Wednesday, August 24, 2016

Healthcare Improvement Idea

I was able to retrieve Sean's ideas via my email copy.  So here we go:
"If one were drawing up a system from scratch, some form of single payer would make sense.

Since we're not doing that, we need to build on the ACA and make it better. Given cost projections have come in under budget thus far, we could afford, for instance, to address some of the problems in the individual markets whether it is subsidizing providers to increase competition in some areas (premium increases are lower in competitive areas) or increasing subsidies to citizens, which would increase the number of folks with coverage and improve the coverage they do have.

States, like Minnesota, which use a "clearinghouse" model for their exchanges, could switch to an "active purchaser" model in which the states can restrict access to the exchange to only companies that offer plans that meet their goals in addition to those that meet the minimum requirements. . For instance, MNSure plans tend to be low premium/high deductible. The problem with this is that the tax credits available under the ACA are primarily based on the premium. This means that in actuality, people pay more out of pocket here than they do in many other states which have higher premiums and lower deductibles.

We could allow younger people to buy into Medicare if they wanted, too.

We can also do some systemic things to reduce costs. Allowing Medicare to negotiate drug prices would be a major win for that program, for starters. Similarly, Medicare has been in the process of doing more competitive bidding for some supplies and tests -- that should be expanded.

Now, what would *you* do? " Sean

Tuesday, August 23, 2016

Natural Consequnces

MP Exceptionalism keeps giving.
"You are absolutely correct that there are many rewards to be gained by going to school, learning, working, staying married, saving, investing, etc. One of which is I can easily afford the higher premiums they are going to charge me for making bad choices. This is one of the strengths of America.

I guess I see taking money from one citizen to pay for the poor choices of another is also immoral. Trade offs..." G2A

"Further punishing those whose lot in life enables a meager existence fraught with the constant peril of physical and financial collapse. All in order to save oneself a pittance on the tax bill, and to impose some vague idea of "moral justice" on those percieved as "lessers". Thanks, but I think I'll take Mr. Udstrand's version of morality 10 times out of 10." Matt
"I guess I see taking money from one citizen to pay for the poor choices of another is also immoral. Trade offs..."

This is where ideology become incoherent as well as immoral. This is how a citizen of a liberal democracy is converted into a "victim" of oppressive government simply because citizens pay taxes. The horror. Yeah I don't like paying for other people's bad choices either... how do I get my money back for the Iraq war and all these stadiums?

You do realize that your insurance premiums don't actually pay for your health care and that your premium dollars aren't earmarked for your health care and your health care alone right? One way or another we all pay for each others health care whether your in a private or public system." Paul 
"As we have discussed before.

I have 3 children, two are savers and one is a spender. When the spender can not afford to go out with her friends and I refuse to give her additional money to do so, am I punishing her?

When my other 2 kids go out and the spender is stuck at home with Mom and me, am I rewarding them unfairly?

If I gave the Spender more money, what message would that send to the Savers / Spender?

What behavior would that promote?

All Americans are given the opportunity to attend free public schooling, what they do with that societal investment in them is up to them and their Parents. There are natural consequences if one squanders that incredible opportunity. No punishment or judgment required." G2A
"You correct. Insurance is a pool of money to spread the risk. This is a very personal cost / benefit, unlike stadiums and wars.

If people want to be covered from the pool. Please have them pay their premiums." G2A 

Monday, August 22, 2016

Bathroom Ruling

Thank heavens for now.  Common sense is still in charge.

Remember my view: private parts should determine which restroom / locker room one uses.

And if the individual is uncomfortable they should be free to use a family / private room.

Please remember that transgender folks are only 3 out of 1000 people.

