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Go ahead and correct my facts if they're wrong, but as I pay taxes into these programs, is it fair that they go to people who lived (say) being a hundred pounds overweight but wouldn't quit the donuts?

I think that is a very fair question Cally. It probably reasonable to have medicare and medicaid costs to be set up based on how healthy or unhealthy they are similar to private life insurance cost. The healthier you are the better deal you get on life insurance and vice versa. One's health is a factor of self inflicted issues to a great degree. People that make healthy choices should somehow be rewarded even on public programs. How it would be implemented, I'm not sure. But a great question.

Quote from: Jaime on Sat Mar 15, 2025 - 17:47:35I think that is a very fair question Cally. It probably reasonable to have medicare and medicaid costs to be set up based on how healthy or unhealthy they are similar to private life insurance cost. The healthier you are the better deal you get on life insurance and vice versa. One's health is a factor of self inflicted issues to a great degree. People that make healthy choices should somehow be rewarded even on public programs. How it would be implemented, I'm not sure. But a great question.

One of the reasons I'm asking it is because of all of the outrage at how unfair student loan forgiveness is. I mean, especially in my generation, the entire adult world preached that we pretty much couldn't go wrong going to college regardless of the degree.

Now, oh well, it's not victimhood, it's purely your own fault, you're on your own. We can't even look at it like a failed business that declares bankruptcy which is essentially what it is: you essentially made a career investment, but unlike a business owner who runs his business into the ground even from utter stupidity, nope, can't do that with a student loan.

My retort is, if we're really going this route of "but it's your own fault so you shouldn't be helped" then we need to seriously re-evaluate the application of the way that anyone is an individual recipient of tax-dollars. Yes: why is it fair that I take care of my body but my medicaid/medicare taxes get collected by people who utterly wreck their health? Who moves to Florida and doesn't expect to get hit by a hurricane? I mean, it goes on and on. Like sure, in a vacuum it makes sense to say student loan forgiveness is "unfair" because it is, but I'm just saying, if we're going that route, we need to go through every taxpayer funded program and add a "but not if it's your own fault" clause.

Quote from: Cally on Sat Mar 15, 2025 - 16:40:04Go ahead and correct my facts if they're wrong, but as I pay taxes into these programs, is it fair that they go to people who lived (say) being a hundred pounds overweight but wouldn't quit the donuts?

"Is it fair" is usually a bad question, IMO.  There are many places in life where what is BEST is not what is FAIR.

The country would be better off if healthcare was a social service than having it be an industry designed to make money off of people. 

Right now, though, it's definitely an industry that's exploiting people.  The fact that the government is paying money directly to the pharmaceutical companies and insurance companies doesn't negate that.

Quote from: Wycliffes_Shillelagh on Sun Mar 16, 2025 - 20:05:45"Is it fair" is usually a bad question, IMO.  There are many places in life where what is BEST is not what is FAIR.

The country would be better off if healthcare was a social service than having it be an industry designed to make money off of people. 

I don't think the two options you listed are the only options.  Healthcare as a social service does not have a very good track record. It always seems to end up being very expensive and, in so many cases, no timely accessible.

Quote from: Wycliffes_Shillelagh on Sun Mar 16, 2025 - 20:05:45Right now, though, it's definitely an industry that's exploiting people.  The fact that the government is paying money directly to the pharmaceutical companies and insurance companies doesn't negate that.

Clearly it is an industry that is exploiting the system.  The money ties between them medical teaching and research facilities, the medical agencies, the medical industries, the insurance companies, the government and the representatives is really obscene. That doesn't even get to the money ties between government agencies, the representatives and the food industries which we are finding has a direct influence on so much of the chronic medical problems in this country.

I see your point Cally, but in fact... everyone who works who gets a paycheck has a portion taken out for Medicare.

Then once on Social Security, they continue to have monthly withdrawals
taken out of their social security checks.

It is not enough so people who can have to get a Medicare Supplement
that will cover a large chunk of what Medicare wont. And it is not cheap.

Even if one manages to have a private health insurance after retirement for all it still deducted from the Social checks.

So if a person wrecks their health, they will argue they pay into the system.

Same as if they have private coverage they pay for before retirement.

Is it fair? NO! But then nothing about Social Security is at all fair.

