The American Spectator

Jim Hlavac| 5.12.09 @ 4:30PM

Good ol' Mr. Ponzi is surely giggling wherever he is.

Tom Paine| 5.12.09 @ 4:38PM

Considering the amazing success of social security and medicare, the question is not whether they're too big to fail, but why some fool would hope for their failure.

Social security is without a doubt the most popular entitlement in American history. When Bush atttempted to privatize it, 75% of the American people vetoed the idea almost without reservation.

Medicare's administrative costs, when compared with the immensely wasteful and beauraucratic private sector, are amazingly efficient.

Because of these two programs, senior citizens can expect to retire in dignity. They are spared the incredible poverty and dependence senior citizens once suffered.

There is a tax burden, of course, associated with these programs, but it's easy to sit smugly in 21st century America and fantasize about a Utopian world in which the market magically cared for the elderly. The truth is, before these programs existed, the Great Benificent and Invisible Hand of the market let many elders starve or die without proper medical care, and thanks to FDR and Johnson, those dark days are in the past -- forever.

LP| 5.12.09 @ 5:30PM

"Medicare's administrative costs, when compared with the immensely wasteful and beauraucratic private sector, are amazingly efficient. "

REALITY CHECK: That 2% admin cost of Medicare that is so widely thrown around by the left is only the cost of printing the checks. It doesn't consider the other admin costs that any business has such as office assets, etc. for Medicare, those things are hidden in other parts of the federal budget.

Pete| 5.12.09 @ 5:30PM

Attacked by my first troll. I feel special. What do you want me to call him? Not at all racist, just a clever depiction, I thought. He isn't quite black, now is he? And morons like you seem to think he is some sort of Messiah, yes? Hence the term. Attack the post next time, and if you have nothing to say, go worry about global warming.

MarkJ| 5.12.09 @ 5:34PM

Dear Tom,

Read your post. You talk like a guy who really, really, really wants a government job. I cordially suggest you call 1-800-GOV-JOBS. Given your obvious brown-nosing skills, Obama should be able to fix you up with a nice mid-level position somewhere out in the provinces in a jiffy.

Tom Paine| 5.12.09 @ 6:13PM

Pete --

What do I want you to call him? Pete, I don't give a damn what you call him, honestly, but when you choose to characterize him on the basis of skin color, don't be surprised when someone points that out.

Why not try this: instead of spending time thinking up "clever" ways of "depicting" a person based on how he looks or other accidental qualities, spend a little time THINKING reasonably and honestly about an issue. Then, put a little effort into writing the points you want to make and explaining your reasoning. People will take you more seriously, and you won't come off looking like a jackass, as you do above.

Tom Paine| 5.12.09 @ 6:23PM

LP --

What your "reality check" fails to account for is the gigantic administrative costs of private insurance -- often as high as 40%. No matter how you look at it, Medicare is a bargain, and what the country gets for it is very high quality medical coverage for people who would otherwise not be able to afford it. What is it about ensuring that elderly folks can see a doctor that you find so damn objectionable? Is it such a huge burden to pay the tax that allows Medicare? Seriously.

If you think government bureaucracy is maddening, you should try to find your way through the thickets of paper work a private insurance company will throw at you if they suddenly decide they prefer not to pay your medical bills.

The Great and Powerful Invisible Hand of the Market and its Dark Satanic Mills promise much, but let the profit margins shrink an iota below acceptable losses, and the cold blooded frown on Grandma's health and well-being will be enough to change your mind. I earnestly hope none of you ever has to learn the hard way that what I'm saying is true.

Tom Paine| 5.12.09 @ 6:26PM

MarkJ --

Your post is about as witty as rotten cabbage. Why don't you stand up for yourself and make an argument? Why all this farting around with foolish taunts? Be a man, for Christ's sake. All of you. Grow up. Take some responsibility for your ideas. You talk like thirteen year old girls.

W. James Antle III| 5.12.09 @ 7:11PM

Tom Paine, your first post contains a very nice speech about Medicare and Social Security. But it doesn't really address any of the points that have actually been raised: The costs of these programs are starting to exceed the revenues. Partly this is because of slower economic growth and higher unemployment. Over the longer term, it is the result of demographic changes that have altered the ratio of workers paying into the system versus retirees drawing from it.

