11/10/2005

A Fascinating Read

The previous post mentions that interracial marriage and the constitutional amendments that were attempted to outlaw interracial marriage were employed well before the civil rights era. The states had long been outlawing interracial marriage, but there were attempts to outlaw these marriages on a national basis too.

Here is an interesting read that covers the whole topic of marriage in the US and how we have been creating and uncreating laws to control marriage since the founding of our country.

On page 630 there is a particularly interesting quote from the California Supreme Court in 1948 when it finally overturned its anti-miscegenation laws in Perez v. Lippold:

Since the essence of the right to marry is freedom to join in marriage with the person of one's choice, a segregation statute for marriage necessarily impairs the right to marry.

Their reasoning was based on the Equal Protection Clause of the 14th Amendment of the U.S. Constitution. This is the same amendment that the anti-interracial marriage folks hoped to undo with a new amendment outlawing such marriages.

51 Comments:

At 14:22, Blogger lovin' it said...

Have I been blocked?

 
At 14:23, Blogger lovin' it said...

I guess not. Trying again:

You said:

"Whoa! Back up!

Go back and read your OWN words:

Two lesbians are contributing nothing to the civilization of men.

You've got your own words so twisted up trying to make an argument that you don't even know what you've said anymore!"


By men, I didn't mean the human race in general. I meant males specifically.

Remember my initial premise for the reason the state gives special recognition to the marriage relationship.

1. A mother and a father married to each other have the best chance of raising socially integrated children.

2. A woman civilizes a man through marriage.

No other relationship provides these societal benefits. That is why heterosexual marriage deserves special recognition in the eyes of the law.

It's no different then the government giving you a tax credit if you buy a hybrid car. It doesn't mean they are discriminating against drivers of traditional gasoline automobiles. But they are encouraging specific behaviors that offer the most benefit to the larger society.

 
At 22:38, Blogger dorsano said...

A woman civilizes a man through marriage

I have to admit, it's hard to argue with that one - at least while my wife is looking over my shoulder.

Callie!! I think he's crushin on you.

 
At 08:07, Blogger dorsano said...

There are more children in the world than there are loving couples to care for them. If same sex couples in a committed, loving relationship can pick up some of the slack, the do us all a favor.

 
At 14:02, Blogger lovin' it said...

Nope! Happily married. I do think you're cute though. ;-)

 
At 14:03, Blogger lovin' it said...

dorsano - Actually, I agree.

 
At 17:16, Blogger dorsano said...

Nope! Happily married. Nope! Happily married. I do think you're cute though.

Me or Callie? :)

I was hoping you and Callie might consider getting hitched so she could civilize you and then you two could reproduce and create a new species

then we could end this cultural civil war and create a sustainable health care delivery system, a sensible energy policy and address the 1/2 dozen or so other major problems the country faces.

 
At 05:11, Blogger lovin' it said...

Oh, definitely Callie.

 
At 08:19, Blogger lovin' it said...

But I don't have any problems with health care or energy. When I need to take one of my kids to the doctor, I write them a check. And when I need to fill up my Suburban, I fill it up. What problems are you having?

 
At 09:26, Blogger RedStateExile said...

By men, I didn't mean the human race in general. I meant males specifically.

Remember my initial premise for the reason the state gives special recognition to the marriage relationship.

1. A mother and a father married to each other have the best chance of raising socially integrated children.

2. A woman civilizes a man through marriage.

No other relationship provides these societal benefits. That is why heterosexual marriage deserves special recognition in the eyes of the law.

It's no different then the government giving you a tax credit if you buy a hybrid car. It doesn't mean they are discriminating against drivers of traditional gasoline automobiles. But they are encouraging specific behaviors that offer the most benefit to the larger society.


Funny, women serve to the benefit of the male species. Okay, I got it. You're not a homophobe, just a sexist pig. You just want women to bow down and serve YOUR needs whether we have a desire to or not. WHATEVER!! That's not even worth discussing anymore.

