# Conservative opinion on US health care **URL:** \ **Category:** Great Debates\ **Created:** [July 26, 2009, 9:42pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356 "2009-07-26T21:42:05Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [July 29, 2009, 3:17pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/61 "2009-07-29T15:17:36Z")
> [@BobLibDem](#): > > Still, where would we be without it? SS has given independence to a great many seniors who otherwise would have had to move in with their kids. Without Medicare, what would the mortality rate of the elderly be? Sure, and by the same logic without Russian food lines the people would have starved. Had the government not appropriated the resources needed to run those programs, they could have been put to other, equally or more productive, uses. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 29, 2009, 3:18pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/62 "2009-07-29T15:18:34Z")
> [@Shodan](#): > > I suspect that if a private corporation tried to set up Social Security in its present form, they would be arrested for creating a Ponzi scheme. Why? Do you even know what a Ponzi scheme _is_? :dubious: ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [July 29, 2009, 3:37pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/63 "2009-07-29T15:37:23Z")
I can’t explain **everything** to you, **Elvis** - you are going to have to try to keep up on your own. Good luck. Regards, Shodan ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 29, 2009, 4:03pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/64 "2009-07-29T16:03:01Z")
That’s all the answer we need. Thanks for the confirmation. :rolleyes: ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [July 29, 2009, 4:39pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/65 "2009-07-29T16:39:54Z")
> [@ElvisL1ves](#): > > Why? Do you even know what a Ponzi scheme _is_? :dubious: Do you? Such systems are called Ponzi schemes if their liabilities exceed the funds set aside to pay those liabilities, and they can only pay their current liabilities by creating _more_ liabilities due in the future. It’s like getting a new credit card each year to pay off your previous credit card, it is only sustainable until you can’t get enough new credit cards to cover the ever-increasing debt. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 29, 2009, 5:10pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/66 "2009-07-29T17:10:16Z")
> [@Grumman](#): > > Do you? Such systems are called Ponzi schemes if their liabilities exceed the funds set aside to pay those liabilities, and they can only pay their current liabilities by creating _more_ liabilities due in the future. The key points being pyramiding, and the illusion of creating money. A Ponzi scheme \*must \*fail, mathematically, after a certain number of stages, because it simply runs out of people. But SS is a transfer-payments tax system. There is no investment, no fund, no account which you have on deposit somewhere that is the source of your future income. It’s just taking money from the employed to give to the retired. There is no pyramiding, and no illusion of creating money. It’s sustainable as long as receipts match payments, and all that takes is setting the necessary tax rate. It is quite common among hard-righties, as our friend **Shodan** illustrates, to falsely depict it as a “scheme”, Ponzi or other, for the purpose of undermining its credibility. It doesn’t matter to them that the system is still as functional as it ever was, and can continue to be so with just some tweaking of the numbers, only that it was done by the Democrats. ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [July 29, 2009, 5:28pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/67 "2009-07-29T17:28:44Z")
> [@ElvisL1ves](#): > > The key points being pyramiding, and the illusion of creating money. A Ponzi scheme \*must \*fail, mathematically, after a certain number of stages, because it simply runs out of people. Yes, and this one is going to fail when you hit a change in demographics that leaves you with proportionately more retirees than workers. It will not fail catastrophically, as the government will simply continue to force people to take part, but they will have to rip off one generation or another by taking more money from the workers or giving less money to the retirees. > [@](#): > > It’s just taking money from the employed to give to the retired. There is no pyramiding, You are taking money from the current generation of workers and giving it to the current generation of retirees, with the promise that the next generation of workers will give _them_ money when _they_ retire. That is _exactly_ how a pyramid scheme works. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [July 29, 2009, 5:37pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/68 "2009-07-29T17:37:09Z")
> [@Grumman](#): > > Yes, and this one is going to fail when you hit a change in demographics that leaves you with proportionately more retirees than workers. No credible economic model has ever forecast this eventuality. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 29, 2009, 5:37pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/69 "2009-07-29T17:37:54Z")
