Giuliani Calls for Massive Military Build Up To Take On China and Russia

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steross

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#61
I'm not saying hospitals and doctors should not be paid for their services. I just believe their services should be available to all through government sponsored programs. There are programs to feed the needy, but more and more Americans are being denied proper health care daily due to uncontrollable circumstances.
Medicare is already 30 Trillion in the hole just in promises to the disabled and over 65. How exactly would we create another government program to cover everyone else without guaranteeing the bankruptcy of the USA?

In my experience there is a perversity that occurs in our system. Medicaid is the prime example, and the military system is similar. These groups pay nothing toward their health care and have essentially open access to emergency services without fear of penalty. I find that these patients use the ER much more frequently (makes sense). But, they also demand the most care while there. They want every blood test. They want an MRI when they twist their knee. Generalizing, they are much more demanding than patients with private insurance. Even when the private insured patient has no new out of pocket costs for care, they don't demand in the same fashion. I believe there is a psychological reason for this. When something important like health care becomes a free entitlement, the desire to utilize to its fullest extent is increased. People negotiate services, people demand rights.

I hate the problem of the uninsured more than you do. It impacts me every single day. But, there is no easy solution. I feel the best would involve:

Get rid of the employer-based insurance system.
Get rid of Medicare and medicaid.
Have the government offer or pay for insurance coverage for everyone that cannot afford it. It would consist of complete coverage for preventive services and catastrophic coverage only. That would be low cost but still cover critical needs.
More inclusive insurance could be offered only in the private sector.
 

RoVerto Solo

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#62
Medicare is already 30 Trillion in the hole just in promises to the disabled and over 65. How exactly would we create another government program to cover everyone else without guaranteeing the bankruptcy of the USA?

In my experience there is a perversity that occurs in our system. Medicaid is the prime example, and the military system is similar. These groups pay nothing toward their health care and have essentially open access to emergency services without fear of penalty. I find that these patients use the ER much more frequently (makes sense). But, they also demand the most care while there. They want every blood test. They want an MRI when they twist their knee. Generalizing, they are much more demanding than patients with private insurance. Even when the private insured patient has no new out of pocket costs for care, they don't demand in the same fashion. I believe there is a psychological reason for this. When something important like health care becomes a free entitlement, the desire to utilize to its fullest extent is increased. People negotiate services, people demand rights.

I hate the problem of the uninsured more than you do. It impacts me every single day. But, there is no easy solution. I feel the best would involve:

Get rid of the employer-based insurance system.
Get rid of Medicare and medicaid.
Have the government offer or pay for insurance coverage for everyone that cannot afford it. It would consist of complete coverage for preventive services and catastrophic coverage only. That would be low cost but still cover critical needs.
More inclusive insurance could be offered only in the private sector.
Can you explain what I have in bold red further? I think I understand what you are saying about government sponsored insurance, but I am not sure.
 

steross

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#63
No cost for preventive services (well baby checks, immunizations, mammograms, colonoscopy.........)

Catastrophic coverage- would kick in to cover medical costs over X dollars (say $2000 or $5000) in any calendar year. So, you would pay for your visit for a sore throat, the coverage would kick in if you had a heart attack, accident, or 50 sore throats. This coverage would be provided or paid for by the government for those that can't afford it from the private sector.

For those wanting more coverage than that, it would be available in the private sector only. Sort of like car insurance. You must have liability, but you can obtain comprehensive.

I realize this isn't ideal. I realize that some people would not be able to afford the first $100 of care. I just can't see us as a nation affording comprehensive free universal coverage without bankruptcy, care rationing, or a complete change in what is considered standard of care.

Doesn't really matter. This would never get past the elderly voting block as it would end medicare.
 

RoVerto Solo

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#64
No cost for preventive services (well baby checks, immunizations, mammograms, colonoscopy.........)

Catastrophic coverage- would kick in to cover medical costs over X dollars (say $2000 or $5000) in any calendar year. So, you would pay for your visit for a sore throat, the coverage would kick in if you had a heart attack, accident, or 50 sore throats. This coverage would be provided or paid for by the government for those that can't afford it from the private sector.

