If you want to know what the healthcare the left really wants will look like – look at the VA.

        I would completely elminate medicaid and medicare – though medicare is more complicated and it involves money people actually paid to government.

        Why – because a part of what drives prices down is an underserved market.

        That Walton family became incredibly rich by realizing that 4th and 5th quintile people were a market to be served – if you could provide products cheap enough.

        As I have said before – sell to the rich, you can be Harry Winston. Sell to the bottom of the market and you can be the Walton family.

        But then Adam Smith said the same thing 250 years ago.

  28. dhlii permalink
    March 9, 2017 8:26 pm

    The politization of everything.

    If you do not want things to become politicized – keep government out of them.

    It is unlikely that the GOP and DNC are going to war over your garden – because MOSTLY that is not something government is involved in.

    When you involve govenrment in something it AUTOMATICALLY become political.

    Trump is talking about defunding PP if they continue to perform abortions – I say GOOD!

    I think PP should continue to do exactly what it is doing now.
    I do not care alot about their selling the body parts and organs from aborted fetuses.

    I have contributed to PP in the past.

    But I do not beleive that the government should be paying PP to provide womens healthcare – much less abortions.

    You want to depoliticize PP – ge tthem off the government teat.

    Nor is that view limited to PP.

    End ALL welfare – corporate welfare, social welfare, all subsidies, all research grants, all arts and humanities funding.

    That will depoliticize all of that.

    If you support those things – give to them – yourself.

    It is unlikely many of you will go so far as I do.

    But atleast you should think about the fact that when government funds something, it becomes political. That is unavoidable.

    You do not have the choice of spending other peoples money and not having it be political.

    When you rant about the politicization of everything, you are just ranting about the fact that everything has become the busines of government.

  29. dhlii permalink
    March 9, 2017 8:34 pm

    Cultural Degeneracy:

    Rick, you are becoming an old fogey.

    I am 59 – popular culture pays very little attention to the values of 59 year olds – and I do not think it should. Harry Chapin is dead, John Lennon is Dead, Leonard Cohen is Dead,

    Most of the artists I would be inclined to buy are dead.

    My kids are dragging me to an Ed Sherren concert. He is ok, but I would not pay $45 for a ticket to see him – Bob Dylan – Absolutely.

    So I will sit in my chair and listen to my old albums and enjoy myself.

    And my kids can listen to whoever they want.

    While I have addressed mostly music – the same applies to the rest of culture.
    I do not have to like what you like, or what my kids like.

  30. dhlii permalink
    March 9, 2017 8:38 pm

    Trump derangement syndrome

    WOW! Something we nearly agree on.

    I am not quite on board with SJW.

    There is no such thing as social justice.
    Rights and justice are individual.

    While people are entitled to whatever oppinion they wish.
    The demand to use of force aka government to impose your oppinion on others is not
    righteous opposition – it is inherently immoral.
    I find little to distinguish a social justive warrior from a nazi.

  31. dhlii permalink
    March 10, 2017 1:12 am

    American gun culture.

    Rick – get a grip.

    The gun issue has been studied thoroughly. The Obama CDC post SandyHook tried to find evidence that guns were bad and found the opposite.

    There are myriads of studies right and left.
    The evidence is in. With few exceptions there is no compelling evidence that gun laws change anything.
    Those exceptions:
    There are more successful suicides among gun owners
    Communities with laws restricting guns are more likely to have higher rates of crimes like home invasions because criminals have less fear of confronting an armed homeowner.

    But mostly – nada. Left or right the impact is near zero.

    Austrailia is touted for having gone from relatively broad gun rights to severe restrictions as a result of a famous mass shooting.
    Mass shootings declined dramatically. Mass killings did not. There is now a higher rate of deadly arsons.

    There are differences between different countries int he world. But those differences have more to do with culture and demographics. Multi-cultural countries, diverse countries and countries with more minorities have higher rates of violence – guns or no guns.

    Adjusted for race as an example there is no significant difference in the rates of violence between the US and the EU.

    The bottom line is that gun advocates are fighting for freedom – whether you like them or not.
    Gun opponents are fighting for feel good restrictions on liberty that have proven universally ineffective.

    Honestly I do not understand how an informed intelligent person can support gun control.
    It is beleiving in the tooth fairy.
    If only we could get rid of guns – people would be better.
    Scottland has a very high crime and murder rate – they use knives.

  32. dhlii permalink
    March 10, 2017 1:31 am

    Racial animosity.

    The world is not and never will be perfect.

    There is no doubt we need to do better on many things including race.

    But grow up. This is not the 20’s or the 60’s.

    I grew up in a world where there was more racial prejudice and conflict than today – and my parents lived in a world with more than I. And my children – who are both Asian, will grow up in a world with LESS than today.

    I am angry and BLM and Obama for taking a real problem and turning it into a race problem.

    There are FAR FAR too many instances where the police shoot first and ask questions later.

    Is race a factor ? I do not know. But who cares ?

    Policing is a difficult and dangerous job – if you can not do it without killing innocent people.
    Even if you can not handle most criminals – including armed ones without killing them – get another job. As with many other things we have set our selves up regarding policing.
    We can not dismiss officiers who might move to force to fast – so we only have trying to convict them of a crime left. We have done the same in teaching. A teacher that has sex with a student should be fired. That is not possible today – so we convict them as sexual preditors.

    Regardless, the fact that we are not and will not ever be perfect is not an excuse for the racial pandering of the left today.

    In a book on sales, I once read
    All things being equal – we deal with those we know.
    All things not so equal – we deal with those we know.

    Whites blacks, asians, geeks, atheletes, law enforcement, military, men, women – we tend to gravitate towards those similar to us.

    That is never changing. We can not legislate it out of existance.

    If the world were perfect we might be blind to gender, race, …. in our choices.
    But it is not.

    We are not and will not be past the point where the would is imperfect.
    We are far past the point where governmnt should be micromanaging our choices based on measures of prejudice.

    Today it is the left selling hate. Anyone who does not share their views on any topic – is a hateful, hating hater.

    One of the messages of this past election is that that kind of politics is not working so well anymore.

    I have two asian kids. I worry about racial biases more than most posters here.
    I know that my kids race will narrow their options.
    I know that it will color the perceptions of others towards them.

    Still it is past time for government to endeavor to fix this. Government can’t.
    But it is getting better – alto better.

    And the left is actually making it worse not better.

    BTW this is true for the entirety of identity politics – race, gender, orientation.

  33. dhlii permalink
    March 10, 2017 1:38 am

    Disruptive technologies

    What incredible economic stupidity.

    Sure you might be replaced by a robot.
    But get a clue, there is not and never will be any limit to our ability to make use of the human resource.
    Absent our actually creating our own replacement through technology – homo computerus we are always necescary.

    The luddites were wrong 250 years ago, they are wrong today.

    Lets try the absolutely most fundimental principle of economics that there is:

    Standard of living increases when greater value is produced at less human cost.

    Think about that ?

    There is absolutely positively no way in existance to improve peoples lives, unless they do more with less effort.

    Contrary to your luddite argument – robots dramatically increase standard of living.
    Much more is produced with much less effort.

    If you want the world of your children to be better than today – you need to embrace disruptive technology.

  34. dhlii permalink
    March 10, 2017 1:46 am

    Online amen corners and fake news.

    We are almost on the same page – though my guess is that you think the past was somehow better.

    What is different today is that we have some many sources of information that someone with discernment can note when the traditional media is lying to them.

    I absolutely agree that people should fact check, read multiple sources, get out of their comfort zone.

    I visit American Thinker, AEI, NRO. and ThinkProgress, DailyKos, Mother Jones.
    And myriads of others between.

    But expecting that everyone will fact check everything is too much.

    At the same time – what I would say is really really good about today, is that we ARE more skeptical. We trust government less than ever, we trust politicians less than ever, we trust the media less than ever, we trust most sources of authority less than ever.

    And I think that is a good thing. We need to trust the elites less and ourselves more.

    If you develop a health problem today – do you google the issue and learn what you can BEFORE visting the doctor ?

    As Reagan said “Trust but verify”

    • Priscilla permalink
      March 10, 2017 11:15 am

      “If you develop a health problem today – do you google the issue and learn what you can BEFORE visting the doctor ?”

      Oh yeah…..I’ve done that many times, and ended up thinking that I had some life-threatening disease, which, thankfully, has never been true, at least so far.

      But this is why genuine fact-checking (not the BS, politically tainted fact-checking that the media often does) is so important. Critical thinking and fact checking, using the tools that are available to all of us, should be a skill that is taught in school in almost every subject, starting from the early grades. Unfortunately, that is happening less and less, as teachers are being forced to teach to tests, and many curriculum are being designed to narrow, politically correct models, which encourage just the opposite of critical thinking.

      • dhlii permalink
        March 10, 2017 12:02 pm


        The responsibility to do your own critical thinking is and always has been our own. That is unavoidable. The tools to do so are now better than ever.
        But exercising judgement is still needed and we are not all going to do that the same or as well.

        I would note there is no truly objective anything.
        There is only our own personal assessment.

        That does not BTW mean all ideas and oppinions are equal.

      • Priscilla permalink
        March 10, 2017 12:16 pm

        Agreed, Dave. Re-reading my comment, I realize that it could have sounded as if I was advocating that individuals rely on others, presumably academia and media, to do their fact-checking for them. I advocate just the opposite (although, when it comes to scientific data, people like me need a lot of help!).

      • dhlii permalink
        March 10, 2017 10:43 pm

        The media, academia, doctors, scientists, all kinds of authorities can have input in our decision making.

        But the decisions are ours.

        You are free to chose to rely on someone else. You can even pay more to let someone else make choices for you or to have to do less yourself.

        You are free to make good decisions – or bad ones.

        And quite honestly we are not all going to make the same quality decisions.

        But it MUST be your choice.

        Just to be clear – it is near certain, that a top down approach where everyone loses the ability to make some or all of their own decisions, will on the whole mean fewer people make absolutely catastrophically stupid choices. but it will mean that the average results will be worse for most of us.

  35. Roby permalink
    March 11, 2017 11:41 am

    “As it is now, it gives us an idea of what all of our lives might be like under single payer. ”

    I’d be happy to have Canada’s single payer system, as Canadians are. I don’t see any way to get there from here, so I spend 0.00% of my life engaged in activism for a US single payer system.

    Even if we had the most capable politicians, the most efficient bureaucrats and the most well informed, patient, and generous population, it would still be a gigantic undertaking to get to single payer in the US. You cannot radically change how 320 million people get health care at a pen stroke and all the economic entities that presently exist cannot simply be made to disappear! Allegedly, we would save about 5% of GDP (based on the bad assumption that what happens in the way of system operation in another society will transfer to ours!) So, our politicians are supposed to sign off on revolution that will eliminate 5% of GDP at a pen stroke!?! Not going to happen! We will have a mixed system until the end of time, that is how we have been wired, rewiring will produce chaos. Fagedaboudit.

    There is still a LOT wrong with our system as any fool can tell. Wanting to improve it is natural. As one example, an insured person will pay a small fraction of what an uninsured person will pay for the same service, for an uninsured person the service is absurdly unaffordable. That is totally weird and backwards from a moral standpoint. No one can have all the health care they want unless they are filthy rich and can pay out of pocket. For everyone else there is some limit. The limit, as Ron said, is a lot crappier and costs some years of life expectancy I am sure, if you are on medicare. Statistically, by comparing life expectancies, its not a huge difference. For certain individuals its a life or death difference. The people who are either poor or on crappy insurance have, statistically speaking, lousy health lifestyles, food, exercise, occupations. I don’t blame liberals (or compassionate conservatives, or moderates, or libertarians) for wanting to improve outcomes for those in the lower part of this chain, but there is only so far you can go with that starting from the American system and culture.

    The American life expectancy all the same is ~80, which ranks us in 43rd place, which is deceptively poor. A 1 year increase would move us up by 20 places, a 4 year increase, would move us to #5. Eh, 80, 84, the point is we lived to be 49 on average 100 years ago. I think health care must be delivering something, and the distinctions between most developed countries are by one or two years in life expectancy unless you live in Japan and live on fish and rice and do yoga every day, or Monaco where, I have no idea what they do in Monaco but they live to be 89 so someone ought to look into them.

    Anyhow, on the quality of life under single payer, which according to WIki only exists in Canada and Taiwan, sounds pretty good to me (its what I originally was going to post in reply to your dark single payer outlook Priscilla but then I got sidetracked):

    “Canadians strongly support the health system’s public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported “public solutions to make our public health care stronger.”[19][20] A Strategic Counsel survey found 91% of Canadians prefer their healthcare system instead of a U.S. style system.[21][22]
    A 2009 Harris-Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States.[23]
    A 2003 Gallup poll found 25% of Americans are either “very” or “somewhat” satisfied with “the availability of affordable healthcare in the nation”, versus 50% of those in the UK and 57% of Canadians. Those “very dissatisfied” made up 44% of Americans, 25% of respondents of Britons, and 17% of Canadians. Regarding quality, 48% of Americans, 52% of Canadians, and 42% of Britons say they are satisfied.[24]”

    • Priscilla permalink
      March 11, 2017 4:50 pm

      Roby, as long as you’re healthy and don’t need surgery, Canada’s health system is great.

      When you are in trouble, and need medically necessary surgery ~ surgery that would be performed within days, or sometimes hours, in the US ~ not so great.

      “Canadians who need medically necessary surgeries waited longer than ever for treatment – with average wait times hitting 20 weeks, a new Fraser Institute report concludes….“Long wait times aren’t simply minor inconveniences, they can result in increased suffering for patients, lost productivity at work, a decreased quality of life, and in the worst cases, disability or death,” Barua said.”

      America’s healthcare system has long been the greatest in the world. Don’t believe everything you read.

      • Roby permalink
        March 11, 2017 8:19 pm

        I can find literally no evidence that we are the best in the world as a healthcare system. I found a whole lot of studies and rankings, we fared poorly in all of them. Most expensive, with only mid level outcomes is the synopsis.

        Here is just one source, I could easily list 5 or more different studies, but who has time to read all that. I post a few though.

        This is a good and fair overview of the subject and teh claim of best in the world.

      • dhlii permalink
        March 12, 2017 12:22 am


        What does “best” mean ?

        As an aside – cross country evaluations are incredibly difficult.

        As an example Europe has greater life expectance than the US.
        The determine live births completely different than we do.
        Just counting live births the same as most of the world would probably add a year to US life expectances.
        We know that left expectance varies with race – the EU is far less diverse than the US.
        Comparing racial groups US life expectances are about the same as Europe.

        The US is far more obese than the EU – that has a strong negative effect on life expectance.
        At the same time we are far better at dealing with the problems caused by obesity – such as diabetes.

        Americans drive about twice as much as europeans – and therefore are more likely to be in fatal traffic accidents.

        We are more violent – though just like health, violence has demographic patterns, and our rates of violence are not that different by demographic group.

        returning to that demographic thing, we have far more racial diversity than any other nation.
        The swedish medical system needs to deal with the health issues of people not merely from the same race – but the same tribe.

        The US has the best cancer care in the world, the best heart care.

        US ratios of hospital beds to population – are lower – but we move people through hospitals faster – and that is generally regarded as a good thing.

        Another part of the metrics you have to watch out for – when something that appears to be a bad metric is actually a good one.

        I do not BTW think that the US has the “best” medical care in the world.
        I do not even know what that would be.
        I do not think we deliver the best value in the world – even adjusting for the amount we subsidize the rest of the world.
        I do not think we do the best at making consumers happy – though we do far better than the left would give us credit. And if you doubt that, you will learn otherwise quite quickly if you even manage to impose single payer.

        One of the problems with your surveys of purported satisfaction by country with medical care is they presume that those taking the survey fully appreciate the differences between their care and what others have. Otherwise they are just measures of nationalist pride.

        If the US ever goes single payer – the left has an enormous problem.

        Either you are going to probably quadruple the cost of healthcare – which is what you would have to do to give everyone the same care that those of us with good private health insurance get, or you have to substantially reduce the quality of care of those of us with good private healthcare – and that will result in a political blood bath unlike anything you have ever scene.
        Or you have to find some way of preserving the status quo – basically having distinct have and have not health care. And isn’t that what you are looking to avoid ?

      • dhlii permalink
        March 12, 2017 12:25 am

        Why would I ever trust anything from one of these political fact check organizations ?

        I would paraphrase Ben Rhodes about the media – they are a bunch of 26 year olds with absolutely no life experience – you can feed them most anything you want and they will repeat it and thank you for it.

        I prefer to get my “facts” from … well data, reality, not people half my age who have no real life experience and are stupid enough to think that healthcare is a right.

        Anything that imposes a requirement to act on others, is neither a right, nor sustainable.

      • dhlii permalink
        March 12, 2017 12:43 am

        Why am I supossed to trust an oppinion peice that attributes a quote of Joseph Goebels to JFK ?

        But lets look at your article – people with enough money to get whatever health care they want
        Either – choose completey private and totally divorced from the state very expensive care in Europe, or come to the US.
        That single statistic alone should tell you everything you need to know.
        Do you think the uber wealthy would have been disuaded by your other statistics if they thought they were meaningful ?

        I can artificially construct metrics to make any system better than others.

        Are those people involved in ‘world governance” the people you would trust about anything ?

        Further why is it that you think the metrics cited are important ?

        The most critical facets of health care – what is necescary to get life expectancy into the mid 70’s is the standard of best care in the US in 1950. While many important things have changed since then, what doubled life expectancy was antibiotics, plasma, and sterile procedures. Everything else is adding weeks not years to life expectancy.

        As I noted before by demographic group US “outcomes” are equal or better than most if not all of the rest of the world – though it is going to be hard to compete with a monoculture like Sweden where everyone belongs to the same religion and tribe.

        Finally I will note once again:

        A lamborghini and a ford will get you across manhattan at rush hour in about the same time.
        No one sane would argue they are equal.

        Americans are buying more than “outcome”
        I have told the story of my parents death – and their care leading to it.
        The US healthcare system did absolutely nothing to make either live longer – that was not possible.
        But there last years were better – and the experience of family and friends was better.

        And that is what we are paying for.

        Where is your metric for that ?

        Americans on medicaid, or medicare without supliment, or the uninsured would be quite happy with european healthcare.
        Those with private insurance or medicare with supliments are going to peel your skin with a razor if you try to take from them what they have.

        The best of US care exists elsewhere.
        But it does not exist for such a large portion of the population elsewhere.
        In most of the world you have to be very rich to get what most americans expect.

        Finally I will note that the US has about 15M immigrants. and about 45M 2nd generation immigrants – that is 5 and 15% of the population respectively.
        Nearly all of these came from countries that are dirt poor.

        Lets see how well european healthcare holds up when 15% of their population is recent immigrants from dirt poor parts of the world.

      • Roby permalink
        March 11, 2017 8:22 pm

        List of the 16 best systems, US not on the list.

      • dhlii permalink
        March 12, 2017 12:59 am

        Lets see Luxembourg has a slightly larger population than the Hamptons.
        Do you think Luxembourgs Healthcare is as good as the Hamptons ?
        Singapore and Hong Kong top everybodies list of the countires with the greatest economic freedom.

        Total taxation levels in Singapore and Hong Kong are only SLIGHLTY higher than americans pay to social security.
        Can the left deliver single payer, working law enforcement, national defence, a court system, infrastruction, …… for 20% of GDP ?
        Until you can comparisions to Singapore and Hong Kong are just admissions that your ideology is an expensive failure.

        The population of Switzerland is about the same as Virginia – why don’t we compare Switzerland to Virginia ?

        The population of the netherlands is about that of New York – and I think New your might have a tiny bit longer life expectance.

        The population of swedent is about that of Minesota – and alot of minesotans come form scandanavia – and life expectance in minnesota is higher than Sweden – and any of the rest of europe.

        Austrailia and New Zealand are also ranked much higher than the US in economic freedom.
        And Austrailia has about the population of Texas.

        Do I need to go on ?

        Germany probably has the largest population – about 1/4 that of the US.
        And its healthcare is no better than new england.

        I suspect that Conneticut has better healthcare than any of these tiny nations.

      • Roby permalink
        March 11, 2017 8:29 pm

        Graphs and charts. Nerdy.

        “Cross-national comparisons allow us to track the performance of the U.S. health care system, highlight areas of strength and weakness, and identify factors that may impede or accelerate improvement. This analysis is the latest in a series of Commonwealth Fund cross-national comparisons that use health data from the Organization for Economic Cooperation and Development (OECD), as well as from other sources, to assess U.S. health care system spending, supply, utilization, and prices relative to other countries, as well as a limited set of health outcomes.1,2 Thirteen high-income countries are included: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.”

      • dhlii permalink
        March 12, 2017 1:08 am

        What part of your Commonwealth report actually tells us about the quality of health care ?

        Why does lower cost mean better ? It say nothing about quality, nor tells you anything about the experience.
        I can go to “dutch wonderland” far cheaper than “Disney World” – I do not think dutch wonderland is a better experience.

        Why do the number of doctors and hospitals matter ?
        Why doesn’t smaller numbers mean better ?

        Why do you keep assuming the meaning of various metrics ?

        The US has more obesity – and more diabetes, and more amputations.
        That is not a function of our health care systems but of peoples choices.
        In the US the Obese get far better care and have far better outcomes than the rest of the world.

      • dhlii permalink
        March 11, 2017 9:20 pm

        I would not overplay the superiority of US Healthcare.
        While there are many positive attributes,
        Many of those purported socialists schemes in Europe are closer to free market than ours.

        The left likes to sell european healthcare as if it is all single payer or fully state provided,
        Some of it is – but not most of it.
        All of it includes a mandate – but much of it is otherwise very free market.

        Equally important, much of it is not as badly government mangled as ours.

        I am not trying to sell europe – just note that if we are making comparisions we should do apples to apples.

    • dhlii permalink
      March 11, 2017 6:54 pm

      Many canadian are happy with their system – many Brits are happy with the NHS.

      They have their ford focus’s and they are happy.
      They have never got the chance to have a lamborghini and they never will.

      Canada’s system has problems.
      First – like healthcare throughout the world it is heavily subsidized by us.

      One of Trump’s campaign promises that I hope he keeps was to break down the barriers preventing drug re-importation.

      Do that and drug prices throughout the would will rapidly normalize.
      The rest of the world will quickly have to pay more,
      and americans will pay less.
      There will not likely be much actual drug re-importation – because prices levels will adjust to prevent it.

      But Canadian and european drug costs will rise significantly, and US costs will drop.

      BTW I doubt you would actually be happy with the canadian system, and I doubt canadians would be happy with it either – if they had had a real free market choice before.

      I would also note that Canada and the rest of the “social democratic world” has slowly been dismembering their safetynets – because they can not afford them.
      Because standard of living has been rising int he US faster than those countries.

      As the canadians if they would give up being twice as well off in 20 years as today, in exchange for their healthcare – and then see if they would be happy.

      Alot is made of polling that says people are happy with a bunch of provisions of PPACA.
      But when the same polling questions are asked – with each question reframed as “would you be willing to pay more for …” those opposed outnumber supporters by more than 2;1 – even for the most popular provisions.

      We are all happy with what we think we are getting for free.
      Few of us are happy with much of anything government does – when we have to pay for it.

    • dhlii permalink
      March 11, 2017 7:13 pm

      If you think Single payer will save a single penny you are smoking dope.

      Anyone even offering such nonsense is a complete economic imbecile.

      Single payer absolutely destroys the means of knowing the price of anything.
      That ALWAYS results in skyrocketting prices.

      The only reason that a few other nations of the world have managed to impliment single payer without absolute disaster – is because we have global markets that are mostly NOT single payer and therefore the canadians as an example get a reference for what prices should be from those nations that are not single payer.

      If you move the US to single Payer you will wreak havoc on the healthcare of the entire world.
      Because our healthcare system is the price reference for most of the world.

      The US subsidizes the global development in drugs.
      It subsidizes the global development of medical technology.
      It subsidizes the advance of medicine world wide.

      Just try a simple experiment to see what would happen.

      Trump promised to permit the re-importation of US manufactured drugs.
      Impliment that.
      Very rapidly US prices will drop and those throughout the world will rise.

      Those countries that have imposed price controls – will no longer be able to buy drugs – unless they pay market prices.

      In a short time, you will get a clue of how enormous the subsidy that the US provides the rest of the world is.

      You will also get a clue as to what will happen with Single payer.

      Any significant change to US healthcare will have substantial effects on the world.

      Though arguing with you is pointless. You have no idea what a price is and why it is important. You do not understand that absent government interference prices are the way people communicate what they want to those who produce – and that communication is bidirectional.

      How well do you think Cell service would work if you could call anyone in the world and talk, but no one could talk to you ?
      That is what Single Payer is – it is also what socialism is, and it is why socialism failed.

      Is The USSR still here ? Is the PRC really still socialist – or has it become a form of single party capitalism ? Is North Korea, Cuba, Venezuela your idea of a working country ?

      Can you name any “socialist” nation with a higher standard of living than the US ?
      Can you name any Socialist nation that had not either:

      Failed completely
      Ended up in poverty
      Or had to back pedal significantly on socialism.

      None of this is an accident.

    • dhlii permalink
      March 11, 2017 7:24 pm

      First comparisons to what the US has – or what it had are disengenuous.

      While I have noted that the US provide Lamborghini care to most of us.
      US healthcare it not even close to a free market.
      And in fact US healthcare prior to PPACA was such a botched up quasi socialist mess that the healthcare in most of Europe despite being “universal” is close to free market than the US.

      And once again you rely on surveys or polls.
      What does the average canadian really know about healthcare elsewhere ?
      What does the average person in any country know of healthcare elsewhere ?

      Regardless, you can not measure satisfaction – unless you are also measuring peoples willingness to pay for it.

      Which is why prices are so important.

      The price at which to people agree to an exchange establishes – for producers and consumers what people think the value of something is.

      Producers direct resources based on the price, they know what to produce and how much to produce.

      The left seems to think that prices (and costs) are objective – that is complete nonsense.
      Value is subjective.

      McD’s knows that whatever the price of its burger or fries that lowering that price will increase sales. And I will absolutely guarantee you there is an army at McD’s trying to figure out how to lower the price of everything they sell AND maintain or increase profits.

      Walmart has done exactly that – to the benefit of myriads of 4th and 5th quintile consumers.
      Provding them with goods they could not otherwise have afforded.

      How is that going to happen in Single Payer ? There is only one buyer – Government there is little incentive to lower the price. Government has no means to even know what the price is.
      Prices go up, not down.

      Did Nixon’s wage and price controls work ?
      Did FDR’s NRA work ?

      Can you name any instance ever where any government has ever successfully controled a price ?

    • dhlii permalink
      March 11, 2017 7:41 pm

      These “some other nation is somehow better” games are idiocy.

      If you like Canada or Sweden batter go there.
      If you do not want to go there – nothing prevents you from accomplishing whatever it is that you think is so great about wherever inside of a voluntary arrangement.

      If somewhere else really is better – why is it that you need to impose their approach on all he rest of us by force ? If whatever Canada or wherever has is so great – why doesn’t it just happen from the bottom up ?

      The reason that you need force to impose these stupid approaches – is because they do not work, and most people know they do not intuitively work, and will not voluntarily subject themselves to something that will fail.

      That is also why when you ask people if they are willing to pay for some purportedly popular approach – they are not.

      BTW how is it that you think Single Payer is actually going to save money ?

      We have a shortage of doctors – do you understand why ? Because fewer people are willing to go through the effort and accrue the debt necescary to become a doctor for the decreasing reward and increasing burdens that have been imposed on doctors.

      We are importing doctors from other countries – because it is the only way we can get enough doctors who will do the job for the amount that we pay – and that is despite the fact that being a doctor is not a low paying job.

      The only means we really have of detecting medical fraud today is private insurance companies – as there is no consequenctial fraud detection in medicare or medicaid.
      So if you go Single Payer – how are you going to know when government is being defrauded ?

    • dhlii permalink
      March 11, 2017 7:45 pm

      Why do you think that you can compare “satisfaction” rates between countries ?

      Americans are far far used to greater choices more freedom greater opportunities.
      We are dissatisfied by our healthcare system – because it too strongly resembles our government – we do not get the same freedom, opportunity choices in healthcare as we are used to elsewhere.

      Europeans are used to less – they are a 30% overall lower standard of living.

  36. March 12, 2017 11:55 am

    Dave, your free market at play.

    We can’t keep national secrets secret. How the hell do we think employers can keep our genetic information secret.

    And I suspect this is a way for the employers and insurance companies to eventually charge more for premiums once a woman’s genetic markers come back as having an increased risk of breast cancer, a males with an increased rick of heart problems or anyone’s markers indicate any chronic ailment that might show up in 20 years. Free (immoral) market, charge for what may happen years from now to increase your profits now.

    And I voted for this idiot!. I sure will not next time!!!!!!!!!!

    • dhlii permalink
      March 12, 2017 2:21 pm

      You are under the delusion that just because you or I are of the oppinion that something is a bad idea that it should be illegal.

      BTW – I am far more inclined to trust a private entity than a public one.

      IF defamatory or otherwise harmful information about me is exposed by a private entity – I can sue them.

      Have you ever tried to sue the government for anything ?

      Just after I got married – many many years ago, my wife played the organ for a local church.
      One sunday walking the 4 blocks to that church, she was accosted on the street by a man who put something that appeared to be a gun in her back. He forced her into the basement of an abandoned building. She escaped about 4 hours later and managed to attract the attention of a police officer who took her to the emergency room.
      Whatever you guess happened – reality was worse.

      After we recovered somewhat, we contacted a lawyer.
      We found that the police knew that bad things were happening in this basement and during weekdays an officer checked it every hour. But this was a weekend and they did not check at all over the weekend.
      We were told that the city was immune from lawsuit, but that we could sue the owner of the building for improperly securing the building.

      Today my wife is an appelate criminal defense attorney and probably 3/4 of her cases are “sex offenders”. Two of her clients are on the national list of the “exhonerated” – that is not merely they got off on appeal, that is not subsequenctly found “not guilty” but actually innocent.
      That is a real big deal.

      Anyway, one of the reasons we limit what government does – is because generally we can not hold government accountable when it makes mistakes.

      If the owner of the building had a private security service and they had failed to make their rounds – there would have been a very strong claim.
      But failures of government rarely have any consequence.

      Yes, I trust private parties with my confidential information.

      With respect to your specific example:

      I have zero problems with things people agree to voluntarily and I do not prejudge them.
      This does not sound like a good idea to me – but I can construct circumstances where it might be.

      If your insurance company offered a discount if you had genetic tests done and the results came back negative – would you do them ?

      I have had to “pee in a cup” for a variety of jobs. I have had to have my background investigated thoroughly to get a security clearance.

      If a client or employer makes something a condition – I can say no.
      Conversely I can and have imposed conditions on my services.

      Someone asked my to do some work between xmas and new years once and I demanded an egregious fee – and they agreed, and that year my family celebrated xmas on Jan 3 – and did so more joyfully than normal.

      Yes, insurance companies might charge different rates depending on the results of tests.
      And I have no problem with that.

      I would prefer to think of those different rates – as discounts for being at lower risk.

      Further if I am at higher risk for a heart attach or some other problem with a genetic component – I would prefer to know that.

      I am more likely to do better on cardio fitness, if I know I have a predisposition to cardio problems.

      I would guess that a women with Breast cancer markers might be more likely to get regular screening.

      I would also note that though I can not predict when, it is certain that we will have the ability to turn on or off these types of genes in the future. We are already doing some preliminary work.

      As an example we can already spray mosquitoes with “pesticides” that will make specific species – such as those carrying zika and malaria infertile after about 3 generations.

      We have the ability today to deliberately exterminate very specific species of pests.
      We have not yet chosen to do so.

      • March 12, 2017 3:40 pm

        Dave, I have a better understanding of where you are coming from. So I hope this explains my position so you have a better understanding of me.

        I also do not trust government when it come to things like health care, retirement funds, etc. BUT, I trust corporate America less than I do government. If we do not have some regulations, you and I would be running around in Ford Pinto’s with exploding gas tanks, or cars with exploding Takata air bags. Sure, your position that we don’t have to buy a Pinto (no longer made) or a car with one of those air bags is valid. But most people would not be researching air bag explosions, so for those that did not research and they got toasted by a gas tank explosion or blinded by shrapnel from the air bags, I guess law suits for surviving families or damages for being blind the rest of your life makes up for corporate Americas greed (there’s that word again!)

        Yes, I agree that women and men who find out they have genetic markers for chronic illnesses is a good thing. But it should be their decision and not part of an agreement if you want insurance or not. If the employer offers discounts, that’s a good thing. I agree with you.

