Moments when a piece of entertainment completely lost you.

[Kaelik]

And out of curiosity, which state do you live in?

[AndreiChekov]

And out of curiosity, which state do you live in?

California

[DSMatticus]

I'm going to guess that you haven't actually tried at-fucking-all to get medical coverage (presumably because that would require giving some amount of information to the government, you know, like you already do if you file taxes), because California has expanded medicaid to cover low income adults and if you genuinely cannot afford health insurance then you almost certainly either have access to medicaid or substantial subsidies.

But more generally, healthcare was always socialized; it was just socialized in a way that caused large amounts of unnecessary human suffering while simultaneously preventing idiots from realizing that they were already paying for other people's hospital bills. The fact is that when Bob McBroke gets a $50k hospital bill for his lung cancer treatment and files for medical bankruptcy, the hospital doesn't magically get back the money they spent treating him. That money is gone, and if the hospital needs to cover their losses then they'll do that by raising prices on the customers who can pay. If your hospital bills go up because Bob McBroke couldn't pay his bills, you're paying Bob McBroke's hospital bills! Gasp! Socialism!

But honestly, it gets worse than that. Because while hospitals are required to provide treatment in case of emergencies regardless of the patient's ability to pay, they are not required to provide treatment to patients who will inevitably die without treatment but are currently stable. There are real examples of hospitals calling up cancer patients ahead of surgery to tell them that unless they're ready to pay a couple thousand bucks upfront they may as well not show up. That's certainly "unsocialized" medicine - you will never have to help pay such a person's hospital bills, but it'll be because they fucking died of an otherwise preventable illness. Also I lied, eventually their illness will progress to the point that it lands them in the emergency room which will be even more expensive and you'll end up paying that instead. Oopsies!

Unless you never plan to go to a hospital ever, but the fact is your control over that is very limited - and you are then essentially gambling other people's money that you won't get stick, because if you do get sick and can't afford it it's just going to be other paying customers who foot your bills. Gasp! Socialism!

[AndreiChekov]

I'm going to guess that you haven't actually tried at-fucking-all to get medical coverage (presumably because that would require giving some amount of information to the government, you know, like you already do if you file taxes), because California has expanded medicaid to cover low income adults and if you genuinely cannot afford health insurance then you almost certainly either have access to medicaid or substantial subsidies.

But more generally, healthcare was always socialized; it was just socialized in a way that caused large amounts of unnecessary human suffering while simultaneously preventing idiots from realizing that they were already paying for other people's hospital bills. The fact is that when Bob McBroke gets a $50k hospital bill for his lung cancer treatment and files for medical bankruptcy, the hospital doesn't magically get back the money they spent treating him. That money is gone, and if the hospital needs to cover their losses then they'll do that by raising prices on the customers who can pay. If your hospital bills go up because Bob McBroke couldn't pay his bills, you're paying Bob McBroke's hospital bills! Gasp! Socialism!

But honestly, it gets worse than that. Because while hospitals are required to provide treatment in case of emergencies regardless of the patient's ability to pay, they are not required to provide treatment to patients who will inevitably die without treatment but are currently stable. There are real examples of hospitals calling up cancer patients ahead of surgery to tell them that unless they're ready to pay a couple thousand bucks upfront they may as well not show up. That's certainly "unsocialized" medicine - you will never have to help pay such a person's hospital bills, but it'll be because they fucking died of an otherwise preventable illness. Also I lied, eventually their illness will progress to the point that it lands them in the emergency room which will be even more expensive and you'll end up paying that instead. Oopsies!

Unless you never plan to go to a hospital ever, but the fact is your control over that is very limited - and you are then essentially gambling other people's money that you won't get stick, because if you do get sick and can't afford it it's just going to be other paying customers who foot your bills. Gasp! Socialism!

I filed taxes, and the obamacare papers. I have a pretty large family, so the total cost estimated was $900 per month. I make about $1200 right now.

I am well aware of how hospital pricing works, and what you are talking about is actually freemarket, not socialism. I am fine with that system. And I am fine with setting up a payment plan with a hospital to pay them over time after i have used their services. On top of that, I have only ever needed a doctor once in my entire life. I would rather pay monthly for a few years after the fact than pay monthly to make sure I have the money immediately. Hell, I'd rather take a bank loan to pay them, and then repay a bank.

[Kaelik]

I am well aware of how hospital pricing works, and what you are talking about is actually freemarket, not socialism.

