Health care - administrative incompetence

[Vorticity]

And those exceptions would be?

Military personal, students with high scholastic ability, some select industries.

Hey, you know, I think I've seen this episode!

"YOU ARE OBSOLETE!"

"RUN, RUNNER!"

 

[TFian]

Lol wut?

 

[Wildy]

Lol wut?

The first picture is from the The Twilight Zone episode "The Obsolete Man" where being "obsolete" is a capital punishment. Wordsworth, the bloke in the foreground is tried and found guilty of being obsolete because his job as a librarian has become obsolete because of government policies.

The second picture is from the film Logan's Run. Basically the city where he lives has a life expectancy of 30 years. They have it because they kill everyone on their 30^th birthdays under the guise of being "renewed" at Carousel. Logan 5, the man in the picture, is a sandman. His job is to kill "runners", those who decide to try and flee the city and live instead of going to Carousel. How they know that people have reached their 30^th birthday is determined by a crystal that is implanted into their hands at birth. When that crystal starts flashing your time is up.

It's got to do with this section of the discussion:

I object to being forced to pay for people who can't pay themselves, yes. There are some exceptions I'd make to this, however it most certainly would not be for the elderly.

And those exceptions would be?

Military personal, students with high scholastic ability, some select industries.

Basically your exceptions would create such a situation. If those "select industries" were unselected or a student started to fail or a soldier had to leave the army then they would lose their benefits and become obsolete.

 

[MatildaGage]

True, but we don't have the money for everyone to be treated with the less expensive treatments either.

That would be less of an issue if we had a more rigorous prevention approach. Many expensive diseases can be prevented if we are willing to change laws, change human behavior, and have across-the-board preventative medicine covered at 100%. There are many creative ways to save money and prevent disease. Too bad many people don't want to hear that. They'd rather treat the disease after it develops, or refuse to pay for those who are struck with it.

Cost-saving analysis of screening colonoscopy

Economic analysis of a school-based obesity prevention program

Smoking Prevention Campaign Saving Billions In Smoking-Related Care

Pregnancy-Related Benefits and Cost Savings from Raising Cigarette Taxes

The Battle Over Taxing Soda

Widespread airbag use could result in dramatic cost savings for US trauma centers

 

[TFian]

Basically your exceptions would create such a situation. If those "select industries" were unselected or a student started to fail or a soldier had to leave the army then they would lose their benefits and become obsolete.

Not really. I never advocated capital punishment for unproductive citizens. I do think however we should withdrawal all support for unproductive citizens or otherwise invalid and let them fend for themselves.

 

[Wildy]

Not really. I never advocated capital punishment for unproductive citizens.

The point doesn't really have anything to do with killing the unproductive citizens. That part is more hyperbole than anything.

I do think however we should withdrawal all support for unproductive citizens or otherwise invalid and let them fend for themselves.

What do you consider an unproductive citizen to be? Am I correct in the assumption that "invalid" is a person with a disability rather then just a sick person? Are these two categories mutually exclusive?

If someone was in one of the exception categories and became invalid should that person lose any support they would have received?

What would happen to a sick person in a "selected industry" if their industry became unselected?

 

[TFian]

What do you consider an unproductive citizen to be?

One that does not productively contribute back to society as a whole. Of course what counts as productive changes with time, so there should be some sort of peer review as to what constitutes a productive citizen held at generational intervals.

Am I correct in the assumption that "invalid" is a person with a disability rather then just a sick person? Are these two categories mutually exclusive?

Yes and no. Depends on what type of illness. Are we talking a cold, or end stage bowel cancer? If the illness causes one to become disabled, yes, they are invalid. If they can no longer productively work or otherwise contribute, they should be revoked of any support system provided by the state. Communities may support them if they wish, but my guess is once it becomes too expensive they'd learn the wisdom of cutting them off the teat. I'd support state funding for euthanasia options for the disabled as well, as long as it remained strictly optional.

If someone was in one of the exception categories and became invalid should that person lose any support they would have received?

Yes of course. Unless they can find work in a new industry, or otherwise another category.

What would happen to a sick person in a "selected industry" if their industry became unselected?

