The Medical Contract

image edited to hide card's owner name. author...

A Medicare Card, (Photo credit: Wikipedia)

I read a George Will column on the Supreme Court’s review of the ACA in this morning’s Joplin Globe that prompted me to submit a letter to the editor. With apologies to those readers who have endured my essays on this before, here’s the letter:

Dear Globe Editor:

George Will declares (Globe, 3/27/2012) that the Obamacare individual mandate problem is simple: compelling people to “buy” insurance violates traditional contract law. If that principle is upheld, he says, then there would be no “stopping point” to Congress’ powers. OK, fair enough. But like his political allies, Will fails to point out an obvious inconsistency. The healthcare system is financially broken because Congress in 1986 forced it by extortion to provide services (through ER’s) to anyone who could not pay for them, the threat being that if it didn’t, Medicare and Medicaid fees would be denied. That law, “EMTALA“, is the reason 41 million people feel that health insurance is not a necessity.

EMTALA is just as much a violation of common law as the individual mandate, and probably more so, and yet no one (of either party) is calling for its repeal. Why is that? I submit that it is because the pols all understand that the electorate is self-indulgent. We love that America has “the best healthcare system in the world”, but we would rather not think about it costing 2 ½ times as much as it should.

The ACA is an improvement, but it is still unaffordable because of EMTALA. The only way out of the financial mess I can see is to make healthcare a tax-supported program like Medicare, the so-called “public option”, but it seems that will have to wait until the present system collapses, something it is now doing in slow motion.

I wanted to add more but I figured that it was about as long as the average reader will wish to spend pondering the dilemma. The few people I talk to seem to have insurance, are satisfied with it and just wish the controversy would go away. But as I said at the letter’s end, it won’t because the system is unaffordable.

EMTALA was enacted because of hospital “dumping” of impecunious patients on the diminishing number of hospital ER’s that would take them, and as a result it became probably the largest “unfunded mandate” of all time!  Yet just imagine what America would feel like without EMTALA, with the sick and injured piling up on the sidewalk! Conservatives and libertarians say they want an affordable system that accommodates personal responsibility, a system wherein the marketplace controls costs according to supply and demand. GOP Rep. Paul Ryan’s plan would have done that, but it didn’t adequately fund the care that the poor and the middle class need. And, it had another problem, one I have not seen discussed. It would have greatly diminished the volume of business for the medical industry because people, being people, would have been loathe to spend their limited (only $6,000!) healthcare money until it was pressingly necessary, thus bypassing preventive care (something the ACA supplies, by the way).

Is It Too Late To Buy Some Health Insurance?

Isn’t it interesting that the medical industry seems to be pretty much on the sidelines on this controversy? They have long enjoyed the business, but now are struggling as the government runs short of money. They know that the federal coffers are not bottomless. They know that something has to change, and whatever that turns out to be, it will be painful for both the industry and for the patients. If the individual mandate is overturned we will still find ourselves facing unaffordable deficits. If the GOP prevails in the election and is successful in repealing the ACA, we will probably be back to the Ryan scenario and increasing numbers of sick people stacking up.

The case before the Court is historic and its effects will be long-lasting, but no matter what the decision the problem still won’t be fixed. How the nation will face that problem, or not face it (stalemate), will be determined largely by next November’s election results.

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About Jim Wheeler

U. S. Naval Academy, BS, Engineering, 1959; Naval line officer and submariner, 1959 -1981, Commander, USN; The George Washington U., MSA, Management Eng.; Aerospace Engineer, 1981-1999; Resident Gadfly, 1999 - present. Political affiliation: Independent, tending progressive as the GOP recedes from its Eisenhower roots.
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24 Responses to The Medical Contract

  1. ansonburlingame says:

    Jim,

    No matter how the Supreme Court rules in June, we are just really getting started in the HC reform debate. We all know that ACA is only a first step towards universal care controlled by the federal government if progressives get their way. So assume ACA and the public mandate is deemed Constitutional by the Court, which for sure seems to be a stretch based on oral arguments, but who knows for sure.

