I call off work and, uninsured as I am, run down to medexpress and drop a franklin on some medical attention.

The attractive female PA, having been happily granted permission to peer into the lovecraftian nightmare realm of my crack, collected a swab and diagnosed (with seventy percent certainty) one massive fucking yeast infection. She wrote me up for prescription lotramin ($8 OTC) and an antibiotic.

I go to the folks in the white coats milling about the corner of the grocery store and show my AAA card (half off!) and I'm told that the antibiotic is free, but the $8 OTC lotramin is fifty dollars after my AAA discount.

wait what

"Oh wait!" the whitecoat says, "You're self-pay, I forgot, it's only $15 then."

They charge insurance companies almost seven times more for the same prescriptions? Why? Whitecoat says that's just the way the world works.

That was about ten days ago, and my ass is much improved. Now, I receive a bill in the mail for $115, the price of an office visit. Turned out that I was allergic to that antibiotic, and two days following my original evaluation I went back to inquire in a calm fashion about the raging itchy rash that had broken out all over my entire body (and I do mean my entire body). It was this visit which I was being billed for, despite repeated assurances that I could come back as many times as I liked up to ten days after my initial visit.

So I call medex billing. "Oh! You're self-pay, yes you should not have gotten that bill, let me take care of that."

What again? Insurance companies don't have any grace period at all?

Isn't this some sort of fraud? Don't people realize that when insurance companies are flagrantly overcharged this way, it's just passed right along to the people paying the premiums? Why don't insurance companies feel competitive pressure to choose more affordable providers? Where is this market distortion coming from and how much of our healthcare costs are the result of it?

Case in point.

John goes to doctor who is covered on plan he has but performs a service that is outside the scope of their benefits coverage.

Doctor charges insurance $1600 for services, knowing that since he is contracted with the insurance company the member has, he is only going to get $1600. He doesn't know if the service is actually cover-able or not, so it becomes a crap shoot.

Here is the fun part.

Doctor and Member get an EOB (explanation of benefits) stating that we are not paying for non covered services.

Doctor sees this and goes, "Cha-ching! Bill that patient $1600!

Patient gets bill and EOB from us and one of two things will happen:

Patient calls the office of the doctor's billing and they talk them into a payment plan to pay off the $1600 and/or threaten collections. (happens most of the time)

Patient calls insurance company and wants to know if something can be done; generally, this is a moral dilemma. Since morals are thrown out the window 99% of the time where I work, they advise that there is nothing to be done and we tell them that they can file a grievance and blah blah blah long battle to ultimately fail 9 out of 10 times.
This leaves the bill in their hands and most of the time in collections effecting credit and all that fun stuff.

Or

We can call the doctor's office and fight for the member, negotiating to be billed on their self pay rate.

This normally goes well, but rarely gets to that point.

TL;DR:
Doctors and insurance companies are equally to blame for the state of healthcare in the US.

Also, if you have questions about exactly how messed up or backward or even how your insurance actually works. I can probably help you.

It's quite a sickening field to be in. But at least the benefits are good.

So there I am in Paris not feeling well at all with a world-spinning-round-and-round ear infection, at the hospital for some tests. Having reminded the insurer a couple of hours earlier that I still hadn't got the letter, they e-mailed it just before I left the house. I give the letter to the nice lady at the registration desk, and she looks it over, then slowly looks back and forth between me an the paper.

"What's this?" she asked, in that "Why are you wasting my time?" way only French bureaucrats have perfected.

"It's my payment guarantee."

"We cannot accept this."

"??"

She handed it back to me...and that's when I realized the idiots at TRICARE had sent me my authorization to be seen at a French hospital in Italian. Dafuq?

In their defense, at least they fixed it relatively promptly when I called them from the waiting room.

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Peanut butter ass Shaq Brahmin Bloodlust booooze lime pole over bench lick:
TL;DR:
Doctors and insurance companies are equally to blame for the state of healthcare in the US.

Also, if you have questions about exactly how messed up or backward or even how your insurance actually works. I can probably help you.

It's quite a sickening field to be in. But at least the benefits are good.

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It almost sounds like there's monopolistic collusion among doctors and insurance companies to soak massive amounts of money from the insured and hide the true costs.

I'd love to see some investigative journalism on this.

