Bizarre Health Care Reactions

[Kolar]

No. I do not believe that a first-dollar payment system is insurance. Insurance is a fine concept, when it is insurance. A system that merely allows one to pay a small price for a service that is shouldered by the rest of society is not insurance, it is an entitlement program.

So wait, if people who are sick are paying higher premiums and co-payments are the non-sick actually subsidizing their health care? I would say one of the few problem with private insurance is that those payments tend to price the costs of being healthy out of the reach of a lot of people and wind up causing most to refinance their home and possessions. But as bad as that is wouldn't a person like you say that balances it out? So if I am reading this right you want "insurance" as long as it pays for no one else except yourself, and if you pay for everything at base cost out of pocket? That isn't insurance.


If I don't care what Fox News thinks about health care reform, odds are I won't give a shit about some partisan right wing think tank.

[Jerome Scuggs]

What unique programs or legislation caused decreased waiting times from 2007-2008?

The reason premiums are high for people with risk is specifically because the government prohibits discrimination. This leads to 1) over-utilization, and 2) higher costs. If you can't discriminate, then you have to raise prices to account for the fact that you must now give "insurance" to people who will ultimately be a net loss in terms of profit. You can temporarily shift that net loss onto others by force, such as socialized healthcare, but that just means the problem becomes systemic and you pay a bigger price down the road.

Unless the government removes the price structure from the industry, and doctors work for free, the laws of economics will trump any attempts to distort the market. But if doctors had to work for free, the laws of human nature would trump that.

If you want to find information that's not biased in some way, you'll never learn anything. Which may explain something, because clearly you have refused to read anything. Why don't you instead read whatever you find, and use the good sense god gives you to make decisions for yourself? If Karl Marx himself said that healthcare costs have risen 400% in the past four decades, I wouldn't disregard him because he's your hero. Facts are facts. You should try looking at them and making up your mind sometime.

[Jerome Scuggs]

To put it another way, 100 years ago, the government first intervened with it's implementation of liscensing, which restricted the supply and therefore drove up the price. Then they tried to fix the rising prices, which caused even more supply issues, so on, so forth, until we are here. I read films of various papers from the era, and see no mention of a "crisis". If cause and effect is to be believed, I would see the crisis as occuring as an effect of government policy, not as a cause.

Edit: a Chicago paper from 1910 has a hilarious story written by a woman who went to "civilize the Mongoloids". They "almost resembled humans"! And to think those type of people also thought government regulation would be a good idea. You should look into the history of the flexner report - Ron Paul gave a speech in congress on it, but I suppose you treat people you write off as ignorant by ignoring them. Fabulous.

Edit 3: and I know how easy it is to say "well obviously we needed the AMA", but such a statement would be like saying "well obviously we needed to invade Iraq, there were no special interests who would have benefitted, it was for the general good". The law had more to do with satisfying the special interests of businessmen than solving any problem.

[Epinephrine]

Read this, thought of Jerome cause it mentions his favorite philosopher:

http://www.nytimes.com/2009/10/05/op...t-edcohen.html

==================================

The Public Imperative

By ROGER COHEN
Published: October 4, 2009

NEW YORK — Back from another trip to Europe, this time Germany, where the same dismay as in France prevails over the U.S. health care debate. Europeans don’t get why Americans don’t agree that universal health coverage is a fundamental contract to which the citizens of any developed society have a right.

I don’t get it either. Or rather I do, but I don’t think the debate is about health. There can be no doubt that U.S. health care is expensive and wasteful. Tens of millions of people are uninsured by a system that devours a far bigger slice of national output — and that’s the sum of all Americans’ collective energies — than in any other wealthy society.

People die of worry, too. Emergency rooms were not created to be primary care providers.

Whatever may be right, something is rotten in American medicine. It should be fixed. But fixing it requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society.

Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.”

A reader, John Dowd, sent me this comment: “In Europe generally the populace in the various countries feels enough sense of social connectedness to enforce a social contract that benefits all, albeit at a fairly high cost. In America it is not like that. There is endless worry that one’s neighbor may be getting more than his or her “fair” share.”