    If no constitutional barriers are erected against ACA by the Court then politics to “kill it” incrementally will rage or of course, depending on Nov 2012, ourtright and very legal repeal of the entire bill. If that happens we reset to 2008 laws and begin again to attempt, democratically, to untie this Gordian Knot called HC.

    In the meantime pictures like the above will continue to flourish on the humanitarian front.

    As for the picture, the solution is rather obvious. A supply of clean water and clean clothes, some aneseptic ointment and maybe some home care stitches would surfice for the young man that should not have gotten in a fight in the first place (hypothetically!). Now a poor woman giving birth on the steps of the hospital would be a different picture for sure. But civilization survived for a very long time without OB/GYN rooms for every birth in the world.

    I won’t belabor the debate here, but only note that no matter what SCOTUS decides, this is not over by a long shot.

    I also note that the book upon which I have blogged and will add more blogs about, indicates that China’s HC system today is primarlily a privatedly funded HC system. To me that was astonishing. But I suspect most poor people in China deal with HC matters on their own and with a lot of help from families, as they have been doing for millennia now. And they have 1.4 Billion souls to attempt to take care of, not 320 Million. As well some 85% of Chinese like their current system of government today! Only 13% of Americans like what Congress is doing.

    Anson

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  2. jwhester says:

    Well Jim, if you really haven’t met anyone who can’t get insurance in the private market, then let me be the first. I had cancer, and I do not have a job that offers health insurance. The private insurance industry will not sell me insurance at any price. It is only through ObamaCare that I can buy health insurance.

    Without ObamaCare I would have no choice but be one of those who do not pay into the system. If I got cancer again, who knows what might happen. It is little comfort that an emergency room would have to accept me if I had an “emergency.”

    As ansonburlingame said, civilization survived many thousands of years without the benefit of modern science. I wish we would all stop romanticizing the past to the degree of regressing America back into the Dark Ages.

    I agree that it is a complicated issue. Health Care is different from other commercial products because deep down we all believe that people have a right to health care. If we didn’t, then we wouldn’t flinch at the notion of some homeless person expiring on our city streets when a simple medical procedure could save his/her life. To most Americans it is unseemly for anyone to die or suffer needlessly from a disease for which we have a cure.

    I believe what has interfered with curing the sick is the intrusion of “for-profit” medicine. Publicly traded corporations are too intertwined with healthcare. By definition, corporations have no souls. They have only one interest, and that is making money. They are not immoral, per se, but they are amoral, and until we quit hiding behind the shield of capitalism and recognize that in certain areas a little bit of socialism is appropriate, then I don’t think we will find a lasting and good solution.

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  3. Jim Wheeler says:

    What I said, John, was that the “few people I talk to” seem to have insurance, meaning that I don’t find much opportunity to talk to people about such things. (Is it strange that people will open up in blogs but not in person?) I don’t doubt there are many in your situation and I certainly welcome your input here. In fact, I agree with all your sentiments, as you will see if you read my latest post (of a few minutes ago) on healthcare in China.

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  4. Jim,

    I too read George Will’s column in the Tulsa paper. I was pleased to get confirmation of the concern I’ve had for some time now over the Individual Mandate regarding the government’s power to unilaterally alter the terms of contracts and its continued abuse of the Commerce Clause. If this part of the ACA is OK’d by SCOTUS, we might as well kiss contract law goodby. I still think the Supremes will overturn the ACA. If they don’t then shame of them.

    Some time ago I kicked around some numbers to see what the economic impact might be of, essentially, nationalizing the country’s health care system. It has also been my opinion all along that people should not be treated as profit centers but as patients in need of health care. It is an absurdity to say that health care is or should be a part of a free market system. No providers compete for services to individual patients. Indeed, patients are at the mercy of the interplay between government, private health insurance, and the health care providers themselves; e.g., hospitals, doctors, pharmaceutical companies, medical equipment suppliers, etc. The facts that we have so many millions of our citizens without health insurance, that the number one cause of bankruptcy is medical costs, and that our health care on a per capita basis is the highest in the world, are all testimony to the failure of the free market system in this critical area of the economy. (I’m also adamantly opposed to EMTALA, but that discussion is for another day.)

    Now, in the interest of full disclosure, I have no less that 4, count ‘em FOUR, members of my family who are doctors; two MD’s and two DO’s. Therefore, the following is merely a hypothetical exercise, not a suggestion.

