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View Diary: Big Government / Small Government Messaging (41 comments)

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  •  The reason that many people do not want (1+ / 0-)
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    VClib

    "big government" is that, with government comes government control, and -- necessarily -- less individual freedom.  For example, I can tell you as an employer that, once government mandated health insurance for all, it also eliminated some choices.  For young healthy adults, it makes much more financial sense to have  very high deductible, catastrophic health care plan plus an HSA, where you get far lower premiums in exchange for paying for the every day medical costs out of your HSA. Young healthy employees generally come out much better financially with that model, and we provided that option.  The ACA will effectively eliminate that option for our employees by mandating what is covered by an approved insurance plan.  

    That's what is fueling the libertarian streak in some young people, I think.  There's the notion that government should stay out of their lives except in certain limited circumstances like defense, and a recognition that taking government benefits and/or funds means subjecting yourself to more government control.  A healthy distrust of our government is an underlying tenet of our Constitution -- it's the reason that Congress has only enumerated powers rather than plenary powers.  The drafters wanted to limit what Congress could do.  

    Government money and benefits always come with government control. It's always a trade-off:  how much individual freedom are you willing to exchange for government services and benefits? When people say they don't want "big government," they generally do not like the federal government control that comes with federal government benefits.  

    One way of measuring the size of government is to measure the size of government spending, because government spending comes with government control.  That's why people look to government spending as a % of GDP as a measure of how "big" government is in terms of spending, and the associated control.  

    •  Individualism not the answer (0+ / 0-)

      Young adults often take out NO health insurance and don't make other wise precautions.  That isn't a virtue.  They've been hearing the small government message all their lives without enough debunking, so they may repeat what they've heard.  Yes, young adults who gamble on little or no insurance often win.  Most young people who drink and drive while wearing no seat belt win that bet too, but let's not say that makes it a god idea.  In a single payer system, young people will pay less for equal coverage as they will be paying lower taxes on lower incomes.

      •  Financially, individualism is better for some (2+ / 0-)
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        Whatithink, VClib

        not better for others.  That's the point.  We've run numbers -- a lot -- and a young healthy employee is better off with a very high deductible, catastrophic coverage plan and an HSA, than he/she is paying the higher premiums for a "full coverage" plan.  Other employees, with more chronic conditions, are not.  

        In the pre-ACA world, that young healthy employee had choices, and could chose the financially more advantageous option.  In the post-ACA world, that same employee doesn't have those same options, and will end up (most likely) paying more for a full coverage plan.  

        We carefully run those financial options each year for our employees, and go to a lot of effort to educate them as to all their options.  The ACA takes away some options that are more financially advantageous for some employees.

        That is the case with all government involvement.  Efforts to benefit us as a whole always result in less individual freedom.  It even manifests itself in silly things like NY's large drink ban.  In an effort to positively affect the health of "us" as a whole, I can no longer buy that large drink, even if I'm one of the people who only does that a couple of times a year.  

        Government involvement is almost always that kind of trade-off.  

        •  Partly you're confusing (0+ / 0-)

          ACA with government health care.  As I said, a single payer system might give fuller coverage at a lower price to young people than the pre-ACA private options.  ACA was designed to benefit big business, so it doesn't provide advantages that could have been otherwise.  Government involvement designed to be nice to billionaires will have more shortcomings.  Government involvement of, by & for the 99% will still have trade-offs (what doesn't), but will be better on the whole.  Anyone who can do better without society can go do so in the wilderness; those who want the benefits of a civilization lives within rules which should be made by the majority for the common good.  Should there be a law about large drinks?  The answer to that question doesn't tell us whether people should have to pay payroll taxes, whether public schools should require immunizations, whether we should be forbidden to throw our kitchen trash in the street, etc.  There's a difference between questioning individual laws and questioning government involvement as a whole.

          •  I don't know of anyone, even libertarians (2+ / 0-)
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            nextstep, VClib

            who is questioning government "involvement as a whole."  It's a matter of degree.  Everyone, except for perhaps anarchists, agrees that government is a necessary thing, and that there are some things -- defense at the federal level, police protection at the local level, for example -- that government must do, because individuals cannot do that individually.  

            It's a matter of degree.  Everyone agrees there must be a government.  The questions are (1) what areas should the federal government be involved in -- where is it worth it to give up freedoms in exchange for government involvement?  Different people put that line in different places.  and (2) How involved should government be in those areas -- should it just be a "last resort" option for a few, or should it have direct control over everyone, for example?  Again, different people put that line in different places.  

            And, of course, we don't know whether single payer would be financially better, or worse, for that person who had a very high deductible plan and an HSA.  We do know that single payer is still going to have to have many people who pay in more than they take out, to make up for the few who don't pay in much but consume hundreds of thousands of dollars -- or even millions of dollars -- in heath care.  And, equally obvious is that it would have to limit options. When you don't pay for health care, you have no qualms about spending $50,000 dollars for a treatment that has a 2 in 10 chance of prolonging 90 year old great-grandma's life for 6 months.  Or, maybe great-grandma has been paying for years for a super "Cadillac" supplemental Medicare policy that would pay for it, so she gets that treatment.  For a single payer system to work financially, there are going to have to be limits on what services will be available in which instances -- and 90 year old great grandma won't get that treatment.  (You're more likely to end up with "single payer" plus -- where everybody pays taxes for a single payer system, but there's extra insurance coverage for those who can afford it, or an "outside of the government" system for those who can afford it (sort of like the fact that we all pay for public schools, but some pay extra to send kids to private schools).  

            Government involvement is always a trade off of freedom/independence for services/benefits.  Different people put the lines of when that is acceptable in different places.  

            •  Single payer doesn't mean (0+ / 0-)

              everyone has a comparable pay-in / pay-out, but private plans don't do that either.  Insurance companies figure their premium rates to get enough money for those with few bills & those with big bills.  It's not inherent to gov't.

      •  So in your big government scenario, (1+ / 0-)
        Recommended by:
        coffeetalk

        if a younger person is paying less for equal coverage, and in the private sector they are paying less because their risk is less, how is the first better if along with it comes a loss of freedom? I think sometimes you want everyone to buy into the 'anything that betters you and not society' is selfish meme, and that isn't always the case.

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