JayB

You're confusing the way that people live vs how well effective their doctors and hospitals are. Life expectancy variation in developed countries has much more to do with lifestyle choices, social forces, and accidents than it does clinical efficacy. The connection between something like insurance coverage and longevity is loose enough to lead to outcomes like the fact that hispanics outlive whites by ~ 2.5 years despite being three times a likely to lack coverage. The Danes live like 9 months longer than Bulgarians despite spending something like 20X more on health-care than Bulgarians in real terms. The proper conclusion to draw from these figures isn't that the Bulgarian health system is 20X as clinically effective as the Danish system, but that once you bring sanitation and vaccination up to a certain standard the aggregate effects of health spending on longevity are quite marginal at the population level. Variations in infant mortality have more to with registration artifacts that get introduced when different countries use different standards to determine what constitutes a live birth. A super-premie that dies in the US counts as an infant death, but it's a mulligan for most of the rest of the world. Ditto for quite a few babies that die anywhere between 24-72 hours after birth. Even direct comparisons of clinical efficacy are difficult because the standards that determine who get into a study are different, and can easily be biased by a population that's younger and healthier going into the study. Having said that, produce some studies of clinical efficacy and we can have fun parsing those stats, which are the only meaningful ones to use when determining how effective a medical system in a developed country is. I find your assertions about how government rationing works in practice amusing, since in every system where the government is the sole payor the government can and does draw the line between who gets treated and who doesn't.

You can have an interesting discussion about which method of rationing is more brutal than the other, but the central issue with granting the state monopoly over anything is the extent to which it extends the state's power over individual citizens. It is literally impossible to argue that giving the state the sole discretion over how medical care is delivered and funded dramatically increases the power that the state exercises over the citizenry. The state that can influence, let alone absolutely determine, whether or not I get a heart valve repaired or whether or not my premature child is worth saving has far more direct and meaningful power over me than a state that can, say, intercept e-mails that terrorist suspects overseas send to my inbox. Yet the same folks that absolutely reject the arguments for granting the government the power to intercept e-mails from terrorist suspects on the basis that they infringe on inviolable individual liberties, that the government can never be trusted with such powers, etc - are literally begging for the same government to be granted sole discretion over their medical care. Don't get it.

Pauperization is NOT efficient in government or elsewhere. Got it? Yes - show me a list of all of the folks in government that would be pauperized by converting their pension to a 401(K) and increasing their deductibles, co-pay's and premiums. Since they're so much more highly educated and trained than their private sector counterparts, they'll surely have no problem finding better paying work in the private sector if their total compensation drops below what they deem acceptable and/or "living."

Yes - the quality and selection of wine, beer, and spirits in California is a pale shadow of what we've got here in Washington. of course, the only difference between Washington and California is the wine and liquor laws Supply follows demand.

The government that can deny prostate surgery on the basis of a subjective value judgment has all the tools it needs to deny abortions on the same basis. How do you square a desire to thwart government efforts to control speech with a desire to grant the same government a monopoly over all medical spending and clinical decision making? "Stay away from my opinions, but I'll gladly let you determine whether I qualify for the mitral valve replacement or not."

Cost efficiency in government is bad. Got it!

Not very likely if your pals, the Koch brothers who want to eliminate 90% of laws and regulations, have their way. how is subsidizing their fuel or letting them destroy the environment in the process going to save the public money? the environment that hasn't seen an increase in effective revenue for 30+ years? the ones that you try to incite to hatred against public workers for having benefits at all? All the more reason to make government expenditures more efficiency by delivering the same level of services and infrastructure development at a lower cost!

wrong, wrong, wrong.. Are we in a nested sarcasm loop here or are you really not getting the whole facetious thing?

You see where all that's gotten us, so uh...yay? Yay!

Yes - the quality and selection of wine, beer, and spirits in California is a pale shadow of what we've got here in Washington.

Actually - they'd be subject to all of the same health, safety, and engineering standards. The only difference would be that it would cost the public less money to build the same bridge. There are god knows how many government contracts fulfilled by non-union companies that submit low bids all of the time that manage to do so without shipping in freighterloads of impoverished thirld-worlders. Ditto for the vast majority of all production activity that occurs in the US in non-union environments.

