The Last Homely House
General => Council of Cobra => Topic started by: TheJord on October 16, 2009, 04:29:40 PM
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I know this particular topic is being debated in the US at the moment, and I am studying Welfare Economics so I was looking for some views from some Americans on public healthcare.
I should add that I am looking for non-normative views, which means I dont want "It's evil" because I could so "It isn't evil" until time ends. I need to understand why you dont see public healthcare as a efficient, productive or pleasant way to spend your tax dollars.
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Personally, I believe the problem should be solved in the market, not by government. I think healthcare providers should offer up front pricing which would allow the consumer to choose where they go for healthcare. Following normal capitalist trends, most folks would choose the least expensive form of care and this would cause other providers to lower their costs, or go out of business. It's the way of capitalism. I also think we should do away with minimum wage, but that is another topic altogether.
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I quite like not getting sucked of all my money every time I break a bone or get ill.
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So you would prefer it was sucked out before hand for someone elses bone?
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I'll have to sadly admit that I've not really looked into this as much as I should have - I guess I'm being the typical American that so infuriates me. Too lazy to really look into an issue but all too ready to express an opinion.
As far as upfront shopping - most health plans that I've been covered by don't let you pick and choose alot - unless it's an emergency. It is true that the insurance firms involved in Health Care are some of the most profitable companies in the U.S.
I do hear a lot about how the government will mess it up and yet Medicare is generally well received. In some of the debates elderly have expressed concern over taking Medicare away from them.
I think a lot of the debates seem to center on the two main modes for swaying the American public at large. You either convince them that they will have to pay an unfair burden because others are lazy or incompetent. Or you convince a group that they will be singled out and the benefits they now receive will be greatly reduced or tremendously more expensive. You generally don't need to supply any facts.
You hear the opponents tell horror stories about how bad health care is in countries like Canada, England and France and then you'll see a documentary like Michael Moore's show the opposite. It would be interesting to hear from some of our non-American members.
I guess I view any Health Care Reform as only half the issue. The other issue is the American life style which has to put an increased financial strain on the system. Everyone's cost would drop quite a bit if American's adopted a more reasonable life style.
There is also the present situation where you have large employers (Wal Mart) that offer poor coverage, their employees pay a much higher percentage of the premium than most other work places and the coverage itself is said to resemble much of what they sell. Cheap and crappy. Wal Mart supposedly has one of the lowest percentage of full time employees with health care. You can save a few pennies by shopping there but the employees suffer from the display of 'capitalism'. If you have to compete against companies like this you have to be tempted to follow suit.
Sorry for the rambling.
Chuck
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So lets get heathcare out of the employers hands and put it into the consumers. Most people are generally happy with car insurance, which they buy and finance themselves. Why should they not be able to do the same with health insurance?
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We in the Netherlands do have public healthcare. That said it also must bu mentioned that our society is radically different than yours. We too are a capitalistic country, but for most Americans we will be considered as a communistic state. I.e. government is all over the place :) I will try to explain how that came. Don't feel like a history lesson, skip to the end....
In our history we see a certain development. Mid 19Th century we still had a king, but all over Europe things got wild. In order for the people to stay calm he offered to withdraw his powers for 'real' democracy. Liberal party became most powerful, but was run by the leaders of capitalism. When the Industrialization hit us late 19Th century -we were late, didn't really need it earlier- the situation of the poor became increasingly sad. Government was run by those who also ran industry and they were only about growing money, and becoming more rich. Not only did they pay low wages, also the workhours were awful (14-16 hours a day average), the working circumstances were ridiculously dangerous and everyone, even children age 6 had to help in the factories.
No one was able to do anything about this. No one cared for them cause we didn't have strong institutions to deal with it. Sure, the church would provide some help, but they didn't get political. The only people with the right to vote, were young man, that payed a certain amount of tax. That had to be rich people, hence people with well payed jobs IE, leaders of capitalism. So for years and years nothing happened.
In that time certain people rose against that. You had socialist people, christian people each with their own agenda. Socialist wanted equal rights for the poor, and they wanted the workers being able to also vote, that way being able to make altering in government. Christian parties wanted their schools to be payed by government also and they started to work together in order to get what they want. Due to pressure from society, like strikes done by the socialists, and huge political gatherings by the Christians, things changed. In 1917 everyone got the right to vote, well the men at least, 2 years later followed by women.
