Already posted a review, but I wanted to second it and say that this was a extremely fun read. Looking forward to the next Radovan and Count Jeggare novel! Keep up the great work Dave!
Cheers!
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Mark, congrats from a random person! Paizo is incredibly lucky to be able to draw you into their infernal clutches.
Analysis of Paizo's global economic reach... Capitalgasim?
There was a point in this book's life where I would mumble things like "madness," "train wreck," and "bane of my soul." Sounds like me writing my thesis (due in three days). Particularly the parts like "train wreck," and "bane of my soul." I hope I come to love it after the defense. Oh, and on topic, really looking forward to this book! :-)
Congrats to all, and to Matt for taking the golden egg!
Not an easy choice for me. But in the end, I think Goodall has the chops: +1 vote for Cult of the Ebon Destroyers I really like Doom of the Dream Thieves, but it's just not a 32-page module. It's not even a single adventure path issue. The ideas in it are great, and I'm really hoping Paizo picks it up and makes it into a full adventure path in couple years time, or a couple modules that are linked together. But Matt Goodall's writing and theming won me over in the end. Cult of the Ebon Destroyers is tightly put together: good pacing (except maybe the initial chase scene - but keep the festival!), interesting elements, characters I can see being developed into some interesting NPCs...it has the goods! The other two adventure proposals also had some great moments. I hope to see all four names in the credits of future releases.
If this talk was an IPO announcement, I'd invest immediately.
Two solid entries, and easy votes:
Votes for people I want to see what they do in the next round:
Best of luck to all!
In no particular order: Richard A. Hunt - Slithering Horror
Actually, that appears to be reverse alphabetical order. Hmmm.
China Miéville?! Wow. Not a name I was expecting. I'm excited to hear Paizo and China have hooked up! His fiction has been one of my favorite discoveries of the last couple years. Can't wait to see what he does here. And, of course, all the rest of you awesome authors. :-)
When life begins is clearly contentious.To be clear, when "life" begins is not contentious. There are pretty clear biological requirements for something to be considered "alive". And it is pretty clear that a parasitic humanoid lifeform is alive. The issue isn't when life begins, the issue is when "personhood" begins. You're absolutely right. It was a poor choice of words; sorry if the meaning wasn't clear.
Boy, I really loved this item. The imagery is beautiful, and the results very functional for low level parties. I would steal this if only I had a campaign to steal it for. Look forwarded to see what you do in round 2!
When life begins is clearly contentious. Nothing new there. And that's exactly why women should have the right to choose. I think, in the above discussion, both sides have more or less admitted that they can see others side's point of view, they just don't agree. So, we do what we normally do in a liberal (as in free) society: we allow the individual to choose, while putting restrictions on that choice such that more radical views are out of scope. That is exactly how modern abortion law is written, more or less. Personally, I'm anti-abortion. I would never want someone I know to get an abortion, and I would strongly consul them against it, no matter what stage of the pregnancy they were at (well, past implantation in the uterine wall). But I recognize that I have no particularly good way to discern when life really begins, that opinions differ. And that I am a man. It's never a decision I will never have to face personally, as I am biologically incapable. And I think that counts for a lot. So, when it comes up for a vote, I vote for some restrictions, against others, but never to outlaw. The would be enforcing my views on others in a situation where I believe there is reasonable disagreement. That would be anti-democratic.
I absolutely love the name. A classic pun that isn't over distracting. Love it.
Our views on state as power and violence are doubtless an unbridgeable gulf. I can't imagine any argument that would make me believe other wise. If one disobeys the dictates of the state the state uses violence to take your property, imprison or kill you. I'm not sure what you suggest the alternative is. Obviously this leads to a fundamental difference in what we believe government is permitted to do. All I am saying is that either you learn to build a state that is seen to be representative, or you stay pissed off forever at being "forced" not to do things. People will always organize, be it at the local level (which we both agree we prefer), or a larger state or national level. To believe otherwise is to discount the social nature of humans. As such, it's rather important we figure out how to build social structures that are minimally coercive. There will never be complete agreement on what that means, but it is clear preferable to have structure close and local such that it is controllable, rather than far away. On that we agree. My suggestion was to start building such structures, rather than endlessly b+#%+ing about Washington. That is all. There are anarchists that do this, and most of them are incorrectly written off by libertarians (and the mainstream) as hippies, which is both ideologically wrong and, frankly, offensive. Not saying you do that, but that's how your argumentation is coming across. My second point is that I separate the here and now from the ideal future. I don't see how making millions of people's lives horrid is a good way to get from here to there. It's also completely unnecessary if we weren't all so set on destroying the government before alternative means of organization are in place.
