See? Repealing the Law of Scarcity Is Easy!
The ways of Washington.
To the surprise of no one who understands Congress, ObamaCare passed, and the Usual Suspects are celebrating this leap into the abyss. President Obama, has signed the bill, declared that he and Congress answered “the call of history.”
In the eyes of some people, to question the virtue of ObamaCare is racist and indicative of a wish to see people get sick and die. Think I exaggerate? Read Paul Krugman:
…[T]he emotional core of opposition to reform was blatant fear-mongering, unconstrained either by the facts or by any sense of decency. It wasn’t just the death panel smear.
It was racial hate-mongering, like a piece in Investor’s Business Daily declaring that health reform is “affirmative action on steroids, deciding everything from who becomes a doctor to who gets treatment on the basis of skin color.” It was wild claims about abortion funding. It was the insistence that there is something tyrannical about giving young working Americans the assurance that health care will be available when they need it, an assurance that older Americans have enjoyed ever since Lyndon Johnson — whom Mr. [Newt] Gingrich considers a failed president — pushed Medicare through over the howls of conservatives.
And what are these “facts”? The Congressional Budget Office declares this new legislation will “control” health care costs and reduce the federal deficit. So if you question the “nonpartisan” CBO you must be a racist who hates sick people. Yet when we step back at look at this legislation, the reality is different from what was presented on the House floor or on the New York Times editorial page.
Let us start from the beginning. Medical care is a scarce good. That truth is fundamental to understanding everything else about its production and distribution. Someone must produce this good, and what is produced and who receives it (at least in a free market) are determined by the laws of supply and demand. We can rail all we want against the alleged unfairness of reality, but the fact remains that producing and obtaining units of medical care entail opportunity costs. Something of value must be given up.
Yet in a single vote we heard members of Congress declare that they were going to “provide world-class health care” to needy Americans and save money! They will provide nothing. All they can do is to coerce someone to provide medical care for someone else. In his classic piece that I often quote, “7 Fallacies of Economics,” FEE President Lawrence Reed lists his seventh fallacy as The Fallacy of Economics by Coercion. Indeed, at the heart of this bill, with its mandates, fines, and arbitrary dates, is the attempt to impose a specific medical regime by force. Reed says this about such coercion:
There’s an old adage which is enjoying new publicity of late. It reads, “If you encourage something, you get more of it; if you discourage something, you get less of it.” The good economist realizes that if you want the baker to bake a bigger pie, you don’t beat him up and steal his flour.
Medical care will be no less scarce with the passage of this law. Insurance companies could find price ceilings on their premiums while, at the same time, they are expected to pay unlimited amounts on care for whomever wants it. This is not sustainable under any circumstances, and the framers of this law know it. In the end the government will turn insurers into “public utilities” while raising taxes to finance subsidies. The result will be long lines and less medical care than many people receive now. Thus the law of scarcity will impose itself even though Congress officially has repealed it.
Comment by Norman DeLaHunt on 24 March 2010:
‘Replace’ rather than ‘repeal’.
This is a softer and more gentle word.
And it sounds less like a ‘party of NO’ word.
Norman DeLaHunt
Pingback by Repealing the Law of Scarcity Is Easy! « thak’s cool links on 24 March 2010:
[...] The Freeman | Ideas On Liberty » See? Repealing the Law of Scarcity Is Easy!. It’s kinda like flying. You can defy gravity for so long, but then you run out of fuel. [...]
Comment by triliberty on 24 March 2010:
Congress creates problems and they they clean then up creating bigger problems they have to clean up and again they have to clean up that problem too! Free Market is the answer! True Capitalism is the answer! We in American have never seen true Capitalism it doesn’t exist here.
Comment by Steve Hogan on 24 March 2010:
Yes, the claims are simply outrageous and frankly quite laughable. Universal coverage, better quality, and lower cost – all through government mandates. Square, meet circle.
Comment by Drik on 24 March 2010:
The scarcity will be combatted by the continued onslaught against all other factors of our economy, keeping any other possible job alternatives scarcer. Folks will be glad to get ANY job, and working as a doctor will be one of the few jobs left where one can get a regular paycheck. Sure a lot of them will be from foreign countries, but it will be doctors and they will work and they will be glad to get it, lest they join the great unwashed and struggle day to day with even getting food on the table. Don’t forget, the goal is fairness. Can’t lift everybody up, but you can durn shure knock a few folks down. Folks will build windmills and lightbulbs at GE or they will do healthcare, or they will get by on the government dole. Not that attractive after the rationing kicks in.