BTW - wasn't Daniel shore a "Senior News Analyst?" Don't think it was a matter of someone blurring hard-lines between different job categories at NPR as much as Juan giving the people that hired him a reason to want him gone by appearing on a network that I suspect all of them loathe.

Employers can hire and fire whoever they want, IMO. As long as the state isn't fining, incarcerating, or dispossessing someone for their voicing their opinions it's not a free speech issue IMO. I think they didn't like having someone on board who also appeared on Fox, and they were looking for a pretext to get rid of the guy for a while, and they spotted an opening here. They have that right.

Have to say I'm happily astounded by the tone of the comments on this one over at The Stranger...

That's a neat idea, but quite unnecessary since there's literally millions of unemployed construction workers around the country that would travel here of their own accord and make their own arrangements for housing if they were offered the opportunity to work for whoever offered the low-bid. Much better to employee the fewest people, at the greatest expense, building or repairing the least infrastructure. A + B + C. That, and a few billion dollars gets you a half-built tunnel.

Yes.

Unlike the author of the above post. I don't think the purposes of laws regulating the sale and distribution of alcohol should include guaranteeing any subset of brewers or distillers a market for their goods. Methinks you mistook the authors purposes for my own.

No one doubts that the Koch brothers are using their fortune to engage in political advocacy through a variety of outfits. Advocacy - yes. Conspiracy - no. Unless it's a reverse conspiracy engineered to have legions of leftist dupes overcome by the political equivalent of the vapors discredit the notion by claiming to have unveiled some kind of nefarious sub-rosa campaign so deftly engineered and camouflaged that they were unable to unmask it...with a series of four mouse clicks.

That's one alternative. Another would be awarding the contract to the company that can do the best job for the lowest price with workers that are legally qualified to work in the US. That might be a contractor that uses union workers, it might not. It doesn't really matter if your objective is to build or maintain public infrastructure as efficiently as possible. It evidently matters quite a bit if your main objective is to distribute pork to a favored constituency, actually building or repairing stuff is a distant second. That's why the folks in NJ are getting a half-built tunnel. No biggie - if you're a Keynesian it doesn't really matter whether the tunnel gets built or not.

How do you know that Koch Industries, Inc haven't implanted you with a thought control device that has compelled you to destroy the credibility of conspiracy theories involving Koch Industries, Inc by personally vouching for them...? I've heard that you can detect Koch Industries, Inc thought control devices (planted directly behind the retina by completely noiseless nano-scale insect-drones) by taking a household laser-pointer, shining it directly into your eye for 4.328 minutes, and then turning off the lights and asking a friend, partner, etc whether or not they can detect a faint glow at the back of your eye. If the answer is yes, the only way to deactivate the device is to vote Republican for the next 6 election cycles. If no spouse, partner, or friend is available - simply stare into a web-enabled camera after illuminating the Koch Industries, Inc sub-retinal mind-control implant with the household laser and post the resulting footage on Youtube with "Squotodlor the Toltec Goat King Will See You Now, Billy" in for the title and one or more members of the Koch Industries Inc Sub Retinal Mind Control Implant Detection Squad Members will review the footage and report the results on the "comments" section in 1.4 hours or less. The code word is "Whammo!" Finally - remember that those who deny the Existence of Koch Industries Inc sub-retinal mind control implants are already under the control of such implants and must not be trusted. That is all.

