Friday, January 10, 2014

ANOTHER LIBERTARIAN MARKET FAILURE

Peter Suderman, talking about the GOP's Obamacare strategy, seems disappointed that Republicans have been reluctant to propose sweeping changes to the nation's health care scheme besides Repeal Because Freedom. His Republican sources also complain of it, with (considering the Party's historic obstructionist approach to all things Obama)  breathtakingly transparent insincerity: One of them -- "'We don't have a Republican majority that remembers how to govern and understands how to juggle trade­offs,' one health policy aide complains" -- actually made me laugh out loud.

As you would expect, Suderman gives a favorable hearing to the ideas of libertarian-conservative wonks:
In a 2009 paper, "Yes, Mr. President: A Free Market Can Fix Health Care"...
What'd I tell you?
...[Cato Institute Health Policy Director Michael] Cannon laid out a plan for converting Medicare into a voucher system (he now favors Social Security-style direct payments to enrollees), ending state-based monopolies on both insurance and clinician licensing, capping federal spending on Medicaid through block grants, and eliminating the tax preference for employer-sponsored health care. 
Eliminating that tax preference, which since World War II has allowed employers to purchase health coverage for employees on a tax advantaged basis, would actually result in a substantial tax cut, Cannon argues counter-intuitively.
I'll say it's counterintuitive. So is the rest of it, for those of us who've been trained by decades of experience to hear "ending state-based monopolies," "capping federal spending," etc. as the patter of privatization bunco artists.
If employers cashed out the amount they now pay for health insurance, workers with family coverage would see an average compensation increase of $11,000.
Question for my readers residing in workaday reality: If your boss got a $11,000 windfall, would you expect him to forward it to you?  (These are the same people who'll tell you that if your landlord is absolved of rent control and can charge any rent he likes, he'll lower yours.)
The trick would be to replace that tax preference with the creation of very large health savings accounts-tax-free savings that could be applied toward health purchases. Versions of these accounts exist today, but they are capped at $3,300 for individual coverage and $6,550 for families; Cannon's proposal would dramatically increase the cap, perhaps tripling it, and in the process free thousands in individual income both from taxation and from employer control. The result would be to simultaneously give individuals control of thousands of dollars in compensation now tied up in employer health benefits, while eliminating the government-granted financial advantage of employer-provided coverage. Individuals, and not their employment status, would then dictate health insurance coverage.
And if that worker bee, freed from the necessity of paying into a liberty-restricting group insurance program, finds his car needs a new transmission and his home needs a new boiler, and he doesn't put as much into that savings account as he'd planned, and suddenly gets cancer, it's sad trombone time (though libertarians won't feel sad themselves, because Moochers Have It Coming).

Suderman also talks about last year's government shutdown; he knows it was unpopular and counterproductive, but he doesn't appear to know why. It's simple: The nation may dislike Obamacare, but that doesn't mean they prefer Pay or Die.

183 comments:

  1. It's simple: The nation may dislike Obamacare, but that doesn't mean they prefer Pay or Die.

    Roy, Roy, Roy. Obamacare IS the GOP plan, aka Pay or Die.

    The nation may dislike it, but it's still (as always) the lesser evil compared to the brand new GOP plan (adopted ,as always, in response to the cynical neoliberal adoption of the previous GOP plan): Pay or DIE DIE DIE!
    ~

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  2. PulletSurprise1:34 PM

    I read the 2nd hyperlink as "histrionic obstructionist approach." Both work equally well.

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  3. though libertarians won't feel sad themselves, because Moochers Have It Coming


    That's always the unspoken truth in these libertarian solutions. If we were to switch to Suderman's system and people died, then it would not be viewed as a failure of the system. It would be viewed as a failure of the individual. It's a feature, not a bug.


    I've always felt that the libertarian economic view would be perfect for the Garden of Eden. If we were all born on equal footing with equal access to opportunity, and there weren't any predators or deceivers, then their "Let every man stand or fall on his own merits" position would make sense to me. Unfortunately, we live in a world where men often fall because of factors outside of their control, or never even get the chance to climb up. No one on the right side of the spectrum (or even some parts of the left) wants to admit this, but sometimes people get fucked over. I happen to think those people should get a second chance.

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  4. Another Kiwi2:06 PM

    One is unaware as the current market for medical excitements but I am unsure as how much one could get for $11,000. Looking at http://www.besthealthinsurancebook.com/resources/medical-cost-by-principal-procedure.html one can see that, one could have 2 (two) circumcisions a year. With a bit of chipping-in from the old savings you can have a prolonged period ECG. Be still my beating...oops wrong mettyphor there.

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  5. Waingro2:08 PM

    "he now favors Social Security-style direct payments to enrollees),
    ending state-based monopolies on both insurance and clinician licensing,
    capping federal spending on Medicaid through block grants...." (blah blah blah, jerking off motion)

    I don't understand the fetish to create some new, Rube Goldbergian policy apparatus out of thin air. If you threw a dart at a list of all the OECD countries, picked any random country and them implemented a carbon copy of their health care system, it would still be cheaper and cover more people than our system.

    It's almost as if they don't actually care and are just engaging in cheap tactical maneuvers to dilute the debate.

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  6. Spaghetti Lee2:17 PM

    Question for my readers residing in workaday reality: If your boss got a
    $11,000 windfall, would you expect him to forward it to you?



    Hey, these are the guys who can get Charles Koch to write them a check just for pumping out the ol' bullshit. Maybe they assume that once the boss realizes all his workers are fellow free-marketeer comrades in arms, he'll shower them with cash, too.

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  7. Spaghetti Lee2:18 PM

    If we let the free market decide, people could have as many circumcisions as they wanted.

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  8. Ah, the good ol' Medicare voucher proposal. The Congressional Budget Office evaluated that one in the context of Paul Ryan's 2011 budget plan (aka iteration number whatever of the standard Republican "slash spending to [almost, but not quite] pay for massive business top-bracket income tax cuts" plan). Quote:

    Under the Roadmap, the value of the voucher would be less
    than expected Medicare spending per enrollee in 2021, when the voucher
    program would begin. In addition, Medicare’s current payment rates for
    providers are lower than those paid by commercial insurers, and the
    program’s administrative costs are lower than those for individually
    purchased insurance. Beneficiaries would therefore face higher premiums
    in the private market for a package of benefits similar to that
    currently provided by Medicare. Moreover, the value of the voucher would
    grow significantly more slowly than CBO expects that Medicare spending
    per enrollee would grow under current law. Beneficiaries would therefore
    be likely to purchase less comprehensive health plans or plans more
    heavily managed than traditional Medicare, resulting in some combination
    of less use of health care services and less use of technologically
    advanced treatments than under current law. Beneficiaries would also
    bear the financial risk for the cost of buying insurance policies or the
    cost of obtaining health care services beyond what would be covered by
    their insurance.

