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Thread: It's time for national healthcare - Page 123







Post#3051 at 03-28-2012 12:45 AM by pbrower2a [at "Michigrim" joined May 2005 #posts 15,014]
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Quote Originally Posted by playwrite View Post
Maybe in the long run (and yes, I know what Keynes said about that), it would best if they both go down in flames.

A clean sweep by the GOP in November might be enough to keep the Bush tax cuts from expiring, but they will carry through on the debt ceiling agreement spending reductions and more. That alone would be enough to tip us back into a severe economic contraction exacerbated by Europe being in recession and the BRICs slowing considerable. A remaining recalcitrant Dem in the Senate could kill the Bush tax cuts - that would likely throw us into an economic depression. Add to that the impossible health care costs to an increasingly large share of the population that Debs points out, and it is lights out again.
A clean sweep by the GOP stands to make America a very nasty place in which to live with the only good things in life for most people are those that no politicians can take away. There might be beautiful days with flowers in bloom and birds singing, but that too could happen in Dachau. GOP economics stands for a near-negation of Keynesian practice, so if there is any downturn it will be a cascade from one disaster to another. Military policy will be dictated by economic interests that find war profitable. Foreign policy will be a ramped-up neo-colonialism enforced with diplomatic bullying and outright invasions. Needless to say, America will become a cheap labor country... and Mexico might have an 'illegal immigrant' problem from the north. Tax policies will only intensify the destruction of small business as competition to cartels and trust and as opportunity for those who don't want to live like sharecroppers. Voting requirements will be made increasingly rigid in almost all states that only "the right people" can vote. Constitutional mischief -- the sort that resembles the old Article 6 of the Constitution of the USSR (the dominant Party becomes the "leading force" of political life and the infamous Article 58 of the Soviet criminal code that made just about any action or inaction a criminal act at the whim of someone in the political hierarchy -- becomes possible with a permanent majority and a Party boss as the de facto ruler over a weak, corrupt, and ineffective government.

Can that last? I doubt it. Eventually the irresponsible leadership goes too far and either takes on a set of enemies too big or creates a dangerous underground of urban and mountain warfare.

There is absolutely nothing in the GOP traditional, let alone current wingnut, bag of tricks that can pull us out of what is coming; I really don't think they understand how what the consider success since Reagan was absolutely dependent on unsustainable household debt and that can never again for decades be a route out of what they have created. And Romney attempting to pull a "only Nixon could go to China" turnaround would require him to not only outdo Obama but FDR on the Keynesian front - even if he does eventually, it will be far far too late.
It was household assets that made American conservatism possible before Ronald Reagan. Even as small-scale creditors people with pension funds, insurance policies, savings accounts, stocks, and bonds had cause to protect the value of their assets from inflation and from government squeezing out the private sector with excessive spending. Such tends to make small-scale creditors conservatives of the style of Gerald Ford. The South, in which people were mostly far poorer than Northerners because they had fewer assets to protect and were often heavily in debt, was more liberal on economics (if not race or criminal justice) than the North. Debtors, in contrast, want inflation to alleviate the stress of debt and more economic opportunities to make paying off a debt easier.

America has gone from having a predominance of small-scale creditors and a few big debtors (mostly Big Business which has floated large loans as bonds) to having a predominance of people deeply in debt but relatively few giant creditors (corporations squeezing workers with low pay and gouging them as customers have begun to accumulate assets and retire debt). Big-scale creditors insist upon their pound of flesh -- and this time the pound of flesh could turn into peonage if the Hard Right gets its way.

I will still be going all out for Obama and hope that he wins. There's a slight chance he will "be more flexible" not only with the Russians but with real fiscal support in his second term. However, if he should go down with the ACA that would help relieve that nagging concern of mine of having the Dems in power when the shit hits the fan next year - it will taint the Party in power for at least as long as Hoover was tainted - i.e. forever.
The era of GOP dominance, should it happen, will be the sort of time that people can wish that they could sleep through in the manner of Rip Van Winkle. Unfortunately that scenario is pure fiction. For many, happiness might depend upon either the Afterlife or reincarnation. In a situation as dire as the bad scenario of an America Gone Bad, that might be all that those now in middle age or who might become the victims of the system could ever hope for.
The greatest evil is not now done in those sordid "dens of crime" (or) even in concentration camps and labour camps. In those we see its final result. But it is conceived and ordered... in clean, carpeted, warmed and well-lighted offices, by (those) who do not need to raise their voices. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the office of a thoroughly nasty business concern."


― C.S. Lewis, The Screwtape Letters







Post#3052 at 03-28-2012 12:56 AM by Odin [at Moorhead, MN, USA joined Sep 2006 #posts 14,442]
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Quote Originally Posted by annla899 View Post
David, I know I am hounding you in some ways. But in your world Barack Obama has serious credibility problems. In mine. those problems are not serious in the next voting cycle.

Perhaps because I live in cynical Chicago world of hard-ball politics. But among most people I know, this election is a no brainer. Your level of disappointment makes me wonder if you haven't spent too much time in history as it is written and interpreted rather than history as it is lived.

With deep respect, a liberal Boomer who was 24 when Reagan was elected, who has long thought you early Boomers have had the luxery of idealism.
I think Dr. Kaiser is stuck in the Beltway Bubble, sadly. He seems to think what happens in the halls of power is all that matters.
To recommend thrift to the poor is both grotesque and insulting. It is like advising a man who is starving to eat less.

-Oscar Wilde, The Soul of Man under Socialism







Post#3053 at 03-28-2012 01:31 AM by annla899 [at joined Sep 2008 #posts 2,860]
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Quote Originally Posted by Odin View Post
I think Dr. Kaiser is stuck in the Beltway Bubble, sadly. He seems to think what happens in the halls of power is all that matters.
Perhaps those of us in the hinterlands see things differently.







