640 thoughts on “Liberals are Smug

  1. I have a feeling that four years from now I’ll still have that random wtf moment when I remember Donald j. Trump is our president.

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  2. “Donald J. Trump ?@realDonaldTrump 26 Dec 2016
    The world was gloomy before I won – there was no hope. Now the market is up nearly 10% and Christmas spending is over a trillion dollars!”

    It’s hard to take credit for Christmas happening but, well, there ya go.

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    • It’s hard to take credit for Christmas happening but, well, there ya go.

      For God so loved the world that he gave himself, DONALD TRUMP, that whosoever voteth for him is a bigly winner, unlike the losers who did not, who are very sad people, just very sad.

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  3. So a friend of mine posted a meme yesterday on Facebook, let me explain it.

    It quoted that tweet, and said:

    Notice how Trump always says “enemies” instead of “opponents.” And those who “fought me” instead of “disagreed with me.”

    His endless rhetoric of personal war and us-vs-them is what keeps America divided.

    I had to point out that’s not quite right.

    Yes, Donald’s terminology is telling, but, ‘the president should have been polite when mentioning the defeat of the other side here’ is not correct.

    If there’s some sort of policy debate, and the Democrats go to the press and say ‘We don’t like what the Republicans are doing’, it is perfectly reasonable for the Republicans to say ‘Yeah, but you lost, so, uh, tough’. Do it politely, like the meme said, yes, unlike the rudeness of Trump.

    But, if you do it politely, it’s okay to mention it when talking about whose policy gets done. (It might be a bit silly and counterproductive to do it after losing the popular vote, but whatever.)

    But the problem is…this wasn’t a policy discussion.

    This was a *HOLIDAY GREETING*.

    The president should not have talked about the other side, or at least not talked about how they lost. That is an *absurd* thing to do in a holiday greeting. It doesn’t matter how polite it is.

    Hell, that’s not just absurd *for the president*. This isn’t some presidential norm he’s tripped over here. You don’t mock losers when wishing people holiday greetings! *Normal* people know not to do that.

    Actually, you’re not really supposed to mock losers *at all*. It’s called being a gracious winner.

    But you’re certainly not supposed to do it as part of a holiday greeting.

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      • First, she said she was probably *their* enemy, not that they were *her* enemy. She was saying the Republicans probably thought of her as the enemy, not that she thought of them as the enemy.

        Second, you did notice I didn’t say you can’t ever call political opponents your ‘enemies’, right? I really don’t have a problem with that. It’s perhaps overly hostile, but it’s *okay* to be overly hostile at specific points in politics….and if anyone has a right to be overly hostile to anyone, it’s Hillary Clinton to Republicans. (Whether or not it’s a good thing to *say* that is something else.)

        What *I said was that a) you do not gloat over your defeated opponents (Whatever you call them) in politics, and b) you *especially* do not do it during a damn HOLIDAY GREETING.

        This tweet actually shows three very serious problems with Trump, sorta summarizing him in a nutshell:

        1) Trump cannot tell the difference between the generic situation of just saying some form of ‘Happy National Whatever Day This Is’ to *all* Americans, the sort of pointless platitudes the president is expected to do over and over…and a political situation.

        He doesn’t understand the president is often supposed to operate as ‘voice of the government’ instead of ‘a Democratic/Republican politician’. Sometimes there’s a fine line, but that line is nowhere near ‘generic holiday mention’. The president wishes everyone a good year, end of story, full stop. It is not rocket science.

        2) Trump defaults to hostility against people he sees as his enemies in *all* situations. Even in situations where *society* (Not just presidential norms, but actual society itself) demands a lack of hostility, like saying ‘Happy New Year’ to people.

        Even actual mortal enemies are supposed to be able to politely ignore each other as they walk past on the street, or even *pretend* to wish each other a good morning, or not start yelling at each other in social situations.

        3) Trump’s hostility includes gloating, something that generally isn’t acceptable in politics. Or, really, in real life either.

        Seriously, people, I mean, imagine a New Years Party, where everyone counts down, and yells Happy New Year, and then one guy keeps yelling ‘Even for that asshole Pete over in the corner, the loser who got fired from his job last week. He doesn’t even know how he’s going to pay his rent this month, what a loser! Meanwhile, I just got promoted! Sucks to be Pete! But Happy New Year anyway Pete!’

        Wait, imagine that, but imagine you’re at some local ball drop (Or whatever your town drops), and it’s *the guy MCing the thing* doing that.

        Trump not only can’t manage not doing that, he can’t manage that *impersonally on Twitter*.

        What the actual fuck? It’s becoming extremely clear we elected someone with a *serious personality disorder*.

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    • Richard Branson said he was invited by Trump to lunch and Trump spent the entire dinner talking about how 5 people refused to help him or slighted him in some way and then spent the rest of the dinner talking about how he was going to destroy those five people.

      https://www.virgin.com/richard-branson/meeting-donald-trump

      Donald Trump is an incredibly thin-skinned man who can’t let anything go. All the people who voted against him, all the people who mocked him, all the people who spoke against him, are to be humiliated again and again. The good thing about being a left critic of Trump is that he was never going to consider you for a cabinet position in the first place. But look at what he did to former opponents who decided they wanted a prize or to lackey up? He humiliated them again and again and they still got nothing. I don’t know who got it worse, Christie who was made to fetch Trump’s lunch from McDonalds or Romney.

      We will have to see what Trump can do to the opposition.

      But really this kind of rhetoric is just the logical conclusion of what the right-wing media has been doing for years. No wonder his fans cheer at it.

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      • The thing is here — it’ll never end. Because the people Trump wants the approval of? The people he wants to acknowledge him and praise him?

        It ain’t the American public and it’s not world leaders (not even Putin, although he’s so dreamy).

        It’s Hollywood and the New York moneyed elite. The guys that stopped inviting him to parties, stopped lending him money, made fun of him AND his show even though he’s a star like them!.

        That’s why SNL gets him every time, and while Alec Baldwin can jerk his chain without even trying. THOSE are the people he wants the approval of, the people whose disdain he recognizes and is incredibly sensitive about.

        So I guess it IS liberal’s fault. They treated a tight-fisted boor of a debtor like…a tight fisted boor of a debtor, and he’s gonna show THEM.

        And for the next four years, he’s going to be the most easily trolled person on the planet — because he can’t stop paying attention. Obama’s going to keep yanking his chain just by being more popular and continuing to exist — and having the approval of the very people that reject Trump.

        And for all I can tell, they’re right to reject him. He stiffs the help, welshes on his debts, the only charity he donates to was the slush fund he used to bribe officials and pay off lawsuits, and he apparently enjoys harassing actresses.

        What sane human being would invite him to a party if they didn’t have to?

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        • People have been speculating about this for a long time. Garrison Kellior probably summed it up best.

          http://www.chicagotribune.com/news/opinion/commentary/ct-donald-trump-losing-garrison-keillor-20160831-story.html

          This is painful for a Queens boy trying to win respect in Manhattan where the Times is the Supreme Liberal Jewish Anglican Arbiter of Who Has The Smarts and What Goes Where. When you came to Manhattan 40 years ago, you discovered that in entertainment, the press, politics, finance, everywhere you went, you ran into Jews, and they are not like you: Jews didn’t go in for big yachts and a fleet of aircraft — they showed off by way of philanthropy or by raising brilliant offspring. They sympathized with the civil rights movement. In Queens, blacks were a threat to property values — they belonged in the Bronx, not down the street. To the Times, Queens is Cleveland. Bush league. You are Queens. The casinos were totally Queens, the gold faucets in your triplex, the bragging, the insults, but you wanted to be liked by Those People. You wanted Mike Bloomberg to invite you to dinner at his townhouse. You wanted the Times to run a three-part story about you, that you meditate and are a passionate kayaker and collect 14th-century Islamic mosaics. You wish you were that person but you didn’t have the time.

          I am not sure how true this is but maybe it is true enough. I think that one thing that helped Trump is that he is from Queens and even though he grew up ultra-wealthy, he still has an outsider edge that people picked up on.

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  4. I perversely find this sort of comforting. If Prez. DJT can’t manage this kind of low hanging fruit is speaks poorly for his ability to coordinate genuine change on things I care about.

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          • The next six months will be crucial.

            In the sense that they are the part of time that has not been decided yet, and is about to happen next, yes.

            In the sense they will be unique, no. Donald Trump will be a problem for four years, or until impeached. It will not get any better.

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            • Believe it or not, David Brooks said probably the best thing about Trump I’ve heard yet. When asked about the Russia Lovefest Trump’s engaging in, he said something like (I’m putting it in my own words now…) “right now Trump and Putin are courting, and soon they’ll try to get married in terms of policy, but given that each of them have huge egos and over-react to the merest slights, the divorce will be quick and acrimonious. And given Trump’s temperament, rather than Putin’s, the inevitable angry breakup should worry us all.”

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      • I think Trump has made us acutely aware there were actually some *other* Overton Windows we didn’t ever notice.

        We all knew about the Left/Right Overton Window, but he’s made us aware of the Asshole Overton Window, and the Corruption Overton Window, and the Competence Overton Window.

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        • But… Trump’s approval ratings have only increased since election day. I’m trying to wrap my brain around that, but there you go (could just be that the election is over and everything is going to some kind of low energy state)

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    • Maybe.

      Normally Presidents are… Presidental. They skate above things with other people (often the VP) take the role of the designated bad guy.

      Thing is, no one is under the illusion that Trump is a nice guy.
      Or that the Dems are going to take losing to him with composure and good cheer.

      I’m not sure there was any low hanging fruit there. Trump is, once again, diverting attention from things that matter (what he’s doing) to things that don’t matter (what he’s saying).

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        • Sure, but even by those standards I think we’re cutting new ground.

          Some is the whole “didn’t start mourning until after the election” bit. Most elections have the winner known weeks or months in advance. Even in 2000 both sides knew losing was at least possible. The Dems though they had it in the bag.

          Some is losing to Trump, specifically. At various points in the election there was speculation that he was a Dem plant.

          Having said all that, I do wonder if it goes further than that and speaks poorly for the long term stability of the country. If it’s actually a matter of life or death for the top guy to be yours, then every election needs to have the rule book tossed out.

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            • As evidenced by the hoards of roving Democrats laying siege to the land.

              How many riots did we have after the election? How many people, apparently seriously, thought that Trump’s election meant they personally were now in danger?

              The Imperial Presidency has not, yet, grown to the point where it’s a life or death matter.

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              • My argument is that this election was not a life or death matter, but that if Trump-and-Co’s vision is realized, there are many people in this country who will be substantially harmed.

                Very understandable opposition to Trump is being treated like hysterical wailing with zero basis in reality.

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                • Because both sides have to be the same. If they’re not the same, you may be forced to vote against your team.

                  But if they’re the same on [insert whatever issue here], then it’s a wash. Ergo, Hillary must have been JUST as corrupt as Trump, meaning Trump’s corruption couldn’t be an issue because HRC was the same.

                  For the media BSDI is lazy journalism, an attempt to avoid having to get involved in complicated matters and just get a quote from both sides (and thus be “objective” which is better than anything ever).

                  For pundits and a lot of voters, BSDI is necessary cover. Dealbreaking positions stop existing because both sides are the same on it which means you can ignore it and vote for your team or whatever.

                  Liberal opposition to Trump must be equal — in all manner and context — to conservative opposition to Obama, because if it’s not then someone might have to change their side.

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                  • BSDI also focuses attention on the battle between personalities, like this was the Apprentice season finale, between Trump and Hillary.

                    As someone here pointed out, Trump’s supporters don’t seem to have an agenda, no big policy initiatives, no change in direction for the government other than Piss Off Liberals and Stomp Hillary.

                    Thus the shock and awe when they discover that there is now an incoming power center that has an agenda of its own, very different than any coal miner in West Virginia or steelworker in Ohio ever imagined.

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                    • BSDI may be what both of you say, but in my view it’s primary function is to reduce “both sides” to exactly the same “its” which each side criticizes the other of doing. And the purpose of this is to signal an elevated viewpoint from which the “game” is being played. So, so-called “non-partisans” invoke this trick to maintain their abject and objectively justified rejection of entering into that abysmal fray, all the while advancing their own ideological views and policy positions fully accompanied by snipes at (in this case) the other side.

                      From a media pov, BSDI constitutes a cover that they’re presenting the news impartially, fairly and objectively so’s to maintain street cred within the journalistic/media community. And they’re not wrong to do so, in one sense: if “both sides” reduces merely to the specific complaints Xs have about Ys (with the variables replaceable by Ls or Cs, or HRC or DJT, etc) then they’re absolutely correct. “Both sides complain about the other with equal strenuousity! Fair and balanced!”

                      Of course, facts get left outa the calculus on either view. But that’s by design, tho serving different purposes in each case.

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                • My argument is that this election was not a life or death matter, but that if Trump-and-Co’s vision is realized, there are many people in this country who will be substantially harmed.

                  Consider: Many people were already in the process of being substantially harmed to the point where they saw “disrupting the status quo” as preferable to maintaining it.

                  I would suggest Chris Arnade’s work as a starting point for evidence for how this view is different from a simple “both sides do it”.

                  When it comes to the media, the main thing to notice (and, perhaps, freak out about) is the whole issue of the uncertainty whether any particular criticism of Trump is grounded in aesthetics or grounded in policy given that there have been a metric buttload of aesthetic criticisms of Trump.

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                        • Should I have said “were dealing with the aftermath of having been substantially harmed”?

                          Is this one of those things where one of us is talking relative position and the other is talking about absolute position?

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                          • Neither. I’m talking about semantics. “harmed” means many things, but to use the word deliberately ambiguously (as I’m inclined to believe you did, given your response) seems disingenuous.

                            I’m not disagreeing with what I take to be your deeper point, btw. Just the means to demonstrate that point.

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                            • Well, how’s this:

                              There are a bunch of people out there in a position where, were any of us placed within it, we would consider ourselves “harmed” to have been placed there.

                              The people who are there also consider themselves harmed by being there despite perhaps not having traveled as far to get there as we would have had to travel to get there.

                              It is these people who Chris Arnade is reporting on and it is his perspective that is worth considering, especially if one is hoping to avoid a “both sides do it” take on why people voted for Trump.

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                              • and it is his perspective that is worth considering, especially if one is hoping to avoid a “both sides do it” take on why people voted for Trump.

                                Man, now I’m really confused since you’re the one who introduced all this to make a “both sides do it” take.

                                If you’re saying people are pissed off and feel mistreated and that’s why they voted for Trump, then say it. I’d agree.

                                I just don’t think responding to Kazzy with a “the other side thinks they’re harmed too!” comment quite gets beyond the equivalence threshold. As if there was nothing at stake in this discussion other than “well, BSDI!”

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                                  • Well, now I fee like an a*****e.

                                    My gripe in these types of discussions is that two views can be correct: ie., that Kazzy’s view that certain types of people will experience harm as well as the view that folks who voted for Trump have already experienced harm (so that’s why they voted for him in particular) can be true.

                                    Are those (let’s stipulate) conflicting harms reconcilable politically? Maybe, maybe not. If they are, we ought to try to move along one path, if they aren’t we end up going along another path.

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                                    • The main thing I want to avoid is truth-independence.

                                      “This dynamic is going on.”
                                      “There is also another dynamic going on that is similar.”
                                      “BOTH SIDES DO IT! JESUS YOU ALWAYS PULL BOTH SIDES DO IT!”

                                      When “BSDI” comes out, it doesn’t even matter anymore whether there are multiple dynamics.

                                      The important thing is to get in the first word then, when someone else points out another dynamic, yell “BSDI!”

                                      And that has nothing to do with whether the dynamics exist and are the drivers behind various phenomenae.

                                      Are those (let’s stipulate) conflicting harms reconcilable politically?

                                      I have no idea.
                                      They very well might not be. We could easily be in a “we have to pick whose turn it is to be in the barrel” situation.

                                      If that’s the case, yelling “BSDI” makes a lot of sense. It pretty much does a good job of dismissing any concern that precludes fixing your own concerns.

