Morning Report – Low construction hiring the new normal? 1/21/14

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Markets are higher this morning on no real news. We won’t have any economic data until Thursday. We also have a snowstorm targeting the Northeast today, so bond desks will probably start heading home early and tomorrow may be a thin day as people are snowed in.
This week promises to be dull as there are no important economic data points and the FOMC meeting looms large next week. On Thursday, we will get existing home sales and the FHFA Home Price Index.
The WSJ is predicting that next week’s FOMC meeting will be full speed ahead on tapering.
Construction spending continues to increase, but construction hiring is lagging, according to CoreLogic. Is this a new normal? You can see from the chart below that construction spending and hiring used to correlate reasonably well, but but they did not during the recovery. It is certainly possible that the reason for this is that construction firms still had excess capacity and were able to meet the new demand without workers. FWIW, virtually every publicly traded homebuilder has been saying that skilled construction labor is hard to find. Don’t forget that we have underbuilt for 10 years and once household formation begins to recover we will need a lot of new construction.

51 Responses

  1. Another good rider in the omnibus.

    “Half of taxpayer funded research will soon be available to the public
    By Andrea Peterson
    January 17 at 6:06 pm”

    http://www.washingtonpost.com/blogs/the-switch/wp/2014/01/17/half-of-taxpayer-funded-research-will-soon-be-available-to-the-public/

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  2. FWIW, virtually every publicly traded homebuilder has been saying that skilled construction labor is hard to find. Don’t forget that we have underbuilt for 10 years and once household formation begins to recover we will need a lot of new construction.

    Do you think this is a result of people moving to find work (i.e., many of them back down south of the Rio Grande) or more that people have retrained into other jobs? Any indicators either way?

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    • McWing:

      Ya know, the President’s right, Republicans do need to be reminded of racism.

      I’m still none the wiser about how in the world conservative opposition to the federal government expanding Medicaid is the “flip side” of progressive assumptions that any states rights argument is grounded in racism. To be honest I think it was just Obama’s “non-partisan” way of trying to associate conservative arguments with racism.

      And I still remain curious why someone (Mich/Obama?) might think that making sure poor Mississippians are healthy is “important” for the rest of the nation. Any ideas? I can understand why it might be important to someone as an individual. But I can also understand why it might be relatively unimportant to other individuals. So in what way is it important to the nation as a whole?

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  3. I think it is because a lot of them found work in other sectors of the economy (particularly the energy sector). I am sure many who left Southern California construction jobs are sitting in North Dakota right now and re-assessing their decision.

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  4. Interesting. Volokh as part of the Washington Post.

    http://www.washingtonpost.com/news/volokh-conspiracy/

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  5. And I still remain curious why someone (Mich/Obama?) might think that making sure poor Mississippians are healthy is “important” for the rest of the nation.

    Because they’re Americans, just like Marylanders and Connecticutians (or whatever the correct plural is).

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    • Mich:

      Because they’re Americans, just like Marylanders and Connecticutians

      The only way this response makes sense to me is if you are making a moral, not a factual, claim.

      I thought you (via Obama) were making an appeal to the self-interest of conservatives by claiming that the health of poor Mississippians somehow has a positive/negative effect on all Americans. If this were true, then presumably one would be able to identify what those positive/negative effects actually are. But now it seems that you are really just making an appeal to your own moral compass. That is, the health of poor Mississippians is important to you as a matter of morality and therefore it should be important to everyone else. This is pretty typical progressive fare. Most of the progressive project, and the progressive tendency to concentrate decision making power at the federal level, derives from a desire to impose a progressive sense of right/wrong on everyone else, regardless of what they think.

      This just further confirms that the other part of your/Obama’s argument, ie that this concern for the health of poor Mississippians runs counter to the sense that Obama is a power hungry guy who just wants to destroy states rights, is non-sensical. Not only is there nothing about a sense that the health of Mississippians should be a matter of moral concern to all Americans that contradicts the view of Obama as a power hungry guy desiring to destroy states rights, it actually tends to confirm it.

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  6. jnc:

    Whatever did you do to poor Esperanza/SlowerLower to make him haunt you so? You’ve got your own little stalker now!

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  7. I thought you (via Obama) were making an appeal to the self-interest of conservatives by claiming that the health of poor Mississippians somehow has a positive/negative effect on all Americans.

    I am. And the fact that you disagree is simply one of the reasons why we’re on opposite ends of the political spectrum.

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    • Mich:

      I am.

      Well, then, what are those positive/negative effects?

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      • Scott, Let’s use me as just one example; and I am just one of millions, and if you consider all others due to many other available reasons, we are talking multi-millions. But here, for my personal situation/case.