    Anyway, my analysis of costs is based on the data from the Census Bureau and the Veteran’s Administration for 2010. Because it is recognized as one of the best health care systems in the world, I used the VA as a model for this comparison:

    $2,584,200,000,000 . . National Health Care Expenditures – 2010
    309,330,219 . . . . . . . . U. S. Population (July 1, 2010)
    $8,354.18 . . . . . . . . . . National Health Care per Capita

    $42,371,585,000 . . . . VA Health Care Expenditures – 2010
    8,300,000 . . . . . . . . . .VA Health Care Enrollees – 2010
    $5,105.01 . . . . . . . . . .Cost per Enrollee

    $1,579,133,935,835 . . .VA Health Care Cost Extrapolated to U.S. Population

    $1,005,066,064,165. . . Net Savings Total
    $3,249.17 . . . . . . . . . . .Per Capita Savings
    63.65% . . . . . . . . . . . . .Percentage Savings

    This analysis shows there would be a savings over more than one trillion dollars to the U.S. population and all Americans would be covered. This is a gross oversimplification, of course. And the medical industrial complex, as you call it, will never let it happen. So long as Medicare holds out, I’ll be OK. I do worry about my progeny though.

    Herb

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    • Jim Wheeler says:

      You have done an outstanding and original analysis of the problem and its possible solution, Herb. It really makes the point. I would have expected no less from you. Thanks.

      As for your medical relatives, I’m sympathetic because as an engineer I loved the practice of engineering, but the business side of aerospace was a turnoff for me – too much posturing, duplicity and customer hand-holding. Similarly, if I were a doctor I would want to concentrate on the practice of medicine.

      I am glad too that you agree on EMTALA and I hope you will return to the subject soon. I hope you agree that while EMTALA is not technically an unfunded mandate, it has the same effect as if it were. I submit that it is political hypocrisy to condemn the ACA without addressing EMTALA.

      For the arithmetically challenged, Herb’s analysis shows approximately ONE TRILLION DOLLARS in potential savings by switching to a government-run healthcare system and while I’m sure there are many fine points to quibble about in the comparison, that massive number is nothing to sneeze at, IMHO.

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  5. ansonburlingame says:

    Be very careful here, Jim and Herb,

    You may well be comparing apples to oranges. The VA system has very strict limits on who can participate, and it is not open to the general public.

    But Medicare IS open to the general public. Here are those very briefly compared numbers.

    (about) $550 Billion per year for all over 65

    (about) 50 million people eligible

    Per capita cost is thus (about) $11,000 per patient under Medicare, far above the “national average” calculated above by Herb.

    There is however one number used by Herb that we can all agree with. It is the $2.5 Trillion (in 2010) for total HC costs nationwide under various systems. The public option thus would move in total that $2.5 Trillion to the coffers of the federal government.

    You CLAIM by doing so that total number MIGHT come down to $1.5 Trillion based on government price controls or “force” on the medical providers to charge much less for services and materials (drugs). On the other hand, using Medicare performance in per capitat costs that number would go UP, far above the current $2.5 Trillion. Let’s see 11/8= 1.3 x 2.5 = $3.4 Trillion, ALL coming from the federal coffers in 2010 alone.

    Now go “tax the rich” to find that extra few $Trillions???

    Based on Herb’s analysis, everyone in America should simply be allowed access to the VA system of HC, right? Now try to predict the per capita cost of that change.

    Finally, all of the above per capita costs (except Medicare) DO NOT incorporate the “everyone gets HC insurance regardless of medical history. Wonder what the cancer patient’s premiumns would be from a private insurer when ACA kicks in to mandate that he receive insurance coverage but with no mandate on how much the premiums will become. Out of sight would be such premiums, in my view, unless you intend to bankrupt the entire private insurance industry which of course many progressives would love to see happen.

    Just let government replace it with universal care payments for each and every American, right?

    Anson

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    • Anson,

      To start with, you have a little apples to oranges problem. Medicare (and Medicaid and SCHIP) is NOT a health care provider. It is a government insurance program for senior citizens, much like private insurance, and it s NOT open to the public.