Comment by John Thomas on 26 March 2010:
Why is it that we lack journalists/op-ed writers that can think and instead get the likes of Krugman?
Voting for bread-and-circuses every day for everybody has to be far more damaging to this country than any external threat could hope to be.
Comment by scott on 29 March 2010:
You’re all wet. Currently, these very people GET health care. The only way your argument bears any resemblance to reality is in your academic world. You argue for free markets yet never define such a thing. Just as the old adage should justify drug prohibition, but the opposite is true.
Free markets can be best defined by the principle that the customer is always right. Yet in professional markets we aren’t smart enough to know if we are getting good advice/service; we are buying expertise. Then, there are utilities. Utilities are inelastic goods that all must use.
You boast of capitalism yet ignore externalities? Point to ONE private medical school in the US. We pay to research the drugs that patents privatize the gains.
The only way your arguments make any sense is if we refuse to treat those who don’t have money. To treat people in a class 5 emergency room versus in a doctor’s private office is a misuse of services which any universal coverage system WILL address.
I work in a competitive industry. It’s ironic that I have to argue with professors–one of the weakest professions. You want to assert your special knowledge in a fallacious appeal to authority, yet you don’t even know your own industry, much less the real industry that is my life.
Again, you special maxim would mean we have no drugs nor electricity, water or other utilities. Finally, if you looked at the various utilities in America, I would assert that the best operated among the various utilities is water resources. And, water is the most socialized of all the utilities. (I live in TEXAS where we deregulated electricity. Despite the most lax environmental laws we now pay among the highest rates in the country. OK has a publicly traded electric utility that sells electricity to retail customers below our wholesale rate yet still earns a profit.)
Worse than any demon you have warned us about is misapplying models to markets. There ARE private free markets, there the customer is always right, has the power and freedom to change firms and some clarity about the good/service they’re buying. These are almost all win win transactions where both parties are happy for the exchange.
Do you really feel the same way when calling your bank, electric company, cable, phone? These utilities have their parameters set by the gov’t. They get their easements from the gov’t. They sign contracts with various gov’t for access, parameters, service and funding. No free company has to deal with these restraints.
Again, where there is an inelastic demand curve, where use is ubiquitous, there is no real consumer choice. The customer is powerless. How many people stopped buying gas when the prices became so totally detached from supply and demand and were instead driven up to $4/gallon by speculators and traders with Goldman Sachs? Today, we have another glut in oil, yet prices keep rising. It is the very inelasticity of oil that allows commodities traders to run up the price and we have no choice but to take it.
There are no alternatives to oil. So, we have to take it. The CFTC used to check trades against actual supply and demand but the “London Loophole” prevented the CFTC from doing such analysis.
You’re Libertarian argument rests on the principle that no one answer addresses all market needs. I agree. But, there is not just one market but at least three, the free market, the professional market and the utility market. These each function differently, have different drivers and incentives. The consumer is king in the free market and powerless in the utility market. Ignoring these differences is as foolhearty as ignoring the hypocrisy of professional accountants and professors telling those in the free markets how things work.
Comment by scott on 29 March 2010:
You know there is no greater evil than the sophist in the world of enlightened discussion. The failure of libertarians to address the critiques I’ve offered screams sophistry.
I agree with your points relative to prohibition, the military, debt generally and civil rights. I agree with preserving market forces as much as feasible. However, all serious thinkers of policy quickly realize there are these 3 different markets. Professionals have guilds and fiduciary rules which govern their behavior. Utilities are regulated. These aren’t necessarily fixed as markets can change, but to never define free markets allows you to fool yourselves into thinking you’re saying something worth the ink.
Again, I find it funny that you write this from one of the weakest professions. Your fiduciary requirements are pretty meager versus legal, medical or other serious professions where your power is profound and subject to remuneration; you don’t even carry E&O! So, what hypocritical frauds are you? I am a free marketeer WELL AWARE of the profound difference of working with competitive suppliers, versus bloated corporate market abortions that aren’t competitive but use their size to destroy the market.
Did you forget that an essential aspect of gov’ts is to enforce anti-trust law? These aren’t easy or simple but they make sense. Again, you ignore reality. Just as the old minimum wage laws are bad drivel. This ignores the reality that the power lies with the employers and that no law will be passed that disadvantages employers. To suggest otherwise ignores the political process. Poor, minimum wage workers have no lobby. Hence, while minimum wage laws can be too high or too low as “arbitrary laws” only a fool or retard would fear excessive minimum wages.
