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Subject: How I could become a libertarian rss

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My dad has been very ill for years. Recently, I was looking at different care for him for when he gets very debilitated. I found a small facility with 20 beds and very caring people. Cost is high but there is a special extra. Because they do not accept Medicare (rehab) and duh 20 beds, the state specially charges an extra 300 bucks a month for which the patient receives squat. Fuck Pennsylvania.
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R. Frazier
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First off I am very very sorry about your situation, however I do not think I am understanding what you're saying.

The state charges more to the patient because the state facility doesn't take medicare? I am just not wrapping my head around where the extra charge is coming from.
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Sorry to hear it. However, universal health care might help you more than libertarianism.
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Grand Admiral Thrawn
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I'm with Ryan, does the line-item explain what the charge is for?
 
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John So-And-So
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That goes directly to Obama, so he can funnel it to freedom-hating muslims.
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CapAp wrote:
That goes directly to Obama, so he can funnel it to freedom-hating muslims.


And Communists.
 
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rylfrazier wrote:
First off I am very very sorry about your situation, however I do not think I am understanding what you're saying.

The state charges more to the patient because the state facility doesn't take medicare? I am just not wrapping my head around where the extra charge is coming from.


Yes, that was sorta my point. I'm not grasping why they are charging this. Supposedly this is a charge to penalize the institution for not allowing some of their all of 20 beds to be used for government purposes. Maybe there's some charge they have for that they feel they need to recoup. Maybe they want more centers that provide care for out of hospital care? He's gone through this several times, where he is hospitialized on life support then needs 30 days of physical therapy where they put him in rehab. You need to have a facility that accepts patients for a temporary stay to provide care. They offer 100 days on Medicare, after which you are fucked if you don't either get better fast.

So yes, I understand they need more facilities that do that, but 20 beds, really? Let's definitely load it onto the patients paying $9000 a month. I mean, who will freaking notice another $300? Let's fuck with them more. That's what they get for having the parents that are really ill. Screw them!

I have no fucking idea other than screw you, PA!

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robigo wrote:
Sorry to hear it. However, universal health care might help you more than libertarianism.


So you imagine somehow I am for more than spending all of my earnings? I am not against the ACA but if you think it helps with long term care them you are very deluded. Go read the act. It does not do anything for people with advanced illnesses that need custodial care for many years.
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she2 wrote:
... I'm not grasping why they are charging this. ...

This is purely a guess. I could not be more ignorant about PA laws.

Remember the Medicare drug law Bush introduced? One of the things in it (as I recall) was that drug prices could not be negotiated--the price the drug company wanted was the price. By contrast, most of Medicare is the price the USG wants to pay, take it or leave it. Most places take it, but some places leave it because they don't feel they make enough money.

Some people, especially older people, have insurance or funds above (or besides) Medicare that can pay higher rates. But if institutions take only these patients, that means these higher-paying patients are not spread evenly across all institutions: some institutions are "cherry-picking" the most profitable patients, lowering the average rate level for other institutions.

My guess is that the fee is an attempt to level the field so cherry-picking doesn't hurt institutions who do not or cannot cherry-pick. (Obviously, if no one takes Medicare patients, those who only have Medicare get no medical care and die appallingly.)

(Please understand that this is a possible explanation, not an endorsement.)

Of course, you can look in nearby states and see if you can get a better result. As you may already know, hospitals usually have agents that can help you find places (I believe they get a fee from the place). Be aware that the places are going to try to sell you, pressing your buttons, even if (depending on your dad's condition) your dad wouldn't even notice their "feature".

I'm very sorry you and your dad are in this situation. From experience, while it's good to be prepared, don't borrow trouble (from the future). "Sufficient unto the day is the evil thereof." It is possible something unexpected will happen that you cannot plan for. Remember to take care of yourself; if you're not well, you can't help your dad.
 
