Ahhh, Libertarian Health Care Agitprop

By Justin Gardner | Related entries in Comedy, Health Care, Libertarian, Video

Boo!



And yes, I know it’s a joke and I actually found parts of it funny, but do they honestly think things like this will be effective?

Let me put it another way…do libertarians not realize that our system, which doesn’t cover 40M+ people and is bankrupting our country, needs serious reform?

And I’m talking real reform, not the health savings account, tax deduction and deregulation ideas they’ve floated the last decade. Because those measures would still leave out those who can’t afford health care and have preexisting conditions.

I’m just saying, there’s a reason why these folks find themselves on the political fringe most of the time.


This entry was posted on Saturday, June 27th, 2009 and is filed under Comedy, Health Care, Libertarian, Video. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

31 Responses to “Ahhh, Libertarian Health Care Agitprop”

  1. Tully Says:

    First, define “real health reform.” Specifics, please. Then we can start toalling up the tab.

  2. Jason Arvak Says:

    The statistic on the image is actually true and a potentially serious problem with single-payer systems — lack of incentive to invest in equipment resulting in shortages of that equipment. You can’t mock it away, Justin.

  3. Nick Benjamin Says:

    You know what’s really amazing?

    The right claims that our system is clearly superior because we have lots more machines to do medical tests, but it’s also inefficiant because we do too goddamn many tests. That’s why they want HSAs and high copays so patients will say no to unnecessary tests. Like CT Scans.

    BTW, if you want to see actual data on what health spending gets various countries type this into wolfram alpha:
    life expectancy age 50 canada

    That’ll give you the projected lifespan of a Canadian who is 50. Try a few random industrialized countries. I tried several. Norway, Canada, Sweden, the UK, France and Germany beat us slightly. We edged out Denmark, and kicked Estonia’s ass. Let us not speak of Japan, for a typical Japanese newborn makes it to 84.

    Note that while countries frequently have different methods of reporting life expectancy these are limited to deaths in infancy. For example some countries count stillbirths as people who died at zero in their life expectancy stats, others don’t.

    I compared the US to Canada at higher ages. We beat them when you get to 82. Which implies our socialized, single-payer MediCare is a better than the Canadian version.

  4. Jim S Says:

    First you need to prove it’s really a problem, Jason. There’s lots of claims about how bad systems with government involvement are but besides the fact that they aren’t as bad as libertarians and other irrational people like to portray them as being, there are also other systems.

  5. Jason Arvak Says:

    For reasons that are beyond comprehension, my response to Nick and Jim has been blocked by the automatic blocking software on this site.

  6. Jason Arvak Says:

    I agree with health care reform to increase coverage, Jim. Thus, I am not a member of the stereotyped “right” that you and Nick appear to presume I am with your responses.

    But from both experience and research, I know that equipment shortages are a major cause of rationing in both Canada and the UK. As I have explained elsewhere, this is because single-payer systems only fund equipment investments at a discount (budget setting being a political rather than pragmatic process — “do more with less” is the usual demand) from PRESENT demand while for-profit systems fund equipment investment fund equipment investment at market cost based on expectations FUTURE demand. That results in excess capacity in the for-profit system but also, given imperfections in the distribution of demand, greater access overall to whatever segment of the population has access to health care generally.

    Now, I think if we recognize this as a problem instead of trying to just blow it off as some kind of right-wing talking point that is beneath notice by the morally and intellectually superior thinker, it should be possible to craft a reform program that mitigates or even eliminates the problem, perhaps by incentivizing equipment investment by providers based on expected future demands.

    I point out these problems in an effort to improve the discussion of available alternatives, not because I want to block reform. Perhaps it is worthwhile for those on the left to drop their presumption that everyone who questions them is a right-wing obstructionist just like it is worthwhile for those on the right to drop their presumption that any form of health care reform is “socialism”.

  7. Jimmy the Dhimmi Says:

    From Investor’s Business Daily:

    “According to ‘Income, Poverty, and Health Insurance Coverage in the United States,’ a Census Bureau report published last August, of the 45.6 million persons in the U.S. that did not have health insurance at some point in 2007, 9.7 million, or about 21 percent, were not U.S. citizens…Also among the uninsured are 17 million Americans who live in households where the annual income exceeds $50,000; 7 million of those without coverage have incomes of $75,000 a year or more.”