Comment by James Madison Fan on 30 March 2010:
Scott,
Some interesting points but a little hostile. I’d offer that while a sophist can be exposed in enlightened debate you can’t have an enlightened debate when one of the participants defaults to ad hominem when you disagree. If you can’t logically and respectfully examine a counter thesis why should anyone take you seriously?
“…only a fool or retard would fear excessive minimum wages.”
This is an Argument by Generalization fallacy.
Your desire to help “poor minimum wage workers” does you credit and I would like to see change in the plight of the underclass but it is economically impossible to legislate a “living wage” for every position because the market can’t support it.
Increasing the minimum wage doesn’t have any effect on the real value of what the worker earns because the increase matriculates through the entire model. Supply and Demand remain the same but there is an artificial increase in cost so the curve moves to the right. Floor goes up. Ceiling goes up. Nothing changes. It is a “feel good solution” that doesn’t actually solve anything which is intended to mollify their constituents.
The only way to increase real wages is to increase scarcity of labor. The more unskilled workers that immigrate here the lower wages will be. That’s why limiting immigration relative to economic growth is so important and why unrestricted illegal immigration is so dangerous.
In addition to competing with foreign nationals working in the US illegally we are outsourcing both blue and white collar jobs to India, China, and other nations. This means less demand for unskilled US workers as well as a growing percentage of skilled workers as well. Job scarcity increase. Labor scarcity decreases. Wages stagnate or drop. That’s what happens when you participate in a world economy where the interacting markets are so disparate. Why pay someone $10.00 an hour to make a Tupperware container when you can pay someone in Paraguay 10 cents an hour and ship it North for a fraction of the cost?
Do I blame Corporate America for this? No. Why? They have a fiduciary responsibility to their shareholders to make as much money as possible. Our laws force the predatory behavior we find so loathsome. If we don’t like the behavior then we need to modify the laws that mandate it. Unfortunately it seems likely that allowing corporations to make decisions based on ambiguous criteria holds far more danger than the soulless money machines we currently face.
With that said while I think Mr. Anderson’s article fails to adequately address the situation.
What he doesn’t mention is we have defacto nationalized health care in the form of the Emergency Medical Treatment and Labor Act (EMTALA) as well as other services such as Medical, Medicaid, etc. which require hospitals to render service regardless of if the patient can pay or not.
As a result Emergency Rooms (ER’s) are forced to treat people that cannot pay and look towards the government to recoup their losses. What’s worse is that minor illnesses and injuries that could be treated for hundreds of dollars if caught early but often progress to the point they are life threatening.
For instance an uninsured worker with a minor cut that gets infected could be treated with antibiotics for a couple hundred dollars or less but due to the prohibitive costs involved he fails to seek treatment until it threatens limb and/or life. At that point he goes to an ER and we spend thousands, tens-of-thousands, or even hundreds-of-thousands on a hospital stay that could have been easily avoided. Due to this I think it is quite possible this law or something similar might save us money.
In addition to this there is more than a hint of fruad when an insurance company takes your money for years under the assumed risk that you won’t get ill and cancels your policy when you do. To revisit Mr. Reed’s bakery analogy it would be like paying a baker $10 a month over the course of years for a wedding cake on the off chance you might need one and having the baker opt out of the contract when you annouce that you are engaged. He had the option to opt out prior to that but enjoyed the income but when it comes time to uphold his end of the bargin he suddenly finds the arrangement less interesting.
I also have some difficulty with pre existing conditions. I don’t think someone that has cancer, AIDS, diabetes, or something similar should be condemned to agony and death but I am also not comfortable with the concept of unlimited free health care and I have yet to find a solution to this Gordian Knot.
The problem with the article as well as the replies and the entire health care debate for that matter is the failure to properly address that this issue is at the intersection of ethics and economics.
If you will forgive some hyperbole, I think the question is: Do we want to see people dying in the streets from conditions that could be treated easily and inexpensively?
I find this question very interesting because it asks us to consider where personal rights begin and societal responsibilities to protect the least among us begins. That is not an easy question to answer regardless of the economics involved.
Comment by scott on 31 March 2010:
“Unfortunately it seems likely that allowing corporations to make decisions based on ambiguous criteria holds far more danger than the soulless money machines we currently face.” Doesn’t this conclude your argument with ad hominem as well. I appreciate you didn’t rest your argument on the ol’ libertarian favorite, it’s difficult so screw it, the gubmint is bad.
Also, I like that you point out that if you want market medical care then it should be COD. That is socially unacceptable, for selfish medical reasons it is socially unacceptable.