                                      If, however, they can be reconciled… well, that’s why we need to make a proper diagnosis in the first place.

                                      Of course, at that point, it looks like we’re doing triage. And who are we to pretend to be doctors? Who are we to say “this is the guy who gets operated on”?

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                                      • This reminds me of what undermines man domestic arguments.

                                        “Ugh, it really frustrates me when you leave your dirty laundry on the floor.”
                                        “Yea, well, you haven’t done dishes in a week!”
                                        Now what? Both people may be right. But you can’t really argue about the laundry and the dishes at the same time.

                                        A far more productive approach is, after the second person tries to shift the dynamic, to say, “I hear what you’re saying about the dishes. We should absolutely deal with that. But I really need to talk to you about the laundry right now. Let’s settle that and then we can discuss the dishes, now or at a later time of your choosing.”

                                        If I’m understanding you correctly, you seem to be encouraging the former, highly unproductive approach. “Quick… get a counter jab in so we don’t actually have to deal with their concerns.” Am I misunderstanding that?

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                                        • If I’m understanding you correctly, you seem to be encouraging the former, highly unproductive approach. “Quick… get a counter jab in so we don’t actually have to deal with their concerns.” Am I misunderstanding that?

                                          Encouraging? If anything, I merely noticing it and pointing it out.

                                          There are a lot of dynamics and a lot of people who have been hurt and there are a *LOT* of chores that just aren’t getting done.

                                          Now if we’re saying that we can’t argue dishes and laundry at the same time, and maybe we can’t, I’m saying that we’d be better off taking turns discussing the chores, first you can complain about the dishes, then I can complain about the laundry than saying “I don’t even need to listen to you complain about the dishes until I have clean laundry. To the washing machine… GO!”

                                          Because if we’re saying that we don’t have to listen to the other people until sufficient of our concerns are met, we are going to find ourselves wondering why they are not only not doing the dishes but no longer listening to us at all.

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                                          • I think alternating is a good approach. The problem is that people often assume the presence of their own concerns justifies tuning out others. That helps no one.

                                            But the thing here was… YOU raised the other concerns. In response to an expression of concerns. No one here denied that concerns exist on all sides. But your response to an expression of concerns was reminding us that other people have concerns… a reality no one here denied and which was immaterial to the concerns being expressed.

                                            So, yea, I’d call that encouraging the approach by employing it.

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                                            • The other concerns were actual, though.

                                              So run with the analogy: “I worry that if Trump gets elected, people will stop doing laundry!”

                                              “People haven’t been doing the dishes for years.”

                                              “BOTH SIDES DO IT!”

                                              Now, is it fair to point out that the dishes haven’t been done for years in response to someone worrying about the laundry starting to not be done?

                                              Perhaps I should have let you continue to worry about the laundry.

                                              Exactly who do you think will be harmed by Trump’s election and how?

                                              We can look at stuff like abortion rights, employment numbers, and transgender issues. Will any of these harms be measurable?

                                              I think it’s important that they be measurable to some extent.

                                              If they’re not, we’re likely going to be able to use the exact same events to argue that these harms happened and that they didn’t because, as we said, these harms aren’t measurable.

                                              Let me know when you’re done.

                                              I think that there are other dynamics going on, measurable ones, I think that they are relevant to the debate but I want you to establish what you see as the relevant harms that you think are going to happen in Trump’s America first. We’re going to need to keep an eye out for them, after all.

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                                              • I definitely think the harm can be measured. We can count the number of women who wanted abortions but couldn’t get them because of barriers that were erected. Hell, we could then calculate the costs to these families and society as a whole as the result of unwanted pregnancies being brought to term.

                                                LGBT rights… well, we could probably count up the folks who are denied services.

                                                And once we get to a 1, well, we have evidence of harm done.

                                                The good thing is that I don’t think most of the harms — on either side — are opposite ends of a balance. As I said above, we can address unemployment in the rust belt without touching abortion or LGBT rights.

                                                Where things get hairy is when the avoidance of these harms come into conflict with one another. At that point, we have to put both/all harms on the table and get into the nitty gritty.

                                                However, I have to point out a flaw with your approach.

                                                You posit that the person complaining about the dishes is different than the person complaining BSDI. I contend that they are one in the same. In fact, in this scenario, it was you who did both. You raised the issue of the harms suffered by Trump supporters as if that was itself a counter argument to the harms likely to be suffered by Trump opponents because, hey, both sides were harmed.

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                                                • There’s a certain style of argumentation that doesn’t want to get into the weeds, because once you get into the weeds you’re dealing with complex realities that are complicated, hard to parse, often heavily contextual, and basically really, really messy.

                                                  It’s a very ideological style, very “ivory tower”.

                                                  Because you can be pure to your ideology (or in your denunciation of one) precisely because you’re avoiding the messy details of reality in favor of intellectual constructs.

                                                  Everyone does it to some extent. There’s always a balance between the big picture view and the detail view, but when you run into arguments where details, where data itself, is irrelevant…..

                                                  Well, that’s generally a sign you’re talking philosophy not real world problem solving. And there’s a nasty strain of that style that loves BSDI because it frees them from those petty details (like that both sides aren’t the same) to get back to that really interesting philosophical stuff.

                                                  (Unsurprisingly, this is often done by people to whom those details really are irrelevant. Whatever context you’re discussing has nothing to do with them. If you’re not gay and wanting to get married, you can hand-wave away gay marriage to focus on things like “Should government be involved in marriage” because the question, to you, is pretty much entirely intellectual).

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                                                  • Ideologically driven folks might be unwilling to look into the details regarding the policies and principles they support, but are often VERY keen on getting into the details when criticizing their opponent’s ideologically driven views. (“See this very small thing over here? The one I’m pointing at? You see it? BOOM! You suck!”)

                                                    The devil may in fact reside in the details, but that cuts both ways. Or all ways indiscriminately. No ideologue comes out unscathed.

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                                                • To bring us back to marriage, let’s instead look at the iterated prisoners’ dilemma.

                                                  To reframe your statement within the dilemma, you said (and this is a paraphrase) “I’m worried that the other prisoner will start defecting.”

                                                  So when we point out that the other prisoner was a defectee multiple times in the dilemma, it is not a “both sides do it” to point out that we have defected against the person we’re worried about defecting against us.

                                                  Indeed, worrying about them defecting against us is something that we ought to have done before we started defecting against him.

                                                  “Both sides do it”, at that point, becomes an accurate way to describe an equilibrium within the dilemma.

                                                  Which is different than the “both sides do it” of assigning moral culpability.

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                                      • When “BSDI” comes out, it doesn’t even matter anymore whether there are multiple dynamics.

                                        That confuses – deliberately, in my view – the basic complaint, which is justified given you’re earlier comment: “There is also another dynamic going on that is similar.”

                                        Given that *in that sentence* you’re establishing an equivalence between the two dynamics (by using the word “similar”), it’s incumbent upon you, the speaker/critic, to identify in what ways the two dynamics are similar but not identical. Without that you become the person who’s introducing the BSDI equivalence, rather than, as you claim, your justifiably irritated interlocutor.

                                        Btw, BSDI is not an equivalence partisans make in a two sided war. That would make no sense, correct? (“We’re just the same as these guys, actually, so uh, yeah, I don’t know what we’re fighting about…”) It’s a judgment spectators of that war make to express disdain of, or contempt for the conflict (as well as signal that they’re above all that silly team-oriented, fray-based squabbling! Let’s not forget signaling theory here!).

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                                        • Well, my “both sides do it” was not saying “man, the Republicans in congress are like the Democrats in congress” but “you’re worried about laws and policies that will harm you and yours… I’d point out that there have been multiple laws and policies passed against the people who voted Trump and they’re shaking things up”.

                                          It wasn’t intended to be a particularly partisan observation as much as a “defectees gonna defect” observation.

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                          • Well, I thought that “substantially harmed” was an accurate enough descriptor of those who Chris Arnade refers to as “the back row”.

                            Certainly not inaccurate to the point where it doesn’t describe why they weren’t willing to disrupt the status quo.

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                            • That’s just it, tho. Those folks may be harmed (in some sense of that word) but that’s a different type of harm than Kazzy’s talking about wrt Trump’s policies (rolling back RoevWade, Muslim registries, deportations, etc).

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                              • Well, Kazzy seems to be specifically carving out that he’s not talking about “life and death” harms, but other kinds.

                                The people I’m talking about survived this long, that’s for sure.

                                But that’s why I see them as relevant.

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                  • I agree but would argue that those people could be helped without harming many of the people Trump-and-Co are potentially going to harm.

                    You can address unemployment without bathroom bills.

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                    • Further, the argument I’m seeing put forth is that liberals should sit down and shut up because Trump isn’t hanging people from the White House awning. My argument is that even if people don’t die as a result of Trump-and-Co’s policies, many people will be harmed.

                      The truthiness of this seems independent of whether or not people were harmed by Obama’s policies or would have been harmed by Clinton’s.

                      Here is how I’m seeing the discussion often going:
                      1.) Liberals complain about something Trump says/does.
                      2.) Non-liberals (or folks such as Dark Matter, however he identifies) argue that liberals ought not complain because no one is/will be dying in the streets.

                      If liberals push back against that opposition, I struggle to see how a valid response is, “Well, Obama harmed people, too. And Clinton would have.” Even if that’s true (I agree that it is), it says nothing about the legitimacy of complaints about the harm caused or likely to arise from Trump-and-Co’s policy.

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                      • My argument is that even if people don’t die as a result of Trump-and-Co’s policies, many people will be harmed.

                        Oh, that’s probably true. That said, it is very important to not be crying wolf here.

                        There has been a lot of wolf-crying in the last… I don’t even know how long. Can we go back far enough to remember when people were complaining about how women would be treated in Mitt Romney’s America? Comparing Mitt Romney to Hitler?

                        It’s certainly true that there are people who would have been harmed if Romney got elected instead of Obama getting re-elected.

                        I have no doubt of this. That said, it’s a difficult thing to gauge, isn’t it? I mean, looking back now, would it have been *THAT* bad if Romney got elected?

                        Would it have been as bad as those who argued against his Freudian slips in which he indicated that he saw womens’ place as being in bondage indicated?

                        I submit to you: no. It would not.

                        If liberals push back against that opposition, I struggle to see how a valid response is, “Well, Obama harmed people, too. And Clinton would have.” Even if that’s true (I agree that it is), it says nothing about the legitimacy of complaints about the harm caused or likely to arise from Trump-and-Co’s policy.

                        At this point, it becomes important to figure out what we’re measuring.
                        Because if we agree that we’re just picking who gets hurt and how bad, it’s pretty important that we demonstrate that we’re good at measuring harm.

                        The harm-measuring skills of the people who opposed, for example, Mitt Romney strike me as being calibrated imperfectly.

                        Wolf has been called a lot. This calls future wolf calls into question.

                        This is very, very bad because there is a wolf out there and, someday, we will very much wish that we had a shepherd class worth listening to.

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                      • 2.) Non-liberals (or folks such as Dark Matter, however he identifies) argue that liberals ought not complain because no one is/will be dying in the streets.

                        Oh, I’m all over the place.

                        And my point is Liberals need to pick their battles. If you react every time he’s an ass, then he owns you.

                        He’ll have policy proposals out there which matter, and you’ll be complaining about some outrageous tweet which is totally off topic. Trump is sucking all the oxygen away from his opposition by deliberately mis-channeling your outrage.

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                    • Is there a point at which “we could help you without harming many of the people that your preferred politicians would harm!” evolves into a trivially true statement?

                      That is, it’s true… but you never have thus far and why in the hell would someone have believed that Clinton would have offered the help that you’re talking about?

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                      • What “help” are we talking about? If it’s talking credit for other people’s actions and telling lies about bringing jobs back, yeah, she could have done that too.

                        If it’s creating jobs rebuilding infrastructure, no, Clinton probably couldn’t have gotten that through an obstructionist GOP Congress. (Obama couldn’t.) Can Trump? We’ll see.

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                        • CNN was on during dinner and the sound was off but the chyron read something to the effect of “FORD TO NOT BUILD FACTORY IN MEXICO, WILL BUILD IN MICHIGAN”.

                          Followed by “CEO STATES ‘THIS IS A VOTE OF CONFIDENCE IN TRUMP'”.

                          Now, you and I both know that there’s a lot of stuff going on with the Ford thing and it’s just as likely to have happened under Clinton.

                          But that chyron… The narratives surrounding Trump seem to have lives of their own.

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                  • Consider: Many people were already in the process of being substantially harmed to the point where they saw “disrupting the status quo” as preferable to maintaining it.

                    Indeed they saw disrupting the status quo as preferable, but that just a subjective view, not an objective fact. There are millions of iterations of disrupting the status quo in which the disrupters will end objectively worse.

                    And so far, most of the hints we have about scenarios of disruption bode quite gloomy for the disrupters, which will not see the mines reopen, or the industrial jobs come back, but might instead lose their health insurance, their Medicaid, their Medicare, and the industrial safety regulations that help keep the few remaining miners alive.

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                • Very understandable opposition to Trump is being treated like hysterical wailing with zero basis in reality.

                  Really? I see very little opposition to Trump that isn’t hysterical wailing. I think too many libs have internalized their own normalization ideas to their own detriment. I think they’d be better off if they’d treat Trump as a normal President and criticize him on that premise when the situation arises.

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                • Very understandable opposition to Trump is being treated like hysterical wailing with zero basis in reality.

                  The very understandable opposition to Trump is being drowned out by the hysterical wailing.

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                  • He’s spoken with a foreign leader to interfere with American foreign policy while still a private citizen. Not only does that violate all norms of behavior for presidents-elect, it’s against the law.

                    Yeah, I know, hysterical wailing. I’ll try to say something sensible instead.

                    He’s a stealth socialist who’s going to confiscate all of our guns, send his enemies to reeducation camps, and ban religion!

                    Now do I sound like a sensible conservative?

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                    • Dark Matter: The very understandable opposition to Trump is being drowned out by the hysterical wailing.

                      Mike Schilling: He’s spoken with a foreign leader to interfere with American foreign policy while still a private citizen. Not only does that violate all norms of behavior for presidents-elect, it’s against the law.

                      Great example. So how much time/whitespace have we spent talking about *that* as opposed to him being an ass with the X-mas greeting and proposing having his daughter as first lady?

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                      • Great example. So how much time/whitespace have we spent talking about *that* as opposed to him being an ass with the X-mas greeting and proposing having his daughter as first lady?

                        It’s not how much time *we* spend, really.

                        It’s how much time we can get *the media* to spend on it.

                        As I said on the first lady thing, the proper response to that from people who oppose Trump is ‘Wow, that is an interesting thing Trump is doing there. Well, you’ve informed everyone of that, now how about you inform us about *rolls 20-sided die and picks reason that Trump should not be president from table* how Trump is threatening to leave our allies in Eastern Europe hanging because of his weird Putin entanglement.’

                        The first lady thing was something that, correctly, was reported by the media as existing. We can’t blame them for that. The people opposing Trump could either make it a real story by (for some weird reason(1)) being upset by it, *reducing media resources*, or not make a story. (And, luckily, I think people managed to avoid the bait.)

                        This tweet, OTOH, is worth mentioning, if only to add to the ‘Trump is an asshole and cannot stop being an asshole’ pile.

                        ‘Look, he can’t even neutrally wish all Americans a New Year. Maybe there literally is something wrong with his brain.’

                        It’s not something the media should spend a lot of time on, but it is something that should be added to the pile of evidence. Just keep talking about how Trump *cannot behave like a president*. That needs to *keep being talked about*.

                        1) You know, even if the first lady thing *wasn’t* just a distraction, it’s not even slightly important and not anything the left or anyone else should be opposed to for any real reason. I mean, it’s an interesting side story, especially as this election we though we were going to have a disruption in the ‘Office’ of First Lady with Bill Clinton, and instead we get one in Ivanka Trump, and we really need to start thinking about our assumptions of all that stuff in the future, and perhaps some sort of ‘First Host’ position might make sense. But it doesn’t seem like there’s *any* reason to *object* to that situation. (Well, except Ivanka Trump also has the same foreign and domestic business entanglements Donald has.)