You continue to contradict yourself anyway. You say we're supposed to serve men, yet you bring in children (that's not MEN per se). Except for the fact that you don't want to be bothered with raising them, you want the woman to do the work.

Then you say women civilize you. I call BULLSHIT on that!!! If that was the case, then why do over 50% of your precious and God-ordained marriages end in divorce? When men start controlling their own bodies, that will be a civilized world! Don't dare lay the blame on women!

 
At 09:33, Blogger RedStateExile said...

Dorsano-

Don't encourage him! I don't think he'd appreciate me taking advantage of him for his money, health care, and non-discriminatory social status while I had my lesbian lover on the side.

Then again, don't think it's never crossed the mind of my partner and I to play the system. We used to joke with a gay guy we know that we could do that (marriages of convenience), but we're too much of upstanding citizens to do that.

We could do the same thing with the welfare system and such. I don't necessarily have to take care of her. She could have kids and let the state take care of them. It's not like they acknowledge me anyway. We'd probably be better off financially than trying to do things the right way.

But no, we're just good decent people trying to take care of each other through the traditional means without being a burden on society and you have these freaks out there trying to screw with you.

SIGH...

 
At 11:36, Blogger lovin' it said...

Callie -

1. Nobody says you have to serve any man. I was talking about benefits to society, not me personally. It's got nothing to do with you being a woman. Limiting marriage to heterosexual couples blocks more gay males then lesbians.

2. How dare you make judgements about what kind of father I am? You know absolutely nothing about it. I know I can't prove it to you, but I am a very involved father. My three daughters get hours of my time every day.

3. I never blamed women for divorce. I mostly blame men for that sin. Women are not without fault, but the majority of the blame does fall on the side of my sex.

4. My health care consists of writing checks for the services and medication I or my family needs. My "insurance" only covers catastrophic care over $3,000, and I pay for that insurance myself.

p.s. Glad to see you're taking advantage of the spam blocking options.

 
At 12:08, Blogger RedStateExile said...

I use "you" in the generic sense. It's kind of like not really meaning the human race in general but males specifically. I don't judge anymore than I AM judged.

Since when do I have to play nice when someone keeps telling me I don't serve any benefit to society to men to society to men to society to men...ad nauseum. And they don't know one from the other.

 
At 13:04, Blogger lovin' it said...

I never said you didn't serve any benefit to society. I don't know you and would never presume to make that judgment without in depth knowledge about you. I said your relationship does not serve the same kind of benefit as heterosexual marriage. That is not the same thing as saying you serve no benefit.

 
At 13:26, Blogger RedStateExile said...

And you can put lipstick on a pig, but it's still a pig.

An insult to my relationship IS an insult to ME. I take it VERY personally.

Twist it any way you want, but you still haven't gotten it through your thick head that you have been insulting me and my relationship for MANY posts now.

 
At 17:24, Blogger dorsano said...

What problems are you having?

Ontario now sells as many vehicles in North America as all the U.S. manufacturers combined. It costs Canadian manufacturers $1,100 on average less to produce an automobile than it does us. Over $8,000 of that is due to health care costs and it's going up at an unsustainable rate.

The high deductible libertarian health care model that your're enrolled in doesn't scale - it didn't in 1930 and won't now. It works for you today because the revenues from Medicare, medicaid, managed care programs and self-insurance pools keep your costs affordable.

You're sort of like the hippies in the 60's who lived off mom and dad's money and thought they had built utopia.

The problem that I have is two fold

(1) I want my employees to go to the doctor when they get sick and come back to work healthy as soon as possible - for that to happen, they need affordable health care.

(2) When anyone in the country can't afford health care - that matters to me, even if it's not me or my kids.

 
At 17:24, Blogger dorsano said...

As to energy, oil is a finite resource - costs have only one way to go. It's also a strategic resource that affects every business in the country.

But perhaps you're not interested in the world you leave to your children.

 
At 17:28, Blogger dorsano said...