        But your trust goes much farther than mine. I think the insurance companies will use this information to jack up rates for those with markers and not give discounts to those who do not have markers. I think they will use this information in some data base so when you leave employment and go to a new employer, that employer/insurance company will say you do not qualify for insurance due to genetic markers. Consultants who have read this proposal are most likely already coming up with plans to get around any “discount” language so corporate America can increase rates for the “marker” group.

        If this happens, in a few short years I believe the only people able to get insurance will be over 65 (Medicare), the poor (Medicaid) and anyone that only has medical claims that are 15-20% of their premiums once idiotic regulations like this one get on the books along with the Rand conservative insurance plan that will give nothing to those needing insurance and give the insurance companies and corporate America a massive tax cut that no one will see other than those companies.

        I am glad someone trust corporate America. I don’t. I trust them as much as I do a rattle snake coiled up in the woods.

      • dhlii permalink
        March 12, 2017 6:03 pm

        Ron P;

        I think if you look critically at your own life you trust “corporations” and free markets far far more than government.

        You engage in myriads of transactions every day – few of these go wrong.
        If they did start to go wrong you would change.

        If McD’s does not deliver the burger you expect of them – you will quit going to mcdonalds.

        I think this is also one of the bizarre dilemas of Trump as president.

        We are 50 days in and more so than any president I can recall in US history he is seeking to keep his campaign promises – often to the tremendous anger of the left.

        Trump is first and foremost a business person, and despite all the complaints about corporate integrity – integrity is THE critical capital of business.

        What does a “credit rating mean” ? It is the measure of the trust that the community has for your fiscal conduct.

        What does a line of credit mean for a business ? It is the extent that other people with money trust you to use their money.

        What are the reputation schemes on various online systems like amazon or ebay about ?
        They are about trying to quantify how much you can trust someone you have never met and never done business with.

        Somewhere I quoted a marketing bible I read “all things being equal you deal with those you know, all things being not so equal – you deal with those you know”
        Why – because free exchange requires trust.

        When you say you do not trust corporate america – that is a conscious remark that is completely at odds with the less conscious conduct of every human being.

        Of course we trust business – not perfectly, but far more than government.

        Trump has done exactly what businesses always do – he has marketed himself, he has sold the product, now he must deliver – and he knows it.

        At the sametime – I always imagine that burger from McD’s as tasting better than it does.
        But I continue to frequent McD’s even so – because they may not quite deliver on my fantasy, but they deliver more value than I gave them.

        Trump is doing the same.
        We have no muslim ban. But we have an immigration EO that no one thinks is perfect, and many think is evil, but meets the minimal criteria of what he promised.

        During the election Trump promised to get and keep us out of the wars of the mideast and the rest of the world. He sold himself as a form of non-interventionist.
        I do not agree with his positions on immigration (though I do not agree with the left either).
        But because he has behaved trustworthy, because he has done something he promised – even though I do not like it, I am more inclined to trust that he will do what he said with respect to keeping us out of wars for the next 4-8 years.

        At the same time I am somewhat worried because he made promises regarding trade that I think are total economic idiocy and I hope he does nto keep them.

        The left – and possibly you, seem to confuse trust worthy with good – or worse still good intentioned. I do not think that Trump is a good person. I think he may prove to be the most trustworthy president ever.
        And I would offer that is because he is a business person.

      • dhlii permalink
        March 12, 2017 6:21 pm

        The pinto resulted in a massive private lawsuit and award.

        No regulation involved. The Pinto is a demonstration of how things should work.

        BTW it is also a demonstration of what you need to fear from government.

        One of the reasons the problem with the pinto was not corrected was cost.
        The fix as “cheap” but the bean counters worked it out – and at about $1M/person harmed it was much cheaper not to fix.

        That sounds horrible – until you know that HHS values a human life at about 225K for the purpose of scoring regulations.
        BTW the pinto lawsuit and $1m value to a human life was in the 70’s and HHS’s value is in 2012.

        Ultimately we MUST place a value on human life to make decisions – and Ford’s $1M value used in the pinto case was actually extremely reasonable.

        While I do not accept the premise that keeps getting offered that but for PPACA people will die.

        Lets say it was true. Should we spend $1T of our wealth if that results in saving 100 lives/decade ? That sounds like a painful and difficult choice – but it is not.
        There are far better places we can spend $1T that would save more lives.

        Let me try another example.

        Lowering the speed limit to 55 undoubtedly save lives.
        Of the top of my head I do not recall the numbers – but lets say it was 1000/year.
        We also travel 4T miles/year. If I did the math correctly the decrease in the speed limit resulted in about 8000 wasted human lives/year
        I guess that an hour driving may be better than an hour dead.
        But I would further note that I have ONLY counted the hours of life wasted driving by a lower speed limit – not all other losses.

        The point is that saving lives costs lives. Ultimately we have to place a value on human lives – or we all end up in poverty due to striving for perfect safety.

      • dhlii permalink
        March 12, 2017 6:37 pm

        Of course insurance companies will try to use genetic markers to drive up costs for some and not discount others in order to profit.

        But you and the left seem to be ignorant of how profits work.

        Lets say McD’s substitutes horsemeat for hamburgers, gets away with it and doubles its profit margins.

        Any business profiting above the risk adjusted norms will draw competition like flies.
        Because If the normal profits are 5% and McD’s is making 10%, any burger can step it steal customers from McD’s and make 7%.

        Absolutely every time a company figures out how to increase its profits (without increasing risk). those profits are SHORT TERM. Ultimately the profit margin returns to the risk justified norm. BUT the price remains lower. This is a significant part of why free markets are always mildly deflationary. Increases in profits ultimately turn into decreses in price. The profit increases are temporary the price decreases are permanent.

        Even the left’s theory of monopoly suffers from this flaw.
        I have never seen a real monopoly – but they are in theory possible in a free market.

        If a company manages to gain control of the entire market AND maintains its profit levels at the norms for its risk level, no one will be motivated to attempt to compete with it.
        But if a “monopoly” uses its monopoly power to profit beyond that justified by its risk level that will trigger the creation of competitors.

        The result is that in a real free market – business not merely have to compete with actual competitiors – but those that do not exist but would the moment profits margines grow outside the norm.

      • dhlii permalink
        March 12, 2017 6:48 pm

        Just to be clear – while I do trust business – atleast inside of the market – In the arena of government I fully expect them to conduct themselves to their advantage and my harm – and to rent the power of government against my interests.

        But even if I did not trust business, businesses can not profit without delivering to me what I want.

        Further I want to directly address your scenario.

        Lets frame it in terms of burgers.

        McD’s could double the price of its hamburgers tomorow – and its profit margin on burgers would skyrocket – but its overall profits would tank.

        McD’s objective is NOT to sell a burger at the highest profit margin – it is to make the most possible money selling burgers.

        That ALWAYS means selling far below the maximum possible price to a much larger market.

        Insurance companies would love to insure only the healthy.
        But doing so might mean higher profits per policy – but it will mean lower total profits.

        It is extremely rare to find a company seeking a smaller higher margin market – and when that occurs – it is generally a niche participant in a very large market.

        Nature’s promise might be happy with a 30% profit margin on 10M of sales.
        Kellog’s would not.

      • dhlii permalink
        March 12, 2017 7:00 pm

        Another argument.

        It is trivial to predict that companies will want to do what would increase their profits.
        But companies do not control markets – there are far more factors to a market than those a company does control – like price.
        Companies do not control the behavior of their consumers.
        When a company changes its behavior, consumers change theirs.
        And just as you try to guess what companies will do with the results of genetic testing information – those companies must guess what you will do when they change prices.

        Markets rarely shrink.

        I would note that to a large extent the insurance industry supported PPACA.
        Insurance companies are perfectly happy insuring all the sickest people in the country – if they can also insure all the healthy people in the country.

        Absent a mandate – you are not going to see insurance companies only insuring the healthy.
        You are going to see them insuring any group they can do profitably.
        And Insurance companies absolutely know – larger groups are always safer.

  37. Priscilla permalink
    March 12, 2017 7:14 pm

    Ron and Dave, this is an interesting discussion. I wonder what most people would say, if you asked them whom do they trust more ~ business or government? I’m gonna guess that most would say government, although I think that I’d choose business. It would be close though, because I don’t much trust either. On the one hand, corporations have been demonized out of all recognition ~ on the other, most corporations are fine with having politicians demonize them, as long as those politicians take their money and do their bidding. So, I suppose I don’t trust either, because I think that they’re fast becoming the same.

    Of course, when we talk about business these days, we’re never talking about small business. That’s a whole other discussion.

    When I read or hear about people claiming that capitalism is at fault for, or can’t solve, our healthcare crisis, I realize how far we have come from a truly capitalist economy and how comfortable we’ve become with corporatism and socialism on a grand scale. I wonder if it’s even possible to get back to something resembling a free market healthcare system, now that there are so many Americans who believe that it’s the government’s obligation, not only to insure that 100% of the people have insurance, but that that insurance provides them with access to all types of healthcare services, including birth control, abortion, sex-change operations, etc. In 8 years, we’ve gone from “Let’s fix what’s broken in our healthcare system.” to “Let’s be like Canada and the UK.”

    • dduck12 permalink
      March 12, 2017 10:03 pm

      Ah, room at the verbal trough.
      Good thoughts Priscilla. I always considered it to be “the business of government” with little businesses the equivalent of sheep while government and big businesses ignore the lambs silence and continue making bleating platitudes.
      -Healthcare: The country, Trump and the Reps have a losing hand. Frankenstein can’t be fixed with duct tape and wire. My fantasy, which would be a win for the country (and Trump’s legacy) would be for Trump/Reps, to really push for a real Single Payer plan.
      Heresy, impossible, crazy, but bold. It would attract enough Dems and therefore would pass, say in two years. Trump would have to do his best Svengali act once he understands “scorched earth” would assure him of a 2020 victory. I don’t see SP coming anyway else; we have a dysfunctional government and greedy big businesses. ——Okay dream over, thanks for your time.

      • dhlii permalink
        March 13, 2017 12:46 am

        If you think we are headed for Single Payer you are living in dream land.

        ObamaCare far from creating the bridge to single payer – burned it down.
        Single payer is not coming – for innumerable reasons – partly because of Obamacares failure.
        But even more because outside of a small number of wingnuts on the left there are few people who do not grasp what a catastrophe it would be.

        Just some simple things to consider:
        Our healthcare is not egalitarian – and we do not want it to be.
        We MIGHT want those at the bottom to get care – but most of us do not think that those getting “free” care from government should be getting equal care to the rest of us.
        No they should not have to “die” for lack of treatment – one of those stupid unicorn arguments of the left. But they should not be competing with the rest of us for the best doctors, the state of the art care, the private rooms, the …..

        Any single payer system MUST be egalitarian.

        This is a fundimental problem whenever we try to make government do something that would normally be done by the market.
        As an example – few would argue publicly that education should not be equal for everyone one – but please show me a single parent who if they could afford to do so would not do whatever is in their ability to ensure their child got a better education than everyone else.

        We are not equal. Get over it.
        We are not equally smart,
        equally handsome
        equally able
        equally artistic
        equally creative
        equally talented.
        Nor would we want a society were we were.

        We are entitled to only ONE form of equality – that is equality before the law.

        Whatever government does – it must do equally.
        If we do single payer healthcare – we must do so equally.
        So what are you going to do

        Reduce everyone to the care equivalent of medicaide ?
        Or raise everyone to the equivalent of the best cadiliac corporate policies ?

        We will revolt if the former and go bankrupt on the latter – and there is no sweet spot in the middle that is both affordable and not going to trigger political revolt.

        Regardless, why is it that you think that republicans would push something that both in fact and in their ideology is incredibly stupid ?

        Fixing our healthcare is pretty trivial – restore free market healthcare.

        It is not knowing what needs done that is difficult it is that we have a mess that most people know is a mess, but no one is prepared to accept the smallest amount of pain to fix it – atleast not of their own pain.

        That said PPACA has actually made shifting to something closer to free market more possible.

        PPACA has started tearing down the employer provided healthcare model.
        That was a stupid mistake created by wage controls during WWII.

        It separate consumers from responsibility for their own choices.
        We need a system where you either pay for your medical care or you pay for your insurance.

        The left is entirely clueless in grasping that it is peoples choices that drive prices DOWN.
        The economies of scale are not all that important – particularly when divorced from individual choice.

        We should remember that one of the biggest companies in the world is Walmart – which sells in large volume to the bottom of the market.

      • dhlii permalink
        March 13, 2017 12:49 am

        We do have dysfunctional government and greedy corporations.

        Of course we have the same in breakfast cereal.
        Only we do not have the problems with breakfast cereal we do with healthcare.
        Because there is less government, and absent government corporate greed serves rather than hinders consumers.

    • March 12, 2017 11:02 pm

      Priscilla, one thing we need to keep in focus is our government was ready right after WW2 to create a national health insurance like Canada or England. Medicare was the outcome since labor unions did not care about retirees, so they did not lobby against it when it was introduced. That was when unions were growing rapidly and had a lot of influence and this influence was used to get legislators to back off. The unions had employer health insurance as a major bargaining chip and they used that to get better contracts and thus increase the number of union members. The healthcare reimbursement system in this country has really never been “free market” since employees got the insurance their unions and employers offered or they bought what was available on the open market, but the rates have always been controlled by state insurance commissioners offices. That is why insurance companies can not sell one national product because most states want to control the rates charged within their state.

      So we can not prove if Dave’s position on free markets would work or not since we have not had free markets to analyze. I know Dave will say anything is better than government being involved, but when the industry has been regulated, or unions have been so influential over plans offered, we really don’t know.

      • dduck12 permalink
        March 12, 2017 11:47 pm

        Good points, Ron P. And as a former insurance agent, I can tell you that aside from NY and a few other states, their insurance departments are just profit centers. Having 50 insurance departments causes enormous costs in time and money for insurance companies, which of course layer on the costs of any insurance product. Another stupid thing this country does.

      • dhlii permalink
        March 13, 2017 1:47 am

        If you want to know how selling health insurance nation wide would work – look at Giegco, Progressive, eSurance, …..

        This is also a reason that government must NOT dictate much about coverage.

        Different insurance companies will come up with different models.

        The GOP is hung up on HDHP’s and HSA’s – which are a far better model than we have today. But they are making a version of the same mistake the left makes all the time in presuming there is one best answer.

        I can tell you exactly why an HDHP and an HSA are the best approach.
        But if that is not what you want – it is not what you want, and you should be free to make a choice I think is stupid.

        Among other reasons – because value is subjective. And my view that HDHP/HSA’s are objectively better which I can prove with numbers on paper is still nonsense.

        The best health insurance for you – is the one that you choose and can pay for.
        And everyone does nto chose the same.

        And this is a major part of the error in the “economies of scale” argument.

        Again go look at the cereal aisle in grocery stores.
        Acording to left economies of scale arguments there should be identical cornflakes from Kellogs, Post and General Mills competing on price and nothing else.
        Yet there are hundreds of choices. competing in every possible way.

        Bernie Sanders thinks that somehow is stupid and at the expense of the poor – which just shows what a huge economic idiot he is.

        Manufacturing is slowly shifting back from China to the US.
        Why – because the price advantage to China is below 15% and us manufacturers are closer to their markets and far far far better at supply chain management,
        and finally and most importantly the US is leading us into a new era of manufacturing.
        The chinese can make a million of anything dirt cheap – and we can not compete.
        But ask for 100,000 each of ten slightly different variations and they fail.

        Us manufacturing is moving ever more towards every single item made bing custom if needed.

        So much for economies of scale nonsense.

        Again WE ARE NOT EQUAL.
        We do not want exactly the same thing.
        We do not want or need exactly the same healthcare.

      • dhlii permalink
        March 13, 2017 1:07 am

        Medicare was created in 1965.
        We were not ready to create a national healthcare after WWII.

        One of the reasons that the US and europe went different directions after WWII is that we experienced the war differently.

        In the US confidence in government was erroding as we approached the War FDR would not likely have been re-elected but for the impending war.
        FDR had already started rolling back much of the new deal.
        It was not going to be possible to fight the world war AND continue the new deal programs.

        In the US businesses were viewed as patriotic participants in the war effort.
        No one had the slightest doubt that it was the engine of capitalism that produced the weapons needed to fight the war.

        Churchill tried to the the US into the war early or atleast starting war preparations early.
        Britian has a serious problem fighting Germany – because they had delayed in moving the country to a war footing.
        Neither the UK nor Germany beleived the US could ramp up war production any faster than they had. Yet remember – From Perl Harbor to VJ day was slightly less than 4 years.
        Within a year the US was producing more war material than the entire axis and the rest of the allies combined.

        In american that was viewed as an accomplishment of free enterprise.
        Americans ended the war with renewed confidence in ourselves and in our businesses.

        Europe experienced a different war.
        Throughout the war in the UK there was deep suspicion of businesses engaged in war profiteering. The european sense of victory was a victory of government.
        The british government mobilized and organized the people. Victory was a collective effort,
        there was much less individual responsibility.

        Even on the battle field the US army ran on the inititive of captains and leutanants.
        Big plans were made by the brass – but hills and towns and villages were captured at the direction of college kids with railroad tracks on their shoulders.
        The US did not have the time to train an army in the craft of war from the top down.
        We gave soldiers guns sent them through basic training and let them learn on the job.

        Americans came back from the war with a tremendous sense of individual accomplishment.

        While the great depression had harmed our faith in ourselves and in business, the depression had eroded our faith in government, and the war had rebuilt our faith in ourselves and in business.

        We were not going to create an NHS at the end of the war. Even medicare was not possible for another 20 years.

      • March 13, 2017 1:29 pm

        Well another instance where information on the internet is not always right. I guess I need to stop researching information on the internet since so many sites reference the actions of unions and their belief this should be part of their efforts and not the governments. One example, but many more that go into detail this subject.

        There was opposition to national health insurance due to the communist, socialist and other political ideologies, but had unions supported this movement, most all of the articles I have read think NHI would have become part of the American policies during the Truman administration, or maybe during the Eisenhower administration. However, most all articles I have read indicate unions wanted this as a major benefit in their negotiations.

      • dhlii permalink
        March 13, 2017 9:11 pm

        There is nothing wrong with internet research – but it does not eliminate the need to use reason, logic and critical thinking.

        Further there is a great deal of difference between reporting what DID happen and reporting what MIGHT have happened.

        Pretending to know what “might” have happened in complex scenarios is hubris.

      • dhlii permalink
        March 13, 2017 1:09 am

        US healthcare was pretty much free market prior to WWII – and it was fairly affordable even for the poor.

        But the big disruption was Medicare. It was far far more expensive than anticipated, and had far greater impact on the rest of the healthcare market.

      • March 13, 2017 1:35 pm

        Now that you and I can agree on 100%. For those that do not know it, Medicare was designed to cover “cost” to provide service to Medicare patients. So if you had a service that was 50% medicare and new technology came out, the first thing after determining demand at a hospital was to look at Medicare utilization. If the usage was higher for Medicare, buy the equipment, 50% of the costs was already paid for and let the other patients cover profit.

        Then after about 15 years (early 80’s) government figured out this system was not working, so they began reimbursing based on the diagnosis patients were treated for, regardless of the cost. So now, all of a sudden, non-medicare patients had to cover much more than 50% of the cost, Rates began to rise and have kept rising ever since.

        And there are many other reasons other than this for high costs at hospitals, but that was the beginning.

      • dhlii permalink
        March 13, 2017 1:34 am

        Ron P;

        There is plenty of evidence out there to demonstrate that free markets in general and free markets for healthcare in specific will work fine – if you bother to look.

        Even in the US – those parts of healthcare – not tightly controled by government have followed the same successful market patterns as other things not controlled by government.
        Lasik, and cosmetic surgery as an example.

        Further there are countries in the world that have very successful medical tourism industries – besides the US that are free market.

        India provides the English releif from the problems of the NHS.
        You can fly to india, get a doctor that is well qualified, speaks english and will provide services for cash quickly and return home, months before the NHS will schedule an appointment.

        Countries like Brazil and Thailand are providing affordable cosmetic and sex change surgery.

        Americans are traveling to mexico to buy drugs – and not just cocaine and Marijuana.

        Increasingly it is possible for americans to buy medical products online.

        One of the most effective dental treatments today is Flouride varnish – treatment by a dentist costs about $100. but you can buy everything you need to do it yourself online for about $30 for 10 treatments.

        There is alot more that you can do – but I do not want to become the next Ron Woodruf (Dallas buyers club)

        Technologically we are not that far away from home drug manufacturing – kind of 3d printing for drugs.

        What is likely the best model for basic health services is NOT the insurance model, but is more od a subscription medical services model – buy your basic healthcare from your doctor the same way as you do your cellphone service.

        Would you pay $50/month per person to have relatively unlimited access to your physician ?
        All the doctors visits and basic serives you need.

        You would still buy insurance for major medical or specialist care,
        but this model would eliminate insurance companies, simplify billing, get government out of large parts of basic healthcare and allow doctors to focus more on patients rather than government or insurance company demands.
        Your doctor could also better explore innovative ways of providing services – such as by phone, online or over the internet.

        Remember the way to increase standard of living is to deliver greater value using less human effort.

        Government and even insurance companies are impediments to greater efficiency.

        This model also reduces medical fraud, and reconnects doctors with patients and without middle men.

        Further it allows doctors to once again do something they have been barred from since Medicare – pricing services by the ability of their patients to afford them.

        Just as lawyers provide a portion of their services as pro bono work – doctors will have the opportunity to deliver some of their services at low or no cost.

        This is also important in another way.
        One of the huge problems with government “charity” is the issue of providing charity in the most effective way to those who will benefit the most.
        Government can not discriminate – private charity can.

        A doctor can discount or provide their serivces free to someone who has lost their job or a family that has just become homeless.
        The same doctor can decide not to provide free survices to drug adicts or alcohilics.
        Different doctors will not make identical choices, and the results will not be perfect.
        But when people decide how to direct their own charity it tends to get put to better use than when government does.

        This may not be what happens, some entirely different solution could arrise.

        But what I can tell you with ABSOLUTE certainty is that get government out of the way and give truly free markets a chance and in 10 years you will have something much different and far better than what you have today.

      • Roby permalink
        March 13, 2017 2:14 pm

        How was cancer treated prior to WWII? You got it, you died. How much did that cost?

        You had a heart attack. They told you to rest in bed. Low cost.

        PreWWII how much health care was there really? They could set a bone, give you antibiotics, stitch something, amputate. DIfferent world now.

        The bass player in my band was diagnosed with colorectal cancer, stage IV two years ago, it had metastasized to his lungs. He played a gig with us last week, will play another next week. They say he has no detectable tumors as of today. PreWWII he would have been inexpensively dead long ago. He has had every high tech treatment you can imagine, all the scans, chemos, radiations, and surgery.He’s a blue collar guy, retired electrician, not rich. Medicare covered all or almost all of this I believe, one worry he did not have was how to pay.

      • dhlii permalink
        March 13, 2017 9:24 pm

        The majority of those things that result in our living to our mid seventies are the result of technology that predates WWII and that came to wide spread used in the 50’s.

        Cancers were treated surgically starting in the mid 1800’s – and that was successful for a large number of cancers. But many cancers are incurable – even today.

      • dhlii permalink
        March 13, 2017 9:39 pm

        Why do you think I would trust Politifact – regardless – read the link you provided.

        Except that they posit an absolutely nonsensical claim – that advancing medical technology caused health insurance – really ? Please explain the logic to that ?

        Sorry, wage and price controls caused businesses to seek other ways to compensate employees – and Health Insurance was only one.

        John Rockefeller’s nephew had scarlet fever – he offered several million dollars – the equivalent of Billions today to anyone who could cure it.

        Today that is a simple disease to treat.

        Things improve – I keep telling you that constantly.
        Those of you on the left want to beleive that only SOME things improve – usually those you can attribute to government.

        Guess what over time nearly everything imporves – but those most closely associated with government improve the slowest.

        If as you say medical care is going to be both more effective in the future and more expensive – then it is going to bankrupt us regardless.

        AGAIN improvement means MORE FOR LESS.
        If we can not ultimately do more for less – you can figure out how to cure or improve anything – and the improvement will not occur – because we can not afford it.

        I keep beating on this drum – because once you actually get it, it will change your understanding of nearly everything.

        You will understand how stupid “we know how to solve X – spend more money” is.
        Get a clue – that is not possible. If we must constantly spend more for the things you want and we are not elsewhere producing ALOT more for ALOT less – we run into a wall – FAST and HARD.

        Your entire progressive ideology can not survive unless what little you leave of free markets is constantly producing ever greater value at ever lower cost.
        Otherwise there is no way to pay for what you want.

        We had affordable healthcare pre WWII.
        But then as now we also had unaffordable healthcare.

        There was then, is now and for ever will be things that are cheap, things that are afordable to most of us, and things that are not.

        If you put government in control – you freeze that as it is – or even lose grounds.
        If you leave it to free markets – in a decade what is unaffordable today will become affordable – as it always has.

        And you have even made my point – no they could not do preWWII what we can do today.
        In some instances the technology existed – but it was not AFORDABLE.
        Government did not change that – free markets did.
        Destroy the market and what is not affordable now – never will be,.

    • dhlii permalink
      March 13, 2017 12:15 am

      And that has already been polled.

      Though I will note – personally I have have problems with polls – they are not the most accurate way of measuring human values – conduct is.

      The fact is that you and everyone else trusts businesses and even big corporations to an extent far beyond what you are conscious of.

      Everytime you buy something – you are giving someone else money in the expectation of getting what they promised in return.

      We only give politicians our vote – and most of the time only a majority of us given the winner our vote, and we do not expect they will honor any commitments they have made.

      • dduck12 permalink
        March 13, 2017 1:02 am

        “If you think we are headed for Single Payer you are living in dream land.”
        I guess, I should have included a smiley, 🙂

    • dhlii permalink
      March 13, 2017 12:18 am

      If you do not want business to buy politicians – reduce the power of politicians.

      As Lord Acton said “Power corrupts”.
      Money is what you use to buy power.

      If you could successfully prevent corporations from buying politicians – so long as they had power to rent – someone else would find a way to bend that power to their will.

      When the left argues to restrict the corrupting influence of corporations – what they are really arguing for is substituting their own influence – which they do not beleive is corrupt – though it is actually worse.

    • dhlii permalink
      March 13, 2017 12:20 am

      I only rarely use the word “capitalist” first it was coined as an insult by marx and second it focuses on the wrong facet.
      The critical factor is economic freedom – free markets.
      While capital is an important economic input, it is not the most critical factor.

    • dhlii permalink
      March 13, 2017 12:24 am

      As I noted I have not looked that hard at “RyanCare”.
      But I am heavily inclined to let ObamaCare fail.

      I think we will be more willing to do things right if we see the real consequences of doing them wrong – we have not seen that.

      It is also important because medicare and slightly further out Social Security are headed into similar death spirals.

      If we replace ObamaCare with ObamaCare lite – we will not have learned the lessons necescary to fix the far bigger problems of social security and medicare.

  38. dduck12 permalink
    March 13, 2017 2:17 am

    “If you want to know how selling health insurance nation wide would work – look at Giegco, Progressive, eSurance, …..”
    Thanks for the advice, but I’m not buying what you are selling.
    Most people know our 50 state system stinks.
    If you disagree and want to stay on point, please just say you don’t in a one word, one comment, answer. I’m really sleepy, so it would be appreciated.

    • dhlii permalink
      March 13, 2017 1:52 pm

      Read, dont read,
      sleep, dont sleep

      You get to make choices for yourself

      I get to make mine.

    • dhlii permalink
      March 13, 2017 2:01 pm

      For the most part I am not selling anything.

      I have absolutely zero problem with people pursuing whatever economic or other model or values they prefer – alone or in concert with others who share the same values.

      So long as they do not impose those values on others by force.
      And that means you can not do so through government.

      If I am wrong and you are right – you should be able to impliment your approach in some voluntary arrangement and demonstrate how well it works such that all of us would choose to join you.

      When Obama was elected I prayed that everything I beleived about the way the world worked was false and that his approach would be successful.

      In the end we all want the same thing – our own betterment and that of others.

      The question is what works.

      Neither you nor I get to declare we are right and everyone else is wrong and impose our will through government by force.

      The default is individual liberty.
      We can – and rarely must infringe on that – but when we do we must justify infringing.

      We bar people from murdering others because the freedom to initiate force against others comes at the expense of the liberty of others.

      When we authorize the use of force by government through our laws,
      that process must be arduous.
      We must believe that we are infringing the least possible
      that what we are doing has a very high probability of working.
      that the benefits must greatly outweight the costs.
      and that opposition is weak, because otherwise we are walking towards an unsustainable police state.

  39. Priscilla permalink
    March 13, 2017 8:18 am

    Dave, I think that letting Obamacare fail, now that Republicans have been campaigning on “Repeal and Replace” would be political suicide.

    And it would be a grand suicide by hypocrisy, as the Democrats, who rammed O-Care through, and have defended an awful, failing system (and I’m not even talking about the online “marketplace,” although that’s a monumental disaster of its own, would campaign on fixing this awful system, using many of the ideas that the GOP has put forth, along with some of their own. And we would end up with a Frankenstein healthcare system that dwarfs what we have now. The call for a regulated, government controlled program such as Medicare would eventually dwarf the arguments for a free market system, and doom the US to a version of the “wonderful” healthcare system that Canada has. And then the poor Canadians would have to go elsewhere for their cardiac by-pass surgeries, for which they have been placed on 18 month waiting lists.

    I understand that letting the current system fail might be the creative destruction that we need. I just don’t think that anyone, even Donald Trump, who, as you have pointed out, is the first president that we’ve had in…..well, certainly decades, maybe over a century…. who actually believes that he was elected to do what he said he would do, has the political will to change the one or two most popular aspects of O-Care. And, leaving those aspects in place, particularly the ACA’s rule that no insurance companies can refuse to cover pre-existing conditions, virtually guarantees that any replacement will be too big and too expensive.

    I support most of what Trump has done. I don’t believe, however, that he ever had his own vision of what “Repeal and Replace” should look like, he thought that Paul Ryan and the GOP had the right idea locked down, and that it would work, as long as he backed it with the power of the presidency. Now that the party has begun to fracture over support for the plan, I’m afraid that we will, in fact end up with bigger and better Frankenstein. And that Trump may find that healthcare is the biggest political minefield of them all.

    • dhlii permalink
      March 13, 2017 2:08 pm

      The most critical thing that republicans MUST do – what Democrats mostly ignored but definitely failed at is fix the economy.

      If we have sustained 3% growth by the 2018 election – having a ‘D’ behind your name will guarantee losing.

      I disagree with Trump and the GOP on many things.
      But that will not matter one whit – if they get growth to 3%.

      And 3% if a VERY LOW BAR. 4 or 5 are reasonable.
      With serious spending cuts we could get 6 or 7.

      We have robust data from the US, and the rest of the world that every 10% of GDP government spends reduces the growth rate by 1%.

      Hong Kong and Singapore have had total government spending of about 20% for 75 years and have had sustained 7+% growth over that time.
      They have gone from poverty to higher standards of living than the US in two generations.

      That is what matters.

      Trump could flash the nation from the oval office – if he managed 5% growth.

      Bill Clinton get it right – its the economy stupid.

    • dhlii permalink
      March 13, 2017 8:06 pm

      Republicans were rope-a-doped into “repeal and replace” and they should have known better.

      I knew when the effort to pass PPACA started that healthcare reform was damn near impossible.

      We can all hate what exists, but it is impossible to get even a plurality to support any proposal.
      It took every trick in the book for Democrats to get enough of their own to support it to pass it without republican support.
      It is likely nearly impossible for republicans to do the same.

      If you want constructive healthcare reform you must let PPACA fail first and have even more of the people – particularly those on the left demanding that something be done.

      Of course EVERY strategy is dangerous.
      Again I have not looked seriously at “ryancare” but my understanding is it is “obamacare lite”.

      Let PPACA fail and Ryan will be able to leverage democratic votes to pass something.
      BUT it will likely be some version of ObamaCare lite.

      Though there is an advantage to failing PPACA – you can then replace it peacemeal.

      First let it fail.
      Then repeal it in its entirety – no replacement, revert back to the mess that preceded it.
      THEN pass incremental reforms, such as national markets. mandate coverage for 20 somethings under their parents policies (no one opposes that and it costs nothing).
      Pass some pre-existing condition legislation standalone.
      Insist that insurance companies can not surcharge people with pre-existing conditions who have maintained continuous coverage. That is not overly costly.