For those wanting more coverage than that, it would be available in the private sector only. Sort of like car insurance. You must have liability, but you can obtain comprehensive.

I realize this isn't ideal. I realize that some people would not be able to afford the first $100 of care. I just can't see us as a nation affording comprehensive free universal coverage without bankruptcy, care rationing, or a complete change in what is considered standard of care.

Doesn't really matter. This would never get past the elderly voting block as it would end medicare.
Are you saying the U.S. Government would provide a base insurance plan where citizens would be required to pay their monthly premiums and if their income did not meet certain levels they would pay nothing or reduced amounts?

What would you expect the monthly cost to be of this basic medical insurance?

The blues are certainly some of the troublesome trade offs.
 

State

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#65
So you would abolish Social Security, social services and charitable giving to those in need.
Thanks for asking. I would definately abolish Social Security as it is today. Why should I give the gubment some of my money to invest for me to later give back to me? I can earn a higher rate of return than the government can.

I would not abolish social services or charitable giving to those in need. For one thing, I don't think you can abolish charitable giving. I give to my Church and other charities/causes as I see fit. If the gubment didn't try to take care of everyone, I think you'd see more charitable giving.

I have no problem with Medicaid. I think Medicare is broken, but I'll leave it to Steross who seems to have more knowledge of it to explain why. But yes, I think people who live in poverty should be provided medical assistance. I grew up dirt poor and my family had Medicaid. There are people who, due to circumstances beyond their control, need that help and I don't begrudge anyone for taking it.

Many of those without health insurance could are eligible for military and civil service. From the little I know of it, civil service coverage is nothing compared to the military's, and I can really only speak to the military side of it. The military is having a hard time meeting its current quotas and they want to add another 100000. That could equate to coverage for 400k or so current uninsured when the families are considered.

And forgive me for being offended, but I hardly consider those who give some time in their lives, time away from their families, and perhaps even their lives to serve the country as sucking on the bureacratic teat. Those on active duty are required to be in fighting condition and the retired only get covered for those disabilities that are service connected.

Full medical coverage is not a right. It is not the gubments job to ensure you live a pain free life into your 90s. People need to take some personal responsibility for their own bodies.
 

steross

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#66
Are you saying the U.S. Government would provide a base insurance plan where citizens would be required to pay their monthly premiums and if their income did not meet certain levels they would pay nothing or reduced amounts.

What would you expect the cost of this base medical insurance premium to be?
That would be one way to do it. The other would be to have to government require each individual to obtain that level of private insurance. Those that could show lack of resources would have those premiums paid by the government.

I don't know exactly what the cost would be. Everyone would be covered and there would be competition to provide the lowest cost insurance. So, I think the premiums would be quite a bit cheaper than they currently are for such a policy.
 

RoVerto Solo

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#67
Thanks for asking. I would definately abolish Social Security as it is today. Why should I give the gubment some of my money to invest for me to later give back to me? I can earn a higher rate of return than the government can.

I would not abolish social services or charitable giving to those in need. For one thing, I don't think you can abolish charitable giving. I give to my Church and other charities/causes as I see fit. If the gubment didn't try to take care of everyone, I think you'd see more charitable giving.

I have no problem with Medicaid. I think Medicare is broken, but I'll leave it to Steross who seems to have more knowledge of it to explain why. But yes, I think people who live in poverty should be provided medical assistance. I grew up dirt poor and my family had Medicaid. There are people who, due to circumstances beyond their control, need that help and I don't begrudge anyone for taking it.

Many of those without health insurance could are eligible for military and civil service. From the little I know of it, civil service coverage is nothing compared to the military's, and I can really only speak to the military side of it. The military is having a hard time meeting its current quotas and they want to add another 100000. That could equate to coverage for 400k or so current uninsured when the families are considered.

And forgive me for being offended, but I hardly consider those who give some time in their lives, time away from their families, and perhaps even their lives to serve the country as sucking on the bureacratic teat. Those on active duty are required to be in fighting condition and the retired only get covered for those disabilities that are service connected.

