Friday, March 26, 2010

Going Greek

Everybody knows that the boat is leaking
Everybody knows that the captain lied

Everybody got this broken feeling

Like their father or their dog just died

--Everybody Knows
, Leonard Cohen

No more fooling around, not in this place.

We'll pull our pants up and make a pile of money

--Zorba the Greek

And, little town, thy streets for evermore

Will silent be; and not a soul to tell
Why thou art desolate, can e'er return

--Ode on a Grecian Urn
, John Keats

Congress has passed the mother of all bureaucratic behemoths in the shape of the Health Care Reform Bill 2010. What else should we expect of bureaucrats?

One thing we do not expect of them is that they should live under the same health care standards imposed upon us, the plebes. We allow them to have the Cadillac of all health care systems and Cadillac retirement plans that the most fortunate among us non-politicos will never experience.

From Bloomberg.com yesterday:

President Barack Obama faces a fight over the health-care overhaul from states that sued today because the legislation’s expansion of Medicaid imposes a fiscal strain on their cash-strapped budgets. Florida, Texas and Pennsylvania are among 14 states that filed suit after the president signed the bill over the constitutionality of the burden imposed by the legislation. The health-care overhaul will make as many as 15 million more Americans eligible for Medicaid nationwide starting in 2014 and will cost the states billions to administer (States Sue Over Overhaul that Will Bust State Budgets).

We are looking a lot like Greece, yet our leaders don’t seem to care.

Why do we accept their moral authority to dictate the policies from which they themselves are exempt? Their actions may possess legality, but that does not necessarily equate to moral authority. There is a disconnect when our leaders enjoy the comforts of nobility, while their constituents -- the people they serve -- struggle for meaningful lives.

Their leadership often looks like parasitism.

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Blogger The Minstrel Boy said...

moral authority? in washington?

it might be that the only place more depraved and corrupt is the vatican.

it makes me long for the relative morality of a rock tour bus. at least everything there was consensual and there wasn't any pretending otherwise.

Friday, March 26, 2010 at 1:35:00 PM GMT-5  
Blogger BadTux said...

The states look like Greece. The United States as a whole does not, because it possesses that magical invention, the PRINTING PRESS, that can be used to monetize the debt if necessary.

Greece is defaulting for the same reason the Ottoman Empire defaulted in 1881 -- its debts were denominated in a foreign currency, the euro, and thus could not be simply printed away. That's the same situation that the states in the US face -- the dollar is essentially a foreign currency to them. But the United States can, and has in the past, use the printing press to deflate its public debt to a reasonable level. If you look at the post-WWII era, the United States did just that -- upon exit from WWII the public debt was more than twice what it is now relative to GDP, and by the mid 60's that had been reduced to less than 20% of what it'd started out as. Then of course President LBJ got us into that little scuffle in Southeast Asia that chewed up over 10% of U.S. GDP for no good reason, as well as chewing up another 3-4% of U.S. GDP on a massive moon race, and that was the end of the decline of the U.S. debt. But the point, the point... the point is that inflation and GDP growth is what resolved the WWII debt, and now, as then, there is relatively little risk that the U.S. is going to end up in the same position as Greece -- or as the Ottoman Empire in 1881, where they basically had to hand control of their economy over to Britain and France because their debt was denominated in pounds and francs.

Regarding the system set up by the ObamaCare bill, it has a number of things that are going to need to be fixed before it is reasonable, but a) we have four years to fix most of those issues before the main parts of the bill take effect, and b) none of those flaws are in the fundamental system set up by the bill, which is sort of a weird amalgamation of the Swiss and Dutch systems with a bit of German thrown in but nothing fundamentally untested, this is all stuff that has worked for the Swiss and Dutch and Germans. Indeed, the Swiss had many of the same problems we had prior to adopting their current system in the mid 90's, and the same kind of entrenched insurers and drug companies fighting their healthcare reform efforts. The end result of the Swiss healthcare reform effort is a system that is more expensive than it has to be, but still cheaper than the current U.S. system and it does achieve pretty much universal healthcare. If we get the same results here that the Swiss got, I will be quite overjoyed.

- Badtux the International Penguin

Friday, March 26, 2010 at 6:36:00 PM GMT-5  
Blogger Lisa said...