    In other words, despite with libertarians and Republicans like to pretend, it's not a magic bullet. It's just making the government pay less money to provide fewer services. Hardly a groundbreaking idea.

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  9. Jay B.2:28 PM

    Now, i'm not married to an economic wizard like Megan McArdle like our friend Suderman here, and I certainly haven't blown Kochs to get on the wingnut gravy train, but I'm curious what these words, strung together even mean, other than "get sick early in the year":

    capping federal spending on Medicaid through block grants

    Again, not being any kind of health care, nor economic expert I assume there is some way of "capping" "through block grants" — you give states a finite amount of money to pay for the health care and if you go over it...Die? Death paneled? It's simply a stupid, buzzworded plate of nothing that resembles anything that happens in the real world. These people are fucking stunted robots, wholly vested in the notion that money hoarding is the entire point of life and people only get in the way.

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  10. It's just making the government pay less money to provide fewer services. Hardly a groundbreaking idea.


    Well, as with most consumer products these days, the innovation is in the marketing.

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  11. smut clyde2:38 PM

    If your boss got a $11,000 windfall, would you expect him to forward it to you?


    Shirley you've noticed your wages going up after every cut in business taxation!

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  12. satch2:41 PM

    Hmm... let's see...

    "Clear out the thicket of regulations and subsidies?" Check

    Sell insurance across state lines? Check

    Block grant Medicaid and voucherize Medicare? Check

    Unlimited health savings accounts (great idea, if you've got a spare $11,000 down in your couch cushions)? Check

    Eliminating tax preferences for employer provided plans? (If a Dem proposed that, the Pugs would be screaming "TAX INCREASE!!11!) Check.

    Tom Price's grand idea that creates a "multilayer system of deductions combined
    with both refundable and advanceable tax credits, ... short-term
    purchasing pools for individuals with pre-existing conditions, and
    attempt[s] to ward off waste by reducing the need for doctors to
    engage in defensive medicine." (Gee, that sounds a lot like ... what's the term I'm looking for? Oh, yeah... a "monstrosity"! Or was it a 'train wreck"? Keeping track of the metaphor du jour is so hard...). Check.

    In other words, the same libertoonian rainbow unicorns that have proven so popular in the past.

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  13. satch2:50 PM

    Second comment out of the gate over there:

    "Yes, start with Medicare. The elderly are the least productive
    and have the most means/assets."


    Now, what was that about the moochers having it coming...?

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  14. KatWillow2:51 PM

    $11,000 would have paid for 2 days of my 7-day stint in the hospital. It wouldn't have covered the ambulance, surgery, and anesthesia services. Oh, and 3 months of pain meds.


    One badly broken leg cost about $65,000.

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  15. Gromet2:53 PM

    The Cato proposal to really work the miracle of tax-free health savings accounts is about as impressive as three-card monte. Triple my ceiling from $3,300 to $9,900? Great, that's all money that I need to know I will earn over the next year and can afford to set aside for no purpose other than health. And if I guess wrong and have a healthy year, I lose that money. Unless Cato means to change the use-it-or-lose-it part of how these accounts work... but if so, doesn't that just make these things into tax shelters for people who always have $10k to spare? Why, I guess it does! Oh well, at least the system will retain the benefit of being totally useless to everyone who's living paycheck to paycheck.

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  16. Well, I see other here have already beaten me to it but I just skimmed through Suderman's "policy paper" (Yes, Mr. President: A Free Market Can Fix Health Care) and boy howdy, it is one giant bag of wishes and ponies held together by magical thinking and patched with self-contradictory blather.

    As Roy points out, he argues for allowing the elimination of employer-provided insurance and anticipates that the employer might not just hand all that money back to the employee. But that's OK, he argues, because then the employee will just go work for another employer who either DOES still offer insurance - a reaction which is not only the fictitious libertarian solution to every labor issue but which undercuts Suderman's own argument that it's unnecessary and wasteful to allow employers to provide insurance - or they will go to another employer who "let's them" buy insurance in the individual market but get paid higher wages...although he admits that even this hypothetical employer of last resort might not return ALL of that insurance money back to the employee, but something something free market something competition something magical fairy dust problem solved.

    Basically, he admits the employee will get boned and lose some (read: most) of that money but it's better than having an health care system that's wasteful with its money!

    And speaking of the heretofore unbelievably crappy individual market for insurance, Suderman wants you to know that "no, no, it's REALLY good, guys." He quotes a line from a study that determined a "large number" of Californians were able to get insurance on the individual market before Obamacare. Sure, he doesn't tell you that the policies ranged from crappy to worthless or that the premiums were to be paid in Faberge eggs and gold ingots they were so expensive or that it's California, which is a more tightly regulated, consumer-friendly market than most states. It's enough to know that a large number of people got boned by individual coverage, and because large is good and waaaay better than small...we should eliminate employer-sponsored insurance. pauses But not replace it with single-payer! Jesus! Suderman wipes flop sweat from head over close call

    It goes on and on. For every real world response to deregulation of the health care industry that we can predict with confidence from past behavior (consumer fraud, worthless policies, denial of care) Suderman has answers a propos of nothing rooted in human experience but what he has found rummaging around in his own curiously spacious ass. "The courts will solve it! People will demand better and get it! Politicians will reregulate!" needle scratch. What? Reregulate? If deregulation is so great why would we ever need reregulation?!? Why reinvent the wheel and cover all of this legislative and judicial ground again? Because opening Pandora's box seems like fun? Thank goodness there are no human consequences to the inevitable problems that will arise from his proposals and it's all just enthusiastic talk around the bong table.

    It's pages of stuff like that; unctuous, self-masturbatory brainstorming posing as analysis. You almost get the sense that he knows he's bullshitting you when the solution to a problem posed by his policy is simply to reverse pieces of his own policy back to the status quo, either directly or through what would amount to decades of attempted legislation and judicial review that no Republicans are going to allow to happen anyway. So I guess in that sense it's kind of ballsy.

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  17. KatWillow2:55 PM

    We must all pray that Sudermann and ArgleBargle never have children.

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  18. satch2:56 PM

    Well, next time be a smart consumer and shop around. Ask your friends who treated THEM the last time they broke their legs. Check out Angie's List. And by all means, ask for a list of the drugs they plan to give you, and check around to see if you can't get them cheaper somewhere else.

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  19. Gromet2:57 PM

    I got a root canal in December and despite decent dental coverage, it's cost me $1,060 so far. To fix one tooth! These people are not interested in reality.

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  20. Gromet3:01 PM

    ending state-based monopolies on both insurance and clinician licensing

    So hospitals will get licensed by who, Exxon? Nike?

    Shorter Cato: "You can trust corporations. Here's a coupon."