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                    • Press Release: President-Elect Obama Calls Foreign Leaders Today
                      November 18, 2008

                      President-elect Barack Obama today returned phone calls to five world leaders and expressed his appreciation for their congratulations on his election. President-elect Obama spoke with:
                      President Fernández de Kirchner of Argentina
                      President Bachelet of Chile
                      Taoiseach Cowen of Ireland
                      President Nazarbayev of Kazakhstan
                      President Abbas of the Palestinian Authority

                      One can certainly question the prudence or motivation of accepting a call from the President of Taiwan, but the complaints that it violates law or custom just isn’t true.

                      Accepting a call from the Palestinian Authority was certainly a signal that interferes with the policy of the sitting president. That’s somewhat the point… signals are signals and the incoming president makes them.

                      You can debate the signal as much as you want… I have no problem with that, but calling into question the right of signalling lest we “normalize” something that is normal is the wrong fight.

                      It’s the 140 character twitter fight, not an actual fight over policy towards China.

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                          • Fair enough, Egypt is different than Taiwan, perhaps… but I’m not seeing a difference in the response. Which goes somewhat to the point that is being made upthread… don’t fight every twitter war as if its the war to fight.

                            I doubt the Logan Act would hold-up to a president elect, but then the good news for Trump’s downfall is that he is inept at navigating the minefield. Eventually he’ll hit a real mine. Be ready for that time.

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                              • Depends what you mean by precedent… if you mean every president-elect who was ever president-elect started contacting foreign governments and signalling their intentions, then yes.

                                President-elect doing so rather ham-fistedly on meaningless matters, then not that I can recollect… unless Regan’s negotiations with Iran count. But then Reagan had the good sense to use back-channels and retain plausible deniability. Trump? He’s using front channels… that’s the break with tradition. All you’d succeed in doing is moving everything to back-channels – which is probably a good idea, but not the object of the exercise as far as I can see.

                                But that’s my follow-on point… is the Logan act the bullet you want to shoot? Because I don’t think you’re going anywhere with that shot at the President-Elect. I can’t say for sure that it wouldn’t work, but (sticking with the hunting analogy) you’re taking a high risk long-distance shot with little chance of success while your prey is on a path to enter comfortably into range if you just wait.

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                                • The reports indicate he explicitly negotiated with a foreign leader in direct opposition to US foreign policy as was being pursued by the federal government at the time. That seems a pretty clear violation of the Logan Act (as I understand it) and troubling because it undermines the sitting President’s (who IS the President for 17 more days) ability to do his job. Imagine there was an international incident in the next two weeks that required an immediate response from our government… would we really want foreign leaders to wonder who that response is going to come from or which one they ought to acknowledge if multiple ones come through?

                                  Maybe pursuing this would be a strategically poor choice but, good god, can we really not stop the partisan shit for 2 seconds and say, “Yea, he really shouldn’t have done that… that is highly problematic. We have one and only one President and that is currently Barack Obama and that will remain the case until January 20.”

                                  Probably not given that recent GOP shenanigans have essentially reduced the Presidency to a 3 year term with a do-nothing year tacked onto the end.

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                                  • Go for it.

                                    I did say he shouldn’t have done that (the way he did it).

                                    Now, if there really was a big international response that truly required both immediate and long-term responses, the President-elect would weigh in – no matter who it was. That’s just not a constitutional crisis.

                                    But that’s still my larger point, Trump is unschooled in the art of governing… he’ll do many things in the next 4-years that are questionable, uncountable imprudent things, and quite possibly one or two that might be genuinely impeachable.

                                    I’m not being partisan… I think his actions are hamfisted and I expect his administration to be the equivalent of a corpse tumbling down a spiral staircase in slow motion.

                                    But President-elect getting involved with World Leaders days before his inauguration isn’t the outrageous act that will generate prison or impeachment.

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                                    • “But President-elect getting involved with World Leaders days before his inauguration isn’t the outrageous act that will generate prison or impeachment.”

                                      So much for law-and-order.

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                                      • Do you think so?

                                        Do you really think Logan would catch a President-elect? Have you gamed out the effect of a weaponized Logan on people who visit Davos for reasons other than x-country skiing? Who’s restraining whom here?

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                                        • Is there a statute of limitations on Logan?

                                          Maybe we can finally get that Jane Fonda once and for all.

                                          Golly, if we start using this against celebrities, imagine the wonders we could create!

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                                          • Dude… Breitbart was wondering just this – way back in 2013 – with cases for Jesse Jackson, Jimmy Carter and Barak Obama ready to go. Sean Penn is reading this thread in fear and trembling.

                                            Plus, there should be at least a tiny bit of reflective irony in that America officially abstained… And John Kerry was totally not involved in drafting the resolution.

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                                            • I distinctly remember my grandfather telling my mother that he didn’t want her to go see “On Golden Pond”. The damn movie won, like, a kabillion oscars. He gave a large speech for him, a small speech by most any other measure, in which he said that he didn’t think much of Jane Fonda and that he didn’t think much of anybody who’d put money in her pocket.

                                              My mom, to the best of my knowledge, never went on to see On Golden Pond.

                                              As the jackboots kick her in the kidneys while someone in the room screams “STOP RESISTING”, I suppose I could console myself with the thought that I only care about law and order.

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                                              • …Jane Fonda…

                                                As the jackboots kick her in the kidneys while someone in the room screams “STOP RESISTING”, I suppose I could console myself with the thought that I only care about law and order.

                                                Reading over her wiki, I see *nothing* about her being physically attacked, as opposed to scorned. People think poorly of Jane because she was photographed during the war sitting on a North Korean anti-aircraft gun cheerfully clapping and applauding.

                                                The jackboots are imaginary, something the left tells itself to justify its actions. The anti-aircraft gun was real, and presumably killed US pilots.

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          • For Democrats, it’s life or death not to have the top guy be a vile, incompetent buffoon. For Republicans, it’s life or death not to have the top guy be someone who’d do a perfectly reasonable job but whom they’ve spent the past 25 years hating,

            Both sides do it.

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          • I’m probably biased but the ground seems pretty well trod. I haven’t seem the Dems suggest he’s not an American*, or that he’s a closet Muslim, or a closet communist
            yet. The year is young though.

            *Though a few of the wingier wingnuts have taken shots at his wife’s citizenship.

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    • Might I suggest that your nonchalant attitude towards Trump has not had the best track record so far and it could be time to reconsider.

      Trump is not in power yet so he can’t do anything against his liberal or left critics. He could put Christie and Romney through a show and make them beg like craven idiot’s without a soul. But Trump does take power in 20 days and he doesn’t strike me as the type to take it lightly if a court rules against him or Democrats actually engage in constitutionally permissible obstructionism. There is also the Sessions’ DOJ which can be turned into a partisan office for screwing and persecuting the opposition.

      What is it going to take for you to be nonchalant and blase? Forced to move back to Canada? A massive, global depression? People getting rounded up into labor camps?

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      • Well I grant I’ve been pretty consistently wrong about Trump in terms of his ability to win the nomination and HRC’s ability to beat him in the general.

        I would ask though, if we’re screaming now about Trump when he hasn’t done anything yet (because so far all he can do is shoot his mouth off) then will that make us more or less effective once he does do something deplorable and we scream about it? Also if we’re screaming and attacking Trump now, before he’s done anything, would that make a creature as presumably malleable as Trump is more or less likely to be willing to consider liberal proposals or objections?

        I mean what’s our strategy here? Is it principled opposition or Obama era full out opposition? Something else? Because whether the goal is to try and pull Trump to the left and work with him; simply protest and try and stop him when he does something bad or ape the GOP and secretly oppose everything he intends to do yelling about Trumps outrages before he’s done any huge outrages strikes me as contrary to all of those strategies.

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        • I see a lot of wishful thinking among my liberal friends, the idea that there is some magic silver bullet, a One Weird Trick that will devastate Trump and the GOP.
          I don’t think it works that way.
          There isn’t One Argument that works for all interest groups, not one big thing that will change millions of minds.

          Constant hammering of points, constant attacks from all different angles.
          A liberal attack on Trump; a conservative critique of the GOP; a religious moral argument against Trump; a economic utilitarian attack on the GOP.
          Personal stories by women who no longer have access to reproducive services; personal stories of working class people cut off from health coverage. Pocketbook issues like the minimum wage.
          Personal attacks on his Cabinet; Comparing the billionaires who loftily talk about how minimum wage workers don’t need breaks, as they themselves idle away their time on yachts.

          In the same way that “I’m from the government and I’m here to help you” went from being a warm promise in 1939 to a punchline in 1979, the tropes that hold up the GOP election victories like “fiscal conservatism”; “Running government like a business”; “we can say Merry Christmas again” need to be mocked and ridiculed endlessly until people get embarrassed to say them.

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          • Okay and assuming we grant your premise does freaking the fish out over tweets lend itself to or hinder that strategy.
            Also, I wonder if it’s possible to replicate the “I’m from the government” rebranding now that those slogans have entire infrastructures of sustaining support interconnected together through the internet.

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            • I’m warming to the Berluscioni strategy of ignoring the antics and focusing on the actual harm.
              “He’s a clown” is not a bug for the GOP base, since their primary goal is to piss off liberals.
              His corruption, the swamp of Wall Street cronyism, and the pocketbook pain seem like better sources of resistance.

              I think that the “run government like a business” really is tired; for most people who have experienced downsizing, outsourcing, temping, and general fuckery by corporations, the image of the heroic CEO isn’t very powerful.

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        • The political science tends to suggest that the best strategy for the Democratic Party is to oppose Trump on every little thing and make the Republicans do all the work themselves rather than work with them. People tend to put all blame or give all credit to the President and punish or reward the President’s party accordingly. The Democratic Party needs to act on this strategy.

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            • Exactly. Playing cynical games is not what Dems are good at. (They have no gift for strategy…) Nor does it strike as a winning play in the long game. Pretty generally across the country Dems are getting their butts handed to them, and until that tide turns at the localish level pure obstructionism will look more like petulance than an expression of power.

              And to your other point, Dems right now lack a compelling narrative, and getting one should be the first order of business.

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          • Well sure, but freaking out over his tweets doesn’t really help that strategy. Loudly and insistently claiming that the Dems are trying to be bipartisan while refusing to cooperate is the 2008- present strategy that worked pretty well (politically) and freaking out over Trumps tweets works against that as far as I can see.

            Also, if we copy the modern GOP’s strategy on this we have to be willing to eat the cost as well: that in any area where Trump & Co get through the blockade liberals and Dems cede any influence over what shape the policy takes. I mean yeah Obama gave away a number of GOP wishlist items early on in an attempt to be bipartisan but Trump is definitely not trying to redo Obamaism.

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            • One thing to maybe freak out about is how the senator with whom he has the longest relationship is the new minority leader.

              I mean, if you have any libertarian inclinations that is.

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              • I was gonna snark that I’d be more worried about him colluding with the Senate Majority leader and House Speaker to potentially liquidate the safety net wholesale but then I reread your comment and remembered we were looking at this from a libertarian perspective in which case those would be considered lifts.

                But yeah, Schumer, being a Senator from Trumps home state, does probably have a longer “relationship” with Trump than the others. That, of course, is relative. I’m also puzzled about what we fear the near powerless minority party leader will do, from a libertarian perspective at least?

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        • I mean what’s our strategy here? Is it principled opposition or Obama era full out opposition? Something else?

          There were some people in my town arranging a protest on January 20th.

          Well, a ‘protest’. Real protests have *actual goals*. There is no possible goal that can be accomplished on January 20th. There is literally no goal listed except ‘Trump not be president’, but they don’t seem to have any idea of how to make that happen.

          So this ‘protest’ is just ‘We are going to make it clear we are opposed to this president before he’s done anything’

          Although, just to be clear, he actually *has* done a lot of stuff, and, as I’ve argue before, should not be allowed to become president because of his business entanglements and the emolument clauses. Congress needs to step up and do their job and impeach him before he takes power.

          But I *know* all that. I can make arguments to that effect, and I’ve been doing so on Facebook.

          But the people trying to do the ‘protest’ just have the argument ‘He’s an asshole, and we don’t like that he’s president’. Hell, they probably are not aware he can kept from taking office by impeachment. (Although not by starting a protest in a small Georgia town *an hour before the transfer of power*!)

          And ‘protest’ that is all people will see, and now ‘the left’ is opposed to the new president for ‘no good reason at all’, because those idiots have absolutely no coherent argument or goal.

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  5. This seems like the same sort of thing the anti-Trump conservatives were complaining about during the campaign (and I was one of them).

    There’s a pretty clear operating double standard that just is. Trump can troll whoever he wants, but libs (or conservatives for that matter) can’t troll back. Trump can be opposed, but he can’t be trolled. I can’t even think of a way to explain it other than to say that Justin Bieber gets to have sex with groupies if he wants to but you don’t. The libs complaints about “normalization” seem to be working in reverse. I know I can’t be bothered about it.

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  6. If the communitariat is still talking about this type of BS 6 months from now, it’s going to be a LONG 4 or more years….

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    • Oh, it’ll be four long years. I’m just curious why you think Trump’s petulant tweet isn’t worthy of criticism. He’s the Leader of the Free World-Elect and he consistently acts like a 4 year old right before being put in timeout.

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      • Because if we devote our attention to every bullshit tweet he puts out (which is practically every tweet) we draw focus away from even more horrible stuff he will be doing. Everyone on our side already knows that he acts like a 4 year old. Everyone on their side already doesnt care. Immature Trump is not the angle that will win you 2020, even if it is true. Even though being president is a place where style does matter, this is still fairly characterised as elevating matters of style over those of substance. Rehtorically, strategically, dialectically, that is never a good place to be.

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        • We’re entering really perverse territory.

          “They don’t care he’s a monster so let him act like a monster. That’s how we’ll stop future monsters.”

          There are, what, 60 million or so people who voted for Hillary? Surely SOME of us can focus on his Twitter nonsense while some of the rest of us can focus on other things, right?

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          • “Surely SOME of us can focus on his Twitter nonsense while some of the rest of us can focus on other things, right?”

            So far, I’m not seeing that…not in the MSM..not here. Not anywhere. All I’ve heard and read, other than a little Russian nonsense and cabinet appointees, is how terrible Trump will be and “journalistic campaigns” for support to prevent the horrors that is “the donald”. That last one came from Slate. Maybe I missed it. I was out of pocket for the last week.

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            • Maybe we live in different realities, since as far as I can tell, the exact same people who criticize his tweets also worry about and criticize his connections to Putin and Russia, his stance on NATO, his foreign policy in general, his trade policies, his domestic policies including Medicare, EPA regulations, climate change, etc and so on, IN ADDITION to his COIs.

              People are amazing things.

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              • What I’ve seen is SPECULATION on what his policies will be. Other than the comment about nato countries paying their fair share, I’ve seen little specific policies announced, since, you know, he’s not president nor has an admin up and running.

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                • Since even you don’t know his policies, it’d be effing stupid for folks to write posts about what the Dems in congress should be doing, yes? I mean, what a waste of time!!

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                  • Really? A few days after the election, I read on Slate articles about how “we must resist a trump presidency” and “don’t normalize this” type articles. That’s perfectly fine, but “here’s how the dems can shut down a trump presidency” or “what’s next for the dems” or “how the dems can take the congress/pres back in 4 years” it’s effing stupid?

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                • So we can’t complain when Trump’s actions show temperament and behaviors that are unpresidential and troubling for our commander in chief. We can’t complain about policies because it’s just speculation about what he is going to do. We can’t complain about the popular vote, Russian hacking, or Comey because that’s just sour grapes. Is there anything legitimate to complain about with this administration?

                  Also, he has made policy proposals (not well thought out or supported, but what can you do?). He has a tax proposal, infrastructure project, withdrawing or renegotiate NAFTA, increased military spending.

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          • “They don’t care he’s a monster so let him act like a monster. That’s how we’ll stop future monsters.”

            Monster? Because of a tweet which didn’t kill or injure anyone?