I always appreciate your economic savvy (and you've had some excellent recent posts on your site re. the topic).

You're right about revving up the printing presses, and of course we're not exactly Greece (I only meant in terms of living beyond our means.) But you say, "inflation and GDP growth is what resolved the WWII debt."

Do you prognosticate GDP growth?

Friday, March 26, 2010 at 9:24:00 PM GMT-5  
Blogger BadTux said...

Lisa, unlike our racist European partners, the population of the United States is still growing and shall continue growing for the foreseeable future. If the population is growing, for GDP to *not* grow would require that per-capita productivity decline. There has not been any significant per-capita productivity decline in the United States since the Great Depression, indeed, the trend has been the other way entirely -- towards greater per-capita productivity.

In short: Greater population + greater productivity = greater GDP. Maybe not in the short run, where we're on the down side of the economic cycle, but we're talking about long-term trends here.

- Badtux the Numbers Penguin

Friday, March 26, 2010 at 9:49:00 PM GMT-5  
Blogger Terrible said...

On the bright side it's no were near as expensive to the country as Bush's tax cuts for the wealthiest few or his illegal wars.

Saturday, March 27, 2010 at 6:58:00 AM GMT-5  
Blogger Lisa said...

Thank you, BT, for explaining the numbers game.

You'd be very good to have at a casino table in NV.

Saturday, March 27, 2010 at 11:39:00 AM GMT-5  
Blogger Lisa said...


p.s. -- of course, that assumes an ever-burgeoning population, and how long do we wish/can we sustain that condition?

Saturday, March 27, 2010 at 11:41:00 AM GMT-5  
Anonymous RangerHazen said...

Well Old Pal your opinion is as screwed up as a soup sandwich.I highly suggest you actually read and understand the bill and it's history (for example HCR's main components were first proposed by RICHARD NIXON in 1971.)and lost in all your hullabaloo and teeth gnashing is the fact that Obama reformed education grants in the same bill so that poor and lower middle class kids could go to college without being financially raped with banks and saddled with high interest school loans....

So let me get this straight...Obama and the Democrats reform health care and education which is exactly what they said they were going to do and you want to repeal it and keep the status quo??? HA HA HA HA HA HA HA!!!

"Why do we accept their moral authority to dictate the policies from which they themselves are exempt? Their actions may possess legality, but that does not necessarily equate to moral authority. There is a disconnect when our leaders enjoy the comforts of nobility, while their constituents -- the people they serve -- struggle for meaningful lives."

A. Because I voted for them...B. Because Barack Obama Nancy Pelosi and Harry Reid and my Representatives Henry Waxman.. Barbara Boxer... and Diane Feinstein (though often flawed at times) best represent my value system and ideology...Thus their efforts have made my "struggle for a meaningful life" much easier.

So again...If you want to deny folks health insurance and take away college education from millions of folks who can't afford it You might want to re-examin your summary.

I sure hope this site does not turn into another cabal of old angry white dudes...If so then oh well... might as well get booted off here too. :)

PS. BaxTux you fracking rock!

Saturday, March 27, 2010 at 12:25:00 PM GMT-5  
Blogger Lisa said...


Speaking for myself, I am totally for universal health coverage. It's just that this plan seems to graft another bureaucracy over an already venal system.

Fr. the conservative side, "With uniquely American ingenuity, we're combining socialist coercion with corporate greed and sleazy price-fixing..." But I kinda agree -- it's a gryphon, and Obama should have had his primary focus on job innovation.

We will possibly have The Mother of All Jobless Recoveries, as The Atlantic reports

I agree that the educational supplement is good, but that could have been done alone.

Saturday, March 27, 2010 at 2:53:00 PM GMT-5  
Blogger Lisa said...


p.s.: The Hill reports today on the "$940 billion over 10 years" cost of the health care initiative. From where will that money arise?

Saturday, March 27, 2010 at 3:57:00 PM GMT-5  
Blogger BadTux said...

Lisa: We know the population will grow over the next 40 years because a) we have half a billion people who want to get into this country, and b) the recent immigrants to this country are popping out babies like toasters.