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  21. It's the Rand Paul approach to licensing- "I can't pass the board examinations, so I'll start my own board!"

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  22. Gromet3:05 PM

    So we determine benefits based on productivity? That's what the Death Panels were supposed to do. I guess it's good now.

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  23. Pray? I say we make sure it never happens by forcing contraception coverage on them through their employers' insurance and against their religious convictions, Obama-style.

    From what I understand that means they'll be FORCED to use Plan B and the world will never have to endure the witless ruminations of a McSuderbargle baby, freeing it up to pursue higher things like freedom and self-betterment.

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  24. LittlePig3:09 PM

    Now's there a stunning lack of basic electoral understanding. Please proceed, Mr. McArdle, but wait until I open a box of Fiddle-Faddle before the oldsters hear your interesting and novel idea.

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  25. Now we know the real reason the GOP was so pissed that Obama was (supposedly) trying to kill off grandma: they wanted to get to her first.

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  26. ADHDJ3:12 PM

    HSA's are not use it or lose it. Money carries over from year to year. You can withdraw money from the HSA at any time, but you have to pay income tax on the way out if it's not for medical expenses.


    They're still kind of shitty and don't solve the major problems in our healthcare system, but they're not that shitty.

    http://www.irs.gov/publications/p969/ar02.html#en_US_2012_publink1000204078

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  27. Cannon's proposal would dramatically increase the cap, perhaps tripling it, and in the process free thousands in individual income both from taxation and from employer control.

    $9,000 for your long-term cancer treatment... Oh frabjous day!!! Of course, just because the savings account isn't taxed, doesn't mean that bank fees don't accrue, which is a feature, not a bug.

    Individuals, and not their employment status, would then dictate health insurance coverage.



    Of course, the ability to pay into the account is dictated by employment status.


    What normal human being would buy this claptrap for a second?

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  28. ADHDJ3:14 PM

    Did. He. Even. Try? Asking. For. A. Friend.

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  29. Emily683:16 PM

    Did he forget tort reform?

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  30. Basically, he admits the employee will get boned and lose some (read: most) of that money but it's better than having an health care system that's wasteful with its money!


    C'mon, what's the purpose of a healthcare system besides saving money?

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  31. Too late, they had a child who traveled back in time and became Milton Friedman.

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  32. Originally, I was going to say that "Palin's Buttplug" was probably a troll and not a serious commenter. But the comment right below that one:

    Those means/assets are their kids' inherintance [sic], so together with their least-productive parents or grandparents, the kids and/or the grandkids will keep voting to keep the program while making the rest of us pay for it.

    There will be no other transition period besides the Great Default. And a painful transition it will be, with millions of elderly people extorting their kids for assitance [sic] through hysterical accusations of ungratefulness. It will be fun to watch.
    (Emphasis added, nausea in original)



    I think I need to lie down.

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  33. It's simply a stupid, buzzworded plate of nothing that resembles anything that happens in the real world.


    Obviously inspired by his wife's cooking...

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  34. satch3:23 PM

    Don't we all know by now how much Libertarians love their thought experiments? And the more complicated, the better, with a government that exists solely for the purpose of coming up with new tax breaks.

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  35. Enriching investors, of course!

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  36. Just wait until Chuck's first class of Indian punditry center hires master the writers' handbook.

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  37. These free-market worshippers only seem to have a passing acquaintance with reality.


    I love that "Oh, employers would totally offer health insurance on their own to be competitive!" bit that proves that most libertarians have never had to look for a job. I remember when some of them claimed, using the same arguments, that the free market would have ended segregation because, hey - the diners that didn't discriminate would have more business! The fact that nothing like this happened anywhere in the United States or anywhere else on the planet doesn't discourage them from believing it.


    At this point, these guys are just a step above those jerkoffs who try to prove their theories by running custom games of Civilization. (Disclosure: I have done this, so I would know)

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  38. Howlin Wolfe3:33 PM

    "slash spending to [almost, but not quite not even minimally] pay for massive business top-bracket income tax cuts" plan.
    Fixticated.

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  39. "Shave a little more off, Doc, the wife likes it neat down there."

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  40. I'd watch that movie.

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  41. At this point, these guys are just a step above those jerkoffs who try
    to prove their theories by running custom games of Civilization.
    (Disclosure: I have done this, so I would know)


    Thus proving once and for all that Egypt would totally win a space race against the Shoshone?

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  42. Howlin Wolfe3:43 PM

    These people are fucking stunted robots, wholly vested in the notion that money hoarding is the entire point of life and people only get in the way.

    JB, I think you've hit it on the head. William Effing Buckley said as much, and I paraphrase: the only true freedom is economic freedom. The more money you have the more freedom you have. And, Erewhon-like, the more money you have the more your freedom is protected, like having a different standard of justice, being able to buy your politicians and their elections to office, hire people to do your dirty work, and to hire propagandists to tell people how good the shit sammiches taste.

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  43. When I want to liberate money from my employer I'm called a thief. Why is suderman's version of Cannon's proposal merely called "freeing" individual income from "employer control?"

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  44. No. Try reading a bit more about this subject.

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  45. Wait, you just blew right by the most important part. When criminals can become doctors then doctors won't be criminals! "Ending the state monopoly hummina hummina hummina" means endingl liscencing exams and the professional limitations on the supply of doctors. Its a rand paul dream!

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  46. In my case it was Alpha Centauri, and I was doing it to relitigate the 2004 Presidential Election.


    This is the real reason I don't play the "Geekier Than Thou" game. It would be too one-sided.

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  47. This is, to a certain extent, the plot of the Canadian show "Continuum"--warning, spoilers, the future world Steve Jobs/Koch Brother owner and inventor of everything, who has accidentally enslaved the entire planet to his needs, sends an emissary back in time to warn his adolescent self that he shouldn't do what he is going to do.

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  48. The theory, as always, is that the good licensing boards with the good doctors will develop a reputable brand and run the bad ones out of business. Hey, if it's good enough when you're selecting a phone service provider, it should be good enough when you're selecting someone to root around inside your thoracic cavity.

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  49. Exactly. You know who has no problem attracting employees? Walmart. They pay shit and have shit for benefits and yet they're inundated with applicants. If they're so uncompetitive why aren't they out of business? Whither libertarian theory?

    In a bad economy (for workers) and a labor market where workers have no bargaining power people not only won't leave their shitty, low-paying jobs, the unemployed will beg and plead and sell themselves to get those jobs. Contra libertarianism, the boned have no recourse.

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  50. I remember when some of them claimed, using the same arguments, that the free market would have ended segregation because, hey - the diners that didn't discriminate would have more business!


    Of course, the diners that didn't discriminate would probably be torched by klansmen in cahoots with the local bigwigs, which puts the lie to that other Libertarian trope, the idea that local control is preferable to federal control.

