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Barriers to Greater Public Investment

BigRat
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1/21/2013 2:21:23 PM
Posted: 3 years ago
I am a skeptic of many forms of public investment (namely so called "green" projects of various types).

However, I do see real benefit in greater public investment in things like basic research, traditional infrastructure, and even education (so long as the education dollars go to productive usage).

The real question here is what exactly is the barrier to this type of public investment?

It really is not declining tax revenues. The real problem is, more than anything else, public health entitlements on the federal level and public pensions on the state and local level.

The Democratic Party likes to market itself as the party of public investment.

However, given the Democratic Party's resistance to reforms in public pensions or health entitlements, it is not hard to imagine a world where the Republican Party takes the cause of greater public investment as their own.

Reforming of entitlements and pensions should go hand-in-hand, politically, with greater public investment.

I often hear defenders of the Democratic Party and President Obama go on and on about the benefits of public investment. I agree with them about many of these benefits, but they never are able to acknowledge what the real barrier to future investment is: the very benefits they defend so passionatley.

For this reason, I do not find it hard to imagine that one day the Republican Party will be more pro-Public Investment than the Democrats.
malcolmxy
Posts: 2,855
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1/21/2013 2:46:57 PM
Posted: 3 years ago
http://www.nytimes.com...

Just as relevant to demonstrate your argument is false here as it was the other place you made it.

If at first you don't succeed, say it louder and more forcefully, eh Adolf? (I'm sorry Goebbels...)
War is over, if you want it.

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BigRat
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1/21/2013 2:48:42 PM
Posted: 3 years ago
At 1/21/2013 2:46:57 PM, malcolmxy wrote:
http://www.nytimes.com...

Just as relevant to demonstrate your argument is false here as it was the other place you made it.

If at first you don't succeed, say it louder and more forcefully, eh Adolf? (I'm sorry Goebbels...)

You are comparing my claim that exploding costs in health entitlements undermines public investment to Hitler's "Great Lie".

Isn't that a bit, I don't know, insane?
BigRat
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1/21/2013 2:55:54 PM
Posted: 3 years ago
Also Malcolmxy,

Krugman's argument here is silly.

Yes, Canada has a better skilled workforce than the southern USA. It just so happens that education is public in the states just like Canada. So, no points here for the pro goverment crowd here.

Also, the idea that Toyota's decision to go north had anything to do with health care is totally based on a guess by Krugman... nothing else.

I am all for lowering health care costs. But, the evidence shows that market dynamics are much more effective for doing this than single payer.

Look at Singapore and Switzerland, both offer universal coverage with market based dynamics (relying more on private sector than public). Both of these countries offer high quality health care for reasonable costs.

That is the model we should be looking at.

Believe it or not, the world is larger than the USA and Canada. And, if we look at the whole world, we see HC systems that work much better than either us or Canada.
malcolmxy
Posts: 2,855
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1/21/2013 3:10:28 PM
Posted: 3 years ago
At 1/21/2013 2:48:42 PM, BigRat wrote:
At 1/21/2013 2:46:57 PM, malcolmxy wrote:
http://www.nytimes.com...

Just as relevant to demonstrate your argument is false here as it was the other place you made it.

If at first you don't succeed, say it louder and more forcefully, eh Adolf? (I'm sorry Goebbels...)

You are comparing my claim that exploding costs in health entitlements undermines public investment to Hitler's "Great Lie".

Isn't that a bit, I don't know, insane?

No, I'm comparing your iterative style of trying to make your point to his oratory style.

I'm a jerk, not a nutball.
War is over, if you want it.

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BigRat
Posts: 465
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1/21/2013 3:20:19 PM
Posted: 3 years ago
At 1/21/2013 3:10:28 PM, malcolmxy wrote:
At 1/21/2013 2:48:42 PM, BigRat wrote:
At 1/21/2013 2:46:57 PM, malcolmxy wrote:
http://www.nytimes.com...

Just as relevant to demonstrate your argument is false here as it was the other place you made it.