            At the moment he’s lacking social skills and/or deliberately manipulating people by pushing their buttons.

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            • “Monster? Because of a tweet which didn’t kill or injure anyone?”

              God, if that’s the level of “monster”, what do we call a president that drops bombs on people from a drone?

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          • Frankly, I’d be satisfied if our media can learn not to quote Trump’s tweets in their headlines and give the impression that they’re conveying information about the real world. At this point, he seems to have figured out how to manipulate the news by making wild claims on Twitter knowing they’ll be quoted in headlines and maybe contradicted in paragraph four (as long as the writer studiously avoids outright saying Trump’s claim is untrue).

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            • At this point, he seems to have figured out how to manipulate the news by making wild claims on Twitter knowing they’ll be quoted in headlines

              (can’t remember where I read it but presumably based on a source within or close to the Trump campaign, but) it’s not something he’s recently figured out: it was pretty much the entire strategy of his campaign. Post a shocking, controversial tweet early in the morning on the predictable expectation that the media, twitterati, 24/7 cables news shows, etc, would drive his messaging for him thru the day and maybe even into tomorrow. IOW, he used his opponents hypersensitivity to PC-civility against them and (obvs) to his own advantage.

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          • “They don’t care he’s a monster so let him act like a monster……”

            Are we supposed to take this as obviously true prima facie? I can think a lot of ways to describe Donald Trump, many or most of them pejorative, and I wouldn’t necessarily buy this.

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            • And thus the normalization begins. He can’t wish the nation a Happy New Year without shitting on half of his constituency. Coupled with his other treatment towards anyone he perceives as standing in his way and I’m comfortable calling him a monster.

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              • I hate to break it to you but the normalization began a long time ago. As it stands, I think this Maginot Line in libs’ minds is a lost cause.

                The American people are thinking about managing Trump, working with Trump, minimizing the risks of his quirks and insecurities. The resistance of the refuseniks is just a means for the governing majority to simply write you out of the equation altogether.

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                • I find it hilarious, in a Peter Sellers-movie sort of way, that the most ringing defense of this Administration that can be made is to compare it to the rule of a mad and evil emperor, something that must be endured and suffered stoically.

                  Combover Caligula, indeed.

                  ETA: I wonder if future historians, sifting thru the ashes of once was, will conclude that the one called “Mike Dense”, was actually a sly political infighter, instead of the gibbering idiot he presented himself as, where he ascends to the throne after the fantastic despot is finally dispatched by the Secret Service.

                  I, Claudius II- Electric Boogaloo

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                  • Yeah, I’m not buyin’ it. For all Trump’s insecurities and foibles, it’s also a substantial opportunity to break out of the cultural and mental sclerosis we’ve gotten into, and for that an occasion of some hope.

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                    • The part I am and remain optimistic about is breaking out of institutional sclerosis. That’s not to say that breaking down some entrenched cultural norms isn’t valuable in its own right, but I’m more interested in how well/if at all Trump can break down the deadweight institutional inertia that governs so much of our governance.

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                        • If I’m understanding you right, I agree. It’s not about normalizing a new set of policies. Not yet anyway. It’s much more about creating a political space where the possibility of deviation from the old can reside.

                          That was Bernie’s message, too, albeit from the left.

                          It’ll take some time before any complaints about “normalization” make sense*.

                          *Well, except wrt conservatives criticisms of liberals, anyway. They’re likely never gonna get tired of that shtick.

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                          • If anything, it’s about creating a new set of norms that might be upheld because there’s a strong majority consensus behind them.

                            Ie, so far a lot of libs want to think “Whatever happens, we have to remind ourselves and others that Trump and his baggage isn’t normal, and respond to him based on that premise.”

                            And then as a consequence you have libs watch Twitter and they see that Trump tweets whatever and so they tweet back “ZOMG LOL Trump!”

                            I don’t think this is going to get any traction because American people (and for that matter the political establishment) is going to interpret these things in a much different way and just ignore the refuseniks.

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                            • What you say is possible. But Trump is still pretty widely reviled in the electorate, by Dems univocally, by GOPers by about half. His policies don’t have a lot of leeway for failure. Nor does “Trumpism.”

                              Rejectionism is easy, governing is hard. He’s on a very short leash. (Or let’s say it this way: he’s got to DELIVER or the whole shebang goes “bang”.)

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                              • That gets back to one of my other comments. Trump needs to do the wall and the SCOTUS appointment. If he does he’ll have a decent-sized leash. If he doesn’t he’ll have very little.

                                One other thing about the downside of Trump that I don’t think libs have internalized. If Trump does crash and burn (gets impeached, resigns, dies, whatever) I think the GOP will be able to Teflon themselves away from him pretty easily. This is a weird situation where the divisive and rancorous GOP primary will actually help in terms of perception and governance.

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                                  • It’s not so much a matter of time as much as continuous momentum toward the construction and completion of the wall. As long as the momentum goes forward, he’ll have as much time as he needs.

                                    “It’s not my fault” is not going to fly at all. In fact, I think that’s the biggest danger for Trump among the Trump-GOP base. If they were willing to entertain that, they didn’t have to have Trump in the first place.

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                                  • How long does he have to build the wall before he stars losing his base?

                                    Just make a fence, hire some drones, have Trump make up a new word (air-fence?) and call it a day. Half of illegals enter legally and then overstay their visas so it won’t matter.

                                    Weirdly Trump could (more or less) continue what Obama was actually doing with different rhetoric. I think Obama has done FAR more rounding up of illegals than he wanted to take credit for… thus Obama’s adventures into publically claiming he was re-writing policy.

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                      • how well/if at all Trump can break down the deadweight institutional inertia that governs so much of our governance.

                        What the hell does that mean?
                        Seriously, what the hell would that mean wrt Trump’s Cabinet, and the Senate and Congress now in power?

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                        • The way defense spending is allocated; the way regulations are enforced; the way schools are funded and how; the way foreign policy is constructed; the way trade deals are made; the way the tax code is enforced; the way criminal justice is enforced; the way social programs are funded and allocations are provided; etc and so ad nauseum.

                          I’m not wedded to very many of our current policies so I’m very open to their revision and a necessary part of that is breaking outa the old thinking.

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                          • And which of his Cabinet members would improve any one of these things?
                            Which members of Congress or Senate would improve any one of these things?
                            For examp;e, will the defense contractors have even one bit less influence than they do now?
                            Will the CEO of Hardee’s/ Carl’s Jr. make labor laws that are better in any appreciable way?
                            Will our trade deals favor international corporations more, or less, than they do now?
                            Will Mitch McConnell or Paul Ryan make the lives of working people better by fulfilling their promise to repeal Obamacare and privatize Medicare and Social Security?

                            There seems to be this thinking that any change is bound to be better. I can think of a dozen ways in which change can be awful and worse.

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                            • Chip, I’m not the type of liberal you think I am.

                              I’m ready for a shakeup. I’da preferred it to be Bernie, but I’m alright with Trump. He’s gonna rattle the cage, and to be honest the cage needs rattling and Hillary wasn’t gonna do it. She’da just caged it all in even more.*

                              *Or whatever you call her type of politics…

                              Add: Or I’ll say it this way: the electorate wanted the cage rattled and we ended up with Trump. It coulda been someone else, for sure. But it wasn’t.

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                              • “He’s gonna rattle the cage, and to be honest the cage needs rattling”

                                There is a great deal of ruin in a nation. Giving the keys to someone who has neither interest nor experience in governance is one way to explore it.

                                For deity’s sake, this isn’t a football team mired in a losing streak. Rattling cages just for the sake of shaking things up gets people killed, and possibly in large numbers.

                                To return to a theme frequently explored on this blog, the Democratic solution to our country’s health care woes was to force everyone onto an insurance policy, then regulate the terms of the policy and the amount of subsidization.

                                Beyond wishing that would put Peter Pan to shame, the Republican plan is essentially to force individuals to absorb more of the costs of their health care and, if they can’t, to do without. That policy approach will kill people.

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                                • Beyond wishing that would put Peter Pan to shame, the Republican plan is essentially to force individuals to absorb more of the costs of their health care and, if they can’t, to do without. That policy approach will kill people.

                                  Every policy approach in health care kills people. Even if we had unlimited resources (which we don’t), the death rate holds steady at 100% and this isn’t going to change.

                                  The issue is one of resource utilization and efficiency, which is something that free markets tend to do very well and governments poorly.

                                  We have problems in that the markets are less than free (asymmetry of information among other problems), and various other problems but whatever.

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                                    • Wait, do you seriously look at the US health care system and conclude that the only problem is that markets are less than free? This is theology, not analysis.

                                      The only problem? No.

                                      The most serious problem? Yes.

                                      A lack of free markets means we’re paying FAR more than we need to, on the orders of a significant part of the GDP. If we had the ability to squeeze money out of the system then we wouldn’t be breaking budgets left and right and there’d be money to spend on other things.

                                      A lack of free markets also has all sorts of nasty side effects other than “money”. For example the lack of transparency means I can’t research how safe “Hospital “A”” is over “Hospital ‘B'”, which means there’s no reason for whichever is worse to improve.

                                      Where we get into religion is when people look at Cuba’s economic system and say “I want that”. They’re still driving cars built from before the revolution because they have no other alternative.

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                                      • Dude, are you even reading the other comments on this thread? We’re not looking at Cuba. We’re looking at France, and Canada, and Germany, and the UK, and Singapore, and all of the other dozens of countries that have universal access and radically lower per-unit costs. People who say we need less government are appealing to…nothing. To a fantasy, a matter of theological belief that markets are the way, no matter how clear it is that the nature of health care and the widespread moral demands around it make the normal function of a market impossible.

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                                        • …dozens of countries that have universal access and radically lower per-unit costs. People who say we need less government are appealing to…nothing. To a fantasy, a matter of theological belief that markets are the way…

                                          What we’re talking about is “how do we fix the current system”.

                                          The big options on the table are “more command and control” and “more market“. Basic economic theory has predictions for what will happen in each case, we should pay attention.

                                          It’s inappropriate to point to other countries’ systems and claim we can import every detail of them here. For example many of our HC issues go away if Americans become less fat, but changing that is unlikely without serious culture changes.

                                          Similarly, referring to “economic theory” as a “religion” is like trying to refer to the “Theory of Gravity” as a “religion”.

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                                          • it’s not that the economic theory is wrong, exactly. To my mind it’s like walking into a room full of engineers who are talking about different ways to reduce drag on an airplane and declaring that, because objects in motion remain in motion, there’s no need to do so at all. The 10,000 foot, big picture theory is not always helpful, and is often actively misleading, when you get down into a particular issue with a bunch of complicating factors.

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                                  • Market efficiency is merely the matching of wealth and resources.

                                    If you have the money and want a toaster, you are matched with a guy who has a toaster and wants money.

                                    Why is this a desirable goal in medicine?

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                                    • Market efficiency is merely the matching of wealth and resources. If you have the money and want a toaster, you are matched with a guy who has a toaster and wants money. Why is this a desirable goal in medicine?

                                      How much more efficient is the world’s best medical system than ours? Twice? Three times? And they don’t use much markets either?

                                      If the cost of medicine were a quarter what it actually is (look at the medical market for pets if you think that’s unreasonable), then there’d be a LOT more medicine actually available at a given price and we wouldn’t be worrying about breaking budgets.

                                      And to be real clear, so that there’s less of a “fantasy world” aspect to this, it means we would be letting sick people die if they didn’t have the money to stay alive.

                                      It also means there’d be a lot more money available for things like college, and paying for medicine out of pocket would be a lot less painful than it sounds.

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                                      • If you think that being poor and diabetic should be a death sentence, then I suppose we’re not going to able to argue very productively. I’d invite you to go make that case to the public and see how many elections it wins you.

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                                        • Geebus H. fellas.
                                          Dark is right about free markets. The way the damn markets are supposed to work is demand comes from subjective value. Let me say it again subjective value, and again, subjective value.

                                          Thats were the demand comes from. That is supposed to set the equilibrium for the iron triangle. Yes the iron triangle is supposed to balance out to meet the various demands of each subjective value in the system. No part of the triangle is supposed to be nailed down by any social construct.

                                          There, the damn thing is fully defined. You do anything to fuck around with that and the black market will start chewing holes in ass. Because black markets are just another name for your fucked up capitalism wasn’t really capitalism.

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                                            • That’s another reason you need the market. Finance assumes you need to find the price of the subjective value. Start anywhere else, your lost, mumbling to yourself in the fog.

                                              Not theology, it’s just regular math, unless people are starting to think regular math is church. If that’s the case, some men you can not reach, so ya get what we had here.

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                                              • Finance assumes you need to find the price of the subjective value. Start anywhere else, your lost, mumbling to yourself in the fog.

                                                Finance doesn’t assume that. Some specific theories of (normative) economics do, tho.

                                                For a whole slew of goods and services markets are a better mechanism to allocate resources than central planning, but health care provision isn’t one of em.

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                                                • For a whole slew of goods and services markets are a better mechanism to allocate resources than central planning, but health care provision isn’t one of em.

                                                  Why is central planning “a better mechanism to allocate resources” for health care?

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                                                • Health care is just a service. It is a important service yes, but again if you start nailing down any part of the iron triangle you instantly make the supply not match the subjective values involved. It becomes inefficient, and not in a good way, like paying for parts of the iron triangle twice, or even three times, instead of once.

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                                        • If you think that being poor and diabetic should be a death sentence, then I suppose we’re not going to able to argue very productively.

                                          People are currently dying because your “command and control” solution results in only one, seriously expensive, epi-pen on the market. That’s what “resource inefficiencies” mean here and the epi-pen is only going to be one example of many.

                                          Countries which claim “food is a right” and insist on using command/control for it typically see starvation because command/control is *that* inefficient.

                                          The number of people who starved to death in the US last year was effectively zero, because we use the market and market friendly policies like food stamps.

                                          So give the poor guy in your example a voucher for medical care and let the market work (you can attach it to his food stamp card).

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                                          • Dark Matter:
                                            And to be real clear, so that there’s less of a “fantasy world” aspect to this, it means we would be letting sick people die if they didn’t have the money to stay alive.

                                            It also means there’d be a lot more money available for things like college, and paying for medicine out of pocket would be a lot less painful than it sounds.

                                            I’m not seeing how this is consistent with this:

                                            So give the poor guy in your example a voucher for medical care and let the market work (you can attach it to his food stamp card).

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                                            • Part of that was me realizing how effective and market friendly Food Stamps are, part of it is we really do have 6 digit cures which only the rich (and/or insured) would have access to and we’d have to drop the idea that everyone can have everything.

                                              In any system, people are going to die because of a lack of resources. A market approach is a LOT more honest about that and skips the obfuscation that other systems try to use to hide it.

                                              Give everyone X dollars a year for HC. Someone is going to die because they need 2X, and the typical middle class guy with a middle class job will be able to pay it.

                                              Command and control tries to pretend that whatever treatment that someone needs can be reserved for him by preventing someone else who needs it less from taking it. That it also requires 0.75X be wasted through inefficiencies and unintended consequences isn’t mentioned.

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                                              • But of course there’s not a set amount of medical care to be distributed; there’s a demand curve that meets a supply curve somewhere. How much of different resources exist will depend upon our scheme to finance it.

                                                If we’re giving everybody a set medical care voucher, then we’ll have some people that get all of their medical needs covered by the voucher without problems, and other people who have expensive acute illnesses, chronic conditions, and disabilities. Those people still die if they’re poor and the voucher only makes a trivial difference.

                                                Of course I suppose you could get around that with insurance, so the costs of the very expensive sick are defrayed by the healthy, but why would insurance companies be willing to sell to people that are going to be predictably expensive to insure? You’ll have to require insurers to cover them, I suppose. But then if you do that there’s no reason for healthy people to buy insurance and the insurers will go out of business, so you’ll have to incentivize the healthy to buy insurance. Oh wait, oops, we just made the Affordable Care Act.

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                                                • Those people still die if they’re poor and the voucher only makes a trivial difference.

                                                  Yes.

