Last July, I wrote a post on how Enron’s free market views influenced the original design of the California electricity market and contributed later to its collapse. I pointed out the parallels between Enron’s flawed market designs and the debate over the public option in the proposed health insurance reforms.
It’s worth revisiting, because matters are now much worse than they were then.
So what kind of structure and rules did Enron demand? First, it needed to eliminate competing institutions that might be able to connect producers and consumers more directly and efficiently. It argued for, and got, a structure that tended to require middlemen.
There was a proposal for a quasi-government "power pool" — a public pool in which producers could sell and consumers/buyers could purchase power directly without a middleman. For a year of debates, Enron and other marketers did their best to eliminate that "socialist," government-controlled concept, but the small band of bureaucrats and allies convinced the state to keep the pool.
Second, once the pool was accepted, Enron’s next tactic was to limit access to the pool. Enron argued for rules that required all non-utility buyers to arrange private contracts to cover their needs, instead of relying on the public pool. That would result in many more opportunities for Enron to be the middleman in those private contracts. The small band of bureaucrats argued against that limitation with some success, but Enron got concessions that tended to discourage many parties from using the public pool.
Enron’s third tactic was to demand operating rules that would force the public pool to operate at higher costs. The bureaucrats objected to these rules and took the dispute all the way to the Governor’s office, but they lost to the Governor’s largest campaign contributors (he still had debts from a failed Presidential run). It was an important defeat.
The Power Pool was eventually created, but it’s rules hobbled it and forced it to operate at higher costs. One particular rule required the public pool to ignore feasible cost-savings and instead deliberately choose higher cost energy when serving customers of the public pool. That made non-pool contracts more attractive and drove non-utility buyers/sellers to Enron’s traders.
Enron and its gullible supporters convinced state and federal regulators that since they were market competitors, their competition would always achieve the lowest cost results, so the public plan should be deliberately forced not to achieve the lowest cost, because that would drive marketers out of business, and they should be protected. California’s largest electricity customers, and federal regulators, bought this ridiculous argument.
Finally, Enron demanded, and got, rules that required the grid system operator to be separated from a part of the public pool — the market separation fallacy. When combined with other ill-advised rules, this meant that the public plan and system operator were often flying "blind," unaware of grid conditions when Enron and other parties were manipulating the market. The result: Enron and others manipulated the market with virtual impunity, raking off hundreds of millions (and some claim billions) of dollars.
If you recognize this pattern, it’s because we’re seeing analogous tactics and strategies in the current health care reform debates.
We see a powerful group of middlemen, the insurance industry, trying to structure the market to require that they remain in the middle of, and extract a rent from, all money flows between providers and patients, as though that’s the only logical structure, even though it’s not.
We see efforts to eliminate any public alternative — the public plan (operating inside a public exchange) — that might be more efficient in reducing and covering costs.
And we see the middlemen and their political supporters in Congress deliberately hobbling the public plan, raising its costs, and restricting access to that public option, on the theory that we shouldn’t do anything to undermine the current private insurance industry. After all, they argue, private markets are always more efficient than a government operation.
That was how I saw the parallels last July, when the public option was still a possibility, but I warned that differences between products, markets, institutions, etc, made such comparisons risky. Yet the sad and astonishing part is that as the health care debate has evolved, the Enron free market view from 15 years ago has triumphed in the proposed health insurance reforms.
There is no public option, so there will be no public insurance altenative and safety net to protect consumers from private insurance discrimination, excessive rates, and other abuses. The insurance market now embedded in the Senate bill is worse that what Enron and its political allies helped design for California’s electricity markets.
We can now see other parallels and predict what might occur in this new insurance market. In California, state and federal regulators failed to pay attention to the concentration of producers — only a few large firms controlled most of the generation, even after the utilities were induced to divest much of their generation monopolies. The predictable problem of market power would then combine with the ability of Enron and other financial marketers to manipulate Enron’s flawed rules. They would then create artificial shortages, exacerbate real shortages (from droughts, nuclear outages, etc) and then bilk consumers for hundred of millions of dollars. And on top of that, state regulators imposed a mandate on utilities to purchase all their residual power from the new flawed "exchange" market. Sound familiar?
Will something analogous happen in health insurance markets? We don’t know, and all crises are different. But we know the health insurance and provider markets are egregiously concentrated — one or two mega-firms control most of the market in most states. We know the industry is still protected from anti-trust laws; until that’s fixed, there’s no way for state or federal governments to bust up the firms with the most market power or prevent collusion to fix prices. And we know consumers will be forced to purchase insurance within this concentrated market and given subsidies to help them do it.
We know there won’t be any meaningful rate regulation. That is what the demise of the rate regulator means. Insurers and providers are essentially free today to raise rates at will; there is nothing to change that. This Administration and Congressional leaders are apparently content to throw up their hands and have this important public policy decided by a virtually unknown "parliamentarian," but it’s their sin, not his.
