Maintenance med that's $300/month.
But maybe you will die without your own maintenance dose. How can you find out whether it is actually good for you? The professional who prescribed it is likely far too overworked to look into it in any detail.
I should have been more specific. My copay is only $30. The last time I had to pay full price for the medication (2001), it was $300/month. A couple times when my insurance information went wacky, the "full price" quoted by the pharmacy for a 30 day supply was in the $300 range.
I had a medical issue from age 14 to 25 that took a lot of work to solve - three specialists, two surgeries (the first one was botched), lots of experimentation. We've tried altering the medication or stopping it, but nothing else works; tapering it off has bad results. Not life-or-death epilepsy results, but something unpleasant enough to make life completely unmanageable and hellish in its own right. Most of the other treatments are either (1) useless or (2) invasive or (3) have side effects that are worse than the illness. I spent 10 years in hell, but the system worked for me eventually. If it was the government, I'm pretty certain I would have found no solution and ended up killing myself, because for one thing, I never would have been able to pursue the problem as aggressively as I did. It would not have been "cost effective" or a "good use of resources."
Yes, but look how we got here. We started with catastrophic medical coverage. You can't afford to pay for rare extremely-expensive medical procedures, so you pay in to an insurance scheme more than you ever hope to take out, and if you are one of the unlucky few whose insurance pays jackpot winnings, at least it doesn't bankrupt you.
But then it turned into payments for routine coverage, and the uninsured prices for routine coverage went up. Pretty soon nobody could afford to be uninsured.
And prices kept rising, to the point that most people couldn't afford insurance either. Employers paid insurance for whole families because they could afford it, they could pass the costs on to customers and also it was an untaxed business expense.
Now we're reaching the point that employers can't afford it either. The only ones who can afford medical insurance are the very rich and the federal government. Plus a few giant corporations that can dicker with the insurance companies.
It wasn't just the government that made it turn out this way. It's inherent in the medical insurance system.
I was a the Ronpaul guy in 2008 and again in 2012, and he summed it up. Once upon a time, people carried major medical and payed out of pocket for routine expenses. But governments mandated that everything be covered. This drove up prices. It was regulation and control that caused the situation we're in. More regulations and more control can ONLY result in higher prices or lower quality of care. We do need a better system, but handing everything over from one monster to another even worse monster is a bad, bad idea.
And you're worried about the government cutting your benefits. If you get a catastrophic problem -- the sort the insurance was originally designed to deal with -- will they pay? Or will they tell you the fine print does not pay for the particular problem you have, and you can spend the last months of your life trying to get them to authorize treatment.... Of course this is better than the government. If it happens to you, it means you chose the wrong insurance company, or the wrong policy. You did carefully read those 70 pages of fine print legalese, right? You know what they say and you know what is required for them to refuse payment. So if it does happen, you will be in a great position to argue with them about the details....
Insurance can't deny treatment. They can deny coverage, but I can still pay, even if it bankrupts me. Not ideal, but the government could deny ACCESS to treatment. I'd rather have an ugly option than no option. Not pretty, for sure, but those are the choices currently on the table.
I think it's partly the big-business mindset. If the one who's hiring is himself a junior manager, and he hires somebody that doesn't work out, that makes him look bad. Hire somebody who's unemployed and there might be a reason he's unemployed. He might have something seriously wrong with him. A reflection on your judgement, that you didn't notice and you got a bad result. But if you hire away a successful employee from another company to do the same job at your company, then if he doesn't work out there was no reason you should have expected he wouldn't. He was doing fine at the other company, right? The only little sign there might be some problem was that he was willing to leave and come work for you.... It looks absurd in the big picture, but junior managers aren't paid to look at the big picture. They're paid to look good and not take unnecessary risks.
If this is the case, I would attribute a lot of it to regulatory capture. Since corporations have entrenched positions, they do not want to rock the boat. A company on the rise would be willing to take more risks.
I've often wondered if we could do something with government hiring where older and unemployed workers get first crack. Not a guarantee of a job, but they are invited to the first round and if the government rejects them all, they would have to explain it based on the applicants' qualifications. I'm not thrilled about having tons of government jobs, but I'd at least like to have people in them who actually appreciate having them and who have a sense of civic duty.