Regarding costs, $94 billion per year, the cost of this bill, is about what the Pentagon spends on ink pins for its officer corps. Just sayin' :). To pay this $94 billion/year out of our $16T gross domestic income requires a tax of... 0.5875% of our gross domestic income. That is, not even a 1% increase in taxes. Frankly, I'll gladly pay 0.5875% higher tax in order to insure that I will have healthcare when I'll need it despite my many pre-existing conditions.

The bill basically turns insurance companies into regulated utilities, like your electric and gas company. Not exactly my choice of how to do things, our experience with regulated utilities is that they end up being more expensive than taxpayer-owned utilities (for example, if I walk across the border from Santa Clara Municipal Utilities into PG&E territory, my electric rates end up 40% higher), but it's not as if we don't have lots of experience with regulated utilities.

The bill's primary problems lie with the subsidies issue. While it exempts families from the tax if insurance would take up more than 8% of their family income (which, given that the average family policy is around $13K/year and the average individual policy is around $6K/year, means families making less than $160K/year and individuals making less than $75K/year are basically exempt), that isn't the same at all as actually providing them with health care. So for most people, carrots, rather than sticks, are what are going to be used to motivate them to buy in to the system, since approximately 80% of the population is basically exempted from the enforcement part of the system right out of the gate. Yet the carrot -- an end-of-year tax credit for part of that $13K or $6K -- comes *after* you've spent a year paying for a product that you didn't have in the first place because, doh, you didn't have the money to pay for it.

The next-to-the-easiest thing to have done would be to just make it a payroll tax deduction in the first place, you get a voucher, and you take that voucher to the insurance company of your choice to get insurance. Of course, *the* easiest thing to do would be that the moment you get a Social Security card, you also get a Medicare card, all financed via a payroll tax and a tax on unearned income. But that would have been too simple, siiiiigh!

In any event, some folks need to check the tin foil linings of their hats, because some of those government healthcare mind control beams appear to be gettin' through. Either that, or they're being paranoid ;-). Just sayin'.

- Badtux the Healthcare Penguin

Saturday, March 27, 2010 at 4:26:00 PM GMT-5  
Blogger Lisa said...


Thank you for your exegesis.

By no means am I afraid of universal health care; it is only civil for a society to offer this. This current attempt is clunky because it's a farrago.

As you state at the end, why not a Medicare card + Social Security card? This was an attempt to address a need that goes the long way around the barn.

Saturday, March 27, 2010 at 4:56:00 PM GMT-5  
Blogger Lisa said...


pps: This is a free-fire zone, and you know we will never disown you :)

It's just that Ranger is trying to reconcile Noam Chomsky with the thinking of his fellows from the swamps of N. FLA.

It is a process, so we will be somewhat patient, while showing him how the other half thinks.

Saturday, March 27, 2010 at 6:26:00 PM GMT-5  
Blogger BadTux said...

"why not a Medicare card + Social Security card?"

That is a good question, and to answer it you have to recall that democracy is the notion that the common man knows what he wants and deserves to get it, good and hard.

Currently over 80% of Americans have health insurance either from private or public sources, the majority of those with health insurance have it via private sources, and over 90% of Americans who have private health insurance have it through their employer. Various non-partisan public health foundations, the most prominent being the Kaiser Family Foundation, set out in the aftermath of the blowup of the Clinton health plan to perform tracking polls to see what health care proposals were most popular. What they found was that the proposals that polled the best were proposals that combined a mandate on employers with subsidies for those who could not afford insurance. As in, roughly 70-80% support stable over more than a decade.

The single-payer alternative has never polled at even 60% even when polled as "Medicare For All", and generally rarely cracked 50% in the tracking polls. Since democracy is the notion that the common people know what they want and deserve to get it, good and hard, our politicians then sat down to give us what we wanted, good and hard. And that, my friends, is that -- we got what we wanted, a system that largely keeps health insurance for working-age families in the hands of our employers, which thus required 2,000 pages of workarounds and kludges to sort of make it into a universal healthcare system if you squint hard enough.

In short, there was no conspiracies involved here in the basic bones of what came out of Congress, it was very carefully crafted to include the policy proposals that polled best over the past fifteen years of tracking polls... along with a bunch of nasty kludges needed to make those proposals sort of workable (for example, the individual mandate, which is needed because otherwise the system goes into a death spiral). What happened to the simple notion of handing out a Medicare card at the same time a Social Security card is issued was something called "democracy", which is the worst of all possible forms of government save for all others that have been tried. So it goes.