The changes made were obvious -in the eyes of the Dutch. Labor got protection from the government against the bosses they exploited their people. 8 hours work a day, minimum wage, some form of public healthcare etc.
After World War II the Netherlands had trouble getting back at their feet. We are a small country, and our economy is based on the service sector. Knowledge economy so you will. We got a lot of Marshall aid with which we were supposed to raise once again from the ashes. Well, what is the number 1 debit post on any company's balance? Wages. So government and companies made an agreement with the people. We will not raise the wages for years to come, in order for us to achieve some growth. In exchange for that they offered more social security. If you lose your job you get welfare, if you reach the age of 65, or have been employed for 40 years, you get welfare etc etc. We truly became a welfare state, but we chose it. That is important to notice. To pay all this we pay taxes, a lot of taxes. We pay taxes over the stuff we buy, over our wages, to drive our cars, etc etc. This to pay for the state we live in. It is built after the principle: we take care for eachother. History taught us that uncontrolled capitalism leads to the exploitation of men. Taught us, so I'm not saying that is will do everywhere (allthough my personal opinion is that it will)
End of history lesson.
Nowadays there are a lot of thing debates due to the crisis. Our society gets older, so the costs rise. We need to find money somehow to get it all payed. I can imagine that is odd in the eyes of some, cause it is troubling recovery from the crisis. On the other hand we all have benefits. We are secured of a base income, even without a job. Don't think that is fun, being unemployed even with the money, cause it is the absolute minimum, and you are obliged, in return of the welfare to take up any job you can.
We are secured of healthcare. The wife of a colleague of mine fell from the stairs and she has got weird complains. She is lying in a hospital, a good one, for over a week now. She's getting all kinds of scans, and she is likely to stay there for at least 2 more weeks. It will not cost her a thing.
The age at which you can quite working rose to 67 this week. Of course you can quite earlier, but then you have to pay for it yourself. Have you been successful, you can. Did you have normal wage, it is likely you are going to work till 67. After that you can retire, and you are 'rewarded' for what you have contributed to society.
I think capitalistic mechanism are not a good thing when it comes to healthcare. There should be no price on being healthy. Anyone should have the right being healthy without being ripped off. I know that it is debatable. But I dislike the growing power of insurance companies as much as I dislike the growing power of banks...still. I don't like it when people have to depend of things with as a maingoal to make the most money possible. Well.....I'll leave it to that. Hope that some one took the effort of reading, :)
EDIT:
Wow, made almost no mistakes in writing English :)
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My Dad has lived half his life in the States and half in England and he says he prefers the English system. He said that if you get really lucky and nothing bad befalls yourself or your family then the English system would lose you money and would be bad for you. But on the other hand if anything did happen, especially anything that required any long term care or rehabilitation or frequent hospital trips the English system saves you A LOT more money.
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So lets get heathcare out of the employers hands and put it into the consumers. Most people are generally happy with car insurance, which they buy and finance themselves. Why should they not be able to do the same with health insurance?
Personally I don't think I would have a big problem with this if employers gave you the money in salary that they now spend on health care. However, how would this prevent the big problem that now exists - millions without any coverage? There are many drivers out there without insurance. Also, I wouldn't say that most people are happy with their car insurance - it's just a necessary item. Everytime you put in a claim you are at risk for your premiums going up. Based on the auto insurance model the elderly would pay a lot more since they are at greatest risk for claims - opposite of the actual auto insurance model where the young pay the most. I suppose one good thing that would come out of it would be that Americans might strive for a more healthy life style since this should lead to lower premiums.
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Thank you Gil-Estel and turin08. Yes Gil-Estel I did read your whole post - since you were kind enough to write it. I never comment on the writings of someone who is writing in a Language that is not their primary language - since I'm American. The joke is: What do you call someone who can speak three languages - trilingual. What do you call someone who can speak two languages - blingual. What do you call someone who can only speak one language - an American.