No, a Freemarket would be where hospitals have the right to refuse to give treatment to people who can't pay in advance, and that would include people who they think won't be able to pay them back, and that would include banks not giving you loans because they don't think you can't pay them back.

Ordering people to perform functions regardless of whether or not they will be paid for is filthy government intervention in the market.

[erik]

Large family but only needed a doctor once in your life? Does not compute to me what with pregnancies, vaccinations, checkups, even if you're lucky and kids don't break shit.

I'll grant that with that wage and cost you cannot afford the plan you looked at, but while I don't know California's plans and rules, at 1200 per month for a large family I expect you should be within poverty guidelines for even further subsidized costs. By the table on this page, your premium should be 2% of your monthly income.



Also note, the cost of a premium is less than the penalty. It is crazy not to use this option if you qualify.

If you cannot afford health insurance then you're a huge risk to a bank and would be unable to score a loan for expensive medical care. Most likely unplanned medical expenses would force you into bankruptcy.

If you are fine with subsidizing people with no insurance by having your costs increased, then I don't know how you are anti-socialism.

And if you are okay with that, then you should be even more okay with subsidizing regular care and checkups for people who could not otherwise afford it so that it saves you* money in the long term because using the ER for things that could have been avoided is extremely wasteful and expensive. Giving people regular checkups and healthcare saves money over covering their tab at the ER.

*While I've been saying "saving you money", really it is saving me money because you aren't going to be able to afford medical care and folks like me will be picking up your tab.

[DSMatticus]

and what you are talking about is actually freemarket, not socialism

No, no it isn't. Don't pretend you know what this shit means, because you don't. As long as hospitals are obligated to provide life-saving treatment (instead of allowing potentially non-paying customers to die in the streets), it will not be a free market. That is an act of government intervention which necessarily redistributes the burden of paying for hospital treatment from the nonpaying patient to people other than that patient.

And no, you will never ever ever be able to work out a deal with a hospital for any serious treatment. Emergency room visits cost thousands of dollars. Serious illnesses cost tens of thousands - if not hundreds of thousands - of dollars to treat. If you or an uninsured family member develops cancer, that ends in death (when a hospital refuses to treat you) or medical bankruptcy (when they treat you but you can't pay), full stop. Well, I mean technically the hospital might graciously accept that they've made a terrible decision saving your life and work out a payment plan that merely cripples your livelihood while still being a substantial loss for them, but the fact remains that a substantial loss is a substantial loss and other people will be left footing the bill you failed to pay for.

Again, you are gambling that you won't get sick using other people's money. That is what you are doing. And calling that "the magical hand of the free market," apparently, because you don't what free markets look like, but man do you sure hate that thing everyone told you was socialism!

Also, your story doesn't add up. If you actually made that much money with a family of that size, your subsidy would be substantial.

[hyzmarca]

Large family but only needed a doctor once in your life? Does not compute to me what with pregnancies, vaccinations, checkups, even if you're lucky and kids don't break shit.

The large family thing actually works against him there, since you can't get subsidies if your income is below the federal poverty level. That's why his premiums are 900, he doesn't make enough money to get subsidies.

But, in California his family should be eligible for medicaid.

[AndreiChekov]

and what you are talking about is actually freemarket, not socialism

No, no it isn't. Don't pretend you know what this shit means, because you don't. As long as hospitals are obligated to provide life-saving treatment (instead of allowing potentially non-paying customers to die in the streets), it will not be a free market. That is an act of government intervention which necessarily redistributes the burden of paying for hospital treatment from the nonpaying patient to people other than that patient.

And no, you will never ever ever be able to work out a deal with a hospital for any serious treatment. Emergency room visits cost thousands of dollars. Serious illnesses cost tens of thousands - if not hundreds of thousands - of dollars to treat. If you or an uninsured family member develops cancer, that ends in death (when a hospital refuses to treat you) or medical bankruptcy (when they treat you but you can't pay), full stop. Well, I mean technically the hospital might graciously accept that they've made a terrible decision saving your life and work out a payment plan that merely cripples your livelihood while still being a substantial loss for them, but the fact remains that a substantial loss is a substantial loss and other people will be left footing the bill you failed to pay for.

Again, you are gambling that you won't get sick using other people's money. That is what you are doing. And calling that "the magical hand of the free market," apparently, because you don't what free markets look like, but man do you sure hate that thing everyone told you was socialism!