If at first you don't succeed, say it louder and more forcefully, eh Adolf? (I'm sorry Goebbels...)

You are comparing my claim that exploding costs in health entitlements undermines public investment to Hitler's "Great Lie".

Isn't that a bit, I don't know, insane?

No, I'm comparing your iterative style of trying to make your point to his oratory style.

I'm a jerk, not a nutball.

Your a jerk who is not particularly well informed.
malcolmxy
Posts: 2,855
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1/21/2013 3:36:30 PM
Posted: 3 years ago
At 1/21/2013 2:55:54 PM, BigRat wrote:
Also Malcolmxy,

Krugman's argument here is silly.

Yes, Canada has a better skilled workforce than the southern USA. It just so happens that education is public in the states just like Canada. So, no points here for the pro goverment crowd here.

Also, the idea that Toyota's decision to go north had anything to do with health care is totally based on a guess by Krugman... nothing else.

I am all for lowering health care costs. But, the evidence shows that market dynamics are much more effective for doing this than single payer.

Look at Singapore and Switzerland, both offer universal coverage with market based dynamics (relying more on private sector than public). Both of these countries offer high quality health care for reasonable costs.

That is the model we should be looking at.

Believe it or not, the world is larger than the USA and Canada. And, if we look at the whole world, we see HC systems that work much better than either us or Canada.

Guess what? Toyota also had a vacant, but operational, plant in CA. The health care reasoning was not a guess.

What, after salary, is an employers #1 expense tied to their individual employees?

The expense is so great, in fact, that Toyota decided not only to shut down operations at its TN plant, but also skip over its dormant, but operational, CA plant (because, who wants a bunch of backwoods hicks assembling their Camry's...I can understand this concept), AND BUILD NEW PLANTS IN CANADA.

OK, genius. If not because of the absence of the incremental cost of employee health care, then what was it? A Japanese proclivity for maple syrup? back bacon?

And, I am not a well indoctrinated jerk. As it turns out, I am quite well informed.
War is over, if you want it.

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BigRat
Posts: 465
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1/21/2013 5:10:39 PM
Posted: 3 years ago
At 1/21/2013 3:36:30 PM, malcolmxy wrote:
At 1/21/2013 2:55:54 PM, BigRat wrote:
Also Malcolmxy,

Krugman's argument here is silly.

Yes, Canada has a better skilled workforce than the southern USA. It just so happens that education is public in the states just like Canada. So, no points here for the pro goverment crowd here.

Also, the idea that Toyota's decision to go north had anything to do with health care is totally based on a guess by Krugman... nothing else.

I am all for lowering health care costs. But, the evidence shows that market dynamics are much more effective for doing this than single payer.

Look at Singapore and Switzerland, both offer universal coverage with market based dynamics (relying more on private sector than public). Both of these countries offer high quality health care for reasonable costs.

That is the model we should be looking at.

Believe it or not, the world is larger than the USA and Canada. And, if we look at the whole world, we see HC systems that work much better than either us or Canada.

Guess what? Toyota also had a vacant, but operational, plant in CA. The health care reasoning was not a guess.

What, after salary, is an employers #1 expense tied to their individual employees?

The expense is so great, in fact, that Toyota decided not only to shut down operations at its TN plant, but also skip over its dormant, but operational, CA plant (because, who wants a bunch of backwoods hicks assembling their Camry's...I can understand this concept), AND BUILD NEW PLANTS IN CANADA.

OK, genius. If not because of the absence of the incremental cost of employee health care, then what was it? A Japanese proclivity for maple syrup? back bacon?

And, I am not a well indoctrinated jerk. As it turns out, I am quite well informed.

Well, I find it odd that someone as well informed as you say you are is saying such blatantly incorrect things.

My main point was that there are much better systems than single payer at lowering costs.

Pretending that the only options are the US system or Single Payer is silly.

There are systems that work much better than both of these that use market dynamics to lower costs.