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  51. M. Krebs4:10 PM

    Regenerative foreskin syndrome is an underreported condition.

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  52. Gromet4:10 PM

    Huh. My employer offers an FSA, not an HSA. For the first time, in 2014 FSAs can be rolled over, but only if the employer stipulates so. Mine did not. So it becomes a game when you set it up in October, trying to estimate how healthy you will be for the next 15 months.

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  53. realinterrobang4:14 PM

    Didn't we have that system once? I seem to remember a little thing called the Flexner Report that basically said independent medical education and licensing work about as well as any person with half a brain in their head thinks it would. Glibertarians really are all about applying 19th Century problems to 21st Century solutions, aren't they?

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  54. M. Krebs4:25 PM

    My brain shut down before I found the part about " if it's not for medical expenses." Are you sure about that? I was under the impression that you have to pay income tax on the way out, period.

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  55. but wait until I open a box of Fiddle-Faddle before the oldsters hear your interesting and novel idea.


    Back away from the Fiddle-Faddle. If the oldsters in question are anything like my parents, they'll blame Obama for it.

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  56. Yes, state intervention is the very definition of JIm Crow. There is no free market, not even when the market is allowed to run rampant and roughshod over the rights and interests of, say, workers and customers. Its still not a free market because in order to function at all it requires state interference to adjudicate ownership and customary relationships. But that being said a "free market" is not necessarily a good or kind or equalizing market even where it does exist. This is the worst fantasy of all--that you can get to a just outcome by following an imaginary invisible will-o'-the-hand. Neither justice nor equilibrium will result from a libertarian paradise.

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  57. Wait, so did you roll your own custom factions? I could see a mashup of Lord's Believers + Morgan Industries for the GOP, but I'm not sure what I'd pick for the 2004 Dems.

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  58. Contra libertarianism, the boned have no recourse.


    It's not contra libertarianism so much as libertarians always grouping themselves with the boners (hehehehehe), not the boned.

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  59. "'We don't have a Republican majority that remembers how to govern and understands how to juggle trade­offs,' one health policy aide complains"

    That's because everyone who was in Congress during the Taft administration is dead, fuckwit.

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  60. I was doing this back when I was on a larg(ish) blog and actually had some readers, so I didn't really have time to whip up custom factions. I ran Believers v. Peacekeepers on a custom map, Iron Man, Transcendent difficulty, with reduced turns (100 or so) and every victory condition except Conquest and Points disabled.


    And I won it, too. If I went digging through my old image hosts, I could probably find the map, which ended up looking scarily similar to the actual election map.

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  61. Spaghetti Lee5:10 PM

    Where do libertarians who comment on Peter Suderman articles rank on the Glorious Axis of Productivity, I wonder?

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  62. M. Krebs5:15 PM

    Okay, never mind! Fuck me, now I need to amend the last two years' returns. I should have a couple hundred bucks coming.

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  63. Dr. Hunky Jimpjorps5:18 PM

    Who needs licensing when we can just crowdsource it! Just start reviewing your laparoscopies and chemotherapy on Yelp.

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  64. Spaghetti Lee6:11 PM

    He was like Benjamin Button except he never got any younger.

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  65. M. Krebs6:17 PM

    CEOs first, then investors.

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  66. whetstone6:30 PM

    give individuals control of thousands of dollars in compensation now tied up in employer health benefits

    But I do not want to dictate my insurance coverage. I have talked to the people who dictate my insurance coverage; their job appears, from my perspective as someone who dislikes dealing with seething hellholes of corporate indifference, to be miserable. I want to read a book, or go on a walk.

    The same people who think that getting a fucking license renewed at the DMV is a trip to the underworld are always pestering me to spend all my free time figuring out how incomprehensibly complex markets work. It's almost like they're up to something.

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  67. KatWillow6:37 PM

    Libertarianism is based on the theory of "Enlightened Self Interest", a theory more flawed than creationism.

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  68. KatWillow6:39 PM

    CEO billionaires are the least productive and have the most assets.

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  69. I don't know that I want to live in a world in which someone called "Palin's Buttplug" isn't a troll.

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  70. Yup. Still waiting on the englightenment of the self, but not seeing it, somehow. Certainly not in the suderman household, even with all those pink salt candle holders.

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  71. ++ This.

    The same people who think that getting a fucking license renewed at the DMV is a trip to the underworld are always pestering me to spend all my free time figuring out how incomprehensibly complex markets work.

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  72. MBouffant7:00 PM

    Hey, my tonsils grew back.

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  73. mommadillo8:52 PM

    Life is much like a shit sandwich - the more bread you have, the less shit you have to eat.

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  74. Derelict9:02 PM

    It's probably the best explanation as to why Suderman can't see the real world around him.

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  75. Geo X9:11 PM

    their "Let every man stand or fall on his own merits" position would make sense to me.



    I don't agree with this, actually. People "fall" for all sorts of reasons, and I don't CARE if it's in some sense their "fault." Society should do its best to protect people from falling, regardless of reason, even in a perfect world. That's what society's FOR, or ought to be. I know that's commie talk, but...

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  76. Derelict9:13 PM

    This is the other great Republican wet-dream of healthcare: That we should "shop around."
    Sure. Everyone with a high-school diploma is more than qualified to decide whether the surgery protocols at Golden Arches Hospital are excessively expensive by comparison to the protocols at Surgery-King Hospital--and to do all that shopping during the ambulance ride while your myocardial infarction is reaching critical state.

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  77. BigHank539:18 PM

    Hey, my tonsils grew back.

    Christ, clumsiest bris in history.

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  78. BigHank539:32 PM

    the libertarian economic view

    Now, see, that's where you took a wrong turn. Libertarianism as currently practiced isn't an economic theory at all. What it is the core of the meanest sort of monotheism (I am going to heaven because I am saved, while you will burn in hell for eternity) with all the God stuff stripped out and replaced with Randite econobabble dogma.

    (1) There are winners and there are losers,
    (2) you can use money to tell the difference between the two, and
    (3) they're not willing to wait for death to do the sorting.

    This is why the arguments, theories, and justifications change on a weekly basis. They're not important. The unspoken goal of libertarianism is the only important thing: punish the losers.

    Did you think it was a coincidence they always vote with the GOP?

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  79. Oh, Jeez... how could I have I forgotten about the ambulance ride! Don't just settle for the first one that comes along, Shop! Compare! YOU'RE the consumer... make THEM bid for your business.

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  80. Ellis_Weiner10:16 PM

    This. All this talk of savings accounts is like discussing with a toddler what kind of cookies Santa would like best. A fucking broken leg could send you into bankruptcy. The only good news in all this is, it makes it easy to wish people like Suderman and the missus WOULD break their legs, or need a simple appendectomy, just to get the bill. It would be instructive (yeah, right) but not dangerous. I could still be a Nice Person (tm).

