Obama’s Op-Ed on Health Care

President Obama, seeing that he is taking a beating in the polls, and that health care is starting to founder took to the pages of the New York Times to lay out the case for health care reform. I think he did a rather bad job of it. He could have done it with far, far fewer words, IMO. Anyhow, lets take a look at what he wrote,

These are people like Lori Hitchcock, whom I met in New Hampshire last week. Lori is currently self-employed and trying to start a business, but because she has hepatitis C, she cannot find an insurance company that will cover her.

I hate it when politicians do this. This is something politicians do all the time, put a face on the issue. One can argue it is to show the issue impacts people’s lives. Well no kidding. Most of what the government does impacts people’s lives. So I find this explanation weak. What I think it is, is an appeal to emotions. “Don’t pass my legislation and you are going to make people like Lori Hitchcock suffer.” I find it rather dishonest since it skirts the actual issues with reforming health care and instead is an attempt to get people to make a decision based on emotion instead.

However, there is a second bit of dissembling here as well. Of course Lori Hitchcock can’t get insurance, she has a pre-existing condition. Insurance cannot and was never designed to cover pre-existing conditions. Its like saying, I can’t cut down a tree with a spoon therefore we need national legislation so that we can cut down trees with spoons. Really? Are you just dishonest or stupid? James laid out the reasoning by looking at car insurance. If you get into a wreck then buy insurance the insurance company is not going to cover your “pre-existing” wreck of a car. Why? The accident already happened, there is no question of “if you get into an accident” you were already in one. Same thing here.

Now maybe we should figure out a way to cover pre-existing conditions, but is insurance really the right vehicle for doing that? Maybe there is some other policy we could put in place to deal with it, or not. But to say insurance companies are being bad in this case is just irresponsible and dishonest pablum. The insurance companies are looking out for their shareholders and possibly even their workers. That is not bad, that is being a good corporation.

I hear more and more stories like these every single day, and it is why we are acting so urgently to pass health-insurance reform this year. I don’t have to explain to the nearly 46 million Americans who don’t have health insurance how important this is. But it’s just as important for Americans who do have health insurance.

Wait one minute. Not all of those 46 million are people with pre-existing conditions. Some of that 46 million are people who have elected not to have health care. Some don’t even need it. Some do. To throw them all in and pretend like it is due to the vile depredations of health insurance companies is like blaming ADM for starvation in Africa.

First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

I’d love to see the mechanism for this. For example, suppose I like my current employer provide insurance, but I lose my job and my coverage. Then what? What if the public option or whatever takes it place doesn’t offer the coverage I had? What then?

In places like France, the Netherlands, and Switzerland they have choice and health care that will follow them. However, there is no public option, and no employer provided health care. In France health care is provided by non-profit health insurance funds, and in the Netherlands and Switzerland via competing health insurance companies.

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.

As I noted earlier, if there are billions and billions to be saved in Medicare and Medicaid, then start there. Hard to argue with clamping down on waste, fraud, and abuse, and I bet the Republicans would get behind it as well. But instead we have to have this massive pile of crap legislation that is hundreds and hundreds of pages long that nobody can read by themselves and who knows what is in there.

Second, this is just not in line with what the non-partisan CBO says about much of the legislation currently out there. The view is that the current legislation will add to costs and any savings are small or years down the road which we can’t wait for. In short, this paragraph is just…well its just downright misleading.

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies.

And here Obama reveals what he is really on about. Not controlling costs or the rate of growth in costs, but in throwing out the goodies to the voters. If the issue is saving money and controlling costs and moving towards providing the best quality health care that is sustainable…why spend any savings on the elderly? This is where the bulk of our costs are already. Spending even more here is just simply astoundingly wrong.

This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors.

So…we spend more today so we can keep spending more tomorrow? Is that the argument?

And our reforms will also reduce the amount our seniors pay for their prescription drugs.

Look, more free stuff for seniors.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition.

Yes, yes we get it already Mr. President those insurance companies are evil and their executives are agents of Satan. Never mind that by separating out those who have pre-existing conditions insurance companies are doing precisely what they are supposed to be doing: providing insurance for those who are healthy in the event of becoming unhealthy. I don’t doubt there are insurance companies that engage in bad behavior such as trying to deny valid claims, but dealing with pre-existing conditions is not one of them.

In the coming weeks, the cynics and the naysayers will continue to exploit fear and concerns for political gain. But for all the scare tactics out there, what’s truly scary — truly risky — is the prospect of doing nothing.

No, what is truly scary is making an already unsustainable and dysfunctional system even worse. We are looking at spending considerably more money than we currently are and any saving that reform provides President Obama is promising to spend on seniors.

Premiums will continue to skyrocket. Our deficit will continue to grow. And insurance companies will continue to profit by discriminating against sick people.

Aside from the last part, none of this will likely change under the reform plans President Obama endorses. In fact, the last part will likely result in an increase in premiums and maybe even the deficit.

In the end, this isn’t about politics.