- Badtux the Tracking Penguin

Saturday, March 27, 2010 at 7:06:00 PM GMT-5  
Anonymous Anonymous said...

I am 100% for universal healthcare closely resembling either the Canadian or Australian system.

It would be funded by tax $s; with the most wealthy paying a disproportiate share; afterall, it is they who benefit the most, financially, from a healthy workforce. They also would enjoy a risk reduction by not having to fund insurance privately through their companies. That has a value.

Cost savings would be realized by forcing reasonable reimbursement levels on physicians and hospitals as well as reducing medically unnecessary services and those services where the marginal benefits do not equal the marginal cost (there really aren't any significant cost savings available through eliminating the insurance companies*). I think end of life costs could also be ameliorated to some extent with a greater emphasis placed on spending where it pays off the most (e.g. children, pregnant mothers.....).

Quality improvements and further cost saving efficiencies would be obtained through forcing improved coordination of care, electronic medical records available online and via other onvious solutions that cannot be developed in our currently fragmented "system".

As far as I can see, Obamacare is an obfuscation on the road to this inevitible destination. A soup sandwhich indeed.


* caveat being that in many of the non-profit companies - like the big Blues - there are interlocking Boards wherein the insurance people and the hospital/physicans are the same. This serves to protect provider reimbursement; meaning every year they get more money and utilization management practices won't dip into their pockets.

Sunday, March 28, 2010 at 4:56:00 AM GMT-5  
Anonymous Anonymous said...

BT, this situation is a failure of democracy as much as it is a market failure. Asymmetry of knowledge is a huge issue as are principle agent problems, failure of markets to form, cartels.

The issue is too complex and too emotional for people to understand it enough to vote in their best interest. Especially when they are being lied to at every step of the way. The BS is coming from every angle.... MIchael Moore, the AMA, elected rep.s.


Sunday, March 28, 2010 at 5:03:00 AM GMT-5  
Anonymous Anonymous said...

One more...BT I respectfully disagree with your economic prognostication.

A growing work force is only one side of the equation. There has to be sufficient raw resources for them to work with and to more generally support them.

Additionally, more workers = lower wages. Stiglitz has found a strong negative correlation between population growth and economic growth. See India, China, Africa......


Sunday, March 28, 2010 at 5:15:00 AM GMT-5  
Anonymous Anonymous said...

And finally, before you can decide what to do about a problem you have to understand what is it.

Let's unveil the 20,000 lb elephant in the room that you never hear discussed;

HC insurance is expensive - and therefore not affordable for many - because HC services are, in the aggregate, expensive . Cost of insurance keeps going up because HC service costs, in the aggregate, keep going up (how's that for ranger simple?).


Because medical technology keeps increasing. There are more procedures that can be done to treat more conditions today than there were 5 years ago and 5 years ago more than there 10 years ago, etc, etc, etc.

This is causing increased consumption on the intensive and extensive margins (or, in non-econ terms, more people can be treated for more conditions and each individual can be treated for more conditions).

A simple illustrative example, that actually is a cost driver, is knee and hip replacement surgery. 20 years ago this was almost experimental. Today it is routine. Everyone and their grandma is having these done at about $12,000+ a joint (actual cost of surgery + rehab and ancillary costs). There are many many other examples; far too numerous to print here.

$12,000 a joint. Well, someone has to pay for that. Most of those having the joint replaced didn't pay in $12,000 in premiums that year. So, guess what, premiums are adjusted upwards next year to cover the costs. And so it goes. Again, joint replacement is merely one little example.

It easy to get angry at insurance co.s, but at least they are trying to curb cost increases by making an effort to approve only those procedures that are deemed medically necessary (though they are often stymied in this effort by various sources).

As much as I am for universal coverage I don't see it addressing the real reason medical services cost are high and getting higher.


Sunday, March 28, 2010 at 5:42:00 AM GMT-5  
Blogger rangeragainstwar said...