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Jon Badolato
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Sorry to hear about your dad, I wish you well in this difficult time. Maybe I am obtuse but I am not understanding

My dad has been very ill for years. Recently, I was looking at different care for him for when he gets very debilitated. I found a small facility with 20 beds and very caring people. Cost is high but there is a special extra. Because they do not accept Medicare (rehab) and duh 20 beds, the state specially charges an extra 300 bucks a month for which the patient receives squat. Fuck Pennsylvania.

Does the state get that 300 dollars ? Just out of interest why are you choosing to use a facility that does not accept Medicare ? Most people in this type of situation would choose a facility that accepts Medicare knowing that end of life costs can be quite large.

Libertarianism isn't your solution. In fact, it isn't anyone's solution to anything.
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Boaty McBoatface
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rylfrazier wrote:
First off I am very very sorry about your situation, however I do not think I am understanding what you're saying.

The state charges more to the patient because the state facility doesn't take medicare? I am just not wrapping my head around where the extra charge is coming from.
Covering the loss they get from not taking Medicare?
 
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It is a shitty thing to have to go through definitely. It sounds like a privately run business doesn't want to take medicare, so has to pay a fine for not complying and they are passing that fine directly along to any customers they get. There's no way to make them not without fixing prices, there's no way to forcecthem to comply under current laws, and not levying afine provides zero disincentivee for non-compliance. It sounds like capitalism at it's (not) finest.
 
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Shadrach wrote:
It is a shitty thing to have to go through definitely. It sounds like a privately run business doesn't want to take medicare, so has to pay a fine for not complying and they are passing that fine directly along to any customers they get. There's no way to make them not without fixing prices, there's no way to forcecthem to comply under current laws, and not levying afine provides zero disincentivee for non-compliance. It sounds like capitalism at it's (not) finest.



I agree it's a tough situation and she has my empathy and sympathy.

But as usual, you are consistent in completely failing to understand even the most basic of things. Creating laws and then using government force or controls to attempt to get them enforced and ending up causing situations where a business passes the burden of the law and it's cost of enforcement onto the potential client is not capitalism at it's best, worst or in any running order. Your inability to comprehend that what this lady is running into are the unintended consequences of excess regulation and burdensome government is part of what I enjoy about reading your posts... it reminds me of why I made an extra special effort to not remain dull and uninformed.

Having money to purchase end-of-life care is always the key to a positive finish to life. Not having enough money to purchase the best care and being forced to accept less is a feature of all societies and all political ideologies. It's not capitalism or socialism or any -ism at work here, it's resources versus demand.

My mom did not get the absolute best in end-of-life care but because she made good money and purchased good insurance and made wise decisions she was able to afford decent care despite the ocean of laws, regulations, enforcers and rules for dying. It's really not so much about free insurance or socialized medicine as it is about understanding what may happen and paying for that eventuality beforehand. If you cannot afford it, then you get less. That is worth fixing in my view but we won't fix it as a nation by creating even more laws and regulations and penalties to complement them.

Clearly Sue understands enough about the concept of libertarians to get that mostly they stand for less regulation, not more... particularly where regulations, laws and penalties end up punishing the supposed class they exist to protect. That's a feature of centralized government, not capitalism.

Good luck to the OP and her dad.
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she2 wrote:
So yes, I understand they need more facilities that do that, but 20 beds, really?


The reason the law applies to all facilities regardless of size is that if you don't include that type of provision a business will take the obvious approach and just create a bunch of facilities that have N-1 beds (where N is the limit beyond which the special rules apply). Due to the way our legal system works, it is very likely this could be made to work within a single facility by leasing rooms to different corporations which through some off short tax haven holding company actually all belong to the same owner.

The government could then respond to how businesses structure themselves to get around the law by writing more and more laws to fix each loophole as businesses figure out how to use them. It turns into a cat and mouse game and the only people that benefit are the lawyers. That is exactly how we end up with 1000s of pages of laws for something which could have been dealt with in much more straightforward way, even if it does harm a few businesses.

