Can Freedom and Debt coexist?
Ok, I’ll comment on your show and ideas.
Long time Robb Wolf listener, and made pretty successful health changes from doing what RB talks about.
I’m 56 years old. I’m one of those evil people on Social Security Disability. Here’s my story.
At the age of 29 I was a self employed construction guy. While on my way to work one day I started getting dizzy driving down the road. I didn’t have any health insurance so I went to the local teaching hospital. They checked my heart and admitted me to ICU. Said my heart was quitting beating. They kept me for observation for 5 days (that wouldn’t happen today) and on the fifth day put a pacemaker in me. This was 1985 or 86. I couldn’t pay for it and that wasn’t a big deal back then.
Guess what this caused. At that very instant I became uninsurable. Like I said, I worked construction and it isn’t well known for having insurance coverage, but any time I worked for a company that offered it guess what happened…I got laid off about the time it was time to add me to the coverage. When this happens you start feeling like a real outcast. Hell, you are an outcast. For 20 years NON STOP my neck hurt. There was nothing I could do about it.
I have had to have two more pacemakers and each time it became harder and harder to get any kind of help with the cost of replacing them. Remember, I’m uninsurable now.
I ended up with diabesity. I had several health problems that were a direct result of the health care system in this country and I was sick and fucked.
I applied for and got SSDI which includes Medicare. Since finally getting health insurance I have been able to address several problems that I had health wise. I now weigh 100lbs less than I did. I can finally see out of both eyes because I screwed up my cornea in a car accident 17 years ago.
Government health care has been a God send to me. I was an outcast in the healthcare system that was in place and I really had no choice but to try to get disability. Thank God I did.
This is really important stuff and I appreciate you posting. Several things I’d like to consider here:
1-When you were self employed that would have been a solid time to have the high deductible catastrophic plan. I know hindsight, 20/20 and all, that but this is what I’m trying to get across to folks to do TODAY. HSA+ high deductible catastrophic plan is very inexpensive and covers for just such a contingency as you faced.
2-I’m glad you noted both the time the hospital kept you (despite lack of insurance) and thee fact they did not sue/try to ruin your credit. That was due in large part to the fact hospitals were more profitable then and ironically for the universal care folks, MORE compassionate. they could be, as they were not facing ever tighter margins.
3-We’ve had employees with SERIOUS prior conditions but our group plan did not change in cost so I’m honestly very curious about that. I’m no insurance expert but this does not jibe with what i’ve seen as an employer.
4-SSI is absolutely a God-send for certain situations. if you recall in the podcast I said there were more market based ways to dispense things like SSI, Medicare etc. You get an account, money is dispersed each year and you figure out (with your doctor) HOW to best spend that. You have effectively an HSA and debit card and pay your doc/pharmacist/therapist directly. you keep the receipts and these are reviewed at tax season, but you remove a mountainous layer of bureaucracy that drives up proces. You are creating a safety net BUT keeping people accountable for their resources and avoiding a 3rd party payer scenario which increases prices.
5-YOU Jeff are also not typical of many of the folks in the system. You have not given up, did not let this situation beat you. Let me know what you think about all this but I can’t emphasize enough I’m not talking about turning people into the streets! It’s exactly the opposite. If we gut the 3rd party payer system, have some market based elements, medicine will become less expensive and better. At present it is increasing in costs at an exponential rate, this from the gov bodies who run these programs. This vector, allowed to continue unchecked will be disasterous.
Point 1 well said. I was 29 years old and bullet proof. Turned out I wasn’t.
Point 2 also true.
Point 3 last company I worked for would NOT take me on their group policy. I was forced to the State sponsored high risk pool, ie shitty insurance for a high price. I bought it.
Point 4 That sounds good UNLESS you have a major medical situation. You can easily spend 1/4 to 1/2 million dollars in some hospital situations. Of course it can go much higher as well.
Point 5 No doubt the system is a fucking mess. There are long waits to get in to see Docs. The system must be improved if it is going to survive. Thanks for this point and not giving me shit personally because I’m on SSDI. Not sure I’d be alive today if not for this program. Again, it can be improved, no doubt.
Point 4- Keep in mind, much of the “price” is an artifact of the 3rd party system…it should not be that expensive. And even that considered, we could alway have riders for special circumstances, especially if the program is not bankrupt! Lasix is a great example of this:
Good stuff Jeff, really appreciate the conversation.