A person being polled is not the same as that person actually voting.
The two are separate and distinct events and should not be confused as being the same.If we give the people what they want then lets rock on with the forever wars.
Ranger Hazen,
Per Lisa's cmt -my essay has NOTHING to do with Cholmsky. Not a fucking thing, and in addition i answer the cmts sent my way.
This entry is not a rant, nor is it or was it against health/insurance reform etc...but a simple statement against the hypocrisy of our leadership. They do as they do and benefit greatly, and then legislate something different for we peons. Only a troglidite could/would really be against a reasonable program that expands health care, but we must realize that the money has to come from somewhere, or we're gonna be just like California. That's where i see us as heading. There are always winners and losers and always something lost when something is gained.
We don't kick old friends off of RAW-we rescind their tabs.
Yes it's simple and old Rangers and Marines get it when it's explained, but we never get rational discussions , but rather emotional clap trap bullshit posing as reason.
One question that keeps popping into mind is-why will we need the DVA vet health care system if this new program is so effective.? Why have shadow systems? Why not use the DVA as an expanded national system?

Sunday, March 28, 2010 at 10:27:00 AM GMT-5  
Anonymous Anonymous said...

Jim, "One question that keeps popping into mind is-why will we need the DVA vet health care system if this new program is so effective.? Why have shadow systems? Why not use the DVA as an expanded national system?"

That is a really good question. Same could be said of Medicare (as someone mentioned upthread).

I agree. If our elected leaders were truly wanting to do right by us they would simply expand one of the existing gov't programs to everyone. End of story. Mission accomplished.

P.S. while I have defended insurance co.s as not being a significant factor in the cost of insurance/healthcare services, they are, however, a significant factor in the cluster fuck that is healthcare reform. They don't want to lose their cushy jobs and they've paid off congress and POTUS (as if I needed to explain that). Physicians/hospitals are also opposed because they fear loss of the interlocking Boards I mentioned whereby their high charges can be protected. Also, they fear the collective bargaining power of the fed.s in a universal system. Medicare has been ramping up cost cutting in a most impressive way and physicians/hospitals are feeling the sting.


Sunday, March 28, 2010 at 11:03:00 AM GMT-5  
Blogger BadTux said...

Avedis, I've actually posted a couple of articles over on my own blog pointing out the point that medical innovation is one of the main drivers of medical expense growth since 1960 and that insurers are being unfairly blamed for the cost spiral -- the costs are being driven by a combination of a) medical innovation, and b) providers, not by insurers, gaming the system.

That said, there is enormous waste and fraud in the U.S. system. Switzerland has an equal amount of medical innovation and a system similar to that set up by Obamacare, but is still over 30% cheaper. Health care is always going to be expensive because, well, we can just do more stuff today than we could fifty years ago, but we don't have to make it stupidly expensive the way it is in the United States right now. The problem is, fixing this is going to require making hard decisions that are simply impossible without having everybody in the system, because otherwise the system will react by kicking people out. That's why Obamacare's mandates upon insurers, companies, and individuals are the most important first step towards reforming the system to get it under control, without that, nothing we try to get costs under control will work, they'll just result in more uninsured people as the system kicks the most expensive people out.

But of course it's only the first step, and a baby step at that. Given that the typical Democratic politician has about as much spine as a jellyfish, the next steps necessary, such as bringing specialist costs under control (a good heart surgeon today can make $1M+ per year in the U.S. system, unlike in any other system in the world, and heart care here in the U.S. is *not* better than in France or Switzerland, two places where specialist salaries are capped at much lower levels), are going to be really, really hard... but at least we have a start. Which is better than what we had.

- Badtux the Pragmatic Penguin

Sunday, March 28, 2010 at 11:24:00 AM GMT-5  
Blogger BadTux said...

Regarding why have DVA -- Britain actually asked that question about their equivalent, now that they have the National Health Service. They attempted to do away with their equivalent of the DVA, but it didn't work, they had to reverse themselves when soldiers started coming back from Iraq and Afghanistan with serious medical issues. It turns out that ex-soldiers have medical issues that civilian doctors who don't specialize in the needs of ex-soldiers simply aren't good at handling. It is not usual, for example, for civilians to be caught near explosions and suffer TBI and PTSD, or have limbs with almost as much steel as bones, and so forth. Rehabilitation of those who have lost limbs or lost much of the function of those limbs in a combat setting is also different than it is for civilians, because the mindset of the person who underwent the loss is different.

