The First Ripples of the Silver Tsunami
September 19, 2009 11:18 AM Subscribe
Nearly 1 in 5 young adults is out of work.
Student debt is the highest its ever been.
With a 10 year job growth of negative 230,000 jobs, the pool of available jobs is the lowest its ever been as a ratio to available college grads.
And even with this dwindling tax base, in order to sustain Medicare and Social Security by 2020, we will need to tax 1.5 workers for every retiree.
The dominant media narrative now is focused on the racial tensions surrounding Obama's health care reform. But in reality, the strongest opposition to Obama now comes not from young whites, who stand to benefit the most from medical reform. It is largely from 'angry white seniors' who fear cuts in the their Medicare.
Are you ready for the Silver Tsunami?
The dominant media narrative now is focused on the racial tensions surrounding Obama's health care reform. But in reality, the strongest opposition to Obama now comes not from young whites, who stand to benefit the most from medical reform. It is largely from 'angry white seniors' who fear cuts in the their Medicare.
Are you ready for the Silver Tsunami?
Give me that rye, you old bag!
posted by Joe Beese at 11:32 AM on September 19, 2009 [6 favorites]
posted by Joe Beese at 11:32 AM on September 19, 2009 [6 favorites]
Not enough to back up the "in reality" claim.
I would counter with my own think assertion that "in reality" the biggest opposition comes from a political party stuck in opposition mode, no matter what, and that generates streams of fear mongering. Every time this issues arises it is the same people who oppose it. And they gin up the same tired scare claims. The GOP heads have pretty much admitted to trying to follow the Gingrich pattern of '92-'94. Defeat health care, disillusion the liberal bloc, agitate the conservative bloc to make gains in the off term election. If whatever comes out of Congress is even marginally good the Republicans are fucked, and they know it.
The "angry white seniors" article basically says the liberal seniors are ok with Obama, and the conservative ones are not.
The added tension this time around is in part because of two things... a lot of people are hurting because of the Bush economic collapse, a lot of those people are white older men btw, and Obama and the Dems are the largest target to direct their pain at. Secondly there IS a racial element to it. The Republicans want to capitalize on that, some of them walk a fine line, some cross that line while looking back and giving everyone else the finger. The Republicans will win a few elections here and there, but until they dump the overt racist elements from their grand old party they are on a downward spiral. America is getting less and less white
posted by edgeways at 11:35 AM on September 19, 2009 [3 favorites]
I would counter with my own think assertion that "in reality" the biggest opposition comes from a political party stuck in opposition mode, no matter what, and that generates streams of fear mongering. Every time this issues arises it is the same people who oppose it. And they gin up the same tired scare claims. The GOP heads have pretty much admitted to trying to follow the Gingrich pattern of '92-'94. Defeat health care, disillusion the liberal bloc, agitate the conservative bloc to make gains in the off term election. If whatever comes out of Congress is even marginally good the Republicans are fucked, and they know it.
The "angry white seniors" article basically says the liberal seniors are ok with Obama, and the conservative ones are not.
The added tension this time around is in part because of two things... a lot of people are hurting because of the Bush economic collapse, a lot of those people are white older men btw, and Obama and the Dems are the largest target to direct their pain at. Secondly there IS a racial element to it. The Republicans want to capitalize on that, some of them walk a fine line, some cross that line while looking back and giving everyone else the finger. The Republicans will win a few elections here and there, but until they dump the overt racist elements from their grand old party they are on a downward spiral. America is getting less and less white
posted by edgeways at 11:35 AM on September 19, 2009 [3 favorites]
The AFL-CIO recently released Young Workers: A Lost Decade, an interesting (and fairly terrifying) report on the economic situation of workers 18-35:
* 31 percent of young workers report being uninsured, up from 24 percent 10 years ago, and 79 percent of the uninsured say they don't have coverage because they can't afford it or their employer does not offer it.In the New York Times, Nagourney recently speculated about a political age gap:
* Strikingly, one in three young workers are currently living at home with their parents.
* Only 31 percent say they make enough money to cover their bills and put some money aside—22 percentage points fewer than in 1999—while 24 percent cannot even pay their monthly bills.
As distasteful as the notion of intergenerational conflict may seem, the fight over health care — not to mention the election of health care reform’s current chief proponent, President Obama — suggests that something is going on. Older Americans are more likely to oppose Mr. Obama’s initiative than any other age group.posted by enn at 11:37 AM on September 19, 2009 [6 favorites]
Hate to say it, but this doesn't just apply to recent college grads - In fact, in my (admittedly limited) experience they have more success in finding work than experienced middle-agers for the simple reason that they'll take drastically lower pay and put up with more borderline-illegal abuse by their employers.
As for health-care reform, let's not kid ourselves here... It sounds like a great idea, until you realize that we have four major issue on the table - "Universal" healthcare, mandatory healthcare, the "public" option, and limitations on pre-existing condition clauses. Of those, three sound great and one sounds innocuous enough given the other three. Given the history of government "reform", I'd bet my left nut we end up with exactly one of those four: Not everyone will have insurance, those who don't (which will include anyone with serious, and therefore expensive to insure, chronic medical needs) will pay fines for the "privilege" of skipping out on "their share" of the burden, and we'll have no "public" option to encourage anything even remotely resembling competition in the market.
And everyone in Washington will applaud the spirit of "compromise" that let them get the worst possible combination of features passed.
posted by pla at 11:42 AM on September 19, 2009 [7 favorites]
As for health-care reform, let's not kid ourselves here... It sounds like a great idea, until you realize that we have four major issue on the table - "Universal" healthcare, mandatory healthcare, the "public" option, and limitations on pre-existing condition clauses. Of those, three sound great and one sounds innocuous enough given the other three. Given the history of government "reform", I'd bet my left nut we end up with exactly one of those four: Not everyone will have insurance, those who don't (which will include anyone with serious, and therefore expensive to insure, chronic medical needs) will pay fines for the "privilege" of skipping out on "their share" of the burden, and we'll have no "public" option to encourage anything even remotely resembling competition in the market.
And everyone in Washington will applaud the spirit of "compromise" that let them get the worst possible combination of features passed.
posted by pla at 11:42 AM on September 19, 2009 [7 favorites]
Old people are more likely to be republicans. I don't know that this universal healthcare stuff is really as much of an age issue as a partisan issue. After all, there isn't really anything to worry about for people over 65, beyond a few scare tactic B.S. from the republicans -- such as the idea that effectiveness testing and not paying for useless procedures is somehow a bad thing
posted by delmoi at 11:44 AM on September 19, 2009
posted by delmoi at 11:44 AM on September 19, 2009
@edgeways
Obama's polls have slipped overall, but he still polls highest amongst 18-29 year olds. His favorability has slipped the most from the already low polling 65+ crowd.
posted by Acromion at 11:46 AM on September 19, 2009
Obama's polls have slipped overall, but he still polls highest amongst 18-29 year olds. His favorability has slipped the most from the already low polling 65+ crowd.
posted by Acromion at 11:46 AM on September 19, 2009
No health care means shorter lives. Do the math.
posted by fourcheesemac at 11:48 AM on September 19, 2009 [1 favorite]
posted by fourcheesemac at 11:48 AM on September 19, 2009 [1 favorite]
@enn,
Damn.
And too bad the AFL-CIO could never compete with the AARP, arguably America's most powerful, wealthy, and influential lobby group.
posted by Acromion at 11:52 AM on September 19, 2009
Damn.
And too bad the AFL-CIO could never compete with the AARP, arguably America's most powerful, wealthy, and influential lobby group.
posted by Acromion at 11:52 AM on September 19, 2009
tax away i say! hands off my social security check! i need my chardonnay and smokes.
posted by billybobtoo at 11:55 AM on September 19, 2009 [1 favorite]
posted by billybobtoo at 11:55 AM on September 19, 2009 [1 favorite]
older people already vote in high %, and they where his worst demographic anyways, so the key to election success for the GOP is to repress younger voters in midterms, to do that they need to be disillusioned, and that is what the GOP is working at hand over fist.
posted by edgeways at 12:02 PM on September 19, 2009 [2 favorites]
posted by edgeways at 12:02 PM on September 19, 2009 [2 favorites]
Nothing new.
That the west is done is not breaking news. Most intelligent, ambitious and/or qualified young people should look for exit options. And honestly, I can't stand most of the "white seniors". Many of them are big mouthed and dump. They don't understand that they
a) grew up in a time of huge economic growth and
b) exploiting the young people since most western governments take a tremendous debt to sustain their artificial high living standards, while at the same time the infrastructure and the educational system falls apart. The bill is left for future generations.
posted by yoyo_nyc at 12:04 PM on September 19, 2009 [1 favorite]
That the west is done is not breaking news. Most intelligent, ambitious and/or qualified young people should look for exit options. And honestly, I can't stand most of the "white seniors". Many of them are big mouthed and dump. They don't understand that they
a) grew up in a time of huge economic growth and
b) exploiting the young people since most western governments take a tremendous debt to sustain their artificial high living standards, while at the same time the infrastructure and the educational system falls apart. The bill is left for future generations.
posted by yoyo_nyc at 12:04 PM on September 19, 2009 [1 favorite]
Old people are no good at everything. I don't know, maybe it's time to reevaluate voting rights at the other end of the age spectrum. We don't give children the right to vote, because society has to take care of most of their needs, and they are too mentally immature for making important, logical decisions. Maybe old people get past a certain point where they vote in criminals and crooks who loot the Treasury with illegal wars and Wall Street bailouts, whilst complaining when times get tight.
posted by Blazecock Pileon at 12:06 PM on September 19, 2009 [7 favorites]
posted by Blazecock Pileon at 12:06 PM on September 19, 2009 [7 favorites]
What kind of pussy young people want health insurance anyway? When you're young, the odds of needing health care are so miniscule as to be nonexistent. There are a billion better things for someone under the age of 33 to be spending their money on than betting that they're going to have an expensive health condition. Do you think boomers spent all their youthful paper-route money on health insurance? They took the chance and spent the money on drugs and Iron Butterfly albums. In those days, young people wanted to overthrow the government. Today, we have the spectacle of perfectly healthy young Americans whimpering like brats and begging the government "Take care of us! Take care of us!" Wee, wee, wee, all the way home.
posted by Faze at 12:08 PM on September 19, 2009 [4 favorites]
posted by Faze at 12:08 PM on September 19, 2009 [4 favorites]
You didn't here a peep from the seniors when Dubya signed in Medicare Part D, the largest domestic spending bill passed since Carter.
Its only socialism if its for other people.
posted by Acromion at 12:13 PM on September 19, 2009 [18 favorites]
Its only socialism if its for other people.
posted by Acromion at 12:13 PM on September 19, 2009 [18 favorites]
* 31 percent of young workers report being uninsured, up from 24 percent 10 years ago, and 79 percent of the uninsured say they don't have coverage because they can't afford it or their employer does not offer it.
* Strikingly, one in three young workers are currently living at home with their parents.
* Only 31 percent say they make enough money to cover their bills and put some money aside—22 percentage points fewer than in 1999—while 24 percent cannot even pay their monthly bills.
Look ma, I'm a statistic now, too!
posted by Scotty_D at 12:15 PM on September 19, 2009 [1 favorite]
* Strikingly, one in three young workers are currently living at home with their parents.