> [@Grumman](#): > > Yes, and this one is going to fail when you hit a change in demographics that leaves you with proportionately more retirees than workers. Just takes some tweaking of the numbers. As I already said. > [@](#): > > It will not fail catastrophically, as the government will simply continue to force people to take part, but they will have to rip off one generation or another by taking more money from the workers or giving less money to the retirees. Ah, another “taxation is tyranny” type, I see. > [@](#): > > You are taking money from the current generation of workers and giving it to the current generation of retirees, with the promise that the next generation of workers will give _them_ money when _they_ retire. That is _exactly_ how a pyramid scheme works. Wrongwrongwrong. The source of the money to be paid in the future is future earnings, and with the right rate set, outgo matches income indefinitely. It’s a transfer-payments system. As I also said. A pyramid scheme works by constantly \*increasing \*the required number of entrants, and inevitably fails because it runs out of people. SS does not. Better go do some more research, friend. ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [July 29, 2009, 6:01pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/70 "2009-07-29T18:01:36Z")
> [@Fear\_Itself](#): > > No credible economic model has ever forecast this eventuality. I assume these credible economic models explain why this eventuality will not occur as the post-WWII baby boomers age? ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [July 29, 2009, 6:09pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/71 "2009-07-29T18:09:31Z")
> [@Grumman](#): > > I assume these credible economic models explain why this eventuality will not occur as the post-WWII baby boomers age? As a matter of fact they do. Here is the [GAO projection through 2080](http://www.ssa.gov/OACT/TR/TR04/IV_LRest.html#wp222190), and at no time is there proportionally more beneficiaries than workers . ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [July 29, 2009, 6:56pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/72 "2009-07-29T18:56:31Z")
> [@Fear\_Itself](#): > > As a matter of fact they do. Here is the [GAO projection through 2080](http://www.ssa.gov/OACT/TR/TR04/IV_LRest.html#wp222190), and at no time is there proportionally more beneficiaries than workers . You have made a mistake - saying “there will be proportionally more beneficiaries than workers” is not the same as saying “there will be more beneficiaries than workers”. I was saying that the ratio of beneficiaries to workers will increase, not that the ratio will be greater than 100%. ---
**Author:** ![Ruminator](https://avatars.discourse-cdn.com/v4/letter/r/b9bd4f/32.png) [@Ruminator](https://boards.straightdope.com/u/Ruminator)\ **Post date:** [July 29, 2009, 7:35pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/73 "2009-07-29T19:35:43Z")
> [@Fear\_Itself](#): > > , and at no time is there proportionally more beneficiaries than workers . It doesn’t have to be an absolute # of retirees outnumbering absolute # of workers to make the system insolvent. When the politicians created Social Security in 1935, there were 47 workers for each beneficiary. Now we are down to 2 workers for each beneficiary. The politicians who created SS were too stupid to predict how SS would run into financial problems. They didn’t foresee the huge demographic shift. Now those math illiterate politicians are all dead and can’t grasp their shortsightedness. Taxes for SS increased from 2% to 12.5% and it _still_ doesn’t have enough money. Today, we have a new group of math illiterate politicians promising UHC with certain projected costs. Those rosy projections are just as stupid as the 1935. To add insult to injury, the nation was stronger financially in 1935 than it is now. We as a nation only have enough brainpower to SPEND. We don’t seem to have the extra brainpower required to actually understand how to PAY for it all. How can citizens realize that politicians are too incompetent to create public programs that are actually sustainable when most of the citizens themselves are financially illiterate? I can’t think of a single long-term government initiative that has come in under the projected costs. Not SS, not Medicare, not NASA Space Shuttle, not Iraq war. I think the Hoover Dam came in under budget – but that was just small 5-year project. With the govt’s stellar track records, why should we believe politicians will write this UHC law correctly (that they are rushing through Congress)? Who cares? Just give me the “free” healthcare and let the next generation in 2030 worry about the broken funding! ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [July 29, 2009, 8:15pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/74 "2009-07-29T20:15:11Z")
> [@Grumman](#): > > You have made a mistake - saying “there will be proportionally more beneficiaries than workers” is not the same as saying “there will be more beneficiaries than workers”. I was saying that the ratio of beneficiaries to workers will increase, not that the ratio will be greater than 100%. You should have been more clear. Just because the proportion changes does not make it a Ponzi scheme. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 29, 2009, 8:16pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/75 "2009-07-29T20:16:27Z")