So yes, even if we did go Medicare For All we'd still need the DVA. We might change their funding in that case and have them funded through Medicare, but in the end they are specialists like any other specialist and there is a need for them.

Sunday, March 28, 2010 at 11:35:00 AM GMT-5  
Anonymous Anonymous said...

BT, followed the link and read your article. We are in agreement on just about all important points.

A small quible, I was full time employed by a major not for profit Blues plan (actuarial) for a number of years and I still do some consulting. Most commercial products are running at a medical loss ratio closer to 90% than 80%. Though you are correct that some of the better functioning competing for profit plans are closer to 80%.

Another....having everyone in the risk pool isn't going to change anything unless you are ready to do something serious and unpopular re; rationing all of those technological advancements along the lines of only accepting those where you pay in line with the benefits derived.


Sunday, March 28, 2010 at 12:15:00 PM GMT-5  
Blogger BadTux said...

Avedis, I arrived at the 80% number by looking at SEC statements of the five largest for-profit health insurance companies traded on Wall Street at the time I wrote that article. It may well be that not-for-profit insurance companies run higher MLR's as you state, but given that it's the for-profit insurers that are being demonized by the Left, they are the ones that I focused upon.

Regarding rationing: One reason why I have focused upon the French and the Swiss in my international comparisons is that both the French and the Swiss have high quality health care systems that are as good as or better than the U.S. system on every available measure, both the French and Swiss systems are significantly less expensive than the U.S. system (as in, 20% to 40% less expensive), yet neither does rationing. What that implies is that there is some low-hanging fruit that can be plucked out of the U.S. system to reduce costs significantly before we have to think about rationing. Unfortunately, unless everybody is mandated into the system via mandates upon both individuals and upon insurers, the system reacts by kicking sick people out of the system in order to reduce costs when we try to pluck that low hanging fruit.

You are correct, however, that at some point we're going to have to put a hard cap on medical spending. The current situation with Medicare is long-term financially unsustainable, for example... even though Medicare costs are rising more slowly than private insurance costs, extrapolating the curve forward by twenty years has Medicare taking up more money than the entire U.S. government spends on everything today. And the problem for private insurers, whose costs are rising even faster than Medicare, is unsustainable even sooner. Unfortunately at the moment these are hypotheticals, and the U.S. public and the U.S. system is completely incapable of handing hypotheticals. Even in FDR's day hypotheticals were a difficult thing to get the U.S. public and political system interested in... one reason why the U.S. was so unprepared for WWII, with most of its battleships being WWI era and only a few battleships and aircraft carriers under construction and basically no reasonable-quality tanks or fighter planes, was that the threat of war with Japan and Germany was merely hypothetical until December 7, 1941. Once the threat was no longer hypothetical the system responded... but what that implies is that we're going to need a health care equivalent of Pearl Harbor to get the real reforms we need. And we just aren't there yet. Thus the current set of patchwork fixes...

- Badtux the Realist Penguin

Sunday, March 28, 2010 at 12:44:00 PM GMT-5  
Anonymous Anonymous said...

First, Jim I hope you don't mind BT and me using your bandwith getting all technical on HC reform.

BT, I am in complete agreement that there is low hanging fruit that would could pick and become more efficient/cost effective - by 20% to 40% - like the Swiss without deny needed care or kicking people out of the system.

That being said, those are one time savings. You reduce by your 20% to 40% and then the cost trend starts rising again because of the technological developments and increased utilization.

See, it is insurance that is funding the development and people (the insured) that are demanding it without thought to cost because it isn't really a market. The patient is divorced from the cost of the care at the point of service. The normal value consideration isn't there.The provider of care is incentivized to provide more care.

Therefore It will always be incumbent on the insurance plan, be it public or private, to do the value calculation and to, sometimes, say "no" at a certain price.

These leads to all sorts of stories in the media about poor old dying Aunt Martha that was denied some treatment or another by the evil HC system.

I am wondering just how well that will work in the US. I can imagine politicians running on a platform of granting more access to expensive treatments of questionable value than their opponent given a public system.