SW Light Rail: Progressive Taxation

MP SW Light Rail Funding

The comments here to an interesting turn and allowed me to have some fun.
"Acronym City: Having lived in both metro St. Louis and metro Denver – and been a regular user of light rail in both places – I'm a fan of light rail as mass transit. My former planning commissioner self was never a fan of the route selected for the Southwest line, largely for reasons that others have already laid out in detail. Lots of people and jobs at one end, not much except large-lot suburbia at the other end, with not enough density to make such a line very plausible economically.  
I don't mind subsidizing light rail, but there have to be enough riders to make the subsidy palatable, and that didn't seem to be the case. NIMBY opposition to light rail's effects on property values is both self-serving and short-sighted. In areas where light rail has been built and is operating, the initial inconvenience of construction has had some negative effects in the short term, but in the long run, property values are UP, not down.  
That said, however, the point made by others about serving a greater number of people than the current alignment seems to do strikes me as one well-made. When Met Council goes back to the proverbial drawing board, I hope they'll pay more attention to that facet of planning.

In theory, there's much to like about Bus Rapid Transit. In practice, not so much. Either the bus is stuck in traffic along with you, or the cost of adding bus-exclusive lanes to existing roads rivals that of building light rail, and buses are less efficient people-movers. If we're REALLY serious about moving commuters in and out of downtown, we'd go ahead and build something like the North Star line to several other destinations, and destinations with… ahem… larger populations than that of Big Lake.

It does appear, however, that, should we lose the $900 million in federal funds – hardly pocket change, even for some of our wealthier citizens – the onus for that loss ought to fall squarely on the shoulders of Mr. Daudt and his GOP colleagues, who, as far as I can tell, have opposed any and every mode of mass transit in the metro area that didn't involve the automobile since I arrived 7 years ago." Ray

"You make sense: If it requires a loss of $900 million, perhaps that is money well-lost with respect to a needed jolt of reality juice.  We'll get the money for other projects, in any case. We are a favorite funding recipient thanks to our productive DFL connections to the Washington money pot.  Perhaps other cities might use some of "our" $900 million more effectively. Hope so." Jim

"We are a favorite funding recipient thanks to our productive DFL connections to the Washington money pot."

Light rail aside, there's a lot of interesting data available on this topic, but when it comes to the "bottom line," DFL connections or otherwise, Minnesota only gets back 72-cents for every $1.00 we send the federal government in taxes. There are only four states that get back less than we do.

Ironically, the states that pay the least in federal taxes are the most dependent on federal "hand outs." Mississippi, for example, a solid "red state," gets back $2.02 for every $1.00 they send in.

So yeah, I suppose we could just keep letting 28% of the federal dollars we contribute go to states that need them more than we do to help them make up for the low low taxes their citizens pay and help them build up their education system, their public health and safety stuff, their infrastructure and maybe help pay for repairing some of the environmental damage their "extra-deregulory" policies may have helped create, etc..

Other articles on the topic you may find interesting:

"Which States Are Givers and Which Are Takers?"

"2016’s Most & Least Federally Dependent States"" Bill

"Bill, Please remember that this is the way the Liberals wanted it, and they got it. Minnesota is a rich state for many reasons, therefore we pay more than we receive. Just like how wealthier people pay in much more than they receive back. Maybe we can call it Progressive taxation for States.

Now if you would like to reduce the money collected and redistributed by the Feds, I am sure most of us financial Conservatives would be happy to go along and give the power back to the states.

And I assume most Liberals would prefer that the money go to help the poor rather than building some fancy transit system for suburbanites." G2A
So the questions are:
  • Are MN Liberals happy to pay more and receive less from the Federal Government?  If so, why is this topic brought up often?
  • Since it is MN's wealthy who are paying this money via the Progressive Federal Income tax, does it matter?