Don't encourage him!

Sorry Callie :)

 
At 18:18, Blogger dorsano said...

Callie, we're in trouble now. Jeb Bush is Channeling Chang

“Chang is a mystical warrior. Chang is somebody who believes in conservative principles, believes in entrepreneurial capitalism, believes in moral values that underpin a free society.

“I rely on Chang with great regularity in my public life. He has been by my side and sometimes I let him down. But Chang, this mystical warrior, has never let me down.”

 
At 06:26, Blogger RedStateExile said...

No problem, Dorsano! You know I'm picking. I'm glad you can talk all this health care crap. All I know is that I'm glad my partner has a FT job right now. Domestic partner benefits were costing me an extra $200 a month (and NO, the married people in my office DON'T pay that extra). If she loses her job or we decide to have a kid, it's nice to have (I'm glad it's there), but DAMN it puts us in a financial hole!

 
At 06:31, Blogger RedStateExile said...

You know, Dorsano, it was scary enough when they falsely claimed to follow JESUS!!! Now, they admit (openly now mind you) to not even being Christians.

I don't know which I'm more scared of. Some "end of the world" Jesus freak or spirit channeling mystical warrior wannabe?

AUUUGGGHHH!!! And we thought his brother was fucked in the head. George is just a drunk, dumb, cokehead!

 
At 10:57, Blogger lovin' it said...

I pay for my own health care and somehow that causes a burden for someone else? Whatever. If everyone did what I did, there wouldn't be a health care problem.

Is oil a finite resource? Undoubtedly. But it is still cheaper then any other alternative out there. Cheaper then wind, solar, nuclear, you name it. Oil will have to go up to $90 a barrel before non-fossil fuel sources of power will make economic sense. Once that happens, we'll make the switch. But why should we start paying such high prices before we have to?

Callie - I'm sorry if you feel insulted. That is not my intention. If you want me to stop expressing my opinions on your blog, I'll never come back. All you have to do is say the word.

 
At 12:39, Blogger RedStateExile said...

You're not sorry. If you really were, you would have just said it and left it at that. Instead, you've got a backhanded way of saying, "Hey, be unAmerican and tell me to stop expressing my opinion."

Look, I grew up in the South and I know slick backtalk coming from a mile away. I wanted SOOO bad to tell you to go away, but knew that being Mr. Rightwing you would wonder what kind of liberal am I to not let you speak your mind. What about free speech?

As I recall, I came back at you and you didn't like it one bit. You got on a little "how dare you..." tirade. Don't come onto my blog and openly insult me and my relationship and NOT expect me to come back at you.

If you are truly sorry, you will begin to show some respect. I'll let you decide what kind of man you will be.

 
At 16:45, Blogger dorsano said...

I pay for my own health care and somehow that causes a burden for someone else? Whatever. If everyone did what I did, there wouldn't be a health care problem.

If everyone did what you did, hospitals and clinics would go broke.

First off - we all pay for the health care delivery system whether or not we have coverage - it's passed along in the cost of most things we buy.

I don't know about your situation but you buying a high deductible policy is most likely a smart personal choice given your current alternatives -

but it's not a model that we can all follow without destroying the system.

It costs on average $11,000 per family per year to keep the health care delivery system running - I'm not talking about the cost of a managed care policy -

I'm talking about the expense side of the balance sheet for the entire system.

If everyone did what you did, hospitals would go broke or the cost of your expenses would rise to $11,000/per year (baring no remediation of the ineffeciencies in the system).

The GM's of the world and the publically funded programs are keeping the lights on in your hospital, the clinics staffed, and they are funding the investment in MRI and CAT and other equipment.

 
At 17:21, Blogger dorsano said...

I pay for my own health care and somehow that causes a burden for someone else?

The point of my post was to demonstrate that what we now is not sustainable - including your policy.