This law sounds like the right solution to me. There isn't any way around it. If you don't serve Medicare patients we will fine you $300. Exactly the way that laws should be written. No thresholds, no exceptions, easy to understand. The only problem is that apparently the fine isn't high enough since this facility still refuses to take a lower profit by serving Medicare patients. That is what is so great about this type of law, you just keep raising the fine until businesses do what you want.

[edit] Also, I would bet you that the amount Medicare pays for this type of service would be profitable for the company. It just isn't profitable enough so they refuse to do it. A capitalist might argue that the business should be able to charge whatever it wants, but amazingly enough a capitalist seems to have no issue with a business using its power and money to influence the government to pass laws which protect the business from competition.

It is a balancing act and we do need laws to keep capitalism in check, but when you have laws and affect businesses that incentivises businesses to try to influence government. It is then up to the people to make sure to keep the businesses in check but unfortunately that doesn't seem to be happening in current times and businesses have used their influence over government to grab a larger share of power and money than is good for society in general.
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sfox wrote:


This law sounds like the right solution to me. There isn't any way around it. If you don't serve Medicare patients we will fine you $300. Exactly the way that laws should be written. No thresholds, no exceptions, easy to understand. The only problem is that apparently the fine isn't high enough since this facility still refuses to take a lower profit by serving Medicare patients. That is what is so great about this type of law, you just keep raising the fine until businesses do what you want.

[edit] Also, I would bet you that the amount Medicare pays for this type of service would be profitable for the company. It just isn't profitable enough so they refuse to do it. A capitalist might argue that the business should be able to charge whatever it wants, but amazingly enough a capitalist seems to have no issue with a business using its power and money to influence the government to pass laws which protect the business from competition.


Conversely, I would make the argument that Medicare may be so inefficient for this service that this facility is willing to pay $300 per patient to avoid it and still it manages to stay in business. Raising the fine only helps us determine just how inefficient it really is, just as raising the punishment for someone that refuses to eat a poop sandwich tells us how bad the sandwich really is. If it were profitable they would freely accept it, no?
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spookyblast wrote:

Conversely, I would make the argument that Medicare may be so inefficient for this service that this facility is willing to pay $300 per patient to avoid it and still it manages to stay in business. Raising the fine only helps us determine just how inefficient it really is, just as raising the punishment for someone that refuses to eat a poop sandwich tells us how bad the sandwich really is. If it were profitable they would freely accept it, no?


No, your argument doesn't even make sense. What do you even mean by 'inefficient'? Private insurance companies use the same billing codes and similar forms as Medicare does. The paperwork is basically identical. The only difference is that private insurance pays more for the service than Medicare does. Also private health insurance will cover some procedures that Medicare does not. That doesn't mean that what Medicare pays isn't profitable, it just means that private insurance is more profitable. If a business can only serve a limited number of customers and it can fill all its beds by serving the most profitable (non Medicare) patients, that is the choice it is going to make.

Private insurance companies can pay more for the same service because they can just jack up the prices of the insurance. Medicare can't pay more because it is very hard for the government to raise taxes. That isn't even mentioning the 'Walmart effect' since Medicare provides insurance for a very high percentage of the elderly. In most cases if you want to stay in business you have to take whatever Medicare is willing to pay you. Doctors who take Medicare are still making substantial profits, just not as much profit as they would like. Doctors bitch and moan about it, but most of them are still making close to $200k per year.

I'm not trying to argue for a single payer system as I do not believe it is the best long term solution. If you try to argue that we should provide health care in the most efficient way, however, a single payer system is way more efficient than private health insurance no matter how you try to compare them.
 
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Jon Badolato
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Quote:
If it were profitable they would freely accept it, no?