Saturday, August 20, 2016

The Morality of Healthcare Financing

MP US Exceptionalism continues to drive excellent discussion.
"Maybe, Just Maybe: The power of the presidency has been so downsized by an ineffective congress that realistically, change just might suggest a tyrant could soon be in control? 
Let's say if all candidates or at least the major two, pass by the concept of a free society, then all credibility; hope for a functioning democracy is a dream ending...who knows?
Sleeping at the gate: The 'people' are left out...and rather than ever being the recipients of positive change like universal health care etc..and if major parties are content with or zeroing into those false gods like money and power and greed, downsizing the people who seem at times to be in a catatonic state of denial? Better wake up Joe B and Joanna too eh?" Beryl 
"Left Out? "The 'people' are left out...and rather than ever being the recipients of positive change"  Now you do realize that a large portion of US citizens consider that changing to Single Payer would be a negative change...   Gallup Healthcare Poll Results
My point is that people's voices are being heard, but their voice opposes your view of "positive". Maybe because they will be paying more and getting less. 
I work with people from many countries, there are definitely pros and cons to single payer plans. That is why most countries have Private Options on top of the public system. Personally I am against single payer for several reasons:
  • Patient does not bear the costs. Little incentive to live healthy.
  • Rationing and long waits for some services.
  • Price controls do not work well, something is going to slip.
  • other
So I am happy that my voice is being heard." G2A

"Rationing of health care under single-payer systems isn't caused by the fact that they are single-payer. They're caused by other policy decisions -- specifically, the desire to limit health care spending. Need proof? There's a single payer system very near to us that doesn't ration care in the way that, say Canada or Britain do -- it's called Medicare and it serves every American over the age of 65. 
We should also acknowledge that our current multiple-payer system also rations care -- by the ability to pay. Every system will ration care to some extent, what we need to decide is on what basis we choose to ration." Sean

"People in America who go to school, learn, work hard, make good choices, work hard, etc get the best medical care in the world when they need it. The disabled and old get the best medical care in the world when they need it. 
Those who do not fit into either category struggle and are handled on a case by case basis. Makes sense to me." G2A

"Really? Ask a doctor if she decides who gets the best care based on their moral worthiness. 
If a disabled or old person did not go to school, learn, work hard, make good choices, work hard, etc does he or she still get the best medical care in the world when they need it?" RB

"Moral Worthiness: I am not sure this is a moral issue, I think this is more of a capitalism and person financial management issue. Thankfully the USA's systems reward the smartest hardest working saving /investing people very well. This is one reason why we are such an exceptional country. 
And yes the best hospitals / Doctors would like to get paid. Thankfully we do live in a society that believes in charity and caring for the old, disabled, so they get good care." G2A

"Pay to play health care is inherently immoral: The idea that people who fail to meet someone or another's moral standard (such as a work ethic) are rightly doomed to suffer injury illness and death is morally bankrupt. 
The idea that financial incentives are (or should be) the primary driver of individual health care, safety, or lifestyle decisions is simply daft. People don't exercise or eat healthy diet because it saves them money, on the contrary many people pay an incredible amount of money to exercise and eat healthy food. 
Nor do people seek to avoid injury for financial reasons... pain avoidance and fear of death are basic biological mechanisms. 
Furthermore we've seen time and time again now financial priorities distort health care and safety decisions frequently producing increased injury and illness. We never had millions of uninsured Americans because they were all lazy an "unproductive" members of society. 
I hate to say but the idea that people who fail to meet some standard of work ethic deserve their fate of death and suffering looks a lot like "final solution" logic." Paul

"Immoral: No system is perfect, however I think ours is best. Pretty much everyone gets some care, but the most responsible citizens get the best care.

The Liberal view that citizens have a right to food, housing and healthcare just because they are standing on American soil is also flawed and doomed to cause disaster. And I would say that it is also immoral because it allows "free loaders" to live as parasites on the efforts of others. (ie drain on society) And if you doubt that there are a significant number of freeloaders within our society, just take part in a group activity, look at our crime statistics, look at the academic failure within our schools, our large welfare roles, etc.

I am actually living proof that money can be a good incentive to living healthier. My company implemented a two tier premium system and I will be paying an extra $180/month for family coverage if I do not lower my sugars and triglycerides. Therefore I am changing my diet somewhat. Now I wish more programs would do this, I mean why should my co-workers need to pay more for my bad choices?