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  81. Waffle_Man10:25 PM

    So, um, my dad's girlfriend died of cancer a few years back. Her total bill for treatment was somewhere around the 2 Million dollar mark.


    Which is to say that if she had gotten a raise of $11,000 dollars a year, and put all of it into a tax-free health savings account, she would've been able to pay for her treatment after a mere 182 years.


    Health care is really fucking expensive.

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  82. I'm have no problem with "enlightened self-interest", such as it is. The part I object to is the perverted sense of self that the libertarians believe in, a self disconnected from the culture that shaped it, the tribe that its a part of, the state that granted it a sense of basic security.

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  83. DocAmazing10:54 PM

    I'm a bit perturbed that I wasted all that time and money going to medical school when I might have just declared myself a physician and let The Invisible Hand sort it all out.

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  84. DocAmazing11:06 PM

    You almost get the sense that he knows he's bullshitting you


    I suspect many libertarians realize that their economic philosophy is as full of holes as a colander that met a 12-gauge, but they're writing for money. Very rich people love to be told that they're superior; the Suderman/McArdle bunch are just clever enough to produce that flattery and cash the checks quicklike.

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  85. bmaccnm12:02 AM

    In places where i have worked as a nurse and nurse-midwife, Haiti, Guatemala, Kenya, Somalia spring to mind, something like this does happen. You are admitted to hospital in labor, or with appendicitis, or as happened to me in the Maya Mountains, pneumonia, and your family and familiars are given a shopping list- gloves, suture, all medicines required. If something isn't bought, you won't have it, even if that something is sterile gloves for delivery. Is this what Suderman wants? Because that's where he is headed.

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  86. redoubtagain12:13 AM

    McSuderman doesn't mention WalMart because he's not on their payroll. Yet.

    ReplyDelete
  87. montag21:57 AM

    "... the patter of privatization bunco artists."


    Now, that's precision in the use of language and, still, it covers multitudes. Nicely done.

    ReplyDelete
  88. MikeJ2:21 AM

    Had she been paying for it herself she would have chosen a less expensive disease to die from.


    Dysentery. It's why libertarians want to privatize water supplies.

    ReplyDelete
  89. montag22:26 AM

    Oh, I think the well-to-do and their wannabe flunkies on the right know quite well that health savings accounts are nothing more than yet one more tax dodge for the wealthy. For 95% of the country, savings accounts, in lieu of a proper plan, amount to a denial of service.



    Isn't it an odd thing, that in the country with the supposed best care in the world, we just don't have a cure for sick fucks?

    ReplyDelete
  90. montag22:46 AM

    Um, self-described libertarians?

    Oops! My bad--you said "normal."

    ReplyDelete
  91. Daniel Björkman2:48 AM

    This. It's why any discussion I have with a libertarian is an exercise in futility on both ends. There is just no common ground to find. They take it as axiomatic that the more decisions you make for yourself, the better off you are. I take it as axiomatic that as long as my basic needs are covered, then the less I need to worry about the exact process by which they're covered, the happier I'll be.

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  92. Aimai, your little précis of Continuum there is so nicely written. I like the show pretty well, but you've reminded me why I like some of their ideas way more than I like the show.

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  93. Gabriel Ratchet3:51 AM

    Well, that's his implied ulterior motive, although the cop herself isn't really in on it -- she still thinks she's trying to stop the anti-corporate "terrorists" who've gone back in time from changing the future, even though as the show progresses it becomes more and more apparent that that future is a dystopian hellhole for all but the privileged class (to whom the cop belongs) and that while the so-called terrorists' methods may be extreme, their cause is actually pretty reasonable -- all of which perversely makes the show seem like a remake of The Terminator told from the Terminator's point of view. It's a great satirical setup, but the generic low-budget Canadian action-adventure show execution makes it hard to tell if the producers even get the joke themselves.

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  94. BadExampleMan4:11 AM

    No, the problem was the Death Panels would've been a quick and merciful death; not nearly enough suffering beforehand.


    I mean, how else would we avoid the Moral Hazard??

    ReplyDelete
  95. BadExampleMan4:14 AM

    They should experiment with thought more often. Eventually, some of them might get good at it.

    ReplyDelete
  96. Frank Nelson5:19 AM

    Of course a disappointment is everywhere.http://www.raygun.com.au/timelapse/

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  97. Nobody can be as far out in la-la land as a libertarian. I recently corresponded with one on a blog, who argued for the US to be replaced by a system of benign corporate warlords. When I pointed out how oppressive & violent this would be, he of course argued free consumer choice would keep the warlords in line. At that point no response was possible, or desirable.

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  98. Buddy_McCue9:17 AM

    Good point.


    The libertarians talks about "freedom" a lot, but they don't mean freedom for everybody, or even most people.


    When it comes right down to it, what they care about most is the maintenance of the established social hierarchy, and little else.

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  99. Buddy_McCue10:00 AM

    Wow, did he actually express it that way?


    Did he really say "benign corporate warlords" or did he have the sense to use obfuscatory language?

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  100. I think its pretty clear they do get it since they are writing it. And i dont think it comes across as all that low budget. Its a bit slow.

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  101. DocAmazing12:37 PM

    In the photos, it looks like a turtleneck.

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  102. Derelict1:04 PM

    Obligatory old joke:
    I had that done when I was a baby--I couldn't walk for a year!
    Thanks! I'll be here all week.

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  103. BigHank531:31 PM

    Who, exactly, is going to keep those 'benign corporate warlords' from deciding to lock the doors and reduce wages to zero?

    The traditional libertarian response is that 'people will follow the rules'. I point out with a population willing to not break an arbitrary ruleset, you can make Marxism work. This rarely goes over well.

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  104. mortimer20001:54 PM

    To fully appreciate the sociopathy of Randian tripe it helps to bear in mind that, for libertarian thought-experimenters like Suderman, people are widgets.

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  105. PorlockJunior2:18 PM

    Hard to beat the circumcision discussion, but I can't resist a concrete real-life example. Couple of months ago, I had an in-patient procedure, which meant showing up at the hospital at opening time and going home around 9:30 that night, with some real fun in between.

    For the hospital alone (not the highly qualified cardiologist and others), what I had to pay was not out of line, somewhat over $1,000 (because I don't have any Part XYZ paid add-ons to the Medicare).

    Medicare paid the real money, over $10,000. Well, those two together would almost fall within the $11,000; so, not too bad. You don't need a stent put in every year, I hope, and it's an old-guy problem anyway, uness you're one of the lucky ones who need it before you're 65, and that's your own fault, no doubt, as the libertarians will explain.