        I always had health insurance throughout my 31 year career, at least up until off-shoring of my particular job/skill set. I lost my job and my employer health insurance beginning on July 1, 2010, and have not been able to obtain employer based health insurance since. And with my congenital disability, I have been an American with pre-existing conditions since I was born. And, since the medical treatment for my congenital disability is very expensive, I was not able to pay the exhorbitant cost for a high risk pool. This is what caused my doctor to officially document that I am no longer able to work. Hence, I have been unable to work for a solid year now that I’ve been “unemployed” and almost 4 years since I had health insurance and not have had any basic preventative care since either; which worries me about what other health issues are just waiting to be emergencies which possibly could have been avoided if I had had health insurance these past 4 years.

        Now if I had been able to be insured, as the PPACA would have allowed me to be, I would have been able to have the surgery I need and RETURN to work. As it is, since I didn’t have an affordable option, my disabilities have now worsened to the point that I need MORE surgeries which will keep me from ever working again.

        Now that means that simply due to the nature of our health insurance, pre-PPACA, I have lost at least 5 years (early retirement at 62) of being a viable member of income makers and tax payers as well as having lost the additional contributions to my retirement. Instead, I am now a member of the so-called takers. And I had no plans to retire at 62 either, I had planned to retire at my normal retirement age of 66 and 2 months; so I’ve lost even more.

        I am no longer a contributor to our nations economy as I no longer have the money to spend on anything, and am actually taking from our economy every time I need medical care. Oh and let’s not forget that we also receive $25/mo from SNAP; again, being a taker and not a viable part of our society.

        Now, multiply that by millions. Uninsured unhealthy citizens do not contribute to our economy, they only COST our economy. Not just in the state they live in, but for all states since they no longer paying federal taxes.

        And I will say once again, that helping others to pay for a monthly insurance premium is much, much, much less costly than leaving them to not only suffer, but to not be able to contribute to our nations needs as our healthy citizens do and leaving all their medical costs to be paid by everyone else.

        And I take offense of some of the comments made by some on here, such as Troll asking “What should be done with America a who think their personal well being is some one else’s responsibility”. Statements like that make someone like me, who has never been a taker in their whole life until last January when I was actually “forced” to be. I didn’t ask for my disabilities. I didn’t ask to have my job shipped away. And if I could do anything about any of it, I most certainly would have.

        Bottom line, unhealthy people make for an unhealthy economy, both state and federal, which affects us ALL. And I personally make no apology for my situation and my need. If anyone doesn’t want to help those like me get the healthcare they so very much need, fine, but don’t expect me to not take it personally.

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        • Geanie:

          Let’s use me as just one example

          I find it is generally not productive to use personal situations to press political points. Too much emotion involved, and it inevitably leads to someone taking offense.

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  8. “Michigoose, on January 21, 2014 at 7:44 pm said:

    jnc:

    Whatever did you do to poor Esperanza/SlowerLower to make him haunt you so? You’ve got your own little stalker now!”

    I’m harder to refute than the usual suspects. He and I have actually agreed on a couple of things.

    I do view Cao & Cef’s disdain/hatred as a badge of honor though.

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  9. @Michigoose: “I thought you (via Obama) were making an appeal to the self-interest of conservatives by claiming that the health of poor Mississippians somehow has a positive/negative effect on all Americans.”

    I just want to say that I think it’s in the interest of everybody to have a healthier nation (for a variety of reasons, but this would include regular physical exercise as being more important than health care, but that’s another discussion).

    To me, the questions would be, how big is that benefit (probably not very large in aggregate) and, most importantly, is the Affordable Care Act making anybody anywhere healthier in any meaningful sense? This I am dubious about.

    I suspect it’s a very poor allocation of resources. That is, the money would be better spent buying electric limousines for wealthy movie stars than paying for the real and figurative shuffling of papers at insurance companies and in the government. I’m guessing we might be getting something like a net $1 of benefit for everything $20 spent or something like that? If we’re going to appeal the self-interest of “selfish” conservatives, I think we’d have to be able to make the argument that we’re getting good benefit for the cost. And I strongly suspect we are not (but this is an intuitive assessment; and human intuition is lazy and easily misled, so it’s good to take such assessments with a grain of salt).

    A $10 a month membership to a gym, if used, would make poor Mississippians healthier by all the common metrics than thousands time that amount spent on wealth redistribution via insurance companies. Yet it’s tough to mandate rigorous regular physical exercise, cheaper to cut checks to pay for disease maintenance.

    As I have mentioned before, I’m paying very little attention to the news and politics. As such, I think I’m getting the experience of your average American. As an Average American, it appears to me that the Affordable Care Act is a godawful mess and a complete failure. A perception mostly formed via osmosis from occasional glimpses of news, and listening to other people who maybe watch a little more news.

