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Author Topic: AmeriPol thread  (Read 4439098 times)

McTraveller

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Re: AmeriPol thread
« Reply #51015 on: May 22, 2023, 03:13:25 pm »

Don't fall into the trap of looking only at one side of the equation: If drug prices go down - again - where isn't money going that it was going before? Who are all the impacted people? It's not just rich CEOs, it's employees of those pharma companies, it's retirement funds, it's local governments from property taxes, etc.

Put another way: How do you get money going back to those people, even if you aren't spending it on "health care"?  Even the CEOs - if they don't have money to buy yachts or whatever, who is going to pay the yacht janitors? What are they going to go do instead of clean yachts?
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hector13

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Re: AmeriPol thread
« Reply #51016 on: May 22, 2023, 03:17:10 pm »

Clean the CEOs house/car/golf clubs instead. It’s a transferable skill.
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Starver

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Re: AmeriPol thread
« Reply #51017 on: May 22, 2023, 03:29:21 pm »

Edit: what you also seem to be forgetting is that if people aren’t paying for private insurance, they can be taxed (like National Insursnce in the UK) to help pay for universal healthcare.
But don't forget that there's the famous American creed: "No taxation without... no, scratch that, no taxation at all, ideally. Well, except for Federal, State and Local taxes on sales, payroll, capital gains, etc, etc... But honestly we say we're cutting it all down, and yet somehow you also need another entire industry dedicated to getting anyone who can afford to working out all the deductables they can to offset the highly convoluted nested and parallel tax-codes..."


Amazing, really, that everyone seems to jump through hoops with taxes already, yet disproportionately distrusts any proposed new (hypothecated?) method of replacing all the ad-hoc non-tax charges currently effectively demanded-with-menaces by non-state (or, indeed -federal!) actors. Or so it seems to me, viewing this issue askew from far off to the side, here.  8)
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Nirur Torir

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Re: AmeriPol thread
« Reply #51018 on: May 22, 2023, 03:35:56 pm »

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Wait what? How are you going to save money if you have the same exact people employed by the universal plan instead of the private plans?  They're just going to accept lower salaries out of the goodness of their hearts?
A quick web search gets me the claim that 9% of insurance company revenue goes to payroll. Combined with the cost savings from not having insurance companies spiraling prices, and it's not that far fetched to think we'd save money by breaking insurance companies and giving former employees food stamps and government housing until they find new work.

https://www.klipfolio.com/metrics/finance/payroll-to-revenue-ratio/
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Additionally, based on US Census data and PWC research, here are Payroll to Revenue benchmarks by industry: manufacturing at 18%, healthcare at 45%, insurance companies at 9%, while retail stores have a payroll to revenue ratio between 10% - 12%.

This entire argument has a weak foundation I haven't seen pointed out yet: The left generally don't want insurance reform as a tool to cut down on government spending. Leftist fiscal ideals are to increase taxes and increase government spending on social programs. That cutting out the insurance companies would reduce a useless and expensive drain in the economy is a happy side-effect, but the main points are increasing lifespan and standards of living. It would be great to never again have to wonder if this bleeding knife cut is bad enough to call an ambulance, and never again see news about college kids dying because they're forced to try to ration their insulin in what is allegedly the greatest country on Earth.

If we combine it with leftist ideas like cheap/free education and job retraining, a safety net for the disabled, and the major infrastructure rebuilding that keeps being floated (The jobs may be temporary, but it's a cash infusion into the local economy combined with better rails and roads making it cheaper to run a businesses), I'm not concerned with lost insurance company jobs. And I'm not concerned that we might only get insurance companies replaced, without other leftist ideals to help the newly unemployed out, because we have a lot of inertia and money making healthcare reform a difficult fruit to pick. It won't happen alone.
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Micro102

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Re: AmeriPol thread
« Reply #51019 on: May 22, 2023, 04:17:25 pm »

If you spend less money on healthcare, then people have more money to spend on other businesses. We spend over $5000 per person more than other countries over healthcare. Clean that up and more things will be purchased. Businesses that don't flood small towns with opiods, creating populations of addicts to make money and suck the life from people can expand and THEY can hire the yacht janitors.
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Maximum Spin

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Re: AmeriPol thread
« Reply #51020 on: May 22, 2023, 05:03:55 pm »