      I do not necescarily agree with the things I have proposed.
      But they are less bad than what we have, would get popular support – and are unlibertarian – not anti-libertarian.

      I am not going to get what I want.
      The question for me is how far in the right direction is necescary for me to not oppose a less stupid solution than what we have.

    • dhlii permalink
      March 13, 2017 8:10 pm

      According to some Roper poll that Time cited about 22% of people support Trump absolutely.
      About 24% support him conditionally, and another 20% are open to supporting him.

      At the top of the list of the two groups that do not just click their heels and solute – at 80% is get the economy working.

      Again if he does that:

      He will be re-elected.
      He stands a chance of being viewed much as Reagan is.
      And I think Trump cares very much about being seen as successful.

      PPACA is not the hill I think he wants to die on. And not one he needs to.
      No one is holding him to promises re PPACA.

    • dduck12 permalink
      March 13, 2017 10:29 pm

      In the past, I often referred to the ACA as a Frankenstein plan. Many others, agreed it is clunky and not a good mechanism for our future health care needs. Time has shown that it has many flaws, and is an expensive way to cover 20 million people. But it has accomplished that and detractors can argue over how efficiently or economically (or not) that that was done.
      Well, so far, the plan that the Reps currently have on the table, I call Dracula’s plan.
      It is worse than Frankenstein’s plan, by far. Draining the blood from people that can’t efficiently use tax credits, giving solvent slackers an out from buying insurance, capping Medicaid less than artfully, setting the stage for increased emergency room usage, allowing too high high premiums for seniors, and other flaws.

      • dhlii permalink
        March 14, 2017 2:39 pm

        While I agree with your assessment of PPACA,

        My understanding of what the GOP is doing is really just PPACA lite.

        I would note several things.

        1) there is no reason to ever expect that any top down solution is going to work.
        As those of you towards the left keep noting health care is complex.
        As I keep noting – far too complex for government.

        2). There is no top down inexpensive way to cover 20M people.
        Further NO PLAN actually addresses providing care for 20M people.
        They address providing insurance for 20M people – it is not the same.
        One of the reasons PPACA failed is because it does nothing to really change healthcare to enable it to serve 20M more people. That is a part of why ER use went up.

        There are not more doctors, more nurses, more hospitals, more clinics, more …

        If PPACA had actually worked and 20M people had started demanding more healthcare – the system would have tanked.

        The reason that did not happen is US healthcare is already “universal” – everyone is getting care. PPACA did not change healthcare – it changed health insurance. that is all.

        Fundimentally the same is true of any GOP plan.

        Most of your critiques of the GOP plan are just bad spin on what are its positive attributes.

      • March 14, 2017 4:09 pm

        “My understanding of what the GOP is doing is really just PPACA lite.”

        And they are doing this because they will be roasted for 2-4 years if they do away with all the “freebies” in the current law.

        They ran their huge mouths for 6 years about repeal and replace and now they can’t say “April fool” For the millions that switched party loyalty due to Obamacare, they have to do something and now they have no idea how to get out of the mess they are in.

        It was easy to pass a repeal bill since they had cover by a democrat that would veto any legislation. Surprise dog, you now have caught the bus and what do you do with it now?

        Just listen to the daily news briefs and the GOP message is not getting out. They have ran their mouths about rising premiums, rising deductibles and all the other negatives and people are not listening. The dem’s have the news cornered with 14 million losing coverage, 15% increased premiums the first 2 years, etc, etc. The GOP could have a Rolls Royce for sale today at a price of a Buick and no one would look at it because they would screw up the message as to how good that car is, but the democrat’s could sell a VW diesel even with all the problems it has had.

      • dhlii permalink
        March 14, 2017 6:33 pm

        Who that benefits from PPACA as it currently is votes republican ?

        The BIG thing the GOP must keep is permitting the 20 something kids of adults to remain on their policies longer. That has no cost, insurance companies will likely adopt that on their own.
        They WANT 20 somethings – they are healthy rarely have problems and all money collected is profit.

        The #2 thing is that PPACA used the young to subsidize insurance for 50 year olds.
        That has already failed.

        the last big thing is pre-existing conditions.
        Again it is near certain that anything the GOP does will require insurance companies to cover pre-existing conditions for people who maintain continuous coverage.

        BTW in polls the majority of people OPPOSE covering pre-existing conditions IF it raises their insurance costs. In fact a majority oppose every single PPACA provision – if it increases their insurance costs.

        PPACA has never been nearly as dangerous for republicans as portrayed.
        It has two huge flaws: diffuse winners and concentrated losers – the oppose of SS and medicare,
        The losers are nearly all republicans and the winners are nearly all democrats.

        That is also part of why it is so polarizing.
        It is why republicans might have less political trouble letting it fail, than in replacing it.

  40. Roby permalink
    March 13, 2017 11:36 am

    I am not advocating single payer or Canadian style health care. But the wait times myth and Canadians crossing the border myths, like most myths, have some grain of truth that has been greatly distorted to fit somebody’s ideological or business purposes.

    Myth #4: Canada has long wait times because it has a single-payer system.

    The wait times that Canada might experience are not caused by its being a single-payer system.

    Wait times aren’t like cancer. We know what causes wait times; we know how to fix them. Spend more money.

    Our single-payer system, which is called Medicare (see above), manages not to have the “wait times” issue that Canada’s does. There must, therefore, be some other reason for the wait times. There is, of course.
    In 1966, Canada implemented a single-payer health care system, which is also known as Medicare. Since then, as a country, Canadians have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times. Their outcomes are otherwise comparable to ours.

    Please understand, the wait times could be overcome. Canadians could spend more. They don’t want to. We can choose to dislike wait times in principle, but they are a byproduct of Canada’s choice to be fiscally conservative.

    Yes, they chose this. In a rational world, those who are concerned about health care costs and what they mean to the economy might respect that course of action. But instead, they attack the system.

    • Roby permalink
      March 13, 2017 11:37 am

      Should be quotes started from “Myth #4….

    • dhlii permalink
      March 13, 2017 8:20 pm

      Ah yes the typical left wing nut answer – spend more money.

      Get a clue – money does NOT fix problems. Often it makes problems worse.
      Everyone always proposes giving them more money to solve any problem.
      In the real world money is a small and sometimes negative factor in solving problems.

      The real solutions to ALL problems are to spend LESS and get more.

      I must have state that atleast twice thuse far – but for a third time.

      We increase standard of living by creating more value with less human resources.
      That is a tautology. Anything that does not do one or both of those REDUCES standard of living.

      No you do NOT reduce wait times by spending more. You reduce wait times by providing services more efficiently – which means spending LESS.

      Over the past 40 years we have quintupled education spending – doubled it if we adjust for inflation, we have given the left nearly every educational penny they wanted – and they still want more – and what has changed – education quality has declined – substantially.

      We have had similar experiences with healthcare – we are paying more for less.

      Now name ANYTHING that is not highly regulated by government that is not CHEAPER in real terms today than 40 years ago.

      Just so we get our measure correct – most means of adjusting for inflation are crap,
      but there is one that most of us learned in high school physics that works.

      When you have a unit – like $ that you want to eliminate from a sequence of equations arange them to cancel it out.

      So tell me something priced in hours of median wage (or minimum wage) labor that costs MORE to buy today than 40 years ago ?

      Get a clue – spending money is the solution to very very very few problems, and it is always at the expense of something else.

    • dhlii permalink
      March 13, 2017 8:24 pm

      Further you make the other typical left wing nut error of confusing collective inaction with individual choice.

      Canadians did not Choose this.

      There is no individual with cancer who has said – I will wait twice as long and possibly die, for the greater good of a cheaper healthcare system.

      You rant and rave that people die as a consequence of being unabl to afford things in the free market – yet you accept that in Canada.
      So in reality you are a hypocrit. You are not really seeking to provide better healthcare and keep people from dying. You just want to impose your particularly solution.

      • Roby permalink
        March 13, 2017 9:23 pm

        “You just want to impose your particularly solution.”

        Er, which one is that? I’ve stated that this is all beyond me and I don’t have a solution. I briefly had one for a minute today and then I realized it was very naive and I recanted. Try it sometime, repeat after me, “I was wrong.” It actually doesn’t hurt a bit.

        The “left wing nut” quotes you are annoyed by are not mine, they are from that left-wing nut organization, the aarp, to which I provided a link. As usual you have missed the entire point. Both our Medicare and Canadian Medicare are single payer systems. The wait times in Canada are clearly not inherent in single payer. Their system costs less because they choose to spend less and provide less service and thus longer wait times. If you find that immoral don’t have at me, go to Canada and give them hell. If you think that no avoidable deaths occur in the US “greatest health care system in the world”, well, you are welcome to add that to you monumental set of delusions.

        Your right wing nut free market utopia is just as irrelevant to modern healthcare as the left wing nut ideas of utopia are. In about 90 posts in a few days you have managed to reiterate the same historically obsolete free market ideas over and over. They are still obsolete. The wax museum of discredited anachronisms awaits your exhibit. Pre WWII healthcare is not 21st century healthcare.

      • dhlii permalink
        March 14, 2017 12:27 pm

        It does not matter which particular solution.
        It does nto even matter if you have one of your own – so long as you support imposing one on everyone by force.

        No I am not “missing the point”

        I am generally completely rejecting the morality of the argument.

        I am not going to fight over whether we should gas jews or shoot them one at a time.
        My point is that you do not have the right to do most of this at all.

        You may not impose your will on others by force.
        You can not even do it when you are right.

        When government acts – it is force, and that use of force must be justified.
        The whim of the majority is not sufficient – otherwise Jim Crow, Slavery and the hollocaust are all examples of legitimate moral government.

        Are wait times inherent to single payer – no!
        But failure is. All wait times are is a form of medical rationing.

        You do not grasp what markets do – and therefore why government intervention MUST fail.

        BTW Medicare is a single payer bubble in a quasi free market.
        It is a distorting of a free market – it too will fail – but not the same as a pure single payer system.

        You seem to think that I have to be able to prove exactly how your bad idea will fail, otherwise you must be permitted to do it.

        In the specific instance of medicare – the impact has not primarily been on wait times, it has been on prices. Depending on which experts you refer to medicare is reposible for between 1/3 and 150% of price increase since it was implimented.

        But lets simplify this. Assuming that some percent of people are not receiving adequate healthcare, and you pass a law that assures that everyone will get adequate healthcare.

        Unless prior to passing your law – there was a vast underutilized supply of healthcare, then you have a problem – you now have more demand than supply.
        That means either the price will skyrocket or you must ration demand (or both).
        There may be other possibilities – but until something happens to raise supply to meet demand, something MUST give.

        In Canada – and the UK and the VA, long waits are the means of making supply match demand.

        Medicare resulted in rapid increases in costs – most of which were subsidized by the private market.
        You appear to have already grasped that if you shift to medicare for all – the country goes bankrupt.

        you increase standard of living by:
        Producing greater value at LESS human cost.

        That has NEVER been accomplished by law or government. Only free markets are able to do that.

        I piss all over lefties because their solutions are magic beans approaches.

        But ultimately so is mine. Free markets only work because they magically deliver more for less, pretty much always.

        But the difference between my magical thinking and yours – is mine has worked, day in day out in the real world, and yours only exists in fairy tales.

        The secret is profit. The primary method of increasing profits is to produce at lower costs.
        Businesses relentlessly try to improve productivity, lower costs – they do so to increase profits.

        But if that was all there was too it, there would be no net gain, free markets would work as the left claims and the rich would just get ever richer.

        But competion also drives profits back down. Profits NEVER rise forever. Businesses do not go form 2% to 4% to 10% to 50% to 98% profits.
        The go from 2% to 4% and then competition drives prices back down and they are back at 2% and they must start the process over.

        Since the 20th century this is somewhat masked by government induced inflation.
        Just to be clear – inflation is monetary. It is NOT driven by business, it is driven by government. It is too many dollars chasing too few goods. The norm in a free market is mild deflation.

        Anyway, now instead of the net benefit being to the rich, it becomes to the consumer, who is constantly getting ever better and ever cheaper products.

        Nothing else does that.

      • dhlii permalink
        March 14, 2017 1:34 pm

        You seem to think that morality is fungible.

        Construct a system of morality that is not rooted in free will.
        It can be done, but it is not the world we have and it is one far less appealing.

        So given that we are sticking with the world as it is:

        All restrictions of liberty are by definition immoral,
        EXCEPT those few that can be justified.
        We can argue over what constitutes justification – but the burden STILL is with those desiring to reduce liberty.

        Your description of the canadian system is loosely correct.
        But you gloss over the fact that individual canadians did not choose this from themselves – others chose for them.
        qed absent justification it is immoral.

        This is not my morality vs. yours.
        I am prepared to listen to you attempt to derive a scheme of morality that does not rest on freedom.
        You should expect when you do to have to address how slavery is immoral – if restricting freedom is not inherently immoral – and many other difficult questions such as these.

        The left has taken the fact that there is no objective truth and deluded themselves into beleiving that there is no such thing as relative truth or that something are not still absolutely false.
        There are not infinite schemes of values and morality that are all equal (among other things you AGAIN run into the Nazi problem).
        Any scheme of morality you construct MUST explain why the things you – and I agree are immoral, are, and why those things we agree are not, are not.

        My point is you do not need absolute truth to end up with
        “we beleive these truths to be self evident”

        To the extent that everything is a matter of oppinion – all oppinions are not equal. Most oppinions can be proven wrong using values that those holding those oppinions claim to hold.

        I know that you do not agree with me that it is immoral for the government of canada to impose choices regarding healthcare on its citizens by force.

        But accepting your position results in a system of values that is internally self contradictory.
        I keep refering back to Nazi’s or Jim Crow – that is just a standard Reductio ad absurdem technique – we all know of the Nazi’s and Jim Crow and Slavery and we all intuitively accept them as wrong. I could use other examples – but these are well known and universally agreed as evil. Regardless, the point is you must come up with a justification for the use of force in Canadian Single payer that does not also justify things we all agree are evil.

        You can not just gloss over these things.

      • dhlii permalink
        March 14, 2017 1:38 pm

        Not selling right wing or utopia.

        I have never pretended free markets are absolutely perfect or utopia.

        What I have repeatedly claimed is that no alternative has thus far proven superior either in theory or practice. Nor does you hybrid apriori regulation approach work as well.

        Just to be clear I am not claiming that no good ever comes of regulation – though regulation very rarely acheives the good it aspires to.
        What I am claiming is that NET regulation makes things worse.

        And again – the burden always remains with you.

        I am not the one selling utopia – you are.

        You are claiming you can do better – you must demonstrate that.

      • dhlii permalink
        March 14, 2017 1:45 pm

        Everything that has changed about healthcare as things have become more “modern” favors markets – not governments.

        We have been through this argument before.
        complexity increases the size of government exponentially.
        It has no effect on free markets.

        One of the problems with your solutions is that the stiffle development.
        They need static invariant systems to work at all – that means little inovation, little complexity.
        little dynamism.

        Your criticising free markets for problems that only exist in government run schemes.

      • Priscilla permalink
        March 13, 2017 10:35 pm

        Roby, you are correct in that avoidable deaths occur under any system. No perfect system, that’s for sure.

        And the other thing that happens in any system is rationing. And those that pay get to do the rationing, because there’s only so much money.

        I would rather have regulated insurance companies doing the rationing than the government. Not because I trust insurance companies, because, lord knows, I do not (does anyone?). But, back when my daughter was a 4 year old cancer patient, and I was spending most of my time in hospitals, talking to other parents of cancer-stricken children and pediatric oncologists, I heard of many situations in which an insurance company denied coverage for a particular treatment ~ usually because it deemed the treatment “experimental.” In every case, doctors went to bat for the sick child, using every possible avenue of appeal, producing evidence of the success of the treatment, the numbers of children that had been cured or put into remission by it, etc. Anything it took. Very often the insurance companies reversed their decisions…..not out of the goodness of their hearts, but because there might be consequences for denying a treatment that might not be as “experimental” as they claimed.

        This is unlikely to happen when rationing is done by a giant government bureaucracies. One need only look at the VA to see what happens when sick people are at the mercy of a government agency that answers to no higher authority.

  41. Roby permalink
    March 13, 2017 11:38 am

    “Myth #1: Canadians are flocking to the United States to get medical care.

    How many times have you heard that Canadians, frustrated by long wait times and rationing where they live, come to the United States for medical care?

    I don’t deny that some well-off people might come to the United States for medical care. If I needed a heart or lung transplant, there’s no place I’d rather have it done. But for the vast, vast majority of people, that’s not happening.

    The most comprehensive study I’ve seen on this topic — it employed three different methodologies, all with solid rationales behind them — was published in the peer-reviewed journal Health Affairs.

    Source: “Phantoms in the Snow: Canadians’ Use of Health Care Services in the United States,” Health Affairs, May 2002.

    The authors of the study started by surveying 136 ambulatory care facilities near the U.S.-Canada border in Michigan, New York and Washington. It makes sense that Canadians crossing the border for care would favor places close by, right? It turns out, however, that about 80 percent of such facilities saw, on average, fewer than one Canadian per month; about 40 percent had seen none in the preceding year.

    Then, the researchers looked at how many Canadians were discharged over a five-year period from acute-care hospitals in the same three states. They found that more than 80 percent of these hospital visits were for emergency or urgent care (that is, tourists who had to go to the emergency room). Only about 20 percent of the visits were for elective procedures or care.

    Next, the authors of the study surveyed America’s 20 “best” hospitals — as identified by U.S. News & World Report — on the assumption that if Canadians were going to travel for health care, they would be more likely to go to the best-known and highest-quality facilities. Only one of the 11 hospitals that responded saw more than 60 Canadians in a year. And, again, that included both emergencies and elective care.

    Finally, the study’s authors examined data from the 18,000 Canadians who participated in the National Population Health Survey. In the previous year, 90 of those 18,000 Canadians had received care in the United States; only 20 of them, however, reported going to the United States expressively for the purpose of obtaining care.”

    • dhlii permalink
      March 13, 2017 8:34 pm


      So long as you are lobbing anecdotal and usually false stories to discredit alternatives – such as what we had previously or a free market – you are going to have to face the fact that similar anecdotes – often true are going to be lobbed at your prefered solution.

      You are correct that many of the problems that are pointed out regarding Canada healthcare are not that large for most canadians – they are for the woman with a treatable blood cancer who died before she could get care.

      But I would not there are worlds of difference.

      In a free market in the unlikely even people actually die – most of the left annecdotes are false,
      they die because in the real world we do not live forever and some people die of cancer.
      Further they do not die as a result of actual choices of other humans, but from the fact that they themselves do not have sufficient resources to save themselves – if that was even possible. They die because the rest of us normally owe no positive duty to act to our fellow man.

      But in Canada when someone dies – they die, because of the actual choices of others.
      They die because Canada can not live up to the promises it made.

      When you take someone;s choices from them – you become responsible for them.
      You have a duty – to do better for them than they would for themselves.
      When a canadian dies because their healthcare can not deliver – that is the result of an affirmative choice of a human, not a default consequence of nature.

      There is vastly different moral implications.

    • dhlii permalink
      March 13, 2017 8:58 pm

      Why would you presume that canadians coming to the US for care would go to the best hospitals ?

      I would assume saudi’s coming tot he US for care would go to the best hospitals.

      Britons conduct a booming medical tourism business with India – because it is good, fast and cheap.

      Canadians are coming the the US for similar – but not identical reasons.

      My GUESS – but that is all that would be, is that they would look for the care they needed affordably and close.
      They would not go to Mass General, or Sloan Kettering, is Flynt Memorial would get them what they needed that they could not get at home.

      Canada’s single payer system has one primary failure – long wait times.
      sometimes that is for ordinary care, sometimes it is for unusual care.

      But Canadians are not coming to the US to get the very best of care.
      They are coming to get care that mostly already exists in Canada but is rationed so that the wait times may result in death before treatment.

      Finally, you report low numbers – but presumably those who went to the best hospitals did so because they needed the best care – or they were going to die.
      So what you are saying is that the canadian system kills people in small numbers rather than treat them.

      And I would guess that is small numbers went to the best hospitals – that EITHER/Both
      larger numbers went to lessor cheaper hospitals or/and many just stayed in Canada and DIED.

  42. Roby permalink
    March 13, 2017 11:57 am

    My health care proposal, which, as god is my witness, occurred to me just now as I was eating my oatmeal :

    Expand Medicare to cover younger people at the rate of a 1 year lowering of the minimum age of entry per year.

    In 2018, 64
    In 2019 63
    In 2020, 62


    A slow evolution of a system that works now rather well for 65+, the oldest, and thus be definition practically least healthy segment of the population.

    In 65 years, no health insurance companies, but gradually and predictably.

    So, now I have changed my position, I AM advocating for single payer, but gradually,

    Just a thought.

    I like it enough that I am sending it to my congress people.

    • Roby permalink
      March 13, 2017 1:47 pm

      Well, a little more reading convinced me this idea is not economically feasible, baby boomers retiring will stress the system enough and lower the already by 2030 without adding a new pool of beneficiaries.

      “Retirement of the Baby Boom generation—which by 2030 is projected to increase enrollment to more than 80 million as the number of workers per enrollee declines from 3.7 to 2.4—and rising overall health care costs pose substantial financial challenges to the program. Medicare spending is projected to increase from $523 billion in 2010 to just over $1 trillion by 2022.[18] Baby-boomers’ health is also an important factor: 20% have five or more chronic conditions, which will add to the future cost of health care (, 2012). In response to these financial challenges, Congress made substantial “cuts” in payouts to providers as part of PPACA in 2010 and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and policymakers have offered a number of additional competing proposals to reduce Medicare costs further (“cuts” in quotation marks because the “cuts” are almost all really more a case of slowed down increases).”

      Ah well, I’ll admit to being nearly entirely ignorant of ow health care is funded. Which can be explained by the fact that the subject is so enormous that only a huge effort would bring a person to basic literacy.

      God help us, this is damned hard even without politics being involved.

      • dhlii permalink
        March 13, 2017 9:16 pm

        How things are paid for is critical.

        IF we could save 11 more people a year – would you pay an extra trillion a peice to do so ?

        The fundimental problem with our healthcare system – is that the choice of service and the cost of those choices are nearly entirely divorced.

        That arrangement is called “moral hazzard” and it is the cause of the housing bubble and financial crisis.

        Why would we look to make it worse ?

    • dhlii permalink
      March 13, 2017 9:01 pm

      Medicare does not cover its costs.

      Everyone knows that – aparently except you.
      Even while not covering its costs, it is already running an ADDITIONAL 200B.year in the red.

      And no medicare does NOT work rather well.
      It is going to bankrupt the country.

      Before you engage in fiscal nonsense – look at Venezuela, or Greece. and see what happens when you promise more than you can deliver.

      • Roby permalink
        March 13, 2017 9:41 pm

        I’m no expert on this, I admit it freely. But you are being hysterical. The US will not go bankrupt. Medicare will be adjusted to meet the demographics. Take a deep breath and calm down. The system worked extremely well for my friend with cancer (not to mention for my parents in their very late 80s for the last nearly 25 years). I expect it to work pretty well for me too. We shall see.

      • March 13, 2017 11:35 pm

        Roby, and you left out one important aspect of Medicare. That is Medicare Advantage plans that are available nationally that a large number of individuals sign up for that allows people to stay in the private insurance market, with much of the funding coming from the Medicare program they would have paid had the individuals stayed in the traditional program.

        Now I know Dave will give us a dissertation as to how bad this additional program is and why old farts should have to buy their own insurance, but for a large number of people who have had a managed care insurance plan when they were younger, these plans are very attractive and offer benefits that the traditional Medicare program does not. And what it does for the government, it fixes the cost for each subscriber so their is no variance due to severity of illness subscribers create.

        And in my state, we have many different plans being offered, so there are many companies, plans, additional cost for additional benefits and offerings one can choose, unlike the ACA plan that is offered where people have no choice.

      • dhlii permalink
        March 14, 2017 2:56 pm


        Just to be clear, I am not arguing that there are not “less bad” ways of doing things than we do now – or have done.

        One of the reasons I am not yet taking a position on “RyanCare” is that
        while I am pretty sure I think it is stupid, the fundimental questions are:

        Is it “less stupid”
        Is it better than letting PPACA fail.
        And is it still less stupid and better than letting PPACA fail if only the first phase is implimented – because the odds of republicans getting the other parts of the plan passed are near zero.

        I heard Ryan on the media trying to placate the freedom caucus – essentially saying – we are going forward with all of what you want – but the first phases is what we can get done through reconcilliation, the rest will come through normal order legislation.

        Well the rest is not passing.

        What I have heard of RyanCare is leading me towards the possibility of supporting it – even if only the first part passes.

        But I am not making a commitment yet.

        While the only real solution is a free market.

        There is such a thing as sufficiently less bad to have the rest of the fight another day.

        For me one of the big deals is does it get government out of the way enough – to let 1000 flowers bloom.

        i.e. does it gut enough of PPACA to give options like subscription medical care a chance.

        We have addressed the fact that paying for basic medical care through insurance is incredibly stupid fiscally and has huge moral hazard problems – regardless of whether government does it or insurance companies do.

        ONE (possibly not the only one) other possible model is to pay your physician a monthly fee for coverage – basically smorgesbord medical.

        This gets insurance out of basic medical – and back into solely coverage in the event of disaster – which is what insurance is actually for.

        Put differently my question regarding RyanCare is does it create enough room and freedom for markets to explore alterative solutions to problems.

        If I think it does – then I will likely support it (holding my nose).

        Because increasing market freedom is what matters – do that and the market will eventually solve the problem for us and make government irrelevant.

      • March 14, 2017 4:17 pm

        Dave i also have no idea about the AHA. What I do know is the GOP is totally ignorant on making their points known to the general public.

        From what I heard today in the white house new briefings is the CBO said that an additional 14 million people would be without insurance. The Spicer went into a bunch of information and the only thing I could take from it was in this 14 million, 6 million are now paying a penalty and they are included in the covered population, where if the new legislation was passed, these 6 million would continue to choose no insurance over coverage. So are they covered or not covered now? Under the new legislation they aould not be nased on a pesornal decision.

        Whatever the answer, the democrats have 14 million reasons to preserve Obamacare. And the GOP keeps spouting off talking points that are not hitting home.

      • dhlii permalink
        March 14, 2017 6:38 pm

        I do not buy anybodies numbers.

        I have read credible explanations of why PPACA did not add 20+M people to the insurance rolls – it is more like 6-9.

        As to democrats having 14M reasons to preserve ObamaCare – then WHY are republicans in control of the entire federal government ?

        PPACA has been one of the most important issues in every election since 2009.

        It is inarguable that it has HARMED democrats and benefited republicans – and continues to do so.

        Yes, democrats have every reason in the world to argue that republicans will have a price to pay. And yes it is hard to gauge how voters will react.
        But based on the past 8 years – PPACA is not a threat to the GOP.

      • dhlii permalink
        March 14, 2017 2:15 pm

        I am not being hysterical.

        I do not think the US going bankrupt is the end of the world.
        I do think it is the only way for left wing nuts to learn.

        Yes, adjustments will be made – they are unlikely to work, and they are going to really really piss people off.

        Medicare is already running 200B/year in the whole.
        That is about $750/per person in the US – every year.
        That problem is growing.

        To some extent we have managed deficits in the past – because the economy was growing fact enough.

        You say there will be adjustments – but those adjustments are fairly large – and get exponentially larger the longer we wait.
        So far our political leaders seem intent to kick the can as far as possible.

        In 2010 “fixing” medicare and SS would have required moderate tax increased, small increases to the age of eligability and sustained 4% economic growth.
        None of those have occured.
        The longer you wait the larger each of those must be.

        Tax increases are problematic -as they negatively impact the economy.
        According to Christine Romers studies (Obama’s CEA) the US is probably already past the revenue optimizing maximum for taxation – that means additional taxes do NOT produce more revenue. We are well past the growth optimizing maximum.

        Or more simply – you can not fix the problem with more taxes – at this point these will reduce government revenue not increase it.

        You say I am histronic.
        Resigned is a better word.

        I have accepted that politicians have already waited past the point at which they could “save” things. Failure is all that is left.
        That will likely take some time yet.

        I will further note – government failure – as scary as that sounds is not the end of the world.
        The USSR failed catastrophically – the world did not come to an end.
        Many nations in the USSR – such as poland and most of the warsaw pact shifted to free markets rapidly without much major disruption.
        There are other examples of large government failure.

        Some do go south – the failure of the wiemar republic lead to hilter.
        That is the biggest danger – the temptarion of people to look to a strong leader making big promisies when things go to hell.

      • March 14, 2017 3:57 pm

        “In 2010 “fixing” medicare and SS would have required moderate tax increased, small increases to the age of eligability and sustained 4% economic growth.
        None of those have occured.
        The longer you wait the larger each of those must be.”

        So on one hand you say compromise is bad, on the other hand here you say inaction is bad.

        So when you can not get everything you want, is it better to get some of it and extend a program, or is it better to not get anything.

        “The longer you wait the larger each of those must be”. At what point does it fail and no fix will save a program.

        I am not aware of much action that has occurred with Medicare and SS given all the coverage of Obamacare for 6 years, so forgive me if there has been some significant legislative discussion on changes to the program. But I will provide a scenario that I would like your feedback.

        Legislation proposed to increase age from 67 for those born after 1960 to 70 for those born after 1965. Medicare coverage tied to retirement age
        Tax rate increased from 6.2% (SS) to 6.5% and FICA to 1.65% form 1.45%.
        Wages subject to SS increased from $127,200 to $140,000.
        (Sustained growth rate can not be legislated)
        Moderates in congress generally accept these changes. Conservatives say no way will they accept any increases in taxes. Liberals say there is no way they will accept increased age to retirement.
        Scoring results in this extending Medicare and SS for 20 years of funding past current law.

        So is it better to do nothing now and let the changes to save the program grow larger each year if something is not done OR:

        Is it better to compromise, raise the age of retirement to 68.5 for those born after 1965 and increase that each year by 6 months until the the age of retirement is 70, increase the tax rate .015% for SS and 1/10% for medicare and make the SS base at $132,000.
        Scoring of this compromise legislation results in adding 15 years of funding past current law.

        I know the numbers may be off, but the example is compromise v unwavering ideology.

      • dhlii permalink
        March 14, 2017 6:03 pm

        No, I do not say compromise is bad.
        I do not say it is good either.

        It is a tool. In and of itself it is morally neutral.

        Some compromises are good.
        Some are bad.
        Some are the lesser evil.
        Sometimes the only way to fix things is to let them fail.

        I do not pretend to know all the answers.

        I can know that what we have is a disaster.
        I can know what will work.

        I do not know what of the alternatives in the middle – the possible compromises, will actually move us in the right direction, or which will make things worse.

        That is why I am on the fence regarding RyanCare.

        It will not work. It is the lessor evil.
        It Might be a compromise that moves us in the right direction.
        But it might not.

        I would suggest comparing SS, Medicare and PPACA

        SS is much older, it has taken far longer to fail – but when it does the failure is potentially on the scale of $50T
        Medicare has take half as long and is already in the begining of failure – and the scale will be less than half that of SS.
        PPACA is about a year from failure – it has failed far more quickly – but PPACA’s cost of failure is small compared to Medicare and SS.

        The largest failures come from things that are very close to working, but run – just slightly off for very very long periods of time.

        You do not get this with markets – because only government can push something to continue in exactly the same way for decades

        This also why I am on the fence about RyanCare.
        I have little doubt it will be better than PPACA.

        But Better is not only not good enough, but potentially more, not less dangerous

        A market solution that is better – but not quite, will be replaced in short order. It will never get the chance to build a huge hidden mountain of failure.

        A government solution that is better – only slightly off, may run for decades, and if it does it can create enormous damage.

        So long as RyanCare is assured of being changed over time – I have no problem with it as a compromise. If it provides enough freedom for the market to experiment and find a better solution – then I have not problem with it. It does not matter what its flaws are – it is not going to be arround long.

        The problem with SS, Medicare, and PPACA is they make no real allowance for the market to replace them if it can do better. They clear their own markets and nothing else can take root.

      • dhlii permalink
        March 14, 2017 6:12 pm

        When EVER has anyone gotten the scoring of any legistation correct.

        Raising retirement ages is a no brainer – and should have been done long ago. It should have been incorporated into SS fromt he start.

        As to the tax changes, as I noted before we are very very close to the revenue optimizing maximum tax level. Increases in taxes may actually reduce revenues.
        I do not want to pretend to be sure on that, because it is fairly complex.
        Amoung other reasons because tax levels are not uniformly the same for everyone – so it is possible that small increased taxes might produce small revenue, or none, or reduce revenue
        but any large increase from here will be net revenue negative.
        It may not be largely net negative,

        Go look at the graphs of past tax rates to tax revenues.