    What’s the consensus of people paying much closer attention? Hyperbole? Going to turn out fine? Or is actually a godawful mess?

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    • Kevin:

      I just want to say that I think it’s in the interest of everybody to have a healthier nation…

      In what way? I guess we’d need to define exactly what we mean by “healthier”, but let’s say that next year the life expectancy of poor Mississipians increased by 1 year. It would probably be fair to say that Mississipians, and hence Americans as a whole, had become “healthier”. What benefits would you expect to accrue to other Americans as a result of this fact?

      I don’t think the actual healthiness of a given person in and of itself provides any benefits to anyone except perhaps to those few who have a personal involvement with the person. For everyone else, any such benefits are derived at the margins not from their healthiness but from any productive activity the person may engage in. So to the extent that healthiness is correlated with productive activity, which in the aggregate (although only for a certain demographic) and at the margins it might be, then I guess the increased health of total strangers thousands of miles away might be said to be of some marginal benefit to me. But as you allude to, this increased health is not cost-free. Not only is there the opportunity cost (could the resources needed to earn a net benefit of $1 by making X demographic healthier provide net benefits greater than $1 if deployed elsewhere?), I am not at all convinced that there is, in fact, a net benefit. It is possible, and I think very likely, that the resources needed to make certain demographics healthier far outweigh any potential benefits that might accrue to “the nation” as a whole.

      But honestly I think whether or not there are any real widespread benefits to making people healthier is largely irrelevant to the people who argue under the assumption that it does. They may truly believe it does, but the claim is really just a marketing ploy for what they want to do regardless of whether or not there are any real national benefits to be gained. I think that they want taxpayers to pay for things like health care and other forms of redistribution to certain demographics because they think it is the morally correct thing to do, not because it provides tangible benefits to those who have to pay. I suspect that even if it could be demonstrated (and it probably can) that the cost of trying to improve the health of, say, poor Mississipians via federal policy is actually greater than any potential economic benefits to be gained from their improved health, people like Obama would still want to do it. Because despite their marketing strategy, their advocacy is not in fact grounded at all in what benefits the “nation” may acquire, but rather in what benefits will accrue to the individuals to whom wealth is being redistributed.

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      • “I guess we’d need to define exactly what we mean by “healthier”, but let’s say that next year the life expectancy of poor Mississipians increased by 1 year. It would probably be fair to say that Mississipians, and hence Americans as a whole, had become “healthier”. What benefits would you expect to accrue to other Americans as a result of this fact?”

        Very minor ones, given it’s only one state. But maybe there could be some lessons learned about what increases health and longevity, and less healthy states could begin to take Mississippi’s example? And not just longevity, but healthier: a more productive and less sick populace means more productive work done, potentially, and less time and money lost to illness.

        “But as you allude to, this increased health is not cost-free. Not only is there the opportunity cost (could the resources needed to earn a net benefit of $1 by making X demographic healthier provide net benefits greater than $1 if deployed elsewhere?), I am not at all convinced that there is, in fact, a net benefit. It is possible, and I think very likely, that the resources needed to make certain demographics healthier far outweigh any potential benefits that might accrue to “the nation” as a whole.”

        I think some of that might be approach. Advocating and encouraging healthier behaviors (incentivizing good health behavior at the personal level) can potentially create high benefit. Funding the treatment of poor health, especially at end of life or the most expensive and most intractable diseases at higher levels . . . probably not.

        “I think that they want taxpayers to pay for things like health care”

        Which is an area in which I think we will probably be spending $10 to buy $1 worth of benefit. I think it’s the wrong direction for us to be going, period. For so many reasons. I don’t think the ACA solves any of the problems it purports to solve, and actually makes some of them worse, and just feeling good about the rhetoric and the sales pitch . . . I just don’t get that at all. Measure results. How many more people are covered? How many people have lost coverage? For how many people is it a wash?

        I’m paying $40 more a pay check now, which will add up to about $800 a year. A little less. I’m also paying $10 more on my copays. On the plus side, I’m getting better prices on most of my prescriptions, of which my family has several. For me, it’s a wash. If I went to the doctor more and got fewer prescriptions, I’d be worse off than before. If I worked somewhere else, my coverage could have gotten much worse or disappeared leaving me to fill in the gaps, which would have been terrible. Again, I think increasing healthiness has net benefits to everybody, but the ACA is not remotely the way to do it, and in fact may be counterproductive while costing more money than simply having done nothing.

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  10. What should be done with Americans who think their personal well being is some one else’s responsibility

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  11. My point is, some people do not take care of themselves, obesity, smoking, alcoholism, drug abuse, lack of exercise. Why should I be obligated to take care of them?