Post#3054 at 03-28-2012 08:01 AM by KaiserD2 [at David Kaiser '47 joined Jul 2001 #posts 5,220]
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Quote Originally Posted by annla899 View Post
David, I know I am hounding you in some ways. But in your world Barack Obama has serious credibility problems. In mine. those problems are not serious in the next voting cycle.

Perhaps because I live in cynical Chicago world of hard-ball politics. But among most people I know, this election is a no brainer. Your level of disappointment makes me wonder if you haven't spent too much time in history as it is written and interpreted rather than history as it is lived.

With deep respect, a liberal Boomer who was 24 when Reagan was elected, who has long thought you early Boomers have had the luxery of idealism.
Quote Originally Posted by Odin View Post
I think Dr. Kaiser is stuck in the Beltway Bubble, sadly. He seems to think what happens in the halls of power is all that matters.
You are each entitled to your opinions. May I point out that those two opinions above are completely mutually contradictory.

Annla, I am just as certain to be voting and contributing for Obama as you are, and in contrast to Playwrite, I can't find any silver lining in a possible GOP sweep. Obama's re-election is a no-brainer in my part of the country just as much as in yours. Nor was I stating my own opinion of him (which is much more complex), I was trying to characterize the opinions of our fellow citizens. His approval rating hasn't topped 50% for a long time. He has not proven that he can improve the lives of ordinary Americans. What I said was that if his signature achievement is thrown out this will tend to confirm that he has very little to offer to the average American. And the election will be decided in Virginia, North Carolina, Florida, Pennsylvania, Ohio, Wisconsin, Iowa, and one or two other states. Not in New England or Illinois.

I will say that if the law does go down, Democratic pusillanimity and double-talk will be party to blame. The mandate is clearly in effect a tax, and thus could be defended under the taxing power. But the Administration didn't want to do that so that it could not be accused of "raising taxes," horror of horrors. And this happens again and again: when Democrats generally draw on their traditions of government activism, they now have to pretend that they are not. But that's another story.

If, Annla, you meant that you think Obama's election is certain, I do not. I have said again and again lately that I thought it was very likely, but he's been slipping lately already thanks to gas prices, and I'm afraid a bad Supreme Court decision in June could change the odds. That's all I said.

I haven't lived in the Beltway for half a century, Odin. Try again.







Post#3055 at 03-28-2012 09:56 AM by annla899 [at joined Sep 2008 #posts 2,860]
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Quote Originally Posted by KaiserD2 View Post
You are each entitled to your opinions. May I point out that those two opinions above are completely mutually contradictory.

Annla, I am just as certain to be voting and contributing for Obama as you are, and in contrast to Playwrite, I can't find any silver lining in a possible GOP sweep. Obama's re-election is a no-brainer in my part of the country just as much as in yours. Nor was I stating my own opinion of him (which is much more complex), I was trying to characterize the opinions of our fellow citizens. His approval rating hasn't topped 50% for a long time. He has not proven that he can improve the lives of ordinary Americans. What I said was that if his signature achievement is thrown out this will tend to confirm that he has very little to offer to the average American. And the election will be decided in Virginia, North Carolina, Florida, Pennsylvania, Ohio, Wisconsin, Iowa, and one or two other states. Not in New England or Illinois.

I will say that if the law does go down, Democratic pusillanimity and double-talk will be party to blame. The mandate is clearly in effect a tax, and thus could be defended under the taxing power. But the Administration didn't want to do that so that it could not be accused of "raising taxes," horror of horrors. And this happens again and again: when Democrats generally draw on their traditions of government activism, they now have to pretend that they are not. But that's another story.

If, Annla, you meant that you think Obama's election is certain, I do not. I have said again and again lately that I thought it was very likely, but he's been slipping lately already thanks to gas prices, and I'm afraid a bad Supreme Court decision in June could change the odds. That's all I said.

I haven't lived in the Beltway for half a century, Odin. Try again.
Thank you for clarifying. Makes a lot of sense. It's sad, but makes sense.







Post#3056 at 03-28-2012 11:53 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by KaiserD2 View Post
You are each entitled to your opinions. May I point out that those two opinions above are completely mutually contradictory.

Annla, I am just as certain to be voting and contributing for Obama as you are, and in contrast to Playwrite, I can't find any silver lining in a possible GOP sweep. Obama's re-election is a no-brainer in my part of the country just as much as in yours. Nor was I stating my own opinion of him (which is much more complex), I was trying to characterize the opinions of our fellow citizens. His approval rating hasn't topped 50% for a long time. He has not proven that he can improve the lives of ordinary Americans. What I said was that if his signature achievement is thrown out this will tend to confirm that he has very little to offer to the average American. And the election will be decided in Virginia, North Carolina, Florida, Pennsylvania, Ohio, Wisconsin, Iowa, and one or two other states. Not in New England or Illinois.

I will say that if the law does go down, Democratic pusillanimity and double-talk will be party to blame. The mandate is clearly in effect a tax, and thus could be defended under the taxing power. But the Administration didn't want to do that so that it could not be accused of "raising taxes," horror of horrors. And this happens again and again: when Democrats generally draw on their traditions of government activism, they now have to pretend that they are not. But that's another story.

If, Annla, you meant that you think Obama's election is certain, I do not. I have said again and again lately that I thought it was very likely, but he's been slipping lately already thanks to gas prices, and I'm afraid a bad Supreme Court decision in June could change the odds. That's all I said.