And point 3 is still a head scratcher for me. i’ll talk to the Specialty Health folks and try to get better educated on that.
As I get to thinking about Point 3 let me clarify. If memory serves me right we had to get 10 or 12 people sign up to get a group going. We were one short, so the company ended up just buying different insurance for different people depending on the person. As I stated, having a pacemaker put in in a class were individual health insurance was NOT available. The insurance companies do not want to cover people that they know will need services. My only option was the State sponsored high risk pool. This was 1/2 million dollars worth of health insurance for $360 a month (Me and the boss split the cost) Once you spent 1/2 million dollars it was gone and you were fucked once again. Remember, this was 12 years ago so I know it is worse now. That is one of the good things about the Affordable Care Act is forcing the goddamn insurance companies to cover the less than perfect among us.
Who the hell is RB? I meant RW. They aren’t even close to each other on the keyboard.
it’s still perplexing. We had someone with a SERIOUS health condition previously but it was not a big deal to get them in this group plan.
to point 3: I am in Texas and the health insurance companies my employer applied to for coverage asked about pre-existing conditions. Our group was rated based on that information. No one was refused coverage based on the information but the premium was adjusted to allow for the admittance of the so called sick individuals in the group.
There was also a one year waiting period before coverage for the pre-existing condition and/or related illnesses would be covered. In essence, we were paying more for the insurance because some of the employees had diabesity and related conditions, but those individuals still had to pay for their prescriptions and doctor visits. Go figure.
Long time Paleo Solution listener or shall we start saying/writing “mega dittos” (might tweak some people too far).
(A) HSA+High Deductible Catastrophic Plans – Guessing many do not understand how “high deductible” insurance works. Although I am willing to describe how it works for me; I would think a better writer than I could write something up with some cool caveman illustrations
(B) SINGAPORE – “a brief word on a path not taken, courtesy of the only rich nation that boasts universal coverage with health outcomes better than ours while spending one-fifth as much per person on health care … In health circles it’s always conservatives who bring up Singapore, because of the primacy it places on personal responsibility.”
I strongly recommend a Paleo Solution podcast business trip to Singapore to checkout their healthcare/fitness scene, deliver a seminar or two while there. The more you learn about Singapore’s health care and health insurance system, the more you will start advocating the same system world wide. It is a free market system via heavy handed gov’t (non)intervention.
“Singapore’s Health Care System: A Free Lunch You Can Sink Your Teeth Into” … http://econlog.econlib.org/archives/2008/01/singapores_heal.html
“The Singapore Model: The city-state of Singapore may have a fix for America’s healthcare woes.” … http://www.american.com/archive/2008/may-june-magazine-contents/the-singapore-model/
“What we can learn from Singapore’s health-care model” … http://www.washingtonpost.com/wp-dyn/content/article/2010/03/03/AR2010030301396.html
thanks for the great info Luke and thanks for listening and sharing!
Different states have different laws and also different insurance companies pretty much divide up states. If you notice, there is usually only one big provider for each state. Again, hopefully the ACA will break up this monopoly.
I appreciate the conversation also, Robb and David. I am enjoying the show. Keep up the good work.
What state do you hail from? Here in California there seems to be several big insurance companies: Kaiser, Blue Cross/Shield, United Health Care, Aetna, etc.
You wrote “If you notice, there is usually only one big provider for each state.” Coincidentally, I just read a woman’s story about the “one big provider” in her home country Portugal, during here college-years.
Here’s how that woman’s story came out while waiting in line at the Colorado DMV, chatting with other people in line.
Coloradan woman – “You see, here we don’t have a right to free health care.”
Former Portuguese woman: At which point I rotated my head like something out of The Exorcist and said in my best *I am controlling my voice because otherwise I’ll shriek so loudly people from Kansas will run in to see what is going on* tone: “You don’t want the free health care they have in other countries. I grew up with it.”
Former Portuguese woman then goes on to describe her dead mother’s test results coming back three-months after death, she further describes having to daily wait in line for a year in order to get her impacted painful wisdom teeth removed, etc etc etc
But hey, at least the Former Portuguese woman didn’t have to pay because the government had the monopoly on providing health care.