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    • Why should anyone be obligated to take care of a seemingly healthy person who doesn’t do any of those things but still falls victim to cancer, or a plethora of other such life altering diseases? I am totally against death panels, which means I support sharing in the costs of health care; for those who get early treatment (regardless of their life style) are usually less costly and the end result is that most will return to work and continue to be a viable citizen.

      And btw, who gives you the right to judge anyone? You have no idea what might have caused someone to turn to alcoholism or drug abuse or gain weight. Many people are obese for reasons other than simply they eat too much. Many people turn to alcohol and drugs because they are depressed, many clinically depressed, and it seems to them that no one cares, etc (especially with the enormous number of jobs that no longer exist in the U.S. and wages that are literally laughable). Perhaps if everyone were able to receive early treatments, many of these things could be avoided.

      But you, nor I, are physicians and have no right to judge what we know nothing about and we have absolutely nothing to lose in helping them get the medical treatment they need in order for them to become viable.

      Or, we can continue with all as it has been for so long (which I take you and Scott prefer) and continue seeing millions of people die (when their death could have been avoided); continue seeing millions file bankruptcy and/or lose their homes (when instead they could have had health insurance instead). I prefer not to have such horrible things happen to millions nor the after affect on our economy.

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      • Geanie:

        Why should anyone be obligated to take care of a seemingly healthy person who doesn’t do any of those things but still falls victim to cancer, or a plethora of other such life altering diseases?

        Legally obligated? No reason whatsoever.

        I am totally against death panels, which means I support sharing in the costs of health care

        Actually it is the “sharing” of costs that necessitates death panels.

        for those who get early treatment (regardless of their life style) are usually less costly and the end result is that most will return to work and continue to be a viable citizen.

        I suspect that is entirely dependent upon the condition that requires treatment.

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        • Sorry I did not respond to several comments until now. After my last comment yesterday I simply was not physically able to type any longer. And today isn’t much better for me (nerves are now affecting muscles throughout my back). But I want to respond (before I get all dopey from the meds I’m about to take).

          While several alternate options to the PPACA have been given, I whole heartedly agree we could have done better. Personally, I prefer single payer. But the fact is, the reality is, we currently have the PPACA, and I do feel it’s better than what we had. And not because “I” need insurance, and not because of any subsidy. I wish I were still working and if so, I wouldn’t cry about my insurance premium also covering part of someone else’s as I am really tired of paying entire medical bills and higher consumer prices, etc. as we all have done for decades to cover the uninsured’s medical costs and/or bankruptcies, etc.

          As far as “those who do not take care of their health”, well, it’s like everything else. There will be those who just don’t give a crap. And remember, America has a huge obesity problem, and a huge alcohol problem, and a huge drug (prescription) problem. Sad that we ignored so much for so long. But, as I see it, the only way to overcome these problems and get more Americans healthy, we must all face it, accept it, take ownership and do all we can, as unified Americans, and see that everyone has access to affordable healthcare. I may be naive, but I honestly believe that most people who are not healthy, want to be healthy. And perhaps having access to healthcare, they will take the initiative and get healthy.

          I will always believe a healthy citizenry is better not only for each individual, but for our nation’s economy as a whole, no matter what part of the country each individual lives in. I also believe extending a helping hand for those who want to do better is much better than berating them for their “previous” choices. Millions have gone down the wrong path, physically, and have recovered, myself included.

          I’ll close with this: Our Founding Fathers acknowledged every citizen the “right to life”, Does that mean that depriving someone access to the healthcare they need to stay alive is a violation of that right? I think it does and I also believe if the Founding Fathers were around today, they would absolutely have created a national healthcare system, and most likely, a single payer. Why do I say that? First because of the “right to life” and also because 4 years after signing the Constitution, George Washington and others faced a multitude of deaths due to small pox. George Washington actually lost many soldiers from small pox and WA-LA, implementation of what we today would refer to as National Healthcare as mass innoculations were provided via both taxes and private donations to whole communities spread throughout. Their basis was the “general welfare” clause.

          Now I am off to take my pain med and muscle relaxers I need to get through the rest of today. I will check in as my pain allows me to. Thanks for the debates and I wish you all a wonderful rest of day!

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        • Geanie:

          Does that mean that depriving someone access to the healthcare they need to stay alive is a violation of that right?

          It depends upon what you mean by “depriving someone access to healthcare”. If by that you mean passing a law that makes it illegal for a person to obtain health care from a willing provider, then yes. If, however, you mean failing to pass a law which forces someone else to provide a person either with health care or the means to obtain it, then absolutely not.