And we know that the very nature of health insurance is such that the theories of efficient competition and competitive pricing simply do not apply. Economists since Ken Arrow have told us this. Yet we still have governments and institutions enthralled by the virtues of free enterprise.
Without rate regulation, without anti-trust enforcement, without a viable public option as escape hatch, without a credible theory of competition, and with virtually no constraints on the industry’s ability to bribe and control the Congress and the White House, there is no way consumers can win in the new health insurance markets. Only an idiot [e.g., a member of the Texas School Board] would believe this will turn out well.
The only question we have left is how the inevitable market collapse, consumer crisis and government bailout will occur. And they will occur.
A reconciliation bill could have fixed much of the Enron-designed market structure in the Senate bill, but the White House didn’t want that. It cut its deals, just as California’s Governor cut his deals in 1996. But no one remembers Pete Wilson.
Updates: And now a word about Dr. Jekyll:
Ezra Klein, Democrats get the bill, and the score, they needed
Jonathan Cohn, Guilty of practicing good government
Brad DeLong, on Marjorie Margolies . . .



107 Comments

Scarecrow: “Without rate regulation, without anti-trust enforcement, … there is no way consumers can win in the new health insurance markets. Only an idiot would believe this will turn out well.” These economic points are the key to why this HCR exercise will fail and fail huge. Not only is there no limitation to the insurance industry’s ability to raise rates, the federal govt is requiring itself (the taxpayers) to pay the difference between what the insured is required to pay and the total premium being charged.
The other great failing is the mandate. Trying to force 30-50 million uninsured to buy insurance that they either can’t afford or choose not to purchase will cause millions of otherwise law-abiding citizens to become lawbreakers. Also, the enforement of this provision will be prohibitive and the political backlash will be extreme.
This is just one more example to convince folks that the cost of keeping “the village” is greater than any benefit derived by society.
Superb post. So glad you picked up on this Enron angle again.
I said to folks on a local blog this morning… as long as we have to discuss this in the kind of speech ponzi schemers/insurance salesmen use, we should quickly understand we are about to cheer ourselves into another big con.
A very important post – I hope it is widely distributed. Thanks Scarecrow.
Aye, disheartening (as the truth often is) but a great documenting of what we have to look forward to as the ‘reform’ becomes law.
The politicians are totally hostage to the “free markets know best”. They have no idea of what a free market is. Even after the debacle of the Great Crash, they are unwilling to admit what Alan Greenspan said: his models, meaning his understanding of free markets, failed.
I followed the california power crisis closely–for a while there, had bookmarked the Cal ISO and was literally looking at what was happening on a day to day basis.
What Enron–and other players–were doing to the gamed system was just amazing and horrifying. And when the taped or transcripted trader conversations came out–it was just incredible.
California is still paying for that, and will for decades to come, I guess. And it isn’t over yet.
Your warning about the similarities with the proposed HCR system are very well taken.
So. There is hope.
I have maintained from the beginning that it will take a complete collapse of the system for any REAL solution to have a chance at implementation. Your post encourages me that the collapse may well happen. Sorry I missed your 1st post on this so thanks for the update.
Here’s what will be really interesting to watch happen. Since the new law will used Forced mandates to buy these crappy products with NO price controls or competition what will happen when large numbers of businesses start to drop coverage and simply tell their employees tough shit go bu your own coverage? I predict we will then see huge numbers of people opting for the fines over having to buy coverage they simply cannot afford on their own. Then it gets real interesting because these folks will if my guess is right simply do what people without Ins. do today they’ll show up for care @ the Emerg. room or they’ll wait to buy coverage when they get really sick like they do now in Mass.
And because that increases the Government’s revenues, the Gov will then have reduced its deficit on the backs of these people.
From the Gov’s point of view this is a feature, a desirable outcome.
For there are many at lower incomes in the Redstates, and they won’t like this at all. Pray the Redstaters prevail on their lawsuits.
That’s why the left has common cause with the Tea Baggers & the Evangelicals. An economic common cause.
20 to 40 Million taxpayers, $50,000 household income, paying 2.5% to 2.8% of their Gross in additional tax.
That’s between $25 and $56 Billion in increased taxes.
Great post!
And in the future, we will see the HealthScam executive emails, similar in nature to the Enron ones where they were excited about making California brown-out.
Excellent post, Scarecrow.
Rachel is playing Enronesque cheerleader now.
Correctamundo — there will be heavy paying of the mandate penalties. It’s just amazing to me that the people on DailyKos.com think they can sell the public on this in November.
Great post, scarecrow. Thanks.
We only begin to heal when the disease, in its wisdom, finally finds a way to make the symptoms big enough and painful enough that we can no longer ignore them and we start to act.
And in this case, our old way of being is asking that we let it die. We’re the ones who are torturing it in our unwillingness to pull the plug and let it go.
It’s time for all of us to move on to what we create next.
A great read Scarecrow, thank you so much for the work you put into it and making available for us readers.