Sorry – forgot the link to that Portuguese woman’s story … http://pjmedia.com/tatler/2012/07/14/if-a-conservative-speaks-in-the-forest/
Interesting stuff! Really appreciate the time and energy you guys are putting into the podcast.
The recent health care legislation is such a frustrating issue to discuss with anyone because it’s so polarizing, but I hope lots of people in FAVOR of it listen to your podcast, because I think you’ve done a good job of laying out some of the systemic reasons why it isn’t such a great idea without just calling everyone in favor of it a self-righteous entitled lefty.
I think you guys are going to be successful in cluing some people in, because how many people have lost weight and felt a million times better because they took Robb’s advice about Paleo and “gave it a shot for 30 days”?
Is there a 30 day Paleo budget? Don’t spend any money that you absolutely don’t have to and see how much extra cash you can squirrel away. Think congress would be willing to take a crack at it?
If you check out the podcast/blog, you’ll see he doesn’t avocdate one-size-fits all: He’s presenting info and acknowledges different people will experience the benefits in different ways. He encourages removal/change in regards to certain foods to see if/how it will affect you: Find what works for you. About the only things he’s personally firm on is getting adequate rest and eliminating grain, which has a lot of negative health effects for most.
Love em all, Robb. It’s a horses for cosrues, but I’d take the video one to post here. Also the one I did as well if you can post that over please so we can share some love -getting all Samuel J on you. If you want that front cut let me know. You know the one where you’re Jason Bourne’s operator :)And the city of the dead is definately being made into long format doc.
@Luke. I just googled health insurance monopolies and got tons of links. Here’s one from the AMA
@Jeff – still wondering what state you are in relative to the “monopoly” you are concerned about.
Now ponder why some health insurers might come to dominate or monopolize the 24 states mentioned in that “AMA Bashes Health Insurance Monopolies” article you linked to. Might it be that those 24 states made it unprofitable for other health insurers to operate in those states via mandates to cover things that are to easy to consume? Acupuncture, Chiropractor, Aromatherapy, Chinese Herbal Therapy, etc.
Think about how expensive pizza would be if there were mandated toppings, denying you the choice of what you want? denying the pizza shop the choice of offering you options?
At the link, a ReasonTV vid (http://www.youtube.com/watch?v=Cdfn0Wiywk4) describing the numerous and often absurd health insurance mandates that exist. You as a health insurance consumer _MUST_ purchase these bells & whistles (i.e. floor mats & dealer provided “rust proofing”) even if you _KNOW_ you will never use acupuncture.
What impact would such state mandates have on the smaller health insurance companies? Why they might say they can no longer afford to do business in the state. End result? Fewer health insurance companies in that state. Viola a monopoly no exists in that state. BTW, monopolies are legal when created/licensed by the state. Do you see where this is going? Those monopolies exist because those states forced them into being. Your state gov’t may have inadvertently created your state’s health insurance monopoly.
BTW, What state do you live in?
Luke, you and I are not going to agree on things. The state I’m in Blue Cross and Blue Shield writes 85% of the health care policies written. This info comes from an independent insurance agent I know.
similar boat here. my business is up and running, only debt is mortgage, and i drive a 05 sub legacy- i leave it unlocked bc its a wagon and a stick so its like no one wants to steal it!
Evander, you can have 5 thou sq feet, only 5 thou!
I’m thoroughly enjoying the podcast, and I’m very happy to hear Dave Ramsey mentioned on the show. His stuff isn’t flashy, but it works. I’m one of the people who quite enjoyed Robb’s forays into politics on the Paleo Solution podcasts, first because it’s hard to truly separate our food system from the politics that shaped it, and second because Robb gets all spun up and it’s quite entertaining when he does.
I’m looking forward to the next show!
And a thought on the various European socialized medical systems:
Let’s begin by looking at the relative geographic and population size of those countries in comparison to the United States. Compare this with, say, France, who is only about as large as the Pacific Northwest.
Not only do we have much greater geographic diversity, we also have 5 times the population, and this expectation that we’re to be some sort of “melting pot” and let everyone retain some semblance of their past national identities and cultures while being wholly American. How does that play into health care? In my opinion, smaller countries, like that of France or even England, have higher cultural homogeneity as well as much more ardent social contracts when it comes to seeking healthcare. During a short trip to England I happened to visit accompany a friend to a doctor visit there. While I was waiting in the waiting area, the red digital reader board displayed a nice, friendly message stating something to the effect of “If you’re late, you have to reschedule. It’s your responsibility to get here on time for your free healthcare.” I loved it!
