GeorgiaDon

I recently heard about an insane example of this. Medicare will pay for a kidney transplant (about $100,000), but by law they can cover the anti-rejection drugs needed to keep the kidney viable for only three years. After that the patient has to come up with as much as $950/month for the co-pay for anti-rejection drugs. Medicare pays about $15,000/year for the anti-rejection drugs. Medicare also pays the full cost for dialysis (about $90,000/year) with no limit on the duration of treatment. Dialysis requires 3 sessions of 3-4 hours each/week, making it difficult for patients to hold down a regular job. So patients with failed kidneys get dialysis ($90,000/year) until a kidney becomes available at which time they receive a transplant ($100,000) and drugs for three years ($15,000/yr x 3 = $45,000). At the end of three years many patients cannot afford the anti-rejection drugs, even if they have insurance, as the co-pay is so high. So they skip doses to make the drugs go farther, which doesn't work and trhe kidney is rejected, or they just stop taking the drugs altogether and let the kidney fail. Then they go back on dialysis ($90,000/yr) until a new transplant is available and start the process all over again. In other words, to prevent so-called "freeloaders" from getting their anti-rejection drugs for "free" (costing taxpayers $15,000/yr) the government would prefer to pay $90,000/yr for dialysis and perhaps another $100,000 for another transplant. Also you can factor in that people on dialysis generally can't work because they have to spend so much time getting dialysis treatment, so they are not paying taxes and are often also collecting disability payments. On the other hand after a successful transplant people don't need dialysis and so they can work and pay taxes. Cutting people off from the drugs they need to keep their transplant viable is beyond stupid, it is insane! Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

If you want to reduce everything to $$ you might have a point, though even there one could still discuss which system results in your butt being butt-hurt for the fewest dollars. We all know of skydivers who (before ACA at least) decided to spend money on jumps instead of health insurance. When they broke themselves they got treated, and although they may (or may not) have paid something towards their treatment most of the bill was absorbed by the rest of us, in some combination of higher insurance premiums (hospitals charging the insured more to cover the costs of caring for the uninsured) and taxes (to pay for medicaid or medicare disability payments). Even if you have insurance, for most people that is through your employment. Get too sick/injured to work, you lose your job and your insurance. For all but the most well off, you were (before ACA) always one serious illness away from bankruptcy. If you recovered from that illness, you likely could never get insurance coverage again. If your cancer relapsed you're on your own. After you've lost your house, savings, retirement accounts then the government would again step in and pay the bill. If the only thing that matters to you is how much your butt will get hurt, perhaps the optimal system is that when people get sick/injured the government never steps in, so once you've run out of butt your treatment stops and you live (or not) with whatever level of benefit you have been able to buy to that point. It seems to me there is a fundamental choice that has to be considered: Choice A. Everyone is completely on their own. If you do not have insurance, or you bought poor insurance, if you don't have personal resources you don't get treatment, whatever the consequences. If you are a student, a kid with parents who don't have resources, a young person just starting out in life and don't have a few hundred thousand in savings, too bad so sad. Your value as a human being is exactly equivalent to how much you can pay. Choice B. As a society we choose not to let people die or suffer life-long disabilities because they don't have the resources to pay for enormously expensive medical procedures. Choice A may or may not be more efficient in $$. If fewer people can afford medical care, that care will become more expensive for those who can pay, just to keep the hospital doors open and staff on hand. Also there will be a lot of people who actually do get unhooked from their chemotherapy drugs or dialysis or whatever and get wheeled out to the parking lot. I'd like to think most people would have a problem with that. If choice B is preferred, there are ways to offset the cost. One is to reduce freeloading by requiring everyone who can pay at least something for insurance to do so. That brings us to the individual mandate Republicans and Libertarians so hate. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Of course a big part of the problem is that all those factories moving to Mexico do so because they can pay their workers shit wages, and so increase their own profits. So for the average Mexican worker there may be more jobs but the pay is so low their quality of life has not significantly improved. Isn't that capitalism in action? Perhaps Mexico could/should have enforced a minimum wage that brought the standard of living up to US levels, but that would have eliminated the incentive for industries to move there in the first place. Also the US heavily subsidizes certain industries to the point where it is almost impossible to compete. US subsidies to corn farmers, for example, made US corn so cheap that over 10 million Mexican farmers were forced out of business. That's over 10 million people whose livelihood has been destroyed by US subsidies, yet those people still have to support themselves and their families. How is it a surprise that many of them end up coming to the US for work? Who pays for locks on the doors to your house, or for security systems? If you want your house to be secure against thieves, don't you have to pay for that yourself? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Republicans have promised a replacement for the ACA that keeps the (expensive) things people say they like, such as coverage for pre-existing conditions, while eliminating all the provisions intended to help pay for that (such as the individual mandate). Basically they have promised a system where people can skip paying for health insurance until they actually get sick. They also promised that no-one would lose their insurance as a result of them repealing the ACA. The only way both promises can be kept is to vastly increase federal subsidies. Otherwise premiums will have to skyrocket in order to cover pre-existing conditions without a large pool of not-yet-sick people paying premiums, and skyrocketing premiums without subsidies will force millions of people to lose their insurance. Personally I expect that two years from now we will see exploding federal spending on health care to cover 20-30 million fewer people than today, while Kelly-Ann Conway looks us straight in the eye and tells us that 20 million fewer somehow means more people are covered (in Trump University math I suppose). Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