Also, your story doesn't add up. If you actually made that much money with a family of that size, your subsidy would be substantial.

5 years ago I had a bill of $14k. I just finished paying it off last year. The hospital didn't lose money, they just had to wait for it. And there was interest as well, so they actually got more money than they originally wanted.

That price was with the subsidies.

And, while hospitals are required to provide life saving treatment, they charge the prices that they want to charge for the services that they provide, which is essentially a free market. Not a completely free market, that would be doctors just deciding not to help people that can't pay, but about as close as you can get without horrible things happening.

[hyzmarca]

That price was with the subsidies.

That's not with subsidies. With subsidies it would be $24.

Given your income level, if you have a large family then you don't make enough money to qualify for subsidies.

But you most certainly are elegible for Medicaid.

http://www.medicaid.gov/medicaid-chip-p ... ation.html

A-fucking-ply, right now. It's free. It will save you a large amount of money and a lot of trouble.

[DSMatticus]

That price was with the subsidies.

No, it wasn't, unless some of the things you have told us are not true. Because that little income will either qualify you for fuck-off huge subsidies OR qualify you for medicaid. You don't live in one of the states with a coverage gap; there is no crack for you slip through.

AFAIK, there are people who will meet with you for free as part of the ACA sign-up initiative or whatever (I assume that's still a thing) and you can talk with them to figure out what you actually qualify for.

And, while hospitals are required to provide life saving treatment, they charge the prices that they want to charge for the services that they provide, which is essentially a free market.

No, it isn't, because sometimes the prices they charge are not paid and the services are still required to be rendered by law. And sometimes they negotiate prices way the fuck down to get any money at all from people for services they are forced to render. Government action is very much a part of healthcare pricing behavior; it's not a free fucking market. It is definitionally and functionally not.

[AndreiChekov]

The rest of what everyone has said will need me to be more sober to answer.

Large family but only needed a doctor once in your life? Does not compute to me what with pregnancies, vaccinations, checkups, even if you're lucky and kids don't break shit.

Ever heard of a home birth? Happens occasionally in Redneckville. Also, vaccinations and check ups are a waste of time. I'm from a group of people that go to doctors only when we can't fix it ourselves, which means pretty much ER shit only. And if I knew enough about sewing wounds shut, I wouldn't have gone myself.

[Maj]

I'm so grateful for the Medicaid expansion. Four months after it went into effect, Ess was hospitalized three times and finally ended up being diagnosed with diabetes, sepsis, and sepsis-induced cardiomyopathy.

My son was diagnosed with ADHD, and it covered all our attempts to avoid medication, and once those failed, it covered medication (he's now in a normal classroom and doing quite well).

Most of all... It keeps me from having to go to the ER. Now, I have access to a nurse line that I can call if I can't handle the problem (and am capable of handling a lot of problems). And failing that, there's a rapid access clinic I can go to so I don't have to spend hours waiting in the ER. If there's one thing I hate, it's wasting my time in the fucking ER.

If you have a family larger than three people, and you make only $1200 a month, GET COVERED. You will qualify for Medicaid. You don't have to use it, but you also won't have to pay for it, and it's a prophylactic against $14,000 ER bills.

[erik]

Also, vaccinations and check ups are a waste of time.

Oh, fuckity fuck.

Vaccinations are not a waste of time. There's a reason we developed them, because those diseases can be fucking brutal and deadly. You're rolling the dice by not getting them, especially if you hang out with lots of other people who also are not vaccinated and are not getting regular checkups. All it will take is one kid to get sick and it will spread like wildfire in a group like that. And checkups are important, especially for children and extra especially for newborns since there are many potentially serious problems that can be nipped in the bud before they become actually serious problems.

Dicking around with your health is one thing, but gambling your kid's health is another. Vaccinations are not a waste of time. What kind of fucked up risk-benefit analysis leads people to avoid vaccinations?

Just look at the complications from things we have vaccinations for, and consider if avoiding any of those complications is worth getting vaccinated for free.

https://en.wikipedia.org/wiki/Pertussis (~2% chance of death for children <1 year, and that's if you get hospitalization, worse if you fuck around and don't go to a doctor for checkups)
https://en.wikipedia.org/wiki/Mumps
https://en.wikipedia.org/wiki/Measles
https://en.wikipedia.org/wiki/Rubella
https://en.wikipedia.org/wiki/Tetanus

Anywho, check out the links people posted, get enrolled. If your numbers were accurate then you qualify for cheap or even free healthcare. And you should take it. If only in case shit happens, or even to avoid paying the penalty tax.