Not necessarily. The reason why this facility likely has only twenty beds is that they do not accept Medicare. If it had many more than that many of those beds would go unfilled. Only people who can afford the high end of life costs on their own are likely to choose a facility that does not accept Medicare. Most fees can be transferred to patients, most of whom could probably afford the care there because they have opted for this facility over one that takes Medicare. Most people who could afford to be in this type of facility and pay for it without government assistance are not likely to quibble about an extra three hundred dollars tacked onto the bill to be able to get the perceived better service they prefer or feel the facility can give them.
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Josh
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[q="DWTripp"]
But as usual, you are consistent in completely failing to understand even the most basic of things. Creating laws and then using government force or controls to attempt to get them enforced and ending up causing situations where a business passes the burden of the law and it's cost of enforcement onto the potential client is not capitalism at it's best, worst or in any running order.
/q]

Capitalism is the part where the business is allowed to ignore the government's regulations and pass the cost off onto the consumer. Regs/no Regs isn't more or less capitalism. Less Capitalism would be not allowing the business to pass the fine on, or not offering the business the option to pay a fine to refuse to comply.

The rest of your post basically backs me up. If you want a bed at a place that won't let medicare riffraff in, then you have to pay a premium in this case $300. So if you have more money you get to buy the 'better' healthcare. Maybe you find a cheaper facility further away, but then you need to factor in travel expenses, and lack of time with the loved one, which all has its own inherent value and the more money you have the more you can adjust these things to your whim. Rich? Buy a house in another state, work 3-4 days a week and spend the rest in the other state with the elder loved one, or just uproot your family and get a new job someplace else because your are wealthy-mobile. If you're not rich enough to do that, then you're not.

That is a very curt and heartless way to look at it, but it is exactly what you just described. More money=more options.

Sue is in the same situation a lot of us here(from what I can gather)will be in. I'll be in it with my mom I'm sure, and provided there's still anything left by the time I get old I'll be in it myself. We have enough money to actually be able to afford decent care, however the penalties/regs meant to insure that the actual poor get bare bones care hit us harder than the actual wealthy because we aren't wealthy, so we end up with fewer choices than we would have had without the safety net. There are a lot of ways to make the whole thing more equitable, but no one wants to talk about those anyway so let's just blame the government and medicare.

One thing I can agree on though is Fuck PA. I've lived here most of my life and, fuck PA. Corbett especially. With a rusty chainsaw. Sideways.
 
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sfox wrote:
spookyblast wrote:

Conversely, I would make the argument that Medicare may be so inefficient for this service that this facility is willing to pay $300 per patient to avoid it and still it manages to stay in business. Raising the fine only helps us determine just how inefficient it really is, just as raising the punishment for someone that refuses to eat a poop sandwich tells us how bad the sandwich really is. If it were profitable they would freely accept it, no?


No, your argument doesn't even make sense. What do you even mean by 'inefficient'? Private insurance companies use the same billing codes and similar forms as Medicare does. The paperwork is basically identical. The only difference is that private insurance pays more for the service than Medicare does. Also private health insurance will cover some procedures that Medicare does not. That doesn't mean that what Medicare pays isn't profitable, it just means that private insurance is more profitable. If a business can only serve a limited number of customers and it can fill all its beds by serving the most profitable (non Medicare) patients, that is the choice it is going to make.

Private insurance companies can pay more for the same service because they can just jack up the prices of the insurance. Medicare can't pay more because it is very hard for the government to raise taxes. That isn't even mentioning the 'Walmart effect' since Medicare provides insurance for a very high percentage of the elderly. In most cases if you want to stay in business you have to take whatever Medicare is willing to pay you. Doctors who take Medicare are still making substantial profits, just not as much profit as they would like. Doctors bitch and moan about it, but most of them are still making close to $200k per year.

I'm not trying to argue for a single payer system as I do not believe it is the best long term solution. If you try to argue that we should provide health care in the most efficient way, however, a single payer system is way more efficient than private health insurance no matter how you try to compare them.