We have spent trillions of dollars on social welfare here and what have we gotten in return? Trillions of dollars of national debt and tens of trillions of promises the government doesn't know how it's going to keep.Also, the middle class. :-) Indeed. The Ascent of Money by Niall Ferguson has a very nice overview of this process. Can't stand Ferguson's politics infused modern history (wherein he forgives Pinochet and other dictators), but his pre-20th century stuff is great. But I think DoveArrow was referring to the expansion of the middle class that took place in the 20th century, in large part due to the GI bill and associated social programs post-WW II, but also because of social improvements that had started to snowball in the late 19th century, and the continuing social movements of the 60s and 70s. That expansion happened for many reasons other than social spending, but without the GI bill (which was a massive, massive social entitlement) the middle class boom would have been much smaller.
...and they have chocolate! Swiss chocolate. Mmm.. Yumm...I'm going to go eat some right now... :-)
I could not disagree more with the supposition that "But the reason that the government got involved was because personal charity was an utter failure at making a substantive difference in social conditions." This is not a supposition, but a historically factual statement. I'll give you one example, but I'm sure you can think of more: the organization of child welfare. States had been involved since the late-1800s, but had by and large never established mechanisms to keep children off the street. Orphanages and foster systems were organized and maintained by religious organizations who often abandoned children once they were placed. This lead to the Aid to Dependent Children act, which eventually morphed into your hated TANF. Much of this happened because of a lack of private and state action. It was not some insidious plan. In the US. We have spent trillions of dollars on social welfare here and what have we gotten in return? Trillions of dollars of national debt and tens of trillions of promises the government doesn't know how it's going to keep. In my experience government charity is inept, wasteful, and intensely destructive. Feel free to add some facts to back up those suppositions. How much wealth has been created because of social spending? Do you ever add that in? Inept I'll give you, but you'll need to argue for intensely destructive. I can think of particular programs, particularly in the 60s and 70s, that were horribly thought out and implemented (inner city housing being one), and lead to much destruction, but you can't use that to paint everything red. Private charities in my experience are far more efficient and they tend to be far more decentralized. Even if you set aside their practical superiority they still have the fundamental advantage of being charity and not government theft at gun point. I view government social programs not as acts of compassion but rather as vulgar displays of power and force of the state over its subjects. See, this is why I try to stay away from American libertarians. You all seem so wrapped up in this "theft at gun point" BS. Do you like your roads? Bridges? Air traffic control? Military (I'll guess not for you on this one)? Computers and the Internet? Modern medicine? None of those things would look anything like they do, or be as large in scope, without the federal funding that got them there. There are costs that society pays together because private enterprise and charity are not systemically equipped to deal with some problems. And in terms of private charities...I think what you are describing is more the difference between large lumbering bureaucracies and small nimble groups of people. The Red Cross and other huge aid NGOs have just as much bumbling and fumbling as the U.S. government, you just have chosen not to see it. As we speak, Haiti is serving as a classic example. The U.S. government and large NGOs are all tripping over themselves trying to get aid out of the Port-au-Prince airport, while the smaller aids orgs have all realized that it's far faster and easier to come across the border from the Dominican Republic. In terms of people deserving their situation I don't see how someone deserves to be born into a bad situation. We should be responsible for our choices. Where one is born it not a matter of choice. Agreed. And that brings us back to TANF. It's goals are: * assisting needy families so that children can be cared for in their own homes
all of which are administered by the States who receive the funding. I think it's perfectly reasonable to disagree with how TANF is implemented, the structures the fed try to impose on the States, and that States or private charity can fulfill those goals by themselves. However, wishing for the death of the program, the goals of which you apparently support, without building a grassroots replacement is a non-starter for me.