* Only 31 percent say they make enough money to cover their bills and put some money aside—22 percentage points fewer than in 1999—while 24 percent cannot even pay their monthly bills.
Look ma, I'm a statistic now, too!
posted by Scotty_D at 12:15 PM on September 19, 2009 [1 favorite]
What kind of pussy young people want health insurance anyway?
Young people with chronic, hereditary diseases, probably. If only their genes hadn't been such pussies while they were developing in the womb, then they wouldn't need insulin shots and medications to keep them alive. Weaklings.
posted by Scotty_D at 12:19 PM on September 19, 2009 [13 favorites]
Young people with chronic, hereditary diseases, probably. If only their genes hadn't been such pussies while they were developing in the womb, then they wouldn't need insulin shots and medications to keep them alive. Weaklings.
posted by Scotty_D at 12:19 PM on September 19, 2009 [13 favorites]
There is one demographic statistic I'm curious about - a number of those "retirees" haven't retired yet. Which means - the "Silver Tsunami" could also create a lot of job openings in its wake.
Has that been taken into account? I'm sincerely curious.
posted by EmpressCallipygos at 12:20 PM on September 19, 2009
Has that been taken into account? I'm sincerely curious.
posted by EmpressCallipygos at 12:20 PM on September 19, 2009
When you're young, the odds of needing health care are so minuscule as to be nonexistent.
That's just wrong. I've known quite a few young people who had serious medical expenses requiring hospital time. Sure, they're less likely to get sick but no one's risk of accident or illness is non-existent. For example, you might have noticed that Swine Flu is hitting young people more than us older folks who have built up more immunity.
posted by octothorpe at 12:22 PM on September 19, 2009 [1 favorite]
That's just wrong. I've known quite a few young people who had serious medical expenses requiring hospital time. Sure, they're less likely to get sick but no one's risk of accident or illness is non-existent. For example, you might have noticed that Swine Flu is hitting young people more than us older folks who have built up more immunity.
posted by octothorpe at 12:22 PM on September 19, 2009 [1 favorite]
I hear a lot of anecdotal evidence to the effect that, as older (i.e. higher-paid) employees retire, they are either not replaced and their workload gets dumped on the remaining employees, or they are replaced by contract workers with no job security, benefits, etc. Either way, the younger workers get screwed.
posted by Stonewall Jackson at 12:26 PM on September 19, 2009 [5 favorites]
posted by Stonewall Jackson at 12:26 PM on September 19, 2009 [5 favorites]
Which means - the "Silver Tsunami" could also create a lot of job openings in its wake.
Even if those jobs do come back it will be offset by increased life expectancy and rising medical costs. Not to mention the rapidly depreciating dollar and the compounding interest that will be owed on the national debt (guess who gets to pay for that?)
posted by Acromion at 12:28 PM on September 19, 2009
Even if those jobs do come back it will be offset by increased life expectancy and rising medical costs. Not to mention the rapidly depreciating dollar and the compounding interest that will be owed on the national debt (guess who gets to pay for that?)
posted by Acromion at 12:28 PM on September 19, 2009
This fits in neatly with my theory that there is nothing good on this earth that baby boomers can't collectively fuck up for the rest of us.
It doesn't have anything to do with the character of that generation. There's just so many of them. The same thing is going to happen in Japan and China as their population ages.
posted by Acromion at 12:33 PM on September 19, 2009
It doesn't have anything to do with the character of that generation. There's just so many of them. The same thing is going to happen in Japan and China as their population ages.
posted by Acromion at 12:33 PM on September 19, 2009
When you're young, the odds of needing health care are so minuscule as to be nonexistent.
It's just as well childbearing is a function of old age, right?
posted by rodgerd at 12:34 PM on September 19, 2009 [1 favorite]
It's just as well childbearing is a function of old age, right?
posted by rodgerd at 12:34 PM on September 19, 2009 [1 favorite]
What kind of pussy old people want health insurance anyway? When you're old, the odds of not dying are so minuscule as to be nonexistent. There are a billion better things for someone over the age of 65 to be spending their money on than betting that they're going to keep breathing much longer.
posted by Benjy at 12:35 PM on September 19, 2009 [6 favorites]
posted by Benjy at 12:35 PM on September 19, 2009 [6 favorites]
EmpressCallipygos : There is one demographic statistic I'm curious about - a number of those "retirees" haven't retired yet. Which means - the "Silver Tsunami" could also create a lot of job openings in its wake.
Those over 70 who haven't retired generally can't afford to do so, and will work until they die (or more accurately, until they spend millions on medicare slowly wasting away in a health care system that doesn't believe in letting unsaveable people just die).
So no, we probably won't see a wave of job openings as Boomers retire, because they'll just slowly trickle off as they die. Of course, by that point, I fear yoyo_nyc has the right idea - The American way of life has neared the end of its run (at least in its current form).
posted by pla at 12:38 PM on September 19, 2009 [1 favorite]
Those over 70 who haven't retired generally can't afford to do so, and will work until they die (or more accurately, until they spend millions on medicare slowly wasting away in a health care system that doesn't believe in letting unsaveable people just die).
So no, we probably won't see a wave of job openings as Boomers retire, because they'll just slowly trickle off as they die. Of course, by that point, I fear yoyo_nyc has the right idea - The American way of life has neared the end of its run (at least in its current form).
posted by pla at 12:38 PM on September 19, 2009 [1 favorite]
Wow, mhoye, gratuitous boomer bashing right out of the gate. I'm impressed.
That said, I am in sympathy with your recognition of the underlying issue: namely, the disrespect and dismissal in this country of our greatest resource--young people--is appalling. We withhold funds from secondary education, then force these kids into debt, we force them into skill sets that don't interest them with the shibboleth that it will help them secure a job, then don't invest in job growth anyway in particular in fields that will have the most immediate impact on society-- science, medicine (not health business, but medical practitioners), education, public service. Nearly every young person I know is either unemployed or underemployed, none of them has health insurance, and half of them are contemplating going even deeper into debt because they are two years out of school, their loans are coming due and there are no jobs.
In fact, it's not the boomers but our elder siblings and parents who are the current primary beneficiaries of Medicare. Boomers just reached the threshold in the last couple of years, so absolve us of creating the problem until we actually are the problem. (Then you can always line us up in front of a few death panels.)
posted by nax at 12:39 PM on September 19, 2009 [7 favorites]
That said, I am in sympathy with your recognition of the underlying issue: namely, the disrespect and dismissal in this country of our greatest resource--young people--is appalling. We withhold funds from secondary education, then force these kids into debt, we force them into skill sets that don't interest them with the shibboleth that it will help them secure a job, then don't invest in job growth anyway in particular in fields that will have the most immediate impact on society-- science, medicine (not health business, but medical practitioners), education, public service. Nearly every young person I know is either unemployed or underemployed, none of them has health insurance, and half of them are contemplating going even deeper into debt because they are two years out of school, their loans are coming due and there are no jobs.
In fact, it's not the boomers but our elder siblings and parents who are the current primary beneficiaries of Medicare. Boomers just reached the threshold in the last couple of years, so absolve us of creating the problem until we actually are the problem. (Then you can always line us up in front of a few death panels.)
posted by nax at 12:39 PM on September 19, 2009 [7 favorites]
It's called a risk pool. Your lower use of the system helps support the higher use at the other end of the system (called "sick people" not just "old people"). You could also call, I dunno, "the social contract"? "Collective responsbility?" "Love thy neighbor as thyself?"
This problem will not be solved through any of the Mine-Mine-Mine rhetoric, neither the idiot "get gummint outta my Medicare" wingnuts, nor the "I'm not sick so why should I care" blindered. The problem affects everyone and Ubi Es Mea might work in Chicago politics, but it's going to destroy the rest of the country. This is what Obama is talking about. Yes, we can play politics along with Mr. Baucus until all that's left standing is millionaire lobbyists, drug-, and hospital execs, or we can do what Barry wants and fucking talk like adults who need to reach an agreement that fucking helps everyone.
posted by nax at 12:52 PM on September 19, 2009 [14 favorites]
This problem will not be solved through any of the Mine-Mine-Mine rhetoric, neither the idiot "get gummint outta my Medicare" wingnuts, nor the "I'm not sick so why should I care" blindered. The problem affects everyone and Ubi Es Mea might work in Chicago politics, but it's going to destroy the rest of the country. This is what Obama is talking about. Yes, we can play politics along with Mr. Baucus until all that's left standing is millionaire lobbyists, drug-, and hospital execs, or we can do what Barry wants and fucking talk like adults who need to reach an agreement that fucking helps everyone.
posted by nax at 12:52 PM on September 19, 2009 [14 favorites]
Sorry, forgot to link the comment for the above. Too busy screaming at the computer screen.
posted by nax at 12:53 PM on September 19, 2009
posted by nax at 12:53 PM on September 19, 2009
When you're young, the odds of needing health care are so minuscule as to be nonexistent
Won't cost anything to cover them then, will it?
posted by Leon at 1:01 PM on September 19, 2009 [10 favorites]
Won't cost anything to cover them then, will it?
posted by Leon at 1:01 PM on September 19, 2009 [10 favorites]
edgeways: "to do that they need to be disillusioned, and that is what the GOP is working at hand over fist."
Do not forget that the word "disillusion" means "to reveal the truth of." Obama is not perfect, but it's not that the GOP is trying to disillusion anybody, it's that they're trying to impose new illusions that are much worse than the reality. That is to say, they are lying.
posted by JHarris at 1:03 PM on September 19, 2009 [5 favorites]
Do not forget that the word "disillusion" means "to reveal the truth of." Obama is not perfect, but it's not that the GOP is trying to disillusion anybody, it's that they're trying to impose new illusions that are much worse than the reality. That is to say, they are lying.
posted by JHarris at 1:03 PM on September 19, 2009 [5 favorites]
Faze: "What kind of pussy young people want health insurance anyway?"
Smart ones.
posted by JHarris at 1:06 PM on September 19, 2009 [6 favorites]
Smart ones.
posted by JHarris at 1:06 PM on September 19, 2009 [6 favorites]
In order to sustain Medicare and Social Security by 2020, we will need to tax 1.5 workers for every retiree.
Those death panels are sounding better and better.
posted by jayder at 1:06 PM on September 19, 2009 [1 favorite]
Those death panels are sounding better and better.
posted by jayder at 1:06 PM on September 19, 2009 [1 favorite]
We simply need to tax rich people more; I fail to see what is so controversial about this.
The generational issues are irrelevant since seniors can't take their wealth with them and any healthcare money devoted to them is largely profit and/or labor since the materials cost is so low. An economy taking care of its people is (literally) a healthy and wealthy one, let's bone up and get'r done.
I look to the scandinavian socialist utopias for inspiration if not emigration. Unfortunately their populations are only in 5 to 10M range; we have entire excluded populations that large in some states.
posted by Palamedes at 1:09 PM on September 19, 2009 [4 favorites]
The generational issues are irrelevant since seniors can't take their wealth with them and any healthcare money devoted to them is largely profit and/or labor since the materials cost is so low. An economy taking care of its people is (literally) a healthy and wealthy one, let's bone up and get'r done.