I haven't lived in the Beltway for half a century, Odin. Try again.
I wish I could have the confidence that Annla and Odin convey. Instead, I can see your scenario as being highly plausible. At its core, unfortunately, is my depressing amazement of how utterly ignorant, intellectually lazy, outright stupid and self-centered a large fraction, if not a majority, my fellow citizens. To have Annla and Odin's certainty, whether conscious or not of it, one has to have a slightly more optimistic vision of one's countrymen.

And just to note, my "silver lining in a possible GOP sweep" is that the outcome will be worse than Pbrower's scenario. but potentially sufficient to wake enough people the F up to finally do something about it - a silver lining with a 20,000 volt electric shock treatment attached to it.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#3057 at 03-28-2012 12:00 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Debs, we can only hope

http://robertreich.org/post/19972321637

Healthcare Jujitsu
Monday, March 26, 2012

Not surprisingly, today’s debut Supreme Court argument over the so-called “individual mandate” requiring everyone to buy health insurance revolved around epistemological niceties such as the meaning of a “tax,” and the question of whether the issue is ripe for review.

Behind this judicial foreplay is the brute political fact that if the Court decides the individual mandate is an unconstitutional extension of federal authority, the entire law starts unraveling.

But with a bit of political jujitsu, the President could turn any such defeat into a victory for a single-payer healthcare system – Medicare for all.

Here’s how.

The dilemma at the heart of the new law is that it continues to depend on private health insurers, who have to make a profit or at least pay all their costs including marketing and advertising.

Yet the only way private insurers can afford to cover everyone with pre-existing health problems, as the new law requires, is to have every American buy health insurance – including young and healthier people who are unlikely to rack up large healthcare costs.

This dilemma is the product of political compromise. You’ll remember the Administration couldn’t get the votes for a single-payer system such as Medicare for all. It hardly tried. Not a single Republican would even agree to a bill giving Americans the option of buying into it.

But don’t expect the Supreme Court to address this dilemma. It lies buried under an avalanche of constitutional argument.

Those who are defending the law in Court say the federal government has authority to compel Americans to buy health insurance under the Commerce Clause of the Constitution, which gives Washington the power to regulate interstate commerce. They argue our sprawling health insurance system surely extends beyond an individual state.

Those who are opposing the law say a requirement that individuals contract with private insurance companies isn’t regulation of interstate commerce. It’s coercion of individuals.

Unhappily for Obama and the Democrats, most Americans don’t seem to like the individual mandate very much anyway. Many on the political right believe it a threat to individual liberty. Many on the left object to being required to buy something from a private company.

The President and the Democrats could have avoided this dilemma in the first place if they’d insisted on Medicare for all, or at least a public option.

After all, Social Security and Medicare require every working American to “buy” them. The purchase happens automatically in the form of a deduction from everyone’s paychecks. But because Social Security and Medicare are government programs financed by payroll taxes they don’t feel like mandatory purchases.

Americans don’t mind mandates in the form of payroll taxes for Social Security or Medicare. In fact, both programs are so popular even conservative Republicans were heard to shout “don’t take away my Medicare!” at rallies opposed to the new health care law.

There’s no question payroll taxes are constitutional, because there’s no doubt that the federal government can tax people in order to finance particular public benefits. But requiring citizens to buy something from a private company is different because private companies aren’t directly accountable to the public. They’re accountable to their owners and their purpose is to maximize profits. What if they monopolize the market and charge humongous premiums? (Some already seem to be doing this.)

Even if private health insurers are organized as not-for-profits, there’s still a problem of public accountability. What’s to prevent top executives from being paid small fortunes? (In more than a few cases this is already happening.)

Moreover, compared to private insurance, Medicare is a great deal. Its administrative costs are only around 3 percent, while the administrative costs of private insurers eat up 30 to 40 percent of premiums. Medicare’s costs are even below the 5 percent to 10 percent administrative costs borne by large companies that self-insure, and under the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

So why not Medicare for all?

Because Republicans have mastered the art of political jujitsu. Their strategy has been to demonize government and seek to privatize everything that might otherwise be a public program financed by tax dollars (see Paul Ryan’s plan for turning Medicare into vouchers). Then they go to court and argue that any mandatory purchase is unconstitutional because it exceeds the government’s authority.

Obama and the Democrats should do the reverse. If the Supreme Court strikes down the individual mandate in the new health law, private insurers will swarm Capitol Hill demanding that the law be amended to remove the requirement that they cover people with pre-existing conditions.

When this happens, Obama and the Democrats should say they’re willing to remove that requirement – but only if Medicare is available to all, financed by payroll taxes.

If they did this the public will be behind them — as will the Supreme Court.
This might be possible without Obama in the WH. A Bernie Sanders or some other gutsy Senator could hold out on the relief for the insures until the PO is put on the table.

It all depends on the severability issue in front of the SCOTUS today.

Also, if this plays out, perhaps MMT would have sunk in to enough folks by then, and they could impose a sane solution rather than Reich’s a new or raised payroll tax (I love the guy, but he’s still fixated on the false myth of evil federal deficits). That solution would be NO NEW TAXES, but instead, a tax scheme where taxes would be indexed to inflation. No inflation, no taxes. We get real inflation (when demand is exceeding supply, the economy is rolling and growing, and everyone is making money hand over fist), then an increase in taxes would make sense to most people (this assumes that if they were smart enough to get MMT, they’d be smart about inflation and taxes). The additional beauty of this solution is nobody is going to see that kind of inflation for a long long time, so no increase in taxes for a long, long time, if ever. This, by the way, is the "fix" for SS and Medicare or whatever deficit hysteria bullshrt the GOP fear mongers keep us fixated upon and stupid.
Last edited by playwrite; 03-28-2012 at 12:13 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#3058 at 03-28-2012 12:30 PM by KaiserD2 [at David Kaiser '47 joined Jul 2001 #posts 5,220]
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Of course I am with Reich all the way, except that there's no way the Supreme Court can make this issue part of the case before them. If in fact the mandate is thrown out, those interested in serious health care reform will have to go for single-payer--there's no other option. That's good thing. To pass it however would require, at the very last, substantial Democratic gains in the House and Senate, which I don't see on the immediate horizon. Some pessimists have already pointed out that we have major health care reform efforts every 15 years or so--under Harry Truman, in the early 1960s, in the late 1970s, in the early 1990s, and in 2009-10. Only two of those succeeded. So we'll have to accelerate the rhythm and experience a most fortuitous political change to get there.