Of course, I could say similar things about government jobs that you say about corporations. Many government agencies discourage hard work, so they can get a bigger budget and grow their empire. There are exceptions, but they are few and far between.
"Capitalism" as we currently practice it is deeply flawed. So are all the other traditional alternatives. So we need something new. I can suggest a few sentences to describe a little of what a solution might look like. There would be a society that was basicly capitalist, and there would be a group of people who created and enforced rules for effective free enterprise. These people would be somehow above the game, they would not care which companies "won". I'm not at all clear how to create such people, but I think a successful economy would somehow do that.
Governments have not done very well at setting and enforcing the rules for economies, so far. But that is not an argument for playing with no rules, or for letting cabals of businessmen create and enforce the rules. We need something new and better.
The point I and others make is that there aren't really objective people who can do this. If there is a group of rule-makers, the people who want to twist the rules in their favor will seek to control the rule-making process. This is not a system of no rules; it is a system of limited rules, applied broadly. The current system is reams of specific rules, applied haphazardly.
By setting a simple process in which parties cannot violate each others' rights in pursuit of their personal aims, you limit the ability of people to bend the rules (because no rules can be written favoring one group). Societal pressure is always better than government pressure. I happen to agree with many (though not all) of the criticisms of the Occupy Movement -- but I abhor, pardon the pun, about 99% of their proposed ideas.
There are a whole lot of deadly poisons that I do not want to be openly for sale to anybody. So I want to keep something like the prescription system. The FDA has a lot of valuable expertise, probably better if they get to ban the worst stuff. Here's an idea -- get a whole lot of people who log into a great big online database and track their symptoms and treatments. When they die they get somebody to log their deaths. So when you get symptoms you can look at the database and get some sort of prognosis by seeing what has happened to other people with similar symptoms. See what happens to people who get different treatments. You'd have to be good at statistics to get full use of a system like that, but some things would just pop out. Particularly, ineffective drugs might tend to show themselves as mostly ineffective.
There are a lot of deadly poisons out there now. Some dude killed his wife by putting antifreeze in her Gatorade. Ever read John Taylor Gatto? A tank of gasoline has the same energy as three sticks of dynamite. We all drive around with giant killing machines (cars) all the time, and that's been A-OK for a century. We have lots of totally legal things that we can use to kill each other. Having more of them out there isn't going to make a lick of difference.
Deadly poisons would not be openly for sale on store shelves. No reputable company would market "poison cola," certainly not in a free, democratic society in which it would be on the internet in about 8 seconds. And I thought we already had plenty of regulations about who can buy those.
Kind of like your database idea, though. It pretty much aligns with my idea of rating things rather than banning them. While I do want more on the market, I also want the information to be very transparent. Like the bit about the epilepsy drug -- it could still be viable for older patients near the end of their life, but not so wise for young people. I don't believe in zero oversight, but I do advocate for rational oversight, which I do not believe we have at the moment.
That's just fine when people pay for their own care. So, say we have a lot of people that the government pays for. Why not assign them randomly to experimental treatment? The treatments that look best so far get the most new tries. Then when a treatment is proven better than the traditional version, the self-pay people might choose to use it. Science works....
Only if it's voluntary! I don't want the government randomly assigning me to an experimental treatment. And in medicine, what works for Patient A won't always work for Patient B. The maintenance medication I take is supposedly not "the best," but for me, it's the only thing that was ever effective (given that I've tried about a dozen different things, I highly doubt it's a placebo effect).
Well done! I agree. I want to take i further. The NYSE was originally founded to be a trading monopoly. You couldn't trade on the NYSE unless you were a NYSE broker, and brokers were at first forbidden to trade on any other exchange. They make a whole lot of money off investors. Why do we need them? The computers and technicians needed to run a fair, honest stock exchange are not very expensive. Why not have a government-owned automated stock exchange? Publish the specialist's book. No brokers. (If brokers want to sell stock advice like racecourse touts, they can do that.) Any citizen can buy and sell stock, at no commission and no fee. Set up a simple tax system so the stock exchange can handle all the taxes for you, but as you say 99% or 100% tax on quick profits, very low tax on profits deferred until retirement etc. Short selling is easy -- if you want to buy stock at somebody else's price and then sell it for less, go ahead. The market would not be set up to maximize the number of transactions because it does not collect a fee per transaction. A private corporation stock market is designed to maximize their own profits. A government stock market could be designed to assist people in building retirement incomes.