I love it when someone tells a bald faced lie. Of course this is about politics. It was one of his big promises during the campaign. If it isn’t about politics then why campaign on it. I’d also offer this suggestion, when you are trying to sell the public on something, try not to close with such an obvious lie.

FILED UNDER: Barack Obama, Bureaucracy, Economics and Business, Government, Health, Health Care, Politicians, US Politics, , ,
Steve Verdon
About Steve Verdon
Steve has a B.A. in Economics from the University of California, Los Angeles and attended graduate school at The George Washington University, leaving school shortly before staring work on his dissertation when his first child was born. He works in the energy industry and prior to that worked at the Bureau of Labor Statistics in the Division of Price Index and Number Research. He joined the staff at OTB in November 2004.

Comments

  1. wr says:

    Maybe we can all agree on one thing in this debate: Despite the fact that both auto insurance and health insurance use the same word, the two businesses do not operate the same way. So while your point about not insuring a car once it’s been totalled makes perfect sense, simply applying that logic to health insurance doesn’t prove some kind of point.

    But you also don’t seem to understand how “pre-existing” conditions are used. If your analogy, it’s not insurance if someone who has had cancer is covered for a recurrence of that cancer. (Although to be fair, someone who has been in an accident will be insured against futre accidents, if at a higher rate.) But the medical insurance companies see that an applicant has had, say, acne and refuse to insure against cancer.

    You might find it an admirable business model that a medical insurance company only wants to insure the healthy and then only as long as they don’t get sick. To me this is fraud and theft.

  2. sam says:

    Of course Lori Hitchcock can’t get insurance, she has a pre-existing condition. Insurance cannot and was never designed to cover pre-existing conditions.

    As we discussed sometime ago (or at least I broached it), with the advent of more and more refined genetic testing, we might all turn out to be uninsurable. Well, probably not all of us, but a number significant enough to constitute a problem to be addressed.

  3. Steve Verdon says:

    Maybe we can all agree on one thing in this debate: Despite the fact that both auto insurance and health insurance use the same word, the two businesses do not operate the same way. So while your point about not insuring a car once it’s been totalled makes perfect sense, simply applying that logic to health insurance doesn’t prove some kind of point.

    Then stop calling it insurance and be honest and say its insulation, cost sharing, or “how I want to hoover up more resources than I’m willing to pay for”.

    But the medical insurance companies see that an applicant has had, say, acne and refuse to insure against cancer.

    Unless you can show a link between acne and cancer, this king of hyperbole isn’t very persuasive.

    You might find it an admirable business model that a medical insurance company only wants to insure the healthy and then only as long as they don’t get sick. To me this is fraud and theft.

    Oh FFS. Where did I write that? The idea behind insurance is to have a large enough population so that the law of large numbers takes over. Now, if insurance companies engage in shady practices like canceling a policy just after you file a claim, then yeah, reform that. But forcing a losing contract onto insurance companies is nothing more than saying, “We want all the healthy people to pay for those with pre-existing conditions.” Maybe that is the best way to do it but have the guts to come out and actually tell people the truth.

    Sam,

    As we discussed sometime ago (or at least I broached it), with the advent of more and more refined genetic testing, we might all turn out to be uninsurable. Well, probably not all of us, but a number significant enough to constitute a problem to be addressed.

    No kidding, in an economy where information is complete and symmetrical then insurance will be very unlikely. You need uncertainty and that usually require imperfect information. Its one reason why the perfectly competitive models are not representative of reality.

    I suppose you could buy insurance prior to having a child that will provide various payouts after genetic testing is done. Here would be a simple way of looking at it:

    Parents are expecting a baby, and we have their genetic profiles and from this work up a distribution of possible problems the baby could have. Based on this the parents could buy insurance so that if the child’s genetics indicate problem D, there is a payout of $x. That money is to be used to offset the cost of treatments, preventative care, etc.

    Of course, there would still be issues with things like accidents, but with enough information you could try to construct reasonable insurance policies.

  4. PD Shaw says:

    The acne issue:

    On NPR a few weekends ago, I heard discussion of Congressional hearings and testimony concerning insurance company practices on denial of claims. That’s different than denying insurance coverage for pre-existing conditions.

    One lady testified that she had been diagnosed with cancer and a treatment was proposed. Her insurer reviewed the claim and saw in the medical records that she had previously received medical treatment for acne, a treatment that was not identified in her insurance application. The insurance company denied the claim for treatment while it reviewed its options. She couldn’t afford the cancer treatment on her own, so she just waited.

    An insurance company was asked at the hearing to explain the connection between cancer and acne, to which the response was that the insurance company might used a different underwriting approach to the risk had it known of the acne treatment. If I may speculate, I bet the insurance company is thinking that it might have written the policy in a way that made it less attractive, and the lady might have gone with a different insurer, who would then be stuck with the cancer treatment.

    Anyway, I wrote this out because the acne/cancer issue has been raised in the comment threads a few times, and I wanted to make sure that this was the same issue. What I heard on NPR was not a pre-existing condition problem, it’s a problem when claims are submitted and people have treated their application with the importance of Minnesota ballot.