Also, the whole idea that a nationalized health care system improves competitiveness is pretty ridiculous to begin with.
CarefulNow
Posts: 780
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1/21/2013 5:51:52 PM
Posted: 3 years ago
At 1/21/2013 2:55:54 PM, BigRat wrote:
Look at Singapore and Switzerland, both offer universal coverage with market based dynamics (relying more on private sector than public). Both of these countries offer high quality health care for reasonable costs.

The Swiss system is the 2nd most expensive in the world. It's basically Obamacare; compulsory private insurance. Singapore's system is very efficient, but it's not particularly market-oriented. Half the hospitals are public hospitals (compare to Canada, where provision is just as privatized as in the US), and the vast majority of people have public insurance.
BigRat
Posts: 465
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1/21/2013 6:16:18 PM
Posted: 3 years ago
At 1/21/2013 5:51:52 PM, CarefulNow wrote:
At 1/21/2013 2:55:54 PM, BigRat wrote:
Look at Singapore and Switzerland, both offer universal coverage with market based dynamics (relying more on private sector than public). Both of these countries offer high quality health care for reasonable costs.

The Swiss system is the 2nd most expensive in the world. It's basically Obamacare; compulsory private insurance. Singapore's system is very efficient, but it's not particularly market-oriented. Half the hospitals are public hospitals (compare to Canada, where provision is just as privatized as in the US), and the vast majority of people have public insurance.

Wrong a number of counts.

First, health care spending should be measured as a share of GDP. Here, Switzerland is about the same as Canada and France.

And, there is no Medicare or Medicaid in Switzerland and it is not nearly as regulated as Obamacare. Saying that it is the same as Obamacare is just being dishonest.

Singapore's system is efficient precisely because it is market oriented.

There is actually a way to measure this. 65% of Singapore health spenidng is private compared to 50% in the USA, 30% in Canada, and 15% in the UK.

Singapore's sytem is the most private by a mile.
malcolmxy
Posts: 2,855
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1/21/2013 6:44:56 PM
Posted: 3 years ago
At 1/21/2013 5:10:39 PM, BigRat wrote:

Well, I find it odd that someone as well informed as you say you are is saying such blatantly incorrect things.

such as?


My main point was that there are much better systems than single payer at lowering costs.

such as? Every country on a single payer system in the industrialized west has a lesser per capita health cost than the US and a better system of care in terms of average patient care.

Now, you're gonna say Singapore, and I'm gonna say Malta, so let's skip past that worthlessly cancelling part of the discussion and you find something more than a totalitarian society and it's "free market" system and find one other example where a non-single payer plan did anything but act as a drag on a country's resources.


Pretending that the only options are the US system or Single Payer is silly.

OK...there is the concierge system, but that has more to do with the service one receives from their PCP than who is covering the charges.

You've got private health care, single payer universal healthcare, and the bending over that is Obamacare.

Give me something else. We're not to Obamacare yet. (please have something better than vouchers ready for this...PLEASE!!)


There are systems that work much better than both of these that use market dynamics to lower costs.

Oh really...do tell of these system and how long they have been being implemented. You have fully piqued my interest here.


Also, the whole idea that a nationalized health care system improves competitiveness is pretty ridiculous to begin with.

It improves the US standing in competing for businesses to open operations and create jobs here because it takes healthcare costs away from the private sector and shifts them to the public sector.

If you owned a business and you could pay your employees 10, or 10 + H where H as a number above zero, which would you choose? Now if I told you H was a function of the country in which your potential new employees were located, which location would you choose?

Never mind. You can't grasp the concept that if a business is able to save money by moving geographically, they will make that move, so obviously you would never be a business owner for any significant length of time before your business was run into the ground by its incompetent management.
War is over, if you want it.

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malcolmxy
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1/21/2013 6:48:06 PM
Posted: 3 years ago
At 1/21/2013 5:51:52 PM, CarefulNow wrote:
At 1/21/2013 2:55:54 PM, BigRat wrote:
Look at Singapore and Switzerland, both offer universal coverage with market based dynamics (relying more on private sector than public). Both of these countries offer high quality health care for reasonable costs.