[TiaC]

Erik, if he lives in California, his kids must be vaccinated if they aren't homeschooled. We actually have relatively sane state politics, so we removed the personal and religious exemptions.

[MGuy]

Erik, if he lives in California, his kids must be vaccinated if they aren't homeschooled. We actually have relatively sane state politics, so we removed the personal and religious exemptions.

Considering what's been said there's a larger than normal chance that he does homeschool his kids. Public school might be too socialist for him so I wouldn't be surprised.

[Hadanelith]

Also, vaccinations and check ups are a waste of time.

Unless you are specifically immunocompromised in such a way that you CANNOT be vaccinated, get vaccinated. Because if you don't, you're gambling with not only your life and health, but that of other people.

[Username17]

OK. Everything AndreiChekov said about capitalism, socialism, and medicine is stupid and wrong. Literally everything. I'm an actual doctor, and it hurt to read that crap.

The basic structure of medicine is wholly unlike the market for, say pizza or automobiles. The "consumers" of healthcare don't get it because they want it, they get it because they need it. If you develop better medicines that cost more, the people who will want them won't be the people with more disposable income but the people who have the conditions the newer medicines treat. Further and more importantly: the people who want the new medicines do not know who they are. The people who know what medicines are and are not desirable for a patient are the prescribing doctors, who are providers and not consumers. The consumers have basically no information, since they cannot diagnose or evaluate treatment options.

So right away there cannot be a "market" for healthcare that is in any way functional. Asymmetric information on that scale means that no effective price mechanism can exist. And the fact that there is no positive correlation between people whose diseases are expensive to treat and people whose incomes could directly pay for expensive treatments makes price rationing of medical services both profoundly immoral and also wholly ineffective.

In fact, the correlation between cost to treat and ability to pay is profoundly negative. Sick and injured people have a difficult time engaging in productive labor and don't have incomes. If they are able to pay anything at all themselves, it is through inter-temporal transfers which are only possible through socially mediated credit and transfer systems. AndreiChekov mentioned paying a medical bill later on - but that still means that someone else was paying for his care at point of treatment and then he paid them back later through the magic of socially enforced debts. Had he died before future wages could pay for his treatment, one hundred percent of the costs would have been borne by these mysterious others.

The way medicine has to be funded is by presently healthy working people paying now and sick and injured people getting treated now. The payers and the consumers are necessarily not the same people at any moment because being a consumer interferes with your ability to pay. The overall cost of the system simply goes up the more steps there are in the transfer of wealth from the healthy who can afford it to the sick who need it. Healthcare in the United States is simply more expensive in the United States where there are competing health insurance groups and doctors have to fight with different agencies and companies to get paid for services and some people pay out of pocket than it is in Canada where the government acts as a single insurance company and all the funding comes from a single pile. And it's more expensive in Canada where there is that layer of government insurance than it is in the United Kingdom where the government owns the hospitals and there isn't billing at all. Overall costs are simply lower when the transfer from those who are working to those who can't work is done quickly and efficiently by having people with incomes pay taxes and having those tax moneys pay for healthcare needs as and when they come up than it is when there are any other steps and levels of private profiteering added to that arrangement. And that is why healthcare amounts to less than 10% of GDP in the United Kingdom and over 17% in the United States. The fact that straight up British health communism is more efficient than American hybrid health socialism/capitalism accounts for about 8% of the total economy of the United States. That's right: 2 out of every 25 dollars in the American economy are dedicated to pushing paper around to maintain a facade of private profit making in the healthcare sector. Going to the Soviet/British model would save $1.3Trillion dollars a year in the United States.

And of course, the things AndreiChekov says about medicine itself are not just wrong, but literally dangerously wrong. Also expensively wrong. The old adage that an ounce of prevention is worth a pound of cure is basically true. Vaccinations that prevent diseases are much cheaper for the individual and society than waiting for diseases to occur and treating them afterward. Refusing to get polio vaccines is a huge risk and the lost wages and costs of treatment for getting polio paralysis are so high that the cost of polio vaccines could run in the thousands of dollars and they'd still be worth it. In actual fact, they cost fifty dollars.