Post#3059 at 03-28-2012 12:31 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Eric the Green View Post
I have been looking at my "crystal ball" a bit, and I really think things will be fine next year. I have yet to see any convincing indication of another severe crash, even though we have done next to nothing to avoid one. So, maybe the gods are looking out for us.

Things around the year 2020 could be dicey though. There is nothing worse in our future than what I foresaw and experienced in 2008-2010, but 2020 does look like a rough transition point. Zero years and years surrounding them are usually at least a bit unstable. This one looks more unstable than usual. If Republicans win in 2016, we can expect both economic and foreign problems to mount through the term, sort-of like a Republican Carter.
My sense is the "step down" in this chart -




- is the new normal.

And with the next economic contraction (ignoring all the other uniquely 4T bad news, we're due for just a normal business cycle downturn next year), this chart will have another "step down" as the new, new normal.

Why the focus on guys? Because women tend not to resolve their frustrations at failing as providers with a gun.

One might take a reading of some of the millions of guys represented by that 10% (I believe) permanent drop and those in the next 10% permanent drop to come. The question is which ones? A relatively few could initiate a chain reaction far beyond the nicities of OWS.

"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#3060 at 03-28-2012 12:46 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by KaiserD2 View Post
Of course I am with Reich all the way, except that there's no way the Supreme Court can make this issue part of the case before them. If in fact the mandate is thrown out, those interested in serious health care reform will have to go for single-payer--there's no other option. That's good thing. To pass it however would require, at the very last, substantial Democratic gains in the House and Senate, which I don't see on the immediate horizon. Some pessimists have already pointed out that we have major health care reform efforts every 15 years or so--under Harry Truman, in the early 1960s, in the late 1970s, in the early 1990s, and in 2009-10. Only two of those succeeded. So we'll have to accelerate the rhythm and experience a most fortuitous political change to get there.
You’re missing the political beauty of what Reich is proposing.

It hinges on the SCOTUS knocking out the mandate but letting the rest of the Act remain in place - i.e. they decide against severability.


That puts the insurers in a very very bad place. Essentially, they will go out of business in a few short years; some will drop out as soon as it becomes clear that no solution is being offered. Back during the debates over the legislation, some pretty smart people on both sides wondered if this indeed was the real plan by Obama.

One political option is to just wait until a multi-billion dollar industry (with billions of lobbying dollars) just dries up and blows away in the wind, leaving ALL Americas without coverage, and then battle it out again. What are the chances of that? Can we say, "Snowball in Hell?"

There will be a fix. The question is only will the Dems roll over and play stooges again.

If you add this to Bush Tax Cut expiration, the debt ceiling agreement for spending cuts, you can see how this is shaping up to be very very powerful change potential.

With every Presidential election, we hear how it is pivotal. This time, there should be absolutely no doubt about that.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#3061 at 03-28-2012 12:59 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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WH could have done better

Regarding the "limiting principle" over the Mandate argument, it's pretty well recognized that the WH lawyer in front of the SCOTUS blew-it.

Krugman has a recent post of this, but it's what one of the commenters, Derek Stodghill, had to say that made sense -


The limiting principle Justice Kennedy is looking for is called captive consumer. In the market for cars, a buyer can say no to not only one car deal but every car deal. In health care, where you or your loved one has their life at stake, you cannot walk away from that deal. That's the case even if it means you must go into debt to pay for it.

In addition, the broccoli mandate works both ways. If the government can't force someone to buy broccoli, it can't force a broccoli farmer to sell broccoli to someone who can't pay (i.e. give it away for free). If the Supreme Court overturns the individual mandate, they must also overturn the law requiring hospital ERs from the requirement to provide services to patients/consumers that can't pay.
- maybe the WH should fly Airforce 1 down to Ft. Worth and pick this guy up?
Last edited by playwrite; 03-28-2012 at 04:58 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#3062 at 03-28-2012 01:15 PM by Ragnarök_62 [at Oklahoma joined Nov 2006 #posts 5,511]
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Quote Originally Posted by playwrite View Post
Discourse on public/private goods? Health care as a public good??
Rags, have you been hitting on the Galbraith bottle?
I guess. I had to Google Galbraith. Lest I get my wrist slapped for trashing another thread, I think a general discussion wrt Galbraith/public/private goods should be moved to the "Economic CF" thread. I'll confine this to just heath care here.

Quote Originally Posted by David2d
I made this point some time ago. Until we start regarding health care like fire protection, police protection, or national defense, we will not get out of this mess. It's something we all need and thus, like those other things, something we all should pay for. And it should not generate profits.
I'll let David speak for himself , if he wants to, to designate health care as a Galbraithian "public good". Honestly, I didn't know Galbraith had that scheme, until that aforementioned Googlefest. This could lead to a thread called "Joneser/Xer Educashun" I know David will cringe, but oh well. The only history class I had was in 7th grade in a 1-12 education system. Kindergarten didn't exist then. So... most of any history I do know came from TeeVee or the internets.