If everyone did what you did, and we used one "insurance company" and that company was the U.S. Government - we'd have Medicare for everyone,

and you would have a $0 deductible. $1 one coverage (meaning no co-pay), cheaper drugs, long term care,

and premiums likely no higher than what you have now.

And U.S. business would have a more competitive posture in the global market place.

 
At 17:29, Blogger dorsano said...

But why should we start paying such high prices before we have to?

I didn't say we should

though your statements are not entirely true. Both TX and MN (interesting combination) are on track to produce 20% of their energy by 2010 - they wouldn't be doing that if it costed them more.

But a sensible energy policy has both a supply side and a demand side component.

The demand for energy will never be reduced (barring a catastrophe of some sort)

but the rate of growth can be slowed with comuter mass transit and conservations measures.

And there should be investements in R&D on strategic, long term sources like fusion.

I'm also not sure that oil or gas is cheaper than nuclear. I don't have a problem with nuclear power plants myself.

 
At 06:13, Blogger lovin' it said...

Callie - I'm not sorry for expressing my opinion. If the only way I can respect you is to agree with you, then you will probably never feel that I respect you.

I've always believed that it was possible to respect a person even while disagreeing. Is there any way that you see that I could disagree with your position on gay marriage without you thinking I am hateful? Or is the very fact that I think only heterosexual marriage should be recognized by the state hate?

I got to be honest, it really sounds to me like that is your position.

Dorsano - What you're saying doesn't make any sense. Every time I go to the doctor, I pay for it. When I pick up meds at the pharmacy, I pay. When my children were born, I paid my hospital bills. No medical institution got one cent less from me because of the type of insurance I carry.

The only people who lost was the insurance company. They don't get the chance to make any money off of me. My catastrophic care coverage is through a non-profit sharing program. But no doctor or pharmicist was short-changed because of my choices.

Your government care system sounds nice, but someone will still have to pay for it. If health care was free, taxes would have to be raised to cover it. And you would pay more in taxes then you do in health care costs now. People would have no incentive to keep costs down by eliminating non-necessary care and the costs would skyrocket. In the end, your plan would lead to government rationing of health care. That I will oppose as long as I am alive.

 
At 08:33, Blogger RedStateExile said...

Gawd, you LOVE to find things that aren't there!!! Then again, that's the MO for the way you guys think anyway.

I didn't say you personally hated me. I said you insulted me. However, if you infer that insulting and disrespecting someone is consistent with hating them, then you've managed to put yourself on the same level as haters without me doing a thing.

Personally, I don't think many of the people who don't want me to be an equal citizen with them REALLY hate me. I just think they are ignorant and uninformed. They've been blindly led by others and never thought for themselves. I bet many have never met a gay person and REALLY had an honest conversation with them.

For those that aren't outright haters of us, it's either ignorance or if they are educated about it (which I think you are) it's simply disrespect and devaluing other human beings. It's not the same as, but it's not far from hating another person. It's just enough to make you feel like they are not worthy of your status in society. It's one step from making that person inhuman and once they are inhuman they can be easily hated.

That's more of an explanation than you probably deserved, but that's my HONEST POSITION.

Now you know.

 
At 10:59, Blogger lovin' it said...

So, I was right that disagreeing with you on gay marriage automatically means I disrespect you as a person. That seems really clear from your explanation.

Well, I'm sorry you feel that way, but it simply isn't true. The Bible I read says that we all are made in the image of God. Because of that, each person has great value. That means that even if I strongly disagree with the choices you make in life, I still have an obligation to treat you with respect and kindness.

Respect does NOT mean I have to agree with you or approve of the choices you make. It does mean I should refrain from insulting or demeaning you. But I will never pretend to agree just to get along.

So, by all means attempt to persuade me by argument, or tell me to get lost if you don't want to hear from my side. But don't tell me that by disagreeing with your position I'm disrespecting you as a person. That's not debate. That's a character attack

 
At 11:36, Blogger RedStateExile said...

Of course, everything is a character attack against poor, pitiful you!!!