Based on the excellent (for Rethugs) damning soundbites the mandate provides (and the fact that zero health-care benefits will be realized by November) The Republicans will clean sweep the Democrats in November like a goddamed hurricane – the likes of which no one has ever seen.
Ken Lay is residing where? Do you suppose he gets those little umbrellas in his drinks? Oh, that’s right, no ice cubes. And California has been without electricity for how long,now?
Bustamante had the goods on Enron and a class action lawsuit in the works to recover the some of the money that Enron looted. Schwarzenegger made a backroom deal not to pursue it – Dick Cheney’s Enron Energy Task Force Hijacking of Cullifornia.
Bustamante and the lawsuit disappeared like Dick Cheney’s conscience.
This phony reform is Obama’s Invasion of Iraq: an economic and social time bomb waiting to blow up in America’s face. And, like Bush, and like his own skimpy past,in which he consistently evaded responsibile decisions, Obama will leave it to others to clean up his mess.
Rachel’s sort of a cross between Lisa Simpson and Mean Girls – cruelly ridiculing everyone who doesn’t agree with her, cackling how they’re all so laughably stupid they can’t see how she’s always right.
Her ratings have given her the confidence to reveal a very disturbing person.
Rachel, as should be obvious by now is a finely tuned psychologically measured propaganda machine.
Ding ding ding ding ding!
And the blind groupthink on the left is every bit as that on the right 8 years ago – made worse by not only having seen it before but having criticized it.
Support the Preznit in a time of
warhealth reform, you traitors!Your update is making me a little sick.
Very few of Rachel’s viewers disagree with her.
Only 3% of self-defined liberals oppose this legislation.
A well-stated description of all Western media.
BTW, what kind of a lass is a fucknoc lass?
I have some news Kelly. IM?
They’re trying to sell it to their readers, not to the general public, so their influence is a lot less than you think (and not everyone there is buying it, anymore than everyone here is against it).
The public is being sold a bill of goods by the media, the insurance lobbyists, and the WH and a number of Congresscritters (although I suspect a fair number of them really don’t understand what they’re voting on: they’re taking someone else’s word for it).
They aren’t doing that, actually.
I also want to say this post was excellent, Scarecrow. Thank you.
The energy market and the health market in this country (not that either thing should necessarily be distributed by a market) would naturally have similar structures. First and foremost, energy and health are essentially the same thing, simply in different domains. Secondly, the goal of the forces who own the country is to maximize the profit extracted from the human resources, and the ways to do that will naturally converge on an optimal solution.
In the perverse sense of “optimal” meaning giving people the least amount of what they need while extracting the most from them.
It’s sickly amusing, the Enron energy market was really about extracting energy from the country and giving it to business, and “health reform” is really about extracting health from the country and giving it to business.
“My health insurance? It’s with “Nosferatu.” Why do you ask?”
That’s very funny. And perfectly true.
Gosh, I guess tonight, I don’t get to be the whipping boy, it is Rachel, NARAL and Planned Parenthood. Well done! Of course, Jane doesn’t have to worry about health care; she has the money to pay for her needs; so she can say, damn the torpedoes and full-steam ahead against those that thing HCR is larger than just abortion. Seems a pity what FDL appears to be degenerating to, a forum for the dark matter opposite Beck/Limbaugh.
the “professional news media” is treating the passage of the healthcare fiasco as proof that we have a functioning democracy.
we do not.
thanks a million scarecrow. wish i had more than one rec to give this post. one of your best, and that’s saying a lot.
Desiring the team sport win, you do not really understand that what you castigate today, is what you will champion later.
Markets are supposed to be about allocating goods and services efficiently, and the myth is that they arise naturally and should therefore be left free to do what they do best. By this definition, government intervention can only make matters worse.
The Enron example was proof that many markets are “designed,” and how well — efficiently/fairly etc — they perform and in whose interest are very dependent on who designs them and who writes the rules under which the participants operate. A given design will have an associated set of incentives, and those incentives will tell you who benefits and who loses.
In the Enron electricity markets, many of the incentives were skewed to benefit a narrow class of marketers — Enron owned no power plants — just as the incentives on Wall Street are designed, on purpose, to benefit a narrow class of bankers, privileged investors and traders. The health insurance market is also something that must be designed, and those who design it will insure the incentives tend induce results that benefit them.
Enron’s object was not to “extract energy,” but to extract money by making trading through them necessary. Similarly, the insurance industry’s object is not to “extract health” but to extract money by making the compensation/accounting system between care providers and patients flow through the insurer. Anything that minimizes the need for this middleman is something the designers would fight as though their survival depends on it, because it does.
It’s all smoke and mirrors anyway. By the time whatever piece crap they pass is suppose to come into effect, the arguments will be moot. It will be stillborn.
aardvark?
When did you find out Obama kill the Public Option with his deal with for profit Hospital Lobby? this happen in June or July of 2009 (says the New York Times)
The funny thing about this is Obama and other Dems ran around the nation telling everybody they love and wanted the Public Option. I mean Obama and Dems in congress must have had a great laugh, shouting Public Option at pep rallys and looking at their followers shout with them, knowing the entire time the Public Option was killed a long long time ago.