Here’s a principle from medical ethics 101, limited resources must be allocated to a demand that can’t be met. So, in the old exercise doctors or hospital administrators are rationing care. Or, if you prefer you can have the insurance company make that ruling; or if you prefer you can have bureaucrats do it. Between a bureaucrat and someone who has a fiduciary duty to make money off me; give me the bureaucrat. At least I have a vote over him. Hell, I could own a thousand shares of some insurance company yet have no say over executive salary.
I get hostile, cause no one will step up to the plate. I am arguing earnestly. I’m not hiding some agenda. That evidently scares libertarians away.
Comment by James Madison Fan on 31 March 2010:
Scott,
“Doesn’t this conclude your argument with ad hominem as well.”
If I accidentally insulted you I apologize. I’m not trying to belittle you or attack corporations; I’m tying to convey that there are potential pitfalls of changing corporate law by making them even less accountable to shareholders based on morality, nationalism, and other intangible criteria because this could be easily manipulated by the unethical. It is entirely likely that the vast majority of corporations could be trusted to maintain a balance but it is a sad fact that quite often we end up giving up rights to protect ourselves from the actions of a select few that can’t be trusted.
“…for selfish medical reasons it is socially unacceptable.”
Interesting observation but I am not sure what you mean by “socially unacceptable?” Millionaires pay out of pocket all the time and as far as I know they aren’t made pariahs due to this? I don’t see a social stigma in paying out of pocket?
What I have noticed that the cost is prohibitive. For instance a single vial of insulin costs $170. Most diabetics use two types of insulin so that’s $340 a month. That wouldn’t bother me so much but the price has nothing to do with development or production. Insulin is fairly cheap and easy to manufacture but you can’t patent a naturally occurring hormone so they create chemical cousins that do the same job they can claim exclusively and this ramps the price geometrically and the same is true for most medications. The moment a generic hits the market the prices plummet because Big Insurance contracts with a manufacturer that will make it for a fraction of the price that Big Pharma was charging so you go from paying $200 a bottle to $20 (Target will fill most generics for $4 a bottle). You would find it difficult if not impossible to do that as an individual consumer.
Another thing that drives up prices is the previously mentioned EMTALA. The Republicans are so worried about Obamacare covering illegal aliens they haven’t stopped to consider our EMTALA mandated defacto nationalized health care already covers them. So if an illegal alien cuts his finger on the barbed wire while crossing the boarder and ends up in the ER two months later with a massive infection that requires an amputation, antibiotics, weeks in the hospital, physical therapy, and sundry the hospital ends up asking the Feds for the money. Typically the hospital only retrieves a fraction of what they bill so they pass that on to the paying customers. The Democrats would offer that we can’t let the poor man die. While I certainly can see the humanitarian side of the issue the volume of uninsured and under-insured taking advantage of this has resulted in dozens of ER’s closing their doors and massive price increases which tends to curb my philanthropic tendencies.
“Between a bureaucrat and someone who has a fiduciary duty to make money off me; give me the bureaucrat.”
Interesting choice. I tend to favor the private insurer. If Kaiser sucks I can always switch to Cigna and if they both suck there are other plans as well. Not to mention I can sue them if they screw up but the Obamacrate can hide behind sovereign immunity.
My daughter was born with an aortic malformation and two defective heart valves that required a million dollars worth of surgery and over a month in the NICU. If Cigna had said “no” I would have been on the phone with a lawyer before the echo had left the room. What do I do if some petty bureaucrat says no? Ask to talk with his supervisor? Write a scathing letter that ends up being round filed by a cubical hamster? Ever try to fight a ticket? Have you ever won? 98% of the time the system does nothing but reinforce the authority of the system. Right and wrong are irrelevant.
I understand that excessive litigation raises the cost of health care but I would rather leave it up to a jury of my peers to determine if the actions of the insurance company are justified than trusting the body politic to hold itself accountable because that happens next to never. The insurance companies are worried that if they screw up they’ll get tagged with a major suit. The government fears nothing. Give me someone that has some skin in the game instead of a spectator with nothing to lose.
I think the Veteran’s Administration provides and excellent model for how the Feds will run national health care. I have a friend with a kid that got injured while in the service and has had to deal with the VA for years now. Major nightmare. It is like going to the DMV but your life is in danger and the doctors are barely qualified to save it. They have rule upon rule that indicates what they can’t do even if they want to so the few physicians that actually know what they’re doing are obstructed by the bureaucracy. The injury makes it so he has to walk with a cane. He’s in constant pain, especially when he stands. If he had real insurance the doctor would have sent him to the operating room years ago. Unfortunately the VA doctors can’t do that because he was assessed at “90%” of what would qualify for the operation under their criteria.