I won’t opine on the exact details of how Medicare might compare with private insurance in terms of efficiency or cost for every service because neither of us have the means to make that determination. I’m only pointing to the behavior of this facility. If it is as you say, “the amount Medicare pays for this type of service would be profitable for the company,” then one wonders why the facility is dodging it at a loss of $300. Is it a personal aversion? Or do they perhaps have a better grasp of the needs of their customers, the value of their service, and the best means for administering it than either you or I do?
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spookyblast wrote:
sfox wrote:
spookyblast wrote:

Conversely, I would make the argument that Medicare may be so inefficient for this service that this facility is willing to pay $300 per patient to avoid it and still it manages to stay in business. Raising the fine only helps us determine just how inefficient it really is, just as raising the punishment for someone that refuses to eat a poop sandwich tells us how bad the sandwich really is. If it were profitable they would freely accept it, no?


No, your argument doesn't even make sense. What do you even mean by 'inefficient'? Private insurance companies use the same billing codes and similar forms as Medicare does. The paperwork is basically identical. The only difference is that private insurance pays more for the service than Medicare does. Also private health insurance will cover some procedures that Medicare does not. That doesn't mean that what Medicare pays isn't profitable, it just means that private insurance is more profitable. If a business can only serve a limited number of customers and it can fill all its beds by serving the most profitable (non Medicare) patients, that is the choice it is going to make.

Private insurance companies can pay more for the same service because they can just jack up the prices of the insurance. Medicare can't pay more because it is very hard for the government to raise taxes. That isn't even mentioning the 'Walmart effect' since Medicare provides insurance for a very high percentage of the elderly. In most cases if you want to stay in business you have to take whatever Medicare is willing to pay you. Doctors who take Medicare are still making substantial profits, just not as much profit as they would like. Doctors bitch and moan about it, but most of them are still making close to $200k per year.

I'm not trying to argue for a single payer system as I do not believe it is the best long term solution. If you try to argue that we should provide health care in the most efficient way, however, a single payer system is way more efficient than private health insurance no matter how you try to compare them.


I won’t opine on the exact details of how Medicare might compare with private insurance in terms of efficiency or cost for every service because neither of us have the means to make that determination. I’m only pointing to the behavior of this facility. If it is as you say, “the amount Medicare pays for this type of service would be profitable for the company,” then one wonders why the facility is dodging it at a loss of $300. Is it a personal aversion? Or do they perhaps have a better grasp of the needs of their customers, the value of their service, and the best means for administering it than either you or I do?


I can field this one.

It isn't actually a loss you see. They pass the $300 onto their customers. As long as they can fill the beds at the increased rate, it is zero loss.It only becomes a loss when by not taking medicare they fill so few beds that it would be more profitable overall to operate by taking medicare and filling all the beds. So, it comes down to profit margin. These are made up numbers but illustrate the example. If I can fill 2 beds out of 10 at 1000% profit, then it behooves me to do so rather than to fill 10 beds at 100% profit. Transparency would alter this dynamic considerably for the healthcare industry.
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Stephen Rost
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jonb wrote:
Quote:
If it were profitable they would freely accept it, no?


...Most people who could afford to be in this type of facility and pay for it without government assistance are not likely to quibble about an extra three hundred dollars tacked onto the bill to be able to get the perceived better service they prefer or feel the facility can give them.


What? So Sue is being unrealistic here? For choosing such an "elitist" service--the best care she sees for her ailing father--she should be ashamed to quibble over an additional $300/month that goes directly to the government?
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Shadrach wrote:



Capitalism is the part where the business is allowed to ignore the government's regulations and pass the cost off onto the consumer. Regs/no Regs isn't more or less capitalism. Less Capitalism would be not allowing the business to pass the fine on, or not offering the business the option to pay a fine to refuse to comply.