I am also thinking that many politicians don't want to be that responsible.


Sunday, March 28, 2010 at 1:28:00 PM GMT-5  
Blogger Lisa said...

Thanks to Avedis and BT, esp., for providing a dialog we don't get in the dailies.


In addition to your erudition I do appreciate your graphical images ("recent immigrants to this country are popping out babies like toasters"), which are both on-target and give a little wry smile in the midst of heavy debate.

Sunday, March 28, 2010 at 1:35:00 PM GMT-5  
Blogger rangeragainstwar said...

Avedis and all,
Of course you all are welcome to kick any horse that you desire on this blog. I will offer guest posts to you. This particular entry went in directions that i would not have predicted. BT and yourself do not agree on my DVA question, but on a gut level i side with your evaluation. My question easily applies to TRICARE also. Indeed the question arises -why join the military at all, if i can get health care elsewhere?The free health care was always a recruiting tool.With other legislation making college loans cheaper etc.. the same question applies to the GI bill. What will be the impact on recruiting?Will we offer free toasters OR 72 virgins?

Sunday, March 28, 2010 at 1:55:00 PM GMT-5  
Anonymous Anonymous said...

Will we offer free toasters OR 72 virgins?

72 virgins....there's a horse worth kicking.

What's with this whole virgin thing anyhow?

Now, offer me a pop tart or two in heaven to go with that toaster and I'm raising my right hand.

Virgins...yawn...I'll take experience any day.


Sunday, March 28, 2010 at 2:28:00 PM GMT-5  
Blogger BadTux said...

Avedis, you are correct that there is not a market when it comes to health care, and that the necessary pooling created by insurance (necessary because modern health care costs *at least* 10% of GDP, just by its very nature, and sick people don't make 10% of the national GDP) in turn creates a disconnect between patient and doctor. In short, modern health care is incompatible with market economics.

On the other hand, various proposals to deal with that by somehow creating a market are doomed to failure by the sheer expense of modern health care and by the fact that the treatments that account for most of the cost of healthcare -- those that are for life-threatening illnesses -- are literally "your money or your life". And people place an infinite value upon their lives, because unlike other things covered by insurance -- such as, say, cars or houses -- you cannot replace your life if it is lost, you get only one life (putting aside the notion of an afterlife, a notion which is thus far untestable and thus unprovable). That is why good heart surgeons can make $1M per year while I as a software engineering manager probably make more than the average family practitioner. Heart surgeons can literally say, "your money or your life", little different from a common mugger in that respect, while family practitioners cannot. You die if you do not get the correct heart surgery from one of the best specialists in your particular disease. You don't (usually) die if your family practitioner gives you a somewhat slapdash annual physical.

Given that, any talk of "markets" in the same sentence as "health care" being able to control costs any better than Medicare makes about as much sense as talking about fire in the context of aquatic civilizations. It is simply incompatible with the fundamental nature of the beast, the provider side of the equation has too much power with that "your money or your life" bit, you might as well talk about a free market in muggers. So at some point, the irresistible force is going to come up against the immovable object: the irresistible desire for more and more advanced treatments is going to come up against the immovable object of the fact that we do not have unlimited resources. And the result is not likely to be pretty, and I at this point have no idea how the ramshackle body politic that is American politics is going to handle that situation, other than freak out big-time which is a given.

Sunday, March 28, 2010 at 2:33:00 PM GMT-5  
Blogger BadTux said...

Ranger, you assume that people sign up for the military for purely mercenary reasons, i.e., because of pay and benefits. While I think it is clear that people would not sign up if they weren't paid or received no benefits, I'm not sure that the quantity of pay or benefits have much to do with recruitment. In the end, most who volunteer today do so for reasons other than pay or benefits (though pay or benefits are important) -- they do so to experience the world, to validate their manhood, to join an organization and become part of a team that is bigger than its individual pieces, out of an idealistic desire to defend their country, or any number of reasons which are as varied as the people who join.