It's kind of interesting the paths that different countries take. The U.S. went through a similar time in history when there was a larger gap between upper and the lower classes. Lower class people worked very long hours and very young people worked in terrible conditions. I'm not a big fan of labor unions but still, at the expense of possibly being labelled a liberal, you have to admit they played a very possitive role in changing the situation in the U.S. There is evidence that we are again widening the gap between the vey wealthy and the rest of society. Since 1980 the top 1% has increased it's share of the total wealth from about 10% to close to 25%. CEO's used to make about 35 times the average salary of their employees and now they are about 300 times. Middle class wages, when accounting for inflation are relatively flat.
It's obvious that there is no utopian answer out there.
Chuck
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I'm interested how public healthcare could (or could not) be aiming towards Pareto optimilaty, which is making people better off without making others worse off.
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I like the idea of taking the coverage out of businesses and allowing americans the power to choose their own coverage and not rely on an employer. However, I don't think a government should mandate that one must purchase insurance coverage. Yes, that means I wouldn't have car insurance if it wasn't required by law. A government has 3 jobs, build roads, maintain an army and print currency. I think it should be up to the people to take care of the rest. The first hospital in Philidelphia was founded by a people's initiative started by Ben Franklin. This hospital was maintained by donations and was free to attend for everyone. No one paid to use this hospital. The best part is, it was maintained by the people and for the people. No government involvement. Ben Franklin also invented the concept of insurance companies.
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A government has 3 jobs, build roads, maintain an army and print currency. I think it should be up to the people to take care of the rest.
Mate thats incredibly naive. A country like that would be in a state of total anarchy and chaos. Such an idea forgets that people are selfish/stupid/evil or just plain disagree over most things.
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A government has 3 jobs, build roads, maintain an army and print currency. I think it should be up to the people to take care of the rest.
Mate thats incredibly naive. A country like that would be in a state of total anarchy and chaos. Such an idea forgets that people are selfish/stupid/evil or just plain disagree over most things.
I think he means the federal government. All the rest should be left to the state governments. ;)
We don't want anarchy, we just want more power in the hands of the states.
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Oh well then i guess that makes sense.
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Don't forget the fact that the current crisis in the US is a result of government intrusion in the first place. Due to price fixing and wage caps instituted by FDR during WWII companies were unable to raise wages to attract workers so they started offering employer based health care in an effort to increase benefits without raising wages. This started the employer based health care system which uses massive insurance companies. The fact is that these insurance companies have supplanted any capitalist health care system and combined with the introduction of the govt. with medicare in the 1960's (or 70's?) has raised the prices of health care dramatically. Prices are huge because most people do not pay directly for their care. There is no incentive to bring down prices because someone else pays for it. Insurance and govt. provided care is expensive because it is a monopoly.
Much is made out of the 35-70 million Americans that are not covered by insurance. Most of the time it is fallacious arguments about how they can't afford it and are dying in the streets. Most of the time this is untrue. Most of those numbers are young people who have made a financial decision to not get care. As young healthy people they are managing the risk and have determined that they don't need care. The coverage is too expensive since they don't use it. They don't have care because they don't need it. They are free to do so, and should be. My wife and I have not had insurance for years and have not had any trouble, we are now getting some because we have made the financial decision that we can afford it and we want to start a family in the next year or so.
Health care is important and needs to be available. The question is one of trade-offs. The fact is that it costs money and right now the US is trillions in debt, it cannot afford these programs. Taxes for such programs are politcally unreasonable for Americans. Europeans here have attested to the tax costs. Liberty is also a consideration in America. The Constitution, if you still believe in it, makes no reference to public welfare programs like social security and healthcare and therefore in my opinion these things should not be legislated. They will not lead to prosperity in any way. Prosperity comes from competition and from the ability to enjoy the fruits of one's labors. Healthcare is dependent on taxes and makes the public dependent on government and will eliminate competition. If there is no alternative but government healthcare, which is a strong possibility since the government doesn't play fair, that is tyranny in my opinion.