If my anecdotes are not convincing Walter Reed was held up as a model for other hospitals and the jewel of the VA systems. In 2007 the Washington Post exposed it as a cockroach and mold infested chamber of horrors where sick and injured soldiers had to take turns standing guard to prevent drug deals in the hallways and keep the incapacitated from being robbed, assaulted, and victimized. This was supposedly the best the VA had to offer and it wasn’t fit for swine much less those that volunteered to give their last full measure of devotion.
“I get hostile, cause no one will step up to the plate. I am arguing earnestly. I’m not hiding some agenda. That evidently scares libertarians away.”
What scares people away is assuming they are “fools”, “retards”, and “sophists.” I applaud you for being passionate and agree that far too many in this country suffer from terminal apathy but when you appeal to “enlightened discussion” you will get more interesting, honest, logical, and introspective replies if you don’t insult the people you want to engage in debate. Well… at lest not until they deserve it. :-p
Comment by scott on 31 March 2010:
I appreciate your engagement with the nuances of the market. The “selfish Medical reasons” was my addressing the EMTALA. EMTALA makes good selfish sense. Leaving people with festering wounds, untreated infections and other chronic treatable ailments present dangers to the larger society, not just the poor suffering indigent.
The cost of this in our town, Dallas, is not born by the wealthy but by homeowners. The wealthy seldom go to the county hospital that all our property taxes fund. Of course they could raise the tax and the homeowners exemption and tax the “wealthy” but that exemption is pretty low.
I’m sorry, but the libertarians seem unwilling to engage in practical discussion. I consider myself a progressive/libertarian. I am not sure I am right about everything, I put my best argument out there and seek rebuttals.
I don’t really have time for those who aren’t willing to discuss in earnest these matters. Typically they aren’t really that informed about their arguments, again conflating free markets with professional and utility markets is to vastly fail to understand the principle challenge of each firm, and the consumers role.
I am a landscape designer/installer. My customers are always right. I have some special knowledge and trade craft that they are buying. I have ample competition, there is no real “need” for my service as there are alternatives as well. So, the customer is always right.
This dynamic is totally different in professional and utility markets. I have written this repeatedly yet still wait to get a response other than, “the gov’t ruins everything.”
As to your ability to sue an insurance company, I guess you don’t live in TX. Here the courts are bought and paid for by the insurance industry. And, you won’t get a hearing in the Supreme Court of the US either.
Now Aetna did a diabetes study and found that you can deny a diabetic insulin for 13 months before the cost of complications exceeds the cost of the insulin. By their standards they would stop offering insulin but for the PR nightmare.
This leads to the biggest externality that no one discusses. Private insurance is all frosting. The real costs accrue once the gov’t gets us on Medicare. So, the insurers really don’t have our longer term interests in mind. The Federal gov’t, one system would be more clearly driven by these considerations.
It should shock the world that Medicare/Medicaid account for only half of our medical expenditures. This considering that we spend half of all medical dollars in the last weeks/months of life. This disproportionately falls on the post 65 crowd, so, this stat reveals the vast waste of the private insurance market–the gross subsidy to the private market.
Comment by James Madison Fan on 1 April 2010:
Scott,
“EMTALA makes good selfish sense. Leaving people with festering wounds, untreated infections and other chronic treatable ailments present dangers to the larger society, not just the poor suffering indigent.”
An Objectivist-Libertarian would offer the following:
“My views on charity are very simple. I do not consider it a major virtue and, above all, I do not consider it a moral duty. There is nothing wrong in helping other people, if and when they are worthy of the help and you can afford to help them. I regard charity as a marginal issue. What I am fighting is the idea that charity is a moral duty and a primary virtue.” – Ayn Rand
Rand would definitely disagree with conscripted charity especially at the cost of personal freedom through taxation by threat of force (arrest). Rand is a bit draconian for my tastes but more often than not her logic is sound. I mention this because a large percentage of Libertarians canonize her and you will see her mentioned quite often in the Freeman.
As a Constitutionalist and student of the Founding Fathers I think we have a duty to the nation which this document describes. The motto of the Founders was “No taxation without representation” not “No taxation.” However, I am already donating a third of my paycheck to Uncle Sam so I have fulfilled my societal obligations. I am happy to help the tired, poor huddled masses especially when it is in my own best interests but I would prefer not to join them in squalor due to my government’s compulsory largess.
I would offer that charity is a moral duty and a primary virtue because it is the foundation for society but excessive charity is exploitation. If you can’t work then you deserve charity. If you can work but choose not to then it is, in effect, slavery by proxy.