Wow. You really have managed to remain uninformed. Have you ever even bothered to look up the word capitalism in the dictionary? Seriously man, it simply means that "things" (the parts of an economy) are primarily owned by people, not the government.

Which has nothing even remotely to do with this issue. This is a problem created by government to attempt to fix an issue that was created by earlier iterations of governments. Capitalism doesn't fine people or businesses, order them to do business only within certain guidelines under threat of punishment or in any way regulate business. Government does that. Well, too much intervention caused this problem.

The solution? I'm not sure what it'll take to fix this problem but I am sure what will not fix it - more of the same regulation and penalties.
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Boaty McBoatface
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DWTripp wrote:
Shadrach wrote:



Capitalism is the part where the business is allowed to ignore the government's regulations and pass the cost off onto the consumer. Regs/no Regs isn't more or less capitalism. Less Capitalism would be not allowing the business to pass the fine on, or not offering the business the option to pay a fine to refuse to comply.



Wow. You really have managed to remain uninformed. Have you ever even bothered to look up the word capitalism in the dictionary? Seriously man, it simply means that "things" (the parts of an economy) are primarily owned by people, not the government.

Which has nothing even remotely to do with this issue. This is a problem created by government to attempt to fix an issue that was created by earlier iterations of governments. Capitalism doesn't fine people or businesses, order them to do business only within certain guidelines under threat of punishment or in any way regulate business. Government does that. Well, too much intervention caused this problem.

The solution? I'm not sure what it'll take to fix this problem but I am sure what will not fix it - more of the same regulation and penalties.

cap·i·tal·ism
[kap-i-tl-iz-uhm]
noun
an economic system in which investment in and ownership of the means of production, distribution, and exchange of wealth is made and maintained chiefly by private individuals or corporations, especially as contrasted to cooperatively or state-owned means of wealth.

However things like cartels do in fact act in a way that restricts or others wise damages free markets, whilst not being governmental (and being capitalist). Of course is a truly libertarian society the fruits of your intellectual effort would have no legal protection.
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William Boykin
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Contrary to the uninformed opinions of several posters in this thread-

Not all libertarians are Randians. In fact, Rand herself wasn't a big fan of Libertarianism at all.

Quote:
AR: All kinds of people today call themselves “libertarians,” especially something calling itself the New Right, which consists of hippies who are anarchists instead of leftist collectivists; but anarchists are collectivists. Capitalism is the one system that requires absolute objective law, yet libertarians combine capitalism and anarchism. That’s worse than anything the New Left has proposed. It’s a mockery of philosophy and ideology. They sling slogans and try to ride on two bandwagons. They want to be hippies, but don’t want to preach collectivism because those jobs are already taken. But anarchism is a logical outgrowth of the anti-intellectual side of collectivism. I could deal with a Marxist with a greater chance of reaching some kind of understanding, and with much greater respect. Anarchists are the scum of the intellectual world of the Left, which has given them up. So the Right picks up another leftist discard. That’s the libertarian movement. [FHF 71]


http://www.aynrand.org/site/PageServer?pagename=ar_libertari...

More to the point-
Not all Randians are necessarily like this guy, who argues that the 99% should 'give back' to the 1%.

http://www.forbes.com/sites/harrybinswanger/2013/09/17/give-...

There are several Objectivists who are actually politically quite liberal, like this woman- [screwed that up the first time round-Dar].

Quote:
Ayn Rand was also militantly in favor of individual liberty. She supported a woman’s right to birth control, abortion, work, the vote, etc. She most likely would have thought the debate over gay marriage was ridiculous – they’re people, therefore they should have the same rights as every other person. While her most famous quote might be, “I swear by my life, and my love of it, that I will never live for the sake of another man, nor ask another man to live for mine.” She also said, “Individual rights are not subject to a public vote; a majority has no right to vote away the rights of a minority; the political function of rights is precisely to protect minorities from oppression by majorities (and the smallest minority on earth is the individual). Those who deny individual rights cannot claim to be defenders of minorities.” Ayn Rand’s philosophy lines up with the liberal cause of social liberty and justice for all.