http://slog.thestranger.com/slog/archives/2010/10/21/vote-no-on-both-liquor-initiatives "Most of the debate around I-1100 and I-1105—the hard liquor initiatives—is all about the big boys: big box stores and big grocery stores vs. distributors vs. labor unions and “Big Beer.” Well, I’m not a boy, and I’m not so big. I’m certainly not Big Beer. As the owner of Schooner Exact Brewing and the president of the Washington Brewers Guild, I’m considered a small craft brewer—10 barrels at a time from a brewery two miles south of the stadiums. We’re a growing operation, adding an employee a month. But Initiative I-1100 in particular could kill my business. So my biggest concern about I-1100 and I-1105 isn’t about cuts to public services or the massive increase in hard liquor outlets. Granted, those are important issues, but for me, defeating these initiatives is about survival, of my business and hundreds more Washington craft breweries and wineries across the state. The reason for my opposition isn’t getting nearly enough attention amid all the back and forth on TV, in direct mail and on the internet. What makes I-1100—which was written by right-wing blogger Stefan Sharkansky—such a problem is the way it summarily eviscerates 39 state laws that give us future big boys a level playing field against the current big boys. A few examples of what that means: If 1100 passes, big producers would undercut us smaller producers by offering large volume discounts to restaurants and retailers. Big companies could buy space on grocery store shelves, pushing aside smaller Washington-based beer and wine labels. Big companies could give away product and essentially bribe bar owners with promotional enticements. The idea that I-1100 “modernizes” state liquor laws is a crock. This is really a power grab by some very large corporations who want to use their considerable weight to monopolize liquor sales. And this isn’t about “competition.” I’m all for competition. The truth is 1100 kills competition. I-1105 is marginally less bad compared to I-1100 for small brewers and the smaller wineries, but we are certainly concerned about I-1105’s provision that repeals all liquor taxes in Washington State. The Stranger dismisses the impressively broad coalition of business, labor, faith, law enforcement and local government urging a No/No as: “…oppos(ing) these initiatives because they want to protect the profits of beer megacorporations.” Oh really? F that. I wake up every day with the burning desire to take profits away from those megacorps—most of which, BTW, aren’t so mega, and employ thousands of Washingtonians. I would never have joined forces with them to fight these stupid initiatives if I didn’t have a damn good reason. The central point The Stranger seems to miss is this: You don’t get good public policy by passing bad public policy. Initiatives I-1100 and I-1105 are bad public policy. That’s why the vast majority of craft brewers—including me—will be voting No and No on I-1100 and I-1105."

-Suspend Davis-Bacon and the cost of every federally funded or assisted public-infrastructure project will drop significantly. -States that are facing staggering pension shortfalls can't afford to tack massive cost overruns onto the public tab as well. -Big public infrastructure projects that are susceptible to cost-overruns, or unreformed public sector compensation. You may choose one. -Infrastructure projects that will generate enough traffic to finance toll revenue that exceeds the cost of the infrastructure will always be viable. Commercially. Probably not politically - at least in Washington.

Benefits that demand access to resources have always been constrained by the size of group resources as you certainly ought to know since your main opposition to the right to a living wage is your bogus claim that we can't afford them. An abortion has little cost and no impact on anybody but the woman (and minimally on the sperm donor). Expensive medical procedures paid by the collectivity drain resources that are needed for other essential tasks and the return on such procedure unfortunately has to be part of the equation until we find a way to reduce its cost or find a way around it. Ergo, you are attempting to compare apples and oranges. The "collectivity" is asserting control over an individual's body in each case. The only difference is the pretext put forth for doing so.

Abortion is certainly a right. Freaking jackboot wanting to control women's bodies. So much for "liberty", hypocritical liar. Haha. "Keep the government out of my uterus! Unless you're a comparative effectiveness research bureaucrat constructing an algorithm to determine whether an operation to remove a tumor from my uterus will generate enough quality-adjusted-life-years to justify the expenditure. Then - by all means!"

Interesting. It'd be interesting to learn if the rules that the FDIC uses for losses on loan-portfolios that get picked up by the bank that takes over the failing bank are discretionary or statutory. One more reason that public insurance for bank deposits larger than ~$5,000 whatever will cover the cash savings of genuinely poor people is a terrible idea. If you have more than that socked away, you could afford private deposit insurance, which would make it more expensive to keep your money at a sketchy bank and cheaper to keep your money at a sound bank. Few people know that even the likes of FDR opposed public deposit insurance because it resulted in significantly more bank failures in the few states that tried it out. When no one had to worry about whether or not their bank was sound, bad banks were able to attract far more deposits than they would have otherwise. The most influential group lobbying for public deposit insurance were community bankers, who knew that it would enable them to attract far more deposits than they'd be able to if they had to compete with large banks. They were also able to limit interstate banking, which also made bank-failures more common than they'd be otherwise. IMO if you've got enough wherewithal to sock away more than a few thousand dollars you can fork over whatever it would cost to insure your stash on your own dime.