    No, the sobering part was the*other* part of the bill, called an Adjustment: The $108,000 (One Hundred Eight Thousand US Dollars), included in the hospital's invoice as the Manufacturer's Suggested Retail Price, which Medicare would not pay or allow them to charge to me.

    Kind of hard to fit that into your private-pay budget on $11,000 a year, I'd say.



    My heart bleeds, if you'll pardon the expression, for the poor hospital, being robbed of this reasonable pay for a day's work. But without the Government, naturally I'd have been able to negotiate a discount in the free market.

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  106. I thought I'd replied to this but it seems to have dissapeared. I actually don't think the show is particularly low budget, and I think its pretty clear that the producers are in on the storyline since they are producing it and its not really a mystery. The show is a bit slow and the writing is a bit dull but as far as special effects or acting its not low budget in that sense--have you tried watching Haven? The acting and the special effects in that show, a classic american show, are just jaw droppingly bad and the writing is about ten times more wandering and confused.


    We bogged down on Continuum because its dark and getting darker and my youngest daughter can't face it. But I think its really clear that they have a goal for the plot which is substantially different from the one you think they start with which is "rah rah" future cop and future corporations, down with the terrorists. I admire that about the show--its rare for a protagonist (the cop) with whom you are supposed to identify to be proven so wrong about everythign she thinks she knows, and so wrong about her own motivations and her own situation.

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  107. Just to add to this--a friend of mine just was hit by a car a few months ago--smashed her leg and bone came through the calf. She has been thorugh multiple surgeries, pins in her leg, and rehab. Luckily she was not working at the time and her husband's health insurance and income could cover her but had she been working she would have been unable to function at work for three months. Meanwhile a teenage boy in our social circle was also hit by a car, also had to have multiple surgeries, but got some kind of infection and ended up with six surgeries and skin grafts as well in a near life or death medical cock up. 11,000 dollars doesn't begin to cover it. Never could. Never will.

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  108. PersonaAuGratin2:39 PM

    Hey, once Yelp and Angie's List include user ratings for "Corporate Warlords," We the People will be in control and it will be paradise!

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  109. JennOfArk2:56 PM

    I'm really late to the thread so someone has probably called this out somewhere below, but what always gets me is how completely bereft of basic math and logic skills these guys are. That is, the whole reason insurance costs only $11,000 per year is that the vast majority of those ponying up the $11K will have less - generally far less - than $11K in medical costs for the year. The overage is what goes to pay for the guy with the $2 million cancer treatment, who, if he had only his $11K, or even being generous the $11K saved each year for the past 10 years, would go untreated. Shared risk is the only way the really big things get treated for 95% of the population. So you can look at these types of proposals as more of an ice floe than any serious proposal to provide actual coverage for serious illness.


    Also, too: you'd need more than two circumcisions a year to cut such massive dicks down to size.

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  110. Meanie-meanie, tickle a person3:01 PM

    Libertarians always start by assuming a can opener. Or, in this case benignity* on the part of the wealthy. Or unicorns, I can never tell the difference...


    *If it ain't a word, it oughtta be.

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  111. Meanie-meanie, tickle a person3:06 PM

    That's the thing about Rand that's always stumped me. He doesn't like the AMA's Board Certification system, do he invents his own? And other "doctors" join him? Does he think he can just invent himself a PhD, fercrapsake? I wouldn't consult that frizzy-haired fraud as an Optometrist, let alone an eye surgeon...

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  112. Meanie-meanie, tickle a person3:09 PM

    The "philosophical" basis of Libertarianism can be stated thusly:
    "I don' wanna, you can't make me, go 'way, leemelone, WAAAAAAH!"
    All else is commentary...

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  113. with all the God stuff stripped out


    More like "supplemented" than "stripped out." Remember, Ron Paul is a theocratic freak, Paul Ryan hasn't been threatened with denial of communion, and an awful lot of the schmibertarian crowd are anti-choice absolutists on fundamentalist theological grounds. If only a present-day John Galt could build a machine to harness the energy of Ayn Rand spinning in her grave.

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  114. Mark_B4Zeds3:27 PM

    I spent $1,800 on a single crown a few months ago. And not because I wanted the most deluxe option, all of the options available were about the same price. I have dental insurance, but it ended up only covering about $600, or about 1/3rd.

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  115. One broken leg cost about $65,000.


    This definitely sounds a bit high for the buyer's market we live in. Why, I know a couple of out-of-work guys who would break both of Suderman's legs for less than that.

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  116. KatWillow3:38 PM

    Ahhh... Remember Lexx? Wery Stwange show, but I liked it.

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  117. KatWillow3:47 PM

    I got braces in the hope of fixing TMJ-caused agonizing headaches: $7,000 (monthly VISA payments spread over 2 years, no interest). Thank goodness it worked- headaches all gone. To me it was worth it, tho I hated looking at that VISA bill. Not many people can afford that. Insurance wouldn't cover it.

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  118. Never saw it. We have a pretty strict regime around here at the moment: Lost Girl, Fringe, The Americans, Orphan Black. I'll watch Sons of Anarchy and Justified when they get back on.

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  119. StringOnAStick6:11 PM

    I work in the dental world. Let me assure you that not all bad dentists get run out of business; some have years, nay decades of time to do shit quality work and never get busted for it.

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  120. Mooser8:19 PM

    "E: Therefore, you is shit! Q.E.D.
    A: Well, what's your historical reference?
    E: You always been shit!!"

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  121. Mooser8:21 PM

    It's a profession which lends itself to burying mistakes.

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  122. Mooser8:25 PM

    And what I've noticed is that everyone in America who isn't kicked in the nuts by poverty likes to think he is rich. And shares the problems of the rich.
    And it is very, very hard for people to accept that the "news" coming out of their TV or Radio is just drivel. Pay attention to current events!

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  123. Mooser8:30 PM

    "...but the generic low-budget Canadian action-adventure show... "


    Until I read that, I had not the slightest inkling there was such a thing! And, I am sure, was a happier and better man for it. Oh well, can't be undone now.

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  124. Meanie-meanie, tickle a person11:24 PM

    a stupid, buzzworded plate of


    Buzzfeed!


    OK, I apologize for that one. No, no I don't.

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  125. Meanie-meanie, tickle a person11:26 PM

    The Libertarians clownsource it. Which, CCTOI, may be the same thing...

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  126. Meanie-meanie, tickle a person11:29 PM

    The whole concept of a religious Libertarian just makes my brane hurt. Anti-authoritarian extremists sucking the cock of the ultimate authority figure, thinking they've figured out how to make everyone else swallow...

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  127. montag211:59 PM

    Long experience suggests otherwise. *sigh*

    Thinking, to them, is finding new rhetorical fallacies with which to convince themselves that they're right.

    In the realm of political economy, they're the backyard tinkerers still trying to build perpetual-motion machines.