        While you can not trivially reach my conclusion that we are at the revenue optimizing max from them. You can trivially conclude that anyone who says they know the change in revenue from any tax increase or cut is deluded.

        So no I do not think you can even add 15 years to SS at this point without significant pain.

        What is going to come is reducing benefits. Ultimately it is now inevitable.
        If you expect to be alive for another 20 years and are not planning on reduced SS benefits you are in trouble,

    • dduck12 permalink
      March 13, 2017 10:42 pm

      The gradual Medicare approach is not new and neither is the Rep/Insurance company objection. This needs to be the mother of all political battles for an all in SP, not a little at a time with constant fighting and repeals every voting cycle.

      • Priscilla permalink
        March 14, 2017 12:06 pm

        So, it seems to me that SP plans ration healthcare for the oldest and the sickest, providing palliative care rather than cures or extension of life. Private plans are more likely to ration based on ability to pay. This is a gross oversimplification of a complex problem, but, it does point us toward the key controversy ~ would you rather have the federal government deciding who gets access to care, or would you rather have a regulated consumer market?

        Do you really want the government to be answering these questions:
        Who should be denied care in a SP plan, a transgender person seeking sex change surgery or an 80 year old cancer patient, seeking curative treatment? Should health insurance cover birth control for a 17 year old or insulin for a 75 year old? Can a treatment for MS be too expensive to be worth it? When should your grandmother be denied treatment, and given palliative, end-of-life care? If a smoker gets lung cancer, should insurance have to pay for his/her treatment? If a drug addict gets AIDS, should insurance pay for the expensive drug cocktails that will maintain healthy life? How about a hooker?

        If a doctor spends 30 minutes with each patient, should s/he be reimbursed more than if s/he spends 5 minutes? Should a obstetrician be paid more than a midwife? A psychiatrist more than a social worker?

        I oppose single payer, because I see it as a one-size-fits-all answer to these questions. For those who support SP, where am I going wrong on this?

      • dhlii permalink
        March 14, 2017 3:23 pm

        I try not to claim to know how some top down approach WILL ration something.
        We can see what it does – when it is implimented.

        ONE of the ways Canada rations is through longer wait times. The same is true of the VA and UK.

        Free markets “ration” by letting individuals choose based on what they have produced.
        They use the fruits of their production to choose each and everything they want.
        They can increase healthcare and decrease consumer electronics – regardless, they choose their own values – individually.

        The other thing about free markets is they are dynamic.
        Providers can figure out how to adjust prices – and the market will grown (and standard of living will increase)

        That does not happen with top down solutions.

        Regardless, there is a difference between saying top down will have bad results and saying what bad results it will have.

        As an example – I do not have a problem with not spending alot on experimental or advanced or life prolonging care for the elderly.

        If that is a choice of the person receiving care.

        I went through a holy war with my family over this a few years ago.

        My father was dying of vascular demensia.
        Two family members could not accept that.
        But my father put the other two of us in charge of his care.
        We respected his wishes.
        We shifted to palleative care when he was ready.
        We focused on making what was left of his life as good as possible – not as long as possible.

        As a consequence the other two siblings made trouble – drug in the office of aging,
        Had him removed from his home kicking and screaming against his will
        Tried to get a hospital to provide him the “life extending” measures THEY wanted – the hospital refused – it was against his will, and against his written wished.
        Anyway he ended up dying – exactly on schedule expect in a nursing home instead of at home in is own room in his own bed as he wanted.

        Nor did this end – the other two siblings pushed the local prosecutors to investigate – after a long investigation they found less than nothing, they actually found that removing him from most of his medicines likely extended his life.
        People who are dying usually have multiple conccurent problems
        My father had Vascular demensia and Chrones – which we knew about.
        But he was also in liver failure – which we did not.
        Turned out that switching to paliative care slowed down the undiagnosed liver failure.

        Anyway AGAIN my point is people should be allowed to make their own choices.

        My mother fought to the bitter end. that is what she wanted.
        She would have spent money for another few months.
        My father was ready to die. He did not want what he ended up with.

        When you determine things top down – someone decides for all of us.
        And we all do not want the same thing.

        When you let markets decide – people get to make their own choices.

        They do not always have every option they want – the world is not perfect.
        But they get to choose for themselves from the avilable options.

      • dhlii permalink
        March 14, 2017 2:42 pm

        Those still pushing SP are smoking crack.

        It is not even worth debating.
        It is just not happening.

        In the unlikely event you succeeded, not merely the US but the global healthcare system would fail extremely quickly.

  43. Priscilla permalink
    March 13, 2017 9:22 pm

    Something we haven’t discussed yet: how much of the Republican bickering over this bill is kabuki theatre, done to provide 1) certain GOP members of Congress with political cover, so that, when the eventual bill passes, they can say they fought for something better, but that they had to compromise, in order to save Americans from a collapsing insurance market. and 2) Donald Trump with evidence of his super-duper dealmaking, when a compromise bill passes.

    It has been many years ~ at least 6, maybe more~ since a law has been passed using “regular order” ~ that is, the House debates, compromises and passes, the Senate revises, adds amendments and passes, the House and Senate form a conference committee to merge the two different bills into a single bill that can pass both houses, and, at long last, the President signs it into law. I think that, given the near certainty that no Democrats will vote in favor of repealing Obama’s signature law, the GOP may not only need to air debate within their own party, as well as to ~hopefully~ show the country that things are being done “right” this time. They may even feel that, if they can get moderate and conservative Republicans all on board, they may pick up a moderate Democrat or two (Joe Manchin, I’m looking at you).

    I see almost no likelihood that the GOP is going to allow Obamacare to fail. They have been running on repealing and replacing for 6 years, and they can’t afford to blow this. They may blow it in the sense that their replacement will suck as bad as the ACA, but I don’t see how they fall apart here. Of course, the GOP has fallen apart many times before, so I could be wrong……but I just don’t see it happening.

    • March 13, 2017 11:46 pm

      Priscilla, I can not see this as being political theater as this is too much like the closing down government (not really) over the debt ceiling. Everyone knew that it was a huge political hot potato for many in the GOP when that was happening and their was little positive when they did it, but the Freedom Caucus or whatever they call it went ahead and did it anyway. SO we all saw the federal parks closed and people staring into the landscape trying to see something, or the kids school tours being turned away from the monuments. The same is happening today and I will be extremely surprised if it passes in its current form.

      But I do agree with you on Joe Manchin. His state voted over 60% for Trump and he is the only, or one of a very few Democrats in congress from his state. If he does what he says he does and “represents” the people of his state, he will support the GOP plan if that is shown to be popular in WVA.

      • dhlii permalink
        March 14, 2017 3:04 pm

        I think shutting down the government was a good thing.

        I think that just like brexit and trump that you misjudge support for it because the press controls what you see.

        There was no real political consequence to it. The GOP has increased its share of government in every election since 2008.

        Even during the shutdown – which was over PPACA not the debt ceiling – though a debt ceing fight was about to occur at the same time,
        There was a fairly large majority of americans who were perfectly happy to see the debt ceiling not raised at all.

        BTW not raising the debt ceiling is NOT the same as shutting down government, nor is it the same as default.

        The GOP lost the spin war.
        But the majority of americans were perfectly prepared to say – government must instantly cut spending to no more than it takes in.

        That would not have been a shutdown – it would have been the sequester on steroids.

        But the GOP caved – and that did anger alot of people.

        In fact one of the reasons GOP negatives were so high DURING the shutdown is the expectation that they were going to cave.

      • dhlii permalink
        March 14, 2017 3:06 pm

        I am not up to date on manchin.


        We do not elect people to do precisely what the voters in their state want.
        We elect them to do what is best for the state and the country.

        Democrat or Republican if you are voting purely based on polls – then why even have congress – go for direct democracy.

    • dhlii permalink
      March 14, 2017 11:59 am

      The complexity in passing legislation is because it is supposed to be hard.
      Most legislation is supposed to fail
      That was how our government was designed.

      The framers gave the federal government more power than they had given it under the articles of confederation. But they intended it to be very difficult to use that power.

      Gridlock is intentional design. If you can not overcome it – then your legislation should not pass.

      You and other keep elevating compromise to a value – it is only a tool – and often an evil one.
      Pork and log rolling are all forms of compromise – do you think they are good things ?
      lobbying is another means that among other things drives compromise.

      In most instances compromise is BAD.

      Without some compromises – PPACA would have never passed – and that would be good.

      I do not want to pretend to know what is in the minds of congressmen.

      I think the Freedom Caucus is more principled than most republicans – but even they are still politicians.

      Regardless, there are only two ways the GOP passes a replacement – with the support of the freedom caucus, or with the support of democrats.

      I think that Ryan is trying to blackmail the freedom caucus.
      I am not sure but I think that is a mistake.

      Too many of them are like me and willing to let Ryan and the republicans do something completely stupid rather than compromise on half way stupid.

      But again the point is that compromise is not always (even usually) good.

      Supreme court compromises have resulted in some of the worst and longest lasting decisions.

      Whether in the court of legislation – bad decisions fail and are replaced.
      Compromise choices take far far longer to get rid of.

      • Priscilla permalink
        March 15, 2017 11:51 am

        Dave, I agree that compromise is a tool, but an evil one? Only if it’s objectives are evil.

        Compromise solutions, if good ones, give everyone something they want and no one everything they want.

        The reason that Obamacare is such a lousy plan is that there was no attempt to compromise with Republicans, who were firmly opposed to the mandates and taxes that the ACA imposed. It is a law that prioritizes INSURANCE over HEALTHCARE, although those two are far from the same thing. And since it prioritized insurance, that’s what millions of people got….useless “healthcare” insurance that limited access to actual healthcare.

        Moving the needle back towards care would be a significant step, even if it does not achieve conservative goals 100%. Or even 50%, right away. Any compromise that acknowledges that people want access to decent healthcare, regardless of what type of insurance plan they have ~ or do not have~ would be a compromise that would refocus the national mindset on what is the important objective. It would certainly not be evil.

      • dhlii permalink
        March 15, 2017 3:01 pm

        Compromise is neither inherently good nor inherently evil.
        Tools are not good nor evil.

        But specific compromises can be either good or evil.

        The argument which I think you are taking exception to is that many compromise solutions are worse than the wrong solution.

        That is a personal observation that has nothing to do with ideology.

        I am increasingly noting as I get older that our worst problems do not come from completely bad ideas, but from ideas that almost work. And often – though not always those are the product of compromise.

      • dhlii permalink
        March 15, 2017 3:12 pm

        No PPACA would not have been better had Republicans participated.

        It would be a slightly less bad disaster that we would be stuck with forever.

        This is why I am still on the fence regarding RyanCare.

        Inarguably it is dramatically better than PPACA.
        BTW it is also better than any compromise between republicans and democrats that might have occured in 2009.

        My question – which I addressed before is does it leave enough room for the free market to ultimately fix things.

        No solution proposed in washington – no top down approach is going to work.
        That is just plain not possible.
        The only question of any top down approach is how long will it take to fail and how bad will the failure be. With the norm being the longer it takes to fail the worse the failure will be – hence one of my problems with compromises.

        I have noted some POSSIBLE ways that healthcare might change in the future – if we are given enough freedom. None of these are meant to be THE solution.

        And that is part of the point. there is no THE solution. There is many things that should be tried and some rejected and other new ones conceived and tested and refined that make things better than they are – not perfect – because the process of both refinement and looking for new ideas proceeds forever.

        One of the problems with top down is that it often forecloses our ability to continue the process of looking for and trying new answers.

        I can as an example examine RyanCare or ObamaCare and see if it allows the possibility of the subscription based healthcare that I have suggested.
        What is harder is to see if it leaves room for the approaches no one has even thought of yet.

        One of the problems with government is that it things there is an answer to any problem.
        That is rarely true, there are usually many answers – and they change and evolve over time.
        And we do not know them ahead of time.

      • dhlii permalink
        March 15, 2017 3:18 pm

        Neither Obama nor Ryan can do much about Healthcare – without going to an NHS type arrangement.

        The resources we have for healthcare did not dramatically change as a result of PPACA and are unlikely to as a result of RyanCare.

        Neither of these changed the number of doctors, or nurses or hospitals or …

        One of the reasons I keep asserting that PPACA did not “save lives” is because how could it ?
        The only reason that PPACA did not radically tank the entire healthcare system immediately – is because everyone was getting healthcare before.
        All PPACA changed was how it was paid for.
        If PPACA (or Ryan Care) actually increased the amount of care given – where would that increase come from ?

        Medicare did increase the amount of care given – doctors visits by people over 65 tripled.
        But the overall health of people over 65 did not change.
        As a result demand exceeded supply and prices shot up.

      • dhlii permalink
        March 15, 2017 3:20 pm

        It is bad enough that government – republicans included seem to feel compelled to mess with health insurance.

        No I do not want them moving the needle back toward healthcare.

        To the extent they should do anything, it is to remove government further from healthcare.

      • dhlii permalink
        March 15, 2017 3:23 pm

        Priscilla – people already have access to healthcare.

        As I note and should be obvious to all:

        There has been no consequential change in any healthcare trends as a result of PPACA.,
        People are neither dying faster, nor slower,
        The slow improvements that predate PPACA have continued unaltered.

      • Roby permalink
        March 15, 2017 12:29 pm

        This issue has become the sore spot that it has due to our successes. We have succeeded in raising life expectancy by almost 20 years since the pre WWII era. We have succeeded in developing (expensive) technologies that can beat cancers that were previously hopeless. We have succeeded so well that the demographics of our society has change dramatically. 9% of the population was 65 or older in 1960, its 15 now and that is rapidly increasing. Its not just us, the same has occurred in many countries.

        With our amazing successes in increasing life expectancy and curing previously lethal diseases have come a new set of problems.

        Pure single payer systems or pure free market systems will not lead to the ideal situation where everyone feels fairly treated and satisfied. There are those who are putting huge hopes on such systems to deliver solutions to our problems. In vain. Every possible proposed system is a compromise that will delight one group and offend another.

        Personally I have no idea what the American system should be, its clearly nearly impossible to come up with a system that is even acceptable to a majority of the population.

        The GOP has had 7 years to study this so that when they came into power they would have an excellent proposal. Obviously, they have no excellent proposal. There ARE no excellent proposals. We will somehow try to pick the least bad of all the alternatives via politics, god help us. The system is so complex and faces such severe stresses that no party to this is capable of proposing a system that won’t have many unintended consequences, that’s a given.

        The good, news, again, is that we have this set of problems because science and medicine did so spectacularly well with a previous set of problems. Those were mostly problems of biology, of cold hard science. Our new set of problems are of sociology, politics, ideology, economics, even religion. Its much harder to work in those arenas!

        But no one I presume would like to go back to the PreWWII set of problems, we will take our set.

      • dhlii permalink
        March 15, 2017 3:37 pm

        Lets see your argument is that free markets have succeeded so well at solving problems that there are new problems – problems because of their successes, problems like people living longer, and having better lives and THESE problems – unlike the prior ones – these alone can not be solved the same way as those of the past were solved ?

        Sorry Roby, outside of a very few narrow areas where the use of force is required top down methods have NEVER worked.
        Hybrid methods work badly,

        Free markets do not work perfectly (nothing does) but they work better than all alternatives ever tried.

        Further there is zero reason to beleive that an approach which only born in the past 500 years, and consistently improved the human condition at a rate dramatically better than EVER before in human history will suddenly stop working – because … well just because you say so.

        There is no IDEAL solution – that is impossible.
        There is not even a solution that is good for both today and tomorow.
        There is no top down solution that will ever meet the disparate needs of different people.
        There is no top down solution that will ever adapt to our changing needs tomorow.

        Until you let go of this nonsensical idea that government has or can find those kinds of answers you doom all of us to repeat a cycle of failure.

        Of course you have no idea – neither do I. Nor should we. Further there is no sane reason to expect that what will be good for you will also be good for me.
        But it is possible for both of us to get what is good for each of us – but that is highly unlikely through anything directed by government.

        Regardless, you are looking to answers where they can not be found.

        On occasion I get accused of being pessimistic.

        I am not, I am quite optomistic.
        I know that given the slightest freedom to do so that we – the people – not our governments will continue to improve our lives far far into the future.
        That we need very little from government to do so.
        I have little idea what the future will bring us. But I know that it will be wonderful.

        What I am pesimistic about is government.
        The idea that 500 odd people in washington can out think all the rest of us, and come up with answers that not merely will work well right now – but for decades to come with little change is insanity.
        Further government has never done so in the past.

        Look arround, we are not fighting over where markets have failed.
        We are fighting over where government has failed.

      • dhlii permalink
        March 15, 2017 3:55 pm

        Your assertion that the GOP should have had an excellent proposal after 7 years – presumes that it was necescary for government to do something.

        It was not necescary to pass PPACA.

        Inarguably even today PPACA is worse than what preceded it.

        I have zero problems with the GOP just plain completely repealing PPACA.
        No replace, just return to what was there before and start the debate anew.

        While even in 2008 there was general agreement that healthcare needed reform – and that agreement remains.
        There has NEVER been even a plurality behind ANY specific means of improving it.

        While I beleive that the republicans (or democrats) can with bare majorities remove anything put in place in the past, not merely PPACA, but ANYTHING.

        I do not beleive even a simple majority is sufficient to increase the infringement of liberty, to increase the use of force, to increase the power of government,.

        One fundimental problem of PPACA- that will also be true of anything republicans do,
        is that general support for reform is NOT general support for specific reform.

        Govenrment can not do something specific, merely because there is general agreement that government should do something.

      • dhlii permalink
        March 15, 2017 5:13 pm

        No one would go back to say cancer treatment prior to WWII.
        But what has health insurance or government got to do with that ?
        We also would not go back to horse and buggies.

        going back to free markets for healthcare ?
        Why not ?
        During the 20’s the primary impediment to working class people ending up in the hospital for a week was not the cost, but the lost wages.

        India even today provides probably better healthcare than the US poor get for prices that nearly all of us could easily afford.

      • Priscilla permalink
        March 15, 2017 12:52 pm

        So, Roby, this is one of those rare times that we are in agreement, at least when it comes to the realities that have led us to this point, and regarding the obstacles that stand in the way of compromise.

        I am pretty sure that we would disagree on the exact best compromise solution. But the fact that we each acknowledge that we might not get exactly what we want, but might possibly get something that has most of what we want, is a good start.

      • dhlii permalink
        March 15, 2017 5:23 pm

        The fundimental problem is not can you get what you want.

        That is close to trivial. We would all agree to far more than PPACA provides for free.

        The critical problem is that healthcare is not a right, that it has a cost, and that when we give some version of it to some or all of us that it still must be paid for.

        The other key point of difference is how to address that cost.

        The left presumes that costs are objective – that they are essentially fixed and makes all its choices based on that presumption.

        Costs are not fixed – absent government they naturally decline – as they must, otherwise our standard of living is frozen.
        But presuming costs are fixed and making decisions based on that has consequences – one of which is that costs go UP, not down.

        AGAIN one of my concerns about Ryan care is that it is irrelevant what specific top down solution is imposed – it will fail, it will increase rather than decrease costs and it will impede what ultimately will solve the problems of health care, which is our self interested application of our individual creativity to the problem for our own personal gain.

        Do you have a problem with someone becoming the next Bill Gates – if in the course of doing so they reduce the cost of healthcare for all of us by 50% ?
        Or if they increase our life expectance by 20 years ?

      • Roby permalink
        March 15, 2017 12:56 pm

        “Every possible proposed system is a compromise that will delight one group and offend another.”

        I meant compromise in the engineering sense, that any object an engineer designs will not be ideal in every one of its qualities and characteristics. A car won’t be cheap and durable, fuel efficient and powerful, etc. It will be good at one thing at the expense of being less good at another, an engineering compromise.

        I certainly don’t mean that people are compromising in a political or ideological sense in developing these healthcare proposals! God Forbid!

      • dhlii permalink
        March 15, 2017 5:24 pm

        Politics is not engineering

      • dhlii permalink
        March 15, 2017 5:43 pm

        I want the absolute maximum of freedom so that people – not government can apply their creativity to the problem in as many ways as possible – over and over again until they find an answer that works.

        AND that we do not stop there – that having found one good answer that the same and other people continue to conceive of and try other solutions until they find one that is better.
        Rinse repeat.

        Now tell me what compromise you propose that will significantly permit that ?

        Because that is the ONLY actual solution.

        You note the miracles that have occured in the past – both pre and post WWII.
        Government has had little or nothing to do with improvements in our medical care, and absolutely nothing to do with reductions in the cost of ANYTHING.

        Our standard of living improves only ONE way.
        Produce greater value at lower human cost.

        That is it. It is true whether it is automobles, energy, food, or healthcare.

        Government has NEVER accomplished that.

        Whatever Obama, Ryan or anyone else is proposing that government do, it is at best a stop gap, waiting for people – free individuals to come up with the real answer to delivering greater value for less cost.

        I have suggested on approach – essentially converting basic healthcare to a subscription model and using health insurance as insurance was intended – for disasters.

        It should be pretty clear to most of us that would be far more efficient than what we have today.

        But I do not want anyone to get the idea that is what I think we should do.
        It might be. It is just an idea – one of myriads. What free markets do is test ideas, fail the bad ones and refine the good ones. And they do it continuously.

        Possibly the largest problem with anything government does, is that it makes that less likely.

        So how am I supposed to compromise with you, or anyone else ?

        Does it really matter exactly which bad solution we pick ? Should I cast my vote for failure in 5 years or ten ?

      • Roby permalink
        March 15, 2017 1:05 pm

        “I am pretty sure that we would disagree on the exact best compromise solution. ”

        Oh No! I can manage to disagree with you on the question of whether I will disagree with you about the solution.

        I literally understand so little of the complexity of healthcare proposals and they are all so nebulous and so boggle my mind in tyrying to comprehend them that I can hardly form an opinion on them at all! I am entirely out of my league! This is why I chose Science as my field and was strong, once I finally got going, in mathematics. That is what floats my boat, equations with actual solutions, problems that can be methodically taken apart, investigated logically and solved.

        Politics, economics, religion, ideology are all horrifying fields to my kind of brain, its a world for masochists and self assured egomaniacs!

        (But I do agree with you basic point, that we would acknowledge that we are compromising.)

      • dhlii permalink
        March 15, 2017 5:52 pm

        Then I doubt you like modern science and the most advanced forms of mathematics – as they quickly leave the realm of certainty. Of absolute answers.

        Regardless, if you beleive you are smart and you know that you are not smart enough to solve these problems for everyone yourself, then you should also have a pretty good grasp of the fact that – no one else can either.

        And yet, oddly they are solveable.

        I have offered some ideas – not because I think they are “the solution”, but just to demonstrate that there are creative and outside the box possibilities.

        I have absolutely zero doubt that if government gets far enough away from this problem, that shortly quality will improve, costs will start to decline and new approaches will emerge.
        Many – possibly mine, will be tried and fail. But all will not fail.
        hundreds of smart people – like you and I but specializing in these areas will try things.
        Most will fail. But a few will succeed, and the results will be better than the most brilliant of us could arrive at on our own – or in a committee of other brilliant people.

        It is not our collective wisdom that is more than our individual wisdom.
        It is our competitive wisdom that is far greater than anything we can accomplish otherwise.

      • Roby permalink
        March 15, 2017 4:54 pm

        Dave, how many words have you used here to try to explain one very simple idea. I get the idea already. I just don’t agree with you. Nor am I ignorant or the concepts you lecture on.

        When you said:

        “The only hope the GOP has is to do better than PPACA.
        The good news is that is not hard.”

        That is when it was obvious that you are blowing smoke, you have no clue your words are empty bravado, ideological intoxication. If its so easy, hire yourself out to them and save them, because they seem to be having trouble finding those easy answers.

        If it needed to be more obvious, then the statement that a large number of cancers were cured in the preWWII days worked to reinforce the fact that your gig is one of projecting fake expertise. I have no idea what kinds of the most deadly metastasizing cancers you think would respond often to surgery alone. lung cancer, liver cancer, brain cancer, melanoma, let alone blood cancers? More of your usual brave nonsense. The treatment of cancer was dismal in the old world, they did not even have a chance to understand what cancer is at the molecular level, a disease of DNA degradation, prior to Watson and Crick’s work followed by tens of thousands of scientists working from their initial DNA structure through to the real understanding of molecular biology, which took more decades.

        You are just blowing smoke, while you speak with extreme confidence, Nor do you love facts. That Commonwealth report you claimed had no data on quality was full of data on quality, graph after graph showing where American treatments of cancer, heart disease etc, stood compared to the other countries. So, you simply sarcastically denied it and it disappeared for you. problem solved, for you, denial accomplished. Thats not how to get an accurate understanding of anything, which is why you don’t have one.

        Let anyone say something that does not fit your free market religion and they become a “left-wing nut” and you reject their ideas or data. Denial mission accomplished again. Ha, I’ll bet Ron was surprised to hear you state that he is of the Left (along with Aarp. Rick, and myself, left wingers all!). Give it up man, practically the whole world is on the left by your standards. Where does that place you?

        People like yourself who project extreme confidence and expertise while talking nearly pure BS have always done well in this world: mostly they have done well with making it a mess. I would not trust anyone with your level of self confidence on one subject, lacking some amazing credentials and achievements, let alone the never-ending list that you lecture on.

        I consider you to be a sincere, well-meaning, sometimes interesting, relentless hard seller of a product that is nearly pure BS. People cannot shop for a cancer treatment or any high tech treatment for a serious disease like they shop for a guitar, a car, or a piece of chicken for dinner because they are not in any way equipped to understand the products and choices other than viscerally. Nor do they actually have a very wide group of choices in most cases, unless they are wildly rich and can go anywhere to be treated; very few people have such options. For these reasons alone, the free market concept applies very poorly to consumers making choices when seeking treatment for serious diseases.

        Dave, you are going, I am sure, to dispute every word of what I wrote at great length, but if you are trying to convince me that you know what you are talking about, you could spare yourself. You do not know what you are talking about in the majority of cases where you project being the one in the real know, who is here to show the light to poor delusionals like myself.

        I am going to let you have the last set of lectures on how little I understand about markets, how far left I am, the large numbers of cancers cured in the preWWII era, the ease of solving the problem of creating an American healthcare system, and anything else that pops into your head to lecture me on. (OK, I am self aware enough to realize that I just did the same thing to you, ha, ha, ouch). Getting further entangled in your bubble is something I will avoid. Have Fun!

      • dhlii permalink
        March 16, 2017 8:34 am

        I tend to be verbose – said the pot to the kettle.

      • dhlii permalink
        March 16, 2017 8:49 am

        You are not obligated to agree with me on anything.

        Nor are you (or I) free to use force – directly or through the proxy of government to impose your ideas on others.

        You may not use force without justification because it is immoral.

        You may not do so because it is impractical – societally the use of force comes at the expense of everything else – the greater the use of force the less of everything else we have.

        You may not do so because ultimately you create overwhelming opposition which will other result in a political swing or pushed far enough actual revolution.

        If you have only 10% vigorous opposition on ten different policies with limited overlap – you have created atleast a majority vigorously opposed to you.

        This is the problem with PPACA and the problem with RyanCare.
        Overwhelming support for reform, is not even majority support for specific reform.
        There was never sufficient support for PPACA – and therefore it should just be repealed or allowed to fail.

        At the same time it is unlikely that Republicans can garner sufficient support for a replacement – and they should not enact one without that support.

        Even a strong minority should be able to repeal legislation or block new legislation,
        but a super majority is necescary (but not alone sufficient) to enact legislation.

      • dhlii permalink
        March 16, 2017 8:56 am

        What is it that you understand but disagree with ?

        If you are suggesting that coming up with something to replace PPACA is polically hard – that is self evident.

        If you are suggesting that something that works better is difficult to conceive ceive – that is nonsense.

        Look around pretty much everything we fight about – is some form or another of government failure.

        Those aspects of our lives where governments influence is small are not perfect, but they are also not national problems.

        Remove something – such as healthcare, from the scope of government – it will not be perfect, but it will also not be disaster.

      • dhlii permalink
        March 16, 2017 9:19 am

        What is the meaning of your rant about cancers ?

        There are cancers that have abysmal treatment rates today. Many of these will be treatable in the future.

        The point I made – the ONLY relevant point, is that government involvment in healthcare has NOT increased the rate of improvement.

        We did not jump from non-existant care to incredible care as government ook over more and more of healthcare.

        Not in cancer treatment. Not in anything else.

        I do not want to go back to the healthcare of the past. I have not argued that we should abandon the advances that have been made.

        My argument is that advances have ALWAYS been made, and will continue to be made.
        That they were made before government got involved, and that subsequent advances would have occured absent government.

        I have however, made a second argument, which is also facially obviously true, and that is the vast majority of the gains in outcome in the past century, are the consequence of medical changes that occurred BEFORE government got involved.

        Even today nations that have implimented most of the medical advances through the 50’s, but little since have life expectances within a few years of advanced nations.

        Absolutely if you have some exotic cancer – come to the US, because otherwise you are dying. But all of us die eventually.

        Life expectances were in the mid twenties for 99% of human existance.
        It is only since about 1500 that they have started to rise dramatically.
        Advances subsequent to the 1950’s as dramatic as they may be have resulted in much smaller increases.

        The medical technology necescary to have an average life expectancy in the mid seventies is broad availability of that developed by the late 1950’s.

        Just to be clear I am not saying that americans lived to their mid seventies by the 50’s.
        It takes years – even decades for technology to become widespread and for the benefits to be widespread.

      • dhlii permalink
        March 16, 2017 9:38 am

        You claim the commonwealth report was somehow meaningful.

        I saw alot of data about hospital beds, money spent, or number of physicians.

        I saw nothing that attempted to correlate that to anything.

        Then I saw alot of data about rates of various different problems.

        But again no effort to correlate any of these to anything.

        I would suggest reading FA Hayek’s Nobel valedictory on the pretense of knowledge, or there is a recent Paul Romer paper on the fundimental problems with economic models.

        It is very difficult to work from the real world to conclusions.

        This is why most scientific progress is made through controlled experiments.

        But in many areas – economics, sociology, that is what we must do much of the time.

        That is why things like the oregon experiment are so important – because we do not often get to conduct controlled experiments.

        Anyway, your commonweath study attempts to do the impossible.

        It draws conclusions – without actually doing proper scientific or statistical analysis from data that is highly unlikely to be able to support those conclusions.

        Is there a signle instance in that report where anyone did anymore than plot a bunch of graphs and see “see these countries are doing better than those” ?

        Americans have a higher standard of living than Europeans (as a whole)
        We have higher food consumption, more diabetes.
        We spend more – because we can afford to.
        We buy results – aside from the specific outcomes your paper tries to measure.

        As an example – the europeans make and buy far more diesel automobiles than the US.
        Can I add a graph of that to your commonwelath paper and conclude from that that people in countries with more diesel cars live longer ?

        The US is more than twice as diverse as europe – we have particiularly high percentages of blacks, We know that life expectance among blacks – even with modern medicine are substantially lower than whites.

        That single factor alone explains nearly all the differences between the US and Europe – infact it explains it in myriads of different topics. –

      • dhlii permalink
        March 16, 2017 10:16 am

        The commonwealth paper you are relying on did not do the hard – often impossible work necescary to actually support the arguments it was making.

        Corrleation is not causation.

        Further in the instance of that paper – you do not even really have correlation.
        The expecation is that given a bunch of graphs of some metrics of healthcare – which we are supposed to presume have something to do with quality and outcome.
        and a separate set of graphs of measures of some specific aspects of health care – which we are also supposed to presume have something to do with quality and outcome,

        Nothing in the paper went to the trouble to demonstrate than anything measured was relevant.

        As an example – more doctors per capita is probably a good thing.
        But it is not a direct measure of anything.

        Doctors in various countries are not equal. Even where they are equal they are not equally productive.

        I keep repeating to you OVER AND OVER,
        that standard of living increases when

        We produce more value with less human resources.

        Therefore the objective regarding doctors is NOT a lower ration of doctors to patients.
        It is a higher ration.
        We are better off – all other things being equal with fewer doctors treating greater numbers of patients.

        And the point of my attack on your commonwealth paper is it makes no attempt to set all other things equal, and without doing so – unless all things actually are equal by default the correlations – particularly small ones are meaningless.

      • dhlii permalink
        March 16, 2017 10:38 am

        What you consider pure BS is responsible for the past 400 years of the most dramatic improvement in standard of living that has ever occurred,

        Intellectually it is the work of Adam Smith – and 250 years of economists since.