I try and separate the current status of things and the future I would like to see. I agree with you that the two political parties in the U.S. are in firm agreement that larger government is better, no matter what either of them may say from time to time during campaign season. But I bitterly disagree that the state's main role must be coercion, as if that is some sort of natural law. Also, your view of democracy seems a tad stale. Modern democratic institutions typically disallow mob majority rule via a constitution. I currently live in a country with direct democracy, Switzerland, and I can tell you that people here do not view the state as coercive institution. This is because they have the power to overturn or add any law they want, be it at the cantonal or federal level. While this can result in bone-headed (and slow) politics from time to time (see the recent Minaret ban, or the struggle over suffrage), in general Swiss society takes it's time and gets things right. There are many reasons why the U.S. and Switzerland are not comparable, but the I encourage you to come visit or read about the history of a country with real democratic structures.
Bitter indeed. You seem to believe that people who are born into a crap situation deserve it. Care to elaborate? Do Africans deserve their situation? African Americans who grow up in the ghetto? Haitians? Curious minds want to know.Access to housing, healthcare, nourishing food, education and retraining requires more than $2 an hour. Allowing employers to pay so little exploits the most vulnerable at a level that ensures little opportunity to escape from poverty. In the end, taxpayers end up footing the bill to support exploitative businesses. I am hardly a statist, and confusing "leftist" and statist is poor, as "leftists" run a very large gamut of thought and political ideology. I'm largely of an anarcho-socialist bent ("libertarian-socialist," although that really only makes sense with the European definitions), which probably means we agree on many fundamentals, but see very different means for achieving similar goals. I also think you make a common conservative mistake, and forget that the government is of and for the people. Instead, you seem to see it as some sort of permanently coercive structure that is unreformable. This is quite sad, as it more or less gives up on democracy. As to the argument that personal charity is preferable to government action: I could not agree more. But the reason that the government got involved was because personal charity was an utter failure at making a substantive difference in social conditions. Or, to put it another way, it was the entity that acted when social movements were heard. Had states acted, many of the programs you likely dislike would not exist. Those who want to see a roll back of government social redistribution would do well to build alternative structures, get them to work, and try to reduce government interference. Doing just the last solves nothing. As to the constitutionality, take it up with the supreme court. I love the idea of small government, but most states in the Union are far from the point where they can be trusted to actually treat their citizens equally and help those in need. I agree that having the feds step in retards the debate that must take place at the state level, but I do not see a solution that would not first allow serious regression, particularly in the South. Which is a way of saying I understand your point, but I don't see a way to actualize it. Also, you didn't answer my questions. They were not rhetorical.
Access to housing, healthcare, nourishing food, education and retraining requires more than $2 an hour. Allowing employers to pay so little exploits the most vulnerable at a level that ensures little opportunity to escape from poverty. In the end, taxpayers end up footing the bill to support exploitative businesses. Bitter indeed. You seem to believe that people who are born into a crap situation deserve it. Care to elaborate? Do Africans deserve their situation? African Americans who grow up in the ghetto? Haitians? Curious minds want to know.
I'm a computer scientist working on peer sampling in peer-to-peer systems. The goal is to design algorithms that allow developers to improve the post-deployment understanding of their systems by low-cost sampling of appropriate state: route tables, logs, auto-tuned parameters, etc. Or, in simple terms, I'm trying to help others to make your illegal downloads faster and easier to find without a centralized tracker. :-) I do very little development myself, as the research largely focuses on using the properties of various mathematics to design more efficient and capable algorithms, and then proving that they work. For example, we've recently tackled the problem of distributed spectral estimation (i.e. eigendecomposition) of the top components of a P2P network's associated matrices. It's all quite fun, but is rather far from the more practical stuff I used to do.