Can you say sick Joke? well lying to Dem base is not funny and smart.
Thanks to Glenn Greenwald, Jane and others we now know who the enemies of the progressive base are.
Scarecrow’s post is clear and well documented. It is a classic post. When Enron came into and got legislation for deregulation (San Diego CA Senator) it also moved the California statehouse to Republicans. That may happen in Congress so the parallel is excellent. I was active in that trying to find energy sources at the time coal was 8 cents a KW way below what people were paying. If the Enrons of capitalism get control of the grid they will have our bank accounts like the insurers do now and will get more. Cost to Californians over $35 billion equal to our budget shortfall.
Your comaprison is a good one. Enron really is the paradigm. It isn’t just healthcare. Enron was also behind the deregulation of derivatives and swaps. They also were able to get an exception to trade OTC future like instruments for oil markets which IBs like Goldman have used to jack the price of oil up to $80/bbl when it should be trading at $35. And they were big into off balance sheet SPVs. In so many ways, Enron was ahead of its time. Much of the financial industry looting that we see today is just riffing off of Enron models.
Hugh, you are so right, often in the early housing bubble as I watched houses priced at twice their worth, Enron’s gaming plan came to my mind. I believe Enron executives created a model that Wall Street perfected and hedge funds in partnership are still plying. It is going to be very unstable world economy without serious regulation that Geithner opposes and Europeans are supporting.
As I listen to people on the left mindlessly parroting the Dem propaganda on this hideous bill as those on the right mindlessly parrot the Faux news propaganda about this hideous bill, I find myself thinking of the approx. 80/20 split on that French experiment/ “reality show” where 80 percent were willing to torture another human because someone told them to do so. Oddly unremarked upon in any of the articles I’ve read about, 20 percent did refuse.
To those who represent the 20 percent in the larger world: I realize most of you are probably also among the minority concerned about overpopulation, as am I, but I nonetheless find myself wanting to implore you to Please Breed.
P.S. Bless you for writing this, Scarecrow. Few may listen, but you do make folks like me feel less isolated in our fact-based outrage.
That’ll be pretty nasty.
Here in CA our Republican leading candidate for governor is promising a 10% across-the-board tax cut in a state which is about to fire 40% of its teachers. That should be fun too.
First, there is a vast right-wing conspiracy.
Second, the conservative conspirators behind this vast right-wing conspiracy prefer to work in the shadows, no oversight or accountability for their actions, no consequences for either them or their agents when caught red-handed.
Third, lying is the fuel that drives the vast right-wing conspiracy, along with an insatiable greed in which enough is never enough.
Thus, the Iraq War. Thus, the Enron debacle. Thus, the health care reform fiasco. Thus, Fox News. Thus, privatization of the U.S. military, intelligence gathering, law enforcement. Thus, charter schools.
Our government, at whatever level, is the enemy of the vast right-wing conspirators, with Grover Norquist being the most recognizable ringleader. Legions of right-wing conspiratorial roaches have been planted throughout our government, at local, state and federal levels, with those on the Texas School Board being some of the most radical and deranged of right-wing roaches. A conservative infestation meant to bring down our democratically-elected government, co-opting and corrupting many of our elected officials, so the cultural war-profiteers can make even more of a profit. Shock doctrine. Scorched earth. A well-planned and well-financed right-wing conspiracy against our democracy. Monopolism for the few, by the few, and screw everyone else. Control the media, control the message, control what people hear on radio and television. Control the textbooks, control what students learn, re-educate the students according to the far-right ideology of the right-wing conspirators. Tear down the constitutional wall separating church and state, and lie while doing it.
So, I agree with Scarecrow. Just as I agreed with Hillary Clinton when she stated in the 1990s that there was a vast right-wing conspiracy. She was right then and this still holds true now. And Hillary Clinton made this astute observation even before we saw the bitter, poisonous fruit of this vast right-wing conspiracy during the Bush/Cheney years. Is anyone paying attention in the administration of President Obama? Not that I can tell. But maybe he’ll do better during the remaining three years he has left in office, meeting head-on the danger that this vast right-wing conspiracy represents to our country, if not the rest of the world? We’ll see. If President Obama continues to ignore the crimes committed during the Bush/Cheney years while kowtowing to vast right-wing corporate interests, then his four years in office will have been wasted and the vast right-wing conspiracy will become even more entrenched, a runaway conservative cancer undermining the very fabric of our liberal democracy, our constitution, our nation’s children’s future…just as the vast right-wing conspirators planned. Who needs the threat from al Qaeda when we have this “Death to America” conspiratorial crowd among us and at the highest levels of our government.
Well, Kelly, I did resign from the board of the local planned parenthood in 1984 when my concerns that the right was rearming re: R v. Wade were scoffed at. I have, in fact been the only psychologist in Kansas to publicly support abortion and homosexual rights. That is a fact. And I was the only mental health professional willing to appear before the joint session of the house and senate of the Kansas state legislature to support George Tiller.