The massive stream is toward "profitizing" the public goods. Swimming against that with already established public goods not only like SS, Medicare but running prisons or even the military is hard enough, what are the chances of taking something like health care that, outside of Medicare, is already fully profitized? In today's world, it's a pipe dream.
Yes, I know. There is a dynamic involved here as well. I'll call it the "diffuse interest vs. concentrated interest dynamic." Essentially wrt health care as it stands, we have a set of concentrated interests (health insurance companies, big Pharma, etc. ) who have a concentrated interest in the status quo. The diffuse interest (if it even exists) would favor single payer. I think if you look at a lot of "insane" public policy in this light, you can see why it exists. Another example is the existance of the mortgage tax deduction, Fannie Mae, Freddie Mac, FHA, etc. Realtors, banks, and house builders are the concentrated interests fueling the existence of those entities. And another thing to consider, Fannie Mae is a fiefdom that will do pretty much anything to justify its own existence and enlists associated concentrated interests to this end. So, back to healthcare, the reason behind the "insurance" part of Obama's plan. Unfortunately, these dynamics eventually lead to a whole lot of bloat, wasted money, and inferior government services which at some point collapses under its own weight.

Yea, there was some counter-trend to the profitizing with student loans and mortgages, but it took a financial meltdown and even those are already eroding against the relentless profitizing current.
Obviously, all I can say is that mortgages and houses are private goods/services. See moral hazard.

One can either view the ACA as all that is possible in our profitizing world (and even then likely to fail against the current, i.e. the current SCOTUS process) or, one can see the ACA as something that needs to fail so that we can get to abject poverty quicker and that, in turn, will lead to a revolt.
Hopefully I covered the above in my discourse about assorted interests.
I can swing both ways on it, but how I swing on it has no bearing to how it will unfold. We're powerless.
Of course, you're a diffuse interest.

There really is no question that the Federal govt, as the money issuer, can afford Medicare-for-all. It would only be a question of such deficit spending causing inflation, and if it did, then raising taxes and/or interest rates to deal with it. MMT would say that taxes destroy spending on private sector goods in order to make room for public sector goods while maintaining price stability. If prices are stable, there is no reason to tax anybody for federal keystrokes on a computer to add funds to bank accounts that pay for health care.
Well, since health care is such a large part of the economy, I still think the VAT is needed to soak up the "freed money" that would no longer get funneled to health care companies. Of course since we're talking universal coverage there may be some increase in the deficit. To me that's just a case of mental masturbation/academic issue. IOW I don't see any incremental increase in the deficit as mattering that much. I think the increased efficiency/freed resources can cover that. I.E. all of those copy machines, faxes, data entry, etc.

It is our collective emotional, not intellectual, ability to grasp that simplicity that keeps us at the mercy of vampire squids and their sock puppet political clowns.
Things like the meme of "socialized medicine" ?

Try this experiment. Just to humor me: assume that the federal deficit was something that was not only far from a problem but actually a necessary means to maintain a growing economy. Imagine that on occassions where the economy is booming and aggregate demand was reaching economic capacity to the point that price increases might become a concern. Imagine that basically technocrats would near-automatically raise taxes and/or interest rates (remember everyone is now rolling in money) to sufficiently manage inflation.
I'll keep this short since I think this also belongs in the economic CF thread. I'll keep it short. I think the problem with the above is that the economy is such a complex system that no technocrat could figure it out. Next, riddle me this. What would have the technocrats done about the '70s stagflation ?

Now take that assumption and listen to any GOP position (other than the culture wars, although you'll find aspects there as well, e.g."why should I pay for someone's birth control pills?"). That assumption devastates EVERY position the GOP espouses. Soon the question would be why do we need the Right as it is currently constituted?
Well, OK if you insist.
1. I do think concentrating on some <insert some huge number here> is of course silly.
2. What I do think matters is the debt/GDP ratio. This is not some <insert some huge number here>. As long as we don't get into say Iceland's number or pull a Weimer, then no prob.
3. The actual deficit for a particular year matters not to me.

Given how that assumption would change the world into a much better place, wouldn't it be worth exploring?
If you mean "saner", then sure.
Last edited by Ragnarök_62; 03-28-2012 at 03:05 PM.
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Post#3063 at 03-28-2012 01:38 PM by Eric the Green [at San Jose CA joined Jul 2001 #posts 22,504]
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Quote Originally Posted by KaiserD2 View Post
Of course I am with Reich all the way, except that there's no way the Supreme Court can make this issue part of the case before them. If in fact the mandate is thrown out, those interested in serious health care reform will have to go for single-payer--there's no other option. That's good thing. To pass it however would require, at the very last, substantial Democratic gains in the House and Senate, which I don't see on the immediate horizon. Some pessimists have already pointed out that we have major health care reform efforts every 15 years or so--under Harry Truman, in the early 1960s, in the late 1970s, in the early 1990s, and in 2009-10. Only two of those succeeded. So we'll have to accelerate the rhythm and experience a most fortuitous political change to get there.
Most likely, the rhythm will hold, and there will be some more success next time.

I see next to no chance that congress could fix a SCOTUS-created health care mess in the next couple of sessions at least. Republicans just have too many seats, and the Senate can't get anything passed.
Last edited by Eric the Green; 03-28-2012 at 01:44 PM.
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Post#3064 at 03-28-2012 04:56 PM by Deb C [at joined Aug 2004 #posts 6,099]
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I wonder if it is possible to vote against your own interests?

Health Care and the Justices' Bottom Line
By Russ Choma on March 28, 2012 2:37 PM

The justices appear to keep most of their money invested in mutual funds and managed portfolios - many of which have holdings in the healthcare industry, though none are funds with a specific healthcare focus. But one justice does stand out for his interest in healthcare: Stephen Breyer.