    “The notion that the uninsured are without health care is bogus, as well. They consumed an estimated $116 billion worth of health care in 2008, according to the advocacy group Families USA.”

    Tighten up the borders, establish individual mandates to sign up (as here in Massachusetts where the number of uninsured has dropped from 11% 3 years ago to less than 3% today), and the problem of the uninsured is solved. Decouple employment from insurance and allow people to deduct health care costs from taxes and watch prices drop. Why is this not feasable?

  8. Fletch Says:

    Let me put it another way…do libertarians not realize that our system, which doesn’t cover 40M+ people and is bankrupting our country, needs serious reform?

    Of the 40+ million “uninsured”…

    –14 million are already eligible for Medicaid/S-CHIP- but are simply too lazy/proud/ignorant to actually sign up.

    –Another 10 million earn more than 75K/yr.- If they wanted “insurance”, they’d have bought it already.

    –What’s the latest figure on “undocumented persons”? Another 12-15 million?

    Who’s left?

    –Meanwhile, many healthy, single, young adults think there are better ways to spend their money than subsidizing their “married w/ kids” co-worker’s childbirth/vaccination expenses and their boss’s viagra prescription…

    The ony problem in my view is the “pre-existing conditions” people… Due to unfair Gov’t treatment of health insurance benefits, they’ve been lured into attaching their health care to their employment for the tax subsidy. I haven’t been that dumb since I was 23 (in 1987).

    As a “libertarian”, I will admit to some “empathy” for them- but, they made their choice. They did not make enough of an effort to secure their own health. Why should I care when it smacks them in the face?

  9. Tully Says:

    I keep asking this question in the hopes that someone will actually look up the answer. (Yes, I know the answer already.) How much of US health care is uncompensated, that is, NOT paid for? IOW, how much treatment for the uninsured/nonpaying patient gets offloaded onto the paying portion of the system?

    The answer may surprise you.

  10. Fletch Says:

    tully-

    IOW, how much treatment for the uninsured/nonpaying patient gets offloaded onto the paying portion of the system?

    I was just trying to “google” that!

    The first article was from 1997.

    The “consensus” was about $50 billion/yr in 2005.

    That’s why fixing health care will cost $4 trillion over the next ten years.

  11. michael reynolds Says:

    Off topic, but Ali Khamenei has a web site. It’s hard to get it to load. But I believe if you click on this link, and then leave your browser open, your browser will try every five seconds to reload the Ayatollah’s page.

    http://www.pagereboot.com/?url=http://www.leader.ir/&refresh=5

    Because we all want to know what he’s got to say.

  12. Nick Benjamin Says:

    Jason,

    I wasn’t aiming that comment at you. I saw the article, started typing my reply, got distracted by the extreme coolness that is Wolfram Alpha. An hour or so later my post was finally ready. And in the mean-time you’d posted.

    You’re exactly right about the drawbacks of a single-payer system. You have to prove to the government bureaucrats that spending money on some new machine, or procedure, is an efficient use of health care dollars. ie: that spending $x on this machine saves more lives than spending the same $x on preventive care. This contrasts will the US System,where you have to prove to some insurance company or hospital bureaucrat that spending $x will result in $x+1 in revenue.

    Fletch:
    One of the big problems in the US is the under-insured. I, for example, have insurance. But it really sucks so I never go to the Doctor.

    And don’t assume that it’s easy to get on government programs, or easy to stay in them, even if you qualify. Sick Around America had a perfect example. The victim was qualified for TennCare. Then there were budget cuts so she got thrown off. She thought this was wrong, s she repeatedly tried to get back into the program. Eventually the state changed it’s mind and let her back in, but in the mean-time she hadn’t been able to treat her lupus. It put her in the ER, and eventually killed her.

    So to recap, Tennessee tried to save money by cutting this woman’s benefits. They were wrong to do this, but they did. By the time they realized they were wrong they were on the hook for an Aerial Ambulance,the ER,etc. And she died anyway. It’s not hard to figure out why we die younger despite the fact we spend more than anyone else on health care.