Contrasting that to the hospital-based clinic I work at now, where people receiving free (yes, free. The hospital wrote off their entire course of visits) treatment couldn’t be bothered to show up on time, if at all. I know everyone gets a flat tire every now and then, but logistical hiccups notwithstanding, there seems to be a lack of “buy-in” by certain subcultures of the American populous when it comes to commitment to their care.
Furthermore, I’ve had the privilege of meeting doctors from around the country who all specialize in my line of work, and they all do things quite differently, but have decent outcomes. Indeed, some are better than others, but if things were “nationalized”, we’re not even talking about someone at the state capitol making decisions about care, we’re talking about having some dingbat in Washington D.C. make decisions about the delivery of care in Alaska or Idaho or Florida, all without any feel or accounting for the local environmental and cultural mores and values.
Essentially, I think we’re too large and culturally diverse to have one system. To compare the US to European or middle-eastern countries (many of whic are no larger than our states) in terms of health care delivery is a poor analogy. It would be more apt if we were to allow each state (funny how word implies some semblance of sovereignty) in the US to formulate its own health care plan that suited the needs and social contracts of its population.
Just my two sleep deprived cents.
Just listened to the second podcast and am liking the direction and info, much like the first. I’ve been one of those people that has defended the health care legislation from an “at least it’s something” mentality, and with the belief that everyone should have health care, as their lack of it costs those who do carry insurance more money and time.
After the explanation you’ve given though, I’m inclined to change my mind. It’s amazing what a few facts can do! And I reserve the right to change it again should new information present itself…
I’ve always been a believer that at the base of these problems is the public’s expectation that the state or federal government will provide adequate education, teach people about money, tell them what to eat, and generally protect people from themselves so that no one has to think or be held responsible for their own actions. The legal system just reinforces all of this by allowing ridiculous settlements for lawsuits that are caused by nothing other than consumer negligence.
I’m of the mind that if you do not carry insurance or take care of yourself, you should be personally liable for the consequences. If you do not have car insurance and you get in a wreck, you should be responsible for your share of the damage and subject to collections just like any other unpaid debt.
Same with health care. If you keep yourself in such a condition (through lack of motivation or knowledge – there are obviously exceptions) that you are perpetually sick and impose a cost on the rest of society by your choices, you should be personally responsible.
I think that people have the right to do as they please, including smokers, drinkers, other drug users, and the like. A free-market healthcare system where people are responsible for paying for their own care would project the costs back to those generating them. And if they want to line a doctor’s pockets so they can keep their addiction, it is their right to do so. So long as it doesn’t affect my care or the costs of my care (which are currently zero, thanks to Robb).
Probably going around in circles here, but I think it all comes down to people’s failure to educate themselves and the belief that a high school or college diploma means that you can stop learning and be looked after for the rest of your life.
Grass fed meat is the way to go! It’s more expensive but its worth it! The cows are fed what they’re susppoe to eat, GRASS lol! Not CORN like the massive produced cows are! Watch the documentary Food, Inc. it will change the way you think about what you eat! It did for me and my husband!
Finally, someone is pnlliug all the right info together and presenting something that works, something that matches what humans need to become truly healthy and live up to our potential.Great work Robb, and I look forward to seeing you uptown on Saturday!
On the topic of “needing” as well as financial independence, I think Francisco d’Anconia’s speech from Atlas Shrugged by Ayn Rand is relevant:
good stuff Kuraje! thanks for sharing. Awesome link.
1. Regarding whether we should start pointing fingers and shaming people in our local communities for being drains on local and/or national resources at a time when things are so tight all the way around: NO. And believe me, I want to say yes. I want to say we should all publicly shame people who are burdens on our finite financial resources. BUT — let’s take the example of overweight people. I was one of ’em. Ten years ago, I was 28 pounds heavier than I am now. That might not sound like a whole lot of weight, but I’m only 5’2″, so 28lbs makes a big difference. And you know what? I was doing “all the right things.” I was exercising like crazy, running my fat @ss off (or damn well trying to!), eating all the “good” low-fat, no-fat, heart-healthy crap I was “supposed to” in order to lose weight. I was fat *despite* doing all the things that were supposed to work. So as much as I would like to paint people with a big scarlet “O” for obese” or “D” for “diabetic,” I just don’t think that’s fair. We can’t necessarily look at someone and know with just one glance that person’s whole history. What finally got the weight off? Me digging deeper and basically doing the *opposite* of the health recommendations seen and heard everywhere. I now eat more butter, steak, and heavy cream than anyone would ever believe in looking at me. But I haven’t had a bagel or pasta in 7 years.