Thank you for the link (part of the reason I love links, things I can follow and read). Interesting, wonder why this didn't get any airplay. Because Labtif is one of the biggest proponents of anthropogenic global climate change there is, and he sees the cooling as nothing more than a lucky break that may, *may* let us get our house into order before we are hot as the dickens. So it doesn't really mesh well with denialist ideology. The *may* is important too. Since a cooler weather cycle would counter warming effects, it obscures, politically, the fact that CO2 is still building up. When the cool period ends, suddenly the heat all comes at once, just as bad as it would ever have been.
So the better thing is the tyranny of the minority?Give it a rest! You are choosing not to listen except to that which you find offense in. I am sick of it.So you believe I, a non-Christian, should pay my taxes to support your religion just because I'm a minority? Oh, look, textbook case of tyranny of the majority.Sure if the voters have an issue kick the mayor, state senator, whatever elected offical out. I still think the local government gets to pick and choose, but the courts don't.So, you'd support tax dollars going to a satanist religious display, then? Freedom of religion means freedom of ALL religions, not just yours.I think this is what many conservatives point to when they say legisating from the bench or activist judges. It is also why judges are less trusted to be fair and impartial these days. American democracy 101: the rights of the minority are protected. That's a fundamental tenet of the U.S., and one should not confuse it for "the tyranny of the minority." Simply, in this case it means that freedom of religion must, by symmetry, translate to freedom from religion, i.e., freedom from religions that one may not believe in. Practically, that means the state can not sponsor religious display, as doing so explicitly supports particular religions. It has little to do with taxes (that would be an issue of fairness, not exactly something taxes ever are), but with religious freedom. Conservatives blow a gasket over this every Christmas, but it's actually a deeply conservative tenet, and very much hearkens back to state religious harassment in Britain and Europe. This is not liberals trying to prosecute Christians, but old American values trying to protect all religious faiths.
Alas, while we never put the "T" marks on the map, a reference to them being there snuck in through the text anyway. Frustrating. No problem. Just wanted to make sure I wasn't going crazy. With my lack of sleep it's good to double check my perception checks from time to time and make sure they aren't slipping too far. :-) Cheers!
Ciao- I very well may just be blind, but the 'T's for the isolation spheres seem to be missing on the map of Delvehaven's first floor and outer grounds. It's easy enough to just prep it before hand, but I wanted to make sure I wasn't missing something obvious.
This contest is what first brought Paizo's existence onto my radar. A truely amazing contest, and I very much look forward to reading this years entries. May the best imagination win!
These are the first pictures *ever* to have made me want to enter the halls of a middle school again. Oh, the memories, they burn... This looks like a really amazing production! Break some legs tonight (particularly Goblin legs)!
Vic- Thanks for the pointers on how number is used. I'm completely ok that this is all quite unavoidable, and it sounds like the information isn't stored permanently by any of the mail organizations. Cheers,
Thanks for the reply Gary and Vic. I appreciate it that Paizo has attempted to interpret the USPS regulations liberally in the past, and has only requested phone numbers when the number of rejections grew too high. Like others, I am curious what the USPS is doing with the phone numbers. Any clarification would be great, but I also understand this might just not be your first priority, particularly since it sounds like junk numbers are likely to work. Maybe someone has a pointer to a USPS privacy policy about international orders? All I can find is a large set of documents largely aimed at user's of their website.
Ciao Paizo- I just entered my phone number for international shipping, but was hoping if you could clarify what these new postal regulations are all about. Why does the U.S. postal service need my phone number? Can you point us to a document that explains these new regulations? Thanks!
seasthyday- Evince is an open source PDF reader that is available for Windows. It allows one to extract any resources from a PDF by dragging them. You can grab the installer here:
Cheers,
What about an early run-in with Sian Daemodus while they are chasing down some Shadowgarms? Sian is aware of the PCs at the start of the module, and might take it upon herself to do a little poking. Alternatively, her role could be broadened. Chammady and Ecardian Drovenge most likely desire additional confusion and cover in the coming months as they prepare for their betrayal. Increasing the level of shadow beasts to the point where the city's defenses are strained could prove to be very useful. To that end, Sian could also be tasked to try and figure out how to encourage more beasts to emerge from the old Pathfinder lodge. Any such encounter would be bereft of information besides the fact that, how interesting, someone else seems to be poking around the same places, bur apparently for very different reasons. That may give the PCs the impetus to try and follow Sian (near impossible unless you pull some dice rolls), or, more likely, do some social networking to figure out who she is. Either way, news that she has been hired on in the mayor's house would be very interesting...