> [@Grumman](#): > > You have made a mistake - saying “there will be proportionally more beneficiaries than workers” is not the same as saying “there will be more beneficiaries than workers”. I was saying that the ratio of beneficiaries to workers will increase, not that the ratio will be greater than 100%. Who has said that the structure of Social Security must be unchanging in the face of demographics changes? You increase the cap a bit to generate more current income. You put off the retirement age (or twiddle benefits in order to encourage people to retire later) to keep people in the working pool and out of the beneficiary pool longer. If you look at the statement that Social Security sends you every few years, you’ll see very clearly what they are doing. Reagan, faced with a much bigger problem, got a commission together and solved it - and I give him lots of credit for it. Why do you hate the Gipper? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 29, 2009, 8:28pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/76 "2009-07-29T20:28:43Z")
Exactly. There are other steps that could be taken with minimal pain, including raising or eliminating the income cap, applying taxation to unearned income, making taxation progressive (or at least less retrogressive), instituting means testing for recipients, etc. The system needs regular maintenance or yes, it will become increasingly inefficient and eventually fail - just like your car will eventually break down if you don’t change the oil. But that isn’t the _car’s_ fault, and the fact that it needs maintenance does not invalidate the concept of having a car. Nevertheless, that is the type of conclusion many of the bathtub-drowners would like to make. Rather than honestly admit they oppose having a tax-funded guaranteed pension program on philosophical grounds, or that it’s because it’s the product of the party they oppose, they’ll claim instead that it simply can’t work for long, en though it _has_ for three generations now, or even somehow claim it to be fraudulent, as we’ve seen again in this very thread. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [August 3, 2009, 8:49pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/77 "2009-08-03T20:49:30Z")
> [@athelas](#): > > Milton Friedman: [http://www.hoover.org/publications/digest/3459466.html](http://www.hoover.org/publications/digest/3459466.html). > > > [@](#): > > > > A more radical reform would, first, end both Medicare and Medicaid, at least for new entrants, and replace them by providing every family in the United States with catastrophic insurance (i.e., a major medical policy with a high deductible)[Note: universal healthcare! sort of]. Second, it would end tax exemption of employer-provided medical care. And, third, it would remove the restrictive regulations that are now imposed on medical insurance—hard to justify with universal catastrophic insurance. Universal catastrophic and primary care insurance sounds great in principle because everyone would spend their dollars more wisely but then in the large beefy middle you end up with people getting helath care (perhaps necessary health care based on ability to pay. I would suggest that health care may be one of those goods that should be distributed (at least to some extent) regardless of ability to pay. YMMV ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [August 3, 2009, 8:59pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/78 "2009-08-03T20:59:18Z")
> [@IdahoMauleMan](#): > > The same way you can run unregulated anything else. > > The company offers a product or service for a specified price. > > The customer decides whether or not to accept it. > > And that’s it. The vast majority of insurance regulation ensuring the solvency of the insurance company. When you are taking money today with the promise of paying it out sometime in the future, how can you NOT regulate that? Most insurance company regulation is basically consumer protection. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [August 3, 2009, 9:02pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/79 "2009-08-03T21:02:53Z")
> [@athelas](#): > > If you feel this way, then wouldn’t the most direct solution be subsidizing care for the poor? Or better yet, since the poor know their preferences better than government bureaucrats, why don’t we just instate a [negative income tax](http://en.wikipedia.org/wiki/Negative_income_tax) and let them decide what to do with the money? Its amazing how conservatives get comfortable with welfare if it means tax cuts. TANSTAAFL. A negative tax is just a fancy word for welfare (the current fancy word if earned income tax credit) and the flat tax is just a fancy word for tax cuts for the rich. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [August 3, 2009, 9:10pm UTC](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356/80 "2009-08-03T21:10:11Z")
> [@athelas](#): > > We can have equity, or efficiency, but not both. This does not have a binary outcome. You can have something other than perfect equity or perfect efficiency. The question is how efficient are we now and can we pareto-optimally improve efficeincy or equity (that is improve equity without decreasing efficeincy or improving efficiency without decreasing equity). Once you get a pareto optimal result you move along the curve until you get an equity/efficiency balance that you are happy with. The problem is that we are not at pareto optimality yet. When private insurance companies spend 7 times as much on overhead and administrative costs (underwriting (cherrypicking), claims adjustment (claims denial) and talent retention (huge bonuses to executive)) as medicare). [Previous page](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356.md?page=3) [Next page](https://boards.straightdope.com/t/conservative-opinion-on-us-health-care/504356.md?page=5)