So I don’t agree with the person who posted on Robb’s blog that the government *can* be the solution if only they gave the “right” advice (i.e. a lowish carb Paleo-type diet), but I see where she’s coming from. And yes, for me, it still came down to personal responsibility — after many years of “doing all the right things,” I finally, FINALLY had to ask myself, why the hell isn’t this working? So ultimately, I took matters into my own hands, but you can see that’s not easy to do when everyone — including our doctors, whom we *trust* to know better — are telling us what to do, so then we do it, and if it doesn’t work, who are we to question it? *Sigh.* I know what you’re saying guys, and I mostly agree, but I hope you can also agree it’s not that cut and dried.
2. Also wanted to say something on another point you brought up, which I think is HUGE but gets very little attention in the national discussions about the economy. You guys were spot-on when you asked what America could be accomplishing if we weren’t spending these astronomical amounts of money on healthcare, wars, etc. (And I’m a veteran myself, so I’m not bashing defense, but the DoD is *notorious* for boondoggle projects and money pits and I can say that having seen it from the inside.) What could we, as a nation, be researching, achieving, pioneering, if our pooled economic resources were going toward more fruitful endeavors? You should listen to Neil DeGrasse Tyson talk about space exploration. (He’s the head of the Hayden Planetarium and a professor at Columbia, I think…or some other school in NYC…been in a ton of TV specials.) I don’t agree 100% that space exploration is the best use of our $$, but just listening to him talk about what America is capable of when we try — when we match the money with the great minds and the *will* to do great things. It’s hard not to be inspired and jazzed up just listening to him remind you of what we can do when we stop whining and start putting some collective effort into something meaningful.
And my last point — related to the above: that’s just on a national level. But think about individuals. How many people stay in jobs they can’t stand for the *sole reason* of keeping their health insurance? I knew plenty of people in the military who stayed not because they liked it, but because it was so *safe.* (Economically, if no other way.) We, as a population, are terrified to take the risk and go without insurance. *How much human potential is lost because people drag themselves from one day to the next, just plodding along instead of really *living?* How many great novels or screenplays go unwritten? How many people with great passion for food aren’t cooking, but are spending their days in a cubicle staring at a computer instead? I know this isn’t a hard-core dollars and cents type question, but I think it’s important. Seriously — how much creativity, beauty, and innovation is lost because so many of us are just too plain scared to leave jobs we hate but we know come hell or high water, that paycheck will be there? (And as an aside for Robb — how badly is that affecting our health? People could eat the most pristine food harvested by angels and blessed by magical unicorns, but if they’re in a perpetual state of “blah,” I don’t think their health will ever be optimal. Good, yeah, probably. Great? No.)
Amy, thank you for your wonderful comment and your insights. We really appreciate you listening and participating in the discussion. The hypothetical question we asked about “calling people out” certainly does bring out a lot of opinions…many which reflects your viewpoint. I think we live in interesting times and as resources become more scarce I am concerned that people will become more and more targeted that are perceived as “consumers” rather than “producers.” Unfortunately, as government gets more involved they (gov’t) often become the judge, jury and executioner around many of these sensitive issues. Frankly, I am not sure how it will all play out but our goal is to foster a variety of discussions around “what its” and solutions to some of these enormous structural problems America faces today. BTW…thank you for you service to our county!
LUKE! So much for my sleep, I have some homework to do, thanks man!
Many people (including Dave and Robb) disagree that the government could be part of the solution if they were only giving the right advice. I find this puzzling. Governments (and other associations of medical experts and agencies etc.) have been giving terrible advice for decades, and …. everyone has been following it and getting fat and sick! So–whether people like it or not–governments do have an astounding ability to effectively influence behavior. You can advocate “beating it back with a stick” all you want to (which may be a good thing in many cases) but, let’s face it, it’s not going to disappear any time soon. I think a more realistic stance would be to hold it accountable for taking a hard look at the evidence and changing its bogus recommendations.