Depends again on what you mean by "sick". Are we talking a terminal or otherwise debilitating disease? If so, I'd imagine one of the following would happen.

A.) He/she would transfer to another selected industry

B.) He(she)'d would now have to pay for their own health insurance, and get treatment through that.

C.) Die or otherwise become disabled, and probably die after that from starvation or otherwise other ailment.

 

[Wildy]

One that does not productively contribute back to society as a whole. Of course what counts as productive changes with time, so there should be some sort of peer review as to what constitutes a productive citizen held at generational intervals.

Like the trial in "The Obsolete Man"?

What do you think counts as a productive contribution to society?

If they can no longer productively work or otherwise contribute, they should be revoked of any support system provided by the state.

So in other words the support system provided by the state supports you until the time you really need it?

Communities may support them if they wish, but my guess is once it becomes too expensive they'd learn the wisdom of cutting them off the teat.

Which happens in all systems. Even UHC systems have a cut off point, the only difference is that it's not "when you get a serious illness".

Yes of course. Unless they can find work in a new industry, or otherwise another category.

And if their only choice is in one of the "unselected industries"?

Depends again on what you mean by "sick". Are we talking a terminal or otherwise debilitating disease? If so, I'd imagine one of the following would happen.

Yep, a terminal or debilitating disease. Then again the way you've phrased it I think they would have already lost their benefits.

A.) He/she would transfer to another selected industry

And if they don't have the qualifications to enter that selected industry?

B.) He(she)'d would now have to pay for their own health insurance, and get treatment through that.

And what chance would that person have of getting health insurance? The insurance company can already see that this person will cost them money so they have no incentive to insure them.

C.) Die or otherwise become disabled, and probably die after that from starvation or otherwise other ailment.

So this is basically a Morton's fork where their decisions would result in this answer anyway.

 

[TFian]

Like the trial in "The Obsolete Man"?

No not at all, it wouldn't be done on an individual basis, but a peer review of all industries and occupations. It would determine for example, if occupations could be automated or otherwise can be rendered obsolete by more efficient humans or machines. It's funny "The Obsolete Man" picked a librarian, because librarians are pretty much obsolete now that we have the World Wide Web and advanced information technology.

What do you think counts as a productive contribution to society?

Ones who can positively contribute to necessary functions of society, and national security.

So in other words the support system provided by the state supports you until the time you really need it?

Depends on how you define "support system". Are you defining it as a "social safety net"? If so, there would be nothing of the sort. There would be a support system for select industries, which would generally be ones required for national security to fight our enemies (domestic & aboard). I think such industries that are critical to our survival should be protected, however if workers can no longer contribute in such industries, you are invalid, and are no longer relevant to the goals of national security.

Which happens in all systems. Even UHC systems have a cut off point, the only difference is that it's not "when you get a serious illness".

Most people wouldn't be getting any support at all, with some exceptions as I've outlined before.

And if their only choice is in one of the "unselected industries"?

Then they must contend with that industries private insurance plans.

Yep, a terminal or debilitating disease. Then again the way you've phrased it I think they would have already lost their benefits.

If they are truly invalid, then yes, no benefits.

And if they don't have the qualifications to enter that selected industry?

Depends. Are you young, and able to afford the time and money retraining? Then you can retain in a selected industry, or work in an unselected industry and contend with their own health insurance options. If you are old however, and can no longer retrain, and no one will hire you, you have become obsolete, and can no longer be productive. They should be offered humane euthanasia.

And what chance would that person have of getting health insurance? The insurance company can already see that this person will cost them money so they have no incentive to insure them.

Most states ban group insurance plans from discriminating against pre existing conditions, so they could go to a group plan. If not, then their luck simply ran out. Sucks to be them I suppose.

So this is basically a Morton's fork where their decisions would result in this answer anyway.

Only if they are invalid and an otherwise burden without contributing anything.

 

[Architect]

Wildy

It would appear that Vorticity hit it the head right on the nail.

Arch.

 

[TFian]

Wildy

It would appear that Vorticity hit it the head right on the nail.

Arch.

Not really, no one is executed here (unless they commit violent capital offenses) or under what I'm saying. They are free to participate in the marketplace, just like everyone else. Hardly dystopian.