I didn't tell you your relationship didn't provide a benefit to society then try to act like that wasn't an insult and that you REALLY respect me and think I have value because I was created in God's image too.

Cut the crap, man!! You're full of it up to your eyeballs!

Yeah, I KNOW we're all created in God's image. It's called being freakin' equal and that's the part you guys just don't get!

 
At 11:55, Blogger lovin' it said...

"I didn't tell you your relationship didn't provide a benefit to society then try to act like that wasn't an insult and that you REALLY respect me and think I have value because I was created in God's image too."

In other words, by the act of holding my beliefs on the subject, I am disrespecting you, regardless of how I express them.

 
At 12:07, Blogger RedStateExile said...

Hold your beliefs on the subject all you want. It's just sad that you can't see you openly insulted me. And it's worse that you don't care.

 
At 12:14, Blogger lovin' it said...

Let me ask again, is there any way that I could express my disagreement with gay marriage that you would not have taken as an insult?

 
At 16:07, Blogger dorsano said...

Every time I go to the doctor, I pay for it.

Everytime you take a cab you pay for it. If you take a cab a couple of times, and you're the only customer - the cabbie can't payoff his cab and he or she goes out business. Is that plain enough for you.

Managed care plans charge a premium - $11,000 per year per family on average. That money isn't given back to the family if they don't use $11,000 worth of service.

The GM's of the world are riding in the same cab that you are - they've built your hospital.

People would have no incentive to keep costs down by eliminating non-necessary care and the costs would skyrocket.

No one takes their kids to dentist to have holes drilled in perfectly good teeth. No one has heart replacement surgergy unless they need a new heart. No one has chemothearpy unless the need it.

In fact, too many people in this country don't go to the doctor as often as they should - not for strep, not for broncitis - not even for kidney stones.

The notion that over consumption is what's driving health care costs up is simply not borne out by any studies. That's why managed care doesn't work.

Medicare isn't government care any more than your policy is insurance care. Actually, the managed care plans are more insurance care than health care as HMO doctors have to spend considerable time justifying their diagnostic procedures to the acounting department.

It seems you're not interested in the topic only in repeating rhetoric you've heard someone else say.

I won't waste any more of your time.

 
At 19:43, Blogger RedStateExile said...

I won't waste any more of your time.

Dorsano-

You've given an excellent explanation. I have a better understanding of this matter. Thank you.

I don't think anyone's time is being wasted but our own with pretzeling with this guy over rightwing rhetoric and word games.

 
At 06:43, Blogger lovin' it said...

Dorsano - Your logic is a bit skewed here. If everybody consumed medical care at the rate I do, there would be less need for doctors and hospitals. Fewer hospitals and doctors would mean more money for the ones still in the business, and they would do just fine.

If everyone paid for their own care, there would be just exactly enough doctors and hospitals to meet demand, and there would be no shortages. Supply and demand works in every other area of commerce in exactly the same way.

Your taxi cab analogy actually supports my point. We don't have taxi insurance. Everyone pays for the service they use at the time they use it. Some use them every day, while others choose to do so only a few times a year. And, lo and behold, there are just about exactly the right number of cab drivers in any given city to meet demand. No need for government intervention. Just the free market at work.

But "free" medical care will drive up consumption. It's almost inevitable. Take me for an example. You think I've only been to the doctor once in the last five years for myself because I never get sick? Nope. It's because I know that going means writing a $65 dollar check for the visit. So, instead of going to the doctor at the first sign of ailment, I wait it out a bit and see if I get better on my own. If it only cost me $10 to go, you can bet your last dollar I'd have gone more often.

 
At 06:45, Blogger lovin' it said...

I meant to say "free medical care will drive up consumption just like free taxi service would drive up taxi use." Sorry for the confusion.

 
At 19:25, Blogger dorsano said...

No one's advocating free medical care - you are confused or being purposely disagreable.

If everybody consumed medical care at the rate I do, there would be less need for doctors and hospitals.