One of my future PC wants to be a Paladin, and wants to know if in this new campaign, the fact to have a mount (because of all new feats for riding with the Hardcover) is a thing that can be important (or playable) or regarding to next battlemaps and dungeons during the campaign, having a mount is useless ? The vast majority of the campaign will supposedly take place in the city, so a mount wont be that useful. When a horse is necessary, it appears the AP will more or less provide them via a NPC. I certainly wouldn't expected a lot of mounted combat.
Anguish, thanks again for all this great material. I haven't DMed in years (expected a brief and aborted RotRL campaign this past January), and I'm putting together a CoT campaign in my spare time. Your stories are inspirational to say the least. Cheers!
You're in luck! It's actually a .NET assembly, which can be run in Linux with mono. I tried this yesterday and the application basically works, although some of the gui is a little off. If you are using Ubuntu, just do the following: sudo aptitude install mono-jit libmono-winforms2.0-cil then just type mono SewerGame_v1.1.exe
This has been an absolutely excellent game so far. Please keep the details coming!
Cheliax is more italy/rome (heavy venitian flavour in Westcrown the former capital) gone terribly, terribly wrong, twisted by diabolical influence. For proof of diabolic influence in Italy, see today's Il Manifesto, Italy's communist daily. The picture of Berlusconi says it all.
While the Swiss system is currently completely private, with government mandates and regulations, my understanding is that at its outset, it looked much like the current proposals in Congress, including a public health insurance plan. It was only recently that they dismantled their public plan when it became obvious it was no longer needed. Sadly, I have no information about this. The understanding I have is that the reforms were largely one-shot, and that matches how most big things in Switzerland are done: years and years of debate, formulation, and false starts, and then suddenly there is enough consensus to push a whole large package through. No idea on the public option. But I'll ask around and try to find more information when I get back.
As it is, I think I am going to have to leave this conversation. Obviously I am 'banging on' and annoying folks, so be it. We shall see what the future holds, for August is... Just checking in from work, so I don't have time to respond to your points, but I wanted to mention that I think you are argueing a largely understandable case on financial issues. The financial concerns in this reform are, indeed, extreme. It is not possible to seriously consider reform without making long term argument that often extend decades into the future, which is all rather unconvincing considering the difficulty of such predictions. It's good to have someone reminding folks of the costs. I just don't happen to find it a convincing argument for two reasons: 1) moral imperative and 2) long term financial security. I hope to find the time later today to come back and address your points one-by-one, but I'm trying to get ready for a business trip and may not have time. If not, I'll certainly give you a response next week. Don't disengage just because folks disagree...
Lets set some matters straight. First, the bill that the Church is concerned about is *not* the health care reform bill. It's S. 1173 and H.R. 1964, the so-called Freedom of Choice Act, which never made it out of committee and died in both in the Senate and House last year. It has not been reintroduced this legislative session, and there is no comparable language I am aware of in the current health care drafts. This means the various Conscious Clause acts that States have passed will continue to stand for the foreseeable future (horribe IMHO, but that's not the point here). Liberals in congress have been trying to pass the act for over a decade without success. So, what you have posted here is pure propaganda, with no relation to the health care reform bill. If you truly are a doctor, please inform yourself about the legislation dealing with your field before spreading misinformation. The whole idea should have seemed suspicious in the first place: do you really believe the Catholic Church would have shutdown 600 hospitals, giving themselves a huge black eye, causing the deaths of thousands? If watching Italian politics and the reaction of the church there to medical regulation means anything, the answer is clearly no. They do some showboating, and then quietly get on with helping people after the politics are done. By the way, over 50% of humans have a difficult time spotting sarcasm in fact-to-face conversations, much less online. Sarcasm tags can be useful...