So, if you think that is “team sport on my part” than you and Jane Hamsher can all go and fuck yourselves. There are larger issues here than just abortion.
The difference between you and me, and Fuck No, Jon, and Scare Crow, is that if I am wrong, I will acknowledge it; I won’t resort to some new conspiracy theory to explain away my error.
The beating I took last night on FDL was not accompanied by anyone stipulating how they had put their butts on the line as I have done. Talk is cheap, and there is a whole lot of useless talk on FDL.
DM
Jason Rosenbaum keeps assuring me that there is federal premium rate regulation in this legislation, and I for the life of me have never been able to find it.
Little help?
CalBuzz.
A decent read, it is . . . some humor in there. *G*
< The most important fact to know is that Enron didn’t produce anything. It didn’t own power plants there. But it had a business plan in which it would buy power (and sometimes operational control) from producers, repackage the deals and resell the power and the deals to others. Enron was like a Wall Street trader, a middleman.
Its business plan thus depended on creating a structure in which Enron could extract rents — money — in the chain between producers and consumers. To do that, it needed a structure and rules to maximize the transactions — and thus money — that would flow through the middleman, Enron’s trading system. >
Well written. More simply still, Enron…. and GolddamnSachs, and JPM-Chase, and Citi, and everyone on Wall Street, and the Republican Party, AND the “DEMOCRAT” Party – all see themselves as FEUDAL LORDS, COLLECTING RENTS from the hapless serfs & peons, who HAVE NO CHOICE.
America’s educational system is so establishmentarian (authoritarian) and Anglo-phile, that most Americans have no conception that, as recently as 100 years ago, WHITE, Western EUROPEANS were the victims of a SUSTAINED, massive genocidal famine policies: That of course would be Ireland, where over a million victims died of famine & famine related diseases, even as British lords, absentee landlords, bankers, and nobles EXPORTED GRAIN FROM fertile IRISH ESTATES at the very height of the famine.
Some things never change: The Autocrats are still out to rob the serfs, all the way to the point of starvation, or today’s denial of health care, outsourcing of jobs, and destruction of the social safety net.
Near as I can tell there is none. But maybe we haven’t drunk the proper koolaid? The blue one seems to make people see reform where there is none. The red one seems to make people see socialists and devils and all sorts of interesting things.
The most important fact we dance around is that capitalism, at least in it’s current incarnation, is at the core of America’s problems. At the same time, socialism and the myriad permutations it presents, is the unmentionable even here at FDL.
Then quit being helpless and DO SOMETHING. If you can, spent $1000 and invest in one each of ten stocks whose companies you despise. As a shareholder, even a shareholder of one share, you have rights. See Elliot Spitzer’s piece on Slate today. As a share holder, you have the right to be canvassed before the company spends money on political endeavors.
they’re already publicy laughing about how they can kick people off their plans, rase rates, and still make more money because of the other guys too scared to stop paying them
Consumers know that when you eliminate the middle man you get a better deal. If you can give me one example where this is not true, please let me know.
Individuals would be much better off without employer-based health care insurance and without the government regulating the insurance industry like a utility.
Do we really want our employers OR the government telling us what plans we can or cannot have…the coverage we MUST pay for regardless of our own self determination?
NO ONE can prevent us from becoming ill. WE can make choices that will vastly improve our chances of remaining healthy but insurance is designed to protect us, not from the illness or accident, but from the event that our care or treatment is so extensive that we cannot provide for it without assistance.
The ‘social justice’ that deems health care a ‘right’ is nothing more than the right for one person to insure themselves at my expense. I do not smoke, drink, eat right, exercise, know my family medical history and actively seek to control my behavior in a way that will hopefully keep me healthier than if I did participate behaviors that put my health at risk.
While I may or may not feel morally obligated to help those who are unable to care for themselves, I do not want the government to mandate that I do this. The social ‘safety net’ designed to help the truly needy is going to become a huge hammock that will break under the weight of everyone wanting to rest comfortably.
The politics of deciding who gets what in the way of medical treatment doubtlessly will push aside traditional affairs of state. Every member of Congress will need to hire several staff members just to manage constituents’ complaints about their care. Elections will be won and lost on the basis of who can get the most in the way of health care for their districts.
We will become a great power whose leaders are tied up in strings as they spend much of their time addressing the medical complaints, valid and imagined, of their electorate.
I really do not want my congressional representatives, or their staff, or a newly created bureaucracy to become my health insurance agent.
Let’s see, that would now be Planned Parenthood, NARAL, Dennis K, me, and who else?
Cronie capitalism, which is what we now enjoy, is not the self-correcting free market capitalism that allows business to succeed and fail on their own merits.
Washington has become too big, too centralized, too corrupt to effectively provide oversight and regulation.
The only answer is to limit the power and influence in Washington DC. The federal government cannot, itself become, ‘too big to fail.’