  13. Jason Arvak Says:

    You’re exactly right about the drawbacks of a single-payer system. You have to prove to the government bureaucrats that spending money on some new machine, or procedure, is an efficient use of health care dollars. ie: that spending $x on this machine saves more lives than spending the same $x on preventive care. This contrasts will the US System,where you have to prove to some insurance company or hospital bureaucrat that spending $x will result in $x+1 in revenue.

    The significant difference that you miss is the focus on the present budget (government system) versus the focus on future revenue (for-profit system). Left alone, this results in more equipment capacity in the for-profit system and shortages and rationing in the government system.

    You also missed my purpose for pointing it out. My purpose is not to just sing the praises of a for-profit system that clearly has many flaws in its ability to provide broadly affordable coverage. My purpose in pointing it out is to move overly simplistic advocates of reform past their pre-written talking points to acknowledge these kinds of problems so that they can adjust for them in their proposals.

  14. Tully Says:

    The answer is a bit under 3%, or about $60B in 2008. Not that $60B is chump change, but with over 15% of the US population uninsured, the deadweight overhead loss from uncompensated care is just 3%.

    What Fletch wrote. A major chunk of our uninsured are voluntarily without formal coverage, and for many of them it’s a sound financial decision, strictly by the odds. In any kind of flat-rate plan the young and healthy get screwed over by the older and less healthy.

    Re: Illegals — yeah, they’re illegal, but refusing all care is not in the cards. Just noticing that they’re illegal doesn’t make them cost less.

  15. Justin Gardner Says:

    Jason,

    First, I think it’s pretty clear I wasn’t the one mocking. Reason was. I want to find real solutions, but they want to go with the same old “Senators will be determining if you can get care when you have a head wound” nonsense. It’s intellectually dishonest agitprop, pure and simple. Also, I have no doubt that the numbers are true, but did you ever stop to think that some of those machines aren’t being used appropriately and could be contributing to skyrocketing costs?

    Second, I’m not proposing a single payer system and none of the legislation has that in it. No doubt many Dems favor that b/c it would solve the cost problems, but it’s not on the table. So why you’re even talking about it is beyond me.

    Last, please stop assuming that people are accusing you of being right wing. Seriously. You and I have had those exchanges before and they’re very frustrating. And I note that after Nick clarified, you didn’t acknowledge that you had assumed incorrectly. Basically, let’s not get into asides about sincerity and intent. They add nothing to the conversation.

    Tully,

    It would also be a sound financial decision for most drivers to not carry insurance, but the reason we need everybody in the system is without the mandate it would be nearly impossible for us to maintain our transportation system.

    And listen, somebody always gets screwed over if something is mandated. But we’re at the point now, and I think we can all agree about this, that if we don’t do something about the situation we’re ALL going to get screwed over.

    Fletch,

    Here’s the thing…you can break out the groups into subcategories all you want, but the point I’m trying to make is that everybody needs to be in the system, much like car insurance mentioned above. Yes, health care is different b/c we’re talking every single, living soul, but everybody has the potential for health problems, so everybody needs coverage in some way, shape or form. Also, I don’t remember anybody saying that it would cost $4 trillion over 10 years. The latest figure I heard was $1 trillion.

  16. Jason Arvak Says:

    Also, I have no doubt that the numbers are true, but did you ever stop to think that some of those machines aren’t being used appropriately and could be contributing to skyrocketing costs?

    I think you’re suggesting that some of the U.S. advantage in number of machines may be excess capacity. Perhaps that it true. We also know that it is true that the U.K. and Canada have serious problems with UNDER-capacity. So what that would mean is that the optimum is in the middle. Thus, I return to my point that by paying attention to the problem — causes and effects — of equipment underinvestment rather than ignoring it or blowing it off, we have a much better chance of designing a reform package that learns from and improves upon the performance of other models rather than blindly embracing them.

    Second, I’m not proposing a single payer system and none of the legislation has that in it. No doubt many Dems favor that b/c it would solve the cost problems, but it’s not on the table. So why you’re even talking about it is beyond me.

    Because the “public option” inevitably collapses into a single-payer system regardless of whether reform advocates admit it right now or not. The government “competing” with private insurers at the same time it has the power to impose regulations on them is an obvious recipe for gaining an absolute advantage for the government program in a very short period of time. In fact, some of the “public option” advocates advocate it precisely for this reason — they know it is the camel’s nose under the tent and that it will lead to the single-payer system they want anyway.