Maradon! fucked around with this message on 06-04-2012 at 10:09 PM.

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Maradon! stopped staring at Deedlit long enough to write:
It almost sounds like there's monopolistic collusion among doctors and insurance companies to soak massive amounts of money from the insured and hide the true costs.

I'd love to see some investigative journalism on this.

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Yeah, every state tries to put their own silver lining on their premium rates and such.

I deal with individual/sole prop plans, (direct pay, single, family, parent/child plans etc).

I also live in NY.

Individual insurance in NY is just about the highest in the US. The silver lining my company uses is "We don't make you screen for this plan and it is available to anyone."

That silver lining means this:

An individual who wants our standard individual plan, which only has in network benefits, pays $1366.99 in premiums. Per month. If you want out of network benefits, it is almost $1800 a month.

Now, if you have a family plan... and you need out of network coverage?

You, your significant other and your precious baby. Oh that's only a hair under $5k a month.

It's not like that means services are free after that point, you'll still have copay, coinsurance, and other responsibilities. And there are plenty of exclusions and stipulations to those plans.

I also used to be in our national account division, which is a HUGE different beast. Also quite scary when you see what corporations pay for and write into their benefits for their lower employees and executives.

But that is a story for another night.

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Bloodsage said:
And one need only look at defense contracting to see the train wreck awaiting if it's all nationalized.

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I don't get all the scaremongering about this. I'm not arguing against you as it could go tits-up in the US, I just don't get it.

The National Health Service in the UK is fantastic and one of the highest rated heathcare services in the world. Of course you get treated faster if you pay privately, but horror stories about people with life threatening illnesses left to rot in waiting rooms are unfounded and untrue. When my mom was diagnosed with cancer she received the best care and best treatment (experimental stuff too) all on the back of the NHS. Hers was too invasive by that point so the outcome would always be the same, but they tried everything and I will always praise them for it.

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And coming in at #1 is Maradon! with "Reply." I'm Casey Casem.
Isn't this some sort of fraud? Don't people realize that when insurance companies are flagrantly overcharged this way, it's just passed right along to the people paying the premiums? Why don't insurance companies feel competitive pressure to choose more affordable providers? Where is this market distortion coming from and how much of our healthcare costs are the result of it?

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Healthcare and insurance companies lobbied for and received an antitrust exemption some years ago. They went on to establish regional monopolies that lets them do whatever the fuck they want; there's no real competition.

Also note that even though the insurance companies are charged absurd prices by healthcare providers, they don't actually pay the charged amount. Like you, I had an ass problem some years back, and the several doctor visits plus diagnostic tests plus whatever cost around $1,500. My insurance company looked at the bill, chuckled indulgently, and paid around a third of that. And that was that; all parties were satisfied.

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Channeling the spirit of Sherlock Holmes, Mortious absently fondled Watson and proclaimed:
I don't get all the scaremongering about this. I'm not arguing against you as it could go tits-up in the US, I just don't get it.

The National Health Service in the UK is fantastic and one of the highest rated heathcare services in the world. Of course you get treated faster if you pay privately, but horror stories about people with life threatening illnesses left to rot in waiting rooms are unfounded and untrue. When my mom was diagnosed with cancer she received the best care and best treatment (experimental stuff too) all on the back of the NHS. Hers was too invasive by that point so the outcome would always be the same, but they tried everything and I will always praise them for it.

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The UK system works in certain areas, and I'm happy your mom received great care for a serious illness. On the other hand, even the UK gov't is looking into the quality of standard health care, and GPs are finding it not worth their time, harming quality at the GP level. And, as a major employer in my area when I was there, I could go on for days of the abuse of the health care system and its effect on the workplace. Though, to be fair, the ridiculously PC labor laws in the UK are also part of the problem.

I also had great experience in France with their medical system...but I was privately insured and got to go to the best hospitals. The one time I did see a specialist who was reimbursed by my insurer through their national health system, she was about 4 months late getting paid--something she said was typical.

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Everyone wondered WTF when Karnaj wrote:
Well, failing the implementation of a single payer model like Canada's, I advocate the Dutch (Danish?) solution: force all insurance providers to compete in a national marketplace for customers, force all healthcare providers to accept all kinds of insurance, and force all customers (citizens) to buy some kind of insurance, offering a subsidy for the poor to do so. Other than that, the government can remain hands-off and allow insurance companies to viciously compete for new customers, keeping premiums, profits, and dividends low. Also keeping insurance providers honest and efficient.