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  128. He used other language, I believe he said "the state would not have a monopoly on security, but security should be provided by military companies in competition, with no state". I dubbed this "warlordism" in an effort to bring the conversation back into reality. Silly me.

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  129. DocAmazing1:31 AM

    Here's the scary part: he has patients.

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  130. Daniel Björkman1:46 AM

    I'd go a step further and claim that the "let every man stand or fall on his own merits" position doesn't make sense to me even if the starting positions were completely identical and accidents never happened. I don't see why our "merits" should grant us rewards or punishments, when they are only an accident of birth anyway.


    Reward the smart people, punish the stupid? Where is the justice in punishing someone for being born with a less functional brain than someone else?


    Reward the hard-working people, punish the lazy? Where is the justice in punishing someone for having less resistance to pain and hardship (which is what being "lazy" amounts to)? It seems almost grotesquely unfair to me, actually - "oh, you don't handle suffering well? Have especially much of it!"


    Now, I do understand rewarding good work for the purely utilitarian reason that that will create an incentive to do good work and therefore make sure that more good work is done. But that's just being pragmatic. I don't see any justice in it. In a world that was actually unrealistically Garden-of-Eden perfect, everyone would do as much as they felt like and get as much as they wanted.

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  131. OK, if you're really interested, he said:
    Well since these competing defense services (let's call them Ace
    Defense, and Trojan Defense) would be paid voluntarily by how well they
    do their jobs, and no system of taxation would be in place to do as
    State's do by inflating the money supply, or taxing us, Ace Defense, and
    Trojan Defense could not afford to go kill each other off. We could
    imagine that their customer base would be very upset with war between
    the two competitors, and would no longer fund the villain here, they
    would all stop paying if they felt their defense service was rogue
    . News
    media which would also be decentralized, ... Another way to keep
    competing defense competitors from doing bad things to each other is for
    them to sign a contract with a judge that they both choose. There are
    so many ways a society could do better than the current system we have
    now. Freeing the market from monopolies, especially the State, since it
    is a territorial monopoly of ultimate decision making
    is how we will
    have a better world.


    So there you have it. In his world, dissatisfied customers would prevent "competing defense companies" -- in a territory with no government -- from fighting each other.

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  132. Yes I explained how in such a situation the warlords would likely take on the mantle of state power and kill whoever they felt like killing. He didn't seem to believe that could happen. "How could they become monopolies? The consumers would prevent it."

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  133. Daniel, that's a really great point, and reminds me of something Corey Robin was saying about extreme Capitalism.

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  134. Jon Hendry2:38 AM

    I'm sure Suderman would respond that it's the fault of the workforce Walmart hires from. They just need to get off their lazy butts and train themselves for better jobs. Once everyone in the US has trained for better jobs than Walmart, they can turn down Walmart's jobs, and Walmart will have to improve conditions.


    That, or Walmart will pressure Congress to grant them a special new retail-worker visa and bring in tens of thousands of foreign workers.

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  135. Jon Hendry2:40 AM

    The next child will be sent back to kill Keynes.

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  136. Jon Hendry3:37 AM

    After all, many procedures are things that a person will only have once in their life. If the results aren't catastrophically bad, how's a person supposed to know if their experience was abnormal?

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  137. Jon Hendry3:47 AM

    The GOP/Libertarian Death Panel operates via the Hospice of Shame.

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  138. Hahahahaha... hooooly hell.

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  139. MikeJ4:27 AM

    Libertarians love to argue that any way you make money, short of physical violence, should be ok, Ask them sometime why they rule out physical violence. They want to be able to use the skills they believe they have more of (smarts) and be protected from people with different skills.

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  140. Davis6:56 AM

    Oh. My. God. That cannot be topped.

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  141. Buddy_McCue8:05 AM

    "Warlordism" sounds like a very good way to describe it.


    I'm reminded of the warring city-states in Italy before it was Italy. Each one enjoyed that "local control" that Libertarians like to talk about.


    Or how about the warring clans of Scotland before it was Scotland? History is full of examples of locally-held powers fighting each other like this.

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  142. Yes, and these now-unemployed workers will get that training how? State-funded programs that no longer exist? Paid programs that cost thousands? Hm-m, it just might work!

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  143. coozledad9:17 AM

    God damn. Reading Kat Willow and Aimai's horror stories, it made me wonder if it wouldn't be worthwhile to spend a few grand to get a portable ultrasound, lay in few grams of heroin, a broad spectrum antibiotic or two and some old surgical manuals in the event I get that 6,000 dollar sprained ankle, broken rib. or a thorn in my foot:

    http://whyisamericanhealthcaresoexpensive.blogspot.com/2014/01/ultrasound-in-south-sudan-what-might-it.html

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  144. Yes, these examples fit. And I'm sure it would work beautifully in a culture that has ICBM's, drones and widespread surveillance.

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  145. I actually feel libertarians should think *less*. They'd be less delusional & more grounded.

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  146. Yes, there is something redundant about "meritocracy". Obviously some people are smarter, stronger or more moral than others. But if we accept that possession of these merits is a good thing, then why would we need to reward people for possessing a good thing? Meritocracy seems perversely anxious that merit may not actually exist, and has to be faked externally.

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  147. "...only when
    we must reckon with the finite resources at our disposal, are we brought
    face to face with ourselves."


    This right here is a huge assumption that has to be granted to libertarians before their arguments can make any kind of sense. Sure, resources are finite, but they are NOT evenly distributed throughout a society, and when you have a wealthy, powerful minority controlling a huge percentage of the wealth, it leaves only a very small, and VERY finite portion for the rest of us plebes to fight over. For example, the U.S. is widely considered "The Richest Country On The Face Of The Earth(tm)", and I suppose in the aggregate, it is. So, why can't we "afford" universal access to health care, or food, or a decent standard of living for the average worker? Because most of the wealth of the country is tied up by the top 1%, and is effectively out of circulation, because as a few become wealthier and more powerful, they just don't tend to become more benign or responsive to the puny "demands" of The Consumer.

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  148. You're right that there's a pragmatic reason for "meritocracy" when people are organized in a hierarchy. It's in the interest of the hierarchy to have certain "merits" at the top. But "meritocratic" people never want to leave it at that, they want to turn it into a life philosophy.

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  149. In other words, libertarians want special protections from the state.

    ReplyDelete
  150. Absolutely, it is absurd to assume that people have relatively equal means. But even beyond that, even if they did, why force them to obsess about their money all the time? It's a harsh doctrine designed to break down human emotions.

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  151. DocAmazing11:55 AM

    Cool article. I order way too many X-rays, partly because that's "standard of care" and to skip it invites attorneys to order a wallet biopsy on you, but also because ultrasound isn't presented as an option. Plain X-rays are a 19th-century technology; CT scans are just 19th-century with a 1980s gloss. I'm going to start asking the radiologists to start checking for pneumonia via ultrasound.