  5. Observer says:

    Steve,

    “how I want to hoover up more resources than I’m willing to pay for”.

    That’s pretty disingenuous. I have a very close family member who receives medication each month for a chronic condition. If his insurance didn’t pay for it, the cost of the medicine would be in excess of $100,000 / year–well beyond his means. Without the medicine, he’d be dead. It’s not a question of not being “willing” to pay. It’s about being able to pay.

  6. steve says:

    “I’d love to see the mechanism for this. For example, suppose I like my current employer provide insurance, but I lose my job and my coverage. Then what? What if the public option or whatever takes it place doesn’t offer the coverage I had? What then?”

    I think Obama is probably mostly correct here. He stipulates “if you dont have health insurance”. You presuppose you have insurance from your employer. Two different situations.

    “Yes, yes we get it already Mr. President those insurance companies are evil and their executives are agents of Satan. Never mind that by separating out those who have pre-existing conditions insurance companies are doing precisely what they are supposed to be doing: providing insurance for those who are healthy in the event of becoming unhealthy. I don’t doubt there are insurance companies that engage in bad behavior such as trying to deny valid claims, but dealing with pre-existing conditions is not one of them.”

    Healthy person has insurance. Healthy person has an illness. That person now loses their job. Should they never be able to get insurance again? Suppose it is something like Hep C. That person can still have an MI or a cancer unrelated to their Hep C. They still need insurance. Too bad for them? Remember that Douthat documented in his book that periods of temporary unemployment are more common now. Also, fewer companies are offering coverage. Maybe we should just define insurance, since you like refining definitions, as as a means of spreading out risk among healthy, more affluent people. If you get sick, you are not eligible for insurance.

    “why spend any savings on the elderly? ”

    Anything we can save now, will probably eventually be needed for the boomers as the number of people on Medicare increases, unless we go to means testing. I suspect we will end up means testing at some point, but no first term president would say that.

    Steve

  7. odograph says:

    Let’s remember that health insurance is supposed to be a solution for health care. When the Canadians or the Brits have a National Health, it helps people with preexisting conditions, it is ably delivering health care.

    Now, folks say health insurance need not cover preexisting conditions; ok but then to what extent is health insurace delivering health care?

  8. Joe Camel says:

    Hey, I can tell some great stories about people like Obama. I can tell you of the 50 (at least) people who choose not to have insurance I know. How about where I work where I and my other so called higher paid peers, subsidize those lower paid associates rates? I can tell you about the 50+ people of “Hispanic” decent, here illegally going to the emergency rooms for treatments of colds and laughing about it. I can tell you about pre-existing conditions, as I have one, as well as a wife with cancer.
    So, instead of re-writing everything, why not deal with things from a issue by issue basis. First, those who are in “true” need of help. That is the start. Once that is settled, move on to phase two. This is the same mindset that got us the Patriot Act, and all the other crap we live with daily. SLOW DOWN..there is no rush here folks. Take a breath.

  9. Brett says:

    In France health care is provided by non-profit health insurance funds, and in the Netherlands and Switzerland via competing health insurance companies.

    However, there is no public option, and no employer provided health care.

    Not quite. About 70-80% of costs are paid out by the funds, who negotiate the funding they receive from the government to pay out. The remainder is covered by insurance and/or out-of-pocket spending, which can include employer-provided health insurance.

    I don’t doubt there are insurance companies that engage in bad behavior such as trying to deny valid claims, but dealing with pre-existing conditions is not one of them.

    Well, there’s the issue of rescission. Plus, if you want to prevent un-insurance (or under-insurance), it’s not enough to merely ban denials based on pre-conditions, since the company could still do something like set premiums for certain groups and people so high that they’re effectively barred from insurance.

    I agree that you can’t really blame insurance companies for denying people based on pre-conditions – that’s their prerogative, and there’s no law against it (at least, no national law). Rescission is another matter.

    Unless you can show a link between acne and cancer, this king of hyperbole isn’t very persuasive.

    Don’t be dense. This type of thing is famous in the health insurance market (for individuals) – you have some usually quite harmless thing, and you get slapped with significantly higher premiums (or simple denial) due to some highly arcane formula they’ve worked out.

    Then stop calling it insurance and be honest and say its insulation, cost sharing, or “how I want to hoover up more resources than I’m willing to pay for”.

    You can call it “cost sharing” if you want. We call it “insurance” because it’s basically a safety net to catch the costly individuals based on the contributions of a whole bunch of health ones – the usual insurance business model, only it may or may not be a business.

  10. An Interested Party says:

    I’m just curious…there are a lot of people who are bitching about their money (or the possibility of) being used to take care of someone else’s health care…do these people feel the same way about their tax dollars being used to fund schools that they don’t send children to? Or roads they don’t use? Or to help senior citizens that they aren’t related to? And what should someone like Observer’s relative do? There is no way this person can pay for his medicine, no matter how hard he works…

  11. Steve Verdon says:

    Observer,

    That’s pretty disingenuous.