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How would this form of de-regulation differ from what was done with AT&T and with the gas & electric companies? Prices went up substantially with those particular forced break-ups. Would not the same problem with ownership of power/telecom lines be mirrored in ownership of hospitals?

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Damnati got served! Damnati got served!
How would this form of de-regulation differ from what was done with AT&T and with the gas & electric companies? Prices went up substantially with those particular forced break-ups. Would not the same problem with ownership of power/telecom lines be mirrored in ownership of hospitals?

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We're not talking about hospitals or really, any physical assets. Establishing a national insurance marketplace simply allows insurance companies to raid each others' previously established territories and lure customers away with lower premiums and better benefits. There's no physical infrastructure, save, I guess, new regional/local offices insurance companies would need to establish in new territories.

The only "deregulation" the hospitals would face would be the fact that they have to accept all insurances. This is actually a massive benefit to them, as now they save on the overhead of dealing with in-network vs. out-of-network insurance, fighting with insurance providers to, you know, actually pay for services rendered to the insured, and so on. They'll be able to cut bureaucratic staff that have nothing to do with actually providing care, enabling them to either hire actual doctors/nurses/techs, or invest in capital improvements.

You may not be aware of this, but right now, approximately one fourth of the money spent on healthcare in the United States each year goes to bureaucratic overhead--something like 400 billion dollars a year. Single-payer models like Canada are around 3 times more efficient, able to spend more of each dollar (or loonie or whatever the fuck) on actual medical care.

I'd again point to defense contracting as an example of what happens in the US when the government tries to "create" a free market. The rules inevitably stifle real competition in favor of leveling the playing field through perks to special interests.

The trick will be to find a way to insure the needy without screwing the rest of us in the process.

Efficiency in healthcare, like efficiency in warfare, is a red herring. Effectiveness should be the goal, and that is a very different thing. Efficiency, for example, dictates one find the point of diminishing returns (or escalating cost), and write off cases beyond that point.

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Karnaj had this to say about Knight Rider:
We're not talking about hospitals or really, any physical assets. Establishing a national insurance marketplace simply allows insurance companies to raid each others' previously established territories and lure customers away with lower premiums and better benefits. There's no physical infrastructure, save, I guess, new regional/local offices insurance companies would need to establish in new territories.

The only "deregulation" the hospitals would face would be the fact that they have to accept all insurances. This is actually a massive benefit to them, as now they save on the overhead of dealing with in-network vs. out-of-network insurance, fighting with insurance providers to, you know, actually pay for services rendered to the insured, and so on. They'll be able to cut bureaucratic staff that have nothing to do with actually providing care, enabling them to either hire actual doctors/nurses/techs, or invest in capital improvements.

You may not be aware of this, but right now, approximately one fourth of the money spent on healthcare in the United States each year goes to bureaucratic overhead--something like 400 billion dollars a year. Single-payer models like Canada are around 3 times more efficient, able to spend more of each dollar (or loonie or whatever the fuck) on actual medical care.

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It might be that California is more prone than other states to have hospitals owned and operated by insurers. It seems slightly less prevalent here in the Bay Area, where Kaiser competes with Sutter Health and John Muir.

I tend to agree with the stated argument on efficacy vs. efficiency, though I suspect there are those who would call the difference semantic. I do not see any means by which the current systems opt for or can pursue either one; the baseline right now seems to be an unguided mess dedicated to lining pockets.

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Tarquinning:

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It was that bad. I actually used a menstrual pad left behind by an ex girlfriend to sop up the blood while I drove to the doctors.

I had been treating the infection as though it were hemorrhoids. Common hemorrhoid medication often contains aloe or other moisturizers, basically creating an ideal environment for a fungal infection to grow in. It was pretty horrible.

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Bloodsage came out of the closet to say:
I'd again point to defense contracting as an example of what happens in the US when the government tries to "create" a free market.

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The whole problem is basing any solution on the idea that healthcare can be a free market in the first place.

Nobody in an emergency room bleeding gallons of blood out their ass has freely chosen to participate in a market transaction, nor do they have any alternatives if they don't want to pay what "the market" has priced their treatment at.

