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Government Health Care: Who's being naive?
Submitted by Jon Henke on Mon, 11/16/2009 - 14:36
in
More than a few people have accurately observed that politics invariably turns into a a protection racket. Note: None have made the point more enjoyably than the brilliant Mary Katharine Ham in this video.
In the Washington Examiner, Dr. Paul Hsieh (of Geekpress) points out that, even if they only intend to give people lower costs and more access, government tends to make offers that you can't refuse. We already see this happening in health care, and more intervention will only exacerbate it - especially as the budget crunch becomes more a more immediate problem.
Suppose the mafia came to your town and forced everyone to purchase all their meals at mob-approved restaurants. The mafia would also select the menu items. [...]
Under any system of mandatory insurance, the government must necessarily determine what constitutes an "acceptable" plan. Hence, this creates a magnet for special interests seeking to include their pet benefits on the required insurance menu.
Massachusetts residents must purchase numerous benefits that they may neither need nor want, such as in vitro fertilization, drug abuse therapy and chiropractor services. If you'd rather purchase low-cost catastrophic-only insurance without those options, tough luck. Mandatory insurance thus violates the individual's right to spend his own money for his benefit according to his best judgment. [...]
Like the mafia, Congress wants to make you an offer you can't refuse. At least the mafia doesn't pretend that it's acting for your own good.
There is no doubt that our current health care system is deeply flawed, and I accept that health care presents a genuinely wicked problem for both markets and democracies. However, the more complex the attempted "solution", the more room there is for errors, unintended consequences, protectionism and rent-seeking. We have already seen the administration try to buy off doctors, pharmaceutical companies, insurance companies and hospitals with legislative favors and protection. That's not an unusual error. That is how legislation works.
Current legislation may be a problem, but the biggest problems lay over the horizon where deficits and debt will force compromises and mandates driven more by public choice theory than public interest.
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Comments
Could it have been more brutal?
The Healthcare bill includes adoption fees http://tomburnett.wordpress.com/2009/11/14/what-obamacare-covers/ Not that I do not agree with assistance to those who want to adopt ... I just find if hard to reconcile making the elderly pay for it with their health care.
Consumer choice is awesome with my private sector plan
In my private sector plan, I was able to choose what services I wanted as part of my HMO. So I decided to cover my liver but not my brain. I also choose to cover my middle finger just in case some rabid liberal bit it off when I disrupted a congressman's public meeting by yelling Obama is a nazi over and over again while people tried to talk reasonably. However thankfully my private sector plan is so flexible that I was able to opt out from covering my right pinky finger. That saved me 30 cents a month. I also choose to cover my left butt cheek but not my right. Obvious I figure one is good enough right? Working my way down, I don't need my left knee. If I blow it out running from the cops after I egged the local abortion clinic, I figured I can hop on the right leg for the rest of my life. Good savings there. God is so great for giving me two legs! I also chose not to take frostbite coverage, alien abduction or the granny death package, but chose to take ear canal damage rider, left metatarsal breakage and the extended warrantee on my spleen. I can have it rotated every 30,000 miles! I hope that was a good decision. What do you think?
Thank God for private sector flexibilities with health care! Goodness knows that a public plan wouldn't have such flexibility! Now I just have to worry about losing my job. Cause if that happens I'ld lose my health coverage! Or have to pay full price for it. Be about $500 per month on COBRA but I could probably go direct like I can with auto insurance. Or could I? Of course I have a preexisting condition so I wouldn't be able to get coverage anyway. Who knew that breaking your arm 20 years ago when I was 18 would keep me from buying private sector health insurance. But anyway, screw portability when I can chose from whatever plan my company tells me they'll let me have!
Is there a party any place that lost the next election after
introducing universal coverage?
The art of the possible
Our present health care system is untenable. Health care costs have gone from 5% to 15% of income in decade. We are unable to refuse treatment to needy people with out insurance. This creates a very inefficient system in which uninsured people get routine care in an emergency room (where it is very expensive) or not at all (leading to more expensive avoidable emergencies). If we don't choose to change our system in a way we like, the system will change for us in a way we may not like.
Democrats have chosen to face this issue rather than bury their heads in the sand. Most experts think one of the European models (regulated private insurance (Germany), single payer private provider (France), national health service (England)) would be best. But this is not possible in our current climate. The House bill, with all the flaws you list, is far better than what we have now or anything Republicans have proposed.
Henke did not propose anything. He did not respond to the obvious answer to his post -- if insurance is mandated, there must be a mandated minimum package. He did not offer a way to assemble that minimum package that is any better than what the House bill. He did not say how to get everyone to buy insurance without a mandate, and he did not propose not to treat uninsured.
Henke does not seem to know much about this issue. If he does, he doesn't show it. Try reading Ezra Klein, or Peter Orszag.
Bottom line: all grump and no ideas . . . yet again.
61% of Americans polled agree with you.
New ABC/WaPo poll out this morning.
Q9. Do you think leaders of the Republican Party are mainly presenting alternatives toObama’s proposals or mainly criticizing Obama’s alternatives?
IF
A person does not want to buy health insurance, should the government force them to do so? Most people say no, & they are right. The house bill would jail & fine a purportedly "free" citizen if he or she did not purchase government approved insurance - if that person wanted catastrophic coverage only, he or she would not be allowed by the government to purchase it.
There are proposals from the Republicans & others on the right to actually fix what's broken with our healthcare system instead of breaking what is good - which is the crux of Democrat plans. That you do not know about these is not the fault of Henke or Ham - bing or google works well for this information.
The problem with health care in the US is not the quality provided, it's the costs. Tort reform & allowing insurance to be sold across state lines may not fix the entire issue - however, it would be a good start. It would be foolhardy to think that a government which purchases a hammer for $200 & "creates (very temporary) jobs" at $50K a pop would bring down the cost of healthcare...
look at the numbers
Tort reform might lower health care costs, but not enough to make much of a difference. The tort reform in Texas hasn't lowered Texas health care costs. Selling insurance across state lines will lead to regulation competition. If a consumer in California buys from an insurer registered in Mississippi, the consumer will not be able to sue in California courts because the compant is in Mississippi, and not in Mississippi because the consumer is in California. The Republican bill writes this insurance company protection Catch 22 in explicitly.
This lowers health insurance costs by protecting insurers from the responsibility of fulfilling their insurance obligations. It's recision on steriods.
The Republican plan does not protect consumers. It does not expand health care coverage to more Americans. It protects providers from having to fulfill contracts or taking responsibility for mistakes.
forcing people to buy insurance
LGM,
I noticed you didn't address Whitehorse's main complaint, which is the Democrats' insistence that free citizens be coerced into buying health insurance. So, are you in favor or opposed?
In favor
I understand your point about forcing people to do something, I really do. But I don't think its such a new idea. We already require drivers to buy insurance. You might say that if you really don't want to buy insurance you can stop driving, but many people don't have that option -- their livelihood requires them to drive. Besides, why should their freedom to drive depend on whether they obey a government mandate? Well, it does, and has for decades. You don't see tea partiers out there with signs equating car insurance with Stalinism. It isn't that big a deal.
Another long settled principle is the right of government to force people to pay taxes. Our society would not function otherwise.
Stupid
The subliminal message from the "brilliant" Hamm and Henke is to associate the Congress' national health insurance plan with gangsters, coercion, force, and brutal violence.
Fearmongering and scary garbage, yet again.
When is that new playbook coming out? Bettter hurry.
Simplicity, huh?
So... single payer then? Wouldn't that be the simplest possible solution by a good long ways?
Well
You need to look at the actual proposal. The single payer solution is 1900 pages of complex new bureaucracies, taxes, & rules to govern the choice of the individual.
The simplest solution is to allow the individual to be in charge of his or her healthcare & insurance choices.
We can't have that
Oh no Whitehorse we can't have that. Wanting to be in charge of your own healthcare and insurance choices makes you a "teabagger", an idiot, a Glenn Beck fanboy nutjob, a guy living in some sort of fantasy bubble world, a tool of the moneyed elite, and a racist to boot (because to oppose Obama makes one a racist automatically). No no. The enlightened, proper, correct and sensible thing to do is to hand over one's sovereignty over health insurance to the wise and educated leaders in DC. And when Republicans stand up for the individual over the collective, they are just being stupid! This isn't about "ideology" mind you. This is about doing the "sensible thing", which, just coincidentally, is the liberal way. But that's not ideology, that's because the liberal way is just simply correct.
I think you've got it wrong, chemjeff
Wanting people to be in charge of their own health care doesn't work. They don't, and with the system we've developed here to date (let's let private industry run the show), it's a particularly bad failure that drives up cost for those of us who do take charge of their own health care. That's part of the reason we have the problem we're in today. It's part of the reason we developed the idea of pooling risk (aka insurance) to begin with. (And this leaves out entirely those who can't get insurance today, or otherwise afford in any way appropriate health care, but maybe you prefer they rot in the streets?). So, let's rejoin reality, shall we?
A 1900 page bill isn't automatically wrong because it's long. Because a bill is long doesn't necessitate the creation of any number of bureaucracies. And because it may involve the creation of any number of bureacracies doesn't also make it bad. I.e., your criticism here is a straw man on all accounts. All bills are longer than most people think they should be but that's because most people have no idea how long a bill ought to be (I'm including you in that group). Oftentimes it's the difference between a chairman's mark and the actual bill written in legalese. Other times it's because it's simply a complex issue, e.g., making sure that all U.S. citizens have access to quality, affordable health care. Just because you don't like legalese or wish that issues weren't complex doesn't make any particular bill bad, either.
Back to single-payer. You can create a long bill or a "short" one if you'd like, but the bottom line is that's it's demonstrably the best and simplest system ever developed in the history of health care. And you know what? It's also proven, repeatedly, to be better than our system in the U.S.
It also gets us the closest we can get to having people be responsible for their own care. You can go to the doctor or not. It's up to you. But you're covered if you need to go. Here we avoid the immensely elevated costs we pay today when people don't have coverage and end up in the ER. Additionally, having coverage encourages preventative treatment, which also results in lower costs all around as generally illnesses are treated early, not when they're exacerbated in severity and cost.
You realize, I'm sure, that this is the entire premise behind insurance. The bigger the pool of participants, the lower the cost for all. And you realize, I'm sure, that those of us who maintain health insurance are all paying more now than we ought to because we allow others to go uncovered. Both of these points nudge us towards single-payer as the most efficient AND effective solution.
And this is just a coverage argument. There's an entire other side of the equation that relates to cost controls. The current bills don't address this issue nearly enough but they absolutely lay the groundwork that will collect the data we need to make smart decisions about how to proceed in that area.
? Do you care for your adopted strawmen as if they were your own
I didn't read anywhere where he mentioned these strawmen. I did, however, read them from you.
Is it sinking in yet?
Is it sinking in yet that the Federal Government shouldn't be getting involved in the Health Care business?
(Note to Progressive Trolls: That was a rhetorical question)
According to the newest poll, out today, the answer is "no".
New ABC/WaPo poll out thi morning. Here is a link to the PDF. The numbers I've given below are the net results - see the PDF for the details.
Q16. Would you support or oppose having the government create a new health insurance plan to compete with private health insurance plans? Do you feel that way strongly or somewhat?
Q.17. (IF OPPOSE/NO OPINION FOR GOVERNMENT PLAN) What if this government-sponsored plan is available only to people who do not receive insurance through an employer, or through the existing Medicare or Medicaid programs – in that case would you support or oppose having the government create a new health insurance plan to compete with private health insurance plans?
Q5. Who do you trust to do a better job handling health care reform - Obama or the Republicans in Congress?
Q4, Overall, which party do you trust to do a better job in coping with the main problems the nation faces over the next few years?
Yawn...
http://www.gallup.com/poll/124253/Say-Health-Coverage-Not-Gov-Responsibi...
Not inconsistent
I don't see that there is any inconsistency between the two. Do you think it is the federal government's responsibility? No. Do you think it is a good idea and they should do it anyway? Yes.
Wrong.
Increasingly, people are realizing it isn't the Federal Government's role.
But if you ask them questions like it's a forgone conclusion that they're going to do it anyway, of course they're going to answer the way they did in the poll you cited.
My initial question, though, was about whether it is sinking in that the Fed Gov has no business being involved at all in Health Care and the trend is yes, it is beginning to sink in.
Good day, troll.
Please point out where in the ABC/WaPo poll
the question was couched "like it's a forgone conclusion".
And then further explain why somone is more likely to say they support something that is a foregone conclusion. If they hate something, they hate something, and it costs them nothing to say so, even if it is going to happen regardless of what they say.
Given the results of this poll, it appears that 7 out of 10 people disagree with your assertion that the federal government has no business being involved at all in health care.
Re: wrong
What is your fascination with "You are wrong/You lose" mentality that you display frequently in your conversations here. What, thin skin or thick skull?
% who oppose ANY kind of government plan is just <= 9%!
From Q17 and Q18 of the poll:
Those who oppose a government run public insurance option for everyone AND a restirced public option for some, would be (43%[oppose] +5%[opinion])* (18%[oppose restricted public plan]) = 8.64%
Similarily thsoe who support some sort of public plan (as framed by the poll) would be 52% + 72%(43%+5%) = 86.56
So people who support SOME sort of government run public plan is at least 87%.
I think the data may have blurred the line between
Government intervention and a Government run public plan. 10% non-interventionist libertarian seems about the right number - that number may grow as people understand their position.
The plan laid out during the election, which does not "read my lips" increase taxes, does not limit care or dictate care, allows people to keep their existing coverage and even reduces the cost of it, and does not cause a future debt that will be past down to the next generation. Works out better pricing for pharmaceuticals and opens up imports of pharmaceuticals ... The vast majority would support.
health care cost
Normal
0
Despite spending more than twice as much as other developed countries, the United States still lags behind in terms of access and quality. Health care costs in the United States exceed those of any other nation. Millions of Americans aren't insured, partly due to the high cost of premiums, and end up resorting to payday loans to finance emergency and routine medical expenses.