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        • Scott, do you think there is any form of national healthcare that you would approve of? Single payer? I ask because either way, with any national healthcare plan, it would be a law and you and I and mostly everyone else would still be paying for the healthcare of our poorest. It’s simply the nature of the beast, just as it was with the “forced” small pox inoculations, paid for by all, just 4 years after the signing of our Constitution. Perhaps the best solution is to ensure no one is poor LOL.

          Troll…. Yes, I agree there are “some” people who simply need to face and take ownership of their own actions. But I am not one of those who ignore the needs of the majority because of the lack of responsibility of the few.

          At this point, I agree to disagree on this subject. We all view how the world should work, how the U.S. should work… and I happily agree to disagree.

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        • Geanie:

          Scott, do you think there is any form of national healthcare that you would approve of?

          No.

          BTW, government imposed (or even just offered) inoculations to prevent a plague or contagion of a specific communicable disease is quite a different thing from generic “national health care”. They are not comparable at all.

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        • Geanie:

          Perhaps the best solution is to ensure no one is poor LOL.

          Actually I agree with this. While it is of course impossible to ever ensure that no one is poor (especially because “poor” is always and everywhere a relative term), what can be done is create an environment in which people are least likely to be poor, and have the most opportunities to avoid being poor. That environment is one in which government is only very minimally involved in economic decision making. Unfortunately what we have is an environment in which government is extremely and increasingly involved in virtually all economic decision making in one way or another. And that is due largely to the pervasiveness of leftist ideology throughout the nation.

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        • That environment is one in which government is only very minimally involved in economic decision making.

          A bold assertion.

          No sane, honest reading of either US history or the Constitution itself could conclude that state recognition of SSM is constitutionally mandated.

          I don’t read it there, but it is neither “insane” nor “dishonest” to extend the 14thA. to homosexuals as a category.

          Former Fifth Circuit Judge Charles Clark, a very conservative Judge, once challenged me from the bench to the effect that the 14th A. only applied to “black persons”. While freeing the slaves was the genesis of the amendment, logic demands that black persons were to be treated to equal protection with some other persons, presumably white ones. The language of personhood seems to demand equal treatment for all individuals, including even women, to me, so I opposed the ERA in the seventies. How much of a leap is it to suggest it must apply to homosexuals? Certainly it applies to them in the state courthouse. Or in the public schools.

          To me, the best argument is the one QB makes – there is a rational basis [albeit a slim one – only a very slim one is needed] for defining marriage as between a man and a woman. Thus, while I would vote to permit homosexual marriage were I a legislator, I would avoid the 14th A. issue on rational basis grounds were I a judge. And even here there is just a small sliver of a rational basis left, once we say homosexuals can adopt and raise children, unless we want to argue that the best interest of the child is served by married parents if they were conceived, but by single parents if they were adopted by homosexuals. This last concern was the one Kennedy voiced from the bench, btw.

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        • We are having an insane day today with SNOW and freezing temps til noon. Then the sun will come out and it will be 70F tomorrow and 75F Sunday. As a result of this INSANE day my case in Williamson County will not be heard. The courthouse is closed. I am going back to sleep. I know some of you think 30F with snow is normal. Here it is a once in five year event, sometimes once in ten years. My twin granddaughters were five yesterday and they cannot wait to go outside and make snow angels, which they last did on an Xmas visit to their aunt in Larchmont, NY, in 12-12.

          But I digress…back to sleep!

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        • Mark:

          A bold assertion.

          Not really.

          …but it is neither “insane” nor “dishonest” to extend the 14thA. to homosexuals as a category.

          I didn’t say it was insane or dishonest to extend the 14th amendment to homosexuals. I do think it is an insane or dishonest reading of the 14th amendment to claim that if it applies to homosexuals (which of course it does) it requires states to redefine marriage for the purposes of state law.

          Does the 14th amendment extend to siblings? If so, does that mean that it requires state law to recognize “marriages” between siblings? Of course not. There is nothing about either the language or the history of the 14th amendment that suggests that the application of the 14th amendment to all citizens disallows states from defining marriage in the same way it has been defined throughout all of human history. To claim otherwise, and to suggest that to oppose legal recognition of SSM is to think the 14th A doesn’t extend to homosexuals, is to my mind dishonest or insane.

          Just to be clear, I don’t think that moral arguments to the effect that SSM should be legally recognized are dishonest or insane. But to argue that the Constitution requires it just furthers us along the path of viewing the words of the constitution as infinitely malleable (and therefore basically meaningless), both justifying and requiring whatever outcomes a judge may view as “just” at any given time. This places our governing decisions in the hands of unelected and unaccountable lawyers in robes, rather than in the hands of citizens, where it properly belongs.