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Regardless of the supposed benefits of federally mandated public health care, the crux of the issue is this; the federal government has no right to legislate health care to the people. To quote section 8 of the United States Constitution:
"The Congress shall have power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;
To borrow money on the credit of the United States;
To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;
To establish a uniform Rule of Naturalization, and uniform Laws on the subject of Bankruptcies throughout the United States;
To coin Money, regulate the Value thereof, and of foreign Coin, and fix the Standard of Weights and Measures;
To provide for the Punishment of counterfeiting the Securities and current Coin of the United States;
To establish Post Offices and Post Roads;
To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries;
To constitute Tribunals inferior to the Supreme Court;
To define and punish Piracies and Felonies committed on the high Seas, and Offenses against the Law of Nations;
To declare War, grant Letters of Marque and Reprisal, and make Rules concerning Captures on Land and Water;
To raise and support Armies, but no Appropriation of Money to that Use shall be for a longer Term than two Years;
To provide and maintain a Navy;
To make Rules for the Government and Regulation of the land and naval Forces;
To provide for calling forth the Militia to execute the Laws of the Union, suppress Insurrections and repel Invasions;
To provide for organizing, arming, and disciplining the Militia, and for governing such Part of them as may be employed in the Service of the United States, reserving to the States respectively, the Appointment of the Officers, and the Authority of training the Militia according to the discipline prescribed by Congress;
To exercise exclusive Legislation in all Cases whatsoever, over such District (not exceeding ten Miles square) as may, by Cession of particular States, and the acceptance of Congress, become the Seat of the Government of the United States, and to exercise like Authority over all Places purchased by the Consent of the Legislature of the State in which the Same shall be, for the Erection of Forts, Magazines, Arsenals, dock-Yards, and other needful Buildings; And
To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof."
The last line is very important. It gives Congress the right to make laws, but only those laws that shall be necessary to the execution, or to the fulfillment of the 'powers vested by this Constitution in the Government of the United States'. Aside from that, Congress can not make any new laws. All other powers are delegated to the states of the union.
That is why we believe that, if laws about health care are to be made, they should be made by the states of the union, not by the union of the states.
-GT
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Health care is important and needs to be available.
Liberty is also a consideration in America. The Constitution, if you still believe in it, makes no reference to public welfare programs like social security and healthcare and therefore in my opinion these things should not be legislated. They will not lead to prosperity in any way. Prosperity comes from competition and from the ability to enjoy the fruits of ones labors. Healthcare is dependent on taxes and makes the public dependent on government and will eliminate competition. If there is no alternative but government healthcare, which is a strong possibility since the government doesn't play fair, that is tyranny in my opinion.
I just have to react, and I do so respectfully. But I do disagree. Healthcare is indeed important. But what I don't get is that you have a natural distrust against the government, which is chosen by the people, and represents the people, but have a naive trust in the market. It is an illusion to think that without regulation quality will rise and prices will drop. History has proven many times that it doesn't work like that. With less control, they will go wild. That is what the crisis has showed. Banks, insurrance companies came up with products that have no right of exsistance, fooling the people, who can not determine what is the right way to go.
And for your first reasoning, that doesn't work. The constitution was written long time ago under other circumstances. Medical care was very, very different than, as it is nowadays. I agree with you that public health care is expensive, but it also works the other way around. Sick people are less productive, and thus contribute less. And since the first line says that 'we the people' find it important to maintain and secure Welfare, one could say that making sure that everyone has access to healthcare, that contributes to the general welfare.
And when it comes to blind trust into capitalism, please, please wake up. It is like deomcracy, the bigger it gets, the worse it works. The whole market mechanism works when the local butcher, gets competition from another he will adjust his prices, will give extra service to keep his customers. At larger scale they will make agreements with eachother, making more money out of it. Trust me, it works like that. In the Netherlands we have had a huge case in which construction companies frauded by making these agreements. And I know most Americans are proud of their country, but I have no reason to believe that Americans are better people than the Dutch ;)
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Health care is important and needs to be available.
Liberty is also a consideration in America. The Constitution, if you still believe in it, makes no reference to public welfare programs like social security and healthcare and therefore in my opinion these things should not be legislated. They will not lead to prosperity in any way. Prosperity comes from competition and from the ability to enjoy the fruits of ones labors. Healthcare is dependent on taxes and makes the public dependent on government and will eliminate competition. If there is no alternative but government healthcare, which is a strong possibility since the government doesn't play fair, that is tyranny in my opinion.