 

[Ivor the Engineer]

TFian,

Did your mother or father think along similar lines to you? Do you have any siblings who agree with your point of view? How many members of your family hold similar views to those you have expressed on how the human race should organise itself?

What will happen to people who are obviously unable to compete in the market because they are physically or mentally handicapped?

 

[3point14]

In TFian's world without compassion, would we stll have had the wisdome of Stephen Hawking? Or would he have been cut off long before he was 'useful'.

I'd also like to see a more detailed definition of:

"Ones who can positively contribute to necessary functions of society, and national security"

as this is very vague.

 

[Wildy]

No not at all, it wouldn't be done on an individual basis, but a peer review of all industries and occupations. It would determine for example, if occupations could be automated or otherwise can be rendered obsolete by more efficient humans or machines.

So a mass trial then.

It's funny "The Obsolete Man" picked a librarian, because librarians are pretty much obsolete now that we have the World Wide Web and advanced information technology.

There is still a lot of information that is either unavailable on the internet or hidden behind paywalls. Until there is a time when both of those things are dealt with then there will still be a need for libraries and librarians.

Ones who can positively contribute to necessary functions of society, and national security.

I was hoping for a more descriptive example rather then you just repeating yourself.

Depends on how you define "support system". Are you defining it as a "social safety net"? If so, there would be nothing of the sort. There would be a support system for select industries, which would generally be ones required for national security to fight our enemies (domestic & aboard).

Perhaps you should tell me what you meant by a "support system" for selected industries. I would have thought that such a system would be a kind of safety net, but apparently that isn't the case.

I think such industries that are critical to our survival should be protected, however if workers can no longer contribute in such industries, you are invalid, and are no longer relevant to the goals of national security.

So why bother helping those in selected industries then? By the sounds of it the only difference between someone in a selected industry and an unselected industry is that the person in a selected industry is given the impression of having a support system.

Most people wouldn't be getting any support at all, with some exceptions as I've outlined before.

And even then there are exceptions to those exceptions.

Then they must contend with that industries private insurance plans.

Which they have no chance of getting because they are, as you put it, invalid.

Depends. Are you young, and able to afford the time and money retraining? Then you can retain in a selected industry, or work in an unselected industry and contend with their own health insurance options.

I guess it would suck if you can't afford the time and/or money to retrain then.

If you are old however, and can no longer retrain, and no one will hire you, you have become obsolete, and can no longer be productive. They should be offered humane euthanasia.

You know I think Architect is correct. Vorticity did hit the nail on the head with those pictures.

The only difference between this comment and "The Obsolete Man" or Logan's Run is that you have the gall to imply that they have a choice between human euthanasia and death even though you know that they will probably starve on the streets if they have not saved enough money to pay for their healthcare. You might as well just kill people who don't have $x in the bank account when they reach the retirement age.

Most states ban group insurance plans from discriminating against pre existing conditions, so they could go to a group plan. If not, then their luck simply ran out. Sucks to be them I suppose.

That may be the case. But wouldn't you assume that unselected industries would just take plans that are similar to the benefits of being in a selected industry and just drop the person the moment after they are accepted to the group plan?

Only if they are invalid and an otherwise burden without contributing anything.

So that's a yes then.

 

[TFian]

Did your mother or father think along similar lines to you?

Did? They're dead now? No but seriously..., I honestly doubt it.

Do you have any siblings who agree with your point of view? How many members of your family hold similar views to those you have expressed on how the human race should organise itself?

As far as I know, none of them do. I'm pretty sure my family wouldn't like the views I express. Why do you ask if I may..err ask?

What will happen to people who are obviously unable to compete in the market because they are physically or mentally handicapped?

If their family can't support them, I'm assuming they'd generally die.

 

[Ivor the Engineer]

<snip>

As far as I know, none of them do. I'm pretty sure my family wouldn't like the views I express. Why do you ask if I may..err ask?

<snip>

Just curious where you got such an unusual point of view from.

Have you always felt this way about other people, or was there a moment in your life when you changed?

 

[TFian]

So a mass trial then.

Not really. More like guidelines for private industry and the state to follow, so they can cut waste and obsolesce.