    Given the social and political realities, I’m accepting this path as inevitable. I’m just suggesting that we should not hide critical issues along the way and that we design our reforms with adequate attention to what we should be able to learn both from our own as well as others’ experience. We should not allow ourselves to be blinkered by single-payer romanticization any more than we should allow ourselves to be blinkered by fetishing free markets.

  17. kranky kritter Says:

    Lighten up the borders, establish individual mandates to sign up (as here in Massachusetts where the number of uninsured has dropped from 11% 3 years ago to less than 3% today), and the problem of the uninsured is solved.

    This is turning out to be an enormously expensive program here in MA. Not really affordable when it was first implemented on the wings of gross underestimates of cost 2 years ago, now it’s an unbearable burden dragging down the state’s budget. I hesitate to call this program a “solution.”

  18. PoliticalPragmatist Says:

    “This is turning out to be an enormously expensive program here in MA. Not really affordable when it was first implemented on the wings of gross underestimates of cost 2 years ago, now it’s an unbearable burden dragging down the state’s budget. I hesitate to call this program a “solution.””

    That’s because it wasn’t combined with cost reforms. Same system, now pushing costs on the state. Unless the bill-payer reforms are combined with cost reforms, there will be no reform at all.

    We have over capacity because we are not treating all citizens and because doctors get paid for performing, not for treating. Most people have never heard of “triage” I guess, because doctors and hospitals are certainly able to decide who needs a CT scan right away and who can wait a week and who doesn’t need one at all.

    Amazing how bad some of the logic is in this debate. The system does not work but do nothing because it could be worse. The George Will solution?

  19. kranky kritter Says:

    Well there aren’t really any ways to “reform” costs. You can control them in some ways via mandates (which bring certain side effects) and via cost-shifting.

    Bottom line for the MA program is that the costs to taxpayers so far have been, to put it kindly, substantial. Massachusetts is not well placed to try to mandate costs because a big part of its economy is based on healthcare, doctor training, med devices, biotech, etc.

    And while the state mandated coverage, for the most part the State isn’t the entity that captured the premiums of the young and healthy folks who were forced to opt in. Insurers got most of that money. So this plan create a new pool of insured folks whose healthcare costs are paid for or subsidized by taxpayers.

    I am extremely skeptical of the “states as labs for innovation” model when it comes to healthcare.

    And while I agree with you there is room for improvement in the areas you cite, I do not think revising in this areas is going to do very much to control costs. At its most basic, the problem is that we have a very high and still quickly growing demand for healthcare, and we simply lack the resources to finance this level of demand. As time passes and costs continue to grow, this inescapable fact is becoming more obvious to more folks.

    We should take the total annual cost of healthcare, divide it by the number of Americans, and then compare this number to median income. That’s a great pace to start Ultimately, as a nation, I really don’t think we want to devote 15 or 20% or more of our incomes to healthcare. But, everyone seems top think that morally we all deserve whatever healthcare we need to stay alive and enjoy a good quality of life.

    And that’s the rub right htere, aint it? Because deserve’s got nothing to do with it. We will get what we can afford to pay for. Right niow there;s isn;’t that great an equilibrium because some folks pay little for great care, other pay more for decent, and some folks pay a lot more for not that much, and so on and so on and so on.

    Now, I am very attracted to a system that provides a better equilibrium. BUT I refuse to kid myself that once some sort of better equilibrium is achieved, the problem of cost growth well beyond our ability to pay will have been solved. It won’t.

  20. Tully Says:

    “It would also be a sound financial decision for most drivers to not carry insurance, but the reason we need everybody in the system is without the mandate it would be nearly impossible for us to maintain our transportation system.”

    Apples and oranges, Justin, and that does not even remotely follow. That’s a truly lousy analogy that does not stand up to even surface anlysis — our “transportation system” wouldn’t even begin to fall apart without mandatory liability coverage. Besides, one can choose not to drive. Gonna choose not to breathe?

    My point is that the healthy uninsured and the self-insured are NOT a net drag on the HC system. THEY PAY FOR THEIR HC EXPENSES OUT OF POCKET, AND FOR THEM, INSURANCE IS A BLATANT RIP-OFF. They are not being hurt by being uninsured, and using them as poster children and bemoaning their “plight” in order to screw them over is gross hypocrisy. The ONLY reason to drag them into the insurance pools is to take their money to subsidize others.