The Swiss system is the 2nd most expensive in the world. It's basically Obamacare; compulsory private insurance. Singapore's system is very efficient, but it's not particularly market-oriented. Half the hospitals are public hospitals (compare to Canada, where provision is just as privatized as in the US), and the vast majority of people have public insurance.

Look at Malta and the US.

Malta is a single payer system with a the same or less costs as Singapore (a place where they cane you if you spit on the sidewalk, but I'm sure they forgo all that totalitarian stuff when allowing their citizens to enjoy the free medical market, right?) and a better standard of care.

The US is #1 in healthcare costs per capita, worldwide, and we have a lesser standard of care than Costa Rica.

(Look ma, I can take outliers and try to force correlation where there isn't any, too...)
War is over, if you want it.

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BigRat
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1/21/2013 6:58:06 PM
Posted: 3 years ago
Thing is, Malcolm, the USA is not, in any way, a free market in medical care.

No country is.

The country that comes closest is Singapore and it works pretty well.

Sure, you can call it an "outlier". But, it is the ONLY country that comes even close to having market dynamics in HC (although Swizterland has some) and it works pretty damn well.
CarefulNow
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1/21/2013 7:49:54 PM
Posted: 3 years ago
At 1/21/2013 6:16:18 PM, BigRat wrote:
First, health care spending should be measured as a share of GDP. Here, Switzerland is about the same as Canada and France.

I go by per capita spending; why is that inferior to %GDP? Anyway, France has much better outcomes than Switzerland, so I really don't see how its being almost as expensive would help your case. And, again, the Canadian system is extremely privatized by European standards.

There is actually a way to measure this. 65% of Singapore health spenidng is private compared to 50% in the USA, 30% in Canada, and 15% in the UK.

That doesn't take into account the seller. It's more often the government in Singapore than in the US or Canada.

Singapore's sytem is the most private by a mile.

No, even by your metric there are tens of countries more privatized than Singapore. You didn't mention them because they exemplify the general relationship as opposed to being exceptions to it.
malcolmxy
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1/21/2013 7:57:39 PM
Posted: 3 years ago
At 1/21/2013 6:58:06 PM, BigRat wrote:
Thing is, Malcolm, the USA is not, in any way, a free market in medical care.

No country is.

The country that comes closest is Singapore and it works pretty well.

Sure, you can call it an "outlier". But, it is the ONLY country that comes even close to having market dynamics in HC (although Swizterland has some) and it works pretty damn well.

OK...one example - Singapore. Cool. I will accept that it is possible, on a small scale, with an obedient population under near totalitarian rule, for your system to work.

1 point to the Libs

There are 6 countries with a better standard of care than Singapore, and 1 among those 6 with a lesser per capita cost.

These are under a FULLY single payer system...they're not theoretical. They're real and they work and they've been in place for a great many years.

You think they're no good? Ask a person expatriated from The UK, let's say for marriage, given the 2 options available to them, which they prefer - UK Healthcare or US Healthcare (and, let's also assume they have a better than average healthcare insurance plan as compared to other Americans).

Which do you think they'll choose?

Now, I know you won't call it free market health care, but would you say it's closer to free market or socialized (and why)?

If the Brit chooses their healthcare system, what could possibly be motivating them? Spite for the loss in the Revolutionary War?

Also, given that the US Healthcare system, from the financial end, is almost totally deregulated until all the provisions of the ACA kick in, what does the US have, if not a free market health system?

I am truly curious about this, because I have no idea what the Libertarian terminology du jour for this deregulated mess that they advocated for is these du jours.

Elighten me, if you would.
War is over, if you want it.

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BigRat
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1/22/2013 12:39:30 AM
Posted: 3 years ago
At 1/21/2013 7:57:39 PM, malcolmxy wrote:
At 1/21/2013 6:58:06 PM, BigRat wrote:
Thing is, Malcolm, the USA is not, in any way, a free market in medical care.

No country is.

The country that comes closest is Singapore and it works pretty well.

Sure, you can call it an "outlier". But, it is the ONLY country that comes even close to having market dynamics in HC (although Swizterland has some) and it works pretty damn well.