I look to the scandinavian socialist utopias for inspiration if not emigration. Unfortunately their populations are only in 5 to 10M range; we have entire excluded populations that large in some states.
posted by Palamedes at 1:09 PM on September 19, 2009 [4 favorites]
Even if those jobs do come back it will be offset by increased life expectancy and rising medical costs.
And robots; never forget the robots!
*starts burying gold bars and ammo in back yard*
posted by ZenMasterThis at 1:16 PM on September 19, 2009 [1 favorite]
And robots; never forget the robots!
*starts burying gold bars and ammo in back yard*
posted by ZenMasterThis at 1:16 PM on September 19, 2009 [1 favorite]
In order to sustain Medicare and Social Security by 2020, we will need to tax 1.5 workers for every retiree.
Our demographics are relatively healthy and our seniors control all the wealth so they can pay for their own f@cking care anyway.
When I look at Japan demographics I just wonder what's going to happen over the next 3 decades. When I was FOB there 20 years ago the population of elderly (80+) was 3M and the population of 20yos was 16M. Now it is 7M and 14M. In 2050 it will be 13M and 8M.
I'm not sure if learning Japanese was a good or bad thing, job-wise. There might not /be/ a Japanese economy in 20-30 years. Entrepôt works for Singapore-scale economies, not sure tens of millions of people can swing it in the face of mainland China finally getting its act together.
posted by Palamedes at 1:20 PM on September 19, 2009
Our demographics are relatively healthy and our seniors control all the wealth so they can pay for their own f@cking care anyway.
When I look at Japan demographics I just wonder what's going to happen over the next 3 decades. When I was FOB there 20 years ago the population of elderly (80+) was 3M and the population of 20yos was 16M. Now it is 7M and 14M. In 2050 it will be 13M and 8M.
I'm not sure if learning Japanese was a good or bad thing, job-wise. There might not /be/ a Japanese economy in 20-30 years. Entrepôt works for Singapore-scale economies, not sure tens of millions of people can swing it in the face of mainland China finally getting its act together.
posted by Palamedes at 1:20 PM on September 19, 2009
*starts burying gold bars and ammo in back yard*
I'm investing in hydrogen. Gonna bug out like the Wizard of Oz, man.
posted by Palamedes at 1:21 PM on September 19, 2009
I'm investing in hydrogen. Gonna bug out like the Wizard of Oz, man.
posted by Palamedes at 1:21 PM on September 19, 2009
And robots; never forget the robots!
Better get some Old Glory Insurance!
posted by Acromion at 1:29 PM on September 19, 2009 [2 favorites]
Better get some Old Glory Insurance!
posted by Acromion at 1:29 PM on September 19, 2009 [2 favorites]
We simply need to tax rich people more; I fail to see what is so controversial about this.
You could tax rich people more . . . well let's take it further than that . . . you could literally take all the rich people's money and you will still not have enough to patch the gaping hole in our budget due, largely, to Medicare.
The generational issues are irrelevant since seniors can't take their wealth with them
Except Medicare isn't using their wealth. There are far more people paying into it than people utilizing it. Already, people on Medicare are utilizing more dollars than they put into the system. Within the next few decades, Medicare will become insolvent as it will be forced to pay out more than it can take in.
and any healthcare money devoted to them is largely profit and/or labor since the materials cost is so low.
Redistribution does not equal profit. Taxing Mary $1 and giving that $1 to a doctor taking care of grandma never created a dollar. It just changed hands.
An economy taking care of its people is (literally) a healthy and wealthy one, let's bone up and get'r done.
So I assume you will be the one changing diapers in the nursing home then?
posted by Acromion at 1:38 PM on September 19, 2009 [2 favorites]
You could tax rich people more . . . well let's take it further than that . . . you could literally take all the rich people's money and you will still not have enough to patch the gaping hole in our budget due, largely, to Medicare.
The generational issues are irrelevant since seniors can't take their wealth with them
Except Medicare isn't using their wealth. There are far more people paying into it than people utilizing it. Already, people on Medicare are utilizing more dollars than they put into the system. Within the next few decades, Medicare will become insolvent as it will be forced to pay out more than it can take in.
and any healthcare money devoted to them is largely profit and/or labor since the materials cost is so low.
Redistribution does not equal profit. Taxing Mary $1 and giving that $1 to a doctor taking care of grandma never created a dollar. It just changed hands.
An economy taking care of its people is (literally) a healthy and wealthy one, let's bone up and get'r done.
So I assume you will be the one changing diapers in the nursing home then?
posted by Acromion at 1:38 PM on September 19, 2009 [2 favorites]
This is nothing a couple death panels won't solve.
posted by mek at 1:38 PM on September 19, 2009 [1 favorite]
posted by mek at 1:38 PM on September 19, 2009 [1 favorite]
What kind of pussy young people want health insurance anyway? When you're young, the odds of needing health care are so miniscule as to be nonexistent. There are a billion better things for someone under the age of 33 to be spending their money on than betting that they're going to have an expensive health condition.
If you're continuing a fine tradition of parody/performance art, I salute you. Encouraging people to play russian roulette with their health and financial future, even if most of the chambers are empty, is a modest proposal indeed. If not, I appreciate the opportunity to say something about this point based on two facts about my own life up through 30.
1) I like doing things outside. Things that could potentially lead to injury. Sure, my chances of dislocating my shoulder in a weird little accident during some horseplay while river rafting was probably slimer than my chances of getting in a car accident, but it happened.
2) Just before I turned 30, I suddenly came down with frequent bouts of crippling, curl-up-in-fetal-position-all-day, worry-if-I'm-gonna-live abdominal pain. Mercifully faded at this point in my life, but over the next 2-3 years I spent months alternately waiting while I navigated between a patchwork of poor insurance options and visiting a series of professionals who had trouble coming to any conclusion about what was going on.
I'm lucky I had some kind of insurance at those points -- I'd gone back to school and gotten it through my University during #1 and #2 I'd had the strangely prescient idea that I should really, really get some temporary insurance the week before (and don't think they were happy or particularly cooperative when it turned out I actually made a claim that close to taking out the policy). I'm also lucky nothing that's ever happened has required more than four-figure expenditures and that I had the money to cover 3 & 4 figure levels of expenses.
I'll also add that I'd be happy to have been regularly paying into a risk pool when I was healthy as a horse in my 20s if it financed the ability of that risk pool to care for me as my needs grow as I age.
But on the other hand... my first experience buying private insurance when I got knocked off my parent's plan supports your point of view. I bought through the NASE/AAS/MEGA hucksters who 10 years and a few class action lawsuits later are still ripping people off. When the insurance industry fails to operate in good faith, rolling the dice and trying to game the system does seem like a better idea.
Now we have the insurance industry -- an industry that's almost universally and completely deservedly loathed even though it's all but necessary -- telling us that buying it needs to be required in order to help them bring their product up to a minimum standard of doing what it's supposed to do. I understand the math behind this, and can support it on an intellectual level if there's any kind of teeth to the laws requiring them to stop recision, to stop uprating, to stop avoiding people who have pre-existing conditions. And I wish I could trust Congress to balance that intelligently. The Baucus bill sure doesn't inspire much confidence, though.
posted by weston at 1:47 PM on September 19, 2009 [3 favorites]
If you're continuing a fine tradition of parody/performance art, I salute you. Encouraging people to play russian roulette with their health and financial future, even if most of the chambers are empty, is a modest proposal indeed. If not, I appreciate the opportunity to say something about this point based on two facts about my own life up through 30.
1) I like doing things outside. Things that could potentially lead to injury. Sure, my chances of dislocating my shoulder in a weird little accident during some horseplay while river rafting was probably slimer than my chances of getting in a car accident, but it happened.
2) Just before I turned 30, I suddenly came down with frequent bouts of crippling, curl-up-in-fetal-position-all-day, worry-if-I'm-gonna-live abdominal pain. Mercifully faded at this point in my life, but over the next 2-3 years I spent months alternately waiting while I navigated between a patchwork of poor insurance options and visiting a series of professionals who had trouble coming to any conclusion about what was going on.
I'm lucky I had some kind of insurance at those points -- I'd gone back to school and gotten it through my University during #1 and #2 I'd had the strangely prescient idea that I should really, really get some temporary insurance the week before (and don't think they were happy or particularly cooperative when it turned out I actually made a claim that close to taking out the policy). I'm also lucky nothing that's ever happened has required more than four-figure expenditures and that I had the money to cover 3 & 4 figure levels of expenses.
I'll also add that I'd be happy to have been regularly paying into a risk pool when I was healthy as a horse in my 20s if it financed the ability of that risk pool to care for me as my needs grow as I age.
But on the other hand... my first experience buying private insurance when I got knocked off my parent's plan supports your point of view. I bought through the NASE/AAS/MEGA hucksters who 10 years and a few class action lawsuits later are still ripping people off. When the insurance industry fails to operate in good faith, rolling the dice and trying to game the system does seem like a better idea.
Now we have the insurance industry -- an industry that's almost universally and completely deservedly loathed even though it's all but necessary -- telling us that buying it needs to be required in order to help them bring their product up to a minimum standard of doing what it's supposed to do. I understand the math behind this, and can support it on an intellectual level if there's any kind of teeth to the laws requiring them to stop recision, to stop uprating, to stop avoiding people who have pre-existing conditions. And I wish I could trust Congress to balance that intelligently. The Baucus bill sure doesn't inspire much confidence, though.
posted by weston at 1:47 PM on September 19, 2009 [3 favorites]
This is nothing a couple death panels won't solve.
All kidding aside, we can still take care of seniors just as well while forgoing the extravagent, runaway end-of-life spending that constitutes the majority of medical costs.
As someone who has worked in a nursing home and a hospice, I have seen seniors put through endless rounds of unnecessary testing and procedures to little benefit (other than the doctors profiting from milking the system).
posted by Acromion at 1:50 PM on September 19, 2009 [2 favorites]
All kidding aside, we can still take care of seniors just as well while forgoing the extravagent, runaway end-of-life spending that constitutes the majority of medical costs.
As someone who has worked in a nursing home and a hospice, I have seen seniors put through endless rounds of unnecessary testing and procedures to little benefit (other than the doctors profiting from milking the system).
posted by Acromion at 1:50 PM on September 19, 2009 [2 favorites]
Old people are more likely to be republicans. I don't know that this universal healthcare stuff is really as much of an age issue as a partisan issue.
The majority of old people (defined as ages 65 and greater) who vote are white. It seems this demographic would be likely to hold on to older notions of what place non-whites have at the American table. Partisanship aside, I'd argue there's most certainly a racial component to opposition to Obama. It just happens that he is addressing a hot button topic the GOP can use to whip up older voters into a frenzy, with opposition tapping into a preexisting condition of mistrust.
posted by Blazecock Pileon at 2:05 PM on September 19, 2009 [2 favorites]
The majority of old people (defined as ages 65 and greater) who vote are white. It seems this demographic would be likely to hold on to older notions of what place non-whites have at the American table. Partisanship aside, I'd argue there's most certainly a racial component to opposition to Obama. It just happens that he is addressing a hot button topic the GOP can use to whip up older voters into a frenzy, with opposition tapping into a preexisting condition of mistrust.
posted by Blazecock Pileon at 2:05 PM on September 19, 2009 [2 favorites]
This fits in neatly with my theory that there is nothing good on this earth that baby boomers can't collectively fuck up for the rest of us.
posted by mhoye at 2:31 PM on September 19 [22 favorites +] [!]