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  152. To this tale of tooth woe I want to add that I had to go get a root canal a few years ago after cracked tooth. I was sent by my dentist, who is always very attentive to what insurance will or won't cover, to the root canal guy and when I got there they shot me full of novocaine, got me into a chair,and then pulled me out to make me sign a piece of paper that said I had to pay 400 dollars up front and would be responsible for all the insurance costs if, later, my insurance didn't pay. I had the money, in the event. But I will never go back to that practice--imagine how terrible it would be to have that done to you without warning, when you are in no condition to refuse to sign that paper but in no condition to pay the money?

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  153. Its not too late--can't you declare yourself a neurosurgeon and start trepanning people?

    ReplyDelete
  154. Also--customers can prevent media monopolies by, what now? No laws in place to prevent monopolies means no monopolies or cartels?

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  155. After Mr. Aimai's brush with extreme back pain, which landed him in the ER twice in two days, I keep a supply of serious pain killers on hand. If that is going to be what keeps you from being immobilized for six hours (which has serious consequences ifyou add it on to 12 hours waiting to be seen in the E fucking R without meds because they can't decide what to do with you) then fuck 'em, we'll self medicate so we can stay ambulatory.

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  156. I'm late to this part of the discussion but does anyone think its psychologically significant that the format of the title is the same as "Yes, Virginia, there is a Santa Claus?" I mean thats the giveaway right there that even Suderman doesn't believe what he's writing, that its pablum boiled up for the toothless and mindless children on the far right.

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  157. DocAmazing12:14 PM

    I have a terrible habit: I offer advice to people I've never seen. So take this with the customary quantity of salt.

    Most back pain, at least in kids, is due to muscle spasm or strain. An overly tense muscle hurts, which sets up a feedback loop causing the muscle to tense up further and to be locked into contraction (tetany). (Here comes the boring part.) Tetany is maintained by calcium in the muscle; it binds to a specific receptor. (Here comes the potentially useful part.) Magnesium also binds to that receptor, displacing calcium, and releasing the contracted muscle. So, if you aren't already doing this, go get a bottle of magnesium oxide pills--400mg should be very available and pretty cheap--and give Mr. Aimai one a day for a week or two, and when his back pain first comes on, give him two or three. They may cause some diarrhea, but they should loosen up a muscle in spasm. (Works in kids, most of the time.) See if that helps.

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  158. DocAmazing12:18 PM

    My patients already need me like a hole in the head...

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  159. DocAmazing12:22 PM

    The part of that that makes my face burn in shame for my profession is that broken toes are left untreated. The most treatment a broken toe with get (unless it's shattered, along with much of the rest of the foot) is to be buddy-taped to the toe next to it.


    I wasn't there, and shouldn't criticize, but I fail to see what an X-ray would have revealed that would have changed your treatment.

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  160. Thank you very much DocAmazing! He's been pretty good for the last few years and regularly does stretches to prevent this from happening. They hypothesize that either his back went into spasm after someone else's luggage fell on his head on an airline trip or else that he had a virus of some kind that affected his muscles. But I will keep this magnesium thing in mind if it starts happening again.

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  161. He seemed to believe that, yes.

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  162. There you go--a ready made market!

    ReplyDelete
  163. Thanks for this tip, Doc Amazing! I have chronic back pain as well.

    ReplyDelete
  164. Mooser1:26 PM

    Wow, a doctor who writes clear, simple understandable English! You must be some kind of a specialist.

    ReplyDelete
  165. MikeJ1:27 PM

    Radium also binds to the calcium sites, but has that whole cancer side effect thing. But it is another option that I'm sure the libertarians would want you to know about.

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  166. Meanie-meanie, tickle a person1:36 PM

    i'd feel better about the bill if i'd have crushed the foot off altogether. Then it would have made sense.

    In '94 I ran a fingertip into my radial arm saw blade. Taped it up, drove to the ER, was home in an hour, $700 lighter. One fucking stitch. I shudder to think what it would cost today. A few years later, I did almost the same thing to a thumb, when a cutoff wheel I was using in my grinder exploded. The treatment this time was about $3. I cleaned it, put on some antibiotic, wrapped it in paper towel and duck tape, then went to the store and got an aluminum finger splint. Probably woulda been good for 2 stitches this time, but today you can't tell anything ever happened to it.

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  167. StringOnAStick1:39 PM

    Exactly. Things to look for: you see the same staff members instead of a never-ending parade of new faces; the latter always indicates problems. Also, if you suspect you are getting the hard sell on something, especially an optional something, you probably are and you should move on, perhaps finding a DDS with higher ethics and less greed.
    Dentistry is expensive because the materials and the costs of sterilization are expensive, and it isn't a job you do well past a certain age. However, some of these guys are way into the sell, sell, up-sell, sell some more business model; you'll know it when you experience it.

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  168. Meanie-meanie, tickle a person1:40 PM

    Gabby Johnson would be so proud...

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  169. StringOnAStick1:54 PM

    And isn't breaking down human emotions the route to total control of the subject population? Scratch a libertarian and you reveal the underlying authoritarian every single time.

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  170. DocAmazing3:45 PM

    Alcohologist, today.

    ReplyDelete
  171. Halloween_Jack5:20 PM

    It's difficult to tell from that screenshot, but it looks like Hizzoner's pie is, if not Chicago deep-dish (which would be political suicide, of course), a more substantial product than the crappy slices sold all over the boroughs that can be folded lengthwise.

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  172. Halloween_Jack5:27 PM

    Dr. Rand Paul has a solution for you.

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  173. Halloween_Jack5:30 PM

    If it involved the Klingon Empire and House Targaryen, I'm in.

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  174. Halloween_Jack5:36 PM

    I know that "Well, it's Kentucky" is simplistic and insulting, but, well...

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  175. Jon Hendry6:33 PM

    And it certainly doesn't help that dentistry is one of the professions targeted by Scientology for selling Hubbard's nonsense "management tech".

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  176. MikeJ7:18 PM

    More pics in the Daily News story: http://www.nydailynews.com/new-york/fork-gate-de-blasio-cutlery-eat-pizza-article-1.1575663

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  177. BigHank539:08 PM

    Here's the scary part: he has patients.


    I'll merely note that he chose a specialty in which it's quite difficult to kill your patients through malpractice.

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  178. brandonrg9:58 AM

    the GOP has always been about massive expansions of Medicaid and guaranteed issue/community ratings regulations.

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  179. Oh, sure, it's all good fun until someone gets an eye poked out.

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  180. I already had a De Blasio crush, but as a fussy fork-and-knife wielder unless the crust is strong enough, right now I could swoon.

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