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Bloodsage screamed this from the crapper:
And that's why I also raised the fundamental question of individual versus collective responsibility, of course. Genuine emergency care, rock on...but in general I don't particularly see why I should subsidize others' general health care, either through increased premiums or taxes.

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How about this: because others will be subsidizing your healthcare, especially as you(the general you, by the way) age. I mean, everyone's body goes down the shitter as they get older, and even if they're rich, they're going to be extracting more from your insurance than they pay in, be that private insurance or, eventually, Medicare. It's not a big deal; older people, on average, need more medical care than younger people, even those who are baking bread in their assholes.

Furthermore, younger people can forgo insurance and probably be OK, least until they decide to have kids. For older people, the diseases they're likely to face are potentially deadly and cripplingly expensive, and their treatment can easily erase a lifetime of accumulated wealth. To me, anyway, it makes absolutely no sense to ruin someone financially, with all the knock-on effects that ruin entails, just because they happened to get sick.

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Aw, geez, I have Bloodsage all over myself!
So we're back to "from each according to his ability, to each according to his need"? Can't say I was ever a subscriber.

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The alternative seems rather less appealing, as it would punish those who have the misfortune of getting sick with either financial ruin for themselves and their families, or, you know, death. I recognize that one can minimize his risks of getting cancer, or having a heart attack or stroke, but one cannot eliminate them.

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Bloodsage came out of the closet to say:
And that's why I also raised the fundamental question of individual versus collective responsibility, of course. Genuine emergency care, rock on...but in general I don't particularly see why I should subsidize others' general health care, either through increased premiums or taxes.

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I think basic care, emergency care, and preventative care should be covered by the government, because the Constitution empowers the government to provide for the general welfare, and what could be more "general welfare" than the health of its citizens; and because the Declaration of Independence states that all men have an inalienable right to life, and as healthcare is a requirement for preserving life, by association people have a right to it as well, and so it shouldn't cost an individual anything. (Basic and preventative care included because it would eventually cost the government more to pay for treating a problem as emergency care when the underlying problem that'd go unaddressed due to lack of basic and preventative care gets worse due to lack of treatment.)

Premium care, or any sort of elective healthcare should be an individuals own responsibility to pay for (or to pay an insurance company to cover). Sort of like the Canadian system -- you can stay in a hospital for free courtesy of the government, but if you want a private room, I hope you're insured.

Drysart fucked around with this message on 06-06-2012 at 04:37 PM.

There's a huge difference between the right not to have one's life taken away (the constitutional guarantee, and even that has limits) and the right to have others pay to increase its length or quality.

It's a sticky problem, but unless there's also an obligation for people who receive welfare or subsidies to actually provide something back to the government...I'm still not convinced of my personal obligation to work to support them. It's easy to wave one's hands and generalize, but tell me exactly why I should be paying someone else's bills.

Now, if we first start having the bottom half of the income brackets start paying their fair share of taxes, maybe we could construct a valid system.

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Bloodsage came out of the closet to say:
Yeah...I don't really read the constitution that way. Might as well go with Finland and declare high-speed internet a basic human right.

There's a huge difference between the right not to have one's life taken away (the constitutional guarantee, and even that has limits) and the right to have others pay to increase its length or quality.

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Firstly, you're setting up a hideously stretched strawman by equating health to internet access. We're not talking about internet access, we're talking about keeping people from dying or living in agonizing pain. Let's keep some perspective here.

And as for preventative care being an important part of any healthcare plan: it's a cost-saving measure. Treating conditions in advance is considerably cheaper than treating them when they're left unchecked and become life threatening.

I am curious as to what you read the general welfare clause to mean. Keeping citizens alive and healthy seems to be the most basic interpretation of those words to me; especially when read in the context of the preamble of the Constitution, where it's listed along with "general tranquility" (keeping the peace domestically) and "common defence" (keeping other peoples from killing us); both of which are rooted in the ideal of not letting citizens die, whether it's due to unrest, invasion, or any other reason.

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Bloodsage came out of the closet to say:
It's a sticky problem, but unless there's also an obligation for people who receive welfare or subsidies to actually provide something back to the government...I'm still not convinced of my personal obligation to work to support them. It's easy to wave one's hands and generalize, but tell me exactly why I should be paying someone else's bills.