Check your facts, please. It's not the Baby Boomers but the generation that precedes it.
Plenty of us boomers are in fact in the same awful situation as younger workers: unemployed, paying either COBRA rates or without insurance. But I think Obama and his team did an absolutely horrible job with the message about what "trimming Medicare costs" would mean, and the rightwing, which seems to be always better at delivering its message, took full advantage of it in August. And going out in the fall to pitch the message to college students, who act like they're at a concert, isn't the way to tamp down the generational conflict.
posted by etaoin at 2:09 PM on September 19, 2009 [1 favorite]
posted by mhoye at 2:31 PM on September 19 [22 favorites +] [!]
Check your facts, please. It's not the Baby Boomers but the generation that precedes it.
Plenty of us boomers are in fact in the same awful situation as younger workers: unemployed, paying either COBRA rates or without insurance. But I think Obama and his team did an absolutely horrible job with the message about what "trimming Medicare costs" would mean, and the rightwing, which seems to be always better at delivering its message, took full advantage of it in August. And going out in the fall to pitch the message to college students, who act like they're at a concert, isn't the way to tamp down the generational conflict.
posted by etaoin at 2:09 PM on September 19, 2009 [1 favorite]
My 92 year old grandmother told my mom, before the last Presidential election that she would vote for Obama. This surprised my mother so she asked why she had decided on Obama. Referring to John McCain she said "he has lived his life and had his chance so it is time to give the young guy a chance." Nice gram, always surprising me.
posted by zerobyproxy at 2:16 PM on September 19, 2009
posted by zerobyproxy at 2:16 PM on September 19, 2009
Are you guys really rising to Faze's lame attempt at (master) baiting? God, it's like trolling but for the severely mentally handicapped. Which you know, should be covered by a national health insurance plan. Wanker.
posted by joe lisboa at 2:38 PM on September 19, 2009 [1 favorite]
posted by joe lisboa at 2:38 PM on September 19, 2009 [1 favorite]
Within the next few decades, Medicare will become insolvent as it will be forced to pay out more than it can take in.
Gonna be a lot rich medical professionals then . . . let's tax *them*!
FWIW, I agree that Medicare is *the* major bomb that's going to go off and taxes alone aren't the solution.
But like I said, I just don't see the wealth *consumption* of the elderly medical sector. There's trillions of dollars going in, and there's trillions leaving it in paychecks. This sorta nets out, though if we continue to borrow to pay our health care expenses this is hella inflationary.
While wages are down overall this decade, I recently saw somewhere that the reason that health care costs are rising might be due to the medical sector being one of the few having pricing power and thus able to stay ahead on the wage-price spiral. (in any inflationary/Zimbabwe-style economy where "new" money first enters the people enjoy more spending power, as these dollars ping around they become increasingly worthless as prices rise to meet increased inflation expectations).
posted by Palamedes at 2:40 PM on September 19, 2009
Gonna be a lot rich medical professionals then . . . let's tax *them*!
FWIW, I agree that Medicare is *the* major bomb that's going to go off and taxes alone aren't the solution.
But like I said, I just don't see the wealth *consumption* of the elderly medical sector. There's trillions of dollars going in, and there's trillions leaving it in paychecks. This sorta nets out, though if we continue to borrow to pay our health care expenses this is hella inflationary.
While wages are down overall this decade, I recently saw somewhere that the reason that health care costs are rising might be due to the medical sector being one of the few having pricing power and thus able to stay ahead on the wage-price spiral. (in any inflationary/Zimbabwe-style economy where "new" money first enters the people enjoy more spending power, as these dollars ping around they become increasingly worthless as prices rise to meet increased inflation expectations).
posted by Palamedes at 2:40 PM on September 19, 2009
This. Raising the cap on FICA taxes so that people pay FICA up to maybe $100,000 or even higher, or make it payable on ALL income and not just WAGES (which basically exempts the wealthy who have no wages per se, but only dividend and investment income) would solve this problem. But first we need MASSIVE reeducation so that people understand the purpose of and see the results of taxation-- to pay for stuff. Hyman Minsky, an economist who saw this whole thing coming decades ago, proposed the solution as "bubble up" investment-- tax-payer funded nurses, teachers, garbage collectors, pothole fillers, cops, firefighters, etc.-- so that people see immediate, ground-level benefit.
That we have enshrined the right of business to make profit because of some "free market" fucking religion in this country is one of the ultimate failures of the left. We gave away the discourse for fear of being called communists. I'd call our liberal leaders "wusses" except that it trivialize the real damage their cowardice has done.
I need to stop reading these threads. Just makes my blood pressure go up, and I have crap health insurance.
posted by nax at 3:05 PM on September 19, 2009 [6 favorites]
That we have enshrined the right of business to make profit because of some "free market" fucking religion in this country is one of the ultimate failures of the left. We gave away the discourse for fear of being called communists. I'd call our liberal leaders "wusses" except that it trivialize the real damage their cowardice has done.
I need to stop reading these threads. Just makes my blood pressure go up, and I have crap health insurance.
posted by nax at 3:05 PM on September 19, 2009 [6 favorites]
There's trillions of dollars going in, and there's trillions leaving it in paychecks. This sorta nets out, though if we continue to borrow to pay our health care expenses this is hella inflationary.
Dude think about what you just said. You just definied wealth distribution, not wealth creation.
Wealth is created when Johnny exchanges his time and energy to grown an apple tree. He then takes the apples and sells them for a profit. If the government takes an apple from Johnny and gives it to Mary, that means Johnny has one less apple and Mary now has it. No new apple was created. It just went from one hand to another. That's called redistribution. Redistribution may be necessary, but it doesn't create wealth in an economy.
So no. Taxing people's profits from their work and giving it to medical professionals does not grow the economy.
Furthermore, only 1 cent on the dollar goes to paying doctors. If you want to tax them more, then you better be willing to pay for their medical education as they do in the UK.
posted by Acromion at 3:08 PM on September 19, 2009
Dude think about what you just said. You just definied wealth distribution, not wealth creation.
Wealth is created when Johnny exchanges his time and energy to grown an apple tree. He then takes the apples and sells them for a profit. If the government takes an apple from Johnny and gives it to Mary, that means Johnny has one less apple and Mary now has it. No new apple was created. It just went from one hand to another. That's called redistribution. Redistribution may be necessary, but it doesn't create wealth in an economy.
So no. Taxing people's profits from their work and giving it to medical professionals does not grow the economy.
Furthermore, only 1 cent on the dollar goes to paying doctors. If you want to tax them more, then you better be willing to pay for their medical education as they do in the UK.
posted by Acromion at 3:08 PM on September 19, 2009
Sheesh. FEAR FEAR FEAR DEATH FEAR anyone? You'd think we weren't capable of a) adjusting tax rates and b) cutting Medicare costs through a variety of proposed options, all of them easily Google-able and widely discussed, sometimes even in the Blue.
I mean, I get the fear that Congress won't do what it needs to, but not this implication that these problems are simply beyond solving and We're All Doomed. Was there ever a less useful attitude?
posted by emjaybee at 3:14 PM on September 19, 2009 [2 favorites]
I mean, I get the fear that Congress won't do what it needs to, but not this implication that these problems are simply beyond solving and We're All Doomed. Was there ever a less useful attitude?
posted by emjaybee at 3:14 PM on September 19, 2009 [2 favorites]
Clearly we need a Millennial Manifesto:
1. Pay off the student loans. Yeah when were 17 we entered into a tenuous agreement and trusted you guys. We'll take on student loans, you get us a job to pay off the student loans and we'll dutifully pay it off. Remember you even got us all together to explain how this was "good debt," which turned out to be good debt for you because we can't default on it and since everyone took out loans to pay for college having a degree is not nearly as important as it was. But yeah pay off student loans and suddenly you have a whole class of young people able to spend $600 more a month on real things that help expand the economy. And to the guy who just sent in his very last student loan last month, we're sorry you got screwed and missed the boat but it can't do all things to all people.
2. Bring back those 80% taxes on anyone making over $150,000. Yeah we have Wikipedia and can learn these things, we know how taxes worked up until Reagan. It helped you a lot because organizations weren't top heavy and so they invested their money in hiring people because giving themselves raises and bonuses. It is kind of funny as you guys started making more money suddenly we had to do away with all this stuff, surprising no?
3. Beatles: Rock Band was a great game, but after spending all that money we learn we have to spend more money on DLCs to get more songs? And you released the mono and stereo remasters separately? This is why we download music and don't pay for it. Furthermore with (2) implemented, having some more understanding copyright laws means we can have more for less. I mean Lolita is 50 years old and Nabokov has been dead for how long and I still can't download it for free?
4. Stop giving the black guy a hard time, it really is embarrassing us. I know you're "not racist" and just moved to the suburbs for "better schools." Also Jay-Z's Unplugged with The Roots as the backing band was a really, really good album so stop dismissing rap music as if it were a Weird Al novelty album.
5. On point 3, you called Beatles Rock Band, "... it may be the most important video game yet made." This just pissed me off, I'm sorry. Where's the multi-page reviews of Mass Effect, Fallout 3 and Grand Theft Auto? Your Wii bowling are mere toys to us, but we like that you're finding other interests.
6. I don't think asking for health insurance is such a big deal. See you insist that we shouldn't have job security and should expect layoffs and job hopping. Hey that's fine, if that's how you want to run businesses that always match their cash flows you're going to have to give us more social programs to deal with this. You can't have your cake and eat it too. And we notice that when you outsource and cut back a lot of it goes right back to you and you end up with a house somewhere, but that goes back to (2), hopefully when you see gains due to technologies and such you spend it on job creation and not on your 'vette.
If you don't adhere to these demands we will be forced to suspend all tech support which will include but is not limited to: setting up your wireless router, setting your printer as the default printing device, transferring images from your camera phone to your computer.
posted by geoff. at 3:16 PM on September 19, 2009 [28 favorites]
1. Pay off the student loans. Yeah when were 17 we entered into a tenuous agreement and trusted you guys. We'll take on student loans, you get us a job to pay off the student loans and we'll dutifully pay it off. Remember you even got us all together to explain how this was "good debt," which turned out to be good debt for you because we can't default on it and since everyone took out loans to pay for college having a degree is not nearly as important as it was. But yeah pay off student loans and suddenly you have a whole class of young people able to spend $600 more a month on real things that help expand the economy. And to the guy who just sent in his very last student loan last month, we're sorry you got screwed and missed the boat but it can't do all things to all people.
2. Bring back those 80% taxes on anyone making over $150,000. Yeah we have Wikipedia and can learn these things, we know how taxes worked up until Reagan. It helped you a lot because organizations weren't top heavy and so they invested their money in hiring people because giving themselves raises and bonuses. It is kind of funny as you guys started making more money suddenly we had to do away with all this stuff, surprising no?
3. Beatles: Rock Band was a great game, but after spending all that money we learn we have to spend more money on DLCs to get more songs? And you released the mono and stereo remasters separately? This is why we download music and don't pay for it. Furthermore with (2) implemented, having some more understanding copyright laws means we can have more for less. I mean Lolita is 50 years old and Nabokov has been dead for how long and I still can't download it for free?