    No, its called being honest, painfully even brutally honest. If person has a pre-existing condition and yet feel he should have insurance anyways, he is basically getting care–i.e. resources–that he is not and has not paid for. We can’t hide it or make it go away by trying to classify it as something else.

    Brett,

    Not quite. About 70-80% of costs are paid out by the funds, who negotiate the funding they receive from the government to pay out.

    I was talking about how the care is provided, it is provided via either private for profit companies or via non-profit groups. The individual still pays premiums and part of the costs. There is no public option like what has been discussed in recent legislation here.

    Well, there’s the issue of rescission. Plus, if you want to prevent un-insurance (or under-insurance), it’s not enough to merely ban denials based on pre-conditions, since the company could still do something like set premiums for certain groups and people so high that they’re effectively barred from insurance.

    Again, it is an issue of what is insurance. As one ages the probability of highly expensive care becomes larger, if it becomes large enough then yeah the premiums will rise. This is same with car insurance as one has more and more accidents. That you can’t avoid getting old is one stand out difference, but also one of the main reasons we have problems with health care costs are the elderly. How do you provide adequate care for the elderly without impoverishing those working to pay for that care?

    Don’t be dense. This type of thing is famous in the health insurance market (for individuals) – you have some usually quite harmless thing, and you get slapped with significantly higher premiums (or simple denial) due to some highly arcane formula they’ve worked out.

    Again, another possible area ripe for reform, but it wasn’t something the President brought up. He keeps falling back to pre-existing conditions.

    You can call it “cost sharing” if you want. We call it “insurance” because it’s basically a safety net to catch the costly individuals based on the contributions of a whole bunch of health ones – the usual insurance business model, only it may or may not be a business.

    Its not insurance when it is dealing with pre-existing condition. Here in a nutshell is how insurance works,

    1. You select coverage in case the “bad state” occurs.
    2. You pay premiums.
    3. If the “bad state” obtains you get the pay out, otherwise you keep paying premiums.

    With pre-existing conditions you start out at (3) without having paid any premiums. Its basically a subsidy.

    Think of it this way, you have two insurance companies, A and B. A and B both deny coverage to people with pre-existing conditions. Abdul Obama (Barack’s cousin) become CEO of A and decides that the evil policy towards pre-existing conditions will be revoked. Now, A has two types of people:

    Type 1: Probability of illness 1%, with a cost of $100,000. An actuarially fair premium will be $1,000.

    Type 2: Probability of illness 100% (pre-existing condition), with a cost of $100,000, the premium is $100,000.

    Now the insurance company has 10,000 type 1s and 100 type 2s. Total costs are $2,000,000 and with 10,100 customers premiums are averaged at $1,980.20.

    Insurance company B is just like A, but with no pre-existing conditions (i.e. they have 10,100 type 1s). Premium for signing up with B if you are healthy is $1,000. Now if you are healthy and getting insurance through A would you want to switch to B? I’m guessing most people would. Thus leaving A with only the pre-existing customers who now have premiums in the $100,000 range.

    Now maybe the solution is to say, “Okay as a society we’ll just cover those unlucky people with pre-existing conditions.” That is, they will get a government program. Problem is, we don’t have that kind of a luxury anymore. We need to reform other parts of the health care segment of our economy to make sure we can do this.

    No current legislation that is under serious consideration does that. Oh sure, we can maybe do it for awhile, but then when costs keep rising eventually something will give. We will have reform forced upon us as we are yanked off this unsustainable trajectory. What will happen then? I don’t know, but I’m thinking it wont be good…particularly if you have a pre-existing condition or are elderly.

  12. sam says:

    On pre-existing conditions. Maybe what we could do is enroll folks turned down by insurance companies because of a pre-existing condition in Medicare. They’d have to present proof, etc. But, you know, enrolling them in Medicare is not that big a stretch: Everybody enrolled in Medicare has a pre-existing condition (me included, though I’m only under Part A right now): old-age and all its attendant stuff. Folks with a pre-existing condition will be taken care of. I can’t imagine that our society will just let them suffer and/or die. Maybe Medicare is the way to go. Just a thought.

  13. sam says:

    Not to say that I’m not aware of the looming problems in Medicare, I only offer it up as an already in-place program.

  14. PD Shaw says:

    Don’t be dense. This type of thing is famous in the health insurance market (for individuals) – you have some usually quite harmless thing, and you get slapped with significantly higher premiums (or simple denial) due to some highly arcane formula they’ve worked out.

    Is the acne thing true, or is it truthy? I heard specific testimony about the failure to report acne treatment as a basis of denial (or delay) of claim approval. That has nothing to do with anything that Obama is proposing or being debated.

    Are people being denied coverage because of acne?

  15. Brett says:

    Is the acne thing true, or is it truthy? I heard specific testimony about the failure to report acne treatment as a basis of denial (or delay) of claim approval. That has nothing to do with anything that Obama is proposing or being debated.