Full medical coverage is not a right. It is not the gubments job to ensure you live a pain free life into your 90s. People need to take some personal responsibility for their own bodies.
The money you pay into Social Security and Medicare is not just being held there for you alone. There are many people who pay into it that never receive a single dollar in benefits. It was established for the welfare of the individual and for the collective good of society. That is why it's called "social" as in sharing.

Do you really think charitable giving would increase if social security was abolished? There wasn't that type of giving before social security was established and I don't think such giving would increase with its elimination.

I know charitable giving by some would decrease if there was no tax benefit for it.

Your suggestion that filling military quotas could be the answer in part is interesting . Do you really believe that putting more people in uniform is the answer to this country's medical needs. Either way the government is paying for the care, is it not?

My bureaucratic teat reference may have been a little harsh, but it was not meant for all that serve our government and its people.

Full medical coverage may not be a right, but I believe access to basic coverage is and the average American is not getting that access.
 

RoVerto Solo

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#69
That would be one way to do it. The other would be to have to government require each individual to obtain that level of private insurance. Those that could show lack of resources would have those premiums paid by the government.

I don't know exactly what the cost would be. Everyone would be covered and there would be competition to provide the lowest cost insurance. So, I think the premiums would be quite a bit cheaper than they currently are for such a policy.
Unforced savings to pay the premiums is the real problem.

What could possibly be society's penalty for not setting aside enough money each month to pay your health insurance premiums, fines or even jail time?

No, the funding of this forced medical coverage will have to be a consumption tax on us all, a form of forced savings when you spend you money. That way the cost of coverage will not be a hurdle for the individual at the end of the month, because he will be jumping that hurdle everyday when he spends his money.
 

RoVerto Solo

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#70
I'm interested in what you consider full coverage vs basic coverage.
You can help me there in making a list, but I will start with a couple of items of medical care:

Basic coverage would include periodic visits to the doctor for preventive health care, but would not include a second heart transplant. Are those two good enough extremes to start a list? From there we can work to a middle ground of the more difficult issues of what is basic health care.
 

steross

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#71
Unforced savings to pay the premiums is the real problem.

What could possibly be society's penalty for not setting aside enough money each month to pay your health insurance premiums, fines or even jail time?

No, the funding of this forced medical coverage will have to be a consumption tax on us all, a form of forced savings when you spend you money. That way the cost of coverage will not be a hurdle for the individual at the end of the month, because he will be jumping that hurdle everyday when he spends his money.
It would be no different than property tax, income tax, speeding tickers or any of the other thing the government makes you pay. The penalties would be similar to those. Realize that everyones income should be higher without the employer paying your health insurance. Also, the tax deductions that employers get for health insurance could be transfered to the individual.
 

State

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#72
The money you pay into Social Security and Medicare is not just being held there for you alone. There are many people who pay into it that never receive a single dollar in benefits. It was established for the welfare of the individual and for the collective good of society. That is why it's called "social" as in sharing.

Do you really think charitable giving would increase if social security was abolished? There wasn't that type of giving before social security was established and I don't think such giving would increase with its elimination.

I know charitable giving by some would decrease if there was no tax benefit for it.

Your suggestion that filling military quotas could be the answer in part is interesting . Do you really believe that putting more people in uniform is the answer to this country's medical needs. Either way the government is paying for the care, is it not?

My bureaucratic teat reference may have been a little harsh, but it was not meant for all that serve our government and its people.

Full medical coverage may not be a right, but I believe access to basic coverage is and the average American is not getting that access.
Your point about SS is well-made and is a great reason why it is a broken system. Blacks die at a younger age on average than others, so they are getting a lower rate of return on what they put into SS than others. If what we put into SS was instead privately held, then what we don't use could be passed on to our heirs. Now isn't that a fairer system?

The system began as a way to provide for the poor during the Great Depression. People didn't live 20 years past retirement then, and the number paying into the system greatly outweighed the number today. The number of workers supporting each beneficiary has declined from 16 workers supporting each retiree in 1950 to just over three workers supporting each retiree today. Only two workers will support one retiree after all the baby boomers retire. The system is doomed to failure.