        Even Keynesians – which are wrong on primarily on the ability of government to exteranlly manage the economy, And separately in that they confuse logical implication for mathematical equality.
        Still otherwise are in agreement with nearly all of my arguments.

        There is very little disagreement over how the economy works on its own.
        There is some disagreement over the frequency, and scope of market failures absent government.

        But your argument is not that the market fails to frequently or in too broad a scope, but that it does not work at all (atleast int he context of heatlhcare) – which even keyes would reject.

        Put more clearly you are not really arguing for anything any economist of any flavor actually accepts.

        Politicians – both right and left, beleive the market will respond if they command.
        Economists don’t – ar atleast don’t beleive the market will respond as commanded.

      • dhlii permalink
        March 16, 2017 10:41 am

        Just to be clear – I do not reject the Commonwealth paper data.

        All I am challenging is there unsupported effort to draw conclusions from that data.

        You can often refute claims of correlation by showing a couple of graphs.
        You can not prove a causation nearly that simply.

      • dhlii permalink
        March 16, 2017 10:48 am

        Most of my argument i NOT that I know what I am talking about.

        My most significant argument is that most everyone else does not.

        Did PPACA come anywhere near working as predicted ?

        According to predictions nearly 100% of us were to end up with insurance.
        The best claim I have heard is a bit more than 5% increase in the numer insured
        The worst is closer to 2%.

        Insurance costs were supposed to decline by 2500/year/family.
        This year alone the nationwide increase according to NYT is supposed to be 22%.

        I can go on and on.

        It was supposed to have near zero net cost.
        It is costing us about 1.6T/decade which is more than even the GOP predicted.

        MY point is not that I know better than everyone else.

        It is that all the people claiming they actually know, do not know squat.

        If government is unable to know what the effects of its policy choices are, then it should not impose politcy choices by force.

        The hubris is not mine.

      • March 16, 2017 12:19 pm

        “Did PPACA come anywhere near working as predicted ?”

        Depends on who made the prediction. Many said it would fail. Some said it was the democrats entry port to single payor. The first group was right. And I agree with the second group had the GOP not won control of the legislature, or at least one wing of it.

      • dhlii permalink
        March 16, 2017 6:16 pm

        What you are saying is that no one – even its creators intended that PPACA succeed ?

      • March 17, 2017 12:22 am

        Dave, when you look at the legislation and see all the piss poor rules and regulations included in that bill, yes, I can agree that it was designed to fail. And if it was designed to fail, what was the ultimate desire from that outcome. If it failed and the democrats were in control, then they could easily promote a single payer system for everyone and possibly get that passed. They would have all the info on why the free market had failed and why government had to come in and take over the reimbursement for everyone. If the GOP was in power, the GOP caused its demise and they could gain control back since they would brainwash the voters into thinking they do not care about poor people.

        1. How many younger workers are motivated by a penalty of $57.00 per month ($695.00) compared to buying insurance for $250-$300 per month (up to $3600 per year). Even with employer insurance, that could be more than double the cost of the penalty. When the penalty is 2.5% of adjusted gross income, you would have to report $120,000 in AGI for the penalty of 2.5% to equal $3,000 (250*12)
        Question: Why make the penalty where it is not a motivator to buy insurance? What is the ramifications if younger healthy individuals do not sign up for Obamacare?

        2. Why include risk adjustments in the original law that was known to be something that would run into difficulties when those become active and insurance companies began asking for their stop loss coverage from the government?
        Question: If the penalties were greater and more in line with the premium costs, would heather individuals sign up and reduce the need for risk adjustments?

        Basically, the failure of Obamacare has been due primarily to those that are healthy not subscribing to Obamacare. If the penalty was, say what the cost of buying insurance is, then there is a good possibility that younger individuals would have signed up. More healthier individuals would have spread risk, thus lowering the claim to premium ratio. And that would have reduced the need for the Stop loss the government had, but the GOP removed when they began tapping into that fund.

        So it was total stupidity on the part of Pelosi and her cohorts (which is a good possibility) for an insignificant penalty or a plan that was designed to fail based on one huge flaw. A penalty that was worth paying to avoid the cost of insurance..

      • dhlii permalink
        March 17, 2017 11:41 am

        Why are we penalizing people for making a wise financial choice ?

        AGAIN, insurance protects WEALTH not HEALTH. If you have no wealth to protect you do not need insurance.

      • March 17, 2017 1:27 pm

        And this is the problem with many who think it is fine to cause people to lose everything over catastrophic health expenses.

        “AGAIN, insurance protects WEALTH not HEALTH. If you have no wealth to protect you do not need insurance.”

        When you have health insurance, have assets, experience a catastrophic health issue, run up against lifetime benefits, the insurance is cancelled and no one else will insure you. Then to pay for future health expenses you use savings, then use retirement funds, then sell your house and finally sell whatever other assets you have. And once you have nothing, you may or may not be able to continue treatment if the physicians will continue to treat you for your illness.

        You may think that is fine. I do not.I am enough of a moderate to understand we need some humanity in America to assist those in need before they have to sell everything to stay alive and to allow spouses to stay in homes they share with someone who may be sick.

        I do not support mandatory insurance, but I do support preexisting condition and some form of catastrophic coverage by the government for individuals with catastrophic illnesses.

        Even Mr Conservative himself supported that and proposed it in an address to America.

      • dhlii permalink
        March 17, 2017 2:37 pm

        Should everyone have the same automobile insurance rate – or should those who have had expensive accidents in which people have been harmed find it harder or more expensive to get insurance coverage ?

        Life is not fair.

        What you are arguing is that once someone has had one expensive healthcare incident – they are now entitled to a free ride for life.

        Absent federal flood insurance – which is another thing that should disappear, people who lived in areas likely to flood could not get insurance or would have to pay alot for it.

        Is that not a good thing ?

        Given that I would end Medicare – why does the fact that Reagan wanted to expand it impress me ?

        I greatly admire Thomas Jefferson.
        That does not require me to condone owning or sleeping with slaves.

      • March 17, 2017 6:37 pm

        Dave. I am not arguing that people should get a free ride.

        If you have auto insurance and get into an accident, the insurance pays, you have your rates go up and you continue to drive. Same with tickets.

        If you have a house that floods, it is considered in a flood plain, the insurance pays and you have to move, you are still “whole” and your assets are still the same since you have money to buy another house.

        But under the old plans, you and your wife have insurance since this became effective when you were 25. At the age of 30 you buy life insurance for $250,000. You develop hemophilia at the age of 35. Your lifetime benefits of 1 million are reached after 2 years of physician, clinic and hospital care. The clotting factor itself can reach your lifetime benefits in 3-4 years and physician and hospital cost reduce that to 2 years. You have 750,000 in savings and retirement funds, most from an inheritance. Within 5 years of diagnosis, you have no insurance (reached lifetime benefits) no one else will insure you, you have spun down your savings and retirement funds so there is nothing left and now your house is up for sale for $500,000 (assume you have it paid for, also from the inheritance). That covers another year of care. Now you are 40 and you have no assets, your wife has few assets other than maybe some Roth IRA’s that have been set aside and you are renting an apartment. After 20 years of marriage, you die from natural causes.

        Remember, access to healthcare for someone like this is not like Medicaid that shelters the primary residence from asset spin down for the spouse. You and your wife are in this thing together, unless your wife decides your not worth losing 1/2 of all your assets and she leaves you before healthcare cost takes everything.

        You accept the fact that it is fine for this family to lose everything based on exceptional healthcare cost. I am of the mind that this country can do something for the few people like this so they don’t lose everything. Maybe we could take 1% of the foreign aide we give other corrupt countries like Mexico that are controlled by the cartels and move that money to our own needy people, all while changing the current healthcare plan to be more like something you would support.

      • dhlii permalink
        March 18, 2017 6:43 pm

        Flood insurance does not work as you claim – because it is primarily government guaranteed.

      • dhlii permalink
        March 18, 2017 7:03 pm

        Health insurance has changed radically throughout my lifetime – on its own.

        When I was a child “major medical” was the norm – for those who had health insurance and most did not.

        Major medical covered pretty much that – long hospital stays and operations.
        It did not cover doctors visits or medication.

        Labor unions and medicare were major factors transforming the market.

        They increased the cost for all of us and increased coverage for some of us.
        Both of which drive demand for increased coverage for all of us.

        When doctors visits were $20 there was no need for insurance and the price was high enough to avoid over consumption and low enough to assure we would see a doctor when we needed it.

        Absent Medicare, unions and government forces that drove businesses to offer healht insurace, we would have a free market, costs would likely be less than 1/3 what they are today and more services would be available to us.

        You talk about lifetime limits – these tend to start over everytime you change insurance – every time you change jobs.

        Treatment for hemophila is 40-50K/year – in unusual cases it is 100K/year.
        In the 70’s I had an employee working for me with Hemophilia – he was able to pay for his care out of pocket.

        BTW – your 35 year old is incredibly wealthy – 750K in savings and a 500K paid for house ?

        You keep telling me to “remember things” that are conditions that are true at some moments in time for some people with some plans.

        Are we supposed to design a national healthcare system arround the possibility of a reare constellation of circumstances ?

        You could be struck by a bus, hit by lightning, or die in a car accident.

        Nothing can protect you from those.

        You want life to be guaranteed perfect.

        You want the government to make floods, huricanes, lightning, tornadoes and anything that could go wrong go away – because if something bad happened that is not your personal fault – then either you must be taken care of or “its not fair”

        Life is not fair – get over it.
        We can not make it fair.

        You and I were not born equal.
        We do not have the same intelligence, physical abilities, talent, skills, we were not born into the same circumstances.
        That is just how it is. It is not governments job to make us equal – do we all need to be lobotomized to the lowest common denominator of intelligence ?

        You seem to think that any disparity requires government intervention.

        Does that apply accorss the world – or only to US citizens ?

        If we are obligated to provide care for US hemophiliacs – why not those of the entire world ?

        Why should the accident of being born in the US give you advantages that no one else in the world has ?

        If we owe some moral duty to american hemophiliacs – don’t we owe the same duty to all hemophiliacs ?

      • dhlii permalink
        March 18, 2017 7:06 pm

        The parameters of health insurance – are whatever it is that we decided when we bought health insurance. In a market we get whatever it is we are willing to pay for.

        If we want our primary residence protected or greater life time limits – we buy them.
        Generally those options that do not exist are those few wanted.

        Though there are some distortions – primarily because most of use do not buy our own health insruance (atleast not directly).

        One of the good things about PPACA is it pushed more people into the individual market.

      • dhlii permalink
        March 18, 2017 7:21 pm

        Bad things happen in the world – it is not fine with me that kids are murdered, raped, starve or are conscripted by warlords accross the world.

        But it happens.

        It is not fine with me that we are not all medically perfect and live forever – but we do not.
        And my dislike does nto change the laws of nature.

        The US spent $35B on foeign aide and about 6B on military aide.
        I have zero problem with ending both.
        Medicare currently runs close to $600B and I beleive is running a nearly 300B/year deficit.

        I have no problem ending all foreign aide – there has been $1T in aide to africa from all nations over the past 40 years and no measurable benefit.

        Foreign aide is one of the most ineffectual things government does.
        and it is by far one of the most corrupt.

        The current healthcare plan I would support is:

        End the FDA, severly reign in CDC,
        End Medicare,
        Terminate all federal medical regulation,

        Let people buy their own health care, and health insurance in a truly free market.
        No EMTLA, no ERISA, no interfereance of any kind by government.

        You want to buy drugs from Canada – great. Or from the internet or ….

        Prices will rapidly drop preciptously, care will be more easily and readily avilable.
        The care available will be the care ordinary people place the most value in – not what bureacrats think we need.

        We will continue to see medical innovation – but now we will be seeking to increase total value – including reduce cost, not just improve outcome. ‘

        Only the free market seeks to concurrently deiiver greater value AND do so at loser human cost. We see rapid price increases in those markets that are least free.

      • dhlii permalink
        March 16, 2017 10:54 am


        Though most of the time my argument is that government does nto know what it is doing – not that I do.

        Still when I make claims they are usually testable.

        Rather than telling me that I do not know what I am talking about – show me.

        We addressed your commonwealth paper.

        Even if I accepted without the necescary support than is not in that article, its analysis.

        The best you can get is one quasi free market costs less than another and is producing by a few narrow measures of outcome better results.

        As I keep pointing out A ford Focus costs less than a lamboghini Huracan.

        i will bet it has lower repair costs too.
        Does that make it more valuable ?

      • dhlii permalink
        March 16, 2017 10:56 am

        I suspect that you do not CONSCIOUSLY understand markets very well – though you subcounsciously understand them dozens of times a day.

        But the real problem I have is that you have great and unjustified faith in government.

      • Roby permalink
        March 17, 2017 2:00 pm

        “You may think that is fine. I do not.I am enough of a moderate to understand we need some humanity in America to assist those in need before they have to sell everything to stay alive and to allow spouses to stay in homes they share with someone who may be sick.”

        You’ve been in the actual healthcare insurance business. You actually know what you are talking about. This is what people sound like when they actually know what they are talking about. All the extreme philosophical baggage is replaced by common sense and common decency. Which still do exist in America, although ideology is trying its hardest to triumph with simplified sweeping campaigns based mythical pure principles.

        Now you have been in the business, could I ask you for your opinion, does health insurance have any positive correlation with better health care and statistically speaking better health?

      • dhlii permalink
        March 18, 2017 4:16 pm

        You may hold whatever values you wish.
        In fact I share and practice yours.

        But you may NOT impose your values on others by force – i.e. through government.

        If we are to care for those in need – WE – you and I are to do so.
        It is an individual moral obligation. It is not an obligations we can impose by force on others.

        I am not at all impressed by people who say “we” should do something when what they mean is “somebody else”.

        Ultimately there are infinitely more “needs” in the world than resources to fill them.

        I as an example am far less interested in covering the medical costs of someone in the US who did not buy insurance than feeding starving children elsewhere in the world.

        Government can not possibly care for every single need that exists.

        All you do when you move a need to government is pit different need advocacy groups against each other.

        Again it should not be the governments role to decide which needs are most pressing,
        Should all women get free birth control – or should poor women get free reproductive care ?

        Further government has a bad records regarding peoples “needs”.

        My local government as an example is now trying to charge drug addicts for emergency services they received when they overdosed.

        While I have no problem with that in principle.
        I AGAIn have a problem when government is involved.

        When you fail to pay a doctor or hospital – maybe you go bankrupt.

        When you do not pay the government you go to jail.

        So you have decided that you have a moral obligation to do something for others – great I agree.

        But government is the worst possible way to address moral obligations,.

      • dhlii permalink
        March 18, 2017 4:19 pm

        Yes, I think that actual people in the actual health insurance feild should make the decisions about what health insurance they should offer.

        And actual consumers of health insurance should make the decisions about what health insurance they want,

        And markets should connect producers and consumers and resolve the differences between what the producers can do and want to do, and what the consumers want and what they need.

        Governments role in that process is assuring that no force is used, that agreements are kept and that when one party harms others they are compelled to make them whole.

        Government is not there to decide what insureres should offer or consumers should want.

      • dhlii permalink
        March 18, 2017 4:23 pm

        Someone else here has been in health insurance and healthcare.

        I have handled the employer side of health insurance for 50+ people for 22 years.
        I have consumed insurance most of my life.
        I have had doctors and healthcare providers as clients in an architecture business.
        I have designed hospitals, and clinics and doctors offices.
        That is about the extent of my experience.

        There are others with more.
        But I suspect that is far more than the legislators and regulators concoting our laws.

      • dhlii permalink
        March 18, 2017 4:31 pm

        Do we need an astronmer to tell us the sun will shine tomorow ?

        There is only one means by which health insurance can possibly effect health outcomes.
        That would be that it encourages people to visit doctors more frequently.

        But even that effect is small and not clearly desireable.

        Medicare more than trippled the consumption of medical services by the elderly.
        That radically increased healthcare costs for everyone – which DISCOURAGES the use of healthcare. And ultimately produced little or no measurable improvement in the trends of life expectance.

        Again we have long term controlled studies of health insurance – and not noticeable improvement in outcomes.

        Why ? Think about your own doctor visits. If you had no insurance at all – but were otherwise situated as you are today – would you choose not to got to the dotoro or hospital if you had a heart attack ?
        Would you choose not to if you got the flu ?

        Health insurance encourages the consumption of healthcare that is optional.
        It does not alter the consumption of healthcare that is more critical.

        Visiting doctors more frequently might correspond to greater sense of well being.
        Might mean fewer sick days for the flu.
        It is not going to be the difference between life and death.
        Because if you life is really threatened – you are visiting the doctor.

  44. dhlii permalink
    March 13, 2017 9:42 pm


    Why would you EVER trust a purported fact check web site – that cites a bunch of facts – ones consistent with the argument they are trying to refute and then speculates on an alternative explanation.

    Fact checking means checking facts.

    When it turns into political speculation about hypothetical alternate arguments, it is far removed from fact checking.

  45. Priscilla permalink
    March 15, 2017 5:38 pm

    Dave, I do agree that Ryancare is better than any compromise that we would have gotten in 2009. I actually think that it’s pretty decent. I also think that we’ll end up with something different, probably not until summer, and it will be Trumpcare. Maybe it will be better, who knows?

    I don’t agree with you ~ or I only partly agree with you ~ about access to care. Yes, most people technically have about the same access to care as they had before Obamacare. But many people who were forced out of their plans because of the coverage mandates of the ACA and are not eligible for the Medicaid expansion or subsidized insurance, can no longer afford to access the care that they once had.

    An example would be a young, single male, healthy for the most part, but who might have a condition such as asthma, which can be controlled by inhaled corticosteroids. Prior to O-care, he would have had a mid-level plan, probably costing $150-250 p/month, which would have had a deductible of about $200, and paid most of the cost of his doctor visits and at least 50% of his prescription costs. He would have had that plan cancelled, because it didn’t cover birth control, maternity and well-baby visits, etc. and had it replaced by an O-Care bronze level policy (I’m assuming he couldn’t afford more than $250 p/month). That policy would have had a deductible of anywhere from $1500-$6000, depending on the options available in his state. Clearly, unless he suffered an illness or injury, his policy would no longer cover anything, because he would never reach his deductible. Let’s say his doctor charged $250 for a yearly physical, necessary for his inhaler prescription, and that he needed 4-5 inhalers p/year at about $200 a pop.

    He would basically have lost access to affordable care.

    • dduck12 permalink
      March 15, 2017 10:39 pm


    • dhlii permalink
      March 16, 2017 11:21 am

      Access to health insurance and access to healthcare are not the same.

      This entire debate is about health insurance. Politicians left and right keep pretending it is about access to healthcare.

      Periodically I buy my wife flowers.

      I typically buy them at the grocery store as if I bought them at the florists they would cost more and I could afford to buy them less often.

      My finances cause me to limit my access to the florist – by choice. But my access to flowers is not constrained.

      Regardless, we do not have the ability to have absolutely everything we want.
      If by choice – or as a result of government – we have more healthcare – then we have less of other things.

      If that is a result of choice – less healthcare means more of things we want more.
      If it is a result of government – by definition it means more things we wanted less, or we would have chosen them.

      I really do not want to get into debates about pre obamacare vs, obamacare vs. ryancare.
      inarguably some people are better off under Obamacare, some were better off before and some will be better off under RyanCare. Inarguably each will have a set of losers.

      What we know is that obamacare did not significantly alter the consumption of healthcare.
      but it did significantly increase the cost.

      • Priscilla permalink
        March 16, 2017 2:08 pm

        Well, yes, my whole point was regarding access.

        And Obamacare attempts to redistribute access, by means of shifting large amounts of insurance dollars from the middle class to the lower class.

        And, in doing so, it has not significantly increased access for the lower class (see Ron’s post re: limited numbers of doctors and hospitals willing to treat Medicaid patients), but it has significantly decreased access for a significant portion of the middle class. So, overall, the government attempt at semi-socializing the healthcare insurance market has lowered access to actual healthcare.

        The reason that certain indicators, such as life expectancy, cancer survival rates etc. may not reflect this lack of access, is the very short period of time that Obamacare has been in effect. Most of the people that would have stopped seeking care due to their lack of affordable options have either not gotten sick yet, or not gotten sick enough to die yet.

        Anyway, we are not disagreeing on the central issue of rising costs. We’re just approaching it from different perspectives.

      • dhlii permalink
        March 17, 2017 12:57 am

        PPACA did not change access at all.

        Everyone had access before and after. It just changed how some healthcare was paid for.

      • dhlii permalink
        March 17, 2017 12:58 am

        PPACA also shifted money from the young to the old.

      • March 17, 2017 1:08 pm

        that’s what any insurance does. Auto insurance paid by drivers that never get a ticket or have an accident pays for claims by drivers that get tickets and have accidents, not enough to get their plans cancelled, but enough to cause payouts by the insurance companies.

      • dhlii permalink
        March 17, 2017 2:29 pm

        As a rule of thumb Insurance strives NOT to shift costs from one identifiable class to another identifiable class.

        Reality does not always perfectly reflect that – but strong perceptions that insurance shifts costs between identifiably class tends to leed in overconsumption by those it shifts costs from and underconsumption by those it shifts costs to.

        Insurance strives for the appearance that the winners and losers are random not selected.

      • dhlii permalink
        March 17, 2017 1:01 am

        Just to be clear, no for the most part we are not at odds,.

        We are sometimes describing things differently.

        I try – though I often fail, to be relatively precise and narrow in the way I use words.

        I think you are using access in a different way than I am,

        It does not make one of us wrong.

      • Roby permalink
        March 16, 2017 3:00 pm

        Who to believe?

        These excerpts form wiki don’t suggest that Obamacare is failing. ” They seem to completely contradict Dave assertions about driving up costs.

        “The ACA has caused a significant reduction in the number and percentage of people without health insurance, with estimates ranging from 20-24 million additional persons covered during 2016.[4][5] Increases in overall healthcare spending have slowed since the law was implemented, including premiums for employer-based insurance plans.[6] The Congressional Budget Office reported in several studies that the ACA would reduce the budget deficit, and that repealing it would increase the deficit.[7][8]

        The CBO reported in several studies that the ACA would reduce the deficit, and that repealing it would increase the deficit.[7][8][229][230] The 2011 comprehensive CBO estimate projected a net deficit reduction of more than $200 billion during the 2012–2021 period:[8][231] it calculated the law would result in $604 billion in total outlays offset by $813 billion in total receipts, resulting in a $210 billion net deficit reduction.[8] The CBO separately predicted that while most of the spending provisions do not begin until 2014,[232][233] revenue would exceed spending in those subsequent years.[234] The CBO claimed that the bill would “substantially reduce the growth of Medicare’s payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs”[235]—ultimately extending the solvency of the Medicare trust fund by 8 years.[236]
        This estimate was made prior to the Supreme Court’s ruling that enabled states to opt out of the Medicaid expansion, thereby forgoing the related federal funding. The CBO and JCT subsequently updated the budget projection, estimating the impact of the ruling would reduce the cost estimate of the insurance coverage provisions by $84 billion.[237][238][239]
        The CBO in June 2015 forecasted that repeal of ACA would increase the deficit between $137 billion and $353 billion over the 2016–2025 period, depending on the impact of macroeconomic feedback effects. The CBO also forecasted that repeal of ACA would likely cause an increase in GDP by an average of 0.7% in the period from 2021 to 2015, mainly by boosting the supply of labor.[7]

      • dhlii permalink
        March 17, 2017 10:59 am

        Much of the “facts”, I am not interested in debating.
        You think the facts are different – so be it.
        That is not the information I am getting.

        The information I am getting claims PPACA has started into the “death spiral”
        i.e. the number of healthy people enrolling on the exchanges is declining and the number of sick people is rising. That is resulting in rapidly rising premiums on the exchanges and insurers dropping out.

        You can find stories to that effect. You have to decide how much credibility you are giving them on their own.

        As I have noted, I think the GOP should do nothing and wait for PPACA to fail.
        I am actually quite confident that it will fail.
        If I am wrong – well then “you win”

        If PPACA actually insurers more people better at lower cost without trillions in government subsidies – who would complain ?

        Regardless, different sources can spin the facts however they please.
        But you can not spin reality.

        There is no reason to do anything about PPACA if people are happy with it and it is working. But then if that was really so, it is highly unlikely that so many people would remain so angry about it after so many years.

        There are some issues – PPACA’s failures are greater in red states. I do not think that is deliberate, but it is a consequence of the design.
        The same demographic issues that effect voting patterns and gave Trump an electoral college win, also effect many other issues including health insurance.

        And again one of the problems with top down solutions is the presumption that difference states, regions, localities and even individuals are all the same – that they want the same thing, and that they need the same thing.

      • dhlii permalink
        March 17, 2017 11:08 am

        Neither CBO nor GAO have EVER been right about their projections of the cost of anything ever. That is not a partisan issue. It is just how it is.

        They tend to be widely optomistic. The greatly underestiment – often by a factor of two or more, the cost of anything, radically over estimate revenue from tax increases and radically over estimate the cost of tax cuts.

        Further both are constrained by rules that prevent them from doing their job very well.

        One of the big deals on PPACA is that all CBO projections presume that medicare/medicaid rate limits will take effect.
        Yet, congress ALWAYS waives those.

      • dhlii permalink
        March 17, 2017 11:11 am

        Just to be clear – while I do not trust the CBO numbers – lets just presume they are correct and repealing ACA would result in a 0.7% increase in GDP.

        Over ten years that is a bit less than a trillion dollars.

      • Roby permalink
        March 16, 2017 3:19 pm

        And yes I did note the last sentence, which taken alone would support repeal.

        I’d love to see one huge study of the effects of the acts, what impacts it had on health most of all. There have been some statements about 50,000 lives having been saved and a CUNY study that claimed 43,000 would die due to repeal, but those numbers could be argued over and disputed, I read some of the research behind them, was not very impressed. but you would think there would be a truly determined CBO study to see how the act actually affected peoples health. That is really frustrating. Eather party could request such a study.

        This has had such a huge impact on us, why are there not harder figures on impacts? That is what should be known first of all before figuring out how to change this.

      • dhlii permalink
        March 17, 2017 11:31 am

        As I noted regarding CBO – it is really not possible to “study” this.
        And I have little trust of the studies anyone produces.

        I have probably cited this before – but Paul Romer published an excellent paper on economic modeling in the past year (though it really applies to all modeling).

        In which he essentially concluded that trying to model complex phenomena like the economy that have multiple concurrent factors is completely impossible.
        Because tiny variations in obscure factors can through everything off, and because even subconscious confirmation biases of the best and most careful people dwarf the sensitivity of the models.

        While that does not mean we should throw in the towel, it means we must return to making choices based on principles and fundimentals of human behavior.

        As to the claims of people who are alive who would not be or will die – these are total crap based on ludicrously stupid assumptions.

        There is no change in the trends of anything.

        There is no reason to expect that would be either.

        As I keep repeating and everyone keeps ignore.

        Health insurance has nothing to do with health outcomes.
        That has been studied repeatedly by people desparate to find the opposite.

        That means anyone predicting a future change in health outcomes is doing so at odds with past data.

      • dhlii permalink
        March 17, 2017 11:37 am

        You ask why are we not trying harder ?

        I have answered that it is a near impossible task.

        But I would also note – we do not ever try that hard with regard to any legislation.

        McD’s has a better idea what a $.01 change in the price of a hamburger will do to its sales and profits than any legislative body of any kind has about anything they do.

        This is also an argument for NOT doing these things.

        If we have no real clue what PPACA will do – why did we enact it in the first place ?

        We can argue about many things regarding PPACA.
        But it is not possible to argument that it worked anywhere near as expected.

        So why is it that you are willing to pass laws that are just massive rolls of the dice ?
        That pretty much always cost much more than predicted ?

        You want to toss out CBO numbers – I do not dislike the people at CBO. I am sure they are trying hard. But thus far history shows CBO to be no better than partisans from either side who are pulling results from there ass.

        If those who are purportedly unbiased can not ever get these things even close to right – why are we doing them ?

      • Roby permalink
        March 17, 2017 12:52 pm

        “As I keep repeating and everyone keeps ignore.
        Health insurance has nothing to do with health outcomes.
        That has been studied repeatedly by people desparate to find the opposite.”

        False. Your sweeping statement is a convenient invention to support your denialist philosophy. Its for your own benefit and will fool some others if they are longing to believe the hogwash you are selling.

        This is how you develop your all-encompassing denialist philosophy, one denial of reality at a time. Its a perfect example of why I don’t ever trust your sweeping statements or buy any of your conclusions. Grandiose nonsense is your speciality.

        5 Pinocchios

        “Estimating The Potential Impact Of Insurance Expansion On Undiagnosed And Uncontrolled Chronic Conditions
        Daniel R. Hogan1, Goodarz Danaei2, Majid Ezzati3, Philip M. Clarke4, Ashish K. Jha5 and Joshua A. Salomon6,*
        + Author Affiliations

        1Daniel R. Hogan is a technical officer at the World Health Organization, in Geneva, Switzerland.
        2Goodarz Danaei is an assistant professor of global health at the Harvard T.H. Chan School of Public Health, in Boston, Massachusetts.
        3Majid Ezzati is chair in global environmental health in the Faculty of Medicine, School of Public Health, at Imperial College London, in the United Kingdom.
        4Philip M. Clarke is a professor in the Health Economics Research Unit at the University of Melbourne, in Australia.
        5Ashish K. Jha is a professor of health policy and management at the Harvard T.H. Chan School of Public Health.
        6Joshua A. Salomon ( is a professor of global health at the Harvard T.H. Chan School of Public Health.
        ↵*Corresponding author

        Policy makers have paid considerable attention to the financial implications of insurance expansion under the Affordable Care Act (ACA), but there is little evidence of the law’s potential health effects. To gain insight into these effects, we analyzed data for 1999–2012 from the National Health and Nutrition Examination Survey to evaluate relationships between health insurance and the diagnosis and management of diabetes, hypercholesterolemia, and hypertension. People with insurance had significantly higher probabilities of diagnosis than matched uninsured people, by 14 percentage points for diabetes and hypercholesterolemia and 9 percentage points for hypertension. Among those with existing diagnoses, insurance was associated with significantly lower hemoglobin A1c (−0.58 percent), total cholesterol (−8.0 mg/dL), and systolic blood pressure (−2.9 mmHg). If the number of nonelderly Americans without health insurance were reduced by half, we estimate that there would be 1.5 million more people with a diagnosis of one or more of these chronic conditions and 659,000 fewer people with uncontrolled cases. Our findings suggest that the ACA could have significant effects on chronic disease identification and management, but policy makers need to consider the possible implications of those effects for the demand for health care services and spending for chronic disease.”

      • dhlii permalink
        March 17, 2017 2:15 pm


        Citing nonsense for notoriously bad political fact check sites is not an argument.

        Again “Health Insurance has nothing to do with health outcomes.”

        This is actually a tautology.

        And should be trivial for you to understand.

        I grasp that it is politically inconvenient for those on the left.
        That it FEELS like there should be some relationship.

        But there is not.

        Auto insurance does not prevent automobile accidents.
        Fire insurance does not prevent fires.

        Insurance does nto stop bead things from happening – it protects your wealth the event they do.

        When you cite a source or study that claims that the sun will not rise tomorow – I need not demonstrate it is both stupid, and biased.

        I am sure I can find some expert somewhere to validate any nonsensical claim that I want.

        You have to digest alot to get to the conclusion, and there is all kinds of gobbldy gook in the middle trying to hint that there were actual benefits, but the final conclusion.
        Those insured experienced less financial stress but no measurable health differences.

        It concludes there was increased access and utilization of healthcare services – but not any actual changes in outcomes.

        I grasp that you do not like the results. But the fact that you and other left wing nuts FEEL that there should be an effect – does not create one.

        I am aware that there are some tiny poorly done studies that have tried to claim otherwise.
        One should always be suspicious of small studies.
        One should always be suspicious of results that defy logic but confirm hopes and bias.

        BTW there is also a 40 year Rand study done by insurance companies that continues to arrive at the same conclusion.

      • dhlii permalink
        March 17, 2017 2:24 pm

        BTW did you actually read the text you cut and pasted ?

        It does not say what you want it to.

        Nowhere does it state there is a difference in outcomes.

        Its strongest statements are probabilities and suggestions NOT conclusions, and not about outcomes.

        No one is debating that people with health insurance utilize more healthcare resources.

        Medicare trippled the medical care consumption of the elederly – but had ZERO effect on outcomes

        And YES I am aware there are studies that claim small decreases in mortatilty due to medicare – but those studies ALL fail to adjust for the pre-existing trend of decreasing mortality.