    Are people being denied coverage because of acne?

    I won’t vouch for a specifically “acne” incident, but in general there have been numerous incidents where someone was either denied coverage or slapped with very high premiums because some thing (often harmless) caused whatever calculations they use at the insurance companies to mark them as “risky”.

  16. Fog says:

    1) What we need to do in this country is already being done somewhere else for less money and equal (or better) health outcomes.
    2) For the richest country on earth, affordable access to healthcare is a moral issue. If we can spend as much money for weapons as the rest of the world combined, we can afford to take care of our own.
    3) When I was young, the common answer to criticism was “You got a better idea?” I want to hear Obama’s critics offer solutions, good ones. Until they do, I won’t give a tinker’s damn about anything they say.

  17. odograph says:

    On preexisting conditions, blue cross once denied me because I had been to a physical therapist once, to ask about a pain in my shoulder. They told me I should enquire with the California major health risk program(!)

    I was healthy, I’ve been healthy, save a few mountain bike stitches in the approx 3 years since.

    I ended up at Kaiser, who at first denied me too, for 4 crazy reasons. I had to write and contest each one. “weight loss? I’ve been this weight since college”

    My experience was that the definitely didn’t want to write individual policies for middle aged guys. They’ll only write that “insurance” for the very healthy.

    If we want health care for all, this ain’t it.

    If our

  18. Andre Kenji says:

    finally, someone that notes that there are others countries other than Canada and the UK with healthcare systems to be compared with.

  19. Andre Kenji says:

    “I’m just curious…there are a lot of people who are bitching about their money (or the possibility of) being used to take care of someone else’s health care…do these people feel the same way about their tax dollars being used to fund schools that they don’t send children to? ”

    In fact, they do. That´s why states with high number of seniors like Arizona have usually low school funding.

  20. anjin-san says:

    I want to hoover up more resources than I’m willing to pay for

    God forbid that you or someone you love should suffer a catastrophic illness or accident. I imagine your tune will change very quickly.

    It’s not a situation that calls for lame witticisms, as real people face real tragedy and the real financial ruin that often follows every day.

    You are a fairly bright guy Steve, but you also sound like a callow prick.

  21. shawninPhx says:

    If we limit medical insurance to pre-existing conditions we should also do it with auto insurance. Anyone with a previous accident should be denied (and, by most state laws, not allowed to drive) and everyone else evaluated by their ticket history.

    My sister has had three accidents – all her fault – in the past ten years and just switched to a new insurer for a lower premium. Crazy, I know. What’s to say she won’t have another accident in 2, 4 or even 1 month from now?

    Yes, health insurance is different from auto insurance, but in some ways it’s also the same. I had seizures as a child and now, at 32, I have a ‘pre-existing’ condition that prevents me from having any coverage for seizures or neurological disorders. How does that make any sense?

  22. DavidL says:

    For the richest country on earth, affordable access to healthcare is a moral issue. If we can spend as much money for weapons as the rest of the world combined, we can afford to take care of our own.

    Healthcare is not a moral issue. Rather it is a commodity, a product of human endeavor. In a free society, no person has the rights to fruits of another person’s labors.

    To cite the one’s example, Lori Hitchcock does not want insurance. She wants treatment for her Hepatitus. Insurance is meant to cover future risk, not past.

    The United State has the highest age of natural death and the lowest out of pocket expenses in the World. Maybe our system is not perfect but it works pretty darn well. It will work better if Obama keeps his hands off of it.

  23. Stan says:

    Sorry, DavidL, to me it IS a moral issue. It is simply wrong for a country as rich as ours to tolerate so much preventable pain and suffering caused by medical need, and doubly wrong when our per capita health care expenditures are double those of our peers.

    Although you haven’t identified your political party, I take it from your post that you’re a Republican and that you’re in your party’s conservative wing. The leaders you support are ardent believers in Christianity without any understanding of Christ’s moral teachings and ardent American patriots without one smidgen of solidarity with their fellow Americans. I tremble for my country when I reflect that God is just.

  24. shawninPhx says:

    DavidL,

    Unfortunately, the US does not have the highest age of natural death. In fact, we’re well down the list. Now, many can argue that average age of death is influenced by many things including accidents, pollution, crime, etc., so a better indication is infant mortality.

    In that area, the US is either 33rd (UN) or 46th (CIA World factbook) in infant mortality rates.

    Finally, your claim that the U.S. has the “lowest out of pocket expenses in the world” is completely false. Even most opponents note that the U.S. pays more for health care than any other nation on earth. While it may seem that we don’t pay for it, there is a direct correlation with wage stagnation and higher insurance premiums (i.e. wages over the years have slowed in growth because employers take more of that money to pay for health insurance premium rises).

    To sum up, we pay the highest costs on earth to have an infant mortality rate of 6.3 deaths per live birth compared to (#1 Iceland’s) 2.9. Something is not right.

  25. anjin-san says:

    In a free society, no person has the rights to fruits of another person’s labors.