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  12. Geanie, I brought up behaviors which only the individual can control. If they expect me to contribute, I expect them to control their behavior. Why is t that a reasonable expectation?

    Why would you assume I prefer the status quo prior to the ACA versus millions dying unnecessarily. I have a different view of what works and how to go about doing it. I’m not arguing in bad faith nor do I think you are even if you prefer Obamacare to pre-Obamacare.

    Finally, what should should a life saving treatment cost?

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  13. @American Mima: “Or, we can continue with all as it has been for so long (which I take you and Scott prefer)”

    Why do you take it that way since they did not specifically say that? In any case, it seems to me that, despite the lofty aspirations of the PPACA, it seems like it’s exacerbating the problems created by employer-funded healthcare and 3rd party payers.

    I do not know that it solves the problems it is meant to solve, or if it just relocates some of them: for example, moving money once dedicate to certain coverage to pre-exisitng condition coverage, or simply increasing the cost of health insurance for everybody (thus becoming an active aggregate restraint on economic activity), thus neutralizing the potential benefit of having pre-existing conditions covered comprehensively.

    My tendency is to suspect that it presents a net economic loss to the economy as a whole, not a gain, although there will be individual stories where things are better for that individual than they otherwise would have been. It’s also my suspicion that as time goes on, it will become apparent that there is no net benefit in regards to increase longevity, increased health, reduced healthcare expenses, etc.

    I also tend to suspect this isn’t going to go down in history as a great governmental accomplishment on either the left or right. It seems to expand government and increase cost while offering few benefits (unless one counts increased bureaucracy and a great deal of waste a benefit) while not covering anybody, and not providing a single payer solution.

    Most of the problems regarding healthcare have alternative solutions that could have been proposed, if not passed, that were not. Bankruptcy could be resolved by a separate universal catastrophic care coverage policy that kicks in for medical bills for catastrophic care, and high levels. Should the government do that? Maybe not, but it certainly would have been simpler and more effective at managing the financial impact on individual citizens than what we got.

    There could have been an expansion of Medicare to cover the unemployed, children in households living below the poverty level, etc. Would not have been perfect but would been simpler and less expensive.

    A less ambitious bill without exchanges and everything else could have been introduced to require pre-existing conditions be covered after a limited period, or that pre-existing conditions previously covered by employer insurance has to be covered by subsequent insurance and cannot be excluded prejudicially, while not requiring instantaneous coverage of all pre-exisitng conditions.

    … anyway, I think it’s hard to argue that skepticism regarding the ACA = not caring about people dying, or that the ACA is going to be a guaranteed net benefit for the economy. Right now, that looks highly doubtful to me, though I’m sure the devil is in the details and I might be missing something.

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  14. @Troll: “Geanie, I brought up behaviors which only the individual can control. If they expect me to contribute, I expect them to control their behavior. Why is t that a reasonable expectation?”

    This is reasonable, and we all accept it when it comes to smoking. Nobody is complaining that insurance companies all ask if you use tobacco products.

    But one could reverse this: lifestyle choices lead to a great deal of medical expense. Certainly, health and mobility is greatly impacted by what you eat, drink, smoke (or don’t) and how much exercise you get. These things have a profound impact on your health, and can have the most positive impact if correctly managed for the least amount of money. I’m not sure what the justification is in paying hundreds of millions to treat conditions that could better be treated by cheap or free behavior modifications. I mean, that money might be better spent getting everybody free gym memberships and campaigning and offering tax incentives for folks to eat better and exercise. It would not be any better received by conservatives and libertarians, and for good reason (government is not our nanny) … but it would have the benefit of being a use of the money much more likely to improve people’s actual health.

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  15. But, as I see it, the only way to overcome these problems and get more Americans healthy, we must all face it, accept it, take ownership and do all we can,

    Or, people can fully face the consequences of their own actions.
    That will modify a lot of behavior.

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  16. @ScottC: “That environment is one in which government is only very minimally involved in economic decision making.”

    Which isn’t likely to happen, so it’s more of an environment where the private sector remains free enough to create more wealth than the government confiscates at any given time. When we get to the point where government regulation and taxation force the economy overall into negative growth, more people are going to be poor. Enough negative growth for long enough, far more people will be poor, allowing poverty to be more egalitarian, if no more enjoyable.

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    • Kev:

      Which isn’t likely to happen

      Regrettably true.

      I think most things, from the New Deal to Obamacare become part of our daily life because enough people go: “Huh. That sounds like a good idea.”