There is still a lot of information that is either unavailable on the internet or hidden behind paywalls. Until there is a time when both of those things are dealt with then there will still be a need for libraries and librarians.

Like what, if I may ask? Examples? It seems we can do the entire role of a library digitally now. The role of a librarian really is obsolete in our society now, and one who can only be a librarian is obsolete themselves.

I was hoping for a more descriptive example rather then you just repeating yourself.

In what way do I need to be more descriptive? What don't you understand? I'm happy to explain myself...

Perhaps you should tell me what you meant by a "support system" for selected industries. I would have thought that such a system would be a kind of safety net, but apparently that isn't the case.

It wouldn't be a safety net for the workers, but a safety net for the industries I suppose, if you want to use that term. Some industries (like weapons research and construction) are important to our survival as a nation, and in which case, the government should support them and make sure they don't go bankrupt, and that their relevant workers can remain healthy and productive. Once that industry becomes obsolete, the workers do as well, if they can not join a relevant industry or work in the private sector.

So why bother helping those in selected industries then? By the sounds of it the only difference between someone in a selected industry and an unselected industry is that the person in a selected industry is given the impression of having a support system.

Because some things are critical to our nations survival. We have many enemies (aboard and domestic) that we must fight.

Which they have no chance of getting because they are, as you put it, invalid.

If you are defective (born without any productive ability) invalid (once productive but now otherwise rendered unproductive) or obsolete (your once productive role in society is no longer necessary) you shouldn't be afforded an expensive safety net.

I guess it would suck if you can't afford the time and/or money to retrain then.

Indeed, I'd hope they'd be able to accept their fate with grace. But of course not all will, but society has methods of dealing with such people.

The only difference between this comment and "The Obsolete Man" or Logan's Run is that you have the gall to imply that they have a choice between human euthanasia and death even though you know that they will probably starve on the streets if they have not saved enough money to pay for their healthcare. You might as well just kill people who don't have $x in the bank account when they reach the retirement age.

They do have a choice. They can either try to compete in the private marketplace, have themselves humanly put down, or beg on the streets and live off people's charity. Or if their family can afford to keep them around, that as well.

That may be the case. But wouldn't you assume that unselected industries would just take plans that are similar to the benefits of being in a selected industry and just drop the person the moment after they are accepted to the group plan?

I'm not sure what you're asking here. Group plans here generally can't discriminate against the ill.

 

[TFian]

Just curious where you got such an unusual point of view from.

A combination of reading specific literary works, some influential people in my life, and changing mindsets.

Have you always felt this way about other people, or was there a moment in your life when you changed?

No, I haven't. My mindset & views have changed a lot over the past few years.

 

[Wildy]

Not really. More like guidelines for private industry and the state to follow, so they can cut waste and obsolesce.

So who would determine these guidelines.

Like what, if I may ask? Examples? It seems we can do the entire role of a library digitally now. The role of a librarian really is obsolete in our society now, and one who can only be a librarian is obsolete themselves.

Scientific journals for example. Online nearly all of them are hidden behind paywalls, but I can borrow copies of them from the library for free.

Incidentally the role of a librarians is only obsolete when there are no more libraries.

In what way do I need to be more descriptive? What don't you understand? I'm happy to explain myself...

Your answer to my question is a very vague description. You said:

"Ones who can positively contribute to necessary functions of society, and national security"

What do you consider to be a "positive contribution"? What do you consider a "necessary function of society" to be?

It wouldn't be a safety net for the workers, but a safety net for the industries I suppose, if you want to use that term.

So it's to protect the industry. And you don't believe that a UHC system would also do the same thing only with greater coverage?

Some industries (like weapons research and construction) are important to our survival as a nation, and in which case, the government should support them and make sure they don't go bankrupt, and that their relevant workers can remain healthy and productive.

So the government would just give them money? Quite frankly I have no idea how your system would work beyond "if you work in a selected industry and get really sick then you're on your own". Could you explain how this system would work?

Once that industry becomes obsolete, the workers do as well, if they can not join a relevant industry or work in the private sector.

Wouldn't many of those industries be part of the private sector anyway? Or do you believe that industries critical to the survival of the state should be nationalised?