If you spend less money on healthcare, then people have more money to spend on other businesses. We spend over $5000 per person more than other countries over healthcare. Clean that up and more things will be purchased. Businesses that don't flood small towns with opiods, creating populations of addicts to make money and suck the life from people can expand and THEY can hire the yacht janitors.
I forgot about this thread overnight and I don't particularly care enough to get back into it, but, seeing this, I absolutely have to reiterate that this is not how this works. Removing a particular channel money is flowing through from the economy does not add any new value. Health insurance companies don't shovel money into a giant furnace to heat the building. If you eliminate health insurance, it doesn't mean "people" magically have more money to spend on other businesses - it means that some people who paid for health insurance (eg, not me) keep that money to spend elsewhere, while at the same time people who worked for health insurance companies and everyone downstream of them have an equal amount less money because they're not getting the money from the first group anymore. Of course, it's possible, even likely, that the money will end up moving between the same people by some other channels, but this does not stimulate the economy any more than the insurance company did in the first place. Nobody has more of anything, overall, because there isn't more of anything overall.
Even if we assume that health insurance provides zero positive value for anyone and is a perverse creation of the Devil that nobody really wanted, removing it creates no new value and can only leave the economy in the same condition at best.
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McTraveller

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Re: AmeriPol thread
« Reply #51021 on: May 22, 2023, 05:09:00 pm »

People will only have that extra $5000 to spend on "new" things only if you trust-bust, so new businesses can come up and those extra $5000 aren't just eaten up by price increases for the same goods and services.  Because you can bet that every owner of a rental unit would love a piece of that $5000 a year, and every subscription service would love a piece of that $5000 a year, etc. etc. (See I can play the pessimism game, too!  ;D)

Seriously please understand the problem isn't that yes, you can easily reduce health care spending. But reducing health care spending isn't free - you have to pay for it with re-training, new laws, etc.  I'm not personally convinced that the USA culture will realize a savings from single-payer health care.  There are other ways to fix health care, but having it controlled by the government is not high on my "likely to succeed" list.

People always say "but it works in other countries!"  But other countries are other people, with different world views and cultural norms.  I don't think you can get to where you want, without changing the culture first.
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Maximum Spin

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Re: AmeriPol thread
« Reply #51022 on: May 22, 2023, 05:14:27 pm »

People will only have that extra $5000 to spend on "new" things only if you trust-bust, so new businesses can come up and those extra $5000 aren't just eaten up by price increases for the same goods and services.  Because you can bet that every owner of a rental unit would love a piece of that $5000 a year, and every subscription service would love a piece of that $5000 a year, etc. etc. (See I can play the pessimism game, too!  ;D)
"People" still wouldn't have that extra $5000 to spend, because you didn't add anything to the economy, you just moved it from one place to another! The long-term and medium-term effects of this are zero, since whatever health insurance company employees were previously spending their money on is no longer contributing to the wages of all the people who buy health insurance.
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Frumple

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Re: AmeriPol thread
« Reply #51023 on: May 22, 2023, 06:03:08 pm »

People always say "but it works in other countries!"  But other countries are other people, with different world views and cultural norms.  I don't think you can get to where you want, without changing the culture first.
The eternal problem with that position is, like. We have socialized medicine already? The medi-etcs., VA, various social security related junk. It's just not universal. Performance, cost metrics, even bloody patient sanctification, etc., generally all match or outperform most privatized insurance while still burning less cash and lives on the altar of mammon.

I don't think our culture would have either problems with it, nor trouble adjusting, once the option is there and the private industry has been curtailed a bit (if only by having a sufficiently strong competition that doesn't think it has a fiduciary duty to omnifuck the maximal number of people). Somewhere between a majority and a supermajority of the country wants a public option. We're not so wildly fucking broken of a country as to not be able to wrap our collective head around a healthcare industry that's not so bloody ghoulish.
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Micro102

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Re: AmeriPol thread
« Reply #51024 on: May 22, 2023, 06:45:57 pm »

If you spend less money on healthcare, then people have more money to spend on other businesses. We spend over $5000 per person more than other countries over healthcare. Clean that up and more things will be purchased. Businesses that don't flood small towns with opiods, creating populations of addicts to make money and suck the life from people can expand and THEY can hire the yacht janitors.
I forgot about this thread overnight and I don't particularly care enough to get back into it, but, seeing this, I absolutely have to reiterate that this is not how this works. Removing a particular channel money is flowing through from the economy does not add any new value. Health insurance companies don't shovel money into a giant furnace to heat the building. If you eliminate health insurance, it doesn't mean "people" magically have more money to spend on other businesses - it means that some people who paid for health insurance (eg, not me) keep that money to spend elsewhere, while at the same time people who worked for health insurance companies and everyone downstream of them have an equal amount less money because they're not getting the money from the first group anymore. Of course, it's possible, even likely, that the money will end up moving between the same people by some other channels, but this does not stimulate the economy any more than the insurance company did in the first place. Nobody has more of anything, overall, because there isn't more of anything overall.
Even if we assume that health insurance provides zero positive value for anyone and is a perverse creation of the Devil that nobody really wanted, removing it creates no new value and can only leave the economy in the same condition at best.

This is the "no new technology" argument again. This is an argument against every bit of technology that would increase productivity, because all the people it replaces would be out of a job and no new wealth would be added, it just makes things more efficient. But we can't just keep things inefficient for the sake of jobs.