As for the question about whether people who are not taking care of themselves should be somehow “called out” in a context where everyone’s tax dollars are going towards healthcare, I would like to say YES. However, that is socially…impractical (to say the least) when practically EVERYONE believes the conventional wisdom put out by governments and their agencies. If we (you) succeeded in relegating governments to national defense and other essentials, the conventional wisdom–which is incredibly entrenched–will still be there. Why can’t governments be held responsible for fixing the diabesity epidemic based on the science that is already out there?
However, just because it’s impractical to “call someone out” (or shame them, as one commenter termed it) that doesn’t mean you can’t share what you know with people that could use some health. Before I started on a low-carb Paleo diet the doctor’s suspected I had MS or another autoimmune condition. I had an MRI and was told by a rheumatogist that my symptoms were non-specific for a precise diagnosis but very probably auto-immune related, and that I should not hesitate to come for another visit once I had some more specific symptoms! Instead I fixed my diet and have seldom seen a doctor since. So, I basically tell everyone about what I’ve learned. Even if they are not “diabese”, they almost certainly know someone who is. I think that is the most that people can realistically do in the current context of government/health agency-sponsored misinformation.
How would you expect the government to solve the problem? It is the quasi-governmental entities and their dogma that have been prolonging recognition of the solution. If the government had not been so involved in trying to solve other problems, perhaps they would not have created this one.
I would like to hear your thoughts on the banking system in a future podcast. Especially your thoughts on :
North Dakota is the only state with a surplus and the only state with a state owned bank. That bank was probably the only bank making loans to businesses from 2008-2011.
your thoughts on “The American System” of Henry Clay and how ironic it is that China is kicking everyone’s ass by basically using “The American System”
The Fed and the debt based monetary system currently used. The fact that if the US paid off their debt the money supply would basically disappear and the economy would come to a halt.
Thanks, really liked the show
One bone to pick: mid way through, you say ‘our economy is fueled by consumer spending.’. This is bupkis: trade, predicated on freedom, is what fuels any economy.
The idea that consumer spending is where economic growth or even functionality comes from is simply Keynes by another avenue.
Thx for doing this podcast Robb.
Brian! You are absolutely correct. I stand corrected. I think I was trying to co-mingle the messaging around what we were asked to do after September 11th (ie. go buy stuff to support the economy) versus what the true foundation of our economy is built on….which is confidence in freedom. I didn’t explain that very well….I’ll do better! Thanks for listening!
@Dave – NP. It’s good stuff.
@Glen Nagy – the reason that North Dakota has a surplus is because they hit oil, big time.
@Dave/Robb – the most critical issue that we face is the Fed’s hyperinflationary practices. This is the most critical thing we’re facing IMHO.
@Brian , I didn’t realize that North Dakota was the only state that has oil, I thought there was a little bit in Texas, my bad. I know they have natural resources and that is a big factor but I do not think it is the only factor. I think having a bank that would actually lend money to business during the downturn was also a big factor.
Robb To your point that when people have more wealth they tend to give more to charity I wonder what happens when we rely on that rather than state sponsored social welfare programs.
First I don’t believe anyone would voluntarily give To charity anywhere near the amount that is taken in taxes for social welfare. Secondly what happens when wealth is reduced regardless of tax rates e.g. Economic downturns. I would imagine that durring hard times donations to charity would be among the first of most family’s discretionary spending to be cut, although it would be the time when it is needed most. Governmental social spending, I’m guessing, often goes up during recessions.
You may argue that one represents a sustainable model and the other does not but I think with a reshuffling of priorities the U.S. govt could pay for its social welfare programs and still balance it’s budget.
The flip side of that is that if you give to a properly vetted local charity you are not paying the exorbitant price of a federal bureaucracy to administer it, or lose it, or re-allocate it. I think the biggest challenge of government programs is that we no longer think it is our job to help. “I paid my taxes, I did my part.” That way is the path of Scrooge.
“Ebenezer: Are there no prisons?
First Collector: Plenty of prisons.
Ebenezer: And the union workhouses – are they still in operation?
First Collector: They are. I wish I could say they were not.