AndreiChekov is perfect testimony for why markets don't work in healthcare. He is not an informed consumer and he is not paying for his needs. He is relying on other people to pay for his needs and he is making choices about medical care consumption that are not only financially ill-advised, but dangerous to himself, his children, and the people around him. He is a person who would benefit immeasurably from healthcare Stalinism, and everyone around him would benefit from him being subjected to Leninist healthcare systems like the ones they have in David Cameron's England.

-Username17

[Koumei]

AndreiChekov admitted to being dumb, but apparently doesn't want to fix this, so I don't really see where the conversation can head. Though apparently he wants to turn his children into bio-warfare labs, which isn't really okay.

[Ancient History]

So, I saw SPECTRE at the box office. It's not the best Daniel Craig Bond movie. Spoilers below.

They did try to tie up all the plots from Daniel Craig Bond 1-3, but given that Skyfall wasn't really tied into any of that, it doesn't work terribly well. Also, they decided to try and do a "serious" take of such old James Bond staples as the villainous secret lair, and strapping James Bond down for some torture. But not like the rope-and-a-chair-with-a-hole-in-it from Casino Royale, but like a dentist chair with robotic drills. Christoph Waltz is...well, there's no way to spoiler this twice: he's Blofeld. Yeah, they went there. It's not really clear WHY they went there. It's not really throwing a bone to any of the fans. Honestly, a lot of the villains seem kind of wasted in their roles. Waltz doesn't have any really good dialogue, like he did in Inglorious Basterds, and Dave Bautista - while he has great physical presence - has like one line in the entire fucking movie. Also, Blofeld is supposed to be James Bond's adoptive brother, which...seems terrible, really. The "B plot" about whether or not drone strikes make James Bond irrelevant in today's modern spy community is just painful.

On the other fronts, it is a gorgeous film in a lot of ways, and I really liked the opening scene in Mexico City during the Day of the Dead parade.

[AndreiChekov]

AndreiChekov admitted to being dumb, but apparently doesn't want to fix this, so I don't really see where the conversation can head. Though apparently he wants to turn his children into bio-warfare labs, which isn't really okay.

I found this amusing.

I'm not going to change my mind based on what you people say. So, it is probably a good idea to just drop this.

Yes, my children will be walking bio-warfare labs, soon my plan will be complete and I will conquer the planet by eliminating every other form of life.

Although, at year's end, I will be forced to have health insurance of some sort, so you guys shouldn't care as much.

[Prak]

Although, at year's end, I will be forced to have health insurance of some sort, so you guys shouldn't care as much.

But...

[Kaelik]

More concerned about whether your HI provider will force you to vaccinate kids for horrible diseases. Kids don't deserve to suffer for your stupidity.

[TiaC]

More concerned about whether your HI provider will force you to vaccinate kids for horrible diseases. Kids don't deserve to suffer for your stupidity.

Admittedly, since he's in California, he'll either be forced to vaccinate them or keep them out of school. So, it's unlikely that they'll be exposed if they aren't vaccinated. Still stupid though.

[DSMatticus]

Yes, my children will be walking bio-warfare labs, soon my plan will be complete and I will conquer the planet by eliminating every other form of life.

Why is it that so many people who bitch about socialism end up being outright parasites? It's like they have no problem with benefitting from the labors of other people; they are just principally opposed to reciprocating.

You know that because other people are vaccinating their children, your children are safer. You know that. You'd have to be an idiot not to. You are completely 100% aware that your children are less likely to catch any of the diseases we vaccinate for because people other than you are vaccinating their children, and as such those vaccinated children will never become the disease vectors that might have otherwise infected your children. And yet despite being completely 100% aware that you are benefitting from the practice of widespread vaccination, you will not actually contribute in turn by vaccinating your children.

Vaccination is not just about protecting your children. If you vaccinate your children, then they cannot become vectors for the disease, which protects everyone your children come in contact with. The more people think like you, the more vectors there are in the general population. The more vectors there are in the general population, the more likely it is your kids will get sick.

Admittedly, since he's in California, he'll either be forced to vaccinate them or keep them out of school. So, it's unlikely that they'll be exposed if they aren't vaccinated. Still stupid though.

I'm going to assume that he doesn't keep his children chained to a radiator in a dark room, and that they have some exposure to other children and the population at large. I mean, I could be wrong, but I'm not prepared to make the leap from "fucking idiot" to "total monster." It's certainly the case that school is an entire building full of germ-factories with weak immune systems, but really "being anywhere anyone else has been recently" is more than enough to pick up something someone else has.