Heh. They probably consider the poor saps who have to explain to the patient with cancer why his insurance just got canceled as disposable. I’m sure they’ve got spreadsheets to compare the costs and benefits of ripping people off enough to get to the edge of shooting up an office. Too much bad publicity and it’s not worth it. Before I get accused of demonizing industry, this is exactly what Ford did with the Pinto.
I think there is a bit more to the story than that.
P1. Risk management is a skill. Good risk management involves sophisticated techniques in origination, underwriting and account management.
It’s the reason that some banks and credit card companies and insurance companies are still standing and make lots of money, and others go bankrupt (or would go bankrupt, if the government didn’t provide them with bailout money).
Go read a little about Warren Buffett’s insurance companies, and then read about how Countrywide originated mortgages, and see if you can spot the difference in how they do business. It’s huge.
Having the government in the business of risk management is a disaster waiting to happen. The process will become politicized. Special interest groups will come lobbying for favors, as they do already with state insurance regulators and national banking regulators.
Plus, government employees have no competence or skill in risk management. They are career bureaucrats who probably wouldn’t know a regression model or CHAID analysis tree if it bit them in the ass.
One only needs to look to Freddie and Fannie to see how the government getting involved in the business of mortgage risk management has turned into a disaster. The process has become politicized and we as taxpayers are on the hook for hundreds of billions of $$, if not trillions of $$. And it isn’t ending. The gubmint essentially handed F & F a blank check on Christmas Eve of last year, when they hoped nobody was looking.
P2. Your point touches on basic issues of freedom of choice. By ‘forcing’ me to participate in a nationwide risk pool, you are removing my freedom of choice to do without insurance and assume the risk myself. You will force me to pay a premium for a product I don’t want.
There are indeed people who, through no fault of their own, have catastrophic events happen to them that make them uninsurable. Subsidizing these high-risk pools is fine thing to do. But the actual % of the population in that category is remarkably small, despite all the sob stories that UHC proponents will trot out on MSNBC. There is no need for a massive government takeover of 1/6th of the economy, with sweeping near-dictitorial powers, to address a tiny portion of the overall population. There are other more efficient and simpler ways to do it. Try and keep things in perspective.
P3. I would have thought this canard would have been thoroughly debunked by now, given the public debate over the past year. Simply measuring life expectancy and correlating it to health care $$ is a tremendously over-simplistic (and wrong) way of measuring health-care spending effectiveness.
The US life expectancy figures are skewed lower by much higher homicide and traffic accident rates…two things that have absolutely nothing to do with health-care spending. Here’s one cite
http://www.aei.org/docLib/20061017_OhsfeldtSchneiderPresentation.pdf
Take a look in particular at the hair-raising homicide rates amongst black Americans compared to other countries. That has absolutely nothing to do with health-care spending, yet drags down our overall life expectancy figures.
When you actually measure how health-care $$ are spent (like treating cancer)and then look at the outcomes of that treatment, the US shoots right to the top.
On the infant mortality side, I’m Googling for a cite, but there is plenty of evidence to suggest that the US figure is ‘low’ because we actually try and save so many low-birthweight babies that other nations simply discard. In other words, we include a bunch of babies in our denominator that they do not, which skews our mortality rate higher.
Here’s one cite