OK...one example - Singapore. Cool. I will accept that it is possible, on a small scale, with an obedient population under near totalitarian rule, for your system to work.

1 point to the Libs

There are 6 countries with a better standard of care than Singapore, and 1 among those 6 with a lesser per capita cost.

These are under a FULLY single payer system...they're not theoretical. They're real and they work and they've been in place for a great many years.

You think they're no good? Ask a person expatriated from The UK, let's say for marriage, given the 2 options available to them, which they prefer - UK Healthcare or US Healthcare (and, let's also assume they have a better than average healthcare insurance plan as compared to other Americans).

Which do you think they'll choose?

Now, I know you won't call it free market health care, but would you say it's closer to free market or socialized (and why)?

If the Brit chooses their healthcare system, what could possibly be motivating them? Spite for the loss in the Revolutionary War?

Also, given that the US Healthcare system, from the financial end, is almost totally deregulated until all the provisions of the ACA kick in, what does the US have, if not a free market health system?

I am truly curious about this, because I have no idea what the Libertarian terminology du jour for this deregulated mess that they advocated for is these du jours.

Elighten me, if you would.

Your position here is really quite ridiculous.

The government finances about 50% of health care in America.

Also, the other half is heavily regulated. Making flatly untrue claims like "US health care is free market USA and deregulation which proves these things are bad" won't get you anywhere.

The fact is, free market health care has worked everywhere it has been tried. Granted, there is limited experience in this (Singapore being one of the few), but the early results are positive.

It is very possible that we are far from having enough evidence that free market HC works, but we certainly cannot say that it does not work at this point... the early evidence is pretty favorable.

I would love to see free market HC tried on a larger, less controlled population. But, as of right now, it isnt. I know some misinformed folks on both sides of the aisle will claim that the USA is an example of free market HC when it just is not.
CarefulNow
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1/22/2013 1:36:59 AM
Posted: 3 years ago
At 1/22/2013 12:39:30 AM, BigRat wrote:
The government finances about 50% of health care in America.

That's skewed by free care. In a country like Singapore, the government has greater control over healthcare, but it charges co-pays. That's hardly a free market; it's more like Marx's first stage socialism.

It is very possible that we are far from having enough evidence that free market HC works, but we certainly cannot say that it does not work at this point... the early evidence is pretty favorable.

Again, there are tens of countries with more privately financed healthcare than Singapore, the largest of which is India. Is Indian healthcare something we should be emulating?
malcolmxy
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1/22/2013 2:21:20 AM
Posted: 3 years ago
Thanks, dude...Jebus, you hear enough Libertarians spout off enough of their patently false bullsh!t exceptions to the rules you know to be true, you start to believe it.

THE TRUTH ABOUT SINGAPORE:

Singapore has a non-modified universal healthcare system where the government ensures affordability of healthcare within the public health system, l

http://en.wikipedia.org...

Approximately 70-80% of Singaporeans obtain their medical care within the public health system.


So, uh...yeah...this is the same kind of free market healthcare system that I would advocate.

Actually, the tax choice saving matrix (I don't know what else to call it...you can be taxed at one of 3 levels, and then those taxes are socked away in a personal medical account) is a pretty decent idea, as is the no "free" services idea (though, you have plenty in your tax surplus account for most services, and it appears as if the government will cover catastrophic loss should it happen before you accumulate a sizable personal tax surplus).

So, to recap -

Price controls are bad...except in Singapore
A single payer system controlled by the government is bad...except in Singapore
Government managing for the healthcare of an entire nation is bad...except in Singapore
There is no way that government can be more efficient than a private entity...EXCEPT IN SINGAPORE

Did I miss anything else where your own rules that you state as absolute truths, while at the same time advocating for a system that shatters those rules in every way you state won't work, that only works in this magic land we call Singapore.

Without knowing it, you've been advocating for a single payer system. Now that you realize it is a government controlled universal single payer system, with HEAVY government price controls, will you be advocating the same for the US or will you find some other false example that you will allow yourself to believe is the opposite of what it actually is?
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