Ebenezer: Oh, from what you said at first I was afraid that something had happened to stop them in their useful course. I’m very glad to hear it. “
Good points. One of the long-standing libertarian talking points has been to have an option: Pay the gov or pay 5013c’s. it would be an either or option and dollar for dollar, unlike the current situation in which my tax deductible donations merely work agains my stated earnings.
This would cause a literal explosion in these organizations and interestingly, a legitimate job infrastructure. Non-profits are also quite transparant in their functioning so one can see how the money is actually getting divvied up. Poorly run operations just die, like they should. This also allows folks to take care of both local and more global issues they are passionate about.
Add a lower flat tax to the mix to remove 99% of the IRS, the off-shoring of money etc, and we have a potent stimulus for economic growth.
For me, this comes down to: Does one put faith in the government (and it’s expansion) or in smart market incentives, self determination etc.
Robb, I like this idea.
It just occurred to me: are free market principles akin to evolutionary principles in that successive years of donations would eventually lead to optimization of cash flow? Not perfection, but continually honed over time.
Not a bad idea.
The closing of my building due to the fact that the CO shooter used to work in it has allowed me to catch up on your political podcast.
I totally agree with the Dave Ramsey, get out of debt and stop trying to keep up with the Joneses idea! He actually has a program thegreatrecovery.com which focusses on these issues as the long term solution to our economic problems. I think our economy would be much less volitive if we could get more people out of debt and living within their means. The problem with the current situation is any little bad news comes out and everyone freaks out and stops spending. Everyone always just spending what they can afford would be more stable.
I have fundamental problems with many ideas behind the libertarian philosophy that I hope you guys can cover in the future. However, I have so many comments that if I say them all here I will be even more of a rambler.
Is the offer for the Healthy Competition book still on? I’m curious to read it because I fundamentally don’t think healthcare markets work, but I’m open to learning ideas that support the opposing side. But if the incentive is there I’m more likely to read it and think about it. Incentives are important as you know 🙂
One thing that really connected with me during the podcast was when you both discussed how hospitals started charging more because they knew the government (or insurance companies) would only pay a percentage of what they requested. And this had the effect of screwing over the guy who is trying to pay cash. I’ve had 2 experiences over the last few years that clearly highlight this point.
First, I hurt myself skiing and needed about 30 stitches. I was between jobs and playing the “COBRA game”, waiting to see if I’d need COBRA before I signed up for it since you can sign up retroactively. At the Urgent Care Clinic, when I told them I was paying cash, they threw away the original bill for almost a thousand dollars and said that will be $350. I just paid it and never bothered with COBRA. I’m guessing they had to submit an invoice for almost a thousand to get paid $350 by insurance companies.
More recently my wife and I went in to our doctor for the exact same test. We both have our own health insurance through our employers. We we received the bills in the mail a few days later. The doctor had charged both of us different amounts for the exact same test, but with the same net payment at the end. It’s as if the doctor recognized that if he charged my wife’s insurance company $200 he would be reimbursed $100, and if he charged my insurance company $300 he would also get $100. And both bills said we did not owe anything additional, so the doctor accepted the $100 as full payment. Funny thing is, we both have United Health Care, but different policies under UHC.
This probably happens all the time. I just don’t know how many people have the experiences I had, that so clearly showed the cost manipulation.
Really great stuff guys. I’m so thankful for your passion to help try and come up with solutions for healthcare and the country in general. I’ve been listening to Robb for a while. Dave, very nice to “meet” you. My wife is from Flint town and my father-in-law is an old school GM guy.I tweeted out this podcast because you two have articulated this healthcare problem so well. I’m definitely spreading the word about these podcasts and look forward to them. Robb, thanks for the recommendation on that book. I bought it tonight and won’t even ask for 100 bucks for it.
So insurance companies (and their investors) now get the profit that used to go to hospitals and doctors. Next time you go to receive medical treatment ask the money person: “How much if I pay in cash?” My musician relative says doctors in particular may give great deals.
I don’t have caveman drawings but I use an HSA and High-deductible plan. MRI, Surgery and like 6 Dr visits this year for my achilles tendon rupture has not hit our $6K deductibe, I think we’re only at about $4K. The bill goes to the insurance and comes back cut in half, that’s what I pay.
I fear that we will have to deal with hyper-inflation before politicians get the nads to restructure entitlement programs. Touch Social Security? No way. Politicians don’t get paid to fix it, they get paid NOT to.
Skip Bayless is a tool. I like the podcast.
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