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Two reasons: Society pays for many of your bills. Why should I pay for roads I don't drive on? Why should I pay for police when I don't call them, or for the fire department when my house isn't burning down? Why should I pay for the Department of Motor Vehicles bureaucracy when I'm perfectly capable of driving without a little card that says I can?

The entire system falls apart if we say people's taxes should only go toward things that directly benefit them personally; because many imperative functions of our society can't function that way. And whatever evil-sounding words you use to describe the concept: collectivism, socialism -- it's one of the basic principles our government was founded on.

It's why the Constitution starts off by enumerating the responsibilities of government to provide for everyone. It's why the Declaration of Independence lists first among the King's failures of government as not providing for the public good.

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Bloodsage came out of the closet to say:
Now, if we first start having the bottom half of the income brackets start paying their fair share of taxes, maybe we could construct a valid system.

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I agree this is a problem. But the root of the problem is wealth distribution, which is the problem facing our society today that all of our other problems stem from. Taxing people who are already below the poverty line isn't going to help anything -- you can only get so much blood from a rock, and driving people who are already desperate into a more desperate situation is likely to cause more problems than it fixes.

Fix the wealth distribution problem and all of a sudden there's more money to support a middle class, and a larger tax base to draw from as a result.

As a positive side-effect, you're not part of the problem, you're one of the people who stands to benefit the problem being solved -- and benefit in a way that would more than pay for the costs of having to "pay someone else's bills" so they can live a good life.

I mean, hell, we're the richest country in history. Don't tell me we can't afford to keep our citizenry from being sick.

Drysart fucked around with this message on 06-07-2012 at 01:01 AM.

And OBTW, it's not a strawman to point out the ever-increasing expansion of what some people consider basic human rights; it's actually the core of the conversation.

Finally, as long as we're playing the logical fallacy game, it's a false choice to say we either tax people below the poverty line, or we rape "the rich." The top 1% of earners already pay 40% of all taxes. There's a lot of room in the middle for fairness in taxation.

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Bloodsage stumbled drunkenly to the keyboard and typed:
Yeah, sorry, dude. If you think redistribution of wealth a) answers any problems at all, or b) can be described in any way as just or fair...we've got nothing to talk about.

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Not sure he was advocating that, but you actually believe that it's ok for someone at the top to make several hundred times more than their "average employee" and still get a multi-million golden parachute/retirement package on top of that, plus whatever they walk away with in stocks, etc, etc?

Seems a little over the top to me. *shrug*

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Quoth Random Insanity Generator:
Can't have it both ways. Either eliminate the BS tax dodges and similar abuses (flat tax everyone, same percentage across the board) or find a way to quit spending. Either put some hands on and actually effectively control, or take all hands off and let shit happen.

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Actually, you can. You institute a flat tax, but still have a minimum earnings cutoff below which isn't taxed at all. Since everyone except the extremely poor pay exactly the same rate, it's by definition fair.

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Channeling the spirit of Sherlock Holmes, Random Insanity Generator absently fondled Watson and proclaimed:
Not sure he was advocating that, but you actually believe that it's ok for someone at the top to make several hundred times more than their "average employee" and still get a multi-million golden parachute/retirement package on top of that, plus whatever they walk away with in stocks, etc, etc?

Seems a little over the top to me. *shrug*

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Actually, he did specifically say distribution of wealth was the problem. And the answer seems to be to punish success, but that's been tried in several places, and hasn't worked yet. Nor can it.

And I certainly don't see why successful people shouldn't make more than the average, even hundreds of times more. A better question would be why should the dude who just pulls the trigger on a rivet gun all day make anywhere near the same pay as someone with huge responsibility and whose decisions and judgment guide the entire corporation? I've been both a technician and the guy responsible for running a small town, and there's no comparison in terms of difficulty or level of responsibility. Damn straight the guy in charge should make significantly more.

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Bloodsage screamed this from the crapper:
Actually, you can. You institute a flat tax, but still have a minimum earnings cutoff below which isn't taxed at all. Since everyone except the extremely poor pay exactly the same rate, it's by definition fair.

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It would be nice if rich people actually paid the same percentage of their earnings in taxes as I did. I would not have any qualms about the rich paying a greater percentage of their income in taxes, though. You know, like they're supposed to.