                                                  It’s also true that many of them will be able to purchase treatment because the treatment itself won’t be so crazy expensive, but I’ve already pointed out that people will die.

                                                  One of the huge disadvantages with this system is people will die, and they’ll know who they are. The vast numbers of people helped by the system (basically everyone but the first group) will mostly have the benefits taken for granted. Worse even people supposedly harmed by this system might be better off with this system than the command/control model because there will be more treatments available/created here.

                                                  If someone is hungry they know it, if someone is not starving to death because the system works then they don’t know it.

                                                  You’ll have to require insurers to cover them, I suppose.

                                                  No.

                                                  You don’t get to buy insurance after your house is on fire. There are things we should do to make sure people can keep their insurance, but that’s probably a different issue.

                                                  In terms of insurance reform what we probably want to do is outlaw everything but major medical. Insurance is supposed to cover big things, not the equiv of changing light bulbs.

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                                                  • I’m still not seeing any inkling here of why anyone should prefer this system to something like a European universal system.

                                                    You keep repeating that yeah, folks are going to die, but it will be different folks, like that somehow a persuasive argument.

                                                    I’m just not getting the concept here.
                                                    Who would benefit from this?
                                                    Why should they?

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                                                    • I’m just not getting the concept here.
                                                      Who would benefit from this?
                                                      Why should they?

                                                      The European system comes with European GDP growth rates. The countries which do the best job at running their social system do so by having few people and lots of oil.

                                                      Let’s use some US numbers to put this plan into perspective. Median household income is roughly $50k, Medical insurance for that median family is what… $15k? Average medical costs $5k? So call Medical Insurance + Costs of $20k (note the gov taxing it from you and giving it to you or someone else counts, as does your company withholding it from your paycheck).

                                                      I’ve been assuming a handwave 4x in inefficiency, so the system in our alternative universe gives you basically the same medicine at a cost of $4k, so the other $16k goes in your pocket. That has serious effects on inequality, the general good, and so forth.

                                                      Now lets assume you (in this universe) are persistently sick to the tune of $80k a year. In our alternative universe that’s $20k a year so in theory you’re no worse off (although yes, it’s going to suck if you don’t have access to that).

                                                      Further, it’s strongly implied that taxes will be seriously less in this alternative universe, this should have good effects on growth rate and other good things so that median $50k is probably an understatement.

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                                                      • I’m more confused now than before.

                                                        What is with the handwaving? Is that like underpants gnomes?
                                                        How do we come up with an assertion that medical costs can be cut to a quarter of what they are now?

                                                        And even if we accept that without question, there are plenty of people who couldn’t afford even that. And many of these are people who are elderly and sick and whose spending is easily multiple times your example of 80K.

                                                        So again, I’m not sure who is supposed to find this attractive.

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                                                        • And many of these are people who are elderly and sick and whose spending is easily multiple times your example of 80K.

                                                          And these are the same people who, if we actually go to UMC, will receive “no” votes by death panels.

                                                          The alternative to an efficient system is NOT that everyone is covered for everything, it’s that we do a better job of obfuscating how that choice is made while also making HC expensive for everyone.

                                                          So again, I’m not sure who is supposed to find this attractive.

                                                          People who want lots more money in their pocket? People who care about growth? People who currently have to choose between paying for HC and paying for HC insurance? People who need epi-pens?

                                                          There’s a lot of suffering that comes with a system as inefficient as ours. We just lack the obvious signs of people starving in the streets that we’d have if this were food. Not knowing who is suffering let’s us pretend there’s none, but all that economic damage has real world consequences even if we don’t know the details.

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                                                          • Which universal system currently is letting sick elderly people die? I’m not aware of any.

                                                            Who are the people currently suffering?

                                                            The only ones I can think of are people who aren’t covered and covering more people was the whole point of the ACA.

                                                            I trying, and failing, to see how going towards a more market based system would decrease suffering.

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                                                            • Who are the people currently suffering?

                                                              Anyone who is paying too much for medical services or insurance.

                                                              Think about how painful it’d be to take a thousand dollars, or even ten thousand dollars, and just set it on fire. That’s basically what we’re having almost everyone do.

                                                              That’s a *lot* of harm. It’s lost opportunities and other economic benefits, and these are big numbers so it’s a big deal. That people aren’t aware of how much harm they’re suffering doesn’t eliminate its existence.

                                                              Which universal system currently is letting sick elderly people die?

                                                              All of them (everyone dies).

                                                              As I’ve pointed out, other systems are better at hiding painful realities, but they can’t function if they don’t have some way to prevent routinely spending millions of dollars on dying elderly to give them a few more weeks of life.

                                                              Just because a treatment is available doesn’t obligate society to pay for it.

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                                                              • Well yes, things would be better if our health care costs were lower, as they are in every country that has implemented universal health care. And yes, every system everywhere has to at some point make painful decisions about resource allocation and accept that we are mortal. So where is your argument against UHC hiding in here? You keep asserting that if we sprinkle some free market juice on our current system we’ll suddenly get costs comparable to, errrr, the various European countries with UHC, but I’m still not seeing what evidence you have to support that.

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                                                                • Ah… no. UHC has never “lowered costs”, which is what we need. As part of the gov taking over HC and putting into place UHC they’ve also put into place things which prevent HC growth.

                                                                  If we went totally into UHC right now we’d have to pay a lot to get UHC (which is why our politicians have flinched away from doing it) and then long term we’d get lower growth in health care. But we’re past the point where reducing the rate of growth can help a whole lot, now we actually need to lower costs. That’s going to be really painful, it means jobs will be lost and so forth.

                                                                  Actual reductions in cost mean doing to our HC system what the market did to the Steel Manufacturers and other industries. The market has a long history of being brutal on entire industries, the government really doesn’t.

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                                                                  • UHC has never “lowered costs”,

                                                                    No, by definition. Leaving out the sick and infirm will make the bottom line look a lot better. See, for example, US health insurance practices until recently.

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                                                                      • Ahh. I was confused for a minute there.

                                                                        Yes, we don’t have UHC (well….) and our costs are higher than many UHC countries with better healthcare provision. (Point 1)

                                                                        What I took Dark to be saying is that a total cost C at T1 without UHC will increase at T2 by the addition of the previously uninsured. Which is, I think correct. (Point 2)

                                                                        Point 1 and point 2 aren’t inconsistent, seems to me. Part of UHC (singlepayer version) is that gummint leverages down prices and so on, thereby reducing costs. But merely adding high risk people onto the rolls without any other changes increases costs.

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                                                                    • Dark Matter: UHC has never “lowered costs”,

                                                                      No, by definition. Leaving out the sick and infirm will make the bottom line look a lot better. See, for example, US health insurance practices until recently.

                                                                      There are dozens of countries which have put into place UHC. Please show me a graph detailing how their costs actually went down when they did so. Not how their costs are different from someone else, how their costs *actually* *went* *down*.

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                                                                      • How are you defining costs? Total costs? Costs per unit care? Costs per person? The metric matters enormously.

                                                                        We could reduce our total costs by providing super gold plated care healthcare to only one randomly chosen lucky American and ignoring everybody else. Or we could raise them by instituting universal overage.

                                                                        Likewise, we could ask if computer costs are down since the 1950s. No, they’re a much larger percentage of our economy now. We each spend far more on a per capita basis as well. But we’re not purchasing the same thing. If you define computer costs as the cost per 32-bit integer calculation or megabyte of RAM, they’ve gone down enormously. But you have to come up with a sensible metric.

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                                                                          • You’re making the same mistake you made earlier though–conflating comparisons across time with comparisons across borders. Two things can simultaneously be true:

                                                                            1) Countries that adopt UHC have higher total costs now than they did in the past.
                                                                            2) If we copy one of models, we will have lower total costs than we are currently spending.

                                                                            The fact that UHC health care countries spend more in total than they did in the past doesn’t imply that we’d have higher costs if we emulated them at all.

                                                                            Regarding the total costs question: Has the US gone completely off the rails because our total costs for cell phones and wireless services have gone up dramatically over the past 30 years? If not, it’s probably good to ask what you’re trying to figure out using that metric.

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                                                                            • If we copy one of models, we will have lower total costs than we are currently spending.

                                                                              So you’re claiming we’ll actually get lower total costs.

                                                                              Countries that adopt UHC have higher total costs now than they did in the past.

                                                                              Who cares about now? We have dozens of examples, what did total costs look like 5 years after they went with UHC?

                                                                              If I recall correctly, I looked at a graph of this years ago and the answer was “up, not down”.

                                                                              doesn’t imply that we’d have higher costs if we emulated them at all.

                                                                              We’re pulling sick people into the system who don’t get care now. We’re pulling poor people into the system who don’t get care now.

                                                                              This STRONGLY suggests UHC will be a lot more expensive than what we have now.

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                                                                              • So you’re claiming we’ll actually get lower total costs.

                                                                                If we did identically the same thing that other UHC countries are doing, yes. Those countries spend less of their GDP on healthcare than we do. So it shouldn’t be a stretch to say that if we do what they’re doing, we’d be spending less of our GDP on healthcare than we do. It’s actually kind of weird to think it would be some other way.

                                                                                If the question is, “Would any arbitrary form of UHC lower total costs?” then the answer is no. There are plenty of UHC designs that would raise costs enormously. Giving everybody their own MRI machine would raise costs. But doing what other countries with objectively lower costs than us do seems like it would lower costs. Why would that not be the case?

                                                                                Who cares about now? We have dozens of examples, what did total costs look like 5 years after they went with UHC?

                                                                                You’re making the same comparison mistake *again*. Your baseline is wrong. It’s producing nonsensical results. Comparing France in 1945 to France in 1950 is an increase. Comparing US 2016 to France 2016 is a decrease. We’re the US in 2016. If we became like France in 2016, the number would go down. Yes, if we were France in 1945, our costs would go up. But we’re not France in 1945.

                                                                                Going back to my cell phone example: Can you explain exactly what you’re trying to get from the total costs metric? Is it bad that we’re spending more on cell services now than 30 years ago?

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                                                                                • But doing what other countries with objectively lower costs than us do seems like it would lower costs. Why would that not be the case?

                                                                                  Because you’re not going to:
                                                                                  1) Get doctors to accept half their salary
                                                                                  2) Kick trial lawyers out of the system
                                                                                  3) Fire whatever percentage of test lab people don’t fit the model
                                                                                  4) Implement serious gun control
                                                                                  5) Have serious death panels
                                                                                  6) Make Americans less fat/murderous/etc, etc, etc.

                                                                                  The concept of bringing in their system in total is simply nonsense. What you want to do is implement UHC to cover people who aren’t covered, and that’s it. You’ve suggested nothing for reducing costs other than pointing to other countries which have some or all of that list (and other things besides), but you’re not going to try doing those things here so that doesn’t really help.

                                                                                  Comparing France in 1945 to France in 1950 is an increase.

                                                                                  So you’re admitting that UHC has *never* actually reduced costs? If so, and assuming you’re not trying anything on my list above, what makes you think we’d reduce costs here?

                                                                                  Can you explain exactly what you’re trying to get from the total costs metric?

                                                                                  Whether or not we can pay for it. Other countries implemented it when costs were cheap and their gov spending was a much smaller percentage of the GDP than it is now.

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                                                                                  • You’ve suggested nothing for reducing costs other than pointing to other countries which have some or all of that list

                                                                                    Interestingly, none of the other, much more theoretical proposals, offer no suggestions for reducing costs either. So the question is this, Dark: if you think healthcare cost per capita GDP is absolutely outrageous and going to get worse, in particular given how shitty our overall healthcare is, then you’ve got a faith-based decision to make too. Or an ideological one, I suppose. I mean, you can stick to your guns about “free market” solutions and watch health care spending rise to 22, 25, 30% or our GDP, or you can bite the bullet and concede that the free market can’t solve this problem.

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                                                                                    • Interestingly, none of the other, much more theoretical proposals, offer no suggestions for reducing costs either.

                                                                                      Oh good grief. Make HC providers post prices and give everyone vouchers so they have a reason to compare. There’s more but the root of fixing a dysfunctional market is to fix the dysfunctional market.

                                                                                      So the question is this, Dark: if you think healthcare cost per capita GDP is absolutely outrageous and going to get worse, in particular given how shitty our overall healthcare is,

                                                                                      Yes.

                                                                                      then you’ve got a faith-based decision to make too. Or an ideological one, I suppose. I mean, you can stick to your guns about “free market” solutions and watch health care spending rise to 22, 25, 30% or our GDP, or you can bite the bullet and concede that the free market can’t solve this problem.

                                                                                      As far as I can tell we’re not *trying* anything close to the free market, and that’s one huge reason why it’s expensive.

                                                                                      One epi-pen, 3rd party pays, no prices posted so no comparisons possible, supply deliberately restricted, and I’m sure there’s more.

                                                                                      “Faith based” is thinking one more layer of government (on top of every layer we already have) is going to make everything work even though we’re nakedly increasing demand, handing out “free” things, and can’t describe why prices will go down other than “other countries have do things we’re not willing to”.

                                                                                      I can and have described ways to make UHC work with reducing prices, but the control of prices is separate from the handing out of “free” goodies aspect that you like.

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                                                                                  • Get doctors to accept half their salary

                                                                                    Some number of doctors will work at any given wage. Reducing doctors’ salaries will reduce the number of doctors, not eliminate doctors entirely. Producing more doctors would also reduce doctors’ salaries. Supply and demand are curves.

                                                                                    Kick trial lawyers out of the system

                                                                                    Why not, exactly? I mean, I’m guessing that the thought experiment health care utopia in your head has no trial lawyers in it at all. In any case, the evidence that a large chunk of our costs are driven by lawsuits is not very compelling.

                                                                                    Fire whatever percentage of test lab people don’t fit the model

                                                                                    I don’t know what this means.

                                                                                    Implement serious gun control

                                                                                    What percentage of our GDP do we spend treating gunshot wounds, realistically?

                                                                                    Have serious death panels

                                                                                    I really don’t get why you think that. It’s not like our current system provides unlimited payouts. Medicare and Medicaid also have plenty of hard and fast rules that let people go without care. You seem to think that Americans are uniquely unable to put limits on benefits, and as far as I can tell you’re basing that belief on absolutely nothing.

                                                                                    What you want to do is implement UHC to cover people who aren’t covered, and that’s it.

                                                                                    No, that’s just a thing you’re ascribing to me because it’s easy to dismiss.

                                                                                    So you’re admitting that UHC has *never* actually reduced costs?

                                                                                    Mary: Hey, we should sell our Suburban buy an Accord like Joe has. Joe spends less on gas than we do.
                                                                                    Mike: Nonsense. When Joe sold his motorcycle and bought the Accord, he started spending more on gas!

                                                                                    If so, and assuming you’re not trying anything on my list above, what makes you think we’d reduce costs here?

                                                                                    Primarily the fact that while those things are contributors, they’re not really what’s driving the dysfunction of our system.

                                                                                    Other countries implemented it when costs were cheap and their gov spending was a much smaller percentage of the GDP than it is now.

                                                                                    This claim makes absolutely no sense to me. Why would lower costs when they implemented it have anything to do with whether it’s affordable now? If the system didn’t work, lower costs at the start would not save it decades later.

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                                                                                    • Dark Matter: What you want to do is implement UHC to cover people who aren’t covered, and that’s it.

                                                                                      Troublesome Frog: No, that’s just a thing you’re ascribing to me because it’s easy to dismiss.

                                                                                      Then when I ask for how you’re going to control costs, you need to say something other than “UHC” (which increases demand and hands out free stuff).

                                                                                      UHC is politically the easy part because handing out free stuff is popular. The really hard part is paying for it and structuring things so it doesn’t bankrupt the system.

                                                                                      DM: Other countries implemented it when costs were cheap and their gov spending was a much smaller percentage of the GDP than it is now.

                                                                                      TR: This claim makes absolutely no sense to me. Why would lower costs when they implemented it have anything to do with whether it’s affordable now? If the system didn’t work, lower costs at the start would not save it decades later.

                                                                                      This is pretty important. It’s *much* easier to stop someone from getting something than it is to take it away, that’s *especially* true for things like jobs, salary, and life giving care.