The ’social justice’ that deems health care a ‘right’ is nothing more than the right for one person to insure themselves at my expense.
And if you are critically injured in a highway accident, nobody should subsidize your bill, and you should receive the bankruptcy you so thoroughly deserve according to your own doctrines.
@ Cassiodorus
According to the American ideal, men are not their brother’s keeper–we are independent individuals with inalienable rights to support our own lives and happiness by our own efforts. That means taking responsibility for your own medical needs, just as you take responsibility for your grocery shopping and car payments. It means no one can claim that his need entitles him to your time, effort, or wealth. Where is the willingness to defend this ideal by saying, “Your health care is your responsibility–and if you truly cannot afford the care you need, then you must ask for private charity–not pick your neighbor’s pocket to pay for it”?
No where do I say that you should be left on your own without assistance. American are generous, as we have proven time and again.
The Founders said you have a right to pursue your own happiness, not that you have a moral duty to serve mine.
Further, all drivers who desire the privilege and responsibility to drive, must carry insurance to protect them from the very circumstance you describe.
but I think that we need to restructure capitalism to be responsive to the common good. So you have publicly owned state banks, state utilities encompassing healthcare, publicly funded education including Universities, etc.
Socialism needs to figure in the discussion, otherwise the change will always remain a pipe dream.
“Market competition” is merely that aspect of capitalism which its defenders like to advertise (see above sales language). The flip side of “market competition” is, of course, market consolidation, whereby those who have succeeded “on their own merits” (i.e. are capable of leveraging access to cheaper resources and labor into greater market share) buy up those who haven’t, and further leverage their advantages into membership in the oligopolies which dominate corporate business in America today.
The upshot of consolidation, in fact the dominant trend in the history of the capitalist system, is a narrow wealth pyramid with a few at the top and a great many at the bottom, and the few at the top can then grant vast favors to those whom they like the most. Thus the “Cronie capitalism” which the above author so thoroughly despises.
I’m curious. If your parents/grandparents are living, do they not have Medicare? If they are, and they have Medicare Advantage, the medical decisions made by their physician directly affect his/her profitability. And medical practices are run by MBA’s, not physicians. So, to you want your parents/grandparents medical care determined by a Medicare bureaucrat, or an MBA or physician who has a bonus hanging on how much money he or she can save? Who do you want?
Indie won’t understand until his or her life or a loved one’s life is on the line.
I would prefer the physician or MBA.
Told you he or she wouldn’t get it.
Founders said we are all in this together. If you choose not to have health insurance, and no fault of your own, are involved in an accident, that would be, slip and fall in your home and break your hip, well, the fact of the matter is, the rest of us taxpayers are on the hook for your medical care. Now, if you happen to own your own home, or have other significant assets, we, taxpayer’s get a break; otherwise, the cost of your care is ours.
I’m sure this justification works wonders for deadbeat dads.
Since nobody actually lives this way, we are in the realm of Robinson Crusoe fantasyland here. In the real world interdependence is a fact of life.
So, Indie, you would prefer the person who has a financial interest in the care of your parent to make the decision about their care. You might want to let them know that, as I think they might want to change their will.
“Sovereign individualism” is typically the doctrine of well off males. Women are capable of receiving the opportunity to feel in the flesh the movement of another human being coming out of their bodies, & thus are (potentially at least) closer to realities of interdependence which are denied by doctrines of “sovereign individualism” (e.g. “I am not my brother’s (sic) keeper”).
I believe all disputes should be resolved at a distance of 20 paces using stinger missiles. If you cannot afford stingers, slingshots will be afforded to you at tax payer expense.
Where do the founders say we are all in this together? The founders wanted to insure the rights of the individual against tyranny while creating a government that would provide for our defense and promote our general welfare.
If I choose not to have insurance and I fall, I am responsible. If I do not have the financial means to care for myself then I must be dependent on the kindness of others or I must find a way to pay off my debt for the care I receive.
High cost of medical care is not caused predominately by uninsured individuals involved in catastrophic accidents.
The high cost of medical care is caused by the third-party payer system that invites inefficiency, fraud and abuse by not directly connecting the consumer with the product and care they receive.
We must all hang together, or assuredly we shall all hang separately. — Benjamin Franklin
Look, I do not believe is the benevolent collectivism of a centralized federal government. It’s that simple.
I want to be free to live my life as responsibly and prosperously as possible.
That was in direct reference to the colonies sticking together against the tyranny of the King. Said at the signing of the Declaration of INDEPENDENCE!
Quite different from the collectivist, centralized government control you seem to subjugate yourself to.
Where do the founders say we are all in this together?
militias, maybe?
but what’s this “promote our general welfare.” thing meant to mean?
are you saying that the lottery of birth is to have dominion over all laws? I want to see 100 of you fuckers locked up together at Alcatraz with XXXXX
*MODNOTE: edited to remove insults — disagree with the message but lets not insult the messenger
Yes.