4. Stop giving the black guy a hard time, it really is embarrassing us. I know you're "not racist" and just moved to the suburbs for "better schools." Also Jay-Z's Unplugged with The Roots as the backing band was a really, really good album so stop dismissing rap music as if it were a Weird Al novelty album.
5. On point 3, you called Beatles Rock Band, "... it may be the most important video game yet made." This just pissed me off, I'm sorry. Where's the multi-page reviews of Mass Effect, Fallout 3 and Grand Theft Auto? Your Wii bowling are mere toys to us, but we like that you're finding other interests.
6. I don't think asking for health insurance is such a big deal. See you insist that we shouldn't have job security and should expect layoffs and job hopping. Hey that's fine, if that's how you want to run businesses that always match their cash flows you're going to have to give us more social programs to deal with this. You can't have your cake and eat it too. And we notice that when you outsource and cut back a lot of it goes right back to you and you end up with a house somewhere, but that goes back to (2), hopefully when you see gains due to technologies and such you spend it on job creation and not on your 'vette.
If you don't adhere to these demands we will be forced to suspend all tech support which will include but is not limited to: setting up your wireless router, setting your printer as the default printing device, transferring images from your camera phone to your computer.
posted by geoff. at 3:16 PM on September 19, 2009 [28 favorites]
Wealth is created when Johnny exchanges his time and energy to grown an apple tree.
If Johnny has figured out how to use his own time and energy to grow trees, he's cracked a much tougher problem than simply what to do with the apples.
Natural resources and the fruits of nature are not created by human production.
posted by hippybear at 3:41 PM on September 19, 2009 [1 favorite]
If Johnny has figured out how to use his own time and energy to grow trees, he's cracked a much tougher problem than simply what to do with the apples.
Natural resources and the fruits of nature are not created by human production.
posted by hippybear at 3:41 PM on September 19, 2009 [1 favorite]
Wealth is created when Johnny exchanges his time and energy to grown an apple tree.
If Johnny has figured out how to use his own time and energy to grow trees, he's cracked a much tougher problem than simply what to do with the apples.
Natural resources and the fruits of nature are not created by human production.
Shh, you'll pop the Gold/Precious Metals Commodity Bubble!
posted by peppito at 3:57 PM on September 19, 2009
If Johnny has figured out how to use his own time and energy to grow trees, he's cracked a much tougher problem than simply what to do with the apples.
Natural resources and the fruits of nature are not created by human production.
Shh, you'll pop the Gold/Precious Metals Commodity Bubble!
posted by peppito at 3:57 PM on September 19, 2009
You just defined wealth distribution, not wealth creation.
True! Retired people no longer work as a rule, so they are consumers not producers of wealth.
And as such it is also true that their medical expenses have to be paid from taxes on present production (wealth transfer to the medical sector) or personal savings (wealth transfer from the patient's family to the medical sector).
Once these payments are in the medical professional's wallet he is free to find some wealth to purchase, be it an apple (or hopefully) an Apple.
Furthermore, only 1 cent on the dollar goes to paying doctors. If you want to tax them more, then you better be willing to pay for their medical education as they do in the UK.
Last year medicare had an unfunded liability of over $30 trillion. Whatever the numbers are, and they are indeed immense, my question is where is the money really going -- what resources are actually being consumed by seniors, vs what is being extracted via the usual capitalist predation on the weak.
Natural resources and the fruits of nature are not created by human production.
Until we make better robots, however, voluntary human labor is required to convert natural resources into wealth. The Laffer Curve is largely BS, but it does exist in the abstract.
posted by Palamedes at 4:01 PM on September 19, 2009
True! Retired people no longer work as a rule, so they are consumers not producers of wealth.
And as such it is also true that their medical expenses have to be paid from taxes on present production (wealth transfer to the medical sector) or personal savings (wealth transfer from the patient's family to the medical sector).
Once these payments are in the medical professional's wallet he is free to find some wealth to purchase, be it an apple (or hopefully) an Apple.
Furthermore, only 1 cent on the dollar goes to paying doctors. If you want to tax them more, then you better be willing to pay for their medical education as they do in the UK.
Last year medicare had an unfunded liability of over $30 trillion. Whatever the numbers are, and they are indeed immense, my question is where is the money really going -- what resources are actually being consumed by seniors, vs what is being extracted via the usual capitalist predation on the weak.
Natural resources and the fruits of nature are not created by human production.
Until we make better robots, however, voluntary human labor is required to convert natural resources into wealth. The Laffer Curve is largely BS, but it does exist in the abstract.
posted by Palamedes at 4:01 PM on September 19, 2009
Pay off the student loans. Yeah when were 17 we entered into a tenuous agreement and trusted you guys. We'll take on student loans, you get us a job to pay off the student loans and we'll dutifully pay it off.
If the wealthy and middle class walk out on mortgages and this is okay, and in some cases, bailed out, it seems more difficult as a culture to argue against nullifying student loan obligations.
posted by Blazecock Pileon at 4:03 PM on September 19, 2009 [6 favorites]
If the wealthy and middle class walk out on mortgages and this is okay, and in some cases, bailed out, it seems more difficult as a culture to argue against nullifying student loan obligations.
posted by Blazecock Pileon at 4:03 PM on September 19, 2009 [6 favorites]
If the government takes an apple from Johnny and gives it to Mary, that means Johnny has one less apple and Mary now has it. No new apple was created. It just went from one hand to another. That's called redistribution. Redistribution may be necessary, but it doesn't create wealth in an economy.
What's it called if the government takes an apple from Johnny and uses it for a public good that everyone has access to and is likely to use in one way or another? Particularly if it lifts a burden that would likely have made the bar to new competitive enterprise higher?
Taxing people's profits from their work and giving it to medical professionals does not grow the economy.
This is only true to the extent that medical and insurance expenses aren't opportunity costs.
posted by weston at 4:03 PM on September 19, 2009
What's it called if the government takes an apple from Johnny and uses it for a public good that everyone has access to and is likely to use in one way or another? Particularly if it lifts a burden that would likely have made the bar to new competitive enterprise higher?
Taxing people's profits from their work and giving it to medical professionals does not grow the economy.
This is only true to the extent that medical and insurance expenses aren't opportunity costs.
posted by weston at 4:03 PM on September 19, 2009
nax : Raising the cap on FICA taxes so that people pay FICA up to maybe $100,000 or even higher, or make it payable on ALL income and not just WAGES
That sounds reasonable, at first - But it has a flip-side.
If you apply those conditions to the input, you'd better apply them to the output as well: If you uncap FICA, you uncap SS; if you include capital gains, you end up with people collecting huge SS payouts who never worked a day in their lives.
And no, I don't make over the FICA cap, nor do I have significant investment income. But you can only "tax the rich" to a limited extent before people realize they'd do better simply not to participate in the US economy at all.
posted by pla at 4:07 PM on September 19, 2009
That sounds reasonable, at first - But it has a flip-side.
If you apply those conditions to the input, you'd better apply them to the output as well: If you uncap FICA, you uncap SS; if you include capital gains, you end up with people collecting huge SS payouts who never worked a day in their lives.
And no, I don't make over the FICA cap, nor do I have significant investment income. But you can only "tax the rich" to a limited extent before people realize they'd do better simply not to participate in the US economy at all.
posted by pla at 4:07 PM on September 19, 2009
Raising the cap on FICA taxes so that people pay FICA up to maybe $100,000 or even higher
It's $106,800 this year, up from $76,200 when I first came back to the states in 2000.
But you can only "tax the rich" to a limited extent before people realize they'd do better simply not to participate in the US economy at all.
This is fine, with a 20% U-6 we need more workers, if the rich want to bug out, more power to them. They will have to leave their money, of course.
posted by Palamedes at 4:27 PM on September 19, 2009
It's $106,800 this year, up from $76,200 when I first came back to the states in 2000.
But you can only "tax the rich" to a limited extent before people realize they'd do better simply not to participate in the US economy at all.
This is fine, with a 20% U-6 we need more workers, if the rich want to bug out, more power to them. They will have to leave their money, of course.
posted by Palamedes at 4:27 PM on September 19, 2009
But you can only "tax the rich" to a limited extent before people realize they'd do better simply not to participate in the US economy at all.
True. Rich people are perfectly capable of taking their money elsewhere.
Besides, another problem with the "soak the rich" model is that you are funneling capital away from the private sector, which creates jobs, and to the government, which redistributes it.
Its like Margaret Thatcher said: "Socialism works until you run out of other people's money." To be fair, if you want to point to western Europe as a model, you have to point out their problems such as a slow growing economy, high unemployment, and demographics that are even worse than ours.
I am very very far from rich. I believe in a progressive tax and all, but there's this misconception that rich people are sitting on this huge pile of money that if we can somehow tap it would fix all our problems.
What about cutting government spending?
posted by Acromion at 5:27 PM on September 19, 2009 [1 favorite]
True. Rich people are perfectly capable of taking their money elsewhere.
Besides, another problem with the "soak the rich" model is that you are funneling capital away from the private sector, which creates jobs, and to the government, which redistributes it.
Its like Margaret Thatcher said: "Socialism works until you run out of other people's money." To be fair, if you want to point to western Europe as a model, you have to point out their problems such as a slow growing economy, high unemployment, and demographics that are even worse than ours.
I am very very far from rich. I believe in a progressive tax and all, but there's this misconception that rich people are sitting on this huge pile of money that if we can somehow tap it would fix all our problems.
What about cutting government spending?
posted by Acromion at 5:27 PM on September 19, 2009 [1 favorite]
Acromion: "What about cutting government spending?"
Take away half of the Pentagon's budget and use it to buy healthcare for the poorest people who don't have it.
Repeat process each year until there is universal health coverage.
Just a thought.
posted by Joe Beese at 5:33 PM on September 19, 2009 [6 favorites]
Take away half of the Pentagon's budget and use it to buy healthcare for the poorest people who don't have it.
Repeat process each year until there is universal health coverage.
Just a thought.
posted by Joe Beese at 5:33 PM on September 19, 2009 [6 favorites]
All kidding aside, we can still take care of seniors just as well while forgoing the extravagent, runaway end-of-life spending that constitutes the majority of medical costs.
Define "just as well". The Op-Ed piece you linked to advocated not spending on an 80 year old's knee replacement and instead spending that money on maternal or child health. Essentially, it's telling the elderly that they don't deserve such treatment because well, they're old. How is that treating old people in any way, just as well as we do today?
posted by cmgonzalez at 5:33 PM on September 19, 2009 [1 favorite]
Define "just as well". The Op-Ed piece you linked to advocated not spending on an 80 year old's knee replacement and instead spending that money on maternal or child health. Essentially, it's telling the elderly that they don't deserve such treatment because well, they're old. How is that treating old people in any way, just as well as we do today?
posted by cmgonzalez at 5:33 PM on September 19, 2009 [1 favorite]
Essentially, it's telling the elderly that they don't deserve such treatment because well, they're old. How is that treating old people in any way, just as well as we do today?
Well, in Rainbow Gumdrop land they pay all the doctors in lollipops, and since there's an unlimited supply of lollipops, everyone can get any medical treatment they want whenever they want.
Unfortunately, since we haven't figured out a way to grow lollipop trees, we have to make choices with our health care.