We are already paying for their housing, education, clothing, and food and in some cases their incarceration from cradle to grave and we’re going to add in unlimited health care? There is a happy medium between being a Fairy Godmother granting their every wish using a taxpayer financed magic-wand and Scrooge’s suggestion that they simply die and decrease the excess population.
It becomes even more difficult to justify when a significant portion of the uninsured are foreign nationals. Obama keeps offering “40 million uninsured Americans.” Liberal sources such as PEW put the number of illegal aliens at 10 million while more conservative sites use numbers as high as 30 million. Are these included in Obama’s 40 million? If so that means illegal aliens represent between 25% and 75% of the uninsured that Obama wants us to cover.
Obama then offers that illegal aliens will not be covered then champions “Comprehensive Immigration Reform” a la Simpson-Mazzoli that grants amnesty to anyone in the US illegally. So Obamacare doesn’t cover illegal aliens because that designation will cease to exist for 10 to 30 million foreign nationals with the stroke of his presidential pen and this will happen every time we revisit Simpson-Mazzoli. How many people am I supposed to pay for based solely on their ability to enter our County by stealth? How much poverty can we import before it bankrupts us? 1 billion Americans and Europeans cannot carry around 5 billion people on our backs like Tiny Tim. They are heavy and they are not my brother.
I also have serious concerns about people that could get insurance but decide they have better things to do with their money. What percentage of the 40 million represents people that expect a government “safety net” to save them from their own stupidity and greed? If you don’t wear a seat belt and end up dead, that’s your own fault. If you don’t check the chamber of a gun before you clean it and end up dead, that’s your own fault. If you would prefer to buy beer rather than insurance and end up dead, that’s your own fault. I am really getting tired of insulating a less than brilliant demographic from the ravages of Darwin using my wallet as a buffer.
At what point have we provided enough?
“As to your ability to sue an insurance company, I guess you don’t live in TX. Here the courts are bought and paid for by the insurance industry. And, you won’t get a hearing in the Supreme Court of the US either.”
I live in California. AKA Rupulicano Del Norte – Santa Ana. We’re approximately three illegal aliens away from ceding, maybe four.
Seems you’re a little jaded when it come to the courts. Talk to P&G about toxic shock syndrome and Dupont about auto immune disorders then ask Toyota what their lawyers are saying about the product liability suits that are about to hit and they’ll paint a different picture. I’m more secure in my ability to get millions out of Kaiser and Cigna than getting even the lowest level Federal cube dweller fired if he puts someone I care for in the morgue.
I have a friend that delivers mail for the USPS. The horror stories about coworkers leave me in awe and that’s pretty impressive considering I work for a County agency. If you complain about field staff nothing will happen and your bills are going to end up in someone else’s mail box on the other side of the county. You don’t want doctors with the same work ethic and attitude towards customer service. You’re talking with someone that works in the belly of a lesser beast that has direct insight into how the greater beast runs. Be afraid. Be very afraid. In space no one can hear you scream. In Washington no one cares if you scream.
“Now Aetna did a diabetes study and found that you can deny a diabetic insulin for 13 months before the cost of complications exceeds the cost of the insulin. By their standards they would stop offering insulin but for the PR nightmare.”
That’s interesting. On an intuitive level it seems flawed. $340 * 13 = $4,420. Even at twice this number it doesn’t cover the cost of a single night in the hospital much less the cost of treating kidney failure, dialysis, retinopathy, neuropathy, sundry infections, stroke, heart attack, and all the other complications. I’d love to talk with that statistician that came up with 13 months because he’s way low-balling the down side and that’s not including the legal ramification of failing to fulfill their fiduciary responsibilities and gross negligence resulting in disability and/or death. It might take some time for a class action to get through the courts but the lawyer’s fees alone would cost more than 4G’s per claim.
“It should shock the world that Medicare/Medicaid account for only half of our medical expenditures. This considering that we spend half of all medical dollars in the last weeks/months of life. This disproportionately falls on the post 65 crowd, so, this stat reveals the vast waste of the private insurance market–the gross subsidy to the private market.”
It might prove that or it might prove that Medicare isn’t as liberal in their coverage as private insurance companies because they have nothing to lose by being frugal. My Dad passed in 2008 from bladder cancer and if he hadn’t had secondary coverage as well as a fair chunk of his own money his passing would have been far more difficult on everyone involved and far quicker. If you want to get your ears pinned back hard core tell my Mom how peachy Medicare is and she’ll spend a fair portion of your life explaining what she had to go through compared to when Dad was covered privately. It isn’t the panacea you seem to think it is.