Breyer, who is also one of the two wealthiest justices, directly owns stock in several major companies in the health sector. His stakes in three of them are worth between $50,000 and $100,000: biotech pharmaceutical company Sigma-Aldrich, pharmaceutical company Novartis and Quest Diagnostics, a lab and diagnostic firm. Breyer also owns smaller stakes in biotech drug companies Amgen (valued between $15,000 and $50,000) and Genzyme (a stake worth less than $15,000.)

Breyer's interests in those five healthcare companies were acquired before the healthcare debate in 2009, and he's actually unloaded stock in other companies -- like Teva Pharamaceuticals -- since the battle began.
http://www.opensecrets.org/news/2012...interests.html

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Post#3065 at 03-28-2012 04:57 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Ragnarök_62 View Post
I guess. I had to Google Galbraith. Lest I get my wrist slapped for trashing another thread, I think a general discussion wrt Galbraith/public/private goods should be moved to the "Economic CF" thread. I'll confine this to just heath care here.



I'll let David speak for himself , if he wants to, to designate health care as a Galbraithian "public good". Honestly, I didn't know Galbraith had that scheme, until that aforementioned Googlefest. This could lead to a thread called "Joneser/Xer Educashun" I know David will cringe, but oh well. The only history class I had was in 7th grade in a 1-12 education system. Kindergarten didn't exist then. So... most of any history I do know came from TeeVee or the internets.



Yes, I know. There is a dynamic involved here as well. I'll call it the "diffuse interest vs. concentrated interest dynamic." Essentially wrt health care as it stands, we have a set of concentrated interests (health insurance companies, big Pharma, etc. ) who have a concentrated interest in the status quo. The diffuse interest (if it even exists) would favor single payer. I think if you look at a lot of "insane" public policy in this light, you can see why it exists. Another example is the existance of the mortgage tax deduction, Fannie Mae, Freddie Mac, FHA, etc. Realtors, banks, and house builders are the concentrated interests fueling the existence of those entities. And another thing to consider, Fannie Mae is a fiefdom that will do pretty much anything to justify its own existence and enlists associated concentrated interests to this end. So, back to healthcare, the reason behind the "insurance" part of Obama's plan. Unfortunately, these dynamics eventually lead to a whole lot of bloat, wasted money, and inferior government services which at some point collapses under its own weight.



Obviously, all I can say is that mortgages and houses are private goods/services. See moral hazard.



Hopefully I covered the above in my discourse about assorted interests.

Of course, you're a diffuse interest.



Well, since health care is such a large part of the economy, I still think the VAT is needed to soak up the "freed money" that would no longer get funneled to health care companies. Of course since we're talking universal coverage there may be some increase in the deficit. To me that's just a case of mental masturbation/academic issue. IOW I don't see any incremental increase in the deficit as mattering that much. I think the increased efficiency/freed resources can cover that. I.E. all of those copy machines, faxes, data entry, etc.



Things like the meme of "socialized medicine" ?



I'll keep this short since I think this also belongs in the economic CF thread. I'll keep it short. I think the problem with the above is that the economy is such a complex system that no technocrat could figure it out. Next, riddle me this. What would have the technocrats done about the '70s stagflation ?



Well, OK if you insist.
1. I do think concentrating on some <insert some huge number here> is of course silly.
2. What I do think matters is the debt/GDP ratio. This is not some <insert some huge number here>. As long as we don't get into say Iceland's number or pull a Weimer, then no prob.
3. The actual deficit for a particular year matters not to me.



If you mean "saner", then sure.
Good response, much appreciated. Thanks.

Just a couple major notes -

- your excellent notion of "diffuse interest vs. concentrated interest dynamic" with Galbriath's of those goods that can be “profitized” (private, concentrated interest dynamic) and those that can't (public, diffuse interest), the former gets the attention, the latter generally goes begging. What's interesting is the degree of money now spent to convince us that we really need the latest shiny private good while much of the public goods desperately needed (good schools, health care, roads) are purposefully ignored. The other thing, such as with health care, is the constant pressure to move public to private because if one can figure out how to make money off of it, the multiplies are staggering, particularly if you can erode away the other bothersome inefficient social values (e.g. untainted meat, grandmothers) of those former public goods.

- I really like your notion of the need "to soak up the freed money" that is exactly the MMT perspective. Taxes are only needed to soak up cash when demand is exceeding supply by too much (you want some of this to happen at the margin because it signals the need to increase capacity, i.e. economic growth) and price stability is put into question. What's cool is that it all goes in and out of the same pot. You don't need micro-managing of the health sector costs by taxes, you're looking at the whole economy instead; unless you are unhappy with doctor salaries and want to try some social engineering – that, however, becomes less of need if everyone is generally happy in a growing economy with sufficient access to good health care.

And some minor ones -

- Medicare, by nearly every measure, is more efficient than the private insurer models particularly when you take into account it is dealing with those over 65 years old where about 80% of the nation's health care costs are located.

- Freddie and Fannie are now completely different institutions than what they were before 2008. They are now 100% federal govt. All new mortgages and refis are now solely backed by them. There would be no housing market and no refi's without them right now. They should probable be merged, re-named, continue to serve their existing function, never again become what they were before 2008, and never again give any portion or aspect of those functions to Wall Street. That's not an efficiency argument; that is a financial survival argument for the country.