It takes capital to reduce pollution. Businesses voluntarily foregoing profit to spend capital on pollution control not required by regulation is a decision that would put them at a competitive disadvantage and get them in trouble with shareholders. Anyone with an ounce of sense understands that. I am hardly surprised that you see no need to reduce mercury pollution. That is entirely consistent with your posting history. You never admit that any pollutant has any harmful effect. It's a shame you weren't born in the 18th century when you would have been free to pollute to your heart's content without any legal requirement to factor in the health consequences. Your so-called "cost-benefit analysis" must be pretty easy when you never acknowledge any benefit to be gained from pollution control. Your concern for "the poor" rings a little hollow, though, when you dismiss any concern that might arise from their exposure to your waste products. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

CFLs contain a very small amount (less than 4 mg) of mercury, and that is released only if the bulbs are broken or not properly recycled. CFLs use significantly less energy than incandescent bulbs, which requires significantly less coal to be burned and therefore on balance less mercury to be released to the atmosphere. source I am sure you will ignore this post, as you did the earlier one that showed the naiveté of your concept of the role of the "market" in punishing polluters and other bad actors. Don Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

All policy reflects an ideology. One ideology is that industry should not cause harm to the public. Another ideology is industry should be allowed to do anything they wish to increase profits, regardless of the harmful impact on the public. You make it quite clear which ideology you prefer. Typical of the industry disinformation campaign. Emissions from point sources such as smokestacks are not evenly distributed over the whole globe, they are concentrated downwind of the source. In the US natural sources account for only 30% of atmospheric mercury, and coal-fired power generation accounts for over 50% of the atmospheric mercury from anthropogenic sources. Once released to the atmosphere mercury is picked up by rain/snow and ends up in the soil and water where it accumulates, year by year. Some of that is converted to methyl and dimethylmercury by bacteria, and those organic mercury compounds bio-accumulate in fish and plants to levels that are toxic for us to consume (not to mention the impact on the ecosystem, which I am aware you don't give a rat's ass about). So yes, a few tons of mercury added to our water and soil and atmosphere every year, accumulating year after year, is a big deal. If the technology exists to avoid that, why would you not do so, unless you put your personal profit ahead of the health and safety of everyone and every living thing downwind of your power plant? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

The oil that is pumped from the ground in, say, Wyoming is sold as gas all over the world, not just locally in Wyoming. Oil production, especially fracking, uses a lot of water, and quite a bit of that ends up back on the surface but heavily contaminated. Regulations require that water to be contained and not just dumped on the land where it would contaminate aquifers and ranchland. Oil could be produced at less cost if oil companies could just dump that water on site. Are you saying that consumers at the gas pump in, say, North Carolina (i.e. "the market") will investigate the behavior of oil producers in Wyoming (and everywhere else in the supply train leading to the gas pump) and only purchase more expensive gas produced by suppliers that voluntarily avoid polluting the land? Won't shareholders punish companies that spend money on pollution control if that is not required by the law? Do you really believe "the market" works to punish polluters? Regulations set a baseline that everybody must abide by. They don't pick winners and losers, they establish a level playing field so no-one can gain an advantage by not cleaning up the messes they make. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Gorbychev wasn't an expansionist. We had an opportunity to work with Russia when they wanted to integrate with Western democracies. We told them to piss off, their economy collapsed, and they reverted to their strong-man ways. So now we get to deal with Putin, who (despite being the object of Trump's admiration) is no friend of the US or the West in general. Giving up California was never on the table. Have you been taking debating lessons from Brenthutch? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Are you really that ignorant of what has happened to the energy sector in the US over the last two years? Thousands of fracking wells have been

