Your two party system is killing you in every area, and you don't even know it.

The argument itself though is very one dimensional. :)

Uhh, no. It just so happens that in this case some Republicans are the only people putting forward the idea of taxing medical benefits as ordinary income, to reduce the role of insurance in the system. I don't even vote, let alone think in terms of democrat vs republican.

Like food stamps.

But you're trying to have your cake and eat it too. You're basically saying "People deserve freedom! But not so much freedom that they can do things I don't like!"

Who draws the line, and where?

Basically, I would see school vouchers as being a way to compete between different schools teaching more or less the same things along more or less the same guidelines, and perhaps with no restrictions, on, say, hiring union labor.

I think the state has a duty to provide non-religious education to everyone, even if you're the lone Christian in a heavily Muslim area, say (or vice versa). If everyone could send their kid to a religious school, in some areas, the market would simply not provide for non-religious education.

That line of argument can be extended in all kinds of ridiculous directions. Should we ban Hummers off the roads? After all, they're driving on roads paved with your tax dollars, and you do not approve!

We should also ban rapists from drinking tap water. After all, my tax dollars pay for water treatment, and why should scum of the Earth like them get to drink it?

Do you see what I'm getting at? If you are going to insist that none of your money goes towards things you do not directly approve of, you're going to have to go for a 100% free-market economy - and by that I mean no police, no fire brigade, no public roads...

"Basically, I would see school vouchers as being a way to compete between different schools teaching more or less the same things along more or less the same guidelines"

... except if the schools teach things you disagree with. Like I said, it's "We should have freedom! But only for things I agree with"... which doesn't strike me as very free at all.

As an aside, one of the problems I see with the various interesting people of the internet is that, for a bunch of allegedly smart people, they harbor a lot of hatred and prejudice. You can't surf without running into hate-filled articles bashing the religious, unions, immigrants, poor people, etc ad nauseum.

For example, the law currently disallows polygamy - but if you look at all the cultures around the world you will find that monogamy is somewhat of a Judeo-Christian idea to begin with - at the very least there are many societies where it is perfectly acceptable.

So now the question must be asked: is our desire to have a monogamous society coming from our Christian roots, or is it something that transcends religion and becomes a shared ideology?

There are a great many issues where it's not easy to say "this comes from religion" vs. "this comes from our social order".

The world is certainly a complex place.

State-sponsored teaching that evolution is bunk, and that the koran/bible/FSM is literal truth, though, is probably crossing the boundary, and that's what we were discussing, not monogamy.

The problem though is that, from the government side anyways, the two arguments are not separable. As soon as you propose to limit/expand the freedoms of one special interest group, all of them swarm out of the woodwork.

The problem is also that you cannot say "this is crossing the boundary" without first defining what the boundary is. Sure, teaching creationism (for us) is well beyond this ephemeral concept of "the line", but fair governance requires us to actually define where "the line" is.

The availability and quality of schools is already a key consideration when choosing a neighborhood to live in. Forcing every last kid in Chinatown to go to a school at odds with their traditions is an affront to liberty. Offering the one Jewish family in Hicksville, Alabama the option of (a) moving to a bigger city, (b) commuting to a decent school, (c) homeschooling or (d) putting up with local school they hate the least, is more palatable to me.

In most cases, the solution would be, "don't live in Hicksville, Alabama if you can't stand the schools." But even if you have to, at least you have options (b) and (d). Public schools don't even give you that much.

Seems to me designing laws allowing some to discourage access to theological/scientific/ideological education that others may desire is the unjust approach.

The goal of the establishment clause, of freedom of assembly, speech, and press, is to protect individual ideological freedom from government interference, is it not?

What danger is there to religious or ideological liberty in allowing vouchers to be used at Catholic schools or Muslim schools or schools with Young Democrats cirriculum or schools with an atheist/skeptic focus? That the government would appear to be funding religious or ideological education? It is a danger to appearances only. The government is not paying more for the extra lessons, and the parents have freely chosen the school.

What danger is there to religious or ideological liberty in requiring--through legal or economic means--that children be educated in a school with only politically approved cirriculum? Two dangers: that the unconscious political or religious mores of a powerful majority will find their way into the approved cirriculum and that it fundamentally denies anyone with a minority view the ability to educate their children within their traditions.

It seems to me that the second case is far more destructive to our goal. The idea that we would like to economically prevent most Muslims from educating their children as Muslims ought to be repulsive to a society theoretically committed to religious freedom. Nor is there safety in sticking to a 'neutral' cirriculum; poli sci and civics have to be taught, American History has to be taught, and science has to deal with the evolution/intelligent design thing at some point. Defining neutrality on popularly divisive topics isn't easy -- and supposing the group that agrees with you will retain political control in the long run is foolishly optimistic.

There is the danger--nay, the certainty--that parents given the freedom to educate their children according to their whims will teach them destructive and false ideas. But this is simply an instance of the highest cost of maintaining a free society: tolerating certain evils because the associated liberty is worth it. It is not the job of the government to serve as a dogmatic gatekeeper, rather it is the job of free citizens to persuade one another in the public forums.

It is my opinion that allowing parents to educate their children any how or way they please, without bias for or against any institution except on the basis of its meeting a minimal functional standard, poses no danger to personal liberty and is in fact a great boon.

"Conservatives" don't hold a monopoly on using a market. In most cases, they're not even completely in the "free market" portion of the gradient.

Please stop with the partisan labels. They're really not all that helpful.

Well, for people with enough money, at least. For others it might not "work" because they would die.