      You also calculate the per capita cost of Medicare to be roughly $11,000. But, according to the Kaiser Health Research and Educational Trust, the average cost of PRIVATE health insurance in 2011 was $5,429 for single coverage and $15,073 for family coverage. I suspect the average may be close to your $11,000. If so, the Medicare may be competitive with the private sector as a health insurance provider. So, your misunderstanding of the difference between the cost of health insurance and the cost of health care negates your conclusion that total national health care costs would go up.

      As to the VA, I know it’s not open to the public. That’s why I said, “the following is merely a hypothetical exercise, not a suggestion.” I was engaging in a simple “What If?” exercise, nothing more.

      Herb

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  6. ansonburlingame says:

    Com’on Herb (and Jim as well),

    Recall, Jim, we had some disagreement a few months back as to whether Medicare was in fact an insurance program of not. Just to point out that prior dispute.

    But whatever you choose to call it, the Federal government PAYS out around $550 Billion each year (and going up) to actually provide payment for HC services to some 50 Million people in the general public that are 65 or older. Average that to a per capita level and sure looks like about $11,000 per person covered. Of course some received little and others a lot, but if you want to use per capita numbers, all the above seems pretty clear to me.

    As well, recall that Medicare only pays 80% of allowable charges. So someone else pays ($11,000/0.8= $13,750 – $11,000 = $2,750 x $50 Million = $137.5 Billion) to tally up the true and total cost of HC for those 65 or older, every one of them. As well that total cost is using government mandated rates, not the as billed rates from providers.

    So 50 million Americans need a total of ($550 + 137.5 = $687.5 Billion) for HC needs (in 2010)
    On a per capita basis that comes out to close to $14,000 per person, in the general public and at or over 65 years of age. Does that round number look a little familar? Seems like that is the figure used in the old Ryan Plan to pay folks directily, per person for old age HC insurance coverage in place of Medicare as we know it today!!

    Of course that figure (on a per capita basis) incorporates the high cost of EOL care, borne almost exclusively by Medicare (+ 20%) today. HC payments for younger folks should not cost (per capita) that much and private companies can calculate such numbers very quickly, just as hopefully government bureacrats can do as well.

    My only point in all of this is I believe the annual, total cost of HC for 320 Million Americans, payment for HC, not insurance for HC, will be in the range of $2.5 – $3.4 Trillion per year for whoever winds up paying for the services and materials. And of course that total HC figure begins to approach the figure (about $3.8 Trillion per year) of the entire spending of the federal government each year (and growing).

    Bottom line is HC for all Americans today, however it is paid for, exceeds the ability of most to be able to pay for it, period. Solution? COSTS must come down before ANYONE, collectively or as a single payer can come up with the money demanded based on the medical needs of all Americans.

    So the problem, in its simplest form, is we, collectively, in this debate either have to get a much bigger “sock” OR we cut rather drastically the amount of “stuff” we current try to cram into that sock. There, in my view is the dilemma over HC in America today.

    China does not have that problem it seems today at least at their “federal” level. They have autocratically said, this is how much you get, Chinese people, and the rest you figure out how to take care of yourself.

    But such will never satisfy the American people and thus here we are today, trying to figure out a way to get “10lbs of stuff in about a 3lbs sock”

    Anson

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  7. Jim Wheeler says:

    @ All,

    More thoughts.

    Lately I read that some of the Supreme Court Justices seem to be just now discovering some of the nuances of what healthcare has become in our country, nuances like the existence of other mandates like Medicare and Social Security (according to an article in today’s Globe). This leads me to muse that perhaps, just perhaps, these nine government employees may have led sheltered lives in that regard. They should get out more. We bloggers have been hashing this stuff around for at least two years!

    I was thinking also about the mandate and how it is to be paid for. I understand that people are to be informed to sign up for HC insurance or face a “penalty” that would be assessed on their income tax returns by the IRS. I suppose there will be a line asking, “Do you have health insurance complying with the ACA?” If so, write in name and policy no. here ______. If not, proceed to calculate penalty in step xxx. This I see as a really big problem. There is a very good reason why Congress introduced the tax-withholding concept – most people don’t have the fiscal discipline to put money aside for the yearly payment. Notably, according to a Wikipedia page, tax withholding was instituted during WW II, a period of public compliance and cooperation with government. The writers of the Medicare legislation also understood the power of withholding, obviously.