With regard to the division of wealth and the amount of tax paid, the issue is not at all whether the tax is flat or progressive. The problem, as illustrated just this year by our President and one his secretaries, is that the wealthy often pay a lower percentage rate on their income than those of lower brackets. The idea of a flat tax is a pretty good one in terms of fairness and effectiveness, provided that those who are able invariably pay that tax rate; our current system would present a problem on the basis that there are vast array of ways to reduce tax liability that do not otherwise benefit the nation. While I like the idea of a flat tax, I have come to prefer the idea of a progressive tax with carefully chosen incentives to reduce liability (for instance, a reduced tax rate for businesses that educate their employees or who hire domestically for their operations; I also prefer this model for employee healthcare); there is more room for revenue preservation and incentives to cooperate in a progressive system.

On the other side of the issue appears to be arguments for and against anything that resembles socialization of medical services. I have heard and wealth of good arguments both ways and this thread does illustrate a couple of good basic ones. It is very true that there are a variety of socialized services in the US and a somewhat wider variety handled by the individual states; our standing military, law enforcement, fire protection, infrastructure maintenance, and host of other things are paid for by taxes levied from citizens. That reasoning would support a certain extent of subsidy for medical care, which is so exorbitantly expensive that 16.3% of the population (as of 2010) are not insured at all and even those that are insured are often burdened by massive medical debt. That said, our government has proven time and again that it is both inefficient and ineffective when managing any kind of program involving the private sector; that would suggest that having the government take control of the medical industry would not be much in the way of solution for medical expenses.

There are vast array of factors involved in the cost of medical care. I am certain that there are those would blame pharmaceutical patents almost exclusively for the problem. Likewise, I am certain that there are those who would blame the high cost of education, which often drives students away the necessary post-graduate study necessary to become doctors; still others would couple that expense with the risk of malpractice litigation as a deterrent to entering the field. There seems be an excellent argument for monopoly as a source of uncontrolled rises in cost. The bottom line is that medical care appears to be an incredibly complex issue that is unlikely to be resolved by any solution as simple as socialization or abandonment to the free market.

Why continue to beat the dead horse?

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Bloodsage + Bloodsage = 2Bloodsage:
Finally, as long as we're playing the logical fallacy game, it's a false choice to say we either tax people below the poverty line, or we rape "the rich." The top 1% of earners already pay 40% of all taxes. There's a lot of room in the middle for fairness in taxation.

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You're right, it's not fair; The top 1% of earners control 43% of the financial wealth of the country, so they should pay 43% of the taxes. The bottom 80% of earners control 7% of the financial wealth, so they should collectively pay 7% of the taxes.

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Bloodsage came out of the closet to say:
Actually, he did specifically say distribution of wealth was the problem. And the answer seems to be to punish success, but that's been tried in several places, and hasn't worked yet. Nor can it.

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It worked right here, in America. The top marginal tax rate used to be 90% -- and guess what, things worked out just fine. Under that tax rate, America became a world superpower, grew the largest and most affluent middle class in history, put a man on the moon, and kicked off the revolution known as the Information Age.

This is not "punishing success". This is paying back the very system that enabled them to be successful in the first place. This is enabling success for the working class.

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Bloodsage came out of the closet to say:
And I certainly don't see why successful people shouldn't make more than the average, even hundreds of times more. A better question would be why should the dude who just pulls the trigger on a rivet gun all day make anywhere near the same pay as someone with huge responsibility and whose decisions and judgment guide the entire corporation?

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You're setting up another strawman here. Nobody says an assemblyline worker should make near the same as a CEO. What we are saying is that the income differential has gone beyond reasonable.

In 1965, a CEO made 26 times as much as an average worker (and even after paying the 70% top marginal tax rate in 1965, still took home about 10 times as much as anyone else). Today, a CEO makes 500 times as much as an average worker. Tell me please, what incredible advances in CEO abilities have been made in the past 50 years that suddenly made them so much more valuable -- and is that worth their workers not being able to afford to take their children to a doctor?

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Check out the big brain on Bloodsage!
Actually, you can. You institute a flat tax, but still have a minimum earnings cutoff below which isn't taxed at all. Since everyone except the extremely poor pay exactly the same rate, it's by definition fair.

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Except that no one is willing to do that. I would agree that it's a fair means of taxation, but then you have the rich complaining that they spend so much more in taxes than "the common man". You also get them threatening to stop donating to charity and such since it's no longer going to benefit them.