I just have to react, and I do so respectfully. But I do disagree. Healthcare is indeed important. But what I don't get is that you have a natural distrust against the government, which is chosen by the people, and represents the people, but have a naive trust in the market. It is an illusion to think that without regulation quality will rise and prices will drop. History has proven many times that it doesn't work like that. With less control, they will go wild. That is what the crisis has showed. Banks, insurrance companies came up with products that have no right of exsistance, fooling the people, who can not determine what is the right way to go.
And for your first reasoning, that doesn't work. The constitution was written long time ago under other circumstances. Medical care was very, very different than, as it is nowadays. I agree with you that public health care is expensive, but it also works the other way around. Sick people are less productive, and thus contribute less. And since the first line says that 'we the people' find it important to maintain and secure Welfare, one could say that making sure that everyone has access to healthcare, that contributes to the general welfare.
And when it comes to blind trust into capitalism, please, please wake up. It is like deomcracy, the bigger it gets, the worse it works. The whole market mechanism works when the local butcher, gets competition from another he will adjust his prices, will give extra service to keep his customers. At larger scale they will make agreements with eachother, making more money out of it. Trust me, it works like that. In the Netherlands we have had a huge case in which construction companies frauded by making these agreements. And I know most Americans are proud of their country, but I have no reason to believe that Americans are better people than the Dutch ;)
Yes, but TheJord did ask for the American view on healthcare. I know you disagree with my standpoint, but I don't think is supposed to be a debate. If you would like to debate me, I'd gladly start a new thread. Thanks. ;)
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Haha, point well made. I will respect Jordy's intend, and let it be. However, a debate is always nice :)...we'll see what the future holds for us :)
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Gil great points. First, don't worry I am not insinuating that the Dutch are worse people than Americans. I am simply pointing out the differences in our political mentality. You point to my naive trust in the market, and I in turn would point to your naive trust in the government (any government, Dutch, American, or otherwise).
My trust is not in capitalism per se. It is in the individual. Capitalism is indeed the worse economic system, except for all the others. A free market is not perfect, that is correct. Neither is a government. However, as I pointed out before the question is one of trade-offs. I believe that the free market presents FEWER negative consquences than a socialistic european system. That is my personal belief. And I cling to it because the free market is fueled by individuals that drive innovation and progress. Government has never produced the prosperity that the free market has. And it has never done away with inequality of outcomes. A free market has revolutionized life on this planet in the past 400 years or so. Government has been around for thousands of years without the success the free market has had in 400 years. The market has casualties, but governments have produced hundreds of millions of casualties through tyranny (communism, fascism, naziism, imperialism, etc.)
I believe that everyone is entitled to an equality of opportunity. To the liberty and freedom to do what they can to be prosperous. However, they are entitled to this opportunity as a privilege that is accompanied with the consequence of their action. I do not believe in equality of outcomes. Some people will succeed and some will fail, they must be allowed to do so. Will people be dishonest? Yes, in some circumstances. But the same is true in a socialist system, fraud is just as rampant if not more so due to true incentives being compromised.
Congress shall have the power...To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof
Above is quoted Article 1, Section 8, Clause 18 of the US Constitution. The current debate is based in the interpretation of the clause. There are indeed 2 interpretations of it. Yours is the one that gives congress any power through the clause. Or as Brutus, the critic of this clause said in 1787, it "leaves the national legislature at liberty to do everything". I subscribe however to the other view which is that the clause allows the congress freedom to carry out the foregoing enumerated powers only. The clause is not for any use, anything that congress wants, but only for the specific things previously mentioned in that section such as defense and the post office.
I believe in this limited view for 2 reasons: 1st, why bother enumerating, or picking certain things like defense, in the previous part of the clause if in the last part you are going to say congress can do ANYTHING necessary and proper. It doesn't make sense to limit government in the rest of the doccument if you say they can do anything in the end.