Why should our society have to pay the huge healthcare costs in part created because of sky rocketing obesity, etc?
G2A Healthcare Cost Drivers 

Wednesday, August 17, 2016

American Exceptionalism

Eric has posted his view on this...  Some I agree with, some I think is silly... (ie Leadership by Committee)


Tuesday, August 16, 2016

The Ideal Economic Policy

MP Economic Policy  This was an interesting read.

Here are Louis Johnston's Economic Goals
  1. Promote faster economic growth. From 1929 to 2001, the U.S. economy averaged 2 percent per year growth in GDP in per capita. Since, then, the economy has grown at about 1-1.5 percent per year. Growth of GDP per capita is the key to growth in average incomes.
  2. Promote a more equal, less skewed distribution in of income. Even if we could get the U.S. economy to grow faster, this will be for naught if the majority of the gains accrue to only a small minority. A healthy economic system rewards those who create and nurture that system, and that includes everyone who participates, not just those at the top.
Here are some of his reform ideas.
  1. Eliminate many (or even most) deductions and credits from the tax code so that the households make decisions based primarily on their own circumstances, not to in order to avoid taxes.
  2. Move from a system of tax brackets to continuous, progressive tax rates. For instance, Donald Trump and House Republicans propose creating three tax brackets with rates of 12, 25, and 33 percent. This system creates “cliffs,” that is places where tax rates suddenly jump when household income changes only a small amount. A better way would be to have the tax rate rise slowly and smoothly as household income rises rather than hit them hard at some arbitrary income level.
  3. Eliminate the distinction between labor income and capital income for tax purposes. Under the current system, someone earning $100,000 in wages pays a higher tax rate than someone else who earns $100,000 in capital gains. Thus, workers and small businesses (who often run their taxes through the personal tax code) end up paying higher rates for no logical economic reason.
  4. Eliminate the corporate income tax and then tax everyone through the personal income tax system as outlined above.

Here are my first comments.
  1. I do agree that a rising river lifts all boats, and a rising GDP should increase the incomes of many.  The challenge is that what we really want to do is increase the disposable income of Americans.  Therefore it is critical to control cost increases while increasing GDP.  Be they amount of taxes paid, inflation, other.
  2. I guess I disagree...  I think what we want is people correctly compensated based on their knowledge, capabilities, effort, personal decisions, investment, etc.  The USA is not a collective where everyone deserves a share for just living on US soil.  The compensation must be competitive with the global markets, or money / jobs will flow elsewhere.  If a person saves money, invests it overseas, makes a profit, etc...  Do the people living in America really deserve a large share?  Same for someone working Overseas?
  3. The tax code is used for more than just collecting money as you note.  You want to use it strongly to drive some kind of equitable income distribution.  Where as I think it should also be used to strongly encourage citizens to save for college, rainy days, retirement, reduce debt load, etc  I don't see that in your plan.  Remember that the Great Recession was only a problem for people with too much debt and too little liquidity...

Monday, August 15, 2016

Trump - Clinton Plans

Based on the plans Clinton discussed last week, I am moving back towards preferring Trump.  She definitely is pandering towards the Sanders far Left crowd...

NPR Plans
FOX Plans
CNN Money Fact Check
CNN Money Clinton Plan Creates Jobs
CNN Family Plan

Saturday, August 13, 2016

Simple Way to Help the Homeless

From Laurie.  "This Republican mayor has an incredibly simple idea to help the homeless. And it seems to be working."

Just coming home from China, this makes sense to me.  However the Liberals just about had a conniption when I proposed it years ago. Then of course some Liberal would decide that the vagrants should be able to unionize, get job security and higher pay...  Then the system fails.

How could we keep this program reasonable?  I would like to have our urban centers / streets as clean and well maintained as those in China.

G2A Way to Create American Jobs
German City Pays in Beer

Saturday, August 6, 2016

Let Them on the Stage

In Seattle, boarding my flight to Shanghai... 

Given the poor 2 choices, how do we get some more visibility for these folks?
CNN Johnson suit dismissed

Thursday, August 4, 2016

Clinton Leading Trump

One knows it is bad for a Conservative when the Fox News Poll has them behind. Iwonder if Trump will start complaining that Fox is too Liberal etc. Thoughts?

FoxNews Poll Results

Even Karl Rove sees a need for change.
And this GOP Rep is campaigning against both Trump and Clinton

This is very interesting !!!

Wednesday, August 3, 2016

Commenters See Red in TRUMP

Eric is right on track here.  MP What Trump Should Say  But the commenters seem to have derailed. It seems that Liberal commenters become unglued when the see Trump's name.
"What upsets me most about the entire Trump situation isn't even what he does or what he says (although I find all of those upsetting).

What upsets me most about the entire Trump situation is that there is a sizable enough part of our American population that finds him acceptable that they have voted him into the position he currently enjoys.

I only hope that my faith in my fellow Americans as a whole will be restored by his resounding defeat in the November general election." Pat
"Now it's us: Too many Americans who know that Trump creates acid stomach for them are still going to vote for him. No matter what it may mean for the country or for the world. That's our failing, collectively. Beginning with all those high-level Republican elected officials who won't renounce him despite being appalled by what he says and does.

Surely there's an educated and thoughtful electorate in this country who can outvote the angry bigots who support Trump." Constance

"First, I agree with Eric on this one.

Second, I will never understand the MP moderation policy. I know committed Trump Voters and they are not angry bigots. Such name calling adjectives... :-)

Third, most of the Trump voters I have met are like the Bernie voters. They feel strongly that the political system has failed the country and they want to see the whole thing shook up.

And though I really dislike their champion... I certainly agree with them. In almost every other aspect of our lives we get more for less as technology takes hold. However the cost of government as a percent of our economy just keeps going up.
Past Spending"  G2A
By the way, Trump finally found a person who will not talk back to him.  Trump Kicks Baby Out  One really can not make this stuff up... 

Voter ID Laws Struck Down

Now I am a fan of the SD style of Voter ID law.  It is interesting what is happening with the more restrictive versions.  Thoughts?

WP Appeals Court Strikes Down NC Law
TT TX Law Issues
Wiki Voter ID
NCSL Voter ID Laws

Monday, August 1, 2016

Excuses Already: Election Rigged

I keep getting the feeling that Trump's campaign is disintegrating in front of him. He may have some money, but nothing like the big boys. And he is already starting to make excuses for his failure.

And if you can not convince the Koch's that you are good for America, I think it is hard to become a Conservative American President.

CNN Model Predicts Clinton Win
CNN Trump Fears Election may be Rigged
CNN Trump Fears Debates?
CNN Snubbed by Koch
CNN Kochs: No Anti-Clinton Ads
CNN Koch Frets

So is there any chance that Trump could:
- Learn Humility
- Feel the Need to Actually Learn about the Issues
- Focus on People Other than Himself
- Think More and Talk Less

I keep hoping so...  But there is no sign of it happening anytime soon.

Sunday, July 31, 2016

How Many Sub-Parties are There?

Eric writes here about the current chaos of our "2" party system. MP 5 Parties in 2?

And in the comments here, Paul and Charles make an argument that both Clintons are actually Right of Center.  MP War On Gov't  Also, Paul makes a note that the Progressives have had it all figured out since the 70's and the Liberals are part of an "Elitism" problem.  I was going to copy some of their comments, but they are too wordy.

My question is where is the center from your perspective? Are there more classifications? What is the difference between a Liberal and a Progressive?  Is the Progressive to a Liberal as the Tea Party is to a Conservative?
  • Democratic Socialists /Progressives
  • Liberals
  • Moderate Liberals
  • Undecided
  • Moderate Conservatives
  • Conservatives
  • Tea Party Conservatives
G2A Political Self Awareness  And remember that per the Nolan Diagram there is "wealth transfer" axis and a "personal freedom" axis.  Are there more that Nolan did not recognize?