Truth is the way we treat the elderly and dying in this country leaves a great deal to be desired regardless of if we’re discussing health insurance corporations, nursing homes, or geriatric wards. There is a “hurry up and die so we don’t have to pay to keep your wrinkled butt alive’ attitude that is pervasive in the system that I found profoundly insulting.
Comment by scott on 1 April 2010:
Sorry, Ayn Rand is silly, Who the hell gave John Galt the land the rail road sits on? Come on with that nonsense. I like the the Ewok example much better but I don’t confuse that with reality.
Look, the fact is that illegal aliens screw the same prostitutes as white kids. You fail to treat medical ailments the cost increases. That’s all that needs to be said. It is true. You can theorize the number of angels that athiest Ayn Rand could imagine from her cloistered elitist existence.
The raw, greedy financial reality is that sick people are communicable.
Finally, since England spends about 50% per capita what we do, then if we added 50% to their budget it would obviate much of what your anecdote blames. That remaining margin is the obscene profits insurers make in a perverse market.
No one is arguing that money won’t get someone better healthcare. But the fact is that medicare is the ONLY primary insurer that will cover anyone over 65. It would make great sense to bring all the cheap younger people on board.
The best way to maximize efficiencies would be a single payer. A single payer could be a private firm by the way. But getting the largest pool and one that covers everyone brings undeniable efficiencies. Treating young people with the interest of the ultimate insurer as the Federal gov’t is in reality would probably increase well care.
Comment by John Anello on 1 April 2010:
JMF,
Glad you are posting again. I figured you would be back to comment on the recent unpleasantness.
Comment by Comment_Whatever on 1 April 2010:
It’s funny. Nobody here knows how the medical system actually works.
Except me. So I’m going to mock you. Not in the hope of you actually learning anything, because you won’t, but simply for fun.
My Position:
The United States current health care system bears no resemblance AT ALL to a free market. “Professional” or “Utility” or any free market at all. It is the anti-free market.
Do any free marketers care to challenge this statement?
Comment by Comment_Whatever on 1 April 2010:
You guys are funny. None of you have any idea how the medical industry actually works.
Let me explain it simply. The medical industry is the anti-free market. It would be very difficult to design a market less free.
In fact, I have no idea how any of you got the impression the medical industry was a “free” market.
Would any of you care to argue this point?
Comment by James Madison Fan on 2 April 2010:
John Anello,
Thanks. It is nice to be back. Actually my hiatus was entirely accidental.
I went to Mexico on a cruise back in October and ended up getting a massive infection in my left foot that nearly cost me my foot and threatened my life to a lesser extent. I had two operations and this cost me several weeks recuperating at home. Work piled up so I haven’t been able to do much besides play catch up.
All this does is prove that our supposedly broken health care system isn’t quite so broken as Michael Moore and his ilk would like us to believe.
Comment by James Madison Fan on 5 April 2010:
Scott,
Some people would offer the concept of an invisible, omnipotent Supreme Being that has nothing better to do than keep a running tally on how many times I screw up is absurd but only 1 in 6 people would agree so the concept of “silly” is relative.
Rand’s philosophical, economic, and political writings are at the center of the Objectivist Movement in much the same way Smith’s writings are at the center of Capitalism and Marx’s are at the center of Socialism and Communism. I do not agree with a great deal of what Rand wrote but I’m a Constitutionalist, not an Objectivist. I am only reporting that Rand’s writings are pervasive in the Freeman not making a judgment on the validity thereof.
“Look, the fact is that illegal aliens screw the same prostitutes as white kids.”
You are assuming that illegal aliens can’t be white kids. La Raza and MeCHA would like you to believe that “illegal aliens” is a pejorative for “Latino” but that is not correct. While 75% of illegal aliens are Hispanic that leaves another 25% that have diverse origins.
I would offer that treating the prostitute would be more efficient that treating her clients after the fact, especially if she is infected with something that can’t be cured such as Herpes S-II or AIDS. The brothels in Nevada provide an excellent model where STD’s are less of a concern than in areas where it is kept in the shadows.
It makes no sense that you can get paid to have sex as a porn star but not as a hooker.
“You fail to treat medical ailments the cost increases. That’s all that needs to be said.”
You left out where the money is going to come from and how much.
“You can theorize the number of angels that athiest Ayn Rand could imagine from her cloistered elitist existence.”
Why is being an atheist relevant? Fact is fact. The flavor doesn’t change based on the presenter.
