The underlying presumption behind [proposals for "reform"] is that government health insurance should be expanded to cover the uninsured.
This presumption is wrong. Government should not subsidize health insurance -- for the uninsured, the poor, the elderly or anyone else -- or regulate health insurance markets.
Friday, October 30, 2009
No Government Health Insurance
My thoughts on the current debate, at cnn.com. My bottom line:
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16 comments:
This hits on the very foundation of the healthcare debate...is healthcare a right or a priviledge to be purchased. Your argument is that it is a priviledge, much like buying a car. I happen to agree but I am afraid that the majority of our country does not. The problem is they have no idea what exactly it is that they are asking for. The mainstream media (with the exception of the fanatics at Fox) seem to be ignoring the state of healthcare in developed "westernized" coutries that have gov sponsered healthcare...it is cheaper, but it's also not as good in many ways.
Elaboration not necessary? or do your credentials just speak for themselves?
@ Joe
"Government should not subsidize health insurance... or regulate health insurance markets"
- because the economic Costs > exceed the benefits of such a policy. Costs are huge because public organizations/policy is inefficient, subject to political decision-making (not meritocracy), &as such it's a waste of tax money (which, I personally believe, should be YOURS to spend - not by someone else [gov't] to be spent on on someone else [uninsured/pharma &medical corporations)
Current regulation (employer coverage) is the prime reason why health care costs are high &why there are many uninsured. Read up on it on this blog or Keith Hennessey's blog
The problem with your argument, an those with similar perspectives is this: true - healthcare is not a right - it is a privledge to an extent. For this argument to work though, you'd have to say that to not have health insurance, you are foregoing a privledge with not harm to anyone else. The problem is when you get sick - you still seek help - insured or not. And because the cost of health care is astronomical, you'll never pay for the service you receive. This cost is absorbed by those that do pay. Now you have a case, where really, it's not so much a priveledge as a necessary expense for a responsible citizen. If you know you can get sick, and accept that you could never afford to pay for your sickness, you carry insurance or find a job that provides this benefit. But what happens when the cost is so high that it is not affordable - where you'd love to be a responsible citizen, but the daily expenses are such that you can't pay more for health insurance than shelter. Basically without any options to turn to, you're left uninsured and a burden to those that do pay, increasing costs.
Although you may be brilliant with respect to economics, you do not shine when it comes to humanity. I respectfully invite you to join the social workers in your community to meet with the uninsured and understand the experience of the human beings you believe should not have health care because in your opinion it would be too expensive to cover them. Leave your cozy Harvard office and come to the proverbial trenches and observe man's inhumanity to man.
Do you live with a chronic autoimmune disease without health insurance Jeffrey? Would you blame those persons for having "unhealthy behaviors" that caused their diseases (i.e. type 1 diabetes, juvenile rheumatoid arthritis, undiagnosed celiac disease)? Or would you simply say they were given bad genes but those who are not achieving target results are not compliant?
You make very broad statements and show a dearth of empathy with respect to individuals who continue to suffer without access to healthcare. If you were desperately ill without any idea of the cause, which tests would you suggest your doctor consider unnecessary and not order? One example: many doctors refuse to run tests for celiac disease because the patient doesn't exhibit typical symptoms, when in fact the research shows many individuals are either asymptomatic or have atypical symptoms. A positive test result can be life transformational for that patient; without the test/diagnosis a plethora of complications are likely to result.
It is not just the poorest segment of society who are living without health insurance today. A single catastrophic illness can certainly put any given family into the impoverished category. "A reasonable balance is for government to provide a social safety net that protects the poor and allows them to purchase SOME health insurance on their own. An alternative is to provide health insurance vouchers, but only to the poorest segment of society." I urge you to choose that voucher for you and your family's health care for a decade or even for a single medical crisis and then revisit this column.
I'll vote for Obamacare over Mironcare on any given day.
Ellen
While its quite clear what you dis-propose as curative, of an unsustainable healthcare delivery system...its also abundantly clear to me, why attending the Harvard school of economics never emblazened my "to-do" list..
This quote is over-the-top: " ..insurers would set higher premiums for the unhealthy, but they would cover anyone willing to pay a sufficiently high price." For most, it's not a matter of WILL, but ABILITY to "pay a sufficiently high price". Musings from an ivory tower, indeed!
"The other possible objection to the cash transfer approach holds that, if left unregulated, private health insurers would deny coverage based on pre-existing conditions. Thus, some people might get no health insurance at all.
This outcome is unlikely, however, assuming health insurance is unregulated."
Oh, I see now! People are only denied health coverage by insurance companies because those companies are regulated! If the gubmint took their mitts off those poor, beleaguered multibillion dollar corporations, this industry that refers to any medical treatment given as a "medical loss" would no doubt choose to start "medical lossing" people right and left! I mean, that's what free markets do, right? They make companies less attentive to the bottom line!
Sorry, prof. Pre-existing conditions are the result of insurers doing what businesses are supposed to do: making a profit.
Then again, how would I know? This mythical "unregulated medical insurance market" exists only in the fevered imagination of glibertarians such as Professor Miron. I'm sure it works great in there! I wonder if everyone's got a pony, too!
Except that all of the other westernized countries that have national healthcare pay less per capita and get better service. Don't believe me? Go to OECD, WHO, CIA Factbook and I think EarthTrends.org has statistics on the health and well being.
Why is this? Probably because the way cost shifting works within the insurance industry benefits from an economy of scale. At any given time (despite when vastly catastrophic and unique happenings happen: plague, spanish flu, etc) there are far more healthy people than sick people. So, the higher percent of the population that pays in will help lower the cost for everyone.
I get that you have libertarian leanings but the facts just disagree with you on this one.
France is ranked No. 1 in the world (According to the WHO) and only paid US$ 3600.00 per capita (according to 2007 OECD statistics). The US ranks 37th and we pay US$ 7290.00.
Now which system is more inefficient?
The position that you have taken in your opinion piece is one morally bankrupt to the point of obscenity. Worse than that, the whole concept is logically and philosophically suspect. You spin out dire and specious predictions for what might happen should any of the (admittedly, majorly flawed by any standard) health care bills are passed, yet you ignore what would be the inevitable consequence of your own favored approach.
Often American citizens are at risk of death or permanent disablitity unless they receive the immediate attention of medical professionals, with the attendant loss of profits for the provider in the event of such a patient being unable to pay.
Your article suggests you would be in favor of repealing EMTALA, but you ignore its very existence. After all, if EDs were allowed to throw out the uninsured and let them die, the cost of insurance would plummet--well, if the controlling institutions decided to generously and of their own free will pass on the drop in expenses to patients, instead of maintaining their current price structures and using the extra revenue to increase the salaries of those in control. As we all know, private corporations never seek to increase their profits above providing better services, and are of course committed to serving the public good, instead of enriching those who control them. Isn't OPEC one of the greatest sources of good in this world, after all?
To sum it up: You've said a toll of completely preventable human deaths are acceptable--not just acceptable, but *necessary* for the greater good, because it is more important that for-profit institutions continue to increase their revenue. For the good of us all, somehow. You have in no way justified your position that for-profit institutions provide better care per capita than charity or government-run institutions. You have not even bothered to distinguish between a non-profit publicly-managed insurance program and the horrible Marxist usurping of every hospital in the country.
(Also, I hope the inability to scroll, copy, paste, and use the arrow/backspace/delete keys in your comment window is an unfortunate mistake in blog settings and not a deliberate attempt to make responding a pain in the fucking ass.)
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