Even worse, the trust funds don't really exist because they have no assets and we've already spent the money on other things. Repeatedly touting the low administrative costs doesn't suddenly make these programs take in more money than they will be spending.

Finally, government-run systems can be pretty coldblooded about Grandma's health too when the costs are too high. One of the ways Medicare tries to avoid this problem is by paying doctors and hospitals less and having them shift costs on to those covered by private insurers. Take away the private insurers and those costs will have to be dealt with by other means, which won't always cut in Grandma's favor.

Medicare can find ways to make its administrative cost figures low. But it can't magically prevent the provision of health care from costing money.

Pete| 5.12.09 @ 7:18PM

Still nothing on the substance of my original post which actually had to do with healthcare. And I would add that rather than merely "point out" my self titled 'clever depiction', you called me racist. It is now, by definition, racist to note color, eh? Is the sky blue in your world? I could care less that the guy is off-white, what I really care about is that he quite apparently hates America and is actively trying to ruin it as quickly as possible. I could think of many worse things to call him based upon his actions, but as you note, I have already made the ultimate faux-pas in noticing that he is neither white nor black. I probably just made the Homeland Security list.

Tom Paine| 5.12.09 @ 7:22PM

Mr Antle,

All your points are well-taken, and the problem you cite in your penultimate paragraph (doctors and hospitals shifting costs to consumers) is well documented. What's more, many doctors are refusing to take Medicare because of lower payments from the government, an obvious problem for Grandma.

But what's the alternative? Grandma and her grandchildren can respond to government irresponsibility by voting politicians the out of office.

The market does wonders for the young and the healthy. I just don't think it helps the old and infirm, which is why Medicare seems like such a great deal.

There is no question that entitlements present an awesome challenge, but I would argue that that challenge is greatly exasperated by the outrage and resentment fomented by conservatives about any and all taxation.

The obvious remedy is to increase Medicare and Social Security tax rates. (When Reagan agreed to raise the Soc. Security tax rate a little more than 1%, he assured its solvency for decades.)

In the end, I think more honesty is needed. Liberals need to be frank: government entitlements are expensive and are going to increase massively with an aging population. That is simply going to mean higher taxes. There's just no question. We're not going to cut these programs, clearly, so we're going to have to pay for them. Conservatives will never take the hit for paying for them (or cutting them), so we're going to have to do it.

Conservatives, on the other hand, need to get off the damn fence: if you see the benefit of these programs, if you agree that the market will do to the elderly in the 21st century what it did to them in the 19th century, then you need to agree that more taxes are going to be necessary. If not, make your argument, and take the hit. Honesty's the best policy.

Tom| 5.12.09 @ 8:11PM

Tom Paine fails to mention that they have been cutting payments to physicians for over 30 years with no impact on the overall cost of care. If an 85 year old wants to have elective surgery so he or she can continue to travel to their second home or play tennis at their country club, society can not continue to carry the entire load. That individual should have to pay some of the costs if they have the financial means to do so. Afterall, Medicare was started when the average life expectancy was 68 years of age. Physicians are limiting the number of new Medicare patients entering their practices or "opting out" of Medicare completely. This will continue to have a dramatic impact on access to care which is probably the federal government's goal all along.

Tom Paine| 5.12.09 @ 8:47PM

Tom --

I doubt the average recipient of Medicare has two houses or belongs to a country club. If you evidence to suggest otherwise, I'd sure like to see it.

As to what is "probably the federal government's goal," frankly, those kinds of speculations don't carry much weight with me. The federal government doesn't have a secret "goal" about anything. People in Congress respond primarily to the will of their constituents. It's the beauty of democracy. Unfortunately, the vast majority of Americans want entitlement programs that drift down from the heavens fully funded. If we want it, we're going to have to pay for it.

You do make an important point. There must be a way to make the system more sensitive to income, so the very wealthy pay more. But that problem sort of takes care of itself with progressive taxation, which conservatives regularly tilt at as the great socialist evil.

In my opinion, social security and medicare are best left as benefits held in common. No class rivalry, no class resentment. If you get to the finish line, you get a check each month to make living easier and you get to see a doctor free.

One thing that often gets left out of this discussion is how these entitlement programs stimulate the economy. Japan, in its financial meltdown, found that the single most stimulating government spending was money spent on care for the elderly.