Which is why the OP suggested a solution that was mostly market based, but with some thought given to those who would be excluded by the market.

OK, I am not being entirely serious here. but I think market solutions don't work that well when it comes to healthcare because patients can neither be fully informed consumers (without a medical degree) nor can they exercise a free choice about when they plan to fall ill. Consider: having your house burn down is also a bit unpredictable, so you buy insurance for that. And indeed, the costs of a home fire can run into the hundreds of thousands, not incomparable to the cost of health problems. And yet, fire insurance is way, way cheaper than health insurance. Why?

Hint: it's not due to competing fire departments. We used to have those, but we got rid of them for a reason.

My Dad was recently complaining that his prescription coverage was cut, so he was now paying about $100/mo for his prescriptions. I asked how much the pills would cost with no coverage, and he dug out the bills and determined they would cost about $600/mo. This sounds outrageous I suppose, until you realize that he pays about $1100/mo for insurance. Granted, that is for more than just drugs, but if insurance was really for unaffordable things, it wouldn't cost that much. My dad is still paying for his monthly prescriptions... just in a roundabout way.

Anecdotes aside, the article points this out too. Would you expect your fire insurance to cover the cost of batteries for a smoke detector? Of course not. But if it did, the batteries would most likely cost more, since instead of having to sell to millions of battery buyers in Wal-mart, battery makers would be selling to mere dozens of fire insurance companies, who would pass on the costs to those buying the insurance, and hence have no incentive to control battery costs. Even worse, the administrative costs of having people constantly file battery-replacement claims would dwarf the cost of the battery itself. So people would suddenly be paying $25 more a month to avoid buying $2 worth of batteries.

Sounds absurd I'm sure, but that is exactly how our comprehensive health insurance works today.

If people actually used health insurance for things that are equivalent to a house burning down, it would function more like other insurance, and get cheaper. I'm 26, and my most expensive health expense to date was my birth. The next closest thing was probably when I had my adenoids out when I was 7. After that, when I broke my big toe ($900). None of those are akin to having a house burn down or getting in a car wreck. The first two were predictable and all three could be payable with credit or HSAs. It makes no sense to pay thousands of dollars a month so you can go to the doctor for free when it would only cost $150 anyway.

My point, though, is that multiple competing private health care providers create administrative overhead without delivering the benefits of competition because sick people are a captive market, and thus normal market forces are unable to operate properly. If you look into the history of private fire companies you'll see problems which are echoed in today's health care system.

Furthermore, there are many free markets in which consumers cannot be fully informed which work just fine. I know very little about the design of video cards, the maintainence of automobiles, how to remodel a house, what makes a good lawyer, whether my glasses are good for my vision, or myriad other things I pay others for on a regular basis. Nonetheless, I am able to navigate these markets just fine and make tradeoffs according to my personal values. The combined effect of consumer reports, public opinion, and paid personal advocates seems to get me there okay.

I submit that in a free market, most would have no more difficulty shopping for a docter than they do for a mechanic.

And while patients cannot choose when or how to fall ill, they can choose what to treat, what to treat well, what to invest in preventing, and what to simply tough out. The dire necessity of my owning a car does not prevent competition between car dealerships.

We've posted the links repeatedly - preventative care improves quality of life but doesn't reduce cost.

And, pre-natal care is FREE in the US, yet many poor folks don't bother.

In other words, both assumptions for your argument are false.

That strikes me as a very questionable assertion. Health problems always get worse with time, becoming more complex and expensive to fix the longer you leave them. How could prevention possibly not reduce costs?

(1) Folks who live longer consume more medical resources, not less. (Dying is always expensive but living also has costs, so shorter lived people cost less.) (2) Preventative care doesn't always work. In fact, it usually doesn't. If it's cheap enough, that can be okay, but if it isn't.... (3) Saving someone from one or even a couple of causes of death is rarely enough. (That's why it often makes sense to ignore prostate cancer. Yes, it may get worse if left untreated, but old men die of lots of things.)

The numbers always matter. Health care is hellishly complicated.

You also seem to be thinking in terms of end-stage "keep them alive vs. let them die" issues. I was thinking more along the lines of toothaches, infected cuts, etc. Yes, it does get more complex - both medically and morally - as the patient gets older.

I'll agree with you on the "hellishly complicated" part though. The politics of elderly care are a moral minefield.

Lifetime is the only rational way to think about it on "govt scale".

Per-incident is really hard to sample correctly. Yes, if you can get someone to not be diabetic, you've saved money, but we're already trying a lot of preventative care so if you look at the incidents as opportunities, you're wrong.

Yes, we're already doing a lot of preventative care, and we're not seeing the results that its advocates claim. (Simple example - Every doctor already says "lose weight".) Most chronic diabetes folks are fairly resistent to preventative care, at least the inexpensive sort, and the expensive stuff isn't close to cost effective AND they backslide.

Here's a question - smoking has gone down by 50% over the past 20 years. Are we spending less on lung cancer?

> The politics of elderly care are a moral minefield.

Yup. 70% of US medical spending is on old people. If you're going to cut spending by 30%, a huge fraction of that has to come from old people.

Probably because it keeps people alive longer, so that they need more care. Smokers, allegedly, are much cheaper to care for in the long term than non-smokers, because they die early.

Pardon posting a political piece, but I was just reading this today and it explains the fallacy.

http://www.realclearpolitics.com/articles/2009/08/14/the_pre...

The free market!

I agree that there needs to be more direct competition for health care dollars.