Now consider this. The cost of a total knee replacement is around $35,000, and that is doesn't even include follow up care, physical therapy, and drugs. Now take an elderly person, say 85 or so, possibly obese, and DOUBLE that. Let's call her Bessie. One knee replacement for Bessie can cost double of what a typical American earns in a year.
Now consider this all-too-common scenario. You have a young person named Sarah who works a low wage job at Wal-Mart with no insurance. She has asthma, but her inhalers cost $250 or more a month, and she can't afford them. She only needs to see the doctor a couple times a year.
Now do the math. You can treat roughly 20 Sarah's asthma for every 1 of Bessie's knee replacements.
In this country, we have chosen Bessie over Sarah. If that isn't rationing, I don't know what is. So let me ask you this: Essentially isn't that telling the young that they don't deserve such treatment because, well they're young?
You wondered how we can treat the elderly "just as well," and this is the good part. Most of the money we spend on the elderly is totally useless. If you read the op-ed you would see the point Dooling is making is that we spend all this money on end of life care even though it doesn't contribute to quality of life. We do this for too many reason to list here, but I can guarantee you that we can cut a significant amount of end of life treatment without harming the health of the elderly.
Here is an example of what I'm talking about that I witnessed time and time again during my work in nursing home. Bessie is do for her annual dental check up and cleaning, but she is completely demented and often combative. She needs to be sedated and transported to and from the dentist. She needs extra staff to restrain her. The dentist gives her a root canal and sends her back with a bill of $2,000. No problem. Charge it to Medicare.
The problem? Bessie is IN HOSPICE! She dies a month later. The root canal was of no benefit to her - only the dentist who used her as a cash register. This occurs because Medicare has almost no cost containment measures, and whenever someone attempts to talk about cost containment, you get rabid seniors showing up at town halls screaming about death panels.
Repeat this scenario over and over and you start to run up a HUGE bill. Look at the effectiveness of angioplasty . . . perhaps barely useful in younger patients, but on the elderly? INSANE!
Three questions:
Will surgeons perform angioplasty on an 85 year old man?
Does Medicare pay for an angioplasty on an 85 year old man?
Has this intervention been shown to reduce heart attacks in 85 year old men?
The answers:
YES
YES
NO
And now you see why health care is so expensive.
posted by Acromion at 6:10 PM on September 19, 2009 [9 favorites]
Well, in Rainbow Gumdrop land they pay all the doctors in lollipops, and since there's an unlimited supply of lollipops, everyone can get any medical treatment they want whenever they want.
Unfortunately, since we haven't figured out a way to grow lollipop trees, we have to make choices with our health care.
Now consider this. The cost of a total knee replacement is around $35,000, and that is doesn't even include follow up care, physical therapy, and drugs. Now take an elderly person, say 85 or so, possibly obese, and DOUBLE that. Let's call her Bessie. One knee replacement for Bessie can cost double of what a typical American earns in a year.
Now consider this all-too-common scenario. You have a young person named Sarah who works a low wage job at Wal-Mart with no insurance. She has asthma, but her inhalers cost $250 or more a month, and she can't afford them. She only needs to see the doctor a couple times a year.
Now do the math. You can treat roughly 20 Sarah's asthma for every 1 of Bessie's knee replacements.
In this country, we have chosen Bessie over Sarah. If that isn't rationing, I don't know what is. So let me ask you this: Essentially isn't that telling the young that they don't deserve such treatment because, well they're young?
You wondered how we can treat the elderly "just as well," and this is the good part. Most of the money we spend on the elderly is totally useless. If you read the op-ed you would see the point Dooling is making is that we spend all this money on end of life care even though it doesn't contribute to quality of life. We do this for too many reason to list here, but I can guarantee you that we can cut a significant amount of end of life treatment without harming the health of the elderly.
Here is an example of what I'm talking about that I witnessed time and time again during my work in nursing home. Bessie is do for her annual dental check up and cleaning, but she is completely demented and often combative. She needs to be sedated and transported to and from the dentist. She needs extra staff to restrain her. The dentist gives her a root canal and sends her back with a bill of $2,000. No problem. Charge it to Medicare.
The problem? Bessie is IN HOSPICE! She dies a month later. The root canal was of no benefit to her - only the dentist who used her as a cash register. This occurs because Medicare has almost no cost containment measures, and whenever someone attempts to talk about cost containment, you get rabid seniors showing up at town halls screaming about death panels.
Repeat this scenario over and over and you start to run up a HUGE bill. Look at the effectiveness of angioplasty . . . perhaps barely useful in younger patients, but on the elderly? INSANE!
Three questions:
Will surgeons perform angioplasty on an 85 year old man?
Does Medicare pay for an angioplasty on an 85 year old man?
Has this intervention been shown to reduce heart attacks in 85 year old men?
The answers:
YES
YES
NO
And now you see why health care is so expensive.
posted by Acromion at 6:10 PM on September 19, 2009 [9 favorites]
True. Rich people are perfectly capable of taking their money elsewhere.
Even this is fine. Pack the benjamins in the Halliburton metal suitcases and fly away. What are they going to do with their money? The rich maintain their position largely through the ownership of successful enterprises. If they want to sell their stock, their land, their income properties, their REITs, they're more than welcome to.
Contrary to their paid-for PR, they are not the productive classes of society. If & when they go I hope they enjoy their custom island off Dubai or wherever they relocate their operations.
here's this misconception that rich people are sitting on this huge pile of money
Money, of course, is obfuscating the issue, since money is not wealth but a claim to it. Capital has accrued to capital for the past 100-odd years, but these capital holdings are claims to wealth and not the wealth itself.
Wealth creation comes from labor, not ownership. The owners qua owners are social parasites as much as granny needing a new hip she can't afford.
There are exceptions, where we can find "good" capitalists, of course. I'm talking generalities.
if you want to point to western Europe as a model,
oh, I do.
and demographics that are even worse than ours
demographics are an interesting thing. A society with no old people will be wealthier, as will a society with no young people. The question any economy faces is is it producing enough stuff to meet its needs and pay its way in the world. Healthcare can be undoubtedly expensive, but, money and medical incomes aside, I question the net economic impact of caring for people.
Granny in a home with 10% nursing coverage isn't really consuming much.
posted by Palamedes at 6:31 PM on September 19, 2009
Even this is fine. Pack the benjamins in the Halliburton metal suitcases and fly away. What are they going to do with their money? The rich maintain their position largely through the ownership of successful enterprises. If they want to sell their stock, their land, their income properties, their REITs, they're more than welcome to.
Contrary to their paid-for PR, they are not the productive classes of society. If & when they go I hope they enjoy their custom island off Dubai or wherever they relocate their operations.
here's this misconception that rich people are sitting on this huge pile of money
Money, of course, is obfuscating the issue, since money is not wealth but a claim to it. Capital has accrued to capital for the past 100-odd years, but these capital holdings are claims to wealth and not the wealth itself.
Wealth creation comes from labor, not ownership. The owners qua owners are social parasites as much as granny needing a new hip she can't afford.
There are exceptions, where we can find "good" capitalists, of course. I'm talking generalities.
if you want to point to western Europe as a model,
oh, I do.
and demographics that are even worse than ours
demographics are an interesting thing. A society with no old people will be wealthier, as will a society with no young people. The question any economy faces is is it producing enough stuff to meet its needs and pay its way in the world. Healthcare can be undoubtedly expensive, but, money and medical incomes aside, I question the net economic impact of caring for people.
Granny in a home with 10% nursing coverage isn't really consuming much.
posted by Palamedes at 6:31 PM on September 19, 2009
The dentist gives her a root canal and sends her back with a bill of $2,000. No problem. Charge it to Medicare.
Medicare doesn't cover dental expenses. Medicaid might, or might not.
posted by Palamedes at 6:39 PM on September 19, 2009
Medicare doesn't cover dental expenses. Medicaid might, or might not.
posted by Palamedes at 6:39 PM on September 19, 2009
Besides, another problem with the "soak the rich" model is that you are funneling capital away from the private sector, which creates jobs, and to the government, which redistributes it
Supply side econ. OK. I'm really (and genuinely) curious about a related topic:
What about cutting government spending?
If you're a believer in supply-side economics, why aren't you a Keynesian in a period where private investment is generally pretty shy?
And as an answer to your question: the biggest reason -- and I'd hazard a guess that it's the biggest by an order of magnitude -- for the most recent increases in spending over the last year are to rescue a private banking and finance sector (and in turn, the larger economy that depended on it) that couldn't behave itself responsibly. The next most recent explosion comes from a very poor foreign policy misadventure. This may put us in a place where we do have to make hard tradeoffs against positive public goods, but it's pretty annoying, and I don't mind at all having a government that seems to be at least ostensibly interested in finding ways to avoid that tradeoff. Because, as I implied above with my response to your apple comment, I honestly don't think "spending" is a problem... unless it's not investing. The private sector is full of companies that hemorrhage cash during a growth phase manage to return value to those who invest during that period. It's all about how wisely that money is spent. Cutting expenditures that don't need to be there is certainly an avenue. Spending money creating infrastructure and services that will return value, though, is a must. You can't create a profit or a profitable system by cutting alone.
I am very very far from rich. I believe in a progressive tax and all, but there's this misconception that rich people are sitting on this huge pile of money that if we can somehow tap it would fix all our problems.
I can also get behind the idea that it's neither moral nor wise to limitlessly tax wealthy people. But we've been largely trending downward on that variable for recent history. Rates are notably lower than those of the 1990s, where we seemed to do just fine at creating wealth, capital gains taxes are at rates low enough that they're essentially regressive. At a minimum, letting those rates return to where they were seems like a no-brainer.
posted by weston at 9:50 PM on September 19, 2009 [1 favorite]
Supply side econ. OK. I'm really (and genuinely) curious about a related topic:
What about cutting government spending?
If you're a believer in supply-side economics, why aren't you a Keynesian in a period where private investment is generally pretty shy?
And as an answer to your question: the biggest reason -- and I'd hazard a guess that it's the biggest by an order of magnitude -- for the most recent increases in spending over the last year are to rescue a private banking and finance sector (and in turn, the larger economy that depended on it) that couldn't behave itself responsibly. The next most recent explosion comes from a very poor foreign policy misadventure. This may put us in a place where we do have to make hard tradeoffs against positive public goods, but it's pretty annoying, and I don't mind at all having a government that seems to be at least ostensibly interested in finding ways to avoid that tradeoff. Because, as I implied above with my response to your apple comment, I honestly don't think "spending" is a problem... unless it's not investing. The private sector is full of companies that hemorrhage cash during a growth phase manage to return value to those who invest during that period. It's all about how wisely that money is spent. Cutting expenditures that don't need to be there is certainly an avenue. Spending money creating infrastructure and services that will return value, though, is a must. You can't create a profit or a profitable system by cutting alone.
I am very very far from rich. I believe in a progressive tax and all, but there's this misconception that rich people are sitting on this huge pile of money that if we can somehow tap it would fix all our problems.
I can also get behind the idea that it's neither moral nor wise to limitlessly tax wealthy people. But we've been largely trending downward on that variable for recent history. Rates are notably lower than those of the 1990s, where we seemed to do just fine at creating wealth, capital gains taxes are at rates low enough that they're essentially regressive. At a minimum, letting those rates return to where they were seems like a no-brainer.
posted by weston at 9:50 PM on September 19, 2009 [1 favorite]
@weston ^^^
OK you got me beat when it comes to the econ stuff. LOL. I agree using wealth to create a public good (ie roads, schools, health care) is a good investment that increases wealth for all.