Where it gets tackier is Medicaid. For people who cannot afford a Medicare Supplement, then that is when Medicaid comes into play.
Medicaid becomes the Medicare Supplement.

Quote from: 4WD on Tue Mar 18, 2025 - 04:51:35I don't think the two options you listed are the only options.

Ok, what else you got?

Quote from: 4WD on Tue Mar 18, 2025 - 04:51:35Healthcare as a social service does not have a very good track record. It always seems to end up being very expensive and, in so many cases, no timely accessible.

It certainly has its own set of problems.

Quote from: 4WD on Tue Mar 18, 2025 - 04:51:35Clearly it is an industry that is exploiting the system.  The money ties between them medical teaching and research facilities, the medical agencies, the medical industries, the insurance companies, the government and the representatives is really obscene. That doesn't even get to the money ties between government agencies, the representatives and the food industries which we are finding has a direct influence on so much of the chronic medical problems in this country.

The less middle-men the more efficient it will be.  And we have industries subverting the very agencies that were meant to police them.  The FDA is most egregiously an arm of the Food and Drug industries, rather than a check on their exploitation of the people.

Quote from: Wycliffes_Shillelagh on Tue Mar 18, 2025 - 15:37:06Ok, what else you got?

The way it was before Obamacare became the law of the land was not perfect but could have been improved with considerably less bureaucratic intrusion into the system.

Quote from: Wycliffes_Shillelagh on Tue Mar 18, 2025 - 15:37:06It certainly has its own set of problems.
The less middle-men the more efficient it will be.

Government intrusion always comes with a whole system of government "middle men". In the twenty five years since retiring, I have lost three doctors that I liked and was quite pleased with their services.  They quit because they could not afford to deal with the tremendous cost of the paperwork involved for the government.

Quote from: Wycliffes_Shillelagh on Tue Mar 18, 2025 - 15:37:06And we have industries subverting the very agencies that were meant to police them.  The FDA is most egregiously an arm of the Food and Drug industries, rather than a check on their exploitation of the people.

It is not the fault of industries subverting those agencies; rather it is the fault of those agencies failing to hold themselves above the attempts to subvert.  It is nothing more than government allowed bribery. Lobbying is acceptable until it consists primarily of paying representatives for favorable legislation.  The money directed to them is obscene.  Additionally, the money that government gives to those companies for directed R&D and other activities is more than obscene.

Quote from: 4WD on Thu Mar 20, 2025 - 17:47:01The way it was before Obamacare became the law of the land was not perfect but could have been improved with considerably less bureaucratic intrusion into the system.

Government intrusion always comes with a whole system of government "middle men". In the twenty five years since retiring, I have lost three doctors that I liked and was quite pleased with their services.  They quit because they could not afford to deal with the tremendous cost of the paperwork involved for the government.

It is not the fault of industries subverting those agencies; rather it is the fault of those agencies failing to hold themselves above the attempts to subvert.  It is nothing more than government allowed bribery. Lobbying is acceptable until it consists primarily of paying representatives for favorable legislation.  The money directed to them is obscene.  Additionally, the money that government gives to those companies for directed R&D and other activities is more than obscene.

"Government intrusion" is not inherently bad.

I think many in the US associate laissez faire (hands off) policy with capitalism.  But for capitalism to thrive, it requires an active government.  Specifically, the government must act to preserve competition. 

We have laws on the books for that (antitrust), but they are not effective/enforceable enough.

Quote from: Wycliffes_Shillelagh on Fri Mar 21, 2025 - 11:33:39"Government intrusion" is not inherently bad.

You are right, government intrusion is not inherently bad; however, it almost always is bad. As we are seeing right now, government intrusion is almost always fraught with waste and corruption.  One problem is that there is no real unbiased way to evaluate effectiveness and efficiency of any operation run by the government. In the private concerns, there is the measure of profit to guide the operation.  That does not exist in the government operation.  If the operation is not getting the job done, the only answer is more money or more people or both. There is almost never a way to determine whether the existing money and  people are being used effectively. And additionally, what we are seeing now is that too many government entities are setting the goals independent of any real need or value to the tax paying citizens. We have become a bureaucracy, not a democracy.

It is almost always the case that if the private sector can do the job, it will do it better and cheaper than the government. There are a few exceptions, national defense being one of them.

There have been books written about this, but it seems so few in the government sector has read them.