  21. Justin Gardner Says:

    Jason,

    Agreed that I think there’s a middle way…which is what I think the current legislation is trying to find since single payer isn’t on the table. I appreciate you think it’s inevitable. I don’t.

    Tully,

    Apples and oranges? More like grapefruits and oranges. True, it’s not a direct parallel, but it’s the closest thing we’ve got to compare it to. And I completely disagree that our transportation system wouldn’t crumble without it. There’s a reason it’s mandatory to carry liability. And in this society, if you want to get ahead, you have to drive unless you live in a large metro with fantastic public transpo. Imagine if liability wasn’t mandatory and there wasn’t a penalty for hitting somebody without insurance. Confidence would be shattered.

    Also, let’s establish one very important thing about all of these “healthy” young adults. Most healthy uninsured adults are not that way out of choice. It’s because they have crap jobs that don’t offer health benefits. I don’t know anybody who is in the corporate world who voluntarily turns down health care b/c they don’t think they need it. But I do know a hell of a lot of people who work in restaurants and bars who don’t have it…but would pay for it if they could get access to it. Because those people get sick…a lot. They have higher rates of drug abuse, alcoholism, sexually transmitted diseases and mental illness…that then leads to more strain on the system down the road b/c their problems get worse and they still don’t have insurance. So to say that it’s hypocrisy to want to include them in the mix is, well, not addressing the realities of modern life.

  22. kranky kritter Says:

    I agree with Tully. Car insurance is not a good analogy, for one very basic reason i particular. Car insurance is insurance against a misfortune that you reasonably may or may not experience.

    Health insurance is part genuine insurance against catastrophic health misfortunes that may or may not occur, and partly a method of financing expenses that are virtually certain to be incurred.

    Also, let’s establish one very important thing about all of these “healthy” young adults. Most healthy uninsured adults are not that way out of choice. It’s because they have crap jobs that don’t offer health benefits. I don’t know anybody who is in the corporate world who voluntarily turns down health care b/c they don’t think they need it. But I do know a hell of a lot of people who work in restaurants and bars who don’t have it…but would pay for it if they could get access to it. Because those people get sick…a lot. They have higher rates of drug abuse, alcoholism, sexually transmitted diseases and mental illness…that then leads to more strain on the system down the road b/c their problems get worse and they still don’t have insurance. So to say that it’s hypocrisy to want to include them in the mix is, well, not addressing the realities of modern life.

    Eloquently stated. And not responsive to the main point. Including young healthy uninsured adults to the pool of the insured will lead to a net GAIN in revenue on the part of insurers. That’s demographically certain. It’s fact.

    Young adults may or may not choose to purchase insurance based on the cost that they will incur. That boils down to whether or not it is subsidized by employers or the government. People do make rational choices and they do so while incurring some risk. Winners and losers ensue. I say this not as a defense of any approach, but rather simply to describe current dynamics accurately.

    Whatever system we end up with next year or 5 years from now or 10 years from now, I think there is strong support for some component of choice. I like the idea of a system where yeah, you have to join, but you can opt in at various levels that combine low cost with higher risk in one option and high cost with low risk in another option.

    Sop for example, two young adults might be forced to get coverage. X takes the low cost-high risk option A and the Ye takes the high cost low risk option B. Later, X starts a family and want to switch to option B. X is then charged a higher premium than Y for the same coverage.

    We’re fooling ourselves if we think that mandating coverage is not in part a matter of capturing available revenue.

  23. kranky kritter Says:

    Wait, it’s only certain to be a gain if they are charged at a rate beyond what the costs of adding them will be. So Was wrong, it;’s not certain. The only thing that’s certain is that this demographic is the least expensive to insure because its the healthiest.

    If the cost is subsidized, then all taxpayers will bear the burden. But it’s unlikely that any cost structure won;’t draw disproportionately upon the healthy young.

    BTW, this further illustrates the point that health insurance is more like lifetime financing for eventualities that are, in the aggregate, virtual certainties. So, young healthy folks would be required to pay when they were young and healthy, then when they were old, they’d consume healthcare at a greater rate than they were paying in later.

