OT: Senator Kennedy is dead/Insurance reform

Well, I guess that is the difference in our viewpoints. I think basic healthcare should be a right for all individuals paid for with taxes similar to schools, highways, etc. With our system, the US is an island in that this is not the case compared to Europe, Canada, etc. I think you could make an argument 10 years ago that our system worked but all the indicators (% healthcare costs vs. GDP, bankruptcies due to medical issues, % of people with insurance, etc.) are rapidly deteriorating. What we have right now is not sustainable. So while what is being proposed isn't the long-term solution, I think the structure is definitely closer to what it does need to be in the long-term. It sets us on a better path but it can and will be tweaked later.

 

I would disagree wholeheartedly. Healthcare isn't a right and never has been. And the situation isn't deteriorating as rapidly as some would like you to believe; in fact if the market is left alone, the situation will improve. I see solutions popping up all over the place. I can go to Walgreen's and see a nurse or a PA in five minutes for a runny nose and get a prescription if I need it. There are lower cost clinics opening up where a person can affordably be seen by a doctor for more serious issues. You shouldn't always have to get an appt and go to a doctor to get treatment. What's not sustainable is the idea that every American have access to the very best doctors at the drop of a hat. That's never been sustainable. The healthcare in the US is still better than that anywhere else if you have a decent job and (it's still better if you don't; poor people don't get bankrupted, it's only the people that have something to lose that get hurt by medical bills.) I'd rather see the government spend it's time ensuring there are enough decent jobs to go around than bankrupt everyone trying to overhaul the entire make sure that everyone belongs to the same HMO instead of just tweaking it to address a few specific problems.

 

It is a right in all industrialized countries in the world except the US.

http://www.kansas.com/950/story/976950.html

"Annual family premium costs will be $30,803 in 2019 based on the average increases in costs over the past 10 years."

"[There has been a] 131 percent increase in health insurance premiums over the past 10 years with the 38 percent growth in wages and the 28 percent growth in inflation."

 

What do public schools, highway road, and social security have to do with your Natural Rights?

Why haggle at all? People can just go to the ER as an uninsured. That model is so incredibely fair and efficient.

 

There's a lot there to unpack, but the overriding thing is "basic healthcare" is already a right for all individuals. Stand up, step away from your computer, grab the nearest knife and hack off your arm. Now go to the nearest hospital and tell them you want to be treated despite being uninsured. You will be! What's being proposed is not basic in any sense of the word. Folks already receive a basic standard of care regardless of their ability to pay. what's being proposed is a (further) takeover of our decision-making power about what sort of advanced health care we want.

And let's not forget that forcing everyone to buy advanced health care, even when they don't want it, is going to make many people's lives drastically worse. Currently a pretty big chunk of folks that count as uninsured can techinically afford insurance. They choose not to. But through the magic of mandates, combined with actually outlawing relatively moderate sorts of catastrophic coverage insurace, these sort of folks, who are generally working middle class folks and often self-employed, are going to be royally and life-changingly screwed.

Not only will this ruin peoples' lives, it the end result will kill people by among other things, denying people the right and ability to seek out advanced, life saving and life improving care for themselves. I can't imagine that putting the government in the business of making that kind of moral and ethical decisions for everyone is really what folks want. Again, this idea seems so obviously wrong on so many levels it's hard for me to comprehend.

As an aside, I can't think of much that's more fucked than our education system. I agree that basic healthcare and basic education should be a right for all individuals, but it doesn't follow from that right having taxation and governmental control of everything gives us the best use of those rights. It's not only unnecessary, but it's counterproductive.

Not quite sure where you're going with this, but what other countries have now isn't sustainable either. The European and Canadian systems face rapidly increasing cost and demographic problems as well. So it's hardly an argument to move to that system, because they have issues too. From a demographic perspective, possibly worse ones. And don't forget that their quality of care will stop improving if we move to that system, as they're largely free riding off our innovations in medical technology. Most of the "rapidly deteriorating" stuff is, by the way, a matter of perspective. Some particular issues that are very obvious from an economic perspective.

