# Deficit spending is awesome!   No wait, it's dung from the anus of Satan.

**URL:** <https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645>\
**Category:** The BBQ Pit\
**Created:** [March 6, 2011, 1:45am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645 "2011-03-06T01:45:20Z")\
**Posts on this page:** 20\
**Page:** 8

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 15, 2011, 11:35pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/141 "2011-03-15T23:35:50Z")

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> [@septimus](#):
>
> 😕 Public health care is a big money-saver, but I don’t think economy of scale is the reason.
> 
> Many times I’ve wished people addressing economic questions would just ignore everything they think they know about economics’ complexities and instead pretend they’re organizing a community on a desert island. You’d want doctors and nurses in your community. Would you consider it productive to also appoint a large number of people whose only function was to deny needed medical care?

Waitaminute–who are the real-world counterparts to the people who deny needed medical care in your analogy?

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**Author:** ![Zeriel](https://avatars.discourse-cdn.com/v4/letter/z/58956e/32.png) [@Zeriel](https://boards.straightdope.com/u/Zeriel)\
**Post date:** [March 15, 2011, 11:48pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/142 "2011-03-15T23:48:14Z")

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> [@Rand\_Rover](#):
>
> Waitaminute–who are the real-world counterparts to the people who deny needed medical care in your analogy?

Insurance providers, mostly, who bend over backwards in a proportion of cases to not provide care as agreed upon in the contract. The google search you want is “rescission”–which is touted as an anti-fraud measure, but has been in a number of cases been shown to be, essentially, a way for insurance companies to make false or malicious assertions about ostensibly undisclosed pre-existing conditions in order to deny lawfully obtained coverage.

See [Blue Cross praised employees who dropped sick policyholders, lawmaker says](http://articles.latimes.com/2009/jun/17/business/fi-rescind17), in which insurance company representative specifically assert they won’t limit rescission to cases of fraudulently acquired coverage, or here [http://www.ama-assn.org/amednews/2010/04/05/bisg0409.htm](http://www.ama-assn.org/amednews/2010/04/05/bisg0409.htm) for an example of an insurance company losing a case of this type.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 16, 2011, 2:52am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/143 "2011-03-16T02:52:08Z")

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Thanks, but I’d like an answer from septimus before I say anything further. Unlike a lot of folks here, I don’t like to assume something and then go off on someone based on my assumption. I just ask a question and wait for an answer.

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**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\
**Post date:** [March 16, 2011, 3:58am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/144 "2011-03-16T03:58:35Z")

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> [@Rand\_Rover](#):
>
> Waitaminute–who are the real-world counterparts to the people who deny needed medical care in your analogy?

In my ideal world, most of the health insurance industry would be shut down, with most of its employees looking for productive jobs instead. Doctors’ and hospital employees also “waste” much time complying with insurance companies’ requests.

Paul Krugman has noted that the U.S. spends more per capita on health care than do public-care countries (even when “per capita” is defined to include those who don’t have health care) and that much of the money spent on U.S. “health care” is indeed spent to facilitate the denial of health care.

Perhaps someone can present employment figures. How many total employees are there in health industry? Insurance-related administrators for doctors and hospitals? (Another controversial area where simple employee counts might help clarify would be Federal education funding. What are total employee counts of teachers? Of administrators?)

(Please note: my comparison is with ordinary public-care, not with Obamacare which I’m afraid was a big mistake.)

There. I’ve answered your question. But IIRC, I’ve posed my own still-unanswered questions in this thread. :dubious:

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 16, 2011, 12:28pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/145 "2011-03-16T12:28:27Z")

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OK. I like how you say “people should use the desert island analogy more to understand economics” and then completely fail at constructing a desert island analogy.

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**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\
**Post date:** [March 16, 2011, 6:51pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/146 "2011-03-16T18:51:16Z")

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> [@Rand\_Rover](#):
>
> OK. I like how you say “people should use the desert island analogy more to understand economics” and then completely fail at constructing a desert island analogy.

You write “Waitaminute–who are the real-world counterparts to the people who deny needed medical care in your analogy?”; then I describe real-world as requested; you complain I’ve dropped the analogy. :smack:

Upthread you misuse “dimension” to mean direction; you’ve defined your own Humpty-Dumptyism for “fiscal conservative.”

Since this is BBQ Pit already, I’ll just come out and say it: I don’t think you’re very bright, **Rand Rover**.

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**Author:** ![Zeriel](https://avatars.discourse-cdn.com/v4/letter/z/58956e/32.png) [@Zeriel](https://boards.straightdope.com/u/Zeriel)\
**Post date:** [March 16, 2011, 7:26pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/147 "2011-03-16T19:26:05Z")

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septimus, can you be a little more clear – you seem to be essentially saying that the mere existence of insurance providers blocks access to care (relative to a public-payer system, anyway). Unless the Krugman cite goes into more depth (which I’d expect, since Krugman is awesome).

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 16, 2011, 10:06pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/148 "2011-03-16T22:06:47Z")

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Right–your desert island version of the US health care system has doctors, patients, and “people who block access to needed care,” and somehow I’m the one who’s not too bright.

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**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\
**Post date:** [March 16, 2011, 11:49pm UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/149 "2011-03-16T23:49:30Z")

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> [@Zeriel](#):
>
> septimus, can you be a little more clear – you seem to be essentially saying that the mere existence of insurance providers blocks access to care (relative to a public-payer system, anyway). Unless the Krugman cite goes into more depth (which I’d expect, since Krugman is awesome).

Without a cite, think of it this way. The executives of insurance companies are responsible to their stockholders, not to their customers. If they can increase their profits by withholding expensive care to their customers, without violating the law or doing to the level that their customers leave, they are obligated to do so. Regulators exist because of this, and regulators are responsible to the people, and thus to the customers. They try to make it more expensive or difficult for insurance companies to withhold care. Regulations proliferate as insurance companies try to get around them. Everyone in this picture is working to fulfill their responsibilities. If we make the people the owners of the insurance system, much of the problem goes away. I work for big companies who are self-insured. Since the insurance companies get their money by a negotiated fee and not directly from premiums, they don’t make money denying care, and I seldom have had the problems you often hear about.

As a secondary effect, the increased cost of people running the insurance system at the insurance side and at the doctors side blocks access to care because it increases the cost. I don’t know the numbers, but even the smallest offices I go to have a full time insurance person, and bigger ones have a whole department.

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**Author:** ![Zeriel](https://avatars.discourse-cdn.com/v4/letter/z/58956e/32.png) [@Zeriel](https://boards.straightdope.com/u/Zeriel)\
**Post date:** [March 17, 2011, 12:21am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/150 "2011-03-17T00:21:18Z")

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> [@Voyager](#):
>
> Without a cite, think of it this way. The executives of insurance companies are responsible to their stockholders, not to their customers. If they can increase their profits by withholding expensive care to their customers, without violating the law or doing to the level that their customers leave, they are obligated to do so. Regulators exist because of this, and regulators are responsible to the people, and thus to the customers. They try to make it more expensive or difficult for insurance companies to withhold care. Regulations proliferate as insurance companies try to get around them. Everyone in this picture is working to fulfill their responsibilities. If we make the people the owners of the insurance system, much of the problem goes away. I work for big companies who are self-insured. Since the insurance companies get their money by a negotiated fee and not directly from premiums, they don’t make money denying care, and I seldom have had the problems you often hear about.
> 
> As a secondary effect, the increased cost of people running the insurance system at the insurance side and at the doctors side blocks access to care because it increases the cost. I don’t know the numbers, but even the smallest offices I go to have a full time insurance person, and bigger ones have a whole department.

Good enough for me–my last question was mostly Socratic anyway since I’m primarily in agreement with you on the issue.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 17, 2011, 12:34am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/151 "2011-03-17T00:34:39Z")

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> [@Voyager](#):
>
> If they can increase their profits by withholding expensive care to their customers, without violating the law or doing to the level that their customers leave, they are obligated to do so.

As a customer, I say thank god for that.

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**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\
**Post date:** [March 17, 2011, 12:38am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/152 "2011-03-17T00:38:13Z")

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> [@Zeriel](#):
>
> Good enough for me–my last question was mostly Socratic anyway since I’m primarily in agreement with you on the issue.

I think what drives the right nuts about this issue is that this is a case where the market doesn’t work - assuming people dying on the street of untreated diseases is unacceptable to you, that is. The insurance company execs are not rapacious monsters, they are just doing their job. Their job is fundamentally at odds with the public good.