You're catching on - slowly but surely - drop the "need" and you just repeated what I said in response to your first post.

 
At 06:23, Blogger lovin' it said...

dorsano - I know very well there would be less doctors and hospitals. That is because there would be less need for them. How is that a problem?

My whole point is that in a free market approach to medical care, there would be exactly enough hospitals and doctors to meet demand. You were trying to say that my way of paying for health care was being subsidized. It is not.


You said:
"If everyone did what you did, and we used one "insurance company" and that company was the U.S. Government - we'd have Medicare for everyone,

and you would have a $0 deductible. $1 one coverage (meaning no co-pay), cheaper drugs, long term care,

and premiums likely no higher than what you have now."

Going to the doctor and not paying for it and having no deductable on your health care policy sounds an awful lot like free medical care to me. This situation you described is exactly what I oppose because it doesn't create any incentive to self-ration. No self-rationing means the government would have to impose rationing. And that I will not willingly accept.

 
At 17:31, Blogger dorsano said...

I know very well there would be less doctors and hospitals. That is because there would be less need for them.

Less need for hospitals - How so? Are people going to start getting sick less often?

My whole point is that in a free market approach to medical care, there would be exactly enough hospitals and doctors to meet demand.

We have "free market" health care now (except for veterans) and I'm not suggesting that we change that.

Going to the doctor and not paying for it and having no deductable on your health care policy sounds an awful lot like free medical care to me.

Medicare is funded through payroll taxes with employers matching contributions. It's not free. Medicare is an insurance company. It negotiates prices with hospitals and doctors just like Walmart negotiates prices with its suppliers.

This situation you described is exactly what I oppose because it doesn't create any incentive to self-ration.

I don't know about you, but my idea of having fun is not spending time in the hospital. I don't need any incentive to "self-ration" and neither does anyone else.

All across America dads and moms are packing their kids in the car for a fun afternoon at the hospital.

"Hey kids, let's go to hospital today!!! Doesn't that sound like fun?"

Yea mommy!!! Can I push the buttons on the elevator myself this time?"

"Daddy, can you read Time magazine again to me? Please?"

As I indicated before, "overcomsuption" is a myth. What in fact happens, is that even people that have full coverage, don't go to the Doctor enough - whether is for a prostate exam, a colonoscopy or to be tested for strep.

 
At 17:37, Blogger dorsano said...

Here's a simple math problem.

Let's say an MRI machine costs $10,000,000
Let's say 10,000 people use it.
What's the cost of that machine per patient?

Answer = $1000

Let's say 50,000 people use it.
What's the cost of that machine per patient?

Answer = $200

If the patients have to pay for that machine (which they do - one way or the other)

Which pool of patients gets the better deal?

 
At 06:09, Blogger lovin' it said...

First of all, we do not have a truly free market system and haven't since the Nixon administration. Most people do not recognize the true cost of their health care for two reasons. Most people don't directly pay their premiums on their insurance. Employer paid health care was a tactic used to get around Nixon's ill-advised wage controls, but once they got in, we've lived with them ever since. People don't recognize how the true cost because when their premiums go up their employer picks up part of the tab.

But just as important is the type of coverage people seem to think they need. When I go to the doctor, it costs me $65. When someone with "full coverage" goes to the doctor, their out of pocket cost might be only $10. Seems cheaper, right? But someone has to pay for the cost of the doctor filing the insurance papers. Someone has to pay the processor for the insurance company. And the insurance company has to make a profit. By the time it's all said and done, that $65 office visit will cost somewhere around $100. And we pay for it, either in reduced salary or lost opportunity. We just don't see it.

And many people do over-consume medical services. Parents taking their kids to the doctor for colds and insisting on useless antibiotics is a well known problem, to use just one small example. I'm not suggesting that people have open heart surgery for the fun of it, but we are as a society very quick to look for a medical solution to problems that the body could cure itself with a little time.