Woah! The Trilogy from Dario Argento! Not the most commonly known director or set of work outside of Italy. Awesome. I can only expect things are going to get really dark as the AP progresses...
So you get to decide what someone means by the word "many"?I'm an Orthopedic Surgeon. The Idea of universal healthcare has tremendous unintended consequences. Many physicians would quit healthcare completely.Lets just stop right there, because you are either knowingly being dishonest, or are just misinformed as to your colleagues opinions: When they say "mass exodus"," and use adjectives that indicate majority several times, yes. Did you look at the surveys? B.J.: Please post some links to support your 600 hospital claim. Sounds totally unrealistic.
I'm an Orthopedic Surgeon. The Idea of universal healthcare has tremendous unintended consequences. Many physicians would quit healthcare completely. Lets just stop right there, because you are either knowingly being dishonest, or are just misinformed as to your colleagues opinions: * The Annals of Internal Medicine did a study in both 2002 and 2007 across 2,000+ physicians from diverse fields. Participants were randomly chosen from the American Medical Association Masterfile. 59% supported national health insurance, 9% where neutral, and 32% opposed it. Of that 32%, about half supported incremental reforms similar to what is on the table now instead of complete reform immediately. That's a grand total of ~78% of doctors who support some sort of reform. It's also worth mentioning that support went up across every category of physician from 2002 to 2007, by as much as 20% in those 5 years. Curiously, surgical specialists were one of three categories that were below 50% in support. (paper here) * The New Hampshire Medical Society also did a study along with the University of New Hampshire that found 66% supported single-payer, and 81% were for universal coverage, including 94% of general practitioners.(results) I can quote more such studies if you want. They all show pretty much the same thing in recent years: around 2/3rds of physicians support single payer, and more support universal coverage. For example, the Minnesota Medicine Magazine had results of 64% and 86% on those two quesitons. (results. No doubt there are doctors against reform, but they make up no more than 20% across the field. Saying 50% of physicians will flee is little more than fear mongering. Many of the 20% would doubtlessly stay doctors.
I'm not sure if those are good examples to point to. The postal service is always running out of money, currently they are talking about closing some postal offices around the country. Medicare is going broke, and even the Prez has admitted that when it does pay, it does pay its fair share, with private insurance getting charged extra from hospitals to make up the difference. The Forest Service has its own financial problems as well. Running low on money and running an efficient service are two different things. The postal service has it's hands largely tied behind it's back when it comes to things like rate hikes - and that's one of the things that makes it so efficient. Same is true with the forest service. During the Bush administration the total money allocated to the forest service was cut roughly by half. Yet they have found ways to cut corners and delay repairs such that they can keep the a service running for the public. Medicare has far lower overhead than any for-profit insurance company. I think they all make excellent examples. The fact they are underfunded in the long run is a separate mater. That is a mater of public decision making, not a reflection on their ability to do a lot with little. Co-ops would have as much teeth has large companies. That is because the larger your pool, there more risk an insurance company is willing to take (easier to spread the cost out). That is why individuals buying insurance always get shafted. We certainly agree there. But co-ops in the form I've read about would be limited to single states, and therefore unable to leverage across larger pools of risk. In larger states like California this could be okay. But much of the mid-west, and smaller easter states may not offer large enough markets for the co-cops to stay afloat. Doing something at the federal level avoids this problem.