    I’m thinking that the ACA writers were very short-sighted here. Around April, 2014 there just might be a whole lot of very upset and angry people who “forgot” to get that insurance. And if that has the same effect as underpayment of taxes, will that trigger even more of a tax penalty? Or are people so compliant that they will quietly and obediently seek out insurance and sign up? The U.S. tax system is largely based on voluntary taxpayer compliance. Some people, notably growing numbers of so-called citizen militias, already buck the system. Will this new “surprise” lead to an even larger citizen revolt? I like a lot about the ACA but I think this part was screwed up, and the reason for it just leads back to the basic problem – it should have been a tax like Medicare, subject to withholding.

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  8. ansonburlingame says:

    Absolutely correct, Jim,

    “….it should have been a tax like Medicare, subject to withholding.”

    BUT, the question remains, “How much of a tax should be withheld and from what?”

    We are talking, ultimately about covering 320 Million people.

    Assume, just for an example that the total annual cost for HC is $3.2 Trillion. That means each and every one of 320 Million people must cough up $10,000 per year to pay for such a huge sum, JUST for HC.

    Take the “low end” of the total cost estimate discussed above which MIGHT be in the range of $1.5 Trillion. That comes out to $4,687 for each of those 320 million people or close to $18,000 for every family of four, just to provide the needed revenues to a single payer to break even in the provision of HC to all Americans.

    Cut it another way if you like. I pay $96 per month for Medicare. In a normal year, call it $1200 for me alone paid into the “fund”. Based on my age (70) and health (good) that is about what Medicare pays for my routine care each year, plus or minus. If I happen to undergo a colonoscopy in a given year I go way over that nominal limit. And of course when (no if) I go into physical decline those annual costs to Medicare skyrocket for sure.

    The technology of medical science simply seems to have far outpaced the entire country’s ability to pay for that technology. So something must “give”.

    That “give” is the great unknown in this debate. What is the nominal dollar figure that CAN be provided by each American to ensure “nominal HC” for each American. Then “lop off” the millions at the low end of the economic ladder and shift that burden to the ones on the high end or middle and see what those huge financial numbers, per person, might be.

    And as for a “tax” to pay for universal HC in America, can you imagine any politician that would call for such huge numbers above?

    And thus the debate continues with little or no discussion of where we actually find the financial resources to affort “nominal HC” for every American.

    Anson

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  9. Alan Scott says:

    Jim Wheeler,

    ” The only way out of the financial mess I can see is to make healthcare a tax-supported program like Medicare, the so-called “public option”, but it seems that will have to wait until the present system collapses, something it is now doing in slow motion. ”

    The problem with your solution is that it will not work . Just because something in your opinion is broken, that does not mean breaking it more is a good idea . Medicare is predicted to collapse in a few years . The numbers do not work. Just like the numbers for Obama-Care. Bernie Maddof would be ashamed of the accounting tricks President Obama used to justify Obama-Care . However bad the current system is the ACA, no Obama-Care, will make it much much worse .

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    • Jim Wheeler says:

      Alan,

      I’m not advocating breaking the system, merely predicting that it will because, as you say, the numbers do not work. But I don’t agree that the ACA will make it “much, much worse.” There’s no evidence of that, but if you have some I would like to hear it.

      I have to note the implication in your comment that the president used accounting tricks to justify the ACA. If you review the history of the legislation I think you’ll find that the public option was what Obama wanted, but the GOP opposition made that impossible. Nobody predicted that the ACA would be completely affordable, only that it would be better that what it replaced – it was a compromise. However, if the SCOTUS rules as expected it will likely all be OBE anyway (Overtaken By Events).

      Thanks for your interest in this important problem.

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  10. Alan Scott says:

    Jim Wheeler ,

    It all comes down to who you believe. Based on his record of handling the peoples money, I have no confidence in anything President Obama says about the economics of the Health care legislation. In other words I tend to believe the critics on the right . For my source I cite :

    http://blog.heritage.org/2012/04/08/chart-of-the-week-obamacares-bundle-of-budget-gimmicks/

    As the article says the disputed cuts probably will never be enacted anyway because providers will drop medicare patients. The assumptions are all totally fantastical .