        AGAIN an argument I keep making regarding government – that you keep ignoring.

        If something is improving and you change something and it continues to improve at the same rate as before YOU CAN NOT attribute the continued improvement to the change.

        To demonstrate that a change has had an effect it must DISRUPT trends.

        There is no evidence that any federal regulation disrupted any pre-existing trend of improvement.

      • Roby permalink
        March 17, 2017 2:47 pm

        “Auto insurance does not prevent automobile accidents.
        Fire insurance does not prevent fires.”

        That is your defence of the absurd? That you are pretending that you don’t understand the basic difference between health insurance and car insurance?

        That is seriously weak and quite funny.

      • dhlii permalink
        March 18, 2017 6:39 pm

        Not pretending anything ALL insurance protects WEALTH.

        The pretence is yours.

      • dhlii permalink
        March 18, 2017 6:41 pm

        Not at all weak.
        Just calling an argument weak does not make it so.

        Just as calling Mohamad Ali a whimp does not make him one.

        Do you have an argument for why Health Insurance is different from all other insurance that is more than “But health insurance is different because I say so”

  46. dhlii permalink
    March 16, 2017 9:02 am

    Even today success in treating cancer is defined as living 7 years after treatment.

    I was going to clarify what I had said – but I went back and read it, and I think it was clear and you are just being deliberately obtuse.

    I have not claimed that cancer treatment has not improved.
    It has, and it will continue to.

    You are just echoing one of the standard fallacies of the left.

    The presumption that if something improved while highly regulated that the improvement was due to regulation.

    AGAIN – look at the trends. Cancer treatment – or pretty much anything else you wish to pick, has been improving for a long time. Long before government was involved.

    To the extent any rates of improvement have been altered by government intrusion – they have slowed.

    • Roby permalink
      March 16, 2017 9:57 am

      For you Dave, Government IS cancer. That is your religion. You believe you have rock solid proof that removing government is the cure to healthcare, the environment, race relations, and pretty much everything else. I believe you have ideological intoxication.

      You, believe it or not, are just like those fanatical closed minded hip liberal PC kids at Middlebury, they are simply your mirror image of absolute conviction, naivete, arrogance, moral superiority, and unwillingness to give any credit to other points of view. What they do wrong, you do wrong, its exactly the same pattern, just as a mirror image.

      Here in the center I must have a masochistic tendency, I look in on the Middlebury “grow the government left” on their college paper website and read their self righteous rants and they make my teeth itch. I read your type of radical Libertarian “remove the government right” rants here and they make my teeth itch. They are actually just the same rant with opposite polarity.

      I think to myself, in both cases, god help us if either of these philosophies ever really wins. Hopefully they will cancel out more or less. But they don’t help the problem solving environment that less fanatical Americans are trying to live in.

      • dhlii permalink
        March 16, 2017 11:35 am

        Inarguably the trend in the cost of US healthcare has diverged radically from that of the rest of the world – starting in 1965 with medicare.

        What is this country fighting about – not me specifically, but the country as a whole, that is not some issue of government failure, and most likely over the past 50 years ?>

        If I am so wrong about government – why is it that pretty much universally everything we fight over is some government F’up – usually with the economy ?

        Not what do I fight over – but what do YOU and everyone else fight over ?

        I recall some advice as an employer.
        When a supervisor comes to you and says they have a problem with an employee.
        You side with the supervisor.
        The second time – you side with the supervisor and ask questions.
        The third time – you fire the supervisor.

      • dhlii permalink
        March 16, 2017 11:37 am

        Government is a tool. It is a hammer.
        It is useful for pounding nails.
        It is pretty close to useless for cutting wood.

        Government is force. Those problems that actually require force, require government.

        It is generally accepted that using force when it is not necescary is not moral.

      • dhlii permalink
        March 16, 2017 11:42 am

        There is an enormous difference between our exchanges an middleburry.

        They are exchanges.
        You get your opportunity to speak,
        as do I.

        No one is silencing you.
        You can not silence me.

        The problem with those at Middleburry was not that they beleived they were right.
        It is that they beleived they were allowed to use force to silence those they thought wrong.

        That would be false even if they were right.

        “Those who won our independence believed that the final end of the state was to make men free to develop their faculties, and that in its government the deliberative forces should prevail over the arbitrary. They valued liberty both as an end and as a means. They believed liberty to be the secret of happiness and courage to be the secret of liberty. They believed that freedom to think as you will and to speak as you think are means indispensable to the discovery and spread of political truth; that without free speech and assembly discussion would be futile; that with them, discussion affords ordinarily adequate protection against the dissemination of noxious doctrine; that the greatest menace to freedom is an inert people; that public discussion is a political duty; and that this should be a fundamental principle of the American government.”
        Louis Brandeis

      • dhlii permalink
        March 16, 2017 11:50 am

        Clearly you entirely miss the problem at Middlebury.

        It has absolutely nothing to do with most of what they beleive.
        It has nothing to do with whether they are right or wrong about what they beleive.

        It has do do with a single beleif only – put into action.
        The beleif that some viewpoints are so repugnant that any expression can be supressed.

        It is that they sought to shrink the overton window down to only their own beleifs.
        And that they were willing to use force to do so.

        It is not their specific beleifs that were the problem, but their willingness to use force to supress the expression of the beleifs of others.

      • dhlii permalink
        March 16, 2017 11:50 am

        Your not in the center.

      • dhlii permalink
        March 16, 2017 12:02 pm

        To varying degrees my “philosophy” has informed not merely our government but governments arround the world for the past 250 years.

        Greater freedom has always correlated to more rapid increase in standard of living.
        That is sufficiently self evident that since the 80’s most of the countries in the world have been increasing their freedom – and the result has been a doubling of global standard of living.

        In the US during the 19th century – a far from perfect time, but one with mostly greater freedoms – atleast if you were white and male. standard of living doubled every 15 years.
        As the scale of government has increased in the late 20th century it took about 45 years to double the standard of living, In the 21st century US that is closer to 60 years.

        So my “radical” “extremist” approach atleast in the past resulted in much faster improvement in the human condition.

        And AGAIN,

        what is it we – not me, but the country is constantly fighting over ?

        Varioius different ways government has failed and what to do about it.

        I chose my arguments.
        But the debate topic is universal.

        I have not forced you to debate fixing government failure.
        I am just trying to get you to consider than maybe the fact that everything publicly debated is about government failure should lead you to contemplate that the problems is government.

        BTW if libertarianism is so far out radical – why is it that the relationship of the nations of the world to each other is even more extreme – anarcho-capitalism ?

  47. Roby permalink
    March 16, 2017 10:37 am

    “I keep repeating to you OVER AND OVER”

    Something we can agree on! Yahoo!

    You just have not processed (after how many presidential terms? of these exchanges?) that you are not a prophet in my eyes bearing tablets and that in general I believe you are a fanatic who distorts everything to fit to your religion.

    When oh, when am I going stop resisting and to become your disciple or at least join your religion you wonder. And you will keep on wondering.

    Вот неугомонный старик! Шуток не понимает.

    • dhlii permalink
      March 16, 2017 11:28 am

      And in all of these exchanges – has the government solution to anything actually worked ?

      I am not the one selling tablets. You are.

      It is not “my religion” that has failed – repeatedly. It is yours.

      “When oh, when” are you going to quit buying false promises of politicians ?

      I’ll tip my hat to the new constitution
      Take a bow for the new revolution
      Smile and grin at the change all around
      Pick up my guitar and play
      Just like yesterday
      Then I’ll get on my knees and pray
      We don’t get fooled again
      Don’t get fooled again, no no

      • Roby permalink
        March 16, 2017 12:02 pm

        Ironically that is the first song I ever performed lead vocals on in a band Jeez 40 years ago in NJ (badly).

        Dave, I would not dream of converting you from your belief, it would break your heart.

        But you are dead set on changing my ideas which you caricature as being the opposite of yours. They aren’t.

        What I believe in is that neither the free market nor government are THE Answer, they are two inevitable forces in tension. I hope that neither side vanquishes the other, tyranny would result. That is “my religion.” It has not failed. Seen on the large scale the tension between the free market and government enabled the civilization that has built the western world.

        You are hard-selling the idea that this balance of forces approach is a failure because there are problems and imperfections. I’m not buying your dismal view. Apparently I’m the optimistic one here. Why don’t you have some respect for my little ideas and leave me in peace?

        (Dduck would have handled all this long ago with 10 words or less and freed himself from the perpetual argument with Dave trap.)

      • dhlii permalink
        March 16, 2017 6:14 pm

        Reality does not care what you or I beleive.

        That is one of the more important points I am trying to get through.
        I am either right, wrong or partly right.
        There is no ‘it is just my oppinion” with respect to what is true or false.
        We may not know exactly what is right, but that does nto mean all views are equal.

        We do have evidence. And the evidence demonstrates that top down approaches – whether collectivist, redistributive or not substantially underperform bottom up solutions to the vast majority of problems.

        I am constantly saying “government fails” that is not strictly speaking true.
        What is true is that government tends to underperform even random chance at making choices.

        The USSR did not collapse because its people were worse off than in 1917.
        It collapsed because the standard of living in the west was rising faster.

        It is likely that Venezuelans will abandon socilialism, But if they do not it just means Venezuela will do poorly – not everyone will die.

        I am not opposed to “hybrid” solutions. That was the position I started from.
        But the more time I have spent looking into things the more aware I am that government can not even do things like the roads better than they would be done privately.
        And infrastructure is something that government has a better than average track record at.

        I am NOT selling perfection – that is not attainable.

        With respect to “balance of forces”.

        1). The burden is STILL on those using force to justifiy it. To at the very least demonstrate it will perform better.

        If we look at PPACA – it has a few positive attributes.
        It has a number of negative ones.
        If those balanced – which they do not,
        it would still under perform the mess that preceded it.
        It costs about 1.6T/decade to on the whole be LESS than what preceded it.

        2). I think it is up to YOU to define what the limit of government is.
        I have given you my limits to government. They are fairly well defined,
        the dovetail nicely with both what data we have on what works AND with our concept of morality as it has evolved over the past 7000 years.

        If you can not define the limits of governmnt, you have unlimited government and it should be obvious that is going to fail.

        3) Aside from the moral justification, and the practical justification – does your solution work, you still have the usually unfactored cost and scale of government.
        How much of our human resources are you going to dedicate to the mostly unproductive effort of governing ?

        The more law you have not merely do you increase compliance costs, but you increase enforcement costs.

        I can probably hit several other points, but I would note – only the first argument
        is “ideological”

        Your optomistic ?

        I trust that what has solved our problems in the past – us mostly without governmnt, will continue to do so in the future. You have placed your trust in something that even the left thinks has a horrible track record.

        You do not even have a solution to the problems of corruption and rent seeking that does not involve:

        Wishing that we will magically elect incorruptible politicians.
        AND using force to censor the voices you do not want to hear.
        Which means making a choice for all of us of what voices are have the right to be heard.

  48. Roby permalink
    March 16, 2017 11:44 am

    Dave, I never was a fan of Ocare. I agree with Priscilla that it was done badly because one party rammed it down the other’s throat without compromise. I have said that consistently for 8 years or so now. Never changed my mind.

    Priscilla’s story of the young man who lost affordable care fits my 3 kids cases pretty well. I see the harm, its in front of me. My liberal kids don’t love Obamacare.

    I’m all for something better.

    Your perpetual anti-government rant is a red herring. Government IS involved in this and you are smoking something if you think that you will get it out. You are being irrelevant if that is your position.

    The old position that it was OK that there were tens of millions of uninsurables because they were fine because bankruptcy is there is save them ended with Ocare. Even the GOP had been making moves to try to address this, its a serious issue, Ocare was crafted frankenstein like out of GOP spare parts if I understand correctly.

    What is in front of us now is a painful political struggle to find a compromise.

    Your free market, let there be uninsurables and let them go bankrupt approach is not on the table. Post 50 times per day and try to beat me into submission to buy into your religion if you want. Uninsurables is a concept that is dead now in America post Ocare, not because of the free market side, the Ins Industry side, which established the concept and would have kept it forever but because of your dreaded government and regulation side. Three cheers for Government!

    You will now most likely go on a binge of posting to justify bankruptcy as the healthcare safety net although you have no chance in hell of persuading me. Knock yourself out.

    • dhlii permalink
      March 16, 2017 12:16 pm

      Which do you prefer – individual bankruptcy or national bankruptcy ?

      Regardless, whatever we consume – including healthcare is paid for by what we produce.

      That BTW is just a permutation on
      Standard of living rises when we produce more value with less human effort.

      YOUR entire argument is that we should have more healthcare available to consume.
      And your vehicle for doing so is government force.
      That inhernetly means we shall have less of something else.
      Worse it means we shall have less of something we chose, in return for more of something we did not.

      It is not BTW my free market.

      It is just free individuals making their own choices. – you me, everyone.

    • dhlii permalink
      March 16, 2017 12:22 pm

      I have no idea what it is you think you mean regarding “uninsurables”.

      The FACT is we do not have the resources to provide every person with serious health problems every possible existing means of care.

      That will NEVER change. ObamaCare can not change that, RyanCare can not change that. Nothing can change that.

      If I grasp what you are arguing, you seem to be saying that post obamacare the political circumstances have changed such that arguing that the sun will rise tomorow is off the table.

      Yes, a few of the signifcant ideas from ObamaCare – primarily the mandate, came from some obscure heritage paper from the 80’s.

      I do not recall defending everything republicans have done.
      I have not as of yet taken a position on RyanCare.
      Regardless, I am not a republican.
      At best the GOP is the “lesser evil”.

    • dhlii permalink
      March 16, 2017 12:27 pm

      But your not for something better.

      Your still hung up on the idiotic idea that government can somehow magically make healthcare more available and cheaper.

      The two are inherently connected. Healthcare becomes more available ONLY when it becomes cheaper.

      Even government programs are premised on that.
      ObamaCare becomes more available by giving healthcare to some and subsidizing others.

      The fundimental problem is that only appears to lower the cost. In reality it raises the cost.

      Worse the markets are not fooled – and the attempt of government to lower the cost raises the cost in another way.

      The result is LESS, not more.
      While it MIGHT mean more healthcare, it means less of whatever we would have chosen ourselves.

      Anyway when EVER, has government sustainably made anything cheaper ?

    • dhlii permalink
      March 16, 2017 12:30 pm

      You do not seem to grasp – it does not matter what is on the table politically.

      We can impliment whatever bed ideas we want,
      and they too will fail, and we will do this again.

      We can compromise, or work together, or fart butterflies.
      But that will not produce a plan that works.

  49. dduck12 permalink
    March 16, 2017 9:26 pm

    Too bad there isn’t an equivalent of Imodium for this blog. My apologies Rick for being blunt. You do have a fine intelligent blog.

    • Priscilla permalink
      March 17, 2017 11:54 am

      Not to worry, dd12. We’ve always been a wordy bunch. You are a good influence, but even your inspiring brevity can’t change things quickly. Rome wasn’t built in a day. 😉

    • dduck12 permalink
      March 17, 2017 8:27 pm

      Priscilla, I don’t buy green bananas so it seems more like Nirvana or Gomorrah that is being built and in a Pluto year. Sorry, I gave up looking for a pony in verbal dung heaps which clog the highway of intelligent discourse. BTW, you do a Goldilocks comment style.

  50. March 17, 2017 10:08 pm

    Roby, this afternoon you asked my opinion concerning health insurance and if I thought it improved health outcomes. I deleted the e-mail and I tried to find the post here, but with so many I gave up and just decided to start a new one instead of attaching it to your comment..

    Does health insurance improve health outcomes? Right now this has two answers from my perspective. I will give you my opinion based on one, what happened at my hospital when I was there and two, what appears to be happening since the PPACA became effective.

    One, the type of insurance you have makes a complete difference. In many areas, there may be insurance sold, but many physicians may not accept that insurance as reimbursement, so you have to find one that does and then is that the doctor best for your condition. This is the same for Medicaid. You may find GP’s taking that insurance, but if you enter the hospital with a cardiac condition, you may leave with a prescription for blood thinners, while the patient in the next room gets a stent to unblock an artery because they have a cardiovascular surgeon as their attending physician, while the medicaid patient has a cardiologist attending.

    Two, the data is not old enough to make reliable projections concerning the health outcomes since the ACA in my opinion. But all the indicators suggest that people that are able to access services by a GP for preventative care will be healthier in future years than those that do not. For instance, colonoscopies have increased in numbers since Obamacare as it is a required covered service. How many cancers that would have shown up in 10-15 years that have been stopped since small polyps now are removed and not allowed to grow into cancer is hard to put a number on, but it is happening. How many women who have had pap smears that would not have had GYN coverage and not had that screening that has prevented invasive cancer is hard to determine, but I suspect that is happening. And that goes for all the other screening procedures like mammograms and how many lumpectomies have occurred compared to a total removal of the breast. Hypertension control now will prevent or delay future heart and kidney problems as will a host of other preventive services that will prevent or delay other problems related to not controlling those issues. So I am of the opinion that health insurance does improve health outcomes, but I think more data is needed to give a totally reliable answer.

    Hope this is what you were asking.

    • Roby permalink
      March 17, 2017 10:23 pm

      Huge thanks for taking the time to answer that so carefully. It seems so intuitive, one would think that this whole situation provides a basis for a huge amount of data gathering and analysis. I easily found a little, which supports your opinion, but I would have expected to find more.

      • March 17, 2017 11:32 pm

        ” I easily found a little, which supports your opinion, but I would have expected to find more.”

        This is because the information you are looking for is more scientific than political. With political information, the writer can say almost anything including “insurance increases life expectancy” even though that has not been proven. In science, it take years for some things to be proven and documented.

      • dhlii permalink
        March 18, 2017 8:03 pm

        Actually the information is neither political nor scientific.
        It is economic.

        Your own writing demonstrated this perfectly.

        You say PPACA increased the number of colonoscopies.
        I agree that is likely to produce a small decrease in colon cancer deaths over the long run.

        And when it does Robby will find a study that says so, and jump up and down and say “see this proves I am write – a measurable improvement in outcome from better health insurance”

        What you are “right” about is that a specific combination of money and policy results in a postiive long term change in colon cancer.

        That is not at all the same as a NET change in outcome.

        Both the oregon experiment and the rand study looked at ALL outcomes.
        While they did not find many instances – such as colon cancer where there was a specific positive change – I would not have been surprised if they had.

        But the KEY finding is not – did colon cancer go up or down.
        It is did mortality rates go up or down.

        And the answer is they were unchanged.

        AGAIN, Health insurance is about protecting WEALTH – not HEALTH,

        Unless you are going to significantly alter the societal resources devoted to

        healthcare overall you are not going to change healthcare outcome.s.
        But you MIGHT change colon cancer outcomes.

        Which Is why Roby can likely find some studies that atleast hint of positive benefits from PPACA.
        But PPACA can not be NET positive.

        Politics does not trump the laws of economics.

        Science SOMETIMES allows us to create more value at less human cost.
        But absent doing so – Science and scientific studies do not change the laws of economics.

        Absent the creation of more value at lower human cost – all gains in one area MUST be paid for by losses in others.

        That which is seen and that which is unseen.

      • dhlii permalink
        March 18, 2017 7:51 pm

        No it is not “intuitive”, what you call “intuitive is a permutation of the “broken windows” fallacy.

        Which Bastiat address almost 200 years ago.

        This is at the root of our argument over health insurance and outcome.
        You think it is intuitive – but it is actually not.
        IT “feels” like is should. Intuitive and feeling are not the same.
        Those things that are actually intuitive also work logically.
        Intuition means little more than we grasp that a result follows logicially – without having to do all the work of logical analysis.

        When we “feel” the result should be one thing – but it is not – that is not “intuitive”.

        The most common reason for these failures – is shallow reasoning.

        The archetype example of the broken windows fallacy is concluding that a brick thrown through a store window increases economic activity.
        The shopkeeper must repair the window, and the glazier than spends on something else and so on and so forth and “intuitively” the economy grows.

        But the reality is that it does not. Because the shopkeeper had a loss – the broken window.
        When it is fixed he is worse off than when he started.
        But if that window did not get broken – the shopkeeper would h ave done something else with his money.

        Ron noted that PPACA increased colonoscopies.
        What he did not note is that it decreased something else.

        This is also why you will not see a change in overall trends as a result of PPACA.

        You MIGHT see improvements in things that PPACA favors.
        But for every gain there must be a loss somewhere else.

        We only have the wealth we have produced each year to consume.
        There is no more. If we buy more cars – we must buy less of something else.

        We can improve healthcare ONLY by producing greater value, at lower human cost.

        Doing more colonoscopies does not produce greater net value – unless you managed to do more colonoscopies at LESS human cost. In all other cases more colonoscopies comes at the expense of something else.

        That which is seen and that which is not seen – but must be present always.

        Economics is not zero sum – because we can and do consistently produce greater value at less human cost.

        But what we can consume is zero sum with what we have produced.

    • dhlii permalink
      March 18, 2017 7:36 pm

      You answer comes down to “I don’t know” and that is OK.

      But what we do know is that Both the Rand Study over 40 years and vcontinuing, and the results of the Oregon experiment still show
      Health insurance does nto change outcomes.

      I am also not happy with this “insurance equals access” nonsense.

      No it does not. The poor got to ER’s all the time, no insurance, plenty of access.
      The rest of us are always free to buy whatever medical service we choose.

      You made some distinction between medicaide patients and private insures.

      I would like a BMW, I can afford a honda.
      I have access to a car, regardless,

      We are not entitled to Lamborghini healthcare.
      If you decide that we must as a nation somehow provide the best possible care to everyone all the time – we go bankrupt it is that simple.

      There is no working model of an economy that allows everyone to have the best of even a single part of that market without that economy failing.

      One of the reasons that things have prices – is to limit consumption – not merely to what we as individuals can afford, but to what we as society can afford.

      You noted that PPACA mandated colonoscopy coverage – and that increased the number of colonoscopies and probably reduced the number of deaths from colon cancer in the long run.
      My mother died from colon cancer – so that matters to me.

      At the same time given that the amount we are spending on healthcare is fixed, increasing colonoscopies means decreasing something else, and that means an increase int eh numbers dying from that problem.

      You keep trying to pretend there are unlimited resources,
      There are not. Single payer systems still have to ration healthcare – they just do not do so using price, Long wait times is one method.
      Completely nationalized healthcare STILL has to ration healthcare – because ultimately – individually or collectively there are limits to what we can afford.

      As you noted – in the US medicaid patients do not get the same care that private insured do. I am still personally free to decide I want better healthcare – and I that I will pay for it.

  51. Roby permalink
    March 18, 2017 10:15 am

    This will be my one, yes, much too lengthy, word soup for the day. Both to spare mailboxes, and because I got fish to fry.

    “With political information, the writer can say almost anything including “insurance increases life expectancy” even though that has not been proven.”

    You are correct of course. But what does that mean? No matter how many studies are performed over how much time, it never will be statistically proven. Its the nature of that type of study. Statistical studies can’t prove whether the Mediterranean diet is helpful, which type of fat is better, whether taking fish oil is good for your health, or whether having a glass of red wine every day is helpful or harmful. First of all, all these issues are lost in the sea of hundreds of other genetic and lifestyle factors. The signal can never rise above the loud noise of a population study or metastudy unless its something as drastic as smoking many cigarettes for many years, being an alcoholic for many years, or being morbidly obese for many years.

    Time, as you say, is needed for such proof, in this case, literally a lifetime, which is how long it would take for the full effect of a change in insurance policy to work its way through the “experiment”. So, if Obamacare remained unchanged for the rest of time you could start to see the hint of an effect in decades. Its only a subpopulation lets call it 10% that would be seeing a positive change. (I’ll give Priscilla’s argument a point here, because I am not a Ocare fanatic ,and I’ll admit that its likely that another subpopulation is now in a Worse state insurance wise under Ocare and will have worse outcomes to balance against the better outcomes of the newly insurable group.) You still could never prove anything conclusively about the link between insurance and life expectancy. If cigarette smoking ceased completely tomorrow it would take decades to show up in life expectancy and in those decades many other events, positive and negative, would have occurred to mask the effect. Proof is impossible.

    Support for the existence of a correlation, on the other hand, is very possible, especially when you involve the other half of thinking about such problems: Mechanism. Is there a plausible mechanism by which having health insurance would lead to better outcomes, individuals who live longer because they got better health care, especially preventive health care?

    Clearly, yes, there is such a mechanism. And, it cuts both ways, if Ocare pushed another subpopulation out of the market, then it affects them too.

    That’s as strong as its ever going to get for facts to support increasing the percentage of the population with health insurance.

    Unfortunately, this leads back to arguments for Universal health insurance or Universal single payer.

    And yes, I know that the the only way to actually have a system that comes close to providing the idealistic dream that every person would have access to as much high quality health care as they need would be to increase the amount of everything, hospital rooms, doctors, nurses, machinery, everything. More care, bigger system, more expensive. And our system is already the most expensive, so…. Efficiency? I hear Dave hollering about efficiency. Efficiency is a codeword that translates to lower salaries to the people who do the dirtiest work in healthcare, unless someone invents a pill that cures cancer and another one that cures heart disease and a third one that cures obesity.

    This is a really incredibly difficult problem to make progress on. A lot more scientific data would be helpful, not to prove anything, but to get an idea of the mechanisms and complications that are really at work. The purpose of having that data would be to try to choose the best alternative among potential health care systems. Its would be a hard problem for a fair objective all powerful God to tackle, in our case its the political system tackling it, which means not just the politicians but you and me.

    But no, Dave, you cannot just remove healthcare from the domain of government and thus politics, although as sure as the sun rises in the east there will be another huge pile of sweeping untrue generalizations about “What we know is that…’ which actually always means “What Dave’s religion believes is that…”

    • March 18, 2017 12:29 pm

      Roby, I think we agree on this.

    • Priscilla permalink
      March 18, 2017 6:23 pm

      I think that the government has a role to play in healthcare and insurance. But it is a regulatory role not a central role. The problem that we have now, as a result of the ACA, is that people believe that universal healthcare and healthcare insurance is a a right, and, further, that healthcare is defined by politicians. So, for example, abortion and sex-change operations are defined as “healthcare” under the ACA. Birth control is defined as “women’s healthcare.”

      As a rule, none of these things are necessary for health. That doesn’t mean that, in certain circumstances, such as a situation in which pregnancy endangers the life of the mother, they can be necessary as emergency healthcare procedures ~ or that there may be some who feel that their mental health would be adversely affected by not having a sex-change or an abortion. But, as a rule, no.

      And if routine healthcare were affordable, as in you could walk into your doctor’s office, pay $25 for an exam and get a bottle of antibiotics for $5 for your infection, we would only need insurance for catastrophic illness or injury. Things like mammograms could be done at places like Planned Parenthood, which could also perform abortions for a fee. Just as plastic surgeons charge for their non-essential services.

      When I worked in the corporate world, my field was wellness and fitness. J&J believed that a healthy workforce was a productive workforce, and put millions toward building state of the at fitness centers and developing wellness programs (Smoking cessation, weight loss, diabetes control, stress management etc) with the intention of making these things free to every employee, throughout the country. And, guess what? It was like pulling teeth to get most employees to take advantage of any of them. I used to contract with a mobile mammogram outfit that would come to the workplace and provide mammograms for $40, and after 4-5 years, I stopped bringing them in, because not enough women signed up.

      I don’t know what the answer is. I’m sure that single payer is the wrong way to go, but I’ll be damned if I know the right way.

      • dhlii permalink
        March 18, 2017 10:44 pm

        Bottles of antibiotics are readily available for $5 – without a perscription or doctors visit.

        You may not legally purchase them for human consumption.
        But you may legally purchase them.
        And unless you Samsung TV rats you out how you consume them is your own business.

        Soon enough and affordably will we be able to manufacture many many drugs on our own in our homes. Again ones we are not legally allowed to, as well as ones we are legally allowed to.

        The same technological advances that allow us to manufacture our own AR15’s in our basement without licenses, or registrartion or background checks will gradually come to most everything.

      • dhlii permalink
        March 18, 2017 10:45 pm

        Your experience at J&J merely demonstrates that it is really hard to change human behavior.

        Passing laws does not make that easier

      • dhlii permalink
        March 18, 2017 11:00 pm

        I beleive the average cost for health insurance for the typical family in MA in 2013 was 17K/year The cost for castastrophic coverage is a bit more than 1200/year

        So who can not manage there ordinary family health expenses – doctors visits etc for 14K/year ?

        Yes, I know there are rare examples where that is not true.
        But that is not the case for 95% of us.
        So why are we all CHOOSING to pay so much ?

        That catastrophic pan is going to cover most everything that all of you are worried about – heart attacks, cancer, ….

      • dhlii permalink
        March 18, 2017 11:15 pm

        I head to see an orthoped on Monday morning.

        I have a problem with my left shoulder.
        I know what the problems is to 95% certainty.
        I know what needs to be done.
        And infact, even if I were wrong the doctor is nearly certaint o do exactly as I predict,
        because the way you get to the 5% is if the treatment for the 95% fails.

        I need a cortesone shot,
        a perscription for a super duper NSAID
        and a persription for physical therapy.

        The actual cost of the cortesone shot is negligable – but there is no means to get one without a doctor – so I (or my insurance company) must pay for the visit.

        I can skip the super NSAID by overdosing on standard NSAID’s for the same period of time.
        But since the doctor is going to write a persciption it is more comfortable to take one pill once a day than lots 6 times a day.

        I know exactly what the physical therapy will be – and I could just join a gym for 6 months and it will cost less than the copay for the PT.
        Though I would not get the muscle and tendon stretching or the supervision from the Gym.

        So tell me again why it is we should not be paying for ordinary healthcare out of pocket ?

        If I did not have insurance I would not go to the doctor – but I would take lots of ibuprophen and join a gym for 6 months.
        And if the problem was still present – then I would think about seeing a doctor.
        I would be even more inclined to do that if I could get a cortesone shot withot going tot the doctor.

        If no one had insurance the doctor would have to compete with the probability that most of his patients would do as I might.

        The doctor visit woud have to be cheap enough that I would pay a small premium for getting told by a doctor what I already know.

        The above is true of nearly all doctors visits.

        Why do you go to the doctor if you have the flu ?
        They can not cure it. It will go away on its own.

        I have a lung issue that results in a bacterial infection nearly every year.
        I go to the doctor for that – I get antibiotics and codiene so I can sleep.

        I can get antibiotics myself cheap. When I was young codeine was available in the drug store cheap.
        Today I have to go to the doctor. I have health insurance because government has made dealing with my cough many times more expensive.

      • dduck12 permalink
        March 18, 2017 11:34 pm

        Bismarck started nations on the road to taking care of a nation’s health care back in 1893.
        The Bismarck Model survived in Germany for over 100 years and should be part of a model for our nation’s fragmented and dysfunctional health care system.
        Unfortunately, it and variations of it are NOT really insurance, they are social programs, and that drives most conservatives/libertarians batty and other varieties of Reps wary.
        BTW, Although I initially registered to vote as an independent, I had to, because of NY’s stupid primary voting rules, register as a Rep. I generally vote Rep anyway, but my point is that the Reps are wrong and SP is the way to go.
        Will it cost a lot, you betcha. Will some people get rationed, have delays for service and procedures, yup. Will the overall health of Americans be better in the long run, I think so. My 3 cents.

      • dhlii permalink
        March 19, 2017 2:50 pm

        You want to use 19th century germany as your model ?

        Public education also came out of 19th century germany – the better to prepare the people to follow orders and be cannon fodder.

        Bismarks interests in the health of the german people had nothing to do with individuals it had to do with ensuring the strength of the nation in wars of agression.

        The Nazi’s were also big health freaks and ran national schemes of health care and other benefits – whatever they thought served the interests of the state.

      • dhlii permalink
        March 19, 2017 2:56 pm

        Of course they are social programs – they are socialism – and like all such programs they FAIL.

        There is still only ONE WAY to raise standard of living.

        Produce greater value using less human resources.

        Unless what you are suggesting accomplishes that – it HARMS our standard of living.

        IT is our drive to meet our own needs that results in our meeting the needs of others.
        When you attempt to short circuit that – everyone is worse off.

        Has socialism really succeeded anywhere ?
        Even the Swedes and scandanavians have all kinds of trouble making this work.

        The swedes discovered in the 80’s that Swedes outside of sweden had standards of living about double what they had inside sweden.
        Worse when they returned to sweded their standard of living DROPPED.

        The swedes came to realize their “socialism” was the cause of their lower standard of living, and they have subsequently been trying to roll it back.

        But socialism is hard to get rid of once it is entrenched.