Can we not put politics aside for the moment? For the last fourteen years I have provided psychological services in nursing homes. Bureaucrats don’t make decisions as to who lives and dies; families and physician’s do. Hospice, which originally, had a noble goal of providing palliative care at the end of life is now a profit-making industry. Any one noticed how there are many more hospice providers today than there were ten years ago? It is because it is now a for-profit endeavor, run as an HMO, and as such, very profitable. Now, I know very many caring folk who work for hospice; they will all tell you how stretched thin they are because of the demands of their corporate employers.
So, Indie, in the last days of your parents/grandparents lives, you want them to be attended to by a hospice nurse making her corporate quota? I am sure they will be waiting there to thank you in the after-life.
OK, your choice is the Desert Eagle. 357. or a .357 Python. What is your choice? My fourteen year-old daughter does pretty well with the DE.
Promoting the general welfare and providing for the basic need of all citizens are two very different concepts.
As long as government seeks to hold ever expanding control over the decisions that should be reserved for the individual, the pursuit of happiness will be lost, subjected to the whims and desires of the powerful few.
Good God, in the Preamble. “promote the general welfare.” All else in the
Constitution are predicated on the premises set forth in the Preamble.
With all due respect, what you just wrote there is absolute rubbish and has no internal logic; just right-wing gibberish.
No, my parents want to spend their last days at home if at all possible. Or at my home, surrounded by their family and friends.
I do not see all businesses as exploitative or evil. I would prefer to deal with someone DIRECTLY, and determine for myself if they are taking advantage of me, trying to get their hands on as much of my money as they can. Buyer beware.
When a third party payer is involved, how truly connected am I to the costs involved? What is my incentive to see the price lowered, or the quality raised, so that I feel I am getting the most for my money?
So does everyone else. The problem with asserting this as a sort of doctrine or dogma is that responsibility and prosperity are not products of freedom.
Rather, prosperity, under capitalism at least, is what happens when you leverage class advantages (along with other resources) to create for yourself even more class advantages. If you can find it, look at Paula S. Rothenburg’s edited volume Race, Class, and Gender in the United States: An Integrated Study, especially the study by Gregory Mantsios (“Class in America: Myths and Realities”) which compares the resumes of lifelong accomplishment of the rich and the poor. You can see, then, every step of the way, in which the rich take advantage of privileged schooling conditions, gifts from the extended family, and so on, in order to get far more for themselves and their families than the poor ever dreamed of doing. Also see McNamee and Miller’s The Meritocracy Myth, in which the idea that the capitalist economy in the US is in fact a “meritocracy” is debunked.
Responsibility, moreover, accrues to those who have power, and along with vast wealth differentials in the US and in the world economies, belong vast differentials in power. In fact, in the current situation, wealth buys power, just as easily as campaign donations to select Congressmembers has bought the “health insurance reform” the insurers wanted.
totally agree as to the general sentiment regarding statism, but, Socialist anarchism fits that bill as well.
Again, to me there is a big distinction between promoting and providing.
Well the first thing you should do is to stop buying food which has been brought to you on the interstate highway system, since said system is the product of an evil centralized Federal government.
Bye now. I hate day light savings, but it is a fact I have to deal with.
makes sense, cut out the middleman higher a general burser, police for fraud, and bingo – Single payer healthcare!
Run by this crooked government? Heck no!, so we agree.
Did you even bother to find out what I wanted when you wrote this?
You should also stop communicating via the Internet, because the Internet is the product of ARPANET, which is the product of an evil, centralized Federal government.
Individual responsibility and prosperity are the products of freedom. How that freedom is used, how responsibility is exercised and wealth is created is not always greedy nor exploiting.
I do not share your opinion. The constituent who chooses to re-elect year after year, and entrenched and compromised politician is not without power. But the larger the federal government gets, the harder it is for individuals to gain access. One solution is to try and band together and form interest groups, the other would be to limit the size and scope of the government so that their power and influence is limited.
Time to try the latter.
Yes, the single payer should be the INDIVIDUAL.
First, I never said that our federal goverment is evil.
We need a federal government to provide the internet for the general welfare of the citizenry, but should we give everyone wi-fi and a laptop computer?
We are debating the size and scope of the federal government. I simply prefer that it be smaller, and more efficient. You seem to prefer that it be bigger.
I was living in California at the time, and anybody with half a brain knew we were being scammed. The economy was in a minor recession — thus commercial and industrial use was already down. And you don’t go from “no problem” to “rolling brown-outs and locational blackouts” in just two or three months.
We knew we were being robbed.
no, the single payer should be a utility. Your small government in my book has a Pentagon budget for border defense security, no wars, no lilly pads, no adventurism. Militarily we are the second coming of the Swiss.
But, I won’t bargain with economic darwinism. I will leave the final decision to a well informed citizenry.
No, they’re not. They are the product of the interactions with the REAL WORLD which I just laid out in detail, and which you think are a mere “opinion” with which you can disagree. You apparently can’t detail this disagreement to tell me exactly where I’m wrong, either — so it looks to me like you’re just a dogmatic libertarian.