Would you consider a Swiss style system? The government sets up basic regulations and then lets the market operate under them?I would be open to any plan that doesn't create a self-perpetuating array of well-payed sinecures that politicians can disburse to their cronys as payment for favors done. I've always found the implications of that argument interesting. Since there will be waste (and there will be in any social system), we can have none of it. We can not enable a small amount of inequality (i.e., sinqcures) in order to mitigate much larger inequalities (tens of millions of uninsured). Indeed, never mind the efficiency of some existing government programs (the Forest Service, Postal Service, and Medicare all come to mind). Government regulation is a much easier pill to swallow, one reason I had advocated co-ops. Co-ops, as I understand them, would be toothless and unable to control costs. There's a reason the insurance industry supports them: they won't force them to change. But I'm glad you would consider something like the Swiss system. In my time in Europe I've learned a lot about the various systems, and it has always struck me as being the most compatible with American prejudices. The industry would never accept it willing of course, which is why public option seemed like a decent alternative, giving them one last chance to prove their worth to the American public. But I do wish it would be talked about more in the public discussion, as it provides another model beyond the false boogyman of "socialized medicine."
Well, philosophically, I am against big government. I am not sure why you are so pro-government. I could give you many reasons why I have reached this philosophical conclusion that government doesn't run things as well as the private sector, just as sure as you can give me many reasons why you have come to the opposite conclusion. Government has its uses, I just don't see it doing a very good job with the social safety net we have now, and I am reluctant to allow them into healthcare. As always YOMV. Would you consider a Swiss style system? The government sets up basic regulations and then lets the market operate under them?
As an American living in Switzerland for nearly five years, I think I have something to add to this conversation. First off, European models for health care (and economics) differ fairly dramatically between countries. Switzerland happens to share a great number of economic liberal ideals with the U.S., and their health care system reflects this. The major points: * All insurance is private, with over 100 providers competing for customers. The companies are a mix of non-profit and for-profit (although the exact situation depends on the canton), and all must offer the same plans. After the deductible is met, all coverage is 90/10. No deductible is greater than 2,500 CHF (~2350 USD). * Employers must pay a second insurance called "accident insurance." Insurance companies can fight over a particular claim that doesn't fall squarely in one plan or the other, arguing the accident or health insurance should pick up the tab. Problems are uncommon, but this is a negative for sure. * Purchasing insurance is mandatory, with minor penalties for failing to do so. If someone refuses, the government will typically purchase a plan for them, and then send them the bill. Failing to pay that bill leads to a visit from the police. This is highly atypical, as there is little reason not to comply. (argh, my liberty to take on risk, denied! how dare they!) * If you can't afford insurance, the government subsidizes or picks up the tab. * Caregivers are a mix of public and private, but private care is common. Costs are much lower than in the States. My last hospital trip cost me 120 CHF, no coverage from insurance since I was below my deductible. The associated drugs cost another 60 CHF, and the wheelchair I needed for two weeks was 120 CHF. Try getting those prices in the U.S. * I pay 167 CHF a month, non-subsidized (foreigners are not allowed subsidy anyway), 2500 CHF deductible. It's one of the cheaper plans, and a more middle of the road price would be 180-190 CHF. 200-300 CHF for lower deductibles. * Eye and dental are separate, but cheap. I don't carry it, so I'm not up to date on costs, but they are in the low double digits a month. The Swiss see the competition in the market as key to costs. Indeed, costs have actually gone *down* slightly for me during the five years here. DOWN. That's stunning. The mix of non-profits is key, as it keeps the for-profit guys honest. That makes me a strong supporter of a real public option in the U.S., in the hopes that it could do the same. But for-profit can compete and still make money, which should put right-wing fears to rest. The industry is healthy here, and competition well beyond what you can find in most U.S. states. The biggest problem is a lack of doctors, but every Western country currently suffers from the same. Other issues? Well, none that I am aware of. The system is hugely popular, particularly since Switzerland had a horrid system just 20 years ago, very similar to the current U.S. situation. The Swiss right-wing fought hard against the current regulations, lost, and now largely embrace them as fundamental to Swiss life. There was a fabulous interview with the head of one of the center-right parties a year ago where he discusses how important the modern Swiss system is to the economic health and social well-being of the country, and basically apologizes for campaigning against it. So, from my angle, I have an amazingly hard time understanding the fear rife in the U.S. The data doesn't support it. If Switzerland and the rest of Europe are any indicators, well regulated or single-payer health insurance is key to bringing costs down, covering everyone, and in the Swiss case, increasing competition. I beg that people who are currently against real reform actually read the social statistics.
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