                                                                                      Say we look at other countries and decide *half* of all tests are medically worthless, so we the gov decide to make it a lot harder for doctors to schedule tests with the explicit goal of cutting the number in half. Those tests are people’s jobs, how they get their incomes, etc, and there’s going to be a lot of political protests and claims that what we have now is absolutely needed. Ditto if we try to prevent anyone over the age of 90 from being treated for certain types of cancer when we know that these treatments work. Ditto if we try to cut doctor’s salaries in half (or even attempt to double the number of doctors).

                                                                                      On the other hand preventing the creation or import of a band new (seriously expensive) drug or technique is much easier because the people who are going to die without it don’t know that there’s an (expensive) alternative.

                                                                                      When other countries introduced UMC, it increased the cost of the system, but because the gov was paying for it the gov put huge pressure on various parts of the system to lower it’s growth. At the time, per person costs were very cheap because all these fancy cures hadn’t been invented yet and we weren’t spending vast percentages of the GDP on medical care.

                                                                                      Because these systems were on budgets, they needed to find ways to cut costs. However our absurd costs are already baked into the system. Lowering our GDP expenditures on medicine implies people die and lose their jobs. That’s going to be politically unpopular.

                                                                                      Implementing UMC without changing anything is just applying our absurd costs to sick people we used to let die. I don’t see how we do that without breaking the budget, and thus far you’ve been unwilling or unable to say where the cost savings come from, and much more importantly, how those cost savings can work politically.

                                                                                      The low hanging fruit (economically) is not paying for expensive treatments for the old and sick. Half your lifetime medical costs are in the last year(ish) of your life. However you seem to be wanting UMC for the purpose of *not* doing things like that.

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                                                                                      • Then when I ask for how you’re going to control costs, you need to say something other than “UHC” (which increases demand and hands out free stuff).

                                                                                        I’ve been more specific than that. I’ve been referring to any of the systems that every other developed country has set up without the problems your thought experiments indicate will happen. We could try, for example, a single payer system where the government acts as a single giant insurance company, sets reimbursement rates, makes payments, and decides which procedures are covered. Other countries do this. In fact, we do this for the most expensive population via Medicare already.

                                                                                        There are plenty of other models that result in universal coverage and all of them have objectively worked out to be cheaper than ours. Pick one that exists in reality, not one you’re concocting in a thought experiment, because those clearly don’t work as well as the real ones.

                                                                                        You seem to think that I’m saying that making it universal results in savings. It’s the other way around. Adopting a better system saves enough money to make it universal.

                                                                                        Lowering our GDP expenditures on medicine implies people die and lose their jobs. That’s going to be politically unpopular.

                                                                                        So your complaint is not that it doesn’t work economically, but that it won’t work politically. That’s very likely to be at least partially true. Our awful system has shown remarkable political resilience against any attempt to reform it. But your objection holds for any reform that will reduce costs. Any cost reduction anywhere will cost somebody some profit. If we follow your reasoning to its conclusion, we can’t change anything and we’re stuck paying too much for too little forever. We’ll never get anything other than what we have now.

                                                                                        This feels like one of those cases where my idea needs to meet political feasibility tests but yours doesn’t, even though it’s just as politically infeasible (if not more).

                                                                                        I don’t see how we do that without breaking the budget, and thus far you’ve been unwilling or unable to say where the cost savings come from, and much more importantly, how those cost savings can work politically.

                                                                                        Wrapped up in your economic arguments is the assumption that we’re currently getting as much as we possibly can for our money and that it is not possible to get the services for less–that there’s no excess billing or wasted administrative overhead. That if we take the $25 hospital aspirin and say, “We’re only paying $15 for that” that there will be a marked drop in aspirin delivery and we’ll all suffer.

                                                                                        Results elsewhere indicate that it does not. Between the $25 coming out of your wallet and the pennies the aspirin actually cost, that money is going into excess returns that can be clamped down on. The cash that’s being extracted is far in excess of what it cost to provide the services. We know this because the same services are provided elsewhere for less.

                                                                                        Basically, a big chunk of the savings would come from the same place the savings would come from in an ideal free market solution: Greater efficiency. Our system is currently maximally inefficient.

                                                                                        Half your lifetime medical costs are in the last year(ish) of your life.

                                                                                        I’ve mentioned this before, but we already have universal healthcare for the elderly. It’s Medicare. This isn’t even a thought experiment in our own country.

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                                                                                        • You seem to think that I’m saying that making it universal results in savings. It’s the other way around. Adopting a better system saves enough money to make it universal.

                                                                                          Somehow I doubt there’s *any* history of this kind of thing being put into place without large tax increases, that’s a problem right there considering how many countries have done this.

                                                                                          The focus here seriously seems to be on universal with the “save money” aspect being either an afterthought or the calm assurance of ideology. So are you confident enough to do it in two stages? One to save money and two to make it universal?

                                                                                          So your complaint is not that it doesn’t work economically, but that it won’t work politically.

                                                                                          Oh, I don’t think it works economically with where we’re at, and I also don’t think it can work politically either (and you can add culturally to that list). The Dems had a super majority and Obamacare was as far to the left as they could bring themselves to go.

                                                                                          But your objection holds for any reform that will reduce costs. Any cost reduction anywhere will cost somebody some profit.

                                                                                          Markets have done this before, many times. Coal is currently coming under the ax, the Steel workers were brutalized.

                                                                                          That’s in addition to problem that I don’t think *anyone* have any clue, at a detail level, what needs to happen. Do we have too many specialist doctors? Not enough?

                                                                                          This feels like one of those cases where my idea needs to meet political feasibility tests but yours doesn’t, even though it’s just as politically infeasible (if not more).

                                                                                          We already have vouchers around, is it really politically infeasible to force providers to publish prices?

                                                                                          Wrapped up in your economic arguments is the assumption that we’re currently getting as much as we possibly can for our money and that it is not possible to get the services for less–that there’s no excess billing or wasted administrative overhead.

                                                                                          Hardly. But the people you claim will step in and make $25 dollar aspirin cost only $15 are the same people who have given us a single source for an epi-pen (in the name of helping us) and allowed that $25 dollar aspirin to begin with.

                                                                                          Given that we’re already dealing with regulators who have been captured by hospitals (etc), and given that providers understand how to do this, why should I expect the same group of regulators will do better in the future than an impersonal market?

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                                                                      • You can hang your hat on that, but evidence shows that manymany singlepayer systems provide better healthcare at lower costs than the US. I think that’s the relevant data point, myself.

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                                                                        • Great. So if you’re claiming that total costs are actually going to go *down*, then please provide justification for that, ideally examples from other countries experiences. Personally I keep remembering how our politicians keep flinching away from how much UHC will cost.

                                                                          You’re increasing demand, probably by a lot, how exactly are you going to increase supply or otherwise lower costs?

                                                                          And btw I can think of actual real-world answers for this.
                                                                          1) Really strict and broad use of death panels would do it (half your lifetime use of HC is in the last year or two of life)
                                                                          2) Really strict rationing would also do it (although we’d instantly have queues and probably a two tier system).

                                                                          But if your answer is something like “the government will do it” then you’re basically claiming magic based on an ignorance of economics.

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                                                                          • Great. So if you’re claiming that total costs are actually going to go *down*, then please provide justification for that, ideally examples from other countries experiences.

                                                                            The justification is this: pick your model, do what they do, cost goes down. It’s not like there isn’t a solid evidence base to work from Dark.

                                                                            Now, if you’re expressing skepticism about such a system actually working in the good ole USofA, then I agree with you. But it isn’t because the models don’t work. It’s becuase of people like you who demand evidence that can’t be provided for analytical skepticism which begs the question.

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                                                                            • The justification is this: pick your model, do what they do, cost goes down. It’s not like there isn’t a solid evidence base to work from Dark.

                                                                              Great, so if “doing what they do” means we have to be…
                                                                              1) Less murderous
                                                                              2) Less fat
                                                                              3) Not have pockets of people who are poorly educated
                                                                              4) Have a different racial make up.
                                                                              5) Have a unified culture which frowns on abusing the government’s generosity

                                                                              How exactly do you think we’re going do that?

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                                                                              • I think we’re making progress here Dark. Now you’re talking about the cultural problems of instituting something like an NHS singlepayer system.

                                                                                I agree, that’s a tricky one. But it’s a different complaint than the criticizing the mechanisms by which single payer works. The SP model works in a whole slew of countries. If it can’t work here, it’s not because the model doesn’t work, it’s because our culture – including people like yourself, if you don’t mind my saying so – and our politics aren’t amenable to it.

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                                                                                    • Oh, definitely. But if the reason we can’t be France is that it’s politically impossible; that seems no more politically impossible than destroying employer-based coverage, deregulating the insurance market, and letting ER’s turn away indigent patients.

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                                                                                  • Of course all of the market-based reforms that might have a shot in hell of reducing per-unit costs have a similar cultural problem.

                                                                                    Actually no. We already have health savings vouchers, there’s no cultural reason why hospitals (etc) can’t be forced to publish their prices.

                                                                                    The nice thing about (some) market based reforms is it mostly wouldn’t be obvious who is going to be forced out of business in 10 years, nor who is over priced for what they actually do.

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                                                                                    • I would support any measures to make our pricing system more transparent. The disconnect between prices and customers is a primary driver of our cost problems.

                                                                                      If you hired an evil economist and said, “Design a system that produced the worst possible cost outcomes but was still politically difficult to get rid of,” only the cleverest of economists would succeed as well as we have by accident.

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                                                                                      • I remember once we might have needed to work with a specialist for Mayo who didn’t accept our insurance. I asked them to give an estimate of what an office visit would cost.
                                                                                        “We can’t do that. We have no idea what the doctor would need to do.”
                                                                                        “Can you give a likely range?”
                                                                                        “No.”
                                                                                        “Can you tell me if it’s more likely to be $400 or $4000?”
                                                                                        “No!”
                                                                                        “Can you give me a list of procedures you perform and what you charge?”
                                                                                        “This isn’t a restaraunt, sir! We don’t know what the doctor will need to do so we can’t say what it will cost. It just doesn’t work that way!”

                                                                                        We chose not to work with them. And not just because she saw fit to scream at a potential patient/customer. We would not put ourselves in position to have our son’s medical needs exploited via a fucked up system. We found a highly regarded doc who accepted our insurance and payed a minimal copay for a visit and were done.

                                                                                        That doesn’t seem like a well designed system. “You can go here and pay God knows what or you can go there and know you’ll pay $10.”

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                                                                                      • If you hired an evil economist and said, “Design a system that produced the worst possible cost outcomes but was still politically difficult to get rid of,” only the cleverest of economists would succeed as well as we have by accident.

                                                                                        I don’t think they could, actually. No one individual, or even a team, could devise a system so entirely dysfunctional wrt the purported goals while (as you say) making it political difficult to change. It’s an example of spontaneous order which cuts entirely (by almost every objective measure) the other way.

                                                                                        Same with the US tax code for that matter. No one single person could’ve designed that. Not even an evil all-powerful God.

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                                                              • Think about how painful it’d be to take a thousand dollars, or even ten thousand dollars, and just set it on fire. That’s basically what we’re having almost everyone do.

                                                                My God, thats painful. The horror!

                                                                But you know what might be just a tiny bit more painful than spending money?

                                                                Dying of an illness without treatment, I’m guessing. Which was the reality for a lot of people before the ACA.

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                                                                • Dying of an illness without treatment, I’m guessing. Which was the reality for a lot of people before the ACA.

                                                                  And still is now. And will be in the future. I know people society could save (i.e. prolong the life of) if we were spend without limits.

                                                                  The problem is, in a world with limited resources, would society as a whole would be poorer for it?

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                                                              • Just because a treatment is available doesn’t obligate society to pay for it.

                                                                Does the pool of insurees whose premiums cover specific individual costs constitute “society paying for it”? Cuz that’s how insurance works.

                                                                If you don’t want people dying in the streets, and you don’t want society paying for their care, then you’re at an impasse.

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                                                                • By saying that coverage needs to be extended to any given malady, we are, effectively, creating demand.

                                                                  If we are not creating supply at the same time, we’re going to deal with the fact that the price is going up. Or shortages.

                                                                  To switch to the “triage” framework, there isn’t a way to keep adding people to the triage room and put them all in the “take of of this now” pool. Not without creating more doctors/nurses/rooms in which nursing assistants take temperatures and blood pressure.

                                                                  And that’s without getting into the best way to make the US a lot more like England.

                                                                  Pre-Brexit England, I mean.

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                                                                    • It’s more that the stuff we need to do to fix the problem is very, very difficult and it will be easier to create twice as many new doctors than it will be to change the culture.

                                                                      And let me say that I say that statement *KNOWING* how difficult it will be to create twice as many new doctors.

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                                                                      • I’ve been thinking about this all day (yay, maintenance!).

                                                                        In practice, the difference between a thing (an actual thing) and a social construct is a nuclear war.

                                                                        If a thing is a thing, an actual thing, it would still exist after a nuclear war. So a guy with medical expertise on how to set a bone? Still just as useful after a nuclear war as before.

                                                                        A letter from the government promising that if the holder of the letter takes it to an approved HMO that the second hundred dollars of any treatment for gout will be paid for? Not useful after a nuclear war except for as paper.

                                                                        I’m in a place where I see that there are a number of things getting in the way of actual health care. Some of them are preventing actual health care (like the FDA) and some of them are having cash money poured into them rather than into actual health care (to some extent, a lot of insurance falls under here).

                                                                        We suffer from too many social constructs related to health care and from not enough actual health care.

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                                                                        • I’m not sure why what-exists-after-globalthermonuclearwar is an interesting metric to get a grip on the healthcare debate, personally. What you’re effecively saying is that after meltdown there won’t be any Medicare, and because of that we should … what, exactly, I’m confused … scrap it right now?

                                                                          Will we have insurance companies after the bombs detonate? Will they still pay claims? If not, then we gotta scrap them too, right?, since they’re a social construct and all?

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                                                                          • It’s not to help get a grip on the healthcare debate, it’s a rule of thumb to help measure whether what you’re calling for is an actual thing or a social construct.

                                                                            Will what you’re calling for be useful? Like, for real useful no matter what?

                                                                            Or is what you’re calling for only useful in our very specific legal and cultural context?

                                                                            If the answer is “I don’t know which it would be”, then use the nuclear war test.

                                                                            If the thing makes no sense in a post-apocalyptic wasteland, then it’s not something that would help us at this point in our development either.

                                                                            If, however, you find yourself saying “man, I sure as heck would want one of those around!” if you were talking about living 200 miles east of The Glow, then it’s something that is likely to help us too.

                                                                            More adminstrators, lawyers, and coverage?
                                                                            Not going to help.

                                                                            UNLESS.

                                                                            Unless our health care problem is also not a real and actual thing but a social construct as well.

                                                                            If it’s the latter, yeah. Maybe what we need is an even bigger social construct.

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                                                                            • Can’t speak for you, obvs., but it seems that availability of medical care to treat high-temperature burns, broken limbs and bleeding would be really useful in our imagined post-apocalyptic world.

                                                                              Or am I still not playing the game right?

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                                                                              • Seems to me that you’re playing it perfectly.

                                                                                Is whatever you’re calling for something as real as medical care that can treat burns, set bones, staunch bleeding?

                                                                                A set of skills, a set of unguents/tonics/ointments, a set of splints, a set of bandages?

                                                                                All of which are medical care, without quotes.

                                                                                Is what you are calling for medical care, without quotes? If so, it seems to me that you would be calling for something that would help address the problem and get us on the proper track to having less of a health care problem.

                                                                                I mean, heck, you can start playing games like saying “But an MRI machine requires power! Would we have power after a nuclear war?”

                                                                                We can then get into stuff like engineering problems like backup power generators and redundant power and how a guy capable of running a generator would be something that would be very useful indeed after a war and, as such, an MRI running on this guy’s power would be useful, as would be the ability to run an MRI and read its results properly.