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  11. Alan Scott says:

    Jim Wheeler ,

    I happen to believe that conservative propaganda . I believe it is the only workable solution . I believe your ideas will bankrupt this country a lot faster than the current system . One of the free market solutions that is blocked right now is selling health insurance across state lines . I also believe Medicare besides going broke is a major driver of costs .

    I read your link and I’m afraid I am just a closed minded ideologue . I am what you are up against . Thank you for tolerating my dissent .

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    • Jim Wheeler says:

      @ Alan Scott,

      I appreciate you taking the time to read my piece even if you disagree. Unlike some you are at least civil about it, and I always appreciate that.

      As a matter of interest I am currently reading a book by Pulitzer-prize winning author and evolutionary biologist Edward O. Wilson, “The Social Conquest of Earth”. Wilson explains human behavior in the context of what is known from numerous branches of science including archaeology and animal studies and makes the case that technology has far outstripped man’s primal nature. We are not so far removed from a fundamental tribal behavior and yet we have the means to do enormous harm to one another. Passion about war and sports is only one piece of evidence he cites, and I’m waiting for him to mention politics. I’m only about 15% into it.

      In the same vein I read an interesting column in this morning’s paper you might appreciate. Here’s a link:

      http://www.koreatimes.co.kr/www/news/opinon/2012/04/137_109445.html

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  12. Alan Scott says:

    Jim Wheeler ,

    I promise to read your link, right now I am pressed for time . I warn you that you are unlikely to make any headway with me, but perhaps sparring with me will sharpen your arguments . I also warn you I have been banned more than once from political forums . I am not profane, merely passionate in my statements . I go looking for fights .

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    • Jim Wheeler says:

      Then, Alan, you are like the majority who partake of political discourse. You see it not as a quest for wisdom but a battleground where compromise is not an option. If that’s the case, I will find it uninteresting.

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  13. Alan Scott says:

    Jim Wheeler ,

    I find the column you linked to surprisingly fair . I just do not care for the way it states this campaign is different from any other . I have followed each one since Watergate . I have yet to find one that is not the most vicious ever .

    Pardon me for saying this but everyone I come across who talks compromise the way you do means that the other side compromises, while they get what they want . I will compromise as much as I have to, not one milimeter more . Social Security and Medicare ‘ are ‘ going bankrupt. How do you compromise on that ? Oh we will just soak the rich. Go ahead and see if it works. It will not, but you will feel much better .

    For as much as you claim to be an independent, admit it you are a liberal. I can tell by your answers . We can argue whether you are a Socialist. My point is class warfare is failing all over the world . The EU has been suicidally collapsing in slow motion for 3 years now .

    In the US the only way to save SS and Medicare is to do something like Paul Ryan’s plan . Obama has done nothing but demonize anyone who comes up with a real plan . He has wasted 3 and a half years . He will go down as the worst President since James Buchanon. Buchanon did virtually nothing to stop the nation from sliding into Civil War before Abraham Lincoln .

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    • Jim Wheeler says:

      @ Alan Scott,
      1. You might be right about the emotive intensity of the current campaign. It does seem to me that the current one is the worst, but then I’ve been blogging politically only in the last two years, late in life, and I know that activity has sharpened my perceptions a great deal. In the past I have always voted Republican or for a third party candidate (thinking, mistakenly and shallowly, that such a shakeup would be healthy.) Senator Charles Sumner was beaten to a pulp on the Senate floor by an enraged opponent just before the Civil War. He never recovered his health.
      2. Compromise is rare, but not extinct. I recall that Tip O’neal and Reagan got some things done and Missouri’s John Danforth was a well-known compromiser, just to cite two examples.
      3. I have definitely trended more liberal over the last two years, mainly due to blogging activity and introspection. Maybe there was a liberal inside me all the time, waiting to come out. I share that in common with my friend, blogger Erstwhile Conservative, who also used to be, well, conservative. Nevertheless, I don’t like labels because that implies an unwillingness to compromise, something I see as not hopeless as you seem to. As for social government systems, some are indeed self-indulgent and terrible (Greece, Spain), but some are doing quite well (Germany, Finland). Let’s not throw out the baby with the bathwater, Alan.
      4. I actually liked the spirit of Ryan’s plan because the system desperately needs fixing. The problem with his plan as I saw it was that it was overwhelmingly favorable to the rich and abruptly abandoned the rest on short rations. I can easily imagine some form of his plan being acceptable if it somehow embraces and uses true capitalism, some system which actually requires people to shop for price in medical care. Problem is, it’s just not the kind of product that makes that practical. As for the current system, including ObamaCare (ACA), it is corrupt because it is structured around profits to the detriment of quality and preventive medicine. Here is a post I did on that.