Also: people are more willing to take risks if they know a safety net will prevent them from falling into the gutter if they lose. Social security and medicare -- and some day, I hope, universal medical care -- will make people more willing to take new jobs, start new businesses, try new products and inventions, and make investments because the consequences of failure, while they may be steep and painful, will at the very least not endanger their ability to see a doctor if they get sick. We routinely fail to factor in the "opportunity costs" of having market bound health care.

Tom| 5.12.09 @ 9:06PM

Mr. Paine has to admit that individuals over 65 represent the wealthiest generation that our country has ever known. Your second counterpoint concerning the federal government's goals were clearly outlined in the former Senator Daschle's book where rationing of care is a key component. This is the case in EVERY country that has a government-run healthcare system. On a more simplistic point, your statement regarding "seeing the doctor for free" directly goes against any attempt at cost control. Anything free will be overutilized and consumed at a greater volume resulting in higher costs.

Tom Paine| 5.12.09 @ 9:57PM

Tom --

Your assumption that "anything free will be overutilized" is reasonable, but I think not necessarily true.

Japan has an amazing health care system that cares for the healthiest, longest lived people on earth, and they found that easy access actually decreases unnecessary doctors' visits.

The larger issue, however, concerns the rationalist assumptions of market psychology. People over-consume and behave irrationally when they think resources are scarce. They may do so when they believe them to be abundant as well (let's face it, people are not always wise), but I don't think your point means that free health care would necessarily yield higher costs.

Consider this: if you pay for private health insurance, you are paying -- get this, now -- you are PAYING the insurance company to HIRE people to DENY you coverage.

That's simply madness. I pay so that my insurance company can screw me when I need them most. You're telling me that's a good system? It's bizarre that people tolerate it.

Now, I don't know the stats. of the elderly. I accept your figures, and I don't mind. Before FDR, the elderly were dangerously vulnerable to the whims of the market and the handouts of charity. I think the way they have it now is better.

But here's the most important point:

IF Republicans want to go to Florida and tell the elderly it's time for them to pay their own way, they're more than welcome to do so. It's a free country, Tom. Let's see if the conservatives have the courage of their convictions.

Lastly, I don't think you have good information about the way health care systems in other parts of the world work. England seems to be a fairly dysfunctional example of social medicine; Canada has it's problems too. But there are other models of social medicine that are much more effective than ours. (And the people of Canada and England are overall happy with their systems.)

Mary| 5.12.09 @ 10:04PM

You're going to have to start refusing certain treatments to those close to 60 years of age if you intend to keep SS and Medicare solvent.

You can't keep squeezing the producers, and you can't keep letting people collect so much more than they paid into the system.

The government deciding cut-off dates for cancer treatments, etc. might help the process along.

20 years from now I don't think 8 out of 10 people will be satisfied with their health care if it becomes a service run by Washington.

Friedman said that turning the US into a socialist state would be a tall order because of our ingenuity and ability to get around state dogmatics. We'll see.

My Mom just had surgery and everything went very well, thank God. Her doctor is an excellent surgeon, and the young physician who acted in his stead was excellent too. He was a general surgeon for 7 years and then opted for head and neck specialization, via fellowship. In two months he's returning to private practice in Fairfield, CT. He's very sharp. A Yale graduate with the humility to speak of this accomplishment as follows: "I studied in New Haven." :)

I was also impressed with each physician, who when thanked, gave credit and honor to God.

No one has the right to demand that a doctor -who has studied for years to achieve his dream and perfect his art- be satisfied with what profit a petty bureaucrat decides he's due.

It won't work. Defects won't be eliminated, just re-arranged.

I share an apartment building with emigres from the old USSR. When I first moved in, one of my neighbors who was a physician in the Ukraine, told me she made as much as a bus driver. And she didn't speak of it with pride and longing.

The gentleman who lived in the flat below me was a prosecutor in Moscow who began his career at the tail end of Stalin's reign. He kept many of his dossiers and offered to let me have a look-see, but then his wife got sick and he moved in with his kids.

I like my neigbors a lot. You should see what they can do with a little arable land.

Their marriages are strong and not just because of a generation gap. I think they're strong because totalitarianism necessitates a very strong bond here. What might the next generation do for a private bath?

Mary| 5.12.09 @ 10:06PM

I'm reminded of P.J. O'Rourke here: "If you think healthcare is expensive now, just wait until it's free!"