      • dhlii permalink
        March 19, 2017 3:06 pm

        When you answer that it will cost alot – you have already demonstrated it is a bad idea.

        What you are saying is that government will have to spend more of our wealth on healthcare – than we would have chosen to spend on ourselves.

        By definition that means we will be WORSE off not batter.

        What we spend on healthcare (absent government interfereance) directly reflects the value we place on healthcare. If we value it more than the other things competing for for consumption then we would direct more of our wealth to healthcare.

        When you say it will cost alot – you are saying it will cost more than we wanted to spend.

        You are saying we will have less to spend on other things that we value.
        Whether those are cars or houses or kids or education, or entertainment or vactations of time with our loved ones.

        In the unlikely event you are correct and we live longer – which is highly unlikely as there is very little difference in life expectance between the US and SP countries and none at all if you adjust for demographics, regardless, if we live longer – we will do so with less of mony other things that WE chose over healthcare.

        What I do not understand is why you think it is moral for YOU to dictate to everyone else ?

        No one is stopping you from spending more on your own healthcare – if that is your value.

        But you are looking to force all of us to spend more whether we choose to or not.
        How is that moral ?

        Why don;t I or my neighbor or each of the rest of us get to make our own decisions as to how we live our lives ?
        We do you get to dictate to others how they must live ?
        What they must value ?

      • dhlii permalink
        March 19, 2017 3:07 pm

        In other words you want to force all of us to spend more – get crappier service, get less care and have to wait longer for it and all for what you claim is our own good ?

        We have the equivalent of the NHS – with the VA. How well does that work ?
        Why do you want to replicate that on a national scale ?

      • Roby permalink
        March 19, 2017 9:32 am

        Priscilla, we all have our personal experiences that shape our opinions. Yours are pretty fascinating and I certainly respect them, including (especially) having seen a child through cancer.

        In the end, you and I can agree on one thing at least, that this issue is so deep and complex that any rational person who thinks about it long enough to see its complexity is left humbled.

        I have no idea what the best path forward is either, though I can definitely find paths I disagree with more (disowning my previous comment, ha).

        Having government be a provider rather than a regulator of healthcare was set into our system long ago, one may be agin it in theory, but its too wired in (like for example, the existence of tens of millions of assault rifles and high capacity magazines in the hands of citizens, some of which get used to massacre innocents every year) to change. In short, I would like to remove all those 20 round magazines from America and you would like to remove government from any but a regulatory role in healthcare, but neither can actually happen, which leaves both of us angry and frustrated, and, to a certain extent, irrelevant.

      • March 19, 2017 12:29 pm

        Not sure if this is pertinent to your conversation, but I will point this out anyway.
        Government became a provider of healthcare in a huge way when Medicare and Medicaid was approved.
        Then in the early 00’s after many years of experimentation, the federal government approved the Medicare Advantage program, which is the program where the costs that would have been generated by Medicare patients are paid to insurance companies that provide managed care policies for subscribers at a fixed amount. There are minimum requirements that these plans have to provide, but there are many different plans offered nationally that cover many different services and have many different premiums.
        In 2016, over 30% of the Medicare population now subscribe to these plans as they save money and in some instances, provide services that the government program does not.
        As a by-product of these plans, the government knows exactly what it will cost since the insurance companies receive a fixed fee AND I suspect once this population reaches closer to 40% (since it grows each year), there will be much less resistance to changes in this (so called by politicians) entitlement program.

      • dhlii permalink
        March 19, 2017 3:37 pm

        To the extent possible – even when we chose to do something through government that is stupid and immoral. We should atleast choose to do it the least stupid and immoral way possible.

      • dhlii permalink
        March 19, 2017 3:20 pm

        Actual assault weapons are illegal.

        All long guns combined – that would be all AR15’s or similar, all shotguns, all hunting rifles, … combined are about 2-3% of all US guns – that MIGHT be 10M total long guns.
        It is not 10M assault rifles it is not 10M AR15’s.

        There were about 8000 firearms related deaths in 2014 – of those 260 were from long guns. That is about 3%.

      • dhlii permalink
        March 19, 2017 3:23 pm

        There is a vast difference between what you would like and what I would.

        You seek to restrict peoples freedom by force.

        I do not seek to restrict others freedom at all, much less by force.

        There is no moral equivalence between:

        I want to enslave you
        I would to make you free.

    • dhlii permalink
      March 18, 2017 10:08 pm

      Can things be proven in the political arena – probably not.
      Politics – particularly that of the left is indistinguishable from religion.

      Sometimes given enough evidence, people cease to beleive, but proof is hard to come by.

      Can anything be proven ?
      Tomorow someone could take two iron balls to the top of the leaning tower of Pizza and drop then and they, could accelerate at completely different rates.
      But I would not hold my breath.
      Many many things are demonstrable to a standard that most of us accept as proof.

      I have to thank Ron. His colonoscopy example made it crystal clear what the problem with the “studies” you provided was.

      Absolutely games with the parameters of health insurance can have clear effects on the outcome of specific health issues.
      More colonoscopies almost certainly means less deaths from colon cancer.
      But it also means less of some other form of healthcare and more bad consequences from less of that.

      You are constantly running afoul of the seen and unseen consequences of your policies.

      As I have noted, the major studies of the NET EFFECTS of health insurance have repeatedly found, no effect on health outcomes.
      For the most part they have also found nothing in the way of narrow changes.
      But even if they had – that does not alter that changing the parameters of health insurance are not going to change trends in overall mortality rates.
      But they could change trends in colon cancer – at the expence of trends in one or many other things.

      As to what constitutes acceptable statistical proof ?

      Somebody saying something probably might have some impact – that is wishful thinking.

      As statistician saying with an rvalue of something like .95 health insurnace has a zero correlation to overall health outcomes – maybe that is not proof for you, but it is good enough for me.

      I would suggest looking into epistemology – that is the science of knowledge.
      It provides us the tools for addressing such issues as – if there is no absolute truth does that make all asserions equal – the short answer is no.
      The absence of absolute truth does nto preclude absolutely false, or atleast absolutely false in the constraints of this reality.
      Nor does the absence of absolute truth preclude us from knowing that some things are more likely true than others.

      In short – in controvertable proof of anything ? Nope.
      Good enough for most of us ? Yup.

      The effects of smoking btw are not all that drastic.I beleive the acturial results are it has an average 6 month reduction in your life expectance.

      As to all those other issues – are we debating those ?

      Time is a factor – but it is not the only factor, not the most important.

      In those complex systems that involve human behavior – it is very very rarely possible to get from models, mathematics and statistics – to human behavior.
      But it is quite simple to get from human behavior to working models that prove statistically valid.

      This has been a major fight in economics for a long time – but it applies to all science that involves human behavior.

      Human behavior is infinitiely variable, but inside that infinite variety indisputable patterns exist.

      All left and statist ideologies presume that human behavior is highly maleable with only the smallest use of force.

      Reality says otherwise. It has taken centuries of significant amounts of government force to slowly reduce human criminal conduct – and even that arguably did not change as a consequence of government force (atleast not directly), but as a result of improving standard of living.

      Yet the left wants use to beleive that hundreds of thousands of laws and regulations – that most of us are not even aware of are effectively changing our conduct.

      BTW returning to your argument – as YOU framed it.
      If PPACA takes decades to produce a detectable change at a cost of trillions of dollars a decade – then it is a failure.

      BTW that – some subpopulations are better off, and some populations are worse.
      Just another way of saying “that which is seen and that which is unseen”.
      Normally the postive impacts of legislation are obvious and the negative ones are much harder to see. At the same time, normally the positive effects are smaller than the negative effects.

      As to your mechanism argument – it fails – again from the broken windows fallacy.
      Because your “mechanism” argument fixates on looking for positive impacts – which can always be found, and fails to even think about that what matters is NET impact.

      The Nazi’s found innumerable positive impacts to exterminating Jews.
      Even today there are many benefits to society that resulted from Nazi Attrocities.
      Nearly all our scientific work on hypothermia came from experiments conducted by the nazi’s

      The point – there is nearly always some visible positive effect of nearly anything.
      What matters is the NET.

      Most of us would be prepared to cede the knowledge gained from NAzi experiments on Jews in return for millions of lives that were lost.

      So no, your mechanisms argument is meaningless, because you have to look at the whole, not small parts.

    • dhlii permalink
      March 18, 2017 10:09 pm

      I can not conceive of any logical way that your argument – even accepting it at its strongest leads you back to the need for Single Payer or universal healthcare.

      Saying something does not make it a valid argument.

    • dhlii permalink
      March 18, 2017 10:16 pm

      Reading your entire post. I can not understand why you are not libertarian.

      You grasp that most things are incredibly complex, that the data does not exist to prove effects,

      You seem to beleive that it is acceptable to perform gigantic experiments on the entire population for the purpose of gathering data – that you likely can not get, because controlled experiments on humans are extremely hard to do.

      Essentially you have conceded that you do not know the benefits going in, and only hope to prove them decades later – and still seem to beleive that you can impose significant cost and restrictions in liberty in the hope of a small positive benefit.

      The only difference I can see between my remarks above and yours is “spin”.
      And “my spin” is the principles I have been repeating over and over.
      You can not use force against others without justifying it.
      Demonstration to a HIGH degreee of certainty of a net positive result is REQUIRED, but not sufficient for justification.
      You have conceded you do not have that – pretty much ever. That you are imposing froce in the hope of good results.

    • dhlii permalink
      March 18, 2017 10:19 pm

      Of course healthcare is not in the domain of government.

      I am not removing it, you are trying to add it.

      Regardless, in your ideology what is NOT in the domain of government ?

      Further of what is in governments domain – why is one approach acceptable and the opposite not ?

      If government is allowed to impoce universal health insurance on is, can’t is impose no health insurance at all on us ? I can make credible arguments for the latter, but that does nto matter. What principle do you have that permits imposing PPACA that does not equally allow government to forbid health insurance altogether ?

    • dhlii permalink
      March 18, 2017 10:33 pm


      That vast majority of my arguments are rooted in a few things:

      Logic – if my logic is flawed there are rules for logic and you should be able to easily disprove my assertions. Logic is immutable.

      Morality – and specifically morality resting on the first principle that free will is required for and moral system. Again you are free to challenge that. Though I would note that centuries of philosophy rest on that.

      My three legitimate roles for government flow directly from the two items above.
      As does limiting the domain of government to those three things.

      I also continuously assert that:

      increasing standard of living requires producing more with less human effort.
      Are you disagreeing ?

      The items above are “sweeping generalizations”,

      There is something very important about “sweeping generalizations”.,
      If they are false – it is trivial to prove them false.

      Yet, that has not happened.

      I am prone to making some sweeping generalizations that are false – those above are not.
      Such as that government always fails, or to demand examples where some government policy has ever succeeded.

      Almost nothing actually fails all the time – not even government.

      My POINT is that it is really hard to impossible for you to think of the examples that refute these “sweeping generalizations”

      So lets take all the sweeping generalizations further.
      Even if the ones I think are first principles are still no different from the ones I know are false. They are still true 99.99999% of the time.

      If government does not succeed more frequently that every other approach – then government is an unacceptable solution to a problem and that problem is out of the domain of government.

      In otherwords my “sweeping generalizations” need to be more than occasionally false.
      They need to be nearly always false for your ideology to even pretend to be moral.

    • dhlii permalink
      March 18, 2017 10:37 pm

      With respect to the those infrequent occasions that my argumets rest on facts.

      If those facts are unsupportable – again that should be easy to demonstrate.

      With respct to the “health insurance protects wealth not health” argument.

      I have given you two very large studies – done by groups expecting to prove the opposite that look at the ENTIRE effect of health insurance and found no NET benefit.

      You have countered with a bunch of papers that claim it is probable that there is some specific benefit.

      The latter neither refute nor are inconsistent with the former.

      No NET benefits, does not mean no benefits at all.
      It just means whatever benefits there are ar no greater than the harms.

  52. Roby permalink
    March 19, 2017 8:20 am

    I came home at 1:00 am and I used the find function to pull down the posts of yesterday, March 18. There were 27. One each from myself, Ron, Priscilla, and Dduck, the other 23 from Dave, informing us of important ideas like “calling Mohamad Ali a wimp does not make him one. ”

    As someone famously said “that’s not writing, that’s typing.”

    Dave, your best pieces of writing come when you are not in this torrent mode. I doubt anyone is more than skimming a few of your posts at this point. A find search for dhlii reveals that you have posted 200 times in about a week.

    I’d call that more like congesting the ducts of thought than discussion. A person needs to use the find function to determine that anyone else posted anything at all.

    I’ll admit that I myself am obsessive. There must be a different word to describe your level of mental dumping.

    • dhlii permalink
      March 19, 2017 3:12 pm

      Is there an argument in your response ?

      You are free to post or not as you please. As am I.

      I generally post while I am doing other things.

      I enjoy posting.

      I do it for me – not you.

      If you do not wish to read – don’t.
      No one is forcing you.

      So why are you complaining about something that does you absolutely no harm ?

      More of the problems with the left.
      You can not get that you do not have the right to control other people.

      You can not control the health care that others may/may not have.
      You can not control how much someone posts.

      • Roby permalink
        March 19, 2017 4:35 pm

        “You can not control how much someone posts.”

        Nor did I try to or expect you to do anything other than continue to post for yourself.

        Posters here from every part of the spectrum over the years have made the same comment I just made, this is not “another problem of the left” its simply a fairly typical reaction to your using this blog to take a prodigious mental dump for weeks on end until you get bored and move on to some other lucky spot to post for yourself on.

      • dhlii permalink
        March 20, 2017 1:18 pm

        Then what is the point of your post ?

        Of course it is a symptom of people who beleive they are entitled to control what is outside of their control.

        There is no difference between trying to tell me how frequently I should post, and telling me what color I can paint my house.

        In both instances your annoyance at something that is outside your control and not really your business, becomes to you a justification to impose rules on others.

        If you do not want the religious right dictating who you can fall in love with and have sex with, and how you can do it, then do not excercise the same stupid nonsense in other areas with other people.

        To the extent that statists and authoritarians on the right have on occasion felt the right to control others lives – you are correct this is not ONLY a left wing nut problem.

        Regardless, it is particularly common for the modern left to shift from debate and argument to protest, to name calling, to violence and then to censorship and banning things they do not like. They are not alone in that – either at the moment or historically. But at the moment they are the dominant force.

        I would suggest that is because you are losing the argument on logic, and ideas, and that is driving you to more illegitimate means.

      • dhlii permalink
        March 20, 2017 1:22 pm

        Of course I am using this blog – so are you.

        I am using it as a means of self expression. Of putting forth and sometimes refining my ideas and thoughts.

        I am also using it to polish certain skills,.

        And finally I derive satisfaction, pleasure and sometimes joy out of posting.

        So which of those things is illegitimate ?
        Which of those actually harms you or anyone else here ?

        What justification do you have for any complaint ?

        You may read my posts or not as you choose. I am not and can not force you to do so.

        A man said to the universe:
        “Sir, I exist!”
        “However,” replied the universe,
        “The fact has not created in me
        A sense of obligation.”

        My existance my posts create no duty, no obligation no burden on you.

        Read, Don’t – you are free to choose.

      • dduck12 permalink
        March 19, 2017 6:58 pm

        @dhlii@ 2:50. I will not attempt to answer all of your comments, I leave that to the more patient and intelligent people on this blog. But I will answer your comment on 19th century plans:
        “Today, the Bismarck Model serves as the predominant means of guaranteeing universal coverage in Europe, used in Germany, France, Switzerland, Belgium, Netherlands, and others. (Japan is also a Bismarck Model country.) The implementation varies, but all mandate insurance in one form or another. In Germany, for example, employers and employees jointly fund insurance via withholding; in Switzerland, individuals purchase their own policies. Even so, Bismarck Model countries share common traits:…….. ”

        If you disagree, so be it and we can end this discussion.
        BTW, I agree with Roby, you make good points, but the volume of words and multiple posts swallows them up. If your aim is to communicate your points to others, you are failing, and crowding out others from posting. That is rude.

      • dhlii permalink
        March 20, 2017 1:37 pm

        I am not looking to address whether some other countries follow a Bismark model.
        Whether you are right or wrong is irrelevant.

        My point was that the Bismark model was a deliberately hyper nationalist model.
        It is no accident that it lead to WWI and later to the Nazi’s and WWII.

        This is not a model I think you would be comfortable applying to housing, food, employment – and yet ultimately that is where it has lead.

        It is a model that places the state above the individual.
        The purpose of national healthcare im the bismark model is to make citizens that better serve the state.

        Is that really your goal ?

        US healthcare is a disaster – it was before PPACA, and has worsened slowly since just before WWII as government slowly stuck its toes into regulating it.

        I do not want to get into some bizzare comparative battle – as both US and other countried models are far more hybrid that you admit.

        Absolutely Germany has nationalist anti-freedom elements that are immoral.
        But it also has many strong market forces in areas we do not.
        Absolutely there are things in US healthcare that I still think are superior to that of the world.

        The fundimental problem with our private healthcare – aside from way way too much regulation – even more regulation than nearly anywhere else in the world,
        is that it heavily subsidizes all of your bismarking public healthcare.
        Further it somewhat subsidizes bismarkian heatlhcare throughout the world.

        I was hoping that Trump would act on permitting drug re-importation quickly.
        I am concerned that he will do so only narrowly.

        Regardless that would end much of the US susidy of global drug prices and developments.
        In the US drug prices are the 3rd largest component of health care costs – behind hospital care and physicians visits. And they are the fastest rising.

      • dhlii permalink
        March 20, 2017 2:32 pm

        With respect to my posting.

        You are free to hold whatever oppinion you wish.
        I can not stop you from expressing it.
        But I do not much care about your oppinion on my posts.

        My aims are my own, and I am not looking for advice on how to accomplish them.

        Regardless, few people are persuaded by argument.
        When they are it is usually some small insite that is responsible for a pivot in their values.
        And usually that insight is arrived at on their own.

        My views have shifted several distinct times.

        In the late 70’s in college I bought “sustainable living”. EF Schumacher and small is beautiful. Peak Oil, …..
        What drove me away from that was the realization that if the left was correct – only a small percent of the population could be transformed before global disaster.
        If I and mine were among those lucky ones, we were going to have to kill our more numerous neighbors who made poorer choices to survive. I was not prepared to kill people to protect my hydroponic gardens, dry toilet and passive solar home.

        The next major pivot was when someone whose intellect I greatly respected was at odds with me on a significant issue. The mere fact of their disagreement triggered my looking more deeply at the subject – either to prove I was right, or to determine that I was wrong.

        The last big factor was the 2008 financial crisis. Like lots of people I determined to actually learn something about economics. I started the inquiry as a conservative keynesian and came out of it neoclassical.

        I am not expecting to persuade anyone here.
        I do not beleive that is possible.

        If you are going to be persuaded – life will do it to you.
        At best my words might have an impact years from now when your prefered solution is failing.

      • Roby permalink
        March 20, 2017 9:43 pm

        “There is no difference between trying to tell me how frequently I should post, and telling me what color I can paint my house.
        In both instances your annoyance at something that is outside your control and not really your business, becomes to you a justification to impose rules on others.”

        Oh, how you wish I really Had tried to impose rules on you.

        Just imagine, someone criticizing Dave, the king of the crusty critics. Oh, the indignity! Help me, I’m being oppressed!

        You, sir, are being a snowflake.

      • dhlii permalink
        March 21, 2017 8:53 am


        Criticize all you want – I have zero problem with that – so long as I am equally free to defend and criticize myself.

        The problem is not with your criticism, it is the implicit and occasionally explicit presumption that you can go beyond criticism to actually controlling someone else’s behavior and expression.

        In your home, your property your business – you can.

        In public you can not.

        Nor can you circumvent that by restricting expression or conduct through government laws and regulations – except where you can justify those restrictions.

        And justification is not merely what 5 of 9 of us decide.

        Beyond that jumping from whatever the topic at hand is to criticising the frequency or style of my expression is a waste of your time.

        But you are free to do so.

      • Roby permalink
        March 21, 2017 3:05 pm

        “The problem is not with your criticism, it is the implicit and occasionally explicit presumption that you can go beyond criticism to actually controlling someone else’s behavior and expression.”

        For implicit presumptions you must be believing you can read my mind.

        But lets just take up your argument that criticism is some kind of implicit attempt to control someone. In that case you are one controlling ^%$#* libertarian hypocrite, since criticism, often pointy and rude, is your whole gig.

        By your own argument You Yourself are continually oppressing us with your relentless attempts to change us by the brute force of hundreds of thousands of repetitive words, eternal interminable messages from Mr. Obvious.

        Hoisted on your own petard!

        (I run rings around you logically.)

        Egads what a hypocrite! A controlling oppressive libertarian!

      • dhlii permalink
        March 21, 2017 4:56 pm

        Can you read ?

        No where in my post did I ever state I had any problem with criticism.

        What I took issue with is the implicit and explicit demand to control.

        Yes, I am trying to control your efforts to control me.

        I know way is it some libertarian hypocrisy to fail to submit to efforts by others to control you.

        Yes, my schtick is to criticise expressions and ideas I think are wrong.
        I expect exactly the same in return.
        I have no problem with that.

        As to reading your mind. Your right I can not do that.
        But tell me what purpose is served by moaning about the volume of my posts and telling me I should post less ?

        If that is not an implicit effort to control – it is an explict one.

        YES, I am constantly trying to control you.
        I am trying to control your efforts to control me and others.
        Again not capitulating to someone elses efforts at control is NOT hypocracy.

        I have repeatedly made it crystal clear that as stupid as I might think many of your ideas are – you and any other like minded people you can gather into a purely voluntary arrangement are free to structure that arrangement however you wish.
        Operate according to your ideas. See if they work.

        If you can not make them work voluntarily AGAIN the HIGH burden is on you to justify the use of force.

        That is really pretty much my entire schtick.

        You may not use force to impose your ideas on others without justifying the use of force to a very high standard.

        Most all the rest of my arguments are little more than attacks on justification.

        I do not care if you paint your house moonglow yellow.
        I care when you tell me and others what we must do.

        There are circumstances you can do that.
        But they are rare, the exception not the rule.

        And you do not get that at all,.
        and all your responses make that clear.

        I do not recall your EVER trying to make any justification for forcing others into whatever your ideas are.

        I can not recall you even making the ludicrously stupid “majority rule” justification.
        Which I hope you grasp I am very well prepared for.

        The most I think I have seen from you is an implicit version of “my idea is good therefore it can be imposed by force”

        No that is not the way you would describe it. But that is not an inaccurate description.

        In some instance I might even accept that your idea might be good.
        That is still not sufficient to impose it by force.

        Nor is even my agreement sufficient to demonstrate your idea is actually any good.

      • dhlii permalink
        March 21, 2017 5:09 pm

        Words have meaning.

        Tongue lashings might be rude, and annoying – but they are not force.

        Government is force. Advocating that government impose your idea is not force.
        It is advocating the use of force.

        I do support the use of force.
        In a very limited number of well defined instances.
        In all others it is immoral.

        One of those is to resist the use of force by others.
        Self defense is not hypocracy.
        But it might be violent or rude.

        What you write an how you write to a large extent determines how I respond.

        The one thing you can be most strongly assured of is that if you try to claim moral superiotity for your arguments – that I am going to evict you from that moral high ground.

        There is no morality without free will. If you differ on that – actually make the argument.
        Philosophers have debated that for centuries. I am well prepared if you want to try to claim that freedom is not an absolute prerequiste for morality.

        And that is the failure of progressivism. You can only restrict freedom morally with justification.

        I will be happy to debate with you what actually constitutes justification.

        We are unlikely to agree, but even that does not matter.
        Because the moment you commit to a requirement to justify restricting the freedom of others before doing so – no matter what beyond whim and emotion you use as justification,
        I will be able to slowly tear apart your entire ideology.

        Because it rests on a contradiction, because progressivism just ignores without thought the fact that the use of force must be justified.

        You attempt to claim the moral high ground be substituting emotion for facts, logic reason.

      • dhlii permalink
        March 21, 2017 5:17 pm

        Logic is clearly not your forte.
        Hypocracy is holding others to a standard you do not hold yourself to.

        There is only one thing I have ever prohibited you from doing – using force – aka government to impose your ideas.
        The default is freedom, not totalitarianism.

        Words are not force – brute or otherwise.
        Advocating for the use of force is usually advocating for immoral conduct.
        And that is what I attack you for.

        First they ignore you, then they laugh at you, then they fight you, then you win. Mahatma Gandhi

      • Roby permalink
        March 21, 2017 6:23 pm

        “Tongue lashings might be rude, and annoying – but they are not force.

        Exactly, Mr. Obvious.

        You talk too much, that’s all there is to it and 99% of it is low grade ranting, obviousities, false profundity, or stuff that just ain’t so. Any gold is deeply buried in your illogical ranting. You are the proverbial guy who is just intoxicates with hearing himself bloviate. You’d be a more worthy conversationalist if you turned off the diarrhea. That’s just an objective comment, not, as it took you another 5000 words to conclude, force.

        And, if you don’t like my words, take your own advice and don’t read em!

        So, grow a pair, learn some humility (ya got none at all now!) and Quitcherbitchin! (or I shall have to taunt you again…)

      • dhlii permalink
        March 22, 2017 9:13 am

        You are correct – I do write too much.

        And much of it is “obvious”.

        Yet as obvious as most of it is, those of you on the left gloss over it.

        No, it is not “false profoundity”.
        It just is what it is.

        There are really only a few fundimental assertions that I start with.

        I doubt that you disagree with them.

        You just seem to think that following them “mostly” is ok.

        That beating someone up on the street is unacceptable,
        but if you can wrap it in process and procedure and call it majoritarian government that what would be criminal thuggery if you did to your neighbor is OK if you do it through government.

        You want to argue for your ideological nonsense – you are free to.

        But when you step on a moral soap box and start saying everyone else is uncarring, or racist or greedy – because they do not buy into your immoral ideology – then

        Yes, you can expect me to push back – loud and angry and to bring out the fact that your ideology is vile and immoral.

        No, I do not like your words – but I am taking MY ADVICE – as well as that of Justice Brandeis

        “Those who won our independence by revolution were not cowards. They did not fear political change. They did not exalt order at the cost of liberty. To courageous, self-reliant men, with confidence in the power of free and fearless reasoning applied through the processes of popular government, no danger flowing from speech can be deemed clear and present, unless the incidence of the evil apprehended is so imminent that it may befall before there is opportunity for full discussion. If there be time to expose through discussion the falsehood and fallacies, to avert the evil by the processes of education, the remedy to be applied is more speech, not enforced silence.”

      • dhlii permalink
        March 22, 2017 9:32 am

        You wonder why I loath those on the left ?

        Here you are lecturing on humility ?

        I do not recall ever having told anyone here – or elsewhere how to post, what they were free to say, or how to live their lives – outside of their active interfence in the lives of others.

        Get a clue Roby.

        You come off exactly as you think I do.
        Pompous, arrogant, sure that you are right,
        dictating to others. Trying to silence dissent.

        I am not seeking for force my views on you.
        I am not precluding you living your life according to your views.
        I am not seeking to silence you.

        I ask ONE thing of you.
        Not to use or advocate for the use of force against others to impose your views.

        That is ALL. Nothing else.

        Accept that – which is more than just common courtesy,
        it is actually core to the social contract.
        It is why governments actually exist.

        and we will have no problems with each other.

        Regardless, taunt all you want.

        Now, if you think that it is actually morally acceptable to impose your views by force on others – then defend that proposition.

        That is what the Brandeis quote I posted is about.
        You think I am wrong – then expose that.
        Through reason, logic, education, identifying falsehoods and fallacies.

        Attacking my style is just useless stupidity.

      • dhlii permalink
        March 22, 2017 9:36 am

        Read your own posts!

        “Grow a pair”
        “Learn some humility”

        Who seems to feel they are entitled to give orders to who ?
        Who is it that is on their pompous high horse ?

      • Roby permalink
        March 22, 2017 10:24 am

        “Yes, you can expect me to push back – loud and angry and to bring out the fact that your ideology is vile and immoral.”

        That would be pretty insulting to me if I thought you understood the first thing about my ideology. But you never have begun to understand my beliefs. Yes, you despise and loath the left and you need a good far lefty to vent your bile on. If only one would really appear here.

        You are a guy who will claim that health insurance has no connection to health and that health insurance simply does what car insurance does. Then you will write 15 or 20 outraged dissertations when someone says that your statement is absurd. I’m really supposed to beat my head against a wall of stubborn ignorance like that? Why?

        I have given you some credit over the years for being an interesting writer at times when you are not in fanatical diarrhea mode. Its a lot more more credit than you have ever given me or anyone here.

        Think about this Dave: Ron is a libertarian. He presents libertarian ideas beautifully here. I do not agree with all he says or believes but he does libertarian principles proud by being a thoughtful, decent, reasonable, and consistent person who expresses himself calmly, not fanatically. That style of libertarian is a pleasure to discuss anything with. You might learn something from him. (Instead you claimed that he is further to the left than he realizes! Freaking hilarious! Ahh, the left, its coming to get you Dave, in all sorts of clever forms!)

        Have your last (10,000) words at me and I will enjoy a good personal laugh without replying here and leave you to claim that you have scored yet another heroic victory against the loathsome vile left. Poor delusional bugger.

      • dhlii permalink
        March 22, 2017 10:55 am

        I understand that your ideology involves the use of force – aka government against others against their will without justification.

        You have the opportunity to disagree to to justify that use of force.

        I do not like those who would use force without justification.
        That is a common problem not restricted to the left.
        Though currently it is more common with those on the left than the right.

        I loath and despise those who climb up on a soap box and lecture others about morality while advocating immorality themselves.

        I am fully cognizant of the fact that I have stepped up on the same moral soap box.
        And I expect that you will knock me off if I am actually doing so hypocritically.

      • dhlii permalink
        March 22, 2017 11:28 am

        I have claimed – as supported by the major studies that health insurance has no effect on NET health outcomes.

        That we are not overall healthier.

        Your disagreement with that seems to rest in a common fallacy – generalizing from often obvious seen benefits into a false presumption of NET positve value.

        While there appear to be very few seen specific health benefits from health insurance.
        I beleive Ron noted some evidence of increased colon cancer screening – which will likely result in a small decrease in deaths from colon cancer.

        But that is NOT a NET change. The studies I cited – one very long term by the highly reputed Rand group, and the other a rare example of a real world controlled double blind study with publicly available data, both found few specific gains and no net gains.

        BTW the same results have also been found for most (not all) forms of preventive care.
        In those instances the findings are that the cost of preventive care significantly outweighs the cost of treatment later.

        Why ? Because in most instances even though the cost of prevention is low, the frequency of what you seek to prevent is also very low, and even a high cost of treatment does not justify a low cost of prevention across hundreds of thousands of people.

        This is also BTW why you do not want government deciding what healthcare you can and can not have.

        I might personally choose to spend $100 to avoid a .001% chance of getting a $100K disease. Government is never going to do that.

        Regardless, the point is my statement is quite clearly not even close to absurd.
        It is quite literally correct.

        You beleive differently. You are free to beleive differently.
        You are free to make choices in your own life as if that is not true.
        As I am,
        But you are not free to impose your choices on everyone else by force.

        Frankly you are not entitled to force health insurance on others – even if it actually was to their benefit.

        This particular argument – like the vast majority of arguments favoring government intervention on anything. Aside from their serious moral problems.
        Fail because all they ever look at is the hoped for positive consequences and totally gloss over the costs.

        The CBO purportedly just scored RyanCare – ignoring for the moment that CBO’s scoring record – particularly on health care has been abysmal, they are projecting a $342B savings over a decade with possibly 24M people losing insurance.

        The latter sounds horrible. EXCEPT – just as with PPACA, there will be no consequential change in healthcare. There will still be the same number of doctors, and hospitals and nurses and ER’s and ….. Trends in mortality will continue much as they did before.

        PPACA has done exactly ZERO to alter overall trends in mortality.
        If as has been claimed millions of people are alive who would not have been otherwise – life expectance and mortality statitics would show that change in trend.

        I am not going to pretend CBO’s scoring is correct. I do not think it matters much.
        We are not going to really get to do the side by side comparison needed to actually know.
        But Rand did exactly such study over decades with small numbers of people.
        And the Oregon experiment did the same with very large numbers of people randomly selected double blind over several years.

        To the extent we are able to know, with a high degree of confidence the OVERALL health benefits of health insurance are either ZERO os incredibly small.

        Regardless, we do not have 342B or a Trillion here or there to spend willy nilly on whatever make you feel good.