      I think it is definitely true that most people do not operate under a consciously thought out, well considered ideology. However, I do think that after decades of effort, the consciously ideological left has had an impact on the culture such that the average, non-ideological person is becoming much more amenable to leftist policy proposals. That is, they are increasingly willing to think that federally imposed “solutions” to perceived problems are a “good idea”.

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      • @Scott: “I do think that after decades of effort, the consciously ideological left has had an impact on the culture such that the average, non-ideological person is becoming much more amenable to leftist policy proposals”

        Why? Because they sound like good ideas. Conservative ideas, in the abstract, generally sound bad: “Hey, here’s are thought. You pay for your own stuff. And worry about your own retirement. And handle your own life. And we’ll defend you from foreign invaders, and we’re done. And you’ll pay a little less in taxes and rich people will pay a whole lot less in taxes. But that’s fair because they make more money. Also, it’s up to you to deal with the assholes you work for. You don’t like it, quit. And buy your own damned health insurance.”

        Liberal ideas are more like: “We’ll take care of it. Don’t worry. Lollipops and rainbows for everybody!”

        Just by the very nature of political liberalism makes it more appealing, and the ideas more appealing, for those who don’t spend a lot of time thinking about it. Thus: “You’ll pay for my healthcare? That sounds awesome. Lets do that.” And they don’t read the fine print because almost nobody reads the fine print.

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        • Kevin:

          Why? Because they sound like good ideas.

          My point is that they only sound like good ideas because of the influence the political left has had on the culture. There was a time when those ideas wouldn’t have sounded good to most people at all. It would have been shameful and embarrassing to have the government, or really anyone besides oneself or one’s family, doling out the necessities of existence, implicitly suggesting that one was not capable of doing so oneself. There was a stigma attached to accepting welfare/charity, and even when one did it out of absolute necessity, it didn’t feel good or right.

          That has changed. Progressives have to a great degree successfully infused the culture with the notion that not only is it not shameful to look to the government to take care of you, it is in fact the your right to have them do so. The government is supposed to be doing so, and if it is not, you are being cheated somehow. Hence, progressive policy proposals increasingly, as you put it, sound like a good idea to those who don’t spend a lot of time thinking about it.

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        • Scott, I guess my argument is that the change is inevitable (I mean, we’re not talking about a recent change, either: since the age of FDR and then again under Lyndon Johnson we find a society amenable to the government providing and ensuring a certain quality of life, the only thing that’s been changing in the past 100 years is the quantity of things the government is suppose to manage and make safe for us, and the degree to which it is to provide for us, and that tends to move upwards with the overall level of economic wealth and GDP).

          Generally, it only sounds like a bad idea for you to have someone else take care of stuff or give us free money when it’s transparently impossible or an obvious trap. When it sounds plausible and is not obviously a trap, it sounds like a good idea.

          Even today, most people who don’t want to trade liberty for security or have more of their income taken away so the government pays more of their bills . . . they tend to see it as an obvious trap! And/or impossible. And they aren’t wrong . . . look at our national debt. It’s not a matter of if our level of social largesse is impossible to maintain, it’s a matter of when it becomes so unsustainable we can’t even pretend any more. Like Greece.

          Which may be where we are headed. Unless economic growth or technological innovation swoops in out of nowhere and saves our bacon once again (without technological innovation and economic growth since the 1940s I tend to suspect just the New Deal would have bankrupted the country, and certainly without economic growth in the late 70s and through the 80s (and certain innovations) The Great Society might have bankrupted us. In fact, there’s a good chance that it still will, without adding the ACA on top of it.

          But, I’m keeping my fingers crossed!

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        • Kev:

          Scott, I guess my argument is that the change is inevitable

          I suppose. But so is tooth decay, and still we brush our teeth and take other steps to stave it off as long as possible. Unfortunately the decay of progressivism has taken a firm hold of the culture, and no amount of brushing is going to stop it now.

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        • Time to pull ’em all and go for dentures.

          Dentures that the government pays for, naturally. As teeth are a right.

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        • Kevin:

          You said earlier:

          I really don’t care for most of the Republicans or most of the Democrats, so who am I going to root for?

          I think it matters greatly whether we are talking about national politics or local politics. I agree with what you say in the context of national politics, but I don’t root for politicians so much as I root for certain ideologies/policies. And it’s probably more accurate to say that I mostly root against certain ideologies/policies. I think the federal government should be relatively invisible and unimportant to the average daily lives of citizens. And so I am rooting against whichever politician seems the most interested in telling other people what to do. And almost inevitably that is a Democrat, because their ideology is to embrace the power of government to tell other people what they must do.

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  17. @ScottC: “And that is due largely to the pervasiveness of leftist ideology throughout the nation.”