Post-heroic European societies, having paid in blood for violent political movements born of inequality and class struggle, see greater risk in unfettered individualism than in social solidarity. Americans, born in revolt against Europe and so ever defining themselves against the old Continent’s models, mythologize their rugged (always rugged) individualism as the bulwark against initiative-sapping entitlements. We’re not talking about health here. We’re talking about national narratives and mythologies — as well as money. These are things not much susceptible to logic. But in matters of life and death, mythology must cede to reality, profit to wellbeing.

I can see the conservative argument that welfare undermines the work ethic and dampens moral fiber. Provide sufficient unemployment benefits and people will opt to chill rather than labor. But it’s preposterous to extend this argument to health care. Guaranteeing health coverage doesn’t incentivize anybody to get meningitis.

Yet that’s what Republicans’ cry of “socialized medicine” — American politics at its most debased — is all about. It implies that government-provided health care somehow saps Americans’ freedom-loving initiative. Some Democrats — prodded by drug and insurance companies with the cash to win favors — buy that argument, too.

I’m grateful to the wise Andrew Sullivan of The Atlantic for pointing out that Friedrich Hayek, whose suspicion of the state was visceral, had this to say in “The Road to Serfdom:”

“Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance — where, in short, we deal with genuinely insurable risks — the case for the state’s helping to organize a comprehensive system of social insurance is very strong.”

That’s why, when it comes to health, every developed society but the United States has such a “comprehensive system,” almost always with state involvement. However, pooled risk does not necessarily imply a public option. It can be achieved through mandated private-insurer coverage coupled with subsidies. That, for example, is the Swiss way — and where Congress seems headed.

But it’s nonprofit insurers who provide the coverage in Switzerland because health insurance is viewed as social insurance — as it is throughout Europe — rather than a means to make money. One fundamental reason a public option — yes, “option,” not single-payer monopoly — is needed in the United States is to jump-start the idea that basic health care is a moral obligation rather than a financial opportunity.

Another is to provide competition to private insurers and so force waste, excess and cozy arrangements out of the American system. Behind all the socialized medicine babble lurks a hard-headed calculation about money — all the profits skimmed from that waste and the big doctors’ salaries that go with it.

It’s not over yet for the public option. President Barack Obama should still push it with a clear moral stand.

He’s been too deferential. The best bit of his speech to Congress on health care was the last — and even there he left the most powerful words to the late Edward Kennedy: “What we face is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”

Obama then said he’d been pondering American character “quite a bit” and did some “self-reliance” versus government intervention musing.

He should have been clearer and punchier. A public commitment to universal coverage is not character-sapping but character-affirming. Medicare did not make America less American. Individualism is more “rugged” when housed in a healthy body.

[Epinephrine]

Edit: a Chicago paper from 1910 has a hilarious story written by a woman who went to "civilize the Mongoloids". They "almost resembled humans"! And to think those type of people also thought government regulation would be a good idea. You should look into the history of the flexer report - Ron Paul gave a speech in congress on it, but I suppose you treat people you write off as ignorant by ignoring them. Fabulous.

As a point, a lot of the same people (maybe not you, but people) who want to keep healthcare private in America also support the 'tea parties' and also think bringing guns to a town hall with the president is a good idea. I'm sure some of them are bigots too.

So uh, stop with these pointless posts of yours that are completely tangential to the facts.

[Jerome Scuggs]

Hayek reversed his position in a 1976 speech to the mount polerin society.

"There is some justification at least in the taunt that many of the pretending defenders of 'free enterprise' are in fact defenders of privileges and advocates of government activity in their favor rather than opponents of all privilege. In principle the industrial protectionism and government-supported cartels and the agricultural policies of the conservative groups are not different from the proposals for a more far-reaching direction of economic life sponsored by the socialists. It is an illusion when the more conservative interventionists believe that they will be able to confine these government controls to the particular kinds of which they approve. In a democratic society, at any rate, once the principle is admitted that the government undertakes responsibility for the status and position of particular groups, it is inevitable that this control will be extended to satisfy the aspirations and prejudices of the great masses. There is no hope of a return to a freer system until the leaders of the movement against state control are prepared first to impose upon themselves that discipline of a competitive market which they ask the masses to accept."