I’d like to agree with you that we should “limit the size and scope of the government,” but since you believe in dogmas such as “individual responsibility and prosperity are the products of freedom,” I sure as hell wouldn’t trust you to do it.
See, limiting the size and scope of the government depends upon what the government is doing, and it also depends upon the environments (both social and natural) in which the government is operating. So we must be careful to assure that the government accomplishes good deed in this environment, and we can only do this if we recognize reality for what it is. And if you think that “individual responsibility and prosperity are the products of freedom,” you don’t do that.
You just completely arbitrarily assigned which goods and services fall under “general welfare” and those that don’t.
Why is the Internet, as an invention, necessary for the general welfare, but access to it is required to be orchestrated by for-profit gatekeepers, whom are just exploiting public research and infrastructure for private gain?
Here’s the thing about healthcare, it isn’t a functional market; not even close. It has extreme demand inelasticity, when paid for via risk-pooling (which makes sense due to uncertainty) the most effective way to dual optimize for coverage and cost is with a monopoly risk-pool, the information asymmetry is an enormous delta between consumers and producers, and you have almost no capacity to adequately shop for substitutable goods. In short, if you leave it up to markets the producers will always exploit the consumers, because that’s how the balance of countervailing forces works out.
You should better understand the things you advocate for.
No, we don’t. You only believe this because the government does in fact provide it.
But thinking is painful, and dogma provides such comfortable shortcuts!
OK, Indie,
I was signing off, but your last post hooked me in because it is something I do have hands on experience with. I had, in fact, been providing psychological services in nursing homes for seven years when my wife queried me as to whether we should take my grandmother into our home to care for her. My wife had lost her job, but had taken over doing my billing for my practice, and when factored in the cost we were paying for childcare, being a stay-at-home-mom was cost-effective. And, it seem natural to invite my grandmother to live with us. And so we did. We saw her through her 99th and 100th birthdays living in our house. We did have to finally place her in a nursing home, and she died at the age of 101 and three months.
The fact is, my wife paid a substantial penalty in her own health in taking care of my grandmother. We discussed it later, and agreed, we would have made the same decision as to inviting her into our house.
So, Indie, you want to take care of your parents in their old age in your house, which would be your wife taking care of them
Please define the REAL WORLD because IMO everyone has a unique viewpoint and vantage point. We have different perspectives, neither one absolutely right or absolutely wrong.
I am sure there are many areas upon which we could agree, as far as how we would like to limit the size and scope of the federal government.
Good night.
Thanks for the lively discussion.
I am a woman. I am fully prepared to assume the risk to my own health in caring for my parents.
Politicans on both sides were totally compromised. Nothing happened with one blaming other for inaction and payments were made on time by the state to the Enron if I remember correctly of the reports at the time.
Health care scam is more gigantic and will destroy this great nations economy slowly and destroy social fabric by putting people to pay a fine to these enronesque price gougers without any kind of simple logical thought that people sometimes take huge risk of no insurance so that they can take care of their family and personal responsiblities.
When is the Mission Accomplished Banner going to unfold for this scam.
Every where people I see or talk are disgusted with this health care bill and I cannot understand why they are pushing it on American people using all the tricks in the book.
People in congress please remember you are not super rich and your grand-children too might suffer at hands of future AHIP executives who might be worse than present group and who will misuse this mandate even more. What we are seeing is a moral hazard for congress at play.
I am going to vote for GREEN party which does not accept corporate donations as party charter and so will be true to their campaign talk after they get elected. This is better for me to keep my conscience clear that I am doing the right thing for the country.
I hope you’ll bother to answer my questions.
I’d be very interested to know what metric you applied to determine that the research and infrastructure for the Internet fall under public expense for the general welfare, but that gatekeeping access to it should be for-profit enterprise solely the purview of private industry.
Is that the point of government? To spend collective money to enrich industrialists?
Sorry, my teenager . . . . So, if your wife is committed to taking care of your/her parents in your home, it is to your credit. On the other hand, if you are going to rely on home health care, that would be HCBS, being Medicaid, that of course is a different story. If they have the resources, about $30000 a year, they can live in their home. If you are wealthy, all the better for them. If you and they are basically middle-class, the taxpayer will fund their well-being.
That is noble of you. And, I don’t mean that in a snarky way at all. I just don’t think you have clue, as we did not have a clue, how difficult it would be. We kept waiting for that definitive moment we would know it was time to move her to a nursing home. It only came when her physician said so, because of her repeated falls.
So, my best to you, and if there is a way I can be helpful, I don’t think it would be difficult for you to find me.
DM
yeah, who thinks Ken Lay is still alive? I would not be surprised to learn that he is. not at all.
Despite your carefully worded phrases, the philosophy of people like you is “I’ve got mine, screw you”. There will come a time, I guarantee it, when you’re going to wish for support from your peers and society as a whole. I truly hope they answer you by saying “Screw you–I’ve got mine”.