1. The healthcare costs as a % of GDP argument is largely a red herring if you consider it in any sort of historical context. A hundred years ago, for example, folks said (and many... especially socialists actually did say) that it was absurd and a problem that we so much of GDP was spent on food. The same sort of folks would also suggest that the world would fall apart and no one would be employable if the 50% or so of the population involved in agriculture were put out of work by new technology. Today, of course, this seems silly. Looking back over time, we know that eventually basic necessities have shrunk as a portion of GDP not because people stopped needing food, but because of the miracles of economic growth. Not only did our ability to produce food get much better, our ability to produce everything else got much better. So much so that we, in the US, can make food to feed many times the number of people with only tiny fraction of the population (1-2%) doing it.

The relationship between spending on health care and GDP is no different. People desire to spend their income on health because they receive benefits from it. In part it's also high growth government policy has created enourmously skewed tax incentives to spend more on health care. But fundamentally, health care is a growth industry. To make the point more clearly, if the economy is growing, as it has over the long term, more of the growth is in health care than in other areas. That's not a bad thing though. Mathematically, it's much better, isn't it, to have a world where GDP is 100, and you spend 30 on health care, than to have a world where GDP is 80 and you spend 15 on health care. This is something I hope everyone who comes out of the classes I teach realize.

2. Bankruptcies due to medical issues is a fairly insignificant and declining amount, not a growing one. Elizabeth Warren, who's authored the most notable of of scarey bankruptcy is a terrible, horrible social scientist, and frankly the only way I can reconcile the numbers she's generated is to imagine that she's consciously trying to obscure the facts on the ground to suit her political positions. She's generally credited as the source of the "medical bankruptcies are a huge problem". Anyway, the reality is quite different.

The absolute number of bankruptcies in the US has declined significantly (partially owing to a new bankruptcy law, but it's been declining anyway).

In 2001, there were 1.45M bankruptcies, and in 2007, there were just under 730k.
The number of medical bankruptcies, over the same period, fell from about 750k to 500k.

From McArdle, here's a table, post and links to research commissioned by the Canadian government showing that despite Canada's "free" single payer system, the overall and medical bankruptcy rates in Canada are quite close, and in the overall smaller in the US.

3. % of people without insurance is, by any reasonable measure, not big. If it's actually 30M, that's roughly 10% of the population who are uninsured (and 90% who are). Much of that 30M, we know, is rather dubious. And the people without actually receive care anyway.

Add it all up, and we have a proposal to make things slightly better for 5-10% of the population by making things demonstrably worse for the other 90-95%. And that's only in the static sense. When you consider the fact the current plan is going to further the country on the road to bankruptcy and destroy prospects for future improvements in health care, everyone will be made worse off.

How does it set us on a better path? The proposals I've read are drastically more incoherent than our already incoherent plan. What does "the structure is closer to what it needs to be" mean? To me it's sort of like saying if your ultimate goal is to buy a new house, shooting up and setting fire to your current one is a good start.

Which, of course, gets us back to that whole trust issue. I think people are absolutely right to be scared of the end result of a process like this. I sure as fuck don't want it for me or my kids.

 

Well, we definetly have a different deffintion of "basic healthcare".

Using your terminology, these same people are screwing everyone that is paying for health insurance because they are going to the Emergency Room and being treated. Obama said this was to the tune of $900 a year for families with insurance. Guess what...this is going to get worse and worse ever year as the percentages of uninsured are going up.

I can't say I find any of McArtle's work very interesting. She seems to start with a viewpoint and find stuff that sticks. Sorta like a poster. on that article, looks like several commentors on her blog point out logical concerns about her conclusions. But i will take a closer look later if i have time.

Better structure = Eliminate pre-existing conditions and recisisions, ensure every child has health care, Caps out-of-pocket expenses so people don’t go broke when they get sick, end the free ride for people with means at the Emergency Room, Creates a new insurance marketplace — the Exchange — that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices, etc.