That's actually a fairly nifty idea. As long as it's a competitor and not the be-all, end-all. I'd like the option for private equity (for example, the government doesn't like people buying gold... I've noticed that most corporate retirement plans, which tend to be tax-deferred, won't let you choose precious metals funds anymore). But aside from a couple concerns about their overreach, I like how you think here. I might prefer it be done by a private, not-for-profit entity, but I like the general idea. So I'll salute you back. At least we found ONE thing we agree about! Kudos to us!
In good times, government can spend more than it taxes and have a good result. In bad times anything it does is wrong. We need good times, and for that we need cheap alternative energy. We don't know how to do that yet.
Well, not quite. You were right, every system is broken. Socialism/Communism is always broken. Capitalism isn't too broken... up until you run out of places to expand, like now, and then its weaknesses show through. But government spending more than it takes in is almost always bad, because it leads to inflation and diminished ability to act later. Inflation hurts the people you claim you want to protect, the most. Cheap alternative energy would be nice (and was a central plot point in Atlas Shrugged, actually). But really, cheap energy period leads to good times. Bill Clinton was no genius; he had a Republican Congress... the first true peacetime in decades... and gas at 99 cents a gallon. If we all liked the 90s, the formula was deregulation + peace + cheap energy.
I'm more a pragmatist. Others will try to coerce you if you are within the range of their power. You can try to coerce them back if you can carry it off. If you hate to conform even to a minimal extent, you need to live somewhere with no close neighbors. I don't care much about moral rights, it's what they'll do and what you'll do. To avoid coercion, be a hermit.
Well, I do have a lot of hermit-like tendencies! But it's not particularly moral to say to people that you will either coerce them, or drive them into hiding. Sounds like a fascist or a racist or a totalitarian to me: "Do it my way or get lost." I mean, I don't care if people enter into voluntary, socialistic agreements -- I just don't want them to be government-run, or to be compulsory. I like the idea of private cooperative endeavors instead. Who knows, maybe someday I'd even join one, depending on how it was set up.
I agree. Put it this way -- if a slave is allowed to get part of the income from his work and count that toward buying his freedom, it's wrong to tax that money. Similarly, it's wrong to tax a wage-slave's wages. Someone who sells stuff in a marketplace that he made -- it's OK to tax that. But tax wages? No.
We agree, but for different reasons. It is immoral to tax income because you own your labor. The profit for your labor should always go to you. To have it taken from you involuntarily is theft, even if it is for a "good cause" such as Social Security. Nobody else has a justifiable claim to the product of your labor (i.e., your wages) and therefore the only just personal income tax rate is 0%.
Capital gains and corporate income are different, as one isn't labor and one is a special entity with certain privileges and immunities. Those taxes, I'm OK with. I don't necessarily like them, but I don't consider them as evil as a personal income tax on labor, either. I'm always OK with consumption taxes because resources are limited and people should be paying a fair value for them (although we might differ over the rates or what gets taxed more and what doesn't) -- thus creating a reasonable mechanism for the transfer of physical resources into private property. I agree that there are problems about how this transfer happens right now, e.g., corporations getting exclusive rights to resources cheaply.
If you live in an autocratic kingdom, then you must pay whatever taxes the king declares you must pay. If you live in a democracy then you must pay whatever taxes the majority votes for or the majority's representatives assign. If you disagree, go find someplace to live that doesn't do that. I get the impression there are some people who live in yachts on the high seas. There are some disadvantages to being a citizen of the world. Monaco is supposed to accept citizens who don't want to pay a lot of tax, but I don't know what their catch is.
While a democracy may vote in taxes, it doesn't make them moral. For people to seize almost the whole of the globe and then proclaim "If you don't like it, get out" is pretty much just an argument from authority/power rather than a valid line of reasoning. It's the sort of thing a Libertarian, or an Objectivist, would consider amoral and evil.