Back in the Gorbachev days, and even when Yeltsin was in office, I thought the US was missing an open invitation to help remodel Russia into a much more Western-friendly society. Unfortunately it seems that keeping Russia as a bogyman was more useful to the US establishment and to NATO. Clearly some bogyman was necessary to justify the level of military spending in the US, and to justify NATO's continued existence, and at the time there really was nothing available to replace Russia in that role. So, an opportunity was lost, and now we have Putin, an entirely predictable outcome. I often think that the most devastating thing that could happen to the US is an actually peaceful world. Imagine a world where there is no justification for maintaining a ginormous military, no need to spend trillions on fighter planes or nuclear submarines. Could a peace-time economy possibly generate enough jobs to replace the military, or enough business to keep Lockheed-Martin and all the other defense-related industries in business? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Pumping mercury into the environment is the byproduct, but then you know that I'm sure. Do you really think mercury toxicity is any different if it was dumped deliberately as opposed to as a byproduct? Do you think it makes you look smart to twist things around like that? Here's a hint: it has the opposite effect. 1. Proposed rules are not just arbitrary (contrary to the conservative mythology), they are based on actual data to determine the amount of exposure that is "safe" (i.e. no detectable harmful effects). It takes time to do the studies to determine what those mercury levels (or any toxin) are. Also understanding of the harm that is done can change over time as data is generated about sublethal effects due to chronic exposure. That is why regulations may have to be tweaked over time, an exposure level that was thought to be safe, based on short-term studies or obvious effects such as death, may turn out to be unsafe based on chronic exposure or recognition of sublethal effects such as impaired cognitive functioning. 2. Republicans have fought to delay these regulations at every step of the process. It is disingenuous (to say the least) to do everything you can to delay a regulation, then use that delay to argue the government didn't care about the regulation. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

And yet somehow you're just fine with coal-fired power plants pumping mercury into the environment. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

I think you may be looking through the wrong end of the telescope. What was your first look-at-how-virtuous-I-am comment on my HRC postmortem Ron posted? Something about how sad it was that I was filled with so much hate? What was whatsisname's first post saying [falsely as it happens] I took advantage of the NHS? It's not surprising both of you suddenly went mute on those and made tangential shifts when I supplied answers. If responding in kind to less-than-complimentary-comments is trolling, then I'm guilty as charged. Thanks, it gave me cause for yet another wry smile. As a writer, your profession is (I would assume) the communication of ideas. If you intend to say one thing and a sizable element of your audience hears something else, perhaps you should consider the possibility that your effort to communicate your ideas could be at fault. I certainly am aware that I need to take into account my audience when I speak about my research, for example. I would not use the same approach when speaking to an undergraduate class that I would at a research conference. If I give a lecture to a class and later (say, when I ask a question on an exam) discover that 90% of the students have misunderstood a particular point, I assume that I failed to teach that point in a manner my audience could understand. Re-reading your original post, I still find it aggressively smug, patronizing, and somewhat vitriolic. I would not enjoy a personal conversation presented in such a tone; perhaps those people who no longer invite you over for dinner are put off not by your ideas but by how you present them. Nothing about your post invited dissent or discussion of the facts or merits of your positions. It came across as "fuck you, progressives". Given your obvious facility with words, I think it's more likely than not that that was your intent. If it was not, you should take a big step back and reconsider your choice of language. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

I realize this is a forlorn hope, and it would gut Speaker's Corner, but perhaps we could strive for an ethic where any post that contains deliberate insults is just ignored and not responded to in any way. Surely anyone with an actual point to make could do so without resorting to "libtard" or "rePUBican" or "SJW" and so on. It's pretty obvious that Hoop did not post to this thread to convince anyone of the validity of his point of view. However he has done an excellent job of trolling several posters. Why do people bother feeding a troll? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

I suppose carcinogens in our drinking water is just the price we have to pay so the 1% can get even richer. And I have no doubt you'll find some way to argue that black lung disease is a good thing for coal miners. Well, either that or perhaps you'll argue it's just a made up liberal lie to further the "war on coal". Either way, we don't need any stupid safety regulations getting in the way of profits. "Make America Great Again", or "building a bridge to the 18th century"? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