    So tell us David, what happens to you if, God forbid, you suffer a catastrophic accident?

    You are driving home and a drunk driver runs a red light and creams you. You wake up a quadriplegic. Almost instantly, you are a pauper. Your house needs to be retrofitted. You need nursing care. A wheelchair. You can’t work. The bills pour in.

    What do we do with a freeborn man like yourself… take you out back and shot you? No, you will be supported by people you never met for the rest of your life. Its one reason we have a society.

  26. wr says:

    I’ve seen this happen with enough “conservatives” to know exactly how David would react. Suddenly he would discover huge amounts of empathy for people in exactly his situation and realize that it is necessary for society to take care of all quadriplegic accident victims.

    Everyone else, however, still deserves nothing but the back of the hand. Because they are still just leaching off society.

    I’m actually thrilled that Mr. Verdon is posting here, because he is one of the few righties out there willing to say what they believe — they would rather see Americans suffer and die needlessly, as long as they don’t have to pay any taxes. To them, that’s freedom.

  27. DavidL says:

    Stan

    Sorry, DavidL, to me it IS a moral issue. It is simply wrong for a country as rich as ours to tolerate so much preventable pain and suffering caused by medical need, and doubly wrong when our per capita health care expenditures are double those of our peers.

    Although you haven’t identified your political party, I take it from your post that you’re a Republican and that you’re in your party’s conservative wing.

    wr

    I’ve seen this happen with enough “conservatives” to know exactly how David would react. Suddenly he would discover huge amounts of empathy for people in exactly his situation and realize that it is necessary for society to take care of all quadriplegic accident victims.

    shawninPhx

    Unfortunately, the US does not have the highest age of natural death. In fact, we’re well down the list. Now, many can argue that average age of death is influenced by many things including accidents, pollution, crime, etc., so a better indication is infant mortality.

    In that area, the US is either 33rd (UN) or 46th (CIA World factbook) in infant mortality rates.

    anjin-san

    So tell us David, what happens to you if, God forbid, you suffer a catastrophic accident?

    You are driving home and a drunk driver runs a red light and creams you. You wake up a quadriplegic. Almost instantly, you are a pauper. Your house needs to be retrofitted. You need nursing care. A wheelchair. You can’t work. The bills pour in.

    My points are pure Thomas Sowell. I’d make that lower case libertarian.

    Recognizing heatlhcare is a commodity, it is consistent with Christian prinicple not to covert it. albeit I am not a theist.

    I you take out murders and accidential deaths, we lead the world in life expectancy. Building for jails would be more cost effective solution than Obamacare.

    No matter how much John Doe may choose to spend on his heatlhcare, does not create any right for for another person to take Doe’s healthcare.

    The moral responsibility to pay for the consequences of traffic accident rests with the party or parties at fault. In that case that would be the drunk driver.

    No amount of empathy can change healthcare from a commodity into a right. As much as I may covert your mansion, but merely coverting it does not give me any right to it.

  28. shawninPhx says:

    DavidL,

    You still haven’t provided a response as to how we, paying the highest costs in the world, have an infant mortality rate 3x that of the 1st place nation (FWIW, all of the countries that lead in infant mortality have national health care systems).

    I agree that crime, auto accidents, drug/alcohol abuse, etc, all skew end-of-life age expectancies, but none of those factor in to infant mortality rates. That’s why it’s a better indicator of health care quality.

    If this is a sign of a first rate, free-market system then there is clear reason to move away from that and to a system that provides better care at lower prices.

  29. andy says:

    Shorter Steve:
    People who get sick should never get health insurance again and go bankrupt and then just die.

  30. DavidL says:

    You still haven’t provided a response as to how we, paying the highest costs in the world, have an infant mortality rate 3x that of the 1st place nation (FWIW, all of the countries that lead in infant mortality have national health care systems).

    The reason the United States’ infant morality rates seem high, whereas in some nations an infant born with severe problems is counted as born dead and not treated. Whereas here, they get often expensive treatment some many indeed do surive.

    Canadians with high risk pregancies often seek to deliver their babies south of the border. The reverse does not happen. We do prenatal surgery. Does any other nation?

  31. Davebo says:

    James laid out the reasoning by looking at car insurance. If you get into a wreck then buy insurance the insurance company is not going to cover your “pre-existing” wreck of a car. Why? The accident already happened, there is no question of “if you get into an accident” you were already in one.

    Can you name a single state that doesn’t have a “public option” for those who are denied coverage for their car?

    Not a very good analogy.

  32. Drew says:

    “Let’s remember that health insurance is supposed to be a solution for health care. When the Canadians or the Brits have a National Health, it helps people with preexisting conditions, it is ably delivering health care.

    Now, folks say health insurance need not cover preexisting conditions; ok but then to what extent is health insurace delivering health care?”

    Uh, no, let’s not remember that. Rather, let’s remember that health insurance, like any insurance, is intended to be a solution to financing catastrophic medical events. It is not intended to be a pay-all health maintenance plan, which it has morphed into, and is a root cause of our current problem.