Tom Paine| 5.12.09 @ 10:11PM

Mary --

PJ O'Rourke is a genius, and he's probably right.

We may be saving a great deal of money by denying health care to millions of people that need it; by bankrupting American families; by cutting corners and neglecting to treat preventable illnesses. But money isn't everything, Mary.

We could save billions by closing public schools; we could save billions by neglecting roads and bridges. (Wait, we're already doing that.) Why have a space program? Why build monuments and magisterial public buildings? We could even save money by closing libraries and museums. Who needs them? And anyway, the Market will provide.

Tom Paine| 5.12.09 @ 10:15PM

Mary --

I don't think the USSR is a model anyone is looking to.

The fact is, we don't NEED European models, but it would behoove us to ask why people in France, Germany, and Sweden and Norway and Finland all have stronger healthcare systems than we do. And their people love them. The most conservative politicians in France wouldn't DREAM of privatizing the health care system because people are so happy with it.

Can you honestly say what we're doing is working?

I don't know anyone who thinks it is.

Mary| 5.12.09 @ 10:16PM

Oh, and how much do countries with socialized medicine gain from the advances in medical research, etc. that our own system produces?

Sort of like how Europe profits from our willingness to pay part of their defense tab.

Disparity can't be solved just shifted. Personal responsibility is mentioned only by means of cliche. And I think, in future, "the question" here "will keen in pitch."

The quote is Mailer, writing of war in Iraq. His use of language could be so pleasureable.

Tom Paine| 5.12.09 @ 10:20PM

Conservatives do, however, have to face the music:

If you really believe that the government should NOT provide social security and medicare, then you should admit it.

Republicans should call a press conference and declare they no longer support medicare and social security. Everyone has to take their chances, and there's an end on it.

But if the Republicans will NOT do that (and believe me, they won't), then they should admit that these entitlements need to be PAID for, and there's only one way to do it: raise taxes.

For once the moral issue at stake really is clear: unless you're willing to go the voter and say you no longer support social security, you have to support what needs to be done to pay for it. The rest is just talk.

Tom Paine| 5.12.09 @ 10:24PM

I loved Norman Mailer too, Mary, and I have to say, his politics probably would have irritated you considerably.

As to medical advances: France, Germany, and England are responsible for countless medical advances and new medicines.

And in the United States, 80% of ALL new drugs are discovered in PUBLICLY FUNDED universities. They operate, of course, with substantial grants and support of private concerns, but public funding is integral to our discovery of new medicines. Profit is not the only way or necessarily always the best way to motivate people, Mary.

Mary| 5.12.09 @ 10:25PM

Jeremiah-

I didn't say the USSR was a/the model. I was just reflecting.

As I said, whatever our defects are right now they will only be shifted. You're naive to think otherwise. Last stats I saw showed that 80% of Americans were happy with their healthcare.

I'm happy with mine. My parents are happy with theirs. My Mom's been through a couple of serious surgeries and she's in her 70s. Five years from now, if she needs another surgery and she has to look to Washington, she'll likely be denied.

Washington can't provide a solution, it can only spread a kind of mediocrity that really pleases no one and causes a decline in research and development, and yet will be used as a perpetual electoral bludgeon.

Mary| 5.12.09 @ 10:38PM

Jeremiah-

Mailer's politics didn't irritate me. I don't judge people by their politics, but by their behavior.

Have you been hitting the confessional more than usual? If not, maybe you should.

You seem pretty smart, but you've been really vulgar and rude, of late. You're on a conservative blog, why don't you show the authors the respect you seem to so often request of them and others?

How do you square it all, being a Roman Catholic?

Hit your catechism because your passive-aggressive thing suggests imbalance.

Mary| 5.12.09 @ 10:48PM

Oh, and one last thing. It's not about profit, it's about the inappropriateness of the petty bureaucrat -who hasn't the power to save a rat's ass- becoming intimately involved in the salary capping of a highly trained surgeon.

Without a healthy degree of capitalism, your brand of tax and spend liberalism will be seriously constrained. Without the electorate truly understanding that everyone has to contribute to the Country's fiscal well-being, and that means even the poor, we're headed for stagnation at best and disaster at worst.

Personal responsibility is likely to be the cri du coeur of the financially strapped future tax base of America.