                                                                                So, hey, calls for more people capable of running backup power generators (STEM! Or TE!, anyway) would be something that would be useful in this context, assuming that one of the things we’re dealing with is a power crisis.

                                                                                Given that our medical crisis, for all its flaws, is more or less able to keep the lights on, I’d say that an engineer who is capable of running backup power is not something that we need more of *RIGHT NOW*, but it would address the “MRIs need power!” criticism of the thought experiment.

                                                                                Because, I imagine, an MRI machine and someone who knew how to use it and read the results would be useful after an apocalypse… and, as such, qualifies as something actual and real rather than merely something that is a social construct.

                                                                                Now a solution that focuses on the provision of insurance following an incident that does not involve pre-existing conditions according to sub-clause 13b (see attached), strikes me as being a lot more like a “social construct” and “health care coverage” (in quotes) rather than actual and for real health care (without quotes).

                                                                                It seems to me that the creation of newer and more social constructs is, effectively, the creation of demand.

                                                                                While the creation of actual and for real health care is the creation of supply.

                                                                                And if we are having a price problem (and, I submit to you, one of the problems we’re having is a price problem), then we need to focus more on the creation of the supply of health care (like, as you say, the ability to treat burns, broken limbs, and bleeding) than on the creation of social constructs to help us manage and categorize.

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                                                                                • I find this discussion delightfully surreal. Brent the survivalist living in a suitably remote place is going to move a multi-ton piece of machinery to his village, along with the replacement parts necessary to keep it running. All in a post-apocalyptic environment where effective supply lines have been shrunk from the whole globe down to a few hundred miles (depending on how vicious the bandits are that year).

                                                                                  The global supply chains and international educational systems that support modern medicine are most definitely social constructs. And the CEOs whose companies deliver modern pharmaceuticals are the exact same people who lobby Congress for patent protection for their unique molecules.

                                                                                  So, yes, all of modern medicine is a social construct. Without those social constructs, medicine would look a lot like medicine circa 1900.

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                                                                            • This is epic. Not good but epic in it’s own very special way.

                                                                              “If the thing makes no sense in a post-apocalyptic wasteland, then it’s not something that would help us at this point in our development either.”

                                                                              I’m not sure comparing us to a P-AW is all that apt a comparison. But i’m guessing good analogies are just social constructs.

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                                                                                • To be honest, I think the post-apocalyptic thought experiment isn’t anything new, it’s just an attempt to give a contemporary feel to an old song: Hobbesian state-of-nature deja vu all over again.

                                                                                  So, no: there would be no property rights in the imagined scenario.

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                                                                                    • Let’s unpack:

                                                                                      You find a cache of Lipitor in a box. Four full bottles!
                                                                                      Are these worth anything?

                                                                                      You find a memory stick with 17 whole bitcoin on it.
                                                                                      Is this worth anything?

                                                                                      As far as I can tell, Lipitor is something that is actually real and good.

                                                                                      Bitcoin? Well, it’s a medium of exchange. Closer to “social construct” than not. Likely to be worthless.

                                                                                      Well, the memory stick might be worth something.

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                                                                                      • #stateofnature

                                                                                        Eg: “Suppose someone in our postapocalyptic world finds a box of Lipitor. That’s a real thing, with value. What prevents another person from killing the finder in order to take that thing of value? Nothing. Nothing at all. Hence, constraints on murder are a social construct.”

                                                                                        And they are!!!

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                                                                                        • Yes. Indeed.

                                                                                          So, to use these two examples, something that creates more things like Lipitor would help us with our current crisis and something that passes more laws would *NOT* help us in our current crisis.

                                                                                          If we could switch from Lipitor to Epipens for a moment, I’d point to the FDA’s approving only one Epipen to Europe’s ability to have approved eight different kinds of Epipen.

                                                                                          Epipens are good. They’re health care!
                                                                                          Social constructs preventing Epipens from being sold in the US to the point where the sole approved distributor can jack up prices? They’re making things worse.

                                                                                          Is this one of those things where you’re trying to demonstrate how silly this metric is but I’m seeing how apt it is and we’re talking past each other?

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                                                                                          • Social constructs preventing Epipens from being sold in the US to the point where the sole approved distributor can jack up prices? They’re making things worse.

                                                                                            The things the prevent generic epipens from being sold (say) over the counter isn’t “social constructs” but rather “leverage to ensure copyright protections”.

                                                                                            Copyright protections may be (and in fact are) a social construct, but how they get leveraged, enforced, protected, etc, isn’t. Seems to me anyway (ie., it’s more of an “individual” “power” based construct, which at root are not constructs whatsoever).

                                                                                            But I get your point. (I’m just pretty sure that the terms “social constructs” and “individual constructs” – or even etc! – don’t elucidate the phenomenon we really want to talk about. I don’t know what to call it….)

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                                                                                            • Hey, I’m just using it as a rule of thumb to help with figuring out how to distinguish between whether a thing is “supply” or “demand”.

                                                                                              If it’s something that does not require context to be worth something as health care, it’s supply.

                                                                                              If it requires a context to be worth something, it’s demand.

                                                                                              And if we have a price problem then what we have is a situation where the rate of demand is growing faster than the rate of supply.

                                                                                              And we do have a price problem.

                                                                                              My solution to the price problem is to start churning out as much supply as is possible to do so. The worst case scenario for churning out supply is that, no matter what, we have something that is worth something even without context.

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                                                                                              • My solution to the price problem is to start churning out as much supply as is possible to do so.

                                                                                                I’m not sure that will reduce cost, to be honest. Here’s an example:

                                                                                                Our community hospital is experiencing Real Pain (!!) because women are increasingly not opting to have conventional hospital births. Their numbers are way down, and that’s causing problems for the budget and the share holders.

                                                                                                Anyway, to remedy the problem they’ve created a Midwife section of care, where specially CNMs provide global care and deliver with MD backup, if necessary.

                                                                                                Fair enough. Nice market-based decision providing women with a nice market-based option. Problem is, their bill rate to carriers is exactly the same as before. So they make more money by paying CNMs their rate, which is cheaper than an OBGYN MD rate, but still bill the same.

                                                                                                There is no market mechanism constituting a check on this stuff. Flood the market with MDs and the negotiated rate won’t change, the bill rates won’t change, the total cost won’t change.*

                                                                                                It’s a fucked up system dude.

                                                                                                *OK, that may be overstating things a bit. But I’m pretty sure that cost won’t deviate more than a few percentage points.

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                                                                                                • btw, the “Real Pain” comment is based on Real Evidence: the CEO of the hospital had a meeting with my wife to lament how bad their numbers are and ask her what they could do to bring them back up. Which is weird (since she’s effectively the competition…) (Reminds me of Hillary, for some reason…)

                                                                                                  Add: and if you knew how much a hospital charges for a vaginal birth you’d understand why it’s such a big deal…

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                                                                                                • Well… that strikes me as one hell of a demand spike that appears out of nowhere that, really, can’t be accounted for.

                                                                                                  If people want GMO-free, artisinal, small-batch health care and demand they be provided with such…

                                                                                                  I don’t know how to possibly deal with that.

                                                                                                  Well, the two tier thing, I guess. Everybody has X years ago available for cheap. If you want the latest, greatest, bleeding edgest stuff, you get to pay for it.

                                                                                                  But that means that some people will get better health care than other people have available to them which is, apparently, monstrous.

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                                                                                                  • If people want GMO-free, artisinal, small-batch health care and demand they be provided with such…

                                                                                                    I don’t know how to possibly deal with that.

                                                                                                    Sure you do: let the market work as intended. Women get to choose a Birth Center for their maternity care and delivery and the “market” determines the price of that covered service.

                                                                                                    Problem is, that service isn’t “covered” by carriers for lots of women, and when it is the prices aren’t (as usual in the insurance world) determined by the market (since there is no market).

                                                                                                    And not to bash on insurance companies too much here, it makes sense that the “market” doesn’t determine their costs (or alternatively what we’d call “price) since they can only make projections on profitability with a high level of certainty that price (what they call “cost) is stable and predictable.

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                                                                                                  • Jaybird:
                                                                                                    Well, the two tier thing, I guess. Everybody has X years ago available for cheap. If you want the latest, greatest, bleeding edgest stuff, you get to pay for it.

                                                                                                    In a sense, at least, this is the case with very many UHC systems and in the system set up by the ACA: you get a level of insurance coverage provided more or less universally, but people are perfectly able to pay for supplemental coverage on top of that if they want fancier treatments, lower deductibles, etc. It’s not monstrous; it’s the default liberal position.

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                                                                              • Not exactly. It’s more that I think that we’ve got a price problem and that the preferred solution of the elites is to create ways to manage the price problem but the elites tend to manage the price problem in ways that subtly increase demand without increasing supply and, thus, make the problem worse.

                                                                                Sure, we can point to a group of people who are better off than they would have been otherwise, meanwhile there is another group of people who are worse off than they would have been otherwise and without a useful measuring stick of how to measure what, we’re just stuck either saying “the stuff I care about is more important than the stuff you care about!”

                                                                                If you want to hammer out a measuring stick that makes sense to you, we can discuss it.

                                                                                Without that measuring stick, though, I’m stuck looking at the price signal and how price is a function of the rate of growth of supply and the rate of growth of demand and if we seem to be in a situation where we have problems with the price going up and up and up and long lines and shortages and whatnot, I’d say that what would best address this is “more supply” and not “more demand” and if you’re having trouble figuring out whether an instance of a given thing is supply or demand, then use the nuclear war test.

                                                                                A pair of crutches? Supply.
                                                                                A letter explaining that the following treatments have the following deductables? Demand.

                                                                                Easy-peasy.

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                                                                                • Oh its the “elites” talking about it. Got it. Not people, but those dastardly “elites” who are proposing all these bad solution that look like all the successful plans used in other places. You are back to your Econ 101 talk with the high falutin stuff like “price signals” and that guff. Sounds nice and elite but i don’t see how it even starts to talk about all the actual real life examples we have of how to cover everybody well.

                                                                                  You want a metric; are we covering 100%. If not explain to the people who don’t get HC why that is just. Or better yet, assume you don’t get HC since you don’t have that money signal that brings HC and tell me why that is fine.

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                                                                                  • The elites put together Obamacare. The elites wrote the law. The elites voted on it. The elites signed it.

                                                                                    You want a metric; are we covering 100%. If not explain to the people who don’t get HC why that is just. Or better yet, assume you don’t get HC since you don’t have that money signal that brings HC and tell me why that is fine.

                                                                                    Just?
                                                                                    Fine?

                                                                                    We’ve gone from talking about fixing the problem to the way things ought to be in a world that is morally proper and properly moral.

                                                                                    Yeah, I’m going to need you to do more than make accusations of immorality against those who disagree with your efforts to, ahem, immanatize the eschaton.

                                                                                    An appeal to the way the world ought to be is the ultimate social construct.

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                                                                                    • Now you’re just being silly. Obamacare was a negotiated solution among a broad range of interests, many of whom disagreed with each other passionately. The exact same groups are all now in DC, starting to lobby the new administration and Congress.

                                                                                      Grouping all these interests into a collective “elite” conceals far more than it informs.

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                                                                                      • Then I would like to officially withdraw the term.

                                                                                        Please change

                                                                                        Not exactly. It’s more that I think that we’ve got a price problem and that the preferred solution of the elites is to create ways to manage the price problem but the elites tend to manage the price problem in ways that subtly increase demand without increasing supply and, thus, make the problem worse.

                                                                                        To

                                                                                        Not exactly. It’s more that I think that we’ve got a price problem and that the preferred solution of the people in charge of dealing with this stuff on our behalf is to create ways to manage the price problem but the people in charge of dealing with this stuff on our behalf tend to manage the price problem in ways that subtly increase demand without increasing supply and, thus, make the problem worse.

                                                                                        There.

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                                                                                • we’ve got a price problem and that the preferred solution of the elites is to create ways to manage the price problem but the elites tend to manage the price problem in ways that subtly increase demand without increasing supply and, thus, make the problem worse.

                                                                                  Think about the world the elites live in. Money isn’t an issue for them or *anyone* they talk to. Healthcare isn’t an issue because they’re always at the head of the line.

                                                                                  So we see solution after solution which expands access (at the expense of price signals) and/or shields people from price.

                                                                                  without a useful measuring stick of how to measure what, we’re just stuck either saying “the stuff I care about is more important than the stuff you care about!”

                                                                                  And the useful measuring stick is normally “price”, and the way to react or evaluate that is through a market.

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                                                                  • Pre-Brexit England, I mean.

                                                                    I have a red bus to sell to you. One that says “Vote Brexit and send 350 million (pounds, mind you) per week to the NHS.” (*)

                                                                    Whatever else Brexiters might have wanted (mostly never to see again another Polish plumber), Brexiters wanted their to protect their NHS.

                                                                    (*) of course, like many other things the Brexit Campaign said, this too, was a lie, which Boris Johnson sort or recognized when he said that the bus he was riding on might have said that, but he, personally, actually never did.

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                                                                    • So the Faragers (Faragians?) wanted to keep their good old socialized medicine?

                                                                      There’s a leveragable opportunity here for Democrats, I think.

                                                                      I might have a way to save Obamacare…

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                                                                      • Personally, I’m not at all convinced that the GOP is going to repeal the ACA. I mean, they’ll go thru the motions and have a formal vote and all (make their base happyhappy!) but I’m dubious that they will change the basic structure sufficiently to call it anything other than repeal in name only.

                                                                        Additionally, Trump appears to be at cross purposes with a bunch of anti-ACA hardliners views of what happens going forward.

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                                                                        • One of the main things I see from over here is the Democrats giddily laughing that Donald Trump is going to make Americans pay for the wall he’s going to build.

                                                                          Without, you know, noticing that we’ve stopped discussing that building the wall is *BAD*.

                                                                          Instead it’s just “MEXICO ISN’T GOING TO PAY FOR THE WALL!!!! WE ARE!!!!! IN YOUR FACE!!!!!!”

                                                                          You know the thing where people love everything about every constituent part of the Affordable Care Act but hate Obamacare?

                                                                          Tweak it here, tweak it there, call Obamacare revoked to be replaced with Trumpcare (now with improved Medicare upgrades for states who want Trumpcare Medicare Upgrades), thus dismantling Obama’s towering achievement to be replaced by something damn near identical with a great big gilded TRUMP on the front… well, would that be a towering victory for America or would that be a pyrrhic victory that ought to be fought against?

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                                                                          • The two situations aren’t analogous, seems to me. Renaming Obamacare “Trumpcare” is good (or not) for America precisely to the extent that Obamacare is good for America.

                                                                            Building a Wall is a new horizon, going where no man (since Stalin) has gone before. I’m not sure what to think about it except that there ain’t no way in hell the Mexicans are going to pay for it!

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                                                                            • It’s not that the situations are analogous, it’s the the opposition is analogous.

                                                                              If the focus of the opposition is to prevent a perceived win, then pointing out that Trump built the wall but he LIED because he said that Mexico would pay for it and they didn’t!, then that’s one thing.

                                                                              If the focus of the opposition is opposed to the wall itself, then Trump building the wall is a Trump win in its own right.

                                                                              Maybe focusing on how the US paid for it instead of Mexico allows both sides to win.

                                                                              Renaming Obamacare “Trumpcare” is good (or not) for America precisely to the extent that Obamacare is good for America.

                                                                              I agree with this 100%.

                                                                              That said, there are a non-zero number of people who would see turning Trumpbamacare from an Obaman achievement to a Trumpian deal as a dealbreaker in its own right. This is somewhat relevant insofar as a very important number of these non-zero people are in places where they could prevent the transubstantiation of Obamacare into Trumpcare.

                                                                              Which goes back to what is the goal of the opposition. To prevent the referent of “Obamacare” from going away or is it to keep “Obamacare”?

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                                                                          • Without, you know, noticing that we’ve stopped discussing that building the wall is *BAD*.

                                                                            Is it *BAD*?