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  14. Alan Scott says:

    Jim Wheeler ,

    I hope you continue your philosophical journey . I believe that you have to go with what actually works . When I was young and worked in at a ski resort I admit to having severe class envy . I made next to nothing and fitted skis and cleaned hotel rooms. It seemed that all these rich people lived the good life. while I had nothing . After awhile and especially when lack of snow stopped the rich people from coming , I realized that the rich were the ones who gave me a paycheck .

    The ups and downs I have experienced since then have convinced me that economic equality is a red herring . Sure some rich people are scum . But anyone who says they will fix that, requires massive political power . To believe that politicians are more virtuous than millionaires or smarter at allocating resources goes against experience . One only has to look at the scandals in Washington, where politicians funnel money to their supporters to see the folly of that viewpoint .
    Historically one can look at the Soviet example . Theoretically everybody was equal. No rich exploiters . Less extreme examples are the countries in the EU, which is disintegrating . Even in the US, the states that try to solve their troubles by soaking the rich are the ones having the most trouble. Namely Illinois, California, and New York State .

    I always ask my Progressive friends to give me examples of where their stuff is working . One shining example is Germany . But even there, the economy only took off about 2005 when they cut welfare, lowered taxes, and got labor to agree to work rule changes . Southern Europe is a real mess that Socialist governments are largely to blame for .

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    • Jim Wheeler says:

      I agree Alan, we must go with what actually works. Two things that actually work are Social Security and Medicare. Those programs have provided dignity and security to countless millions of seniors, preventing them from sliding into poverty and being a burden to their families, which is the way things used to be in the old days. Economics isn’t simple just as technology isn’t simple, and in fact technology makes it even more of a challenge now that we are committed to a global economy. It’s a constantly shifting dynamic. As an example I saw an interesting item on the evening news last night – an American company has decided to move their TV assembly line from China to, of all places, Detroit! It’s a small operation at present but just might succeed. The rising wages in China, rising transportation costs (fuel), and better U.S. productivity are all factors.

      Yes, Greece is certainly a poster child for runaway socialism, but I have correspondents who testify that medical care in Canada and parts of the EU are equal in outcomes to ours at a fraction of the cost. Our founders recognized that government was both necessary (the common good) and difficult, which is the reason of course why we have three co-equal branches and a legislative process designed to require compromise. But now people are signing pledges never to compromise and that, IMHO, is undermining the government’s ability to function. I wish it were as simple as a choice between pure capitalism and socialism, but it isn’t. Governing people in tribes of millions is hard work and a messy process.

      Thanks for visiting my archives, by the way.

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  15. Alan Scott says:

    Jim Wheeler ,

    I do not want to argue about whether SS and Medicare are good or bad . They exist and too many people, including myself are now far too invested in them to not rely on them one day . One of my favorite pundits to scream at when watching TV is Chris Mathews . He loves to be clever by asking entitlement bashers if they will pledge to forego their SS benefits when they get old since it is a ponzi scheme .

    I figured out an answer to this loaded question . I would say sure Chris, but I want all of the money I and my employers ever paid into SS and Medicare and I am not greedy . I only want 6% compounded interest tax free also returned to me .

    Again SS and Medicare exist. The important question is how to save them . I hate the lies Democrats put out that Republicans only want to kill the two programs and give the money to their rich friends . That has worked for decades. Demographics don’t lie . If SS and Medicare are to exist for those who follow us, even Democrats will have to face up to some hard truths .

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