    I have little doubt that a pre-existing condition insurable pool could be created. Would it be more expensive? Of course, because the likelihood of loss is greater. But I’m sure the priciples of pooled risk still apply.

    There are so many weak minded arguments being made in this thread. Oy…..

  33. shawninPhx says:

    DavidL,

    “The reason the United States’ infant morality rates seem high, whereas in some nations an infant born with severe problems is counted as born dead and not treated. Whereas here, they get often expensive treatment some many indeed do surive.

    Canadians with high risk pregancies often seek to deliver their babies south of the border. The reverse does not happen. We do prenatal surgery. Does any other nation?”

    Unfortunately, this is simply not true. First, the statistics throw out the left and right extremes (i.e. a 23 week old child born in the US and a normal term pregnancy). Secondly, the number of people seeking care in the US for ‘high risk pregnancies’ is very rare. This usually only happens in cases of extreme premature birth where we, in the US, have more experience. This is similar to comparing the number of people in the US going to India and Indonesia for Siamese twin operations. People go to the places where these conditions are more common.

    The fact of the matter is the US is experienced in premature births because a lack of health care means a lack of prenatal care, thus resulting in premature births. This is the merry go round we’re on. No health care = premature babies = higher costs for everyone.

    Finally, yes, there are many other countries that do prenatal operations. Almost all Western European countries do it and, yes, Canada also does (heck, even Cuba has been doing it since the ’80’s). Although, in those countries they do fetoscopic surgery rather than c-section fetal surgeries. They consider it safer and less invasive.

  34. Steve Verdon says:

    People who get sick should never get health insurance again and go bankrupt and then just die.

    Andy,

    Didn’t you read this?

    Now maybe the solution is to say, “Okay as a society we’ll just cover those unlucky people with pre-existing conditions.” That is, they will get a government program. Problem is, we don’t have that kind of a luxury anymore. We need to reform other parts of the health care segment of our economy to make sure we can do this.

    Don’t be such a moron.

    Stan,

    Sorry, DavidL, to me it IS a moral issue. It is simply wrong for a country as rich as ours to tolerate so much preventable pain and suffering caused by medical need, and doubly wrong when our per capita health care expenditures are double those of our peers.

    The flaw in your thinking is almost painfully obvious…it is that you are assuming we will always be rich enough to pay for all the health everyone needs. The whole point of health care reform is about money. Everything else is a sideshow. If we don’t get the coss under control nothing else is sustainable and as it seems to have escaped so many…our current trajectory for health care cost is unsustainable.

    Really, that last part, that’s it. Its money. Forget universal coverage, better care, insurance companies and whatever they do. That is just the side show. Nobody wants to face the real show because once they do, they realize that the side shows can’t go on unless something major happens.

    So andy, Fog, Brett, anjin-san, and Stan, you guys are focusing on the wrong thing.

  35. Our Paul says:

    Back at the summer cottage, at the edge of New York’s fabled North Country. Nearest Wi-Fi at the town of Henderson Library, and not much time for a slow thinker and writer like myself to wax lyrically over health care.

    The denial her cancer therapy for failure to mention acne treatment as pre-existing condition was part of Robin Beaton’s testimony in front of a Congressional committee. A pdf file at her testimony can be found in article in Slate which details rescission. Worth a read, if for no other reason than the multiple links to this practice it provides.

    It is not a minor problem, all major Insurance Companies engage in this practice. It has been reported more than once that bonuses in Insurance Companies are tied to these practices. A correspondent at OTB, in a past thread, was kind enough to lead me to this post. Worth a read, as a graph tells all…

  36. steve says:

    “If we don’t get the coss under control nothing else is sustainable”

    True, yet are you you willing to accept working models that provide quality care while holding down costs? You continue to advocate for free market solutions which have no working model and which break the basic rules you need to make markets work, such as the ability to walk away from a purchase, relative equality in power and information, knowledge about what is truly cost effective.

    Steve

  37. Our Paul says:

    Gasp, Steve Verdon (August 18, 2009 | 04:42 pm) agrees with President Obama’s central point, to wit:

    The flaw in your thinking is almost painfully obvious…it is that you are assuming we will always be rich enough to pay for all the health everyone needs. The whole point of health care reform is about money. Everything else is a sideshow. If we don’t get the coss under control nothing else is sustainable and as it seems to have escaped so many…our current trajectory for health care cost is unsustainable.

    Yes indeed, I do believe that the President has a mentions that word, unsustainable, in all his speeches.

    The guys who do not have a plan are that funny shifty eyed bunch who from one side of their mouth sing that government is too inefficient to run health care, and one the other side of their mouth moan that a public option program would be “unfair competition” to the health insurance industry.

    Perhaps Steve would be kind enough to explain how an inefficient entity can provide “unfair competition”.