In short, the biggest hinderance to recruiting is not the duplication of military benefits in the civilian sector, but, rather, the fact that the U.S. military at present is being used for overseas wars of occupation which have nothing to do with defending our nation, and thus the youthful idealists who would sign up to defend our nation are staying away in droves. Some military benefits clearly do have retention benefits -- my stepdad stayed in the military long enough to receive Tricare for life and a military pension, for example, and likely would not have stayed in the military if not for that -- but he joined in the first place primarily because he was a military brat to begin with and it seemed the thing to do, not because he was looking thirty years down the road to retirement. Young people just aren't that good at looking that far ahead, in the end.

So toasters or virgins, no. Bringing our military home and using it for what it's supposed to be used for -- defending our nation -- yes. I think that will cover the recruitment problem nicely.

Sunday, March 28, 2010 at 2:47:00 PM GMT-5  
Blogger Lisa said...


Well, Ranger is our resident mercenary :) At least, he speaks for a cohort of his fellows, I'm sure.

Couldn't the virgin toasters serve as a consolation prize?

Sunday, March 28, 2010 at 3:41:00 PM GMT-5  
Blogger rangeragainstwar said...

i don't buy the altruistic nature of enlisting, even in the best of times. IE no war. Why would anyone fall behind their peers by sidetracking into the military?it's the bennies, or the illusion of the bennies. Just like avedis i couldn't see much past my pecker, but i ended up with tricare for life/medicare a&b and va since i'm 100%. avedis-we do stray off course every time.

Sunday, March 28, 2010 at 4:41:00 PM GMT-5  
Anonymous RangerHazen said...

Granted it was a long time ago but I enlisted solely out of altruism There were no real bennies for enlisting in the late 70's. Hazens having been serving since the French and Indian war...

Monday, March 29, 2010 at 8:11:00 PM GMT-5  
Anonymous Anonymous said...

Jim, try the Navy hold; might improve that sight picture.

I'm of the same generation as RH. I thought the uniform would help get me chicks. I also thought I might have a chance to be a hero; which would also help with the chicks, but, more seriously, this is a tradition in my family. Needed to do it to be a "man"


Tuesday, March 30, 2010 at 6:21:00 PM GMT-5  
Blogger rangeragainstwar said...

I've always used the Navy hold, even in cowboy action shooting.
When i joined the good girls didn't go out with soldiers, and the high and tight and the soldiers sun burning were dead give aways.But as i've written before -the good girls would come to the West Point mixers on post since they were gentlemen.Right!
I don't really remember why i joined , but Duty, Honor,PER DIEM come to mind. Not in that order.

Wednesday, March 31, 2010 at 10:12:00 AM GMT-5  
Blogger BadTux said...

I actually do remember why I took the ASVAB and attempted to volunteer. I was young, recently unemployed, had no prospects in life, had nothing better to do, had never been outside my home state, had vague patriotic feelings about serving my country, and it seemed like a way to spend four or five years of my life while I tried to figure out what I was all about. As it turned the recruiter salivated over my ASVAB scores and was happy I had a high school diploma unlike half the other losers that came through and we were as far along as scheduling a trip to New Orleans for a physical, but then I crashed my motorcycle and lost a chunk of my foot and that was the end of that. While on crutches and bored stiff I started taking college courses (discovering that if I took two courses, Pell grants would pay pretty much all the expenses, something which Ronny Raygun swiftly did away with because it interfered with his plan for a million-man Army), and did that instead. But I have a suspicion I woulda retired from the Air Farce after 20 years or so if it hadn't been for that motorcycle crash.

Wednesday, March 31, 2010 at 10:21:00 AM GMT-5  
Anonymous Anonymous said...

Actually, lest anyone think I am a completely incorrigible hedonist, right after 9/11 I did try for a reinstated commission and it was purely out of a sense of duty. It wasn't about hatred or revenge or heroism.

My wife wasn't happy, but she undestood and backed me.

I knew that we would be in for a long term war and felt like someone educated, experienced and seasoned such as myself could make a positive difference, even if a small one. I felt like my country needed me. I felt like the Corps needed me. Maybe I could help get this thing done a little better and a little faster, keep some 18 year old alive......

But they told me that, even with prior service, I was too old and too long out of the game (and I was in very good shape. I could have passed any qualifying the military has to offer). Funny, because under current expanded entry guidelines, they most likely would have taken me.


Thursday, April 1, 2010 at 6:57:00 AM GMT-5  

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