More or less, we just need to shoot people in the face for being jerks. I'm sure that would help the overcrowding in some places at least.

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Bloodsage thought about the meaning of life:
Actually, he did specifically say distribution of wealth was the problem. And the answer seems to be to punish success, but that's been tried in several places, and hasn't worked yet. Nor can it.

And I certainly don't see why successful people shouldn't make more than the average, even hundreds of times more. A better question would be why should the dude who just pulls the trigger on a rivet gun all day make anywhere near the same pay as someone with huge responsibility and whose decisions and judgment guide the entire corporation? I've been both a technician and the guy responsible for running a small town, and there's no comparison in terms of difficulty or level of responsibility. Damn straight the guy in charge should make significantly more.

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The wealth distribution in this country is out of whack. I'm not sure how that can be argued, really. Some of it is simply the disparity in level of responsibility of the job, some of it is just lunacy.

The concept that someone can randomly be selected for a job, then do that job BADLY while still getting the massive salary for a few years and then retire/quit/be replaced and STILL get even more money to leave is kinda offensive. If I don't do my job I won't be around for a few years... it would take a couple of months, if that. I won't be getting a big bonus payout when I get let go from my position. The people at the top hold no responsibility to the people working under them. They have almost no loyalty either. They look at a few numbers, make a few decisions and hope that the board thinks they're doing a good job so they can keep doing the same thing over and over again. Very few of those decisions are made in the long-term interest of the company or employees, they're made to maximize profits right now and if it winds up hurting down the line, well that's probably going to wind up being someone else's bitch to fight so who cares?

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A sleep deprived Bloodsage stammered:
Actually, he did specifically say distribution of wealth was the problem. And the answer seems to be to punish success, but that's been tried in several places, and hasn't worked yet. Nor can it.

And I certainly don't see why successful people shouldn't make more than the average, even hundreds of times more. A better question would be why should the dude who just pulls the trigger on a rivet gun all day make anywhere near the same pay as someone with huge responsibility and whose decisions and judgment guide the entire corporation? I've been both a technician and the guy responsible for running a small town, and there's no comparison in terms of difficulty or level of responsibility. Damn straight the guy in charge should make significantly more.

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Punish success? Whose success is punished by progressive taxation? Someone who's wildly successful and makes $20M/yr, even with a 50% tax rate, is still making more than 100x what I make. That doesn't strike me as punishment. It strikes me as a reward earned through a job well done.

The rich paying higher tax rates can and has worked. We've had progressive taxation in the US for a very long time. We've been pretty successful. Progressive taxes are a common feature in advanced nations.

I agree with you on the point that the guy in charge should make significantly more. Management/administrative/executive roles are much harder than grunt roles, and should be rewarded accordingly. That doesn't mean we can't ask those executives to pay more for the things which run the society which made their success possible.

Things like roads, laws, and safety are obvious features of this society, but there are others. Namely, the people who make it possible. The people who work in their factories. The people who ship their goods. The people who sell their goods. The people who buy their goods. No breakthrough product would ever gain traction without people who have the money to buy it.

Progressive taxation keeps the customers buying your products.

It also makes them happier. This is a good thing because when it comes down to it, good government exists for the sake of its people. They have a better quality of life because they can afford your products. They're well fed. They have shelter. They have more financial stability. They're not worried about dying in the street if they get sick. They have safety because there's less crime and more political stability. They have upward mobility because of a good education, enough stability to take risks, and businesses which are hiring because those businesses have enough customers to warrant an increase in production.

Sounds like the makings of every advanced nation on Earth.

Taeldian fucked around with this message on 06-08-2012 at 01:40 AM.

But really, before we can change anything, the myth of America being a great meritocracy needs to die.

Hiring an employee who went to a public school.
Hiring an employee who's children go to a public school.
Using the roads and highways provided by the government.
Relying on the police to protect their business and home from theft, vandalism, and so on.
Relying on the courts to be there to enforce contracts if there is a breach.
And so on, and so on.

The reason people can succeed in America where they can't in Somalia is because the government is here to enforce the rule of law and provide base level services that can be relied upon. The people who are the most successful in our country reap more benefits from these systems than most people, and because of this should be expected to pay more.