It takes a special kind of malignancy to derive enjoyment from watching 20 million people lose their health insurance. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

If we had a popular vote to determine the President, states would not come into it at all. Some Californians would vote for candidate A, some for B, some for C, and so on, just as would happen in every state. Everyones vote would count, and they would all count the same. California and New York would not determine anything, but people who happen to live in New York or California would not be systematically discounted so they count less (as much as five times less) than people who live in Kansas or Iowa. Under the electoral college a handful of swing states command almost all the attention, leaving most of the population in "flyover" territory. My state (Georgia) has been systematically ignored in every election I have been able to participate in, for example. How is that an improvement over a popular vote? It's quite obvious that the main "justification" for the Electoral College is that it inflates the voting power of rural states with relatively small and mostly non-college-educated populations, states that tend to lean heavily Republican. The Electoral College makes is vastly easier for Republicans to win elections without the need to win the popular vote, while on the other hand ensuring that Democrats need to win significantly more than half the popular vote to actually win the election. I find it hard to see much daylight between statements discounting the right of Californians or New Yorkers to have a say in the direction of the county, and statements invoking other rules discounting whole segments of the population based on color. Both are statements that some people are not "real" Americans and do not deserve to have a say in how the country is run. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

No-one is seriously disputing that Trump won under the existing rules. On the other hand it is worthwhile to periodically reexamine "the rules". Why were "the rules" created in the first place? Are they still achieving their intended purpose? Is there a better way to achieve that purpose? Do we even still want to achieve that purpose? Have "the rules" become counterproductive? In 1960, well within the lifetime of many people still living, Jim Crow was "the rules" in much of the country. "That's just the way it is" was a common refrain. People who gained an advantage from those rules were all to ready to overlook the obvious inconsistency with the principles this country was supposed to be guided by. Which statement do you think best embodies the spirit and principles of the USA? 1. One Kansas farmer is worth five Californian city dwellers. 2. All American citizens are equal. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Yes, and no. If your only goal is to earn a decent living, there are lots of options besides spending years and a ton of $$ in college. On the other hand if you have a burning passion to cure cancer (as one of many many possible examples) you really do have to invest the time and effort to acquire the knowledge base to do that. Depending on your chosen field, you might have to go all the way through the PhD and postdoctoral training just to be able to compete for the relatively few opportunities available. Just going through college is no guarantee of success of course, but not doing that takes you out of contention from the beginning. Turning your back on your passion to cure cure cancer and opting for training in air conditioning repair might result in a decent and honest income, but you might spend the rest of your life resenting having given up and "settled" rather than fight for your dream. As a college professor, I suspect that most of my students have not really thought about why they are in college beyond the fact that that is what they were expected to do, by their parents or society. Others are obviously really engaged and are in school because they really want to learn. I also know that I am not smart enough to always tell who is who, and it's not my place to tell anyone they are wasting their time or money. Sometimes it's the "sleepers", maybe just late bloomers, who really take off. A big part of my job is to convey passion for the subject (as in my tag line). Just reciting facts to blank faces is the most trivial part of my job. Also college should be about much more than "job training". Merry Christmas, Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

This is delicious to watch from a safe distance. When America spits, Canada swims.When Canada puts on a sweater, America freezes. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

I doubt that Canada is a "safe distance". A 10% tariff on any goods entering the US won't be good, although the low exchange rate on the Canadian dollar will help offset this some. Increases in air and water pollution won't magically stop at the border. Abandoning the two-state solution to the Israel/Palestinian problem will certainly cause an increase in conflict and terrorism. Launching a new nuclear arms race will increase the odds that someone will miscalculate, and Canada is still in between the US and Russia. At least Trump won't be able to take away your health insurance. The converse is probably true as well. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Do you consider skydiving a waste? Is music a waste? Is art a waste? Do you personally reject anything that is not necessary to survive? What a boring existence you must lead. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Actual numbers are for snowflakes. What is "real" is how he feels in his gut. I wonder if he prefers banks that have "numbers don't matter" accounting principles? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Why is that a troll? I found the story reported on several news outlets, and nothing it indicate it was staged or fake. Should we just ignore such behavior? Should we refuse to acknowledge that some people see Trump's election as justification for blatant racist attacks? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)