"A Liberal's Defense of Ayn Rand", by Bree Ervin.

http://thinkbannedthoughts.wordpress.com/2012/11/09/a-libera...

I know that many of you out there want to paint all Libertarians to be as nutty as Alex Jones, and all Objectivists as complete and utter assholes like Harry Binswager, but the reality is that its a lot more complicated and interesting than that.

Personally, (and I'll admit I'm somewhat of a heretic here amongst my Libertarian friends in Austin), I think that Libertarianism is a specific subset of Liberalism in general. It is not opposed to Liberalism; rather, Libertarians want liberals to understand and respect that in their pursuit of Equality, there can always be a risk of a tradeoff of personal liberty. In this regard, they can be a useful corrective.

My personal beef with Rand is that she doesn't understand Kant- she mistakes the Critique of Pure Reason as trying to replace science and 'reason' with 'mystical' Metaphysics, when in fact, Kant was trying to create better grounds for empiricism without running aground on the limits of Inductive Reason which Hume had pointed out in his famous essay "The Problem with Induction". If anything, Kant was the enemy of 'mysticism' in Metaphysics, because he destroyed the concept of being able to have knowledge of the world "in its itself" separate from sensory experience, and thereby ties metaphysics directly with what Rand would call 'Objective Reality', the very basis of her thinking. George Berkeley he is not.

This mistake over the nature of Kant's work has the unfortunate side effect of Rand dismissing Kant's ethical theory in the Critique of Practical Reasoning, which I think would have been an extremely useful base for her own attempt to provide an ethical basis for Capitalism.

All of this is a shame, because Rand is unique in her desire to show that Capitalism isn't 'a necessary evil', or even 'morally neutral', but in fact 'ethically good'. As such, her voice is an interesting and important one to consider, even if one disagrees.

Darilian


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Stephen Rost
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Shadrach wrote:
spookyblast wrote:


I won’t opine on the exact details of how Medicare might compare with private insurance in terms of efficiency or cost for every service because neither of us have the means to make that determination. I’m only pointing to the behavior of this facility. If it is as you say, “the amount Medicare pays for this type of service would be profitable for the company,” then one wonders why the facility is dodging it at a loss of $300. Is it a personal aversion? Or do they perhaps have a better grasp of the needs of their customers, the value of their service, and the best means for administering it than either you or I do?


I can field this one.

It isn't actually a loss you see. They pass the $300 onto their customers. As long as they can fill the beds at the increased rate, it is zero loss.It only becomes a loss when by not taking medicare they fill so few beds that it would be more profitable overall to operate by taking medicare and filling all the beds. So, it comes down to profit margin. These are made up numbers but illustrate the example. If I can fill 2 beds out of 10 at 1000% profit, then it behooves me to do so rather than to fill 10 beds at 100% profit. Transparency would alter this dynamic considerably for the healthcare industry.


So I’m trying to follow this argument. You have a lemonade stand and I threaten a 10¢ fine on each glass you sell if you don’t adhere to my standards. Suppose it costs you 11¢ to get in compliance. So you decide to eat the fine and charge 60¢ instead of 50¢ per glass. You say this fine isn’t really a loss though because it’s transferred to the customer and you’re still selling lemonade at this increased rate. It’s obvious however that as my fine increases you’re going to sell less lemonade, or at the very least you will need to water it down to stay in the black.

But in the absence of my fine, couldn’t you charge only 5¢ more and actually provide better service? This is where the loss is manifested, it’s an imposed cost that provides no additional service for the customer. It really doesn't matter at what threshold I set the number of glasses (beds) that you can sell and be in compliance--the fine is a net loss for the two parties involved or else you would have gladly chosen to get in compliance without the threat of a fine.
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