Generally, I think people are greedy (which is why capitalism is a great system), but yes, I think when people share a greater personal responsibility for the welfare of others rather than being forced into it that they are more likely to act on it. Here's an interesting tidbit:

In Who Really Cares: The Surprising Truth About Compassionate Conservatism (Basic Books), Arthur C. Brooks finds that religious conservatives are far more charitable than secular liberals, and that those who support the idea that government should redistribute income are among the least likely to dig into their own wallets to help others. link

John Stossel did a story on this and pointed out "That explains why "liberals" want to increase government and social programs. It seems a bit ironic that those who give and volunteer the least are the ones that scream the loudest about increasing the already inefficient government programs to help the less fortunate." link

By saying that some could join the military, I was pointing out that if it's such a priority for someone then that's at least one way they can assure themselves and their families of coverage. It of course is not the answer for everyone. The 300 million paying into the government for the 2 million or so that have served is far different from trying to give the same system to all 300. It's all about personal responsibility and planning ahead rather than planning on the gubment taking care of everything.
 

steross

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#73
You can help me there in making a list, but I will start with a couple of items of medical care:

Basic coverage would include periodic visits to the doctor for preventive health care, but would not include a second heart transplant. Are those two good enough extremes to start a list? From there we can work to a middle ground of the more difficult issues of what is basic health care.
What about dialysis? What about chemo that is expensive but increase survival 3%? What about a heart valve replacement in a 92 year old? What about CPR on a terminal cancer patient? What about the person that stops in the ER on the way to work for to get antibiotics for his cold instead of making an appointment and missing work? The list is endless.

An example that I see every day that is difficult for me with the uninsured: Young adult comes in with sharp chest pain. EKG and chest xray are normal. The vast majority of the time it is just chest wall pain, a muscle or rib problem. But, occasionally it is a pulmonary embolism, or blood clot to the lung. This is what killed David Bloom, the NBC reporter in Iraq. It rarely shows up on the simple tests like xray and EKG.

The modern way to diagnose this problem is a CT scan with IV contrast. That will cost around $2000. So I have a young person with no health insurance that works at Wendy's. Ordering this test will cost them almost two month's salary and it will be normal the vast majority of the time. But, if they are the unlucky one, they have a potentially fatal disease and sending them home could lead to their demise. Not to mention a massive malpractice case that you are sure to lose. So, do you spend their money, or not?
 

RoVerto Solo

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#76
What about dialysis? What about chemo that is expensive but increase survival 3%? What about a heart valve replacement in a 92 year old? What about CPR on a terminal cancer patient? What about the person that stops in the ER on the way to work for to get antibiotics for his cold instead of making an appointment and missing work? The list is endless.

An example that I see every day that is difficult for me with the uninsured: Young adult comes in with sharp chest pain. EKG and chest xray are normal. The vast majority of the time it is just chest wall pain, a muscle or rib problem. But, occasionally it is a pulmonary embolism, or blood clot to the lung. This is what killed David Bloom, the NBC reporter in Iraq. It rarely shows up on the simple tests like xray and EKG.

The modern way to diagnose this problem is a CT scan with IV contrast. That will cost around $2000. So I have a young person with no health insurance that works at Wendy's. Ordering this test will cost them almost two month's salary and it will be normal the vast majority of the time. But, if they are the unlucky one, they have a potentially fatal disease and sending them home could lead to their demise. Not to mention a massive malpractice case that you are sure to lose. So, do you spend their money, or not?
These are all good questions. Maybe the Indians had it right many years ago when their elderly became a burden they were cast out in the wilderness to die.
 

NYC Poke

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#77
I will admit to ignorance about the overall economics of the healthcare industry. But it seems to me that we are already paying for each other's medical care in one form or another, whether as a built-in cost of goods and services or in the form of higher taxes for those who cannot afford or are not provided private insurance.