                                                                            I’m not sure that it is. Stupid, yes. Pie-eyed, for sure. But bad? Idon’t know. (It’s not like constructing false pretenses to invade a soveriegn nation…)

                                                                            I mean, I agree that the envirnomental damage alone mitigates against building the damn thing, but apart from that and the wasted cost it really isn’t going to work and at best will be something future historians and tourists write about and visit to get a first hand glimpse of Trump’s Folly.

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                                                                • If you don’t want people dying in the streets, and you don’t want society paying for their care, then you’re at an impasse.

                                                                  Again, countries which have UHC *do* *not* have blank checks for every single one of their citizens. They let people die. By the standards of your rhetoric, they let people die in the streets because of lack of care. They’re just less honest about it than what I’m suggesting.

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                                                                  • There have been exposes documenting that US hospitals literally dump indigent patients onto the street, sometimes in their hospital gowns, dragging IV tubes behind them.

                                                                    So when you say that European nations ” let people die”, is that a metaphorical statement, or a literal one like the US example?

                                                                    I actually curious to know.

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                                                                    • So when you say that European nations ” let people die”, is that a metaphorical statement, or a literal one like the US example?

                                                                      I’m saying that there are seriously expensive treatments, which could save lives, that they don’t fund.

                                                                      And because they (sanely) refuse to pay for these, people die. Of course the death rate remains 100% everywhere so paying for them would do nothing but break the budget.

                                                                      An interesting example is Abdelbaset al-Megrahi (bomber of Pan Am Flight 103). He was released from a British Prison on “compassionate” grounds, he was dying from cancer and had less than three months to live. Then he went back to Libya, and lived for years apparently with a different level of cancer treatments than he would have gotten in England.

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                                                                      • So your complaint against European systems is what, then?
                                                                        They ration care, which you appear to approve of, except they don’t ration by price?
                                                                        Which gets back to original question of why price rationing is better than triage rationing.

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                                                                        • So your complaint against European systems is what, then?

                                                                          That they don’t reduce costs, and we can’t afford what they’re doing.

                                                                          They ration care, which you appear to approve of, except they don’t ration by price?
                                                                          Which gets back to original question of why price rationing is better than triage rationing.

                                                                          I don’t trust “triage rationing” to actually reduce the costs of the system (as opposed to reduce the growth of costs). To the best of my knowledge there’s no examples of it working this way.

                                                                          We can’t afford what we’re doing now so the issue is whether we go for more government or more markets for reducing costs. Markets actually *are* compatible with “helping the poor” (food stamps), but we have to lose this false idea that we’re always going to help everyone.

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                                                                          • Maybe I missed it in all the conversation, but I still don’t see why we can’t afford a European system.
                                                                            I mean it’s not like European bodies behave differently than ours, or that hospitals operate differently. An appendectomy in Berlin is performed pretty much like in Boston.

                                                                            Politics are diffrrent, yeah, but that’s the variable were trying to change.

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                                                                            • To be fair, our obesity rates are higher than the worst case countries in Europe (although not by much in some cases). The estimates I remember setting the medical care cost of US obesity around 1% of GDP. But European obesity is nonzero, so that doesn’t account for an entire percentage point of difference. And it certainly doesn’t account for multiple percentage points.

                                                                              And of course, they’re still covering *everybody* instead of just most of everybody, so the disparity in cost per person covered is even higher.

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                                                                                • I was using CDC data–can you give me the reference you were using? I’m not finding any reference that goes that high–at least not a group of them that work out sensibly. The reference I can find to 21% of healthcare costs puts the dollar figure at $192B, which is not 3.7% of GDP. It’s about 1.15%. So they’re defining health care costs in a strange way that makes the calculation work out badly.

                                                                                  Simpler to use per capita costs, since our system doesn’t cover everybody. Assuming $192B, that puts the obesity cost at about $600 per person. Let’s pretend obese Europeans don’t exist and we’re just going to eat that $600. World bank data on per capita spending by country:

                                                                                  US: $9403
                                                                                  Canada: $5292 (-$4111)
                                                                                  France: $4,959 (-$4444)
                                                                                  Germany: $5,411 ($3992)

                                                                                  So there’s still a lot to account for here. You mentioned gun violence, which according to smartgunlaws.org (which will probably overstate the case) $8.6B per year, which accounts for another $30 of it. Even allowing for the idea that on top of those variables, those people consume 25% less healthcare than we do, they’re still beating the tar out of us. So how?

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                                                                                  • …reference…

                                                                                    As a share of the nation’s Gross Domestic Product, health spending accounted for 17.8 percent.https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=what%20percentage%20of%20the%20gdp%20is%20health%20care

                                                                                    The estimated annual health care costs of obesity-related illness are a staggering $190.2 billion or nearly 21% of annual medical spending in the United States.

                                                                                    https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=how%20much%20does%20obesity%20cost%20the%20us

                                                                                    I’m curious as to whether those links will work for you (how personal does google make it?). If you don’t get what I do I’ll supply what it seems to be pulling from. Then to get 3.7% I multiplied one by the other.

                                                                                    So they’re defining health care costs in a strange way that makes the calculation work out badly.

                                                                                    That’s certainly possible. When I look at it, yes, $190B seems really low.

                                                                                    Even allowing for the idea that on top of those variables, those people consume 25% less healthcare than we do, they’re still beating the tar out of us. So how?

                                                                                    Two problems. First consumption of healthcare has little effect on the stats that we use to evaluate healthcare when we’re at this level of things.

                                                                                    We tend to rank HC systems by things like child mortality, life expectancy, and so forth. But those sorts of things are drastically affected by things like murder, obesity, SIDS and so forth which are almost entirely cultural in the first world. For example, for all the talk about how poverty creates SIDS or makes it worse, the way to prevent infants from dying is to lay them on their backs, not their fronts.

                                                                                    The 2nd problem is our spending suffers, dramatically, from things already mentioned on this board, tests/visits that are not connected to cost and are impossible to compare and so forth. Bluntly these things seem like what we should expect from “command/control” and are the sorts of things which markets clean up.

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                                                                                    • The links work for me, but I think you’re mixing and matching percentages in a way that compounds error. If we know the total dollar amount and what GDP is, we can get there directly by dividing the two, which factors out any errors in how they define what percentage of the economy is health care spending.. That’s how I did it.

                                                                                      If you use the link that gives the “21% of annual spending” figure and try to backsolve for GDP using hte other, you get completely wrong numbers, so I suspect that their dollar figure is correct but they’re defining their denominator too narrowly and getting incorrectly large percentage. The highest estimates in absolute dollar figures I’ve seen are in the low $200B range, which still puts it at just over 1% of GDP.

                                                                                      We tend to rank HC systems by things like child mortality, life expectancy, and so forth.

                                                                                      Basically, you’re suggesting we have dramatically (like 1.5x to 2x) better health services than those other industrialized countries and we aren’t using metrics that capture that fact. I could definitely see us having better results depending on the metric, but without at least some sensible metric, that just seems to be guess work. Whatever the wrongness of the metric, it would imply an extraordinary difference in the level of care.

                                                                                      Most of these things are knowable and measurable using number, so hand waving away such a large disparity doesn’t really do much.

                                                                                      The 2nd problem is our spending suffers, dramatically, from things already mentioned on this board, tests/visits that are not connected to cost and are impossible to compare and so forth.

                                                                                      Certainly, we do a lot of useless stuff that costs money. But it seems like the other countries with alternate systems either don’t do that or, even with that factored in, they still spend dramatically less per person than we do. So I’m not sure how this applies. You still seem to be speculating that we’d do those dumb things in a way that other countries don’t seem to be.

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                                                                                      • I think you’re mixing and matching percentages in a way that compounds error.

                                                                                        Certainly a possibility.

                                                                                        which still puts it at just over 1% of GDP.

                                                                                        Fair enough.

                                                                                        Basically, you’re suggesting we have dramatically (like 1.5x to 2x) better health services than those other industrialized countries and we aren’t using metrics that capture that fact. I could definitely see us having better results depending on the metric, but without at least some sensible metric…

                                                                                        I’ve seen hints of this, very different survival rates of certain cancers, lack of queuing for important surgeries and the like. The problem is this *very* quickly gets into cherry picking.

                                                                                        Ideally we’d adjust for culture (murder, being fat), which intuitively should be large, but I have no stats for that. Another strong possibility is we’re deep into “diminishing returns”.

                                                                                        You still seem to be speculating that we’d do those dumb things in a way that other countries don’t seem to be.

                                                                                        Oh, they do dumb things too, and because they’re not using markets either, they’re certainly subject to insane prices and so forth. However IMHO we’re further down that path than they are.

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                                                                            • …I still don’t see why we can’t afford a European system.

                                                                              Because these systems don’t reduce costs, they reduce the growth of costs (and even that would be difficult here). They’re also an expensive expansion of the existing system because they bring sick people who were previously untreated into the system.

                                                                              Our system is already really expensive. Expanding that expensive system onto more, often sick, people isn’t going to reduce the total cost of the system.

                                                                              I mean it’s not like European bodies behave differently than ours…

                                                                              If only that were true. If we weren’t the fattest first world nation we’d have a lot fewer sick people. Give us European bodies and many of our problems go away.

                                                                              …or that hospitals operate differently.

                                                                              Also untrue. For example many European hospitals use the “ward” model where one doctor or nurse can deal with dozens of patients at once. Ours are mostly built with private rooms to prevent the transmission of disease (and I suspect, require more doctors and nurses).

                                                                              We’re not going to burn down our hospitals and build European style ones, so we’re stuck needing vastly more people to run them.

                                                                              Politics are diffrrent, yeah, but that’s the variable were trying to change.

                                                                              Politics is a stand in for culture, and culture is one of the hardest things to change.

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                                                                                • No, I think Dark’s making a different point here:

                                                                                  UHC is EASY since all you have to do is open the doors to everyone who currently doesn’t have insurance/access/money to pay cash. So he’s imagining a situation in which UHC is overlayed on the exact same system we have right now, and if we did that, then he’s absolutely right that costs would go thru the roof (wait a minute! costs are already going thru the roof! and they were before passage of the ACA! oh, well, that’s a different topic, so let’s let it go).

                                                                                  What people are referring to as “UHC” is ambiguous to a certain extent, I think, since Dark’s restricting his conception of merely to the coverage component while others (me included) are focusing the systemic changes in pricing and absence of beuracracy (not to mention multi-layered profit motive) that such a system would entail.

                                                                                  So we’re talking about different things. Hence, Dark’s insistence that advocates of singlepayer (say) present evidence that instituting an NHS-like system will actually lower costs. That data, as far as I can tell, isn’t out there. (I looked! A bit anyway.) The nearest bit of evidence to answer his question would come from Canada, I think, since they moved to a national healthcare system only in pieces, with several provinces adopting single payer at different times, which might permit an analysis of the T1 v T2 issue Dark’s worried about.

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                                                                                  • UHC is EASY since all you have to do is open the doors to everyone who currently doesn’t have insurance/access/money to pay cash. So he’s imagining a situation in which UHC is overlayed on the exact same system we have right now, and if we did that, then he’s absolutely right that costs would go thru the roof

                                                                                    This.

                                                                                    Dark’s insistence that advocates of singlepayer (say) present evidence that instituting an NHS-like system will actually lower costs. That data, as far as I can tell, isn’t out there.

                                                                                    Also this. We don’t have any examples of massive savings… because UHC has always been just bolted onto the existing machinery? That’s probably the political reality.

                                                                                    others (me included) are focusing the systemic changes in pricing and absence of bureaucracy (not to mention multi-layered profit motive) that such a system would entail.

                                                                                    If it were this easy and actually going to save money, then it should be possible at a state level. The various state level experiments have had costs go through the roof until the budget breaks.

                                                                                    Next, I’m not sure how “absence of bureaucracy” gets into play here. Are we going to outlaw the hospital having a bureaucracy? We’re not going to use prices to signal anything, and presumably they’ll remain invisible (like what Kazzy found)… So why is this supposed to make anything cheaper? Is having someone else pay those insane bills going to reduce them? Are we going to micromanage the bills with a bureaucracy?

                                                                                    It feels like you’re suggesting GM could save money by getting rid of it’s entire bureaucracy and sales force by simply giving way it’s cars for “free” and billing the government (or that we’re going to double down on everything that makes the system expensive). My expectation is the increase in demand makes other changes moot.

                                                                                    Triage medicine has been suggested… but presumably that means deliberately not treating the old and dying because they’re old and dying. That could work (except politically), but I *think* this is what you want the system will *prevent*.

                                                                                    Savings probably needs to happen by reducing demand some way. “Price” is one way, Queues or Triage/Death Panels is another.

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                                                                  • Again, countries which have UHC *do* *not* have blank checks for every single one of their citizens. They let people die. By the standards of your rhetoric, they let people die in the streets because of lack of care. They’re just less honest about it than what I’m suggesting.

                                                                    I’ll take, Dark! We both agree that I’m dishonest about people dying in the streets and cut our healthcare costs in half.

                                                                    Is it a deal?

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                            • Chip Daniels: For examp;e, will the defense contractors have even one bit less influence than they do now?

                              Mattis has a punchers chance of kickstarting getting the procurement process back into some semblance of order. (He also has a chance of failing miserably in this cause it’s not his background and the Congress in poised to write some blank checks)

                              Similarly, Tillerson may possibly out realpolitik the realpolitick professionals – or he may get out maneuvered (and he probably won’t be big on international climate change management frameworks)

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                              • Everyone may be outmaneuvered. I mean, good point, but that’s the nature of the game.

                                The thing I see is that all of Trump’s nominees are outside-the-institutional-box type people. So if anyone can buck institutional intertia, these types of folks have the best chance.

                                And frankly I have to give Trump credit for following thru on this stuff. He didn’t cave and nominate the (institutionally) “safe” pick.

                                For better or worse…

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                                • I’m giving the benefit of the doubt to the Sec State and Sec Def picks exactly because they’re outside the intitutional box but they are also people with serious accomplishments that I believe will take their jobs seriously.

                                  The people at HHS and Education and to a lesser extent Labor are ideologues with preconceived notions of what works and what doesn’t – they may do a good job, but I wouldn’t bet that way.

                                  I have literally no expectations about Carson and Perry, and I’m not sure if they have any either.

                                  The worst pick for me Sessions, due to my latent linertarianism, but he’s the guy with the greatest chance of easy Senate confirmation and the least oversight and interest from the White House. (I wouldn’t be surprised if we’re getting Messe 2.0)

                                  I don’t have a problem with the Treasury secretary because it’s really hard to be a bad Treasury Secretary.

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                            • For example Trump has already criticized the cost overruns on the F35. It was the sort of thing that libs and conservatives both understood but nobody really said anything about publically until Trump. And even with the cost overruns, it’s not necessarily clear what to do about it. But at least Trump is shaking some things up.

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                              • Huh?? People have been criticizing and talking about the cost overruns on the F 35 and many past weapons systems for years. It’s not even a poorly kept secret. It’s been frequent and common.

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                                  • This is why Trump has so much military in his cabinet — because he’s going to be tougher on defense spending. You know as well as I do that he’s going to follow the standard GOP economic platform:

                                    1. Raise military spending.
                                    2. Cut taxes.
                                    3. A miracle occurs….
                                    4. Balanced budgets!

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                                    • He’s already said he wants to increase military spending (obliquely: “make our military into the best in the world” or some such), but he also wants – I tend to think he’s sincere here – cut our the Congressionally imposed bullshit spending that the military doesn’t want as well as impose a check on cost over-runs.

                                      Oh, he’ll do all the things you say, at least given the evidence to this point: increase military spending, radically cut taxes, huge deficit spending, etc and so on according to the standard GOP model.

                                      But I think he want’s to give the Generals the stuff they want rather than what some Senator from Mumblefuck wants them to have. In fact, he holds politicians in such contempt it wouldn’t surprise me if it was personal more than principled.

                                      Add: “If you’re going to have crime, it might as well be organized crime.”

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                                    • ya know, I can hear Hillary’s voice in my head saying exactly that: “And when we get to Washington, we’re gonna take on the defense contractors! Aand the Senators who get elected by pandering to them! We’re gonna put a lot of defense systems employees outa work!”

                                      {{Shiver}} Flashback nightmare. Sorry.

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