If we really truly needed to keep every person currently employed in the current health insurance, employed, then let's just imagine doing that. We become universal single payer, and instead of maximizing efficiency, we spend the same amount per person and just keep all medical facilities over staffed. The healthcare would just be better. People would have an easier time getting healthcare and would be happier and healthier and that would still result in better productivity throughout the entire US, because the outcome of the healthcare insurance industry is the well being of the people in general and that is valuable in itself. That's basically the entire reason money should be used, to maintain a comfortable happy life.

We also have to think about what sort of new wealth health insurance creates. It's not like it takes resources from the earth or transforms other resources. It just takes money from people while deciding who gets to die sooner. Taking labor from that and putting it towards actually transformative labor would generate more wealth then just keeping the inefficient system that generates taxes by parasitizing part of the population.
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Maximum Spin

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Re: AmeriPol thread
« Reply #51025 on: May 22, 2023, 07:07:45 pm »

This is the "no new technology" argument again. This is an argument against every bit of technology that would increase productivity, because all the people it replaces would be out of a job and no new wealth would be added, it just makes things more efficient.
It's not though. It's not my fault if you can't tell the difference. We aren't discussing a new technology here. There's no new technology of paying for healthcare that's been invented. An actual new technology creates new real value. Real value is still the fundamental thing that the economy runs on, not dollar bills. Nobody has discovered a way to make real value out of "paying for healthcare".
Of course, even real new technologies do cause economic shocks that harm people in the short term. Generally speaking, this is worth it and can't be stopped anyway, but this means that it is, again, still a significant tradeoff and it's worth knowing what you're trading off and having a plan for it. You, not I, framed this as a question of whether single-payer healthcare is an easy and obvious solution without downsides.

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The healthcare would just be better.
Hold on, how would the healthcare be better? It's the same healthcare regardless of how you're paying for it. To get better healthcare, you either need to pay doctors and nurses more for more work - costing more money that now has to come from the government, which means it comes from taxes, which means everyone is forced to pay for it and everyone is a little poorer - or pay doctors and nurses the same or less for more work, relatively impoverishing them and reducing the supply of doctors and nurses available.
In particular, you seem to be assuming that more people would be able to get more medical services than they do now, because the government won't be allowed to refuse to pay for services it decides are unnecessary as much as insurance companies do — but since medical professionals like to feed their kids every day, they need to be paid for the extra work, which means this costs more money, and, by the way, it's extra work that highly-paid insurance actuaries have already determined is not worth the price.

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We also have to think about what sort of new wealth health insurance creates.
Like I implied earlier, if you assume it provides no value at all and nobody ever wanted it, then you have to ask how we got into this situation where nearly everyone buys it and the government recently tried to make it mandatory in the first place. You can complain that insurance companies lobby the government to get that power, but they got the money they used to lobby the government, originally, from people buying health insurance because they wanted health insurance. Clearly it provides some value to people, or people at least think it does. It's fair to theorize that single-payer could provide similar value in terms of socializing risk, although it will do so less efficiently by design; but to imagine that health insurance is just a perverse creation of the Devil is silly.
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It just takes money from people while deciding who gets to die sooner.
Will government single-payer healthcare do anything different? Decisions on allocating scarce resources will still have to be made, and sometimes it is not worth the cost to extend someone's life. Often, in fact.
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Taking labor from that and putting it towards actually transformative labor would generate more wealth.
You can't just "put" people from one industry into another willy-nilly. People aren't fungible, and even if they were, opportunities to extract real value aren't infinite and returns diminish. What would you actually do? Make the middle-aged clerk ladies till cornfields?
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Micro102

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Re: AmeriPol thread
« Reply #51026 on: May 22, 2023, 07:30:12 pm »

There is no point in arguing with someone who will ultimately just hand waive away any source they are given. Let's say I actually spend hours pointing out every little flaw in your paragraphs of gish gallop, and write a detailed plan much like the one in Senator Sanders et al.'s bill, you are just going to ignore it, say it was all proven to not work decades ago, and continue to gish gallop. If I ask you for details, you fall silent until you can gish gallop against another comment.
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Maximum Spin

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Re: AmeriPol thread
« Reply #51027 on: May 22, 2023, 07:53:06 pm »

If I ask you for details, you fall silent until you can gish gallop against another comment.
I like to sleep almost every day. It's a terrible vice, I know.

But the truth is, you're wrong and your ideas are poorly-thought-out mush, and I don't really care to dignify a Bernie Bro with debate in the first place, so I'm absolutely fine staking this one to dust.
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Random_Dragon

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Re: AmeriPol thread
« Reply #51028 on: May 23, 2023, 02:00:27 am »

Oh right, the alt-right troll is back with his shit hottakes again.
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KittyTac

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Re: AmeriPol thread
« Reply #51029 on: May 23, 2023, 02:42:28 am »

Toppest of fucking keks. This was kinda entertaining. You held your ground well Micro.
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