    FWIW, I don’t claim that this is fundamentally unfair, somehow. It’s debatable along lines of partisan philosophy. What I object to is the pretense that forcing the healthy young to pay for more than they will consume is going to do them a favor. In the aggregate, it won’t. Unless subsidized, It will increase living costs for the young in relation to their income, decreasing their purchasing power.

    At the younger demographic, mandatory coverage is most likely going to be about capturing revenue. Again, unless its subsidized. And in case no one has noticed, their is no way for EVERYONE to be subsidized. If it’s coming out of your pocket more slowly due to a subsidy, then it must be coming out of someone else’s pocket more quickly.

    That’s where the conundrum lies. Becuase MOST Americans think they deserve to be subsidized, but there is no way for MOST people to be substantially subsidized, not without tax rates like 50, 60, 70, 80, 90%.

  24. Tully Says:

    Most healthy uninsured adults are not that way out of choice.

    What KK said, and then some. Their choices may be to live in a better apartment and drive a car rather than take the bus or ride a bike, to snort coke and drink too much (and at bar prices!) and haunt the singles bars, but they can access insurance if they wish, and at cheaper than level-rate plans. Insurers and HMO’s love them, they’re free money. They put their financial priorities elsewhere. They’re also putting some other priorities above their health as well, given the examples you cite.

    I repeat: ANY level-rate scheme screws the younger rate-payers to susbidize the older ones. As you yourself note, the younger rate-payers have (on average) much lower incomes and fewer and less expensive health problems, ones that are for the most part the result of voluntary actions on their part. And there’s also the voluntary uninsured who have plenty of income, but choose to self-insure.

    So yes, waving the voluntarily uninsured around as poster children for the express purpose of screwing them over premium-wise is indeed grossly hypocritical. As noted, these are mostly people who are NOT costing the system. And they’re a good portion of the uninsured. Do explain to us how it is NOT gross hypocrisy to use them as poster children in order to screw them over and take their money.

    Once again, the 15+% who are the uninsured cost the system 3% of revenues. Most of the that disparity is due to the fact that those uninsured simply do not NEED health services, and what little they normally do need they pay for out of pocket, and that costs them much less than buying and maintaining insurance. They don’t seek out health $ervice$ unless they’re actually ill, above and beyond colds and such. If you force them into insurance, the predictable result is that they will begin trying to get their money’s worth — their utilization rates will skyrocket and strain the system.

    The vast bulk of the rest of the uninsured are the working poor with families. Forcing them into coverage requires subsidies. You just can’t knick a family $11k/yr (the rough cost of health insurance for a family of four) when their income is $35K or so without driving them deep into real poverty.

    Which brings me back around to something I have said over and over. The idea that we will “control costs” by pumping piles of new money into the system is so completely idiotic that you pretty much have to be innumerate and delusional to believe it. As is the idea that paying less will increase supply. Everyone wants a magic bullet. There ain’t no magic bullets. We will not improve US health care without fundamental restructuring.

    KK — note that these younger people are ALREADY subsidizing health care for the elderly. The Medicare tax has not gone away. The argument there is already generational equity. They are ALREADY paying out of pocket with each and every paycheck for health care, just not for their own. The expectation is that if they live long enough someone else will pay for them.

    For examples of how well universal coverage plans contain costs and to see some of these principles in action, check MassCare or TennCare. Or dig through the history of Medicaid. Or Oregon’s plans a while back to exand the numbers covered by restricting what procedures would be covered.

  25. kranky kritter Says:

    For examples of how well universal coverage plans contain costs and to see some of these principles in action, check MassCare or TennCare. Or dig through the history of Medicaid. Or Oregon’s plans a while back to exand the numbers covered by restricting what procedures would be covered.

    Preaching to the choir there. I agree with you that ultimately costs can only be controls by some form of rationing, so we have to hope it matches some conception of fairness. (Where as we know, mileage varies).

    But as you’ve pointed out elsewhere, there should be some temporary period of cost control if and when we change to some sort of standardized system that cuts out middlemen and paperwork. I’d like to see that happen. Even if such further efficiencies manage to cut cost growth for awhile, it seems worth capturing.

    I also do want a reformed system to have fewer real-world losers like sick folks subject to recission and those who lose coverage due to job loss, then get frozen out on preexisting conditions. Certain perversities of the system shouldbe at the top of the list for, well, recission. I think we agree there.