2nd reason, 10th amendment in the Bill of Rights, also part of the Constitution, strictly define what can be done by the government, a way of covering bases. It says:
Amendment X
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
The powers delegated to the government are explicitly given in the Constitution and previously posted (defense, etc). EVERYTHING else is given to the states, localities, and kept by the people. To understand US political culture one must understand that the government gets its powers from the people, it can't take more powers from us unless we give them up. The government is limited then by the contract that is the Constitution.
Some say the Constitution is old fashioned and we live in new times unforeseen by the founders of America. I reject this. This contract was made to protect us from government and from ourselves. If we are past it then there must be a new contract, but I contend that the Constitution of the United States is the finest governing document that has ever existed and must be kept intact if liberty is to be kept intact. When government is limited man is free. There is no one, especially governemnt, I trust more than myself to take care of me. Except maybe my wife. :)
Sorry for rambling on!
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One thing we tend to forget about the constitution, is that this document was written with the intent that it outlines what a government CANNOT do to the people, not what it CAN do. I know this forum is to talk about US POV in health care, but I forget that sometimes and it casts a new light on the constitution. I just wanted to share that. (winky face) even though jerba just mentioned it.
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Excellent post, Jerba. =D>
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Yeah, that sums it up pretty well. :gp:
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ah the good old federalist/anti federalist jeffersonian/hamilton loose/strict construction debate.
tis a glorious thing to see people still debating their side of the view as the perfect one...
(it feels good to be back, even if only for one post ;))
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Not perfect, just better than any others tried. If you have a better idea, be sure to let us know. ;)
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My idea? hmmm...we give social healthcare a whirl and see if it works. If it doesn't, we kill it, if it does we don't. Could be kinda hard, but hey, worth a try.
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That's all well and good, but it takes a bureaucracy to run something like that, and history has shown that once a bureaucracy is created it takes a great deal more effort to remove it. In any case, the federal government should not administrate it. Just plain unconstitutional. It should be voted on by the people of each individual state. Let New England try it for a decade or so, and if it works, great. Still not up to the feds to implement it.
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the hardest thing about public healthcare for me, and socialism in general is the simple idea that every person that starves to death/dies because of lack of care is a failure of the Church...a failure of Christians, a failure of....me.
Somber thoughts.
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the hardest thing about public healthcare for me, and socialism in general is the simple idea that every person that starves to death/dies because of lack of care is a failure of the Church...a failure of Christians, a failure of....me.
Somber thoughts.
Well, it only confirms that we need Christ ;). And luckily we are accepted by Him, not for what we do, but because He wants to....so cheer up SoP :)
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My idea? hmmm...we give social healthcare a whirl and see if it works. If it doesn't, we kill it, if it does we don't. Could be kinda hard, but hey, worth a try.
Sounds good, except fot the fact that I don't think I can name an 'experiment' in social policy that has ever been killed after being unsuccessful. The fact is once a government grabs a hold of something it won't let go. Thats why we should be careful about what we experiment with and more careful on who we experiment on! If we got rid of 'unsuccessful' programs there wouldn't be much of a social policy left! Boy, I wish we got rid of unsuccessful programs, a great idea. Too bad it won't happen, ever. Reagan once said that a government program is the closest thing to eternal life on Earth, because it never dies! That is why you can't let them start...
And sorry that I haven't been around! Work has been nuts! I assure you I've been busy and not scared of Gil. ;)
I don't know if I'll be able to go point by point as I was before but I'll try to get to your post Gil. :)
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there was the Banks of the US, but that was more fiscal policy.
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SOP: True. It was also back in small government proponents such as Jackson were still around. Also, before lobbying, 'big business' and special interests got involved in politics.
And unfortunately the government owns too many banks now through TARP. Ugh.
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And sorry that I haven't been around! Work has been nuts! I assure you I've been busy and not scared of Gil. ;)
I don't know if I'll be able to go point by point as I was before but I'll try to get to your post Gil. :)
Never intended to scare you off....but since you mention it your self, are you? :D, hahaha. No just kidding, we'll see.
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There's still small government proponents. That what is confusing about that time period, Jackson was a Democrat, but favored large military and small government. He had the individual rights parts though. When did the Republicans shift towards small government anyway? we really should have more political parties...