Rand’s came from the middle class in Russia. Her father’s business was confiscated after the revolution. In her youth she taught ignorant soldiers how to read. She came to the US sometime around the Great Depression to visit relatives and decided to stay even though her resources were limited. She earned a living as a script writer. Not exactly the stereotype for the ivory tower elite you are offering. I’m not commenting on the value of her writing only correcting your misrepresentation that she was unfamiliar with the plight of the underclass.
“The raw, greedy financial reality is that sick people are communicable.”
Old age isn’t but this is where most of the money is spent.
A baseline healthcare system that allows a doctor’s visit so you don’t spread TB, Swine Flu, Chlamydia, or some other disease is one thing. A comprehensive national plan that covers someone regardless of age, condition, and cost is something else entirely. We could have achieved the first by implementing a system where the government would reimburse a doctor for a visit based on the submittal of a authenticated Social Security card.
“Finally, since England spends about 50% per capita what we do, then if we added 50% to their budget it would obviate much of what your anecdote blames. That remaining margin is the obscene profits insurers make in a perverse market.”
You are assuming that for 50% you receive the same or better coverage but that is not in evidence. I don’t see people flying to Britain to get delicate operations that can’t be done in the US due to lack of talent or scheduling issues but the reverse happens throughout Europe and Canada.
There is a data gap in regard to what we’re going to get for how much. If we pay the same and get 80%, 100%, or 120% of the services we currently enjoy then it might be worth the transition but if we spend as much or more and we get 50% of the service it will be a tragedy that will cost the government and insurance industry an unimaginable amount of money to repair. The lack of information in regard to validity is staggering and I cannot fathom committing to a course that could cost us – trillions – if we’re wrong without a much better grasp of the financials.
Just because 100% of the people are covered does not make it superior. The bus is accessible to 100% of the population but that doesn’t make it superior to a station wagon much less a Corvette. I can take the bus to the beach and get there two hours later or jump in my car and be in the water in half-an-hour. What Obama is asking me to do is to give up my car because others cannot afford one and not only do I have to stop driving, I have to pay for the bus while 13% of my fellow travelers get to ride for free even though a majority of them are on the bus illegally or because they made the financial decision that a car was too expensive. I do not think this is a strong foundation for abridging liberties, swelling government, and raising taxes.
What really doesn’t make sense is where Obama is getting the money. He’s going to tax premium health care plans which are predominantly used by the middle class such as teachers and other union workers. Most of the wealthy are self insured so it isn’t going to affect them. Yet another Democrat program akin to Capital Gains and the Death Tax that supposedly “taxes the rich” in an effort to help the poor and middle class but has the opposite effect entirely. It would be nice if they set out to tax the rich and actually succeeded one of these days because they keep missing the mark by a league. All this is going to do is make it more difficult on people that are already hard pressed to pay their premiums so fewer people are going to be insured, not more. In Obamaland the only good health care is Obamacare and the only people that will have access to anything but Obamacare are the ones that can afford to pay the penalties for opting out. So the Rich get uber service while the middle class gets tasked to carry around the poor on our backs yet again.
If the Dems want people to be insured how about giving tax breaks to people that have insurance and companies that provide insurance rather than making it even harder to carry the coverage we already have? The government could indemnify insurance companies against older clients and clients with pre-existing conditions allowing them to write off losses against profits ensuring that a handful of problem clients wouldn’t bankrupt the company. We do this with gambling debt but no one though about applying it to health care? There are dozens of ways to fix health care that do not require nationalizing a seventh of the economy but the Dems weren’t interested in fixing health care in a way that didn’t involve creating a massive new bureaucracy (Barakracy) and I find this invasive, aggressive, and insulting, especially considering how they passed the bill. Right or wrong the process we just witnessed would have sent Jefferson and Madison running for their muskets.
Another thing that needs to be pointed out is one of the reasons health care costs so much is people expect it to cover everything from doctor’s visits to elective surgery rather than protecting you from being hammered by mega bills. We are not using insurance as insurance. It would be roughly analogous to using your auto insurance to cover maintenance, tune ups, and oil changes rather than protecting you in case you have a major accident.
“No one is arguing that money won’t get someone better healthcare. But the fact is that medicare is the ONLY primary insurer that will cover anyone over 65. It would make great sense to bring all the cheap younger people on board.”
In other words we’re going to abridge the rights of the younger generations to finance the medical care of the older generations. We already tried that with Social Security and it is constantly being raided like a giant slush fund and it will likely be bankrupt inside our lifetime. I don’t see that as a particularly convincing model. Do you?