It is my understanding that a large part of our aggregate medical expenditures come from the uninsured who rely on emergency care for their primary treatment, and also prolonging the life of the extremely aged.

steross hinted at some of the ethical difficulties in providing more government-paid healthcare. But we're currently paying about 10% of our GDP (I think that's correct) for healthcare. It just seems to me that we can formulate a better model, and do more good for less.
 

Slugger926

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#78
The modern way to diagnose this problem is a CT scan with IV contrast. That will cost around $2000.
What about that CT Scan and IV contrast that costs $2000?

Is it like the Doctor that looks at a newborn for 15 seconds, and concurs with the dad that the baby is breathing just fine like his sister did 2 years prior, and charges the dad $750.

Is it like the attorney who spends 5 seconds using cut & paste in word to update a credit file under collections and charges the person being collected on $800 on a $400 bill? (something they are probably having their underpaid temp service contractors kick out in mass)

Is it partial payment of the CT scan machine and the engineers that designed the machine? Or partial mainenance up keep?

Or is it like a big corporation that charges $2000 for a minimum wage employ to spend 30 minutes doing something where $10 goes to the employ, $40 goes to the stock holders, and the other $1950 goes to the management chain with $1700 of that going to the top executives and board?:eek:

Where is the real cost? Or does that dye really cost that much to produce?

I am just curious.:rolleyes: (poking fun at all careers)
 

RoVerto Solo

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#79
What about that CT Scan and IV contrast that costs $2000?

Is it like the Doctor that looks at a newborn for 15 seconds, and concurs with the dad that the baby is breathing just fine like his sister did 2 years prior, and charges the dad $750.

Is it like the attorney who spends 5 seconds using cut & paste in word to update a credit file under collections and charges the person being collected on $800 on a $400 bill? (something they are probably having their underpaid temp service contractors kick out in mass)

Is it partial payment of the CT scan machine and the engineers that designed the machine? Or partial mainenance up keep?

Or is it like a big corporation that charges $2000 for a minimum wage employ to spend 30 minutes doing something where $10 goes to the employ, $40 goes to the stock holders, and the other $1950 goes to the management chain with $1700 of that going to the top executives and board?:eek:

Where is the real cost? Or does that dye really cost that much to produce?

I am just curious.:rolleyes: (poking fun at all careers)
Collection lawyers are normally paid on a contingency fee basis and on an agreed percentage of the amount they collect.
 

NYC Poke

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#80
Generally, I think people are greedy (which is why capitalism is a great system), but yes, I think when people share a greater personal responsibility for the welfare of others rather than being forced into it that they are more likely to act on it. Here's an interesting tidbit:

In Who Really Cares: The Surprising Truth About Compassionate Conservatism (Basic Books), Arthur C. Brooks finds that religious conservatives are far more charitable than secular liberals, and that those who support the idea that government should redistribute income are among the least likely to dig into their own wallets to help others. link
Huh. Pretty surprising that a paid fellow of the conservative think tank American Enterprise Institute would come out with such favorable findings to his benefactors. Care to publish the math? The little research I did on this showed that he counted church donations. It doesn't really seem surprising that giving to churches of those who belong to churches would exceed those who are secular. Apples and Oranges.

Furthermore, when I attend my Mom's very conservative church and donate (as I always do, and generously), is that counted as conservative giving? What if that giving were earmarked towards "liberal" causes, such as fighting poverty or providing education in Africa? I learned also that Professor Brooks counted things like blood drives in his calculations. Is he counting pint-by-pint, or per capita?

I wanna see the math (which I was unable to locate on his own website). Otherwise, I'm calling major BS.

John Stossel did a story on this and pointed out "That explains why "liberals" want to increase government and social programs. It seems a bit ironic that those who give and volunteer the least are the ones that scream the loudest about increasing the already inefficient government programs to help the less fortunate." link
I could find another self-serving comment by any number of commentators. Stossel is a self-proclaimed libertarian. But he was quick to sue when he was bitch-slapped by the pro wrestler after he asked if the sport was fake. How much of his $425,000 settlement did he give to charity?