But I am adamant about the fact that the last thing we need to do is spend more on health care than we already do. We have a wasteful, inefficient, and corrupt system. Simply dumping more taxpayer dollars into it is like giving a junkie your ATM card and PIN number.
Since you are all economics savvy, I suggest you read How Health Care Killed My Father in last months Atlantic. It explains quite lucidly how our health insurance system introduces so many cost distortions into the system that pricing becomes impossible for the consumer.
posted by Acromion at 11:51 PM on September 19, 2009
OK you got me beat when it comes to the econ stuff. LOL. I agree using wealth to create a public good (ie roads, schools, health care) is a good investment that increases wealth for all.
But I am adamant about the fact that the last thing we need to do is spend more on health care than we already do. We have a wasteful, inefficient, and corrupt system. Simply dumping more taxpayer dollars into it is like giving a junkie your ATM card and PIN number.
Since you are all economics savvy, I suggest you read How Health Care Killed My Father in last months Atlantic. It explains quite lucidly how our health insurance system introduces so many cost distortions into the system that pricing becomes impossible for the consumer.
posted by Acromion at 11:51 PM on September 19, 2009
Redistribution does not equal profit. Taxing Mary $1 and giving that $1 to a doctor taking care of grandma never created a dollar. It just changed hands.
Not even wrong.
Don't tax Mary, don't give the doctor a dollar, and look, nothing's changed hands -- and Grandma is *dead*.
posted by eriko at 6:00 AM on September 20, 2009
Not even wrong.
Don't tax Mary, don't give the doctor a dollar, and look, nothing's changed hands -- and Grandma is *dead*.
posted by eriko at 6:00 AM on September 20, 2009
. The problem? Bessie is IN HOSPICE! She dies a month later. The root canal was of no benefit to her
Okay, first of all, stop with the condescension.
It was of benefit to her during that month. What would you rather do, not treat her? "Sorry, lady, you're in hospice, we won't give you anything but basic care". That's cold.
Look, I've spent most of my life uninsured and was raised by a disabled mother who has Medicare, so I'm not speaking from a lack of knowledge and information. This has been an issue important to me for a long time.
My mother has MS. She can't really work anymore, but she does need medical care. It's just as inhumane to deny any of the people in your example care - young or old, that care as it would be to deny it to my mother because even though she's not even 50 yet, she is theoretically not contributing to society (from an economic standpoint).
We must rein in costs, but not by flatly denying care to the elderly nor to the young. There are a lot of issues to be ironed out and dealt with, but we need a framework first. But whatever happens, we can't forget the humane treatment.
What you are claiming would not even scrape "just as well" as today.
posted by cmgonzalez at 11:50 AM on September 20, 2009 [2 favorites]
Okay, first of all, stop with the condescension.
It was of benefit to her during that month. What would you rather do, not treat her? "Sorry, lady, you're in hospice, we won't give you anything but basic care". That's cold.
Look, I've spent most of my life uninsured and was raised by a disabled mother who has Medicare, so I'm not speaking from a lack of knowledge and information. This has been an issue important to me for a long time.
My mother has MS. She can't really work anymore, but she does need medical care. It's just as inhumane to deny any of the people in your example care - young or old, that care as it would be to deny it to my mother because even though she's not even 50 yet, she is theoretically not contributing to society (from an economic standpoint).
We must rein in costs, but not by flatly denying care to the elderly nor to the young. There are a lot of issues to be ironed out and dealt with, but we need a framework first. But whatever happens, we can't forget the humane treatment.
What you are claiming would not even scrape "just as well" as today.
posted by cmgonzalez at 11:50 AM on September 20, 2009 [2 favorites]
What age do they mean when they say 'young adults'?
posted by anniecat at 11:55 AM on September 20, 2009
posted by anniecat at 11:55 AM on September 20, 2009
Anniecat: "The national survey of 606 young adults, ages 18 to 29, was conducted February 25 to March 11, 2009."
posted by Houstonian at 12:58 PM on September 20, 2009
posted by Houstonian at 12:58 PM on September 20, 2009
@cmgonzalez
First of all, I feel for you and your Mom. I understand this is a very personal and emotional issue for everyone. I can understand because I have worked in this hands on. I was the one changing diapers, giving baths, getting pooped and peed on. I held people's hands as they died, washed their bodies, and put them in body bags. Right now I work in a clinic for the uninsured where I see the results of medical rationing every day. I guarantee you are seniors are treated exceptionally well compared to your average Wal Mart employee. Perhaps this is why I suffer no illusions about the medical crisis we are in.
But no one involved in health care reform wants to take your Mom's Medicare away, so let's get that off the table right now.
We must rein in costs, but not by flatly denying care to the elderly nor to the young. There are a lot of issues to be ironed out and dealt with, but we need a framework first. But whatever happens, we can't forget the humane treatment.
What you have said does not add up. You want to contain costs without denying any care to anyone. I don't blame you for thinking this, because this is a common illusion held amongst Americans, who are an idealistic and optimistic bunch of people. The UK has a very fair system because they don't pretend to be able to give all things to all people all the time. They make choices, with the understanding that in order to provide the most care to the most people, sometimes you have to deny some care to some people.
When you look at the numbers, there is simply no way to cut enough fat out of the system without cutting to the bone. That is, the real meat of medical costs comes down to high cost interventions carried out in the last year of life, often to no beneficial result whatsoever.
If you look around this country, you will see care being denied every day to those who have no insurance, and this is a DIRECT result of not denying ANY care to those over 65. I really wish I lived in Rainbow Gumdrop land where this isn't true, but this is Earth and lollipop trees don't grow in our climate.
It was of benefit to her during that month. What would you rather do, not treat her? "Sorry, lady, you're in hospice, we won't give you anything but basic care". That's cold.
How is this cold? The definition of hospice is to provide basic health care and to treat pain. Its done all the time. What is cold is seeing young people (I'm talking 50 and under) who can't get basic dental care and suffer from horrible pain because of an abscess.
As I explained earlier, since medical care is not an unlimited resource, we must make moral choices with how it is to be rationed. (Yes I said it - rationed). Sometimes these choices are hard, but if you look at our system is it is now, we are rationing medical care EVERY DAY. Right now uninsured people are DYING for lack of BASIC medical care, but the 89 year old comatose Bessie is running up a bill of $100,000 a month in the ICU for a stroke she will never recover from. So how is this fair?
Furthermore, because of the way Medicare reimbursement works, it encourages doctors to order unnecessary tests and procedures at great expense to the taxpayer. This might be well and good if it produced any results, but studies have shown that it simply does not. There is a plethora of information on this specific topic out there if you are interested.
Simply put, America's seniors are suffering from too much medical care because the system encourages it. Setting up some kind of cost containment is not optional. Without some kind of comprehensive health care reform, Medicare will consume the majority of the US budget.
If you are interested in learning more about this, I suggest reading the Atlantic article I linked to upthread, as well as the NY Times editorial by Dooling.
posted by Acromion at 2:14 PM on September 20, 2009 [2 favorites]
First of all, I feel for you and your Mom. I understand this is a very personal and emotional issue for everyone. I can understand because I have worked in this hands on. I was the one changing diapers, giving baths, getting pooped and peed on. I held people's hands as they died, washed their bodies, and put them in body bags. Right now I work in a clinic for the uninsured where I see the results of medical rationing every day. I guarantee you are seniors are treated exceptionally well compared to your average Wal Mart employee. Perhaps this is why I suffer no illusions about the medical crisis we are in.
But no one involved in health care reform wants to take your Mom's Medicare away, so let's get that off the table right now.
We must rein in costs, but not by flatly denying care to the elderly nor to the young. There are a lot of issues to be ironed out and dealt with, but we need a framework first. But whatever happens, we can't forget the humane treatment.
What you have said does not add up. You want to contain costs without denying any care to anyone. I don't blame you for thinking this, because this is a common illusion held amongst Americans, who are an idealistic and optimistic bunch of people. The UK has a very fair system because they don't pretend to be able to give all things to all people all the time. They make choices, with the understanding that in order to provide the most care to the most people, sometimes you have to deny some care to some people.
When you look at the numbers, there is simply no way to cut enough fat out of the system without cutting to the bone. That is, the real meat of medical costs comes down to high cost interventions carried out in the last year of life, often to no beneficial result whatsoever.
If you look around this country, you will see care being denied every day to those who have no insurance, and this is a DIRECT result of not denying ANY care to those over 65. I really wish I lived in Rainbow Gumdrop land where this isn't true, but this is Earth and lollipop trees don't grow in our climate.
It was of benefit to her during that month. What would you rather do, not treat her? "Sorry, lady, you're in hospice, we won't give you anything but basic care". That's cold.
How is this cold? The definition of hospice is to provide basic health care and to treat pain. Its done all the time. What is cold is seeing young people (I'm talking 50 and under) who can't get basic dental care and suffer from horrible pain because of an abscess.
As I explained earlier, since medical care is not an unlimited resource, we must make moral choices with how it is to be rationed. (Yes I said it - rationed). Sometimes these choices are hard, but if you look at our system is it is now, we are rationing medical care EVERY DAY. Right now uninsured people are DYING for lack of BASIC medical care, but the 89 year old comatose Bessie is running up a bill of $100,000 a month in the ICU for a stroke she will never recover from. So how is this fair?
Furthermore, because of the way Medicare reimbursement works, it encourages doctors to order unnecessary tests and procedures at great expense to the taxpayer. This might be well and good if it produced any results, but studies have shown that it simply does not. There is a plethora of information on this specific topic out there if you are interested.
Simply put, America's seniors are suffering from too much medical care because the system encourages it. Setting up some kind of cost containment is not optional. Without some kind of comprehensive health care reform, Medicare will consume the majority of the US budget.
If you are interested in learning more about this, I suggest reading the Atlantic article I linked to upthread, as well as the NY Times editorial by Dooling.
posted by Acromion at 2:14 PM on September 20, 2009 [2 favorites]
This fits in neatly with my theory that there is nothing good on this earth that baby boomers can't collectively fuck up for the rest of us.
And do you know who we can thank for the baby boomers?
That's right: Hitler. Boomers are post-war babies.
posted by five fresh fish at 5:16 PM on September 20, 2009 [1 favorite]
And do you know who we can thank for the baby boomers?
That's right: Hitler. Boomers are post-war babies.
posted by five fresh fish at 5:16 PM on September 20, 2009 [1 favorite]
But I am adamant about the fact that the last thing we need to do is spend more on health care than we already do. We have a wasteful, inefficient, and corrupt system. Simply dumping more taxpayer dollars into it is like giving a junkie your ATM card and PIN number.
I also hope that's not what we get. I'd love to see a real reboot. And I don't blame anyone who's skeptical about that at this point.
posted by weston at 5:26 PM on September 20, 2009
I also hope that's not what we get. I'd love to see a real reboot. And I don't blame anyone who's skeptical about that at this point.
posted by weston at 5:26 PM on September 20, 2009
When you're young, the odds of needing health care are so minuscule as to be nonexistent.