    Offtopic: Tully, did you see Gran Torino yet? I dunno if Clint had any lines quite as good as “deserve’s…”but it sure had some redemptive moments. Clint’s well into his back 9, so I’m trying to enjoy the last few holes. I thought it was one of his best works.

  26. ExiledIndependent Says:

    KK, your logic would suggest that a government-insured long-term savings account, mandatory for all workers, might be a piece of the puzzle. Pay into it early, use as needed for copays, deductibles, etc. Upon death, unused portion is deposited into public healthcare fund. With people living longer, that won’t be as often as one might think of course. So net revenue each paycheck goes down (do we really want to do that right now?) for individuals, but the individual gets health service later. Rather than subsidizing care for just the elderly, they’re subsidizing (time-shifting) their own healthcare costs.

    This still leaves the question of the non-working uninsured.

  27. Tully Says:

    KK — Not as good as “deserves” and context is everything, but the classic geezer line “you kids get off my lawn” stands out in memory….

    Sooner or later we’ll end up with a single-payer or mandatory-purchase plan for basic health care. But it’ll be a total clusterfuck that makes other nation’ single-payer or mandatory-purchase plans look downright superior unless we first do that fundamental restructuring.

    As I’ve said for years, we have the finest for-profit health care system in the world. It is absolutely unequalled at producing profits. It is backed by the largest combined political lobby in the world, and the idea that we can improve it with “reforms” that play off factions of that lobby against each other is fantasy. We may expand (theoretical*) insurance coverage, but we will not improve the system overall OR contain overall costs that way. Quite the opposite. We’ll get the worst of both, higher costs AND worse care.

    We continue to suffer from the socio-political delusion that things CAN be improved, that they can be fixed so as to serve everyone better. Iffy. More likely is that we will pay the same or more (even much much more) for “universal coverage” that results in diminished individual access.

    ExiledIndie, it’s new taxation on those least able to afford it no matter how you structure it, though that would be a more equitable structural basis. But if the gov’t is running it, it’s inevitable that they will still boost rates above expenses in order to capture the leftovers. Want it to work? Make unused balances inheritable in some fashion, and not confiscatable by gov’t fiat. What gov’t can steal, it WILL steal.

    News flash for the “eat the rich” folks. There aren’t enough rich to go around, and they’re not all that edible.

    [* -- Giving more people Medicaid or the equivalent when fewer and fewer providers are accepting Medicaid because they can't even cover the cost of filing for the reimbursements does NOT result in a real expansion of actual service provision, but the opposite as the MCD system overloads. It just exacerbates the problem of offloading costs onto hospitals and state budgets.]

  28. Technology News Says:

    @Tully
    Rich people worked hard for their status today. Even rich can fall.

    offtopic:
    the gov’t leaders always find a way to fix the issues regarding to their own economy, every country has its own problems not just ours.

  29. DarenGMcDougal Says:

    Yeah! its true..Technology News..all people will fall even they are so rich..if they are not working hard..they will fall to a poor..people.These article will help a lot to our community..Our government ran a health care reform to increase coverage.

  30. Pat Says:

    @Technology News

    It depends on how they (Rich) can manage and What kind of their business.

    @Daren,

    “if they are not working hard..they will fall to a poor..people.”

    Working hard doesn’t mean you can reach your goal or dreams.

  31. patrice Says:

    @tully , yes you right all the good leader in our country are fix the issues regarding to their own economy,

Leave a Reply


NOTE TO COMMENTERS:


You must ALWAYS fill in the two word CAPTCHA below to submit a comment. And if this is your first time commenting on Donklephant, it will be held in a moderation queue for approval. Please don't resubmit the same comment a couple times. We'll get around to moderating it soon enough.


Also, sometimes even if you've commented before, it may still get placed in a moderation queue and/or sent to the spam folder. If it's just in moderation queue, it'll be published, but it may be deleted if it lands in the spam folder. My apologies if this happens but there are some keywords that push it into the spam folder.


One last note, we will not tolerate comments that disparage people based on age, sex, handicap, race, color, sexual orientation, national origin or ancestry. We reserve the right to delete these comments and ban the people who make them from ever commenting here again.


Thanks for understanding and have a pleasurable commenting experience.


Related Posts: