Ok, so what do we cut?

I've heard this idea before but I've never been clear on the implementation. In practical terms, I can see this happening two ways:

1) Government paid medical care is restricted to government clinics, in which the doctors and other ancillary employees are all government employees drawing a salary.

Problem: There is no infrastructure of Federal government healthcare other than the military, VA, Indian Health Service, and a few smattering of clinics here and there.The government would either have to build it from scratch at a cost of trillions or buy the entire medical infrastructure, at a cost of trillions.

2.) Private Practices are paid by the patient per year, in one lump sum fee, regardless of how of how many visits are made.

Problem: This is done in the health insurance world. Called capitation, insurance companies pay per the patient rather than the visit or service. It's not very popular because one really sick patient can really be a massive expense to the doctor if they are constantly coming in for visits, while the doctor is being paid the same as the patient who comes in for a physical once a year.

 

I believe we should solve simple poverty and let Individuals find their own solutions in our market base reality. A welfare-state could merely ensure full employment of human capital resources in our capital economy with its institution of money based markets.

What excuse could persons have for not taking care of themselves if they are not in official poverty?

 

I believe you need your medication adjusted.

 

Says the person who only has a fallacy for his Cause.

 

Take the profit motive out and the problems go away.

In your first statement, we didn't have a VA until we built a VA.

In your second the profit motive would tend to restrict treatment of those patients that really need it.

If we are to be serious about reducing costs we have to change both the delivery method and motive.

 

What a coincidence, I believe we should "burden" the wealthiest with wartime tax rates, even for a War on Drugs, ostensibly, to reduce "causalities" engendered by our warfare-state.

 

By the same logic, take away the profit motive and the initiative to do it in the first place goes away.

Problem: We have a shortage of healthcare providers, but after taking student loans that puts a new doctor over $100k into debt, yet upon graduation he or she will make no more then a janitor.

Problem: We have a lack of new medication to solve descolada, and a pharmicutical company thinks it might have a medication that will help. However, it figures that after spending upwards of $250 million to make a drug it will be mandated to sell it at only $10.

After all, it is a much wiser man then me that stated that profit is the fruit of capitol. ANd without that fruit, we would not have more capitol.

 

I agree that none of those are good options. I was just pointing out why your idea was unworkable.

 

Platitudes about capitalism do not solve problems. They exacerbate them.

The solution we're talking about is limited to Medicare and Medicaid and does nothing to limit any physician's ability to start or operate a practice nor does it limit what services other providers can provide or what they can change for them.

All this does is eliminate the 20% of costs that go to overhead and the drive by providers to provide services that are unneeded in order to drive revenues.

 

The interstate highway system was "unworkable" until we made it work.
So was the Hoover dam, getting a man to the moon, defeating the Axis powers and any number of things that couldn't be done until we decided to do them.

 

In each of those cases, someone was able to describe and execute a plan to do just that. You were not able to do that with your plan.

 

And demonizing Capitolism and trying to urge some kind of Socialist beliefs that seperate profit from motivations is foolish and ignorant. After all, we saw how well that worked in the Soviet Union.

The real issue here is that you can't seperate your political beliefs from trying to achieve solutions. To you, everything is apparently class warfare. While I could not care less (and actually do not like any kind of "warfare").

 

Just cannot bring yourself to cut Section 8 housing?

 

Not unless we cut the drug war first.

 

How would the rich slum lords maintain their wealth otherwise?

 

Because you need Section 8 when you are so busy getting high all the time you can't be bothered to go look for real work.

 

Oh yes, they get so rich renting out their property in ghettos at the rate that the government is willing to pay.

I used to work maintenance at 2 such complexes, and after paying for maintenance, utilities and taxes, it was probably a good thing the owner was retired or she would not have had enough to get by on.

Most "Section 8" complexes are now inside of the lowest income areas, because they could never afford to rent low enough in any other areas. You are not going to find Section 8 in Bell Aire, but it is available in Compton.

And people on Section 8 do not even have to use those houses or apartments. They can use them for any housing, or even to buy a house and apply that money to the mortgage payment.

So sorry, that claim is frankly nonsense. Section 8 is capped per region, and normally much lower then the median rent in the region.

Section 8 in San Francisco caps at $1,500 a month. Good luck finding anything other then the worst slums that rent that low. So your claim is busted, "slumlords" make far more by not renting "Section 8".

 

I didn't give a plan. I presented a high level proposal with some approximations.

Your objection was that we couldn't do because we're not doing it now.

Your objection is invalid.

 

I didn't demonize capitalism. There are times when capitalism is not the right answer.

Is capitalism the right answer to providing police services? Fire services? Disaster services?

When all you have is a hammer everything looks like a nail.

 

That wasn't my objection. My objection was that the transition costs would be in the trillions.

 

OK. Pick a number for your transition costs. 5 trillion good for you?

Using the previous numbers and assuming zero inflation in FPS costs combined medicare and medicaid costs in 2012 were 845B. After transition those costs would be reduced by $300B per year. The transition costs would be recovered in full in less than 20 years.

And that assumes a system with no co-pays and no insurance support.

Of course we could just end medicare and medicaid. Sentence 80s million people to suffer from preventable diseases and early death for the crime of not being rich.

 

I still vote we ditch the drug war as a "no brainer" in modern times.

 

Be better off "not" renting? How would they pay their taxes?

In Alaska, we lived under several welfare recipients, who all lived on the top floor apt (nice ones too), because those apartments had fireplaces, and the state of Alaska pays 3/4 of the rent so they only have to make up the difference since all the utilities are included in rent. I had a job and couldn't afford an apartment with a fireplace.

Jump to Las Vegas where the government is allowing welfare recipients to live in townhouses that cannot be sold/rented because of the poor housing/rental market. So who exactly is being subsidized here? The crack whore or the landlord who is basically receiving a bale out from uncle sugar?

Not sure where you live but you cannot own a home and be on traditional welfare. It has to be in somebody else s name, same with an auto, there is a price limit. The people who are owning homes etc... are most likely drawing partial benefits (food stamps), or on some form of disability, where most welfare rats roam when their benefits run out. They can't work after 10 years of dependency on the government so they are considered unemployable, AKA disabled.

In any case most of the people providing section 8 are making money, if only to maintain the property. Much like food stamps and grocery stores. If you stopped food stamps tomorrow, there is no telling how many stores would go out of business without that revenue generated by welfare and government subsidies.

 

Good question!

I'd cut The Department of Education, Department of Energy, and corporate welfare, for a start.

Then I'd reform welfare to provide assistance for job training only or those who only work part-time. If they don't get job training or a job, they don't get welfare. No more extra assistance to women who have baby after baby with different fathers and no more aid to dependent children. Provide assistance for daycare so they can work.

Cut the pork out of legislation. Stop adding amendments to bills going through Congress unless they pertain directly to the bill.

Stop lobbying in DC altogether.

Reduce salaries and retirement benefits to those in Congress. Tie it to their approval ratings. If their rating is below 50%, they don't get their salary. Also cut the salary of the President or make it tied to his/her approval ratings. Again, if less than 50%, no salary.

I agree with closing military bases in Japan, Korea, and Germany. We don't need to be there anymore. I believe the reason we're still in Japan is out of guilt for dropping the bomb on them, and that was 60+ years ago. Both Japan and Korea should be able to defend themselves by now. They shouldn't need us to do it for them. Also cut bases in the states that don't provide training or whose personnel can be immediately deployed to war zones. Consolidate as many bases as possible, making them joint bases where military personnel from all branches of the Armed Services are stationed.

Cut foreign aid to countries that hate us, like Pakistan, Afghanistan, and Egypt.

Root out all fraud, waste, and abuse from every department in government. Employ more than one inspector general or FWA team to do this.

Cut salaries of administration officials. Most of them are way overpaid anyway. That should be tied to their performance, and they should be highly qualified for the job, not just a presidential appointment. Case in point: FEMA. They don't know what they're doing, as evidenced by their response, (or non-response), to hurricane Sandy. Every presidential appointee, including the "czars", should be fully vetted. If they're not qualified, they don't get the job.

Reform the tax code and get rid of deductions for things like owning a home or having children. It's totally unfair to those of us who don't. A flat tax would be a good idea if you want to tax income. Everyone would pay the same amount in taxes, no matter how much you earn. A better solution would be to stop taxing income entirely and go with a consumption tax, in combination with cutting the above. People would have the ability to save more, therefore invest more, spurring the economy.

Reform Medicare and Medicaid. Get millionaires off the rolls. They have enough money to pay for their health insurance themselves. Bundle health care procedures, such as surgery, to include paying the hospital, physician, and anesthetist all in one payment. Root out all fraud in the system. As far as Medicaid goes, give it to the states to manage as they see fit.

Reform Social Security. Stop giving SS to the very wealthy. They don't need it as they can pay for their own retirements.

 

In my opinion, only a warfare-State would be that inefficient due to waging a War on Poverty. A welfare State could simply provide recourse to eminent domain to abolish poverty in a market friendly manner, as a public policy.