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Sun Feb 24, 2013, 02:44 PM

What can we afford?

Dan Kervick writes:

It is true that there might be certain goals that we would like to achieve but that our society just can’t afford to pursue because of limits on our real resources. But the government is an agent of the society as a whole, so there is no meaningful sense in which the government can’t afford to do something that the society can afford to do. If there is something that we can achieve as a society and that we have decided is the proper job of government, then we can always financially empower the government to carry out our wishes.

Consider the case of health care. Many people claim that we are facing a social crisis over the long-term path of our health care expenditures. But if there is indeed a crisis over our society’s total projected long-run health care obligations, then we need to label it as such. It’s not a deficit problem, or a public debt problem, and pretending it can be addressed by “fixing the debt” or reducing the government’s deficit is, at best, simply an irresponsible punt. At worst, it is a dishonest attempt to exploit public fear and confusion over budgetary matters in order to push Americans into accepting a less prosperous and more unequal society in which the wealthy continue to detach themselves from the rest of the country and its shared commitments, and force the less affluent to accept a lower overall level and quality of health care.

<snip>

So it’s just totally dishonest to say about any problem, “We have to reduce the public commitment, because the government will never be able to afford this”, while saying with the same breath that the whole society will be able to afford it. If the society can afford it, then obviously the government can afford it since the government is just an agent of the society. The separate debate about public provision vs. private provision is a debate about delivery mechanisms, not about budgets and affordability.

(Read more: http://neweconomicperspectives.org/2013/02/blinder-leading-the-blind.html)


Is the problem distribution, or are we facing actual scarcity?

13 replies, 1119 views

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Arrow 13 replies Author Time Post
Reply What can we afford? (Original post)
PETRUS Feb 2013 OP
99Forever Feb 2013 #1
truedelphi Feb 2013 #2
PETRUS Feb 2013 #3
truedelphi Feb 2013 #10
HiPointDem Feb 2013 #12
truedelphi Feb 2013 #13
SoCalDem Feb 2013 #4
Curmudgeoness Feb 2013 #5
PETRUS Feb 2013 #8
Spitfire of ATJ Feb 2013 #6
Starry Messenger Feb 2013 #7
PETRUS Feb 2013 #9
Starry Messenger Feb 2013 #11

Response to PETRUS (Original post)

Sun Feb 24, 2013, 02:50 PM

1. We are facing manufactured "shortages"...

.. deliberately drummed up as an excuse to fuck the general populace out of as much as possible to enrich the fatcat scum that has purchased our government.

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Response to PETRUS (Original post)

Sun Feb 24, 2013, 04:01 PM

2. Here is what many Americans, including no less than Time Mag, are getting mad about

http://www.thedailyshow.com/watch/thu-february-21-2013/exclusive---steven-brill-extended-interview-pt--1

I am no fan of Time Magazine, and neither is Jon Stewart.

But this past week, he had on Steve Brill, a Time journalist, on the TV, and what develops is a knock it out of the park discussion.

We had this Crappopla HC "Reform" that somehow didn't manage to even discuss how the Big Industries, that is, Big Pharma, Big Hospitals, and Big Insurers, have given us the shaft, while either our government leaders don't know it is happening, or don't care.

Watch this article and see why the pricing that surrounds health care and its procedures is an absolute travesty!

http://www.thedailyshow.com/watch/thu-february-21-2013/exclusive---steven-brill-extended-interview-pt--1

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Response to truedelphi (Reply #2)

Sun Feb 24, 2013, 04:50 PM

3. ***WARNING: Vulgar imagery in my response***

Thanks for the link. Someone posted the Time article here on DU the other day and I read a bit of it.

I also saw a blog entry on the Time article. The writer quoted this from Brill:

By the time Steven D. died at his home in Northern California the following November, he had lived for an additional 11 months. And Alice had collected bills totaling $902,452. The family’s first bill — for $348,000 — which arrived when Steven got home from the Seton Medical Center in Daly City, Calif., was full of all the usual chargemaster profit grabs: $18 each for 88 diabetes-test strips that Amazon sells in boxes of 50 for $27.85; $24 each for 19 niacin pills that are sold in drugstores for about a nickel apiece. There were also four boxes of sterile gauze pads for $77 each. None of that was considered part of what was provided in return for Seton’s facility charge for the intensive-care unit for two days at $13,225 a day, 12 days in the critical unit at $7,315 a day and one day in a standard room (all of which totaled $120,116 over 15 days). There was also $20,886 for CT scans and $24,251 for lab work.


And responded with (here's where it gets vulgar):

Alice was fucking ripped off to the tune of any semblance of economic and financial security she might ever have had at the very moment that her husband was dying of cancer. This is beyond awful. This is mortal sin in any religion worth the name. This is pure evil.