When I was younger, I engaged in a lot more high-risk sports activities. I have required health care as a result of some those activities. So I'd say the odds are so significant as to fully warrant health care insurance of some sort.
Between an injury resulting in full hospitalization and a few trips to emergency for various non-life-threatening injuries, I'd say the investment I have made in our healthcare insurance system (single payer via taxation) has paid for itself nicely enough. I don't know whether I have taken out as much as I have put in, but that's absolutely beside the point. And at any rate, I can see how easy it would have been to need it. And maybe any excess I put in was used by someone else.
My wife was run over by a farm truck at age 40ish. If I over-contributed during my youth, perhaps that excess was used in saving her. Maybe it saved someone else. I am damn glad it was always there for me, though, because I now know how easy it is for an unexpected event — like a farm truck blowing a stop sign — to result in horrific injury and heroic surgical and health recovery efforts provided by professionals in our hospitals.
Frankly, it is just plain stupid to not have full universal healthcare. The productivity gains in having a healthier workforce is alone enough to warrant a complete, "free" system. But not only is a healthy public a more productive public, full universal healthcare can also be made not-for-profit, which means it can be less expensive to provide; it can make use of increased purchasing power and greater co-ordination of resources to provide greater service at lower cost; and it can be more efficiently managed, and more easily held to public national standards.
The advantages are so obvious and so easily attained that almost every nation except the USA has a public healthcare system. It's a seriously WTF situation that there's any debate about it.
posted by five fresh fish at 5:38 PM on September 20, 2009 [1 favorite]
When I was younger, I engaged in a lot more high-risk sports activities. I have required health care as a result of some those activities. So I'd say the odds are so significant as to fully warrant health care insurance of some sort.
Between an injury resulting in full hospitalization and a few trips to emergency for various non-life-threatening injuries, I'd say the investment I have made in our healthcare insurance system (single payer via taxation) has paid for itself nicely enough. I don't know whether I have taken out as much as I have put in, but that's absolutely beside the point. And at any rate, I can see how easy it would have been to need it. And maybe any excess I put in was used by someone else.
My wife was run over by a farm truck at age 40ish. If I over-contributed during my youth, perhaps that excess was used in saving her. Maybe it saved someone else. I am damn glad it was always there for me, though, because I now know how easy it is for an unexpected event — like a farm truck blowing a stop sign — to result in horrific injury and heroic surgical and health recovery efforts provided by professionals in our hospitals.
Frankly, it is just plain stupid to not have full universal healthcare. The productivity gains in having a healthier workforce is alone enough to warrant a complete, "free" system. But not only is a healthy public a more productive public, full universal healthcare can also be made not-for-profit, which means it can be less expensive to provide; it can make use of increased purchasing power and greater co-ordination of resources to provide greater service at lower cost; and it can be more efficiently managed, and more easily held to public national standards.
The advantages are so obvious and so easily attained that almost every nation except the USA has a public healthcare system. It's a seriously WTF situation that there's any debate about it.
posted by five fresh fish at 5:38 PM on September 20, 2009 [1 favorite]
What kind of pussy young people want health insurance anyway? When you're young, the odds of needing health care are so miniscule as to be nonexistent.
I underwent chemo and radiation for cancer when I was 19-20. If I didn't have excellent insurance through my family, not sure what I would have done.
posted by krinklyfig at 6:32 PM on September 20, 2009
I underwent chemo and radiation for cancer when I was 19-20. If I didn't have excellent insurance through my family, not sure what I would have done.
posted by krinklyfig at 6:32 PM on September 20, 2009
But I am adamant about the fact that the last thing we need to do is spend more on health care than we already do. We have a wasteful, inefficient, and corrupt system. Simply dumping more taxpayer dollars into it is like giving a junkie your ATM card and PIN number.
The reason medical pricing is as bad as it is is because of how it's arranged to benefit certain parties involved in the system, which by design do not have to compete. One of the very few ways we know will work to manage costs is to bring the government into the insurance side of the picture. There is no reason for the extravagant profits in exchange for actuarial work and financing, and the way the system is set up gives no incentive to bring charges down, and this includes retail charges for services, charges for medical and IT equipment, and salaries of doctors. The Big Lie of the insurance-funded opposition is that the government can't do this well, but we already have examples where it has done well (the VA, right now the top-rated medical provider in the US, and Medicare is not bad), and if we expand to include other countries, we have a myriad of good examples to learn from. The way we do it now causes a lot of people to suffer and die unnecessarily for the sake of the profit motive, which is something we should not tolerate to happen in our own country, particularly when we do have a way (using any of a number of working examples) to solve the problem.
posted by krinklyfig at 6:47 PM on September 20, 2009 [2 favorites]
The reason medical pricing is as bad as it is is because of how it's arranged to benefit certain parties involved in the system, which by design do not have to compete. One of the very few ways we know will work to manage costs is to bring the government into the insurance side of the picture. There is no reason for the extravagant profits in exchange for actuarial work and financing, and the way the system is set up gives no incentive to bring charges down, and this includes retail charges for services, charges for medical and IT equipment, and salaries of doctors. The Big Lie of the insurance-funded opposition is that the government can't do this well, but we already have examples where it has done well (the VA, right now the top-rated medical provider in the US, and Medicare is not bad), and if we expand to include other countries, we have a myriad of good examples to learn from. The way we do it now causes a lot of people to suffer and die unnecessarily for the sake of the profit motive, which is something we should not tolerate to happen in our own country, particularly when we do have a way (using any of a number of working examples) to solve the problem.
posted by krinklyfig at 6:47 PM on September 20, 2009 [2 favorites]
The reason medical pricing is as bad as it is is because of how it's arranged to benefit certain parties involved in the system, which by design do not have to compete.
Exactly. Insurance introduces so many cost distortions that pricing becomes completely opaque to the consumer. What's worse is that the uninsured pay more for the same care because they don't have access to group rate discounts.
When's the last time you walked into a clinic or ER with a reasonable expectation of what the bill will be? Its virtually impossible to price shop for health care because no one knows what anything costs. Being able to compare prices and find the best value is the essence of free markets.
posted by Acromion at 8:42 PM on September 20, 2009
Exactly. Insurance introduces so many cost distortions that pricing becomes completely opaque to the consumer. What's worse is that the uninsured pay more for the same care because they don't have access to group rate discounts.
When's the last time you walked into a clinic or ER with a reasonable expectation of what the bill will be? Its virtually impossible to price shop for health care because no one knows what anything costs. Being able to compare prices and find the best value is the essence of free markets.
posted by Acromion at 8:42 PM on September 20, 2009
Does anyone else find it hilarious that the most favorited post on this thread is mostly about video games?
I'm starting to think that the Boomers are not the ones we should be worrying about ;)
posted by Acromion at 8:51 PM on September 20, 2009
I'm starting to think that the Boomers are not the ones we should be worrying about ;)
posted by Acromion at 8:51 PM on September 20, 2009
When you're young, the odds of needing health care are so minuscule as to be nonexistent.
And yet, at the tender age of 26, I suddenly was struck with a freak medical problem that has no definitively known cause and no clear way of preventing it, and I had to have a major operation and two nights' stay in a hospital.
And that came only a week after having found a lump in my breast, which prompted yet another hospital visit for diagnostic testing.
The place where I worked, a small start-up business, had only just three months prior gotten to the point where it could offer me any health insurance. If they hadn't, I'd still be paying that all off 15 years later.
I know I can ber unlucky, but something tells me that this wasn't because the odds of the young needing health care really are that small after all.
posted by EmpressCallipygos at 9:27 PM on September 20, 2009
And yet, at the tender age of 26, I suddenly was struck with a freak medical problem that has no definitively known cause and no clear way of preventing it, and I had to have a major operation and two nights' stay in a hospital.
And that came only a week after having found a lump in my breast, which prompted yet another hospital visit for diagnostic testing.
The place where I worked, a small start-up business, had only just three months prior gotten to the point where it could offer me any health insurance. If they hadn't, I'd still be paying that all off 15 years later.
I know I can ber unlucky, but something tells me that this wasn't because the odds of the young needing health care really are that small after all.
posted by EmpressCallipygos at 9:27 PM on September 20, 2009
But no one involved in health care reform wants to take your Mom's Medicare away
That's a bit of a stretch. I can't name names off the top of my head but there's almost certainly a non-zero number of people in congress who would scrap Medicare if they thought they could stay in office after doing so. I've seen proposals that would convert Medicaid to a voucher system which has, I think, many of the same problems inherent to converting public schools to a voucher system.
the most favorited post on this thread is mostly about video games?
2 of 5 points of that post involved video games. One of those points was mostly about copyright laws as they relate to games. The entire post collectively was a rant about 'baby boomers' coming from the point of view of a 'millennial' which happened to includ some bits about a video game for humor. So I think you are wrong about what the post was about from both a qualitative and quantitative way.
So, did you really interpret that post to be 'mostly about video games'? One more thing I missed earlier as well: that post doesn't have the most favorites in this thread.
posted by Green With You at 9:38 PM on September 20, 2009
That's a bit of a stretch. I can't name names off the top of my head but there's almost certainly a non-zero number of people in congress who would scrap Medicare if they thought they could stay in office after doing so. I've seen proposals that would convert Medicaid to a voucher system which has, I think, many of the same problems inherent to converting public schools to a voucher system.
the most favorited post on this thread is mostly about video games?
2 of 5 points of that post involved video games. One of those points was mostly about copyright laws as they relate to games. The entire post collectively was a rant about 'baby boomers' coming from the point of view of a 'millennial' which happened to includ some bits about a video game for humor. So I think you are wrong about what the post was about from both a qualitative and quantitative way.
So, did you really interpret that post to be 'mostly about video games'? One more thing I missed earlier as well: that post doesn't have the most favorites in this thread.
posted by Green With You at 9:38 PM on September 20, 2009
What kind of pussy young people want health insurance anyway? When you're young, the odds of needing health care are so miniscule as to be nonexistent.
I underwent chemo and radiation for cancer when I was 19-20. If I didn't have excellent insurance through my family, not sure what I would have done.
Drink some cough syrup and walk it off? Obviously you're not a Reaganite.
posted by Blazecock Pileon at 10:53 PM on September 20, 2009 [1 favorite]
I underwent chemo and radiation for cancer when I was 19-20. If I didn't have excellent insurance through my family, not sure what I would have done.
Drink some cough syrup and walk it off? Obviously you're not a Reaganite.
posted by Blazecock Pileon at 10:53 PM on September 20, 2009 [1 favorite]
The "old people's healthcare," Medicare or Medicaid or whatever you guys call it, has about 3% overhead, no? The healthcare industry skims 30% as middle-man.
So there's an immediate 27% savings on your healthcare dollar.
And it's not like the insurance companies do anything except act as a dollar-siphoning middleman. They don't add the least bit of value or service. They certainly do absolutely nothing that warrants a 30% fee.
posted by five fresh fish at 7:44 AM on September 21, 2009
So there's an immediate 27% savings on your healthcare dollar.
And it's not like the insurance companies do anything except act as a dollar-siphoning middleman. They don't add the least bit of value or service. They certainly do absolutely nothing that warrants a 30% fee.
posted by five fresh fish at 7:44 AM on September 21, 2009
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