Neil Howe: 'Civil War Is More Likely Than People Think'

[Warren Dew]

(12-12-2016, 11:07 PM)Ragnarök_62 Wrote:

Rags Wrote:Medical care and retirement provision are 2 things I don't think free enterpriseTM handle.  As such they should be public goods. 

Medical care depends on random stuff like an odd mutation which causes cancer or losing the genetic lotto and getting early heart disease , type I diabetes, going blind, etc.  There's also random stuff like car wrecks.

Retirement and running out of money is where you win the genetic lotto sorta, but losing the economic lotto and winding up with a body wearing construction job.

Whaddya think, and why?

Warren Dew Wrote:I think a medical system that relies primarily on treatment rather than prevention is ridiculously messed up.  We save a few bucks eating and drinking cheap, mass produced junk food, then spend thousands of dollars of "other people's money" fixing the cancer, diabetes, and heart disease that result.  The problem is, we end up also being those "other people" who pay for everyone's medical expenses.  And we're so far into the system - more than a generation - that most people have forgotten what healthy food actually is.  It's a terrible system.

Wrt junk food. I think most folks know how bad the stuff is.  However, consider the dual minimum wage house hold where mom and dad work their asses off and have no time or energy to cook like the "good old days" with stay at home moms. So to enable folks to procure the more expensive fruits/veggies and cook them, we'd need to either raise the minimum wage [I work minimum wage and my employer doesn't even provide me with health insurance so no savings there] or have a guaranteed national income provided or not with an expanded EITC.

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Quote:The best approach would be for everyone to pay for their own food, doctor's visits, and health insurance; that way, they'd be able to pick a balance that offered them the most benefit for the least cost.

1. That would work if everyone had enough funds for ordinary medical expenses.  Drugs and routine medical visits. The health insurance would need to work like homeowners insurance and be fore catastrophic stuff equivalent to a house fire.

2. The routine stuff can still add up a lot for poor folks though.

We can't really afford a livable guaranteed income yet, but if we cut federal medical support, we could provide a guaranteed supplemental income of about $3000 per year for everyone.  It won't pay rent, but it should be fine for healthy groceries; it's as much as I pay per person, and I shop at Whole Foods.  Replace current welfare programs, and it comes to $4000 to $5000; if people actually lived healthy - and took that vitamin D - that would add enough for some minimal catastrophic insurance once the system adjusted.  People who liived on junk food woould be out of luck, though.

Raise the minimum wage, and you might be out of your job rather than making more money.

Quote:3. Uh, what about the folks who won the genetic lotto and outlive their savings?  The stawk market is not sane or predictable. I mean why did the stawk market go up after Brexit, Trump win, and now Italy's vote?  I'll never understand the stawk market and hell if I can time the thing.

I see retirement as a separate issue.  Right now, we have social security.  Something better could be designed, but it might be best to have it be annuity based to avoid issues about running out before dying.

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Quote:Current employer contributions to health insurance could be turned into pay which people could choose to use on any of these things.

Yes, that's a hangover from WWII wage/price controls.  It's obsolete and stupid.  Nuking the tax deduction should wipe it out.  I certainly don't like a subsidy to health insurance companies by proxy , tax write offs. The concern I have is the freed up money would be used to pad profits and CEO pay. There's way too much of that going on.

Yes.  The transition would be the issue:  we'd have to make sure those expenses got turned into pay, not padded profits.

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Warren Dew Wrote:Some level of regulation would be needed to ensure that the insurance companies were able to make good on their promises.  Some level of subsidy could be provided for the poor by state government or private charity, which might cover a minimum level of medical care in the event of a catastrophic eventuality.  But that's as far as I'd really want it.

Uh, "private charity" ?.   That's an Oklahoma state government special.  I can tell you first hand, that option is a no go. Hell, even state government here is a no go , come to think about it.  All the Oklahoma state government cares about is law enforcement and jails.  Lot's of money goes to those 2 . Yeeahyaaawwwww.  The wahoos we've elected are idiots. Like they cut the income tax just right before the oil price crashed and we have major shortfalls.  If I could, I'd pack up and move to a sane state like Colorado. That's why I never bitch when Eric pans Oklahoma, 'cause he's right.

If we didn't have that guaranteed supplemental income, federal taxes could be reduced massively instead.  States could increase their taxes to make up, providing them with more room for subsidies or state based guaranteed income.  And I think a lot more people would step up with private charity if that were the social norm, rather than just assuming "the government will take care of it".

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Quote:Auto accidents would be covered by auto insurance, of course.

I see big numbers for auto insurance bills to pay for lifetime disability payments.

Most of auto insurance goes to paying for damage to cars, not people.  Heck, the part that goes to people mostly goes to lawyers, not medical bills.  Disability insurance isn't that expensive as long as the benefits aren't good enough to tempt people into using them on purpose.

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Quote:Except for the part about auto insurance, though, that's so far from what we have that we'll probably need to take baby steps even to start moving in that direction.

I have an idea that will save lots of money, but it'll be a big fuck in the ass for Big Pharma.  Let's legalize importation of drugs from the cheapest locations that adhere to generic drug specifications by the FDA?  I say bring 'em in from Mexico/Canada and even India.

Absolutely.  I'm tired of paying for all the expensive drug research costs so the rest of the world pays only the cheap manufacturing costs.  Reimportation needs to be fully legal.