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**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\
**Post date:** [March 17, 2011, 12:39am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/153 "2011-03-17T00:39:27Z")

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> [@Rand\_Rover](#):
>
> As a customer, I say thank god for that.

Oh, so if the insurance company rejects payment for an expensive procedure you’ve had, you don’t protest but say “Thank God for the market working?”

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**Author:** ![Zeriel](https://avatars.discourse-cdn.com/v4/letter/z/58956e/32.png) [@Zeriel](https://boards.straightdope.com/u/Zeriel)\
**Post date:** [March 17, 2011, 1:25am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/154 "2011-03-17T01:25:22Z")

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> [@Rand\_Rover](#):
>
> As a customer, I say thank god for that.

The issue, of course, with the current system is that they DO violate contract law on at least a regular (I have no data as to the frequency, just that I see regular news stories about it) basis.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 17, 2011, 1:35am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/155 "2011-03-17T01:35:53Z")

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> [@Zeriel](#):
>
> (I have no data as to the frequency, just that I see regular news stories about it) .

yeah exactly :rolleyes:

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**Author:** ![humanafterall](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/humanafterall/32/19654_2.png) [@humanafterall](https://boards.straightdope.com/u/humanafterall)\
**Post date:** [March 17, 2011, 1:43am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/156 "2011-03-17T01:43:40Z")

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> [@furt](#):
>
> Fuck no. We don’t let people _in_ our churches unless they’re millionaires.
> 
> Personally, whenever I see someone who _isn’t_ rich, I punch them in the face, just for the fun of it. If they’re non-white, I do it twice. And if they’re poor, black and gay? Well, then I just murder them and rape their children.

Funnily enough, there is a Church of the Almighty Dollar, [http://go.to/thechurchofthealmightydollar/](http://go.to/thechurchofthealmightydollar/) There, you are exploited honestly. They don’t delude you with notions of paradise or eternal bliss they believe in honesty through exploitation, and exploitation through honesty.

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**Author:** ![Zeriel](https://avatars.discourse-cdn.com/v4/letter/z/58956e/32.png) [@Zeriel](https://boards.straightdope.com/u/Zeriel)\
**Post date:** [March 17, 2011, 1:45am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/157 "2011-03-17T01:45:29Z")

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> [@Rand\_Rover](#):
>
> yeah exactly :rolleyes:

Admittedly, hard to get data about contract law settlements if they’re not decided in open court.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [March 17, 2011, 2:18am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/158 "2011-03-17T02:18:54Z")

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> [@Zeriel](#):
>
> Admittedly, hard to get data about contract law settlements if they’re not decided in open court.

But not hard to make up facts that fit your preconceived notions, apparently.

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**Author:** ![Zeriel](https://avatars.discourse-cdn.com/v4/letter/z/58956e/32.png) [@Zeriel](https://boards.straightdope.com/u/Zeriel)\
**Post date:** [March 17, 2011, 4:22am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/159 "2011-03-17T04:22:26Z")

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> [@Rand\_Rover](#):
>
> But not hard to make up facts that fit your preconceived notions, apparently.

Are you, by chance, accusing me of making up the news stories about rescission that were breaking all over the place?

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**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\
**Post date:** [March 17, 2011, 7:42am UTC](https://boards.straightdope.com/t/deficit-spending-is-awesome-no-wait-its-dung-from-the-anus-of-satan/573645/160 "2011-03-17T07:42:09Z")

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> [@Zeriel](#):
>
> Krugman is awesome

Indeed. Any reading this thread who are more interested in self-education than fighting strawmen or listening to the sound of one hand clapping could do worse than read that Nobel laureate, for example [two](http://www.nytimes.com/2011/03/11/opinion/11krugman.html) [articles](http://www.nytimes.com/2009/07/24/opinion/24krugman.html) showing that Republicans oppose efforts to reduce health care costs.

In more than one article, Krugman has claimed that much of the money spent on American health care is spent, in effect, on denying care. I can’t find such an article Googling just now but Dopers could do worse than browse Krugman’s columns, whether they find that specific claim or not.

I don’t recall Krugman claiming insurance industry is inefficient or a drain; that was my claim. I don’t think insurance-related paperwork, profits, etc. create much value.

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