Most importantly, you still seem to be missing my main point. Insurance companies don't pay for medical treatment their customers don't use just to keep hospitals and doctors afloat. They only pay for services rendered. No medical establishment would make extra money off of me if I joined a traditional insurance program.

The only entity that would make money off of me that they currently aren't are insurance companies. I would pay them to pay for my health care, and then pay them a premium on top of that for their overhead, staffing, and profit margin. Not one cent of that additional money would go to any doctor or hospital.

Which is why catastrophic insurance only is the better deal. Eliminate the middle man for ordinary, non-catastrophic care and pay for it directly. That would do more then anything else to reduce the total cost of health care in this country.

p.s. I fail to see the relevance of your math problem. Neither you nor I know how much an MRI machine actually costs, how many people one machine can service in a year, or how many people actually need MRI's per year. But this I know: If everyone who needs an MRI pays for one, the market will provide just enough machines to meet that demand. No need to make people who don't need one pay anyway.

 
At 18:25, Blogger dorsano said...

but we are as a society very quick to look for a medical solution to problems that the body could cure itself with a little time.

That's not true to any significant extent. Studies have shown the exact opposite - people delay going to the doctor until the situation becomes more costly to control.

Insurance companies don't pay for medical treatment their customers don't use just to keep hospitals and doctors afloat.

It sounds like you're unfamilar with Health Maintenance Organizations (HMO's).

We have three models of health care in the country - Medicare, Managed Care (HMO's) and high deductible insurance coverage. This is not counting the (voluntary or involuntary) uninsured.

But someone has to pay for the cost of the doctor filing the insurance papers. Someone has to pay the processor for the insurance company. And the insurance company has to make a profit. By the time it's all said and done, that $65 office visit will cost somewhere around $100. And we pay for it, either in reduced salary or lost opportunity.

or we pay for it in the cost of the goods we purchase -

that's exactly my point. We agree on that.

(the reduced salary is probably not true as the savings are likely to be either passed on the consumer or to shareholders)

The overhead you describe for managed care programs is pretty much right on - I've seen studies ranging from 20% to 40%. And you haven't itemized all the overhead.

The overhead for Medicare is 1% - 3%.

What you don't seem unwilling to factor into your argument is the law of large numbers and risk mitigation.

Here are 30,000 people in TN, GA, MI and other states who won't be buying healthcare and keeping our taxi cab running.

I'm still unclear on what kind of insurance if any you have. If you have to have a $40,000 operation at age 50 to have your prostate removed, are you going to pay for that out of pocket?

If you have insurance now, what do you think will happen to your insurance premiums after you've been diagnosed with prostrate cancer? Will they go up or down?

 
At 21:15, Blogger dorsano said...

First of all, we do not have a truly free market system and haven't since the Nixon administration.

That's when managed care came into existence. Paul Ellwood convinced Nixon that "overuse" or "overconsumption" was the cause of rising health care costs in the 1960's and 1970's. Ellwood's lobbying resulted in the 1973 HMO act.

The inefficient model you describe is the managed care model.

 
At 07:22, Blogger lovin' it said...

My health insurance coverage kicks in for any medical bills that exceed a total of $3,000 per year for my family. I pay everything under that out of pocket. Since my wife and I got married, we've turned in a grand total of 4 claims. One for the birth of each of our 3 children, and one for when my wife had her gall bladder removed.

The doctor we use as a primary care physician normally charges $90 for a visit. However, since we pay directly instead of requiring them to file for insurance payments, we only pay $65 for a visit. That's a 28% savings right off the top. Also, the local hospital gives us a 20% discount for all bills paid in cash for the same reason. That's some pretty significant savings. Add in the profit and overhead for an insurance company to handle those claims, and I've saved some serious jack just by having the discipline to save some money for medical needs.

Your medicare example sounds pretty good, except for one problem. Government funded medical care SUCKS. My father-in-law gets his medical treatment through the VA system, and he hates it. Long waiting lists, the nearest hospital where he can be treated is 90 minutes away, and strict limitations on what type of treatment qualifies and what doesn't.