Because some things are critical to our nations survival. We have many enemies (aboard and domestic) that we must fight.

Which does not address my point.

If you are defective (born without any productive ability) invalid (once productive but now otherwise rendered unproductive) or obsolete (your once productive role in society is no longer necessary) you shouldn't be afforded an expensive safety net.

So in the case of a soldier they shouldn't be given anything even though they put their life on the line for their country?

By the way, your definition of "defective" would apply to every person who has ever existed.

Indeed, I'd hope they'd be able to accept their fate with grace. But of course not all will, but society has methods of dealing with such people.

And those methods are?

They do have a choice. They can either try to compete in the private marketplace, have themselves humanly put down, or beg on the streets and live off people's charity. Or if their family can afford to keep them around, that as well.

Not much of a choice. If they don't have the skills for certain jobs then they would be competing for the lower paid jobs, where they are less likely to be hired because companies would prefer to hire younger people, or they can die quickly, or they can die slowly in poverty and if their family can't afford to keep them (which I would assume would be in most cases) they would probably die in on the streets or be essentially forced to get themselves euthanised.

I'm not sure what you're asking here. Group plans here generally can't discriminate against the ill.

It doesn't matter about what they do now. I'm talking about group plans in your hypothetical world.

 

[TFian]

So who would determine these guidelines.

Depends on what industry.

Scientific journals for example. Online nearly all of them are hidden behind paywalls, but I can borrow copies of them from the library for free.

There are other ways we can go about that.

Incidentally the role of a librarians is only obsolete when there are no more libraries.

Which would only be so the institution itself is obsolete.

What do you consider to be a "positive contribution"? What do you consider a "necessary function of society" to be?

Contributions that have meaningful positive impact on the nations defense, or on the profitability of private industry.

So it's to protect the industry. And you don't believe that a UHC system would also do the same thing only with greater coverage?

A UHC system would be a great tool to protect all industry and people yes, but I'm not interested in that.

So the government would just give them money?

Not quite. The government would protect them from going under and going bankrupt.

Quite frankly I have no idea how your system would work beyond "if you work in a selected industry and get really sick then you're on your own". Could you explain how this system would work?

Sure.

Say you have defense contractor A. Defense contractor A is critical to enhancing your military's ability to defend itself against it's enemies. Defense contractor A is therefore integral to your nation's survival, therefore it's in your best interests to make sure such a company does not fall under in financial ruin. It also relies on employees to make and design such weapons to enhance your defensive and offensive capabilities, so providing them health insurance is probably in your best interest. At least subsidizing it, IE like the Federal Government Employee Benefits system.

Wouldn't many of those industries be part of the private sector anyway? Or do you believe that industries critical to the survival of the state should be nationalised?

They may or may not be nationalized. Would depend on the situation. Sorry for the confusion however, I meant to make a distinction between wholly private (non subsidized or unselected industry) and quasi private (subsidized and protected by the government)

So in the case of a soldier they shouldn't be given anything even though they put their life on the line for their country?

I'm ok with some sort of VA benefits system if that's what you're asking.

By the way, your definition of "defective" would apply to every person who has ever existed.

My bad, let me rephrase. Someone who is born with a disability that would prevent them from ever meaningfully contributing to society in a positive sense. Example, someone born with Down Syndrome.

And those methods are?

The same we deal with criminals today. Imprisonment, exile, execution, etc.

Not much of a choice. If they don't have the skills for certain jobs then they would be competing for the lower paid jobs, where they are less likely to be hired because companies would prefer to hire younger people,

Which already happens now, at least in the US. Maybe different in Australia(?), I can't say.

or they can die quickly, or they can die slowly in poverty and if their family can't afford to keep them (which I would assume would be in most cases) they would probably die in on the streets or be essentially forced to get themselves euthanised.

Once social security is gutted and Medicare is closed down, families will have to learn how to take care of their elderly again, or learn how to shoot them again. This happened in the past before #SS and Medicare, and it will happen again.

It doesn't matter about what they do now. I'm talking about group plans in your hypothetical world.

Oh well, I'd let the health insurance companies in the wholly private industries operate as they see fit ala a 100% free market.