- whoops, forgot one other, aka 1970s stagflation. Do what was actually done and the real reason why it was killed off - deregulate natural gas, allow all the power plants to switch over from oil to gas and break the oil cartel's back so thoroughly that they never ever would try that again.
Last edited by playwrite; 03-28-2012 at 05:22 PM.
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Post#3066 at 03-28-2012 05:17 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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MMT perspective on health care gets some MM love

Carney's got an Austrian background and a Libertarian bent that makes him go bananas when other MMT's suggest strong central govt roles like the Job Guarantee (JG) program. But he does give MMT some visibility and sometimes he gets in really right -
http://www.cnbc.com//id/46880838/com...2#comments_top

Obamacare, the Individual Mandate and MMT

By most accounts, the Obama administration’s efforts to require all Americans to purchase health care had a rough day before the Supreme Court. If the individual mandate gets struck down by the high court, many intelligent people will be simply astonished.

On the face of it, it seems absurd that the government could directly pay for health insurance for all Americans and levy a tax to support that program — but may be barred from requiring Americans to personally purchase insurance. Don’t they amount to the same thing?


In a sense, they do. Under either scheme, Americans would be required to be insured and they would be paying for it.

But that’s only what it looks like on the surface. If you keep in mind that the United States government and private-sector households are fundamentally different when it comes to financing their spending, this result is not absurd.

American households are budget-constrained. They can only spend as much money as they earn or borrow. If the government directs an American citizen to purchase a specific item like insurance, she must curtail her spending or saving elsewhere. Or she must borrow more money, raising her debt obligations to creditors. She is, quite literally, less free because of the directive.

The federal government is not constrained in the way households are.

It hardly earns anything at all, yet it spends billions. So we know right away that the government isn’t earning-constrained like an individual is. The funds in its bank account come mostly from taxes and debt sales.

The federal government can spend far more than it taxes. It can spend more than it borrows. It can even spend in excess of the total amount taxed or borrowed, because the Federal Reserve will buy its bonds as necessary to meet interest rate targets.

In other words, when the federal government spends, its own freedom of action isn’t curtailed in the same way as a household forced to spend.

It can curtail its own freedom through debt ceilings or spending caps.

But the mere act of spending on health care doesn’t do it.

This is one of the key insights of Modern Monetary Theory.

Governments are not solvency-constrained — households are.

Keep in mind that our courts have long recognized an expansive role for government spending, while insisting that the power to levy taxes or mandates on households and individuals is limited.

Although our founding fathers aren’t known to have been MMT advocates, they were politically astute. It’s possible that the system they built includes an implicit recognition that private spending and government spending a very different things. And a government authorized to spend in pursuit of the general welfare may not be authorized to command solvency-constrained households to undertake that spending instead.
- John, I think, is also behind pulling Mike Norman (has probable the most popular MMT site on the Net) out of Faux News hellhole (it was fun watching him do battle with the nitwits there, I must admit) over to being a commentator at CNBC. Norman is on with the econ moron known as Larry Kudlow tonight at 7:10. Hey, we'll get the coverage where we can!,

Oh, by the way, Carney's wrong about the Founding Fathers - they actually were the first to apply MMT with a fiat currency and Ben Franklin knew exactly what they were doing. It is the real reason why King George got pissed off and sent in the Redcoats - get the colonists back on the gold standard so England could resume getting its "take."
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Post#3067 at 03-28-2012 06:13 PM by The Grey Badger [at Albuquerque, NM joined Sep 2001 #posts 8,876]
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Here's how Dana Blankenhorn calls it:

http://www.danablankenhorn.com/2012/...be-upheld.html

Brief summary: it will pass, because it's to the interests of Big Business that it will pass - because health care costs them, too. And passing it will be a Republican victory. And without it, everyone will be crying out for "Medicare for All!"
How to spot a shill, by John Michael Greer: "What you watch for is (a) a brand new commenter who (b) has nothing to say about the topic under discussion but (c) trots out a smoothly written opinion piece that (d) hits all the standard talking points currently being used by a specific political or corporate interest, while (e) avoiding any other points anyone else has made on that subject."

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Post#3068 at 03-28-2012 07:01 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by The Grey Badger View Post
Here's how Dana Blankenhorn calls it:

http://www.danablankenhorn.com/2012/...be-upheld.html

Brief summary: it will pass, because it's to the interests of Big Business that it will pass - because health care costs them, too. And passing it will be a Republican victory. And without it, everyone will be crying out for "Medicare for All!"
Here is the heart of his argument as to why the GOP, in the form of the SCOTUS conservatives, will rule in favor of the ACA -

The reason is basic. Without this law regulating insurance the government has no control over one-sixth of the economy, short of taking it over, which it is otherwise in the process of doing. The current law is a Republican solution, first proposed by Richard Nixon a generation ago, and implemented by Mitt Romney less than a decade ago

What, really, is the Republican Party's alternative to the present law? So-called health savings accounts do nothing to curb health care inflation. They don't keep doctors from engaging in blatant conflicts-of-interest, owning clinics and hospitals, deciding on tests, scans, and the most expensive treatments on their own say-so. They don't keep hospital companies from building palaces in place of treatment centers, with enormous atriums, and a stupid imbalance between specialists and generalists.
What would business face without ObamaCare? Millions priced out of the insurance market, and millions more about to be. No control over costs.
Worse would be this inconvenient truth. Medicare costs less than private insurance. VA care costs less than private insurance. Medicaid costs less than private insurance.
- here's the problem with that argument, the Right doesn't care about ANY of those things.

What you then have to imagine is that enough voters in the right set of Red states will vote-in 60 Dems and/or moderate GOP to allow the Congress to replace the ACA with something.

It's not going to happen. The Right knows that. There is no problem for them to kill off the ACA because, again, they don't care about the problems your guy raises, and just as important, they know there's not enough voters in the right places to make their lack of caring a problem for them.