Medicare coverage is just as bad. The government tells you what treatments will be covered and what won't, where you can go, and how much they will pay. I want no part of any of it. I'll make my own decisions and pay my own bills, thank you very much.

p.s. Since you asked, my premiums are different every quarter. We just collect enough money each quarter to cover the claims that came in. Sometimes it's as high as $1900 per quarter for my family. Other times it's as low as $1200. We just pay whatever is due.

 
At 21:18, Blogger dorsano said...

My father-in-law gets his medical treatment through the VA system, and he hates it

The VA system is different than Medicare. That's another model actually - probably one that you would call "government care" though I don't know much about that one. But you're not the first person who's told me that.

 
At 21:26, Blogger dorsano said...

Medicare coverage is just as bad. The government tells you what treatments will be covered and what won't, where you can go, and how much they will pay.

That's not entirely true.

Medicare coverage allows you to go anywhere you want - the do negotiate prices with providers though just like Walmart negotiates with its providers. I know of very few clinics and hospitals that refuse to negotiate with Medicare.

The government tells you what treatments will be covered and what won't,

That's true - not everything's covered - but most things are - but I agree, it would be nice if we didn't have to supplement Medicare with medigap insurance.

Since you asked, my premiums are different every quarter

It sounds to me like you have a self insurance pool. If the pool is large enough, that is the most cost effective form of health insurance.

Medicare is the largest self insurance pool in existence.

Even if politicians do nothing, self insurance pools like yours will eventually merge with others to create larger pools and more predictable expenses (the law of large numbers) - that's how the free market works

When the regional pools get large enough - they'll have the same efficiencies as Medicare.

 
At 06:02, Blogger lovin' it said...

The same efficiencies as medicare? Medicare is projected to run a deficit in excess of $6 trillion dollars over the next 75 years. You call that efficient? I call that bankrupt.

 
At 09:22, Blogger lovin' it said...

The problem with Medicare is that the deductable is too low. Insurance should only cover catastrophic care. Using insurance to pay for things like doctor visits and the like is unsustainable.

If homeowner's insurance was structured like traditional health insurance, it would cover the cost of caulking your windows and cleaning your furnace, and your premiums would be $5,000 a year.

Normal things like checkups and routine care should be paid out of pocket, with insurance only to cover major expenses like surgury and childbirth. That is the solution to the health care funding crisis.

 
At 17:44, Blogger dorsano said...

You call that efficient

Efficiency refers to the cost of running the program - 1% - 3% in the case of Medicare. Contrast that to the cost of the managed care program that you described above which is anywhere from 20% to 35%.

run a deficit in excess of $6 trillion dollars over the next 75 years.

Medicare is a fee for service program - just like your self insurance pool.

In the case of Medicare Part A (the HI trust fund) it is funded by payroll taxes on earnings (1.45 percent which is matched by employers).

You fund your mini version of a medicare program with out of pocket expenses and your quarterly premiums which vary depending on the costs incurred by the pool.

As of 2005, the HI trust fund has a projected 75-year actuarial deficit equal to 3.09 percent of payroll compared with last year's estimate of 3.12 percent.

That calculation factors in the rising cost of health care -

If Medicare has to pay higher fees to hospitals for service, so will you. Your out of pocket expenses and premiums will increase just like Medicare. They are both fee for service programs.

Your personal version of Medicare is running the same actuarial deficit as the national program (higher actually because your risk pool's smaller)

You just haven't projected your future costs.

 
At 17:51, Blogger dorsano said...

You still seem to be caught up with "overconsumption" - that is also called "moral-hazard" in insurance jargon.

You can read about the moral-hazard myth here. and it is a myth when applied to health care no matter how much you might want to believe otherwise.

We don't consume health care in the same way that we consume other consumer goods. Rich people have essentially unlimited acess to health care.

They don't spend their time in the doctor's office - they spend it on the golf course or some place else.

 

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