    Well said, shawninPhx |(August 18, 2009 | 03:24 pm). I would not concede the life expectancy statistic. Center right folk are fond of discrediting this health index. Their arguments are tedious and contentious, but careful analysis with real examination of data is hard to find. As you would expect, Steve Verdon trotted down this path in a recent post. If the comparison of international health statistics are proved wanting, one set of the problem is solved, and only the finances, specifically government expenses have to be examined. The Insurance Industry, they walk free…

  38. odograph says:

    Drew step right up and says he isn’t looking for a health care solution?

    For kids born with the wrong conditions?

    For kids born with the wrong parents?

    I think this is an unfortunate undercurrent. If you are ok with other people suffering than you can be happy with your insurance, until you need it …

    That’s kind of evil though.

  39. Davebo says:

    Don’t be such a moron

    Yes Steve, I agree.

  40. davod says:

    With regard to pre-existing conditions – I believe COBRA stops an insurance company from being able to deny you coverage for pre-existing problems.

    Under COBRA, your employer is obliged (If you decide to take it up) to provide you with health insurance for a certain time after you leave (I think it is 18 months). The big problem with Cobra is that the former employee has to pay the full cost of coverage that the employer would pay.

  41. Steve Verdon says:

    True, yet are you you willing to accept working models that provide quality care while holding down costs?

    Oh FFS steve. I’ve gone on record as saying moving towards systems like France’s would probably help. If there is good solid evidence that it would help, then yes go for it. I’d support such a move. It wont be enough, but it would be a good starting point. Current legislation does not do this.

    Besides your real beef should be at Obama, the Democratic Congress and so forth. They are the one’s proposing legislation that not only does not reduce costs and cost growth rates, but will in all likelihood increase them. Really, who the f*ck am I but some jerk posting to a blog on the issue. I’m supposed to not only advocate a comprehensive plan to reduce costs, but also come up with one? Really?

    I tell you what the CBO says. I tell you what my economic training tells me. Yes, I’m a proponent of implementing market based policies whenever possible, but I’m also not so blind as to realize that a pure market solution wont work. I’ve looked at the health care systems for:

    Canada,
    The U.K.
    France
    The Netherlands
    Switzerland
    The U.S.
    Singapore
    Germany

    and others, I’ve said that France, the Netherlands and Switzerland all have good systems. Singapores is probably the best. There are possible issues with scaling and population compostions (e.g. France has a much more diverse population and has higher costs).

    Yet this is your response.

    You continue to advocate for free market solutions which have no working model and which break the basic rules you need to make markets work, such as the ability to walk away from a purchase, relative equality in power and information, knowledge about what is truly cost effective.

    This is no true at all. I’ve said repeatedly that moving to the French system is probably best. I’ve pointed approvingly to the system in the Netherlands as well. I’ve also indicated that something like Arnold Kling’s suggestion is a good one where people get vouchers for purchasing health care from the government (or tax credits) along with a mandate to buy at least a minimal insurance package (e.g. some sort of catastrophic coverage). All of this entails significant government involvement.

    Our Paul,

    I’ve been saying our health care system is unsustainable since before President Obama was candidate Obama. Like usual you come in, think you found some sort of amazing point that will make me say, “Oh my God, you are so right!” when in reality you just don’t have a freaking clue.

    Now, lets see if you can grasp another point:

    None of the legislation President Obama appears to address the issue of unsustainable costs. He talks about it, but he has done and will do nothing about it.

    The guys who do not have a plan are that funny shifty eyed bunch who from one side of their mouth sing that government is too inefficient to run health care, and one the other side of their mouth moan that a public option program would be “unfair competition” to the health insurance industry.

    Perhaps Steve would be kind enough to explain how an inefficient entity can provide “unfair competition”.

    Subsidies. You don’t have to be efficient if you recieve subsidies, or can piggy back off of other government agencies. And if you don’t have to worry about state regulations because you are a federal program that’s an added bonus too.

    Davebo,

    Can you name a single state that doesn’t have a “public option” for those who are denied coverage for their car?

    Yes, and guess what they are all subsidized. The bad drivers are subsidized by the good ones. If the public plan was limited just to those who didn’t have any other options and could prove it, then there might be something. Further, make it so that expanding the public option is very hard (e.g. a 75% vote margin in both the House and the Senate) I might be more inclined to go with it as it could be a way to deal with pre-existing conditions.

  42. anjin-san says:

    The moral responsibility to pay for the consequences of traffic accident rests with the party or parties at fault. In that case that would be the drunk driver.

    Please, join us in the real world for a moment. What if the driver is uninsured? Sorry Charlie, the world is a complicated place.

  43. davod says:

    “Can you name a single state that doesn’t have a “public option” for those who are denied coverage for their car?”

    Forgive my ignorance, but I did not know all states offered such a service. I know the law in the states where I have licensed a vehicle says you have to have the vehicle insured to be able to operate it on the road.

  44. DavidL says:

    anjin-san

    Please, join us in the real world for a moment. What if the driver is uninsured? Sorry Charlie, the world is a complicated place.

    In New York State, insured drivers have to buy insurance to cover the uninsured drivers. It covers the costs, but does not absolve moral responsibliity.