[Jerome Scuggs]

I'm still trying to figure this "right to life" thing out - are you guys anti-abortion as well?

[Kolar]

What unique programs or legislation caused decreased waiting times from 2007-2008?

The reason premiums are high for people with risk is specifically because the government prohibits discrimination. This leads to 1) over-utilization, and 2) higher costs. If you can't discriminate, then you have to raise prices to account for the fact that you must now give "insurance" to people who will ultimately be a net loss in terms of profit. You can temporarily shift that net loss onto others by force, such as socialized healthcare, but that just means the problem becomes systemic and you pay a bigger price down the road.

Unless the government removes the price structure from the industry, and doctors work for free, the laws of economics will trump any attempts to distort the market. But if doctors had to work for free, the laws of human nature would trump that.

If you want to find information that's not biased in some way, you'll never learn anything. Which may explain something, because clearly you have refused to read anything. Why don't you instead read whatever you find, and use the good sense god gives you to make decisions for yourself? If Karl Marx himself said that healthcare costs have risen 400% in the past four decades, I wouldn't disregard him because he's your hero. Facts are facts. You should try looking at them and making up your mind sometime.

Did I say I didn't read it? I just won't give it any credence. Want some advice? Drop the Prof. Jerome act and learn how to use a forum. If the Government prohibited discrimination then we wouldn't have 40-50 million people without any kind of health insurance. And for that matter we wouldn't have millions more having their coverage dropped by "pre-existing conditions" and other ridiculous claims.

[Adman]

Do something about it.

Start a revolt. But as long as you argue points on an internet forum you're not going anywhere.

[Epinephrine]

In the vein of Epi's comprehensive post on the Canadian market, a few of us who post on the forums at the Mises institute's website put together some articles in one place for a look at what "my" view boils down to. It's got two articles that illuminate the history of healthcare reform in America, which should be the basis of any informed discussion of such a skewed and misunderstood subject.

In particular is an article discussing the free-rider problem in ER care, which is what most of the heat on the free market solution seems to boil down to. The article concludes the poor and underprivileged would actually have more options (and their dignity) in a market left uninterrupted by government policy.

What's kind of funny about the libertarian view is basically it boils down to this:

If the world was ran the way libertarians wanted it, basically it'd be exactly the same. Everything that the government current mandates would eventually be voluntarily adopted anyway. Poor people the government helps would inevitably be helped by charity. People would WANT to help other people anyway, and the end result basically is exactly the same.

I had a big laugh when the ER article basically said "there's a lot of people going to the ER for free right now, and everyone else pays. But if there were no mandates, people could go to the ER for free and everyone else would pay anyway".

I'm sure libertarians would be very offended by this, but hey to me that's what it sounds like. Just two different ways of ending at the same goal.

To me the only difference is in the libertarian world, there's no enforcement mechanism and free riders abound, while in the rest of the world we recognize that without an enforcement mechanism, even the most lofty ideas won't get implemented properly.

[Jerome Scuggs]

http://www.lewrockwell.com/spl/consc...apitalist.html

For the 12th straight year, Mr. Mackey's company has been praised as one of the "100 Best Companies to Work For" by Fortune Magazine. Whole Foods sells healthy food, practices "socially responsible trade," and prides itself on promoting foods that are grown to support "biodiversity and healthy soils." Mr. Mackey donates 5% of company profits to charity and has been one of America's loudest critics of runaway compensation on Wall Street. And he pays himself $1 a year. He would seem to be a model corporate citizen.

Yet his now famous op-ed incited a boycott of Whole Foods by some of his left-wing customers. His piece advised that "the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us closer to a complete government takeover of our health-care system." Free-market groups retaliated with a "buy-cott," encouraging people to purchase more groceries at Whole Foods.

Why did he write the piece in the first place?

"President Obama called for constructive suggestions for health-care reform," he explains. "I took him at his word." Mr. Mackey continues: "It just seems to me there are some fundamental reforms that we've adopted at Whole Foods that would make health care much more affordable for the uninsured."

What Mr. Mackey is proposing is more or less what he has already implemented at his company – a plan that would allow more health savings accounts (HSAs), more low-premium, high-deductible plans, more incentives for wellness, and medical malpractice reform. None of these initiatives are in any of the Democratic bills winding their way through Congress. In fact, the Democrats want to kill HSAs and high-deductible plans and mandate coverage options that would inflate health insurance costs.

100% right wing think tank, feel free to ignore

[Squeezer]

I'm still trying to figure this "right to life" thing out - are you guys anti-abortion as well?

fetus' aren't alive until they're born. Until then they're completely dependant upon the mother to survive.

But once they take that first breath, yeah I think that a person deserves all possible methods to maintain life unless they choose otherwise.

Sounds pretty personally empowering to me.

edit: And I just shopped at Whole Foods last week. I agree with their practices (as well as Costco's) and try to pay the extra bit necessary to feel good about my purchases. I don't see where any rational person would see his views as ridiculous, so I'm not sure why you posted that. Dems are trying to reform the health insurance industry right now, not Govt. run health insurance. That's somewhat of a pipe dream. You have to start somewhere and I believe it's very evident that major insurance companies need to have more restrictions placed on them so that they aren't out of control raising costs and lowering coverage. I'd be willing to bet most people on these forums wouldn't take issue with his views.

[Jerome Scuggs]

"…What good does it do to have a saint of every conceivable virtue operating a guillotine? Personally, the man may be above reproach. He may have the highest of morals and ethics. He may be imbued with a passion for doing good. But the mechanism he is hired to operate cuts off heads. He may dislike to cut off heads. He may weep with true sorrow whenever a head falls into the basket. But he was hired to pull the rope that lets the knife drop. And when it comes down, off comes the head. That is the way the tool works."

[Cops]

cleanup on aisle five will have a brand new meaning

bumped for truth

[Mattey]

[Ok, I've read through this entire thread, probably spending too much of my time, but whatever, it is a good read.

I'm not trying to attack anyone, I've just realized what I think about health care and the public option.]

Insurance corporations have increased their profits close to 350% over the last decade. In doing so, it has made private health care close to unaffordable for the average American family (I know it's not the mean, but most economists use the median income for a two income household) who make $46,000 dollars a year. The average cost to provide health insurance in America is close to $6,000. When you factor in feeding two children, paying for a mortgage, paying for a car, paying for car insurance and all the other expenses that living in America entail, it is easy to see that $6,000 dollars becomes unaffordable.

The question is, how are the health insurance companies kept in check? In most businesses, corporation's costs are held in check by competition. Some would argue that this is the case with health insurance also. I disagree with this position because health insurance companies aren't vying for something that people want, but for something that is necessary. This puts the corporations in a much better bargaining position, to the point where it isn't even a bargain, they can set prices and people will have to pay them.

The only way to get competition and to therefore keep prices in check (in my opinion) is the public OPTION, keep in mind it is just that, an option. If insurance corporations can provide better health care at a lower cost, only suckers will pay for this OPTION. I think the only way that Americans will get true competition in the health care industry is by providing an option for the average American to buy-in. For proof of this, you can look at Medicare.

A lot of people point to Medicare and say "well, it's bankrupt, it obviously doesn't work." To them I say, it doesn't work because seniors reaping benefits from the system are taking out close to 3 times what they put into it. No system can work if this is the case.

Medicare runs at a 4% overhead, while private insurance companies run at a 30% overhead. The reason Medicare is failing isn't because it's run inefficiently, it's failing because of inflation (seniors putting in money from their 30's to their 60's, and then reaping it from 65-75(on average).) The money that they put in, in their younger years isn't worth nearly as much as the money that they take out in their later years. How do we fix this?

I believe we fix this by allowing everyone to qualify for Medicare down to the age of 0. The catch is, you have to pay for it from the time you hit 18 and for the rest of your life (which is exactly what a public option would be.) Parents would pay higher premiums for their children, effectively covering the costs of insuring people from age 0 to 18.

In this scenario, people will be paying into the system as inflation increases. Their wages will go up, so they will be paying about the same percentage of their income, but it effectively will be worth more.

If you look at the data over the last decade, it is clear that the health care system in America is broken, and it's not trending towards rectifying itself. If a public option isn't the answer to keep insurance revenues in check, then what is?