Our problem is not a matter of shitty policy arrangements. We have plenty of those. Whatever. Policy is a third-order pile of bullshit. Our problem is that it is a sick excuse for a society when this sort of ass-rape is relegated by custom and practice into the sphere of the “private”, the sort of bureaucratic struggle one quietly hires professionals to deal with and hides as much as possible from friends and coworkers. Ass-rape of the more literal sort is also a private affair, in the first order. We insist upon it being public, because a society whose customs tolerated the maintenance of its first-order privacy would be a miserable, detestable place in which the powerful quietly ass-raped the powerless and were never held to account. The difference between literal ass-rape and what happened to Alice and Steven D. is not that ass-rape is criminal while health-care price-gouging, although regrettable, is not. To say that is to confuse cause for effect. Literal ass-rape is criminal because we-the-people as a broad-based mass are disgusted by it and insist upon it being a public and criminal matter rather than a quiet tragedy and struggle. When we hear about a Joe Paterno who overlooks this requirement, we literally hound the motherfucker to death. Perhaps unfairly, in any particular case — pitchforks are simultaneously sharp and blunt instruments! The sheer fear of which is why the powerful create laws. But where laws aren’t there, the pitchforks must always be. A society that expects laws to substitute for, rather than channel, public outrage, is a society not long for this world in any form worthy of the name.


Anyway...

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Response to PETRUS (Reply #3)

Sun Feb 24, 2013, 10:52 PM

10. Vulgar images in a discussion of vulgar

yet accepted "business model practices" are most appropriate. At least, I find them acceptable. After losing my retirement monies to one medical mis-diagnosis (But i did manage to keep the misdiagnosed spouse alive,) I feel few activities are worse tan the business model allowed by our hospital chains.

I also very much liked that last paragraph posted at your link:

As soon as you delve into the policy wonkery in cases like this, you are submitting to a conspiracy by the powerful against the many. The greater the sphere of disagreeable things that are “complicated”, the more it is possible to construct intricate and inscrutable bureaucracies to “arbitrate”. There will be think-tanks and policy papers, funded by people who are well-meaning (in a narrow, idiotically un-self-aware way) but very rich and powerful. The conclusions of which will be earnest and carefully researched but confined to a window not very upsetting to the very rich and powerful. Undoing the ability of plutocrat hospital “CEOs”, or bankers or lobbyists or whatever, to continue the sort of ass-rape to which their lifestyles have grown accustomed will not be on the table. A good society depends on an active public, first and foremost. A society that has allowed the predations of the powerful to become purely private matters mediated via “markets”, courts, academies, and bureaucracies, that has delegated “activism” to a mostly protected professional class, is nothing more than a herd hoping that today it is somebody else who will be slaughtered.

Is that who we are?

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Response to truedelphi (Reply #2)

Mon Feb 25, 2013, 02:45 AM

12. "our government leaders don't know it is happening, or don't care" -- try "enables for bribes" &

 

you'll be closer to the mark.

if congress was swallowed up by an earthquake i wouldn't shed a tear.

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Response to HiPointDem (Reply #12)

Mon Feb 25, 2013, 04:50 AM

13. Hey there -

HiPointDem - I have been known to cue up the DVD player to the exact loop in "Mars Attacks" where the aliens smoosh up DC into one alien-destroyed clump of ash. Gotta hand it to those little guys from Mars - a lot of our problems might be solved.

One other thing, one reason Washington DC is the Capital - the Founding Fathers wanted the nation's capital to be quite aways away from the Big Money Interests of New York City. Of course, they didn't envision a society in which the airplane would unite the East Coast. Or a world when a lobbyist's bribes could be done digitally, without either participant leaving their desk.

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Response to PETRUS (Original post)

Sun Feb 24, 2013, 05:08 PM

4. We can afford what the majority of THE PEOPLE want and need

We decide what it is that we want..
We assign taxation to cover the cost

That's how easy it is..

The more we want need, the more we pay..

It's like car shopping..

If you want a new Cadillac/BMW/Porsche/Mercedes, you cannot expect to pay "used Chevy" prices..

Wars should always cost EXTRA

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Response to PETRUS (Original post)

Sun Feb 24, 2013, 05:45 PM

5. The question I have always had is

"how much are we collectively paying for health care without a universal program?" Each of us either pays premiums, or our employer pays premiums, or the government pays for our care. These dollars will not have to be spent on premiums, although there would be a transfer to higher taxes paying those same "premiums" to the government instead. We do not know if it would cost more or less than the way we do it, because no one looks at it this way. Pay it to this hand, or pay it to that hand, you are still paying it.

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Response to PETRUS (Original post)

Sun Feb 24, 2013, 05:53 PM

7. The wealthy are sitting on a 2 trillion dollar surplus.

It's capital strike. The government can't afford the wealthy. They need to cough up more in taxes. Cutting more services would be insane, it would take more money out of circulation.

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Response to Starry Messenger (Reply #7)

Sun Feb 24, 2013, 06:35 PM

9. Oh, so you wanna punish suc--

Aw, hell... it's such utter hogwash, I can't even type it as a joke.

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Response to PETRUS (Reply #9)

Sun Feb 24, 2013, 11:47 PM

11. lol

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