Tom Paine| 5.12.09 @ 10:53PM

Mary --

I admit that at times I can be rude. I'm a foolish Irishman, and I've a temper.

I believe I show the authors respect; since they sign their actual names to the pieces they write, they seem to deserve it. I admit I have abandoned civility when it comes to Mr Vadum, since he so constantly refers to Nazis and fascism, of which I'm thoroughly tired.

But you're right. I shouldn't lash out with unkind words, and I promise to try to do better.

Mary| 5.12.09 @ 10:56PM

Fair enough, Mc.

Tom Paine| 5.12.09 @ 11:00PM

Mary --

Right again. Liberalism is absolutely dependent on a healthy market. Markets generate wealth. That's what they're for. But markets are a means to human happiness, not an end.

As to the petty bureaucrat:

Bureaucracy, actually, is a beautiful thing. You heard me right.

Bureaucracy has accompanied the civilizing of mankind. Bureaucrats see to it that resources are distributed lawfully, and not in service of bribes, threats, or along lines of clan loyalty.

I don't see how a petty government bureaucrat is different from a secretary at a private insurance firm if they're both refusing people medical coverage.

I think we tend to dislike bureaucrats because we normally interact with them only when our individual will (to drive, say) is negotiating with a public need (to maintain order on the roads). It's inherently frustrating, but where would we be without it? The strong would dominate the weak; taxes would be levied with no promise or representation; and bribery would rule the day.

KevlarKevin| 5.12.09 @ 11:38PM

Tom Paine doesn't care if America becomes a European style socialist state or if it collapses altogether.

Mary| 5.12.09 @ 11:59PM

Jeremiah,

Bureaucracy may have accompanied the civilization of mankind, but it followed upon the heels of entrepreneurs, it did not precede them, and a society that doesn't couple recourses with personal responsibility -which is what we have right now- can only produce the kind of bureaucracy that most people envision when using the term "petty bureaucrat" or as Karl Popper notes the “tyranny of the petty official.”

It's not shocking that democracy tends towards decay, but we're advanced enough now and have had opportunity like none before to witness the effects of both unbridled capitalism and the total society of socialism. And because this is so we ought to be able to dispense with tropes and utopian nonsense. We don't need a middle ground, we need solid ground and I think that's why you seem to want a viable loyal opposition.

The reason I think civility so important is that we seem to be at each other's throat, thinking the annihilation of opposite will bring justice or satisfaction. But the precariousness of both our fiscal and social condition make that dispensation a very dangerous one.

john Schuh| 5.13.09 @ 12:08AM

Tom Paine talks about the USA of a century ago as if it bore any resemblance to the country today. Medicine had no effective remedy for pneumonia which probably carried off more old people than any other ailment. Even in 1935 half of the people in the country who were ten years old in 1880 were dead, which is why social security set 65 as the retirement age. By raising the benefit age to 70 in 2015, and not allowing anyone except indigents, cripples and orphaned minors to draw benefits before that time would fix the problem immediately. The huge increase in medical costs, like the huge increase in college tuitions, have been driven by huge governmental benefits. Back in the '50s, my family doctor opposed socialized medicine because, as he said, he had served in the Army and he toldme that there is no limit to the demand for medical treatment except the ability to pay for it. People don't want to get old, or if they have to get old, don't want to get sick and die.

Curtis Rasmussen| 5.13.09 @ 12:10AM

Social security trust fund will be exhausted in 2037, down from earlier estimates pegged at 2041. Payroll taxes would have to be increased to by 30% or more to cover the entitlements of future beneficiaries. Add on to this the massive tax increases for government healthcare and you have a recipe for financial ruin as money is siphoned off of the private sector instead of being used to make this country prosperous.

Once nationalized healthcare is started, you can never go back. You won't have a choice to stop it if you are dissatisfied. At least now you can choose your own plan or buy insurance to cover costly procedures only and pay for the remainder out of pocket to keep individual cost as low as possible. Not the best solution, but infinitely better than a faceless bureaucracy that does not give a rat's ass about you.

Dylan Reynolds| 5.17.09 @ 2:39PM

Medicare and Medicare Supplement Insurance are the backbone of security for senior americans. We have to protect these programs at all costs.

Medicare Supplement Insurance| 5.17.09 @ 2:40PM

Hopefully the reduction in Funding to the Medicare Advantage program will allow Medicare to return to stability.

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