Again, the only real hope is they strike down the mandate but nothing else. I'm pessimistic; not even the Obama lawyer is arguing for that. The court had to hire a lawyer to argue that case. The Obama guy is arguing for a limited separability that would let the insurers off the hook.

After today, I'm pretty certain that most of anything of real value is going to be thrown out if not the whole thing. History is pretty clear: it will take about two or more decades at least before anything is attempted again.

The only real possibility is that the resulting misery piled on top of all else that is coming will create a fundamental desire for change that will get those 60 Senate votes (which assumes the Presidency and the House as well). I'm actually now partial that along the way that, with the exception of Florida from Orlando down, we let the South secede. Maybe some horsetrading by giving them AZ for Northern VA to the Hampton Rds area and possible NC. I like to keep NM as well - give them KS.
Last edited by playwrite; 03-28-2012 at 07:26 PM.
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Post#3069 at 03-28-2012 07:14 PM by herbal tee [at joined Dec 2005 #posts 7,116]
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Quote Originally Posted by playwrite View Post
Here is the heart of his argument as to why the GOP, in the form of the SCOTUS conservatives, will rule in favor of the ACA -



- here's the problem with that argument, the Right doesn't care about ANY of those things.

What you then have to imagine is that enough voters in the right set of Red states will vote-in 60 Dems and/or moderate GOP to allow the Congress to replace the ACA with something.

It's not going to happen. The Right knows that. There is no problem for them to kill off the ACA because, agin, they don't care about the problems your guy raises, and just as important, they know there's not enough voters in the right places to make their lack of caring a problem for them.


I suspect that the law will be overturned for a very simple reason. Simply put, all of the analysis can be set aside for I believe that above all else the majority on the SCOTUS decides cases with outcomes rather than law in mind.







Post#3070 at 03-28-2012 07:41 PM by Deb C [at joined Aug 2004 #posts 6,099]
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Here's a possible solution.

"The only Good America is a Just America." .... pbrower2a







Post#3071 at 03-28-2012 08:00 PM by Odin [at Moorhead, MN, USA joined Sep 2006 #posts 14,442]
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Quote Originally Posted by playwrite View Post
My sense is the "step down" in this chart -




- is the new normal.

And with the next economic contraction (ignoring all the other uniquely 4T bad news, we're due for just a normal business cycle downturn next year), this chart will have another "step down" as the new, new normal.

Why the focus on guys? Because women tend not to resolve their frustrations at failing as providers with a gun.

One might take a reading of some of the millions of guys represented by that 10% (I believe) permanent drop and those in the next 10% permanent drop to come. The question is which ones? A relatively few could initiate a chain reaction far beyond the nicities of OWS.

Lots of unemployed young men = a very high risk of revolt.

Raging testosterone IS a plus sometimes.
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Post#3072 at 03-28-2012 08:11 PM by Ragnarök_62 [at Oklahoma joined Nov 2006 #posts 5,511]
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Quote Originally Posted by Odin View Post
Lots of unemployed young men = a very high risk of revolt.

Raging testosterone IS a plus sometimes.
::Thinks of Millies @ work:::


Actually, I wish I could have 'em neutered sometimes.TM
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Post#3073 at 03-28-2012 09:28 PM by KaiserD2 [at David Kaiser '47 joined Jul 2001 #posts 5,220]
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Quote Originally Posted by herbal tee View Post
I suspect that the law will be overturned for a very simple reason. Simply put, all of the analysis can be set aside for I believe that above all else the majority on the SCOTUS decides cases with outcomes rather than law in mind.
I am very uncertain about how this will go. It's true that the Republican five have shown a truly remarkable willingness to overturn precedent, e.g. in Heller (throwing out centuries of individual gun control) and Citizens United (throwing out a century of campaign finance regulation.) But are they really willing to wipe out such a key piece of legislation and set a precedent that could undo so much of the last 80 years? I have to wonder whether all the tough questioning was a way to position themselves with their actual constituency--and whether it will wind up a 6-3 vote with Roberts and Kennedy voting to uphold after all. There's no way to know.

During the Clarence Thomas hearings I told everyone who would listen that I didn't think Anita Hill's testimony, which I believed, was enough to keep him off the court, and that's what I still think. But I also said I was violently opposed to his confirmation because of the terrible opinions he would hand down--and boy, was I right.







Post#3074 at 03-28-2012 10:44 PM by Earl and Mooch [at Delaware - we pave paradise and put up parking lots joined Sep 2002 #posts 2,106]
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Quote Originally Posted by KaiserD2 View Post
During the Clarence Thomas hearings I told everyone who would listen that I didn't think Anita Hill's testimony, which I believed, was enough to keep him off the court, and that's what I still think. But I also said I was violently opposed to his confirmation because of the terrible opinions he would hand down--and boy, was I right.
Thomas is 63 (four and a half months older than my father) and if his health holds up, he could stay on the Court for a couple more decades.

I actually miss William Rehnquist. He was as conservative as anyone on the Court now, but once in a while he could be pragmatic.
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http://brucebase.wikispaces.com/1987...+YORK+CITY,+NY







Post#3075 at 03-28-2012 10:53 PM by Odin [at Moorhead, MN, USA joined Sep 2006 #posts 14,442]
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Quote Originally Posted by Ragnarök_62 View Post
::Thinks of Millies @ work:::


Actually, I wish I could have 'em neutered sometimes.TM
You should see the thrift store I work at! My boss is an '83 cohort and the 2 of us keep the place a well ordered machine, we run circles around my '49 cohort coworker!
To recommend thrift to the poor is both grotesque and insulting. It is like advising a man who is starving to eat less.

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