        And that is really what we are talking about. You taking other peoples money so that you can feel good about having done something.
        You are not going to come up with the money your self.
        You really do not actually care if it does any good.
        All you care about is “virtue signalling”.
        You get to do that with your own resources.
        Not everyone else’s.

        Anyway, if my position is “absurd” you should be able to do far more than sputter about it.
        If it is obviously wrong – then it will be trivial to disprove.

        Yes, I read most of the crap you cut and pasted or linked to.
        With people suggesting that there might be this benefit or that benefit.

        First pretty much none of it – not even Ron’s colon cancer screening information,
        actually asserted a known measureable benefit.

        Nor did any of it look at cost at all.
        Nor did any of it consider AT ALL the overall impact – the losses elsewhere.

        If my claim is so absurd not only would the Rand Study and Oregon experiment not back it up, but you could see the impact of PPACA in changes in life expectance and mortatlity.

        What I see is that we have wasted alot of money. Infringed on alot of peoples freedom,
        made alot of people angry.
        To do something that has little measurable benefit,
        But is going to be hard to escape.

        You seem to be under the delusion that ZERO NET BENEFIT, is exactly the same as no winners at all.

      • dhlii permalink
        March 22, 2017 11:51 am

        I have not asked for your credit.

        This is not some quid pro quo situation.

        I have given you about the same respect as a person as you have given me – possibly more.

        I have given your ideas the respect I think they deserve.
        You have done the same.

        You beleive I am wrong.
        I beleive you are wrong.

        The difference that I can see is that your ideology requires imposing itself on others by force. Mine does not.

        You think that health insurance actually improves outcomes – or that any other of your ideas is superior.

        I am not stopping you from testing them out in any voluntary arrangement.

        I even accept that there are actually a few things that you can impose on others by force.
        You can force people to keep their agreements.
        You can force people to fix it when they actually harm others.
        You can use force against people when they initiate force or fraud against others.

        I am willing to listen if you think there are other instances in which the use of force can be justified. But thus far I have not heard you make an argument to do so.

        Even in the unlikely event that health insurance actually had a real effect on health outcomes. Far more than that would be necescary to justify imposing it by force.
        You do not seem to grasp that at all.
        You seem to think that any idea that you concoct that you can convince yourself does some positive good, you are free to impose on others by force.
        You do not seem to care what the actual cost of anything is.
        You do not seem to care that it actually has the positive effects you claim or how great they are,
        You do not seem to care if that cost includes harms other than money.

        And you seem to think it is OK to question the morality of anyone who disagrees with you on any of this.

      • dhlii permalink
        March 22, 2017 12:25 pm

        There is no conservative litmus test.
        There is no progressive litmus test that I am aware of.
        There is no libertarian litmus test.

        Ron is less ideologically libertarian than I – that is an observation not an insult.
        He is more inclined to compromise and place a higher value on comprise.

        We see the world similarly – not exactly the same.

        I have said this before, but I got to where I am through the same pragmantic route that Ron appears to have taken.

        Time, experience, data and research keep showing me that government does not even do those few things that it MUST do very well.
        I accept the limited government that I beleive is justifiable as the best we can do – not as actually good.

        I am not some high school kid who has just finished Atlas Shrugged.

        I have read Kant and Kierkegaard, and Nietzsche and Marx, and Mao,
        and …..

        I have in the past held many of the positions I argue against today.
        Regardless, I am not trying to appeal to my own authority.
        What is true is true, because it is true, not because of who said it.

        You seem to think that this is some right left thing for me.

        The fundimental problem with the left today is not that they are on the left.
        It is that they have become intolerant statists.

        I grew up during the 60’s. While the left had no corner on virtue at that time.
        It was not for the most part the hateful, intolerant, statist left we have today.
        “Turn on, Tune in, drop out”, “make love not war”, “do your own thing”. “anything goes”.
        “I’m not hurting anybody”.

        I live in a part of the country that Jerry Falwell used to call the buckle on the Bible belt – so I know exactly how intolerant and hateful the right can be and has been in the past.

        I will be happy to join you in protesting the West Borro Baptist Church.
        But today they are not the threat to our Freedom

        What I oppose is statism – regardless of the political slant.
        Today the driving force towards the bigger state is the left, and their argument is emotional

        In the past there have been posters here on the right that I have taken on with equal vigor.

        Regardless, I am only more concerned about the left for the moment because they are currently the greatest threat to freedom.

        But I am watching Trump and “trumpism” carefully.

      • dhlii permalink
        March 22, 2017 12:43 pm

        “leave you to claim that you have scored yet another heroic victory against the loathsome vile left.”

        a victory would be a free market healthcare system.
        Like that is going to happen.

        I try not to pretend to know what makes you tick beyond what you write.
        You clearly do not know me.

      • Roby permalink
        March 22, 2017 12:30 pm

        “I understand that your ideology involves the use of force – aka government against others against their will without justification.”

        Government implies laws. There is no meaning to a law if it can’t be enFORCEd.

        You stated somewhere here that when you started posting here many years ago you were more moderate and since then you have become more extreme in your libertarian beliefs. Your own words more or less. I always found you pretty extreme, I hardly notice a change.

        Yes, law implies force, government implies law implies force. Because you are at war with the very foundation of government you get to call everyone who believes in government and regulation at all immoral for believing in law and the force implied by it. So, you apply that to me too, I’m a loathsome vile immoral lefty, blah, blah, blah.

        We started going over this road I literally think it was perhaps 8 years ago now, and the fundamental issue has never changed. If you remove government-law-force in your thought experiment everything winds up great. When I do the thought experiment something far worse than our modern society fills the vacuum you leave behind. Yes government is force, justified by some process. In our case, that process flows from the Constitution of our democratic republic. Oh, I know you would leave some small number of laws standing that YOU personally have proven TO YOURSELF are moral. The problem is that those few laws are your own subjective choice. There are another 320 million people with their own opinions, few of which if any agree with yours. The level of the powerful taking advantage of everyone else in your ideal philosophical universe is a point you never will concede and I certainly cannot release you from your naivety.

        The world of government-law-force is not going anywhere, and that is better than the alternative in my “vile loathsome immoral left wing nut” Universe.

        Its an entirely theoretical world you live in. It gives you the philosopher’s right to call me immoral, vile whatever. Its too silly a proposition to spend words on. Your weird goal is to tempt me to play with you for hours a day on this philosophical playground of the abstract. There is a real world. I live in it. It does not make me (or all those other people) vile, loathsome, immoral, or left wing. That is an extreme and pointless viewpoint. But you are of course free to fantasize.

        Dave, leave me in peace, you win, you are correct about everything. Now, you may preside as a philosopher king over your utopia. I got other stuff to do, I gotta go tyrannize someone.

      • dhlii permalink
        March 22, 2017 8:29 pm


        I am not here to terrorize you.

        You want left alone. I will leave you alone.

        You want to debate, I will debate.

        What does 10 paragraphs of argument followed by a plea to be left alone mean ?

        The shortest response I can give to the gist of your argument is:

        You make the choice between an infinitely powerful state and anarchy.
        It isn’t a binary choice.
        But the fact that there are more than two choices does not mean that all or even most choices are good.

        Purportedly moderates think that the best answer is between two extremes.
        I do not think that is usually true.
        But is sometimes is.
        Particularly when there are excellent moral, logical, practical, and philosophical reasons for defining a specific point on a continuum from anarchy to statism.

        If you can not have morality without freedom, but certain specific freedoms – such as that of initiating force, result in less freedom – and are therefore immoral,
        you can morally and justifiably restrict the freedom to initiate force.

        I wish we had a better tool than government to enforce that restriction. But I have not seen one. Government is essentially a necescary evil.

        If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary. In framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next place oblige it to control itself. A dependence on the people is, no doubt, the primary control on the government; but experience has taught mankind the necessity of auxiliary precautions.
        James Madison

        I have never argued that government is not necessary.
        I am arguing that government must be controlled, and that majoritarian mechanisms are insufficient.

        I have been clear on what I think are the limits of government.

        Even if we can not agree on what they are, can you agree that the government must be controlled too ?
        If so have you given any thought to what might constitute the necessary controls ?

        With respect to moral judgements – if you use a moral argument for your position, you can expect a moral response.

      • Roby permalink
        March 22, 2017 9:55 pm

        “You make the choice between an infinitely powerful state and anarchy.”

        I don’t believe I do. There are states, N.Korea comes to mind, that are far more powerful than my idea of a healthy state.

        But, first, your last post was a nice, temperate and thoughtful piece of writing. When you get off your high horse and focus you do write things that I find very thoughtful and interesting at times. Believe it or not, that is a thing I was trying to communicate to you in my “complaining” posts: one well focused, polite, respectful post is far far more effective than 30 of libertarian fire and brimstone lectures. I cannot tell you what to do. I am giving you my feedback on your style and Dduck has given the same.

        If you wish to discuss morality and government quietly and politely without anger and judgement, I am willing to meet you halfway and try to do likewise. I am not a philosopher. I am not in my element in formal philosophy. I can give you my impressions. I will enjoy this conversation if it stays within bounds. For myself, I am obsessive and this could take over many hours of my life that I want to use for other things. I am attempting to learn to play Bach’s Toccata and Fugue on the violin (among other musical projects) . Its a huge investment of my time, love, and energy. I cannot fall down a rabbit hole of obsessive commentary. I can be just as long winded as you, I don;t want to be. I will trade posts on this, One a day should be my limit. I will try to write something reasonably focused and concise, once a day. If you will take a similar path we may enjoy this and each learn something.

        “With respect to moral judgements – if you use a moral argument for your position, you can expect a moral response.”

        I think that morality is the issue here, its why you get quite irate with people like myself. The thing that seems to anger you more than anything about the left, which you have wrongly placed me in an extreme element of, is believing far too much in government-law-force. You thunder at me like a bible belt preacher because my morality includes government force. I do not understand logically how it cannot. Its not that I love government force. I am, believe it or not a rather free spirit (and my wife…)

        Morality. There is personal morality, group morality, and state morality. Morality as an idea had to start from religion, didn’t it? As time went on and astronomy and biology developed the old underpinning for biblical age morality became weakened. Society’s morality is whatever the majority believe it is. Once it was considered moral and an effort to prevent worse tragedy to massacre and displace the Indians from the east (and then the west) to prevent conflict. This is what Andrew Jackson believed he was doing. Modern society does not approve of the morality of that, from the luxury of our newly comfortable modern lives.

        Once homosexuality was considered immoral, increasingly our society believe that it is not immoral and that condemning it is immoral. A recent and huge change. A person’s individual morality is between them and their god, goddess, or conscience. Sub groups within society (liberals, conservatives, religious groups, to name a few) have their own moralities, and believe that their moral ideas are the only acceptable ones, Universal, perfect, immutable, impeccable, whatever other people groups or society as a whole believes, the others are wrong.

        There is no ultimate bedrock to a universal morality. You have your own morality, which you have invested vast effort in and thought. Your morlaity finds liberals to be vile etc, and morally wrong and offensive. That is your personal opinion, nothing more. We cannot have a conversation based on a universal morality because it is relative, subjective. No matter how much I believe that torturing animals in medical experiments is morally wrong, scientists do it regularly and consider themselves ethical and moral, they even have an entire ethical apparatus to guide them in the tortures. I edit a journal on neuroscience, the papers are one long narrative of torture.

        Etc. Morality is personal. Yours and mine overlap but are not identical. You are being moral according to your lights, I am being moral according to mine. I judge others based on morality much less than you believe I do, because I understand the above.

        Not very concise, was I? At least it is just a single post and I hope to keep to one per day.

        Your move.

      • dhlii permalink
        March 23, 2017 11:14 am

        I do not beleive that your intention is to choose between North Korea and Somalia.

        But absent some criteria for optimal (and/or unacceptable) you are just going to drift – either towards somalia or more likely slowly towards North Korea.

        Further, if you are going to try to stake out the moral high ground – then you had better have a pretty good argument for where that moral high ground its.

      • dhlii permalink
        March 23, 2017 11:17 am

        I do not care how concise you are – so long as that courtesy is reciprocated.

        I have written many things that have been published – they were very polished and concise. It is an enormous amount of work – but I got paid for it.

        I am not paid to post here. I do it for my own pleasure.
        I write fast and relatively sloppy. I rarely correct grammar and spelling and do not put much effort into overall organization. Hence the “streams of consciousness”

        Any criticism of that is valid – but I do not care.

        I try not to hold others to standards I am not going to hold myself to.

      • dhlii permalink
        March 23, 2017 11:42 am

        With respect to “tone”.

        One of the ideological flaws of the left – and one that clearly afflicts you,
        is that because you beleive that you hold the moral high ground, you do not grasp that you are MORE intolerant, condescending and insufferable than you accuse others of.

        I am asking you to think about this.

        Absolutely I “get on my high horse” fairly regularly.
        And I will go after those on the left with my sabre sharpened to a razors edge.

        I do that when you claim that you own the moral high ground.

        That is a claim you are fully entitled to make – I make exactly the same claim.
        But it is also a claim that you should fully expect is going to infuriate whoever you are arguing with and provoke them to their most brutal arguments.

        That is what I expect from others when I stake out the moral high ground.

        That is what you should expect from me if you do.

        Or the simpler version of all of the above – is virtually everything you find objectionable in tone about any of my posts, is directly driven by implicit or explicit versions of the same tone in yours.

      • dhlii permalink
        March 23, 2017 12:28 pm

        I would be very happy to engage in a discussion of the moral issues, but you have framed the debate such that, that is impossible.

        You claim that the moral dimension is critical and that your views are clearly morally superior.

        But then you claim to have minimal interest in the basis of morality,

        And finally assert that morality is personal – that your morality and my morality are somewhat different and that is acceptable.

        Those premises are both wrong and impossible. I would hope that would be obvious.

        I will absolutely agree that the moral dimension is critical.

        Whether we can consciously express those or not
        society and particularly government rests on a foundation of shared morality.

        Ignoring for now the precise parameters of that morality – we can not
        have society, or government absent approximately 90% of us sharing a
        core common morality.

        You note – correctly that our morality overlaps. It also overlaps with that of Trump supporters and all the other disparate views in the country.

        And it is only inside of that area of overlap that we can govern – that we can use force.

        This is also why the nordic social democracies do not fail so easily as other socialist states. Because 98% of their people are not only the same race the same ethnic group, but the same tribe, the same religion. Their core of shared values is far larger than that of those in the US.

        But even they are having enormous difficulty as they accept immigrants with radically different and extremely strongly held values.

        The US is and has always been just about the most diverse nation on the planet.
        To paraphrase Churchill – our treatment of minorities is the worst, except all others.

        This is also why the US is the most libertarian nation on the planet.
        It is also why we have the longest sustained record of prosperity, and growth, and why only a few small monocultures have a higher standard of living.

        It is also why most everything that the left sees as appealing in europe will work far worse in the US.

        In the past the right was properly attacked for attempting to legislate morality.

        Law and government are not divorced from morality – they are inextricably linked.
        What you can not do is legislate outside that moral core that 90% of us share.

        You can not do that from the right.
        You can not do that from the left either.

        You do not understand that there is little if any difference between the lefts efforts to restrict liberty – on some purported moral basis that is not nearly universally shared, that that of the right.

        The right thinks their laws restricting liberty are morally justified – they are or were no less sincere than you are. They are or were no less wrong.

        That are or were no less immoral in doing so.

      • Roby permalink
        March 23, 2017 11:57 am

        “One of the ideological flaws of the left – and one that clearly afflicts you,
        is that because you beleive that you hold the moral high ground, you do not grasp that you are MORE intolerant, condescending and insufferable than you accuse others of.”

        Only, I didn’t. What I said was just the opposite. There is no universal morality. I have mine, you have yours. As I wrote, and I think my meaning is pretty clear,

        “Morality is personal. Yours and mine overlap but are not identical. You are being moral according to your lights, I am being moral according to mine. I judge others based on morality much less than you believe I do, because I understand the above.”

        If you reread what i wrote and then still believe I am claiming the moral high ground then we are simply speaking different languages. At no point did I write that my morality is better than yours, and I would not write that, because I don’t believe it. Neither one of us has the moral high ground. This is as clear as I can make it.

        And its my one post for the day.

      • dhlii permalink
        March 23, 2017 2:30 pm


        Your posts speak for themselves.

        And I too would honestly prefer to focus on the actual argument.

        A pool shark likely can not express the laws of physics that govern his shots.
        But those laws still apply – universally, and even though he can not state F = Ma,
        his choices are driven by those laws of physics and his success and failure is driven by his intuitive grasp of them.

        There is no morality without freedom.
        Belive that, don’t. your lack of beleif does not change it.
        The fact that most of us have not thought of that – does not change it.

        The remainder of morality can be constructed from that foundation.
        And I am sure there are several tomes hat do so.

        That root is as fundamental as gravity.
        If you reject it – you and up with a radically different world – not even close to what we have. Just the simplest facet would be that without freedom as a foundation – slavery is moral.

        You do not have to know the laws of physics – they still apply.
        You can still make decisions in your life, based on your experiential rather than mathematical knowledge of physics.

        Throughout history for long periods of time – and even today, people hold strongly to ludicrously stupid positions on aspects of physics – sometimes even actual physicists.
        Our past and present errors do not change the laws of physics.

        Morality is NOT personal.
        I am extremely hard pressed to think of any truly moral issue that does not involve other people.

        You are free to make choices that might harm yourself – I do not see any moral question, conflict or issue in that.

        You are not free to make choices that actually harm others.

        They are not a personal choice, they are not my morals vs. your morals.
        The only system where you are free to actually harm others is anarchy.

        We can argue over exactly what is and is not moral – just as we can argue over physics.
        But regardless of the results of our argument morality itself does not change.

        Morality is about our relationship to others, and therefore it is absolutely not individual.
        Just as the laws of physics are not individual.

        Our personal grasp of morality might be individual, just as our grasp of physics might be individual. Our grasp like that of the pool shark also might be intuitive rather than reasoned scientific.

      • dhlii permalink
        March 23, 2017 2:47 pm

        This everything is relative nonsense gets extremely tiring.

        Even the science of knowledge tells us that the absence of absolute truth precludes neither absolute falsehood, nor the ability to determine whether A is more probably true than B. And infact the advance of society depends on that. Otherwise we would still be arguing over whether the world was flat.

        Regardless, you do not get to escape the consequences of your own views by claiming that morality is personal.

        It is not.

        Whenever you make a claim that you can have individual (or even majoritarian) values and impose them on others you instantly run up against the problem that you have surrendered the ability to condemn anything that others have done.

        If morality is individual – murder would be moral – atleast for some.
        If the morality of the few or even the majority can be imposed on others,
        then the nazi’s were moral. Jim Crow was moral, slavery was moral.

        If morality is individual – then you can truthfully assert that those who beleive different from you are hateful, hating haters, BUT they can equally truthfully assert that you are the hateful, hating haters.

        You can not have a society without a core of shared values.

        And you can not govern – i.e. use force, outside of those nearly universally shared values.

  53. dhlii permalink
    March 19, 2017 5:29 pm

    This is from IBD so left wing nuts will just reject it out of hand based on the source, but this confronts in a different arean some of the nonsense that is being spewed here on healthcare.

    You can not sustainably make ANYTHING free – or even below cost.
    Even the hint that something is or might be free creates havoc and results in people making choices that are either bad for them or bad for the rest of us or both.

    IBD is looking are student loans but contra the left Healthcare is NOT different.

    That something has a cost is actually an important part of how we make choices.
    The cost of things is what keeps us from making poor or unsustainable choices.

    Everything that each of us consume MUST be paid from from what we produce.
    Making something free to some, does not make it actually free. It still must be paid for.

    Healthcare – must be paid for. If it can not be paid for – then it can not be provided.
    Education – must be paid for. If it can not be paid for – then it can not be provided.

    • Priscilla permalink
      March 19, 2017 7:04 pm

      The nationalizing of the student loan business was part of the ACA, a poorly understood, and under-reported part of it, that was intended to cut out the banks and use profits from student loans to help finance subsidized healthcare.

      Supposedly, only some of the profits would be used for healthcare subsidies, and the rest would be used to pay down the federal debt (hahaha) and increase the availability of Pell Grants. I don’t have any idea how that’s worked out, other than to note that the cost of a college education, now almost impossible for a middle class family to finance without loans, has continued to rise steeply.

      “Free” college would certainly be very expensive.

      • dhlii permalink
        March 20, 2017 2:50 pm

        While markets are incredibly complex, they are fundimentally self regulating.
        whenever some normal market actor creates moral hazzard or inappropriately incentivizes bad behavior – they rapidly adjust or fail.

        While I think that government is more likely to create moral hazard or incentivize bad behavior – and guaranteed students loans increasingly exemplify both,
        that is not so important as that government does not easily fix its mistakes.

        Failure as an example is an important part of the self regulation of free markets.
        Enron failed – that decreases the likelyhood of other businesses following the same strategy. MCI WorldCom got into deep trouble – not so much with government but with investors over its misreporting of revenues – again an object lesson to the rest of the market.

        I do not claim markets are perfect. But there are many differences between markets and government.

        Market actors are allowed to fail. In fact failure is comomplace and an important part of the process of learning in markets – and on occasion we have to relearn things from a few decades before.
        Government is the one institution that is not allowed to fail.
        Wise people would conclude that means government should avoid taking any unnecescary risks and stay out of markets.
        But that wisdom does nto exist on the left and is rare even on the right.

        Markets respond rapidly – and they are supposed to.
        Government responses are protracted – and they are supposed to be.

        Purportedly Keynes backed away from government sitmulus later in his life on the realization that government would never be able to act fast enough to be effective.
        Even Keynes understood that markets recever on their own.

        Outside of government – everything is permitted except what is explicitly prohibited – and it needs to be that way. We want people to have the greatest possible freedom.

        Government is and should be the opposite.
        Adam’s famous aphorism – we are a nation of laws not men it critcal.

        Government is not supposed to try to decide who the good guys and who the bad guys.
        Courts judges, even regulators are supposed to determine – did you violate the law or didn’t you. It you did you are punished. If you did not you are not. In those contexts government is NOT supposed to excercise discretion. It is not supposed to try to let one party off – because their intentions were good, or they are friends with the prosecutor or they contributed to the appropriate pollitical campaign, while convicting another because we do not like him – given the same facts and actions.

        Discretion, judgement quick action and making choices are the routes to corruption in government.

        A corrupt business is far less dangerous than a corrupt government.
        Businesses are not free to use force.

    • March 19, 2017 11:56 pm

      “That something has a cost is actually an important part of how we make choices.”
      “Healthcare – must be paid for. If it can not be paid for – then it can not be provided.”
      “Education – must be paid for. If it can not be paid for – then it can not be provided”

      Dave I agree with you 100%. Surprise.
      The student loan program has done nothing but raise the cost of education. Like I said months ago, it is a vicious cycle. Student can not afford education, government provides loans guaranteed, schools see ease of getting loans, schools see easy way to increase cost, more students can not afford increase cost of education, more loans are given, schools see this increase, schools find it easier than before to raise cost, more students can not afford education………………………….(students graduate with unemployable diplomas, default, tax payers cover the trillions now projected to default)

      And yes, healthcare must be paid for. But it must also be available to those that need services, but can not afford that. You do not believe that should be part of governments role. I believe insurance companies are going to screw the public if there is not some control and regulations. I also believe that we can provide stop loss coverage to those that want coverage in a way that the government and subscribers can agree is of value to both.

      Many conservatives believe if someone has a catastrophic health issue, then it is fine that they die. For instance, my daughter works in the NICU where the cost of care for a premie can reach many hundreds of thousands of dollars, most reaching lifetime limits. To many conservatives, parents that can not afford this care should be fine with their child dying. Many liberals believe all people should have free healthcare and the government should regulate and pay for all healthcare. Then there is a moderate position where some government involvement is needed and in those cases, the cost, if the program is designed properly, would costs less than it is costing today, provide better service than it is providing today, and more people would be much happier.

      By the way, the moderate position will never see the light of day as no politician is going to take the time to develop a plan like that since the liberals won’t help, the conservatives won’t help and the insurance industry sure as hell is not going to help.

      • dduck12 permalink
        March 20, 2017 12:10 am

        ‘By the way, the moderate position will never see the light of day as no politician is going to take the time to develop a plan like that since the liberals won’t help, the conservatives won’t help and the insurance industry sure as hell is not going to help.”
        Yup, yep.

      • Priscilla permalink
        March 20, 2017 9:20 am

        Ron, I do think that the current bill, which significantly amends the ACA, but does not repeal it, makes some headway towards a moderate healthcare plan. Not single payer, not wild-west free market.

        The Republicans and Trump foolishly announced upfront that they would keep the part of O-Care that allowed “children” up to the age of 26 to stay on their parents plan. That has been a godsend to young millennials, who have had to contend with an extremely poor job market, but it also allows those young people who could afford insurance or get it from employers to avoid purchasing a plan….cutting out the healthiest people in the insurance pool for several years. That’s something that will have to be addressed, but it likely won’t be, until real unemployment goes down.

        There will also, at some point, need to be a better plan for those with pre-existing conditions. A subsidized insurance pool seems likely there.

        Your point about preemies is interesting. I think all of us know of healthy children who were born extremely prematurely ~ kids that, a generation ago, would have died shortly after birth, but who who saved by advances in neo-natal care. I wonder if there isn’t more than a few legislators and insurance companies who consider abortion a better alternative, not only because of a woman’s right to choose, but because it’s a relatively low cost alternative. I’m not suggesting that these people want to encourage abortion, but perhaps not discourage. Even as I type that, I realize how inflammatory that idea is….

      • March 20, 2017 11:45 am

        Priscilla, I know that you think some may reject completely what you said about abortion and premies and it being inflammatory, but I will go one step farther and say I believe they would encourage someone to have an abortion if they thought it would do any good. Problem is, most individuals have no idea their infant will be born less than 37 weeks and less than 5 1/2 lbs.

        Sorry to say, but their are three groups of individuals I put in the same category. Politicians, used car salespersons and insurance company executives. From this list you can determine what I really think of them. I my career, I had enough experiences with insurance companies to see how they find every loophole to deny a treatment they can find. Most patients have no idea how to deal with them and we had individuals specifically trained to get bills paid that insurance denied.

      • dhlii permalink
        March 20, 2017 3:43 pm

        Whether the issue is abortion or premi’s
        the oppinion of others does not matter.

        You, the left, the right can hold whatever oppinion they want on what is right for someone else.
        The choices still belongs with that someone else.
        As does the cost and benefits of that choice – whatever they may be.

      • dhlii permalink
        March 20, 2017 3:59 pm

        Some of the most fundimental problems that people have dealing with insurance companies stem from the fact that the beneficiary, and the person paying are rarely the same.

        I dealt with insurance people for several decades as an employer.
        I found most of them friendly and helpful.

        My relationship was different than that of my employees.
        I was paying the bills.
        I rarely had problems with insurance coverage until I became more of an emplyee than employer.

        Nlot merely did insurnace companies not mess with me when I was negotiating the plans and paying the bills.
        But I was often able to successfully lobby for key staff members.

        I recall once we had an employee who rolled a company vehicle 2hours away from the office in the snow. His arm got caught outside the vehicle as it rolled and he very nearly lost it. He was out in the boonies – nowhere near any good hospital and where he was at was threatening to remove the arm.

        I sent one of our staff up to the hospital to advocate an liase.
        We called all the appropriate involved insurance companies.
        We told them what we were going to do.
        We had the employee medivaced to the best care for his problem in the state.
        He was in surgery for 7 hours (the first of many).
        We told the insurance companies this was GOING to happen, that if they could not make it happen – the business would make it happen – and we would be deciding which of them had to pay for it in court later.
        It took the employee 18 months to recover enough to come back to work.
        We paid him full wages through that time – we collected the more paltry medical benefits.
        In return he helped us with his projects whenever he could – it worked out best for both of us.

        Equally importantly the entire rest of our staff was watching this.
        Everyone got a strong message about how important our people were to us.

        For a couple of years afterwords – we had less demands for raises, and fewer people leaving for a bit higher salary.

        We did what we did because it was who we were.

        It worked because we were willing to take the risk, and because insurance companies are far more compliant with those people paying the bill.

        This is one of the problems with employer paid health insurance.

        There are many reasons that health insurance companies F’over beneficiaries.
        One big one is they have no actual liability to beneficiaries most of the time.

        A insurance companies “consumer” is NOT the employee, it is the employer.
        The market incentivises not screwing your customers.
        Beneficiaries are not customers.
        You can not even sue the insurance company if you have employer provided insurance.
        You must go through the ERISA process which takes forever and heavily favors insurance companies.

      • dhlii permalink
        March 20, 2017 3:36 pm

        The provisions allowing kids up to 26 to remain on their parents policies would likely remain even if we went “wild west free market” tomorow.
        They have negiligable cost and people want them.

        One of the problems with many of the critiques for things as they are is this presumption that in a free market they would be that way both now and forever.

        Most insurance charges for dependent coverage – but not much because children – even through there 20’s use very little healthcare.

        Provisions regarding pre-existing conditions and lifetime limits are insurance company efforts to control costs.

        The actual profit margins of insurance companies are incredibly low.
        Increases in costs to insurance companies of medical care mean increased costs of insurance. It is that simple.

        While I am opposed to deciding these things collectively.
        Eve if you do you can not duck the problem – eliminating pre-existing condition prohibitions and lifetime limits is easy. But it will increase the cost of insurance to all of us.
        You can change who makes the decision
        You can not change the costs associated with different choices.

        The left pretends these hard decisions do not have to be made – or that they can be made in some ideologically favorable manner – with no cost.
        That is just bunk.

        Having government make the choices:
        Deprives all individuals of the ability to chose differently.
        destroys the market incentives to find the way to deliver something that people want that is expensive more cheaply.
        Freezes the market exactly as government dictates – stifling innovation.

      • March 20, 2017 4:23 pm

        “The actual profit margins of insurance companies are incredibly low.”

        I call BS on that one. How many billions does it take to match your idea of “profitable” and how much does a CEO have to make to be considered “rich”

      • dhlii permalink
        March 21, 2017 8:37 am

        No BS,

        I am not really interested in some stupid pundit, politician, or reporters claim about what profits or pay should be.

        The profits of ALL business fall within very narrow ranges defined by the risk of that business. The laws of economics dictate that.

        There are likely Billions in profits in health insurance – Healthcare spending per year is about $3T, insurance covers probably have of that. Even at a 8% Return on Revenue that would be tens of billions of dollars a year in profits. But the relevant figure is Return on Investment – and those typically run closer to 2%.

        None of this comes from thin air. It is determined by the laws of economics – which are just laws of human behavior.

        It is simple – and in fact it has to be.

        If the profits of an insurance company are high in comparison to its risks – then the entire stock market would shift to investing in insurance – driving the price of health insurance stock through the roof.

        Further people would be starting health insurance companies right and left – because they were highly profitable.

        No business exists in a vacuum. They are all part of the entire economy.

        The business cycle of profits as well as the nearly fixed relationship between profits and risk levels is extremely well known. It is only possible for any business to operate outside of that risk/profit envelope for very short times.

        If profits rise above those justified by risk – investment rushes into that market raising stock prices, and causing people to form new competing businesses.

        If profits drop below those justified by risk – investment dries up and businesses close or go bankrupt.

        I would further note that the vast majority of investment today comes from our retirement funds – not from Billionaires.

        When companies profit either you get dividends, or the value of your retirement fund increases.

        As to CEO salaries – the salary of anyone in any business is and should be determined by those who own the business. In corporations that is shareholders through the boards they elect.

        If you are unhappy with the pay of CEO’s in business that you own stock in you can vote to change the board, and reduce pay.

        It is not however the business of government or anyone else who does not own the business to restrict what a business can pay its employees – whether those are CEO’s or janitors.

      • dhlii permalink
        March 21, 2017 8:46 am

        Unless you own the company – why do you get a voice in what the CEO or the janitor make.

        There have been all kinds of stupid efforts to reign in CEO pay – unless they come from share holders they will be ineffective and destructive.

        I personally find it hard to understand what some Top CEO’s are making huge sums.
        At the same time I know that businesses that have tried to be cheap about CEO pay have suffered greatly.

        If your IRA is invested in a company – what do you want – a Cheap CEO and a low return on your IRA – or an expensive one and a high return ?

        It is litterally your choice. Because the choice of compensation of CEO’s is made by shareholders through their elected boards.

        You get a vote – and if you do not like the outcome – the CEO pay, then shift your investment to a business whose choices you like better.

        Note that 80% of the ownership of US corporations is by US households – not Billionaires and hedge funds and …

      • dhlii permalink
        March 20, 2017 3:39 pm

        The effect of recessions is greates