    I think it’s probably more a result of our tendency to rely on intuitive logic, which is convenient for snap decisions in eat-or-be-eaten pre-agricultural days, but not always useful now. While some people may be monomaniacs on a mission to have a central government that ensures a future liberal utopia by somehow mandating everything they feel makes for a perfect society while forbidding everything else . . . I think most things, from the New Deal to Obamacare become part of our daily life because enough people go: “Huh. That sounds like a good idea.” Without really subjecting it to any kind of rigorous analysis, which would necessarily involve an objective analysis of pros and cons, case histories, etc. And a very suspicious eye towards the very (documented) human tendency to make causation out of what is often if not usually random correlation.

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  18. @Troll: “Or, people can fully face the consequences of their own actions.”

    Only in the sense that they will get sick and die. Even with someone else paying for it. open heart surgery and cancer treatments and so on are no fucking fun.

    If facing up to the consequences of their own action would make these people change their behavior, their behavior would already be changed. The question is whether or not we should pay for it, because whether we do or not, they will continue their bad behaviors until friends or family stage an intervention or they die.

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  19. @Geanie, Scott:

    “for those who get early treatment (regardless of their life style) are usually less costly and the end result is that most will return to work and continue to be a viable citizen.”

    “I suspect that is entirely dependent upon the condition that requires treatment.”

    I’m pretty sure that preventative care extends longevity and limits environmental illness (and related expense) up until the last years of life, where all the savings are generally lost in ongoing end-of-life medical care that becomes very expensive no matter how much preventative care was paid for in the past, and there are (if I recall correctly) studies that they are actually more expensive (I think based on the long-term medical expenses of smokers versus non-smokers, as it turns out that the smokers died earlier and quicker, and thus were less costly to the healthcare system than healthier people, on average).

    Which is why you’d have to have “death panels” (i.e., be choosy about who you are going to waste money on for end of life care, because, in the end, all this expensive healthcare will end with two things: huge bills, and the patient will be dead).

    The only things that will decrease medical costs is technology that reduces the cost of the most common treatments, or replaces them (i.e., a legit cure for cancer could replace numerous expensive treatments with one expensive treatment). Microsurgery and robotic surgery (initially way more expensive) will get refined and automated, and reduce real costs (overhead of insurance and whatnot is another story).

    It’s a fantasy to think that widely available healthcare will significantly reduce healthcare costs in aggregate without denying expensive healthcare to the very old, as that is when the vast majority of healthcare expenses are accrued. And the healthier you are for most your life, the higher those expenses tend to be, as you tend to hang on a lot longer.

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    • Kevin:

      It’s a fantasy to think that widely available healthcare will significantly reduce healthcare costs in aggregate without denying expensive healthcare to the very old, as that is when the vast majority of healthcare expenses are accrued.

      Totally agree. And the conclusion is not even restricted just to the expense of the very old. What people tend to ignore is that there is a cost to making health care “widely available”. Is that cost really less than the cost of dealing with the health implications of not making it “widely avaialable”? It is almost certainly true that making annual breast cancer screening for all women over 18 more “widely available” at the expense of the taxpayer would lead to a “healthier” population of women. But would it in fact be cheaper than not providing that annual screening, and just dealing with the health implication of the much smaller population of women who actually get breast cancer?

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      • “But would it in fact be cheaper than not providing that annual screening, and just dealing with the health implication of the much smaller population of women who actually get breast cancer?”

        That depends on the math of how much the screenings cost versus treatment versus how many screenings are already done versus what can be done to reduce the price of screenings (there may be technology on the way that will make screenings way cheaper, thus making it a net cost savings to prevent breast cancer, if folks do the math). But the actuarial tables will always be important: that is, while you may save a little money by starting your screens at 18 and preventing breast cancer in everybody, it might be way cheaper to start them at 26 and prevent breast cancer in almost everybody.

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  20. @Geanie: “Scott, do you think there is any form of national healthcare that you would approve of?”

    I’d support one that had some potential to perform as promised. ACA isn’t it, and I can’t really imagine one. Maybe some kind of single payer catastrophic healthcare plan, or Medicare coverage for cancer (our most common bankrupter). Government run exchanges, etc., doesn’t sound like any kind of answer, to me.

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  21. If that is what happens whether I pay or not…

    Guess I’m not understanding where I am co-responsible for their Rob Ford like behavior. If I am responsible then am I not justified in demanding, nay forcing accountability? If not, why not? Seems to me I’m then as guilty as the person themselves. I refuse to do nothing. Why can’t we put them in camps with forced nutrition, exercise, etc.

    You think I’m kidding but if I have to pay I’m going to call the fucking tune.

    There is a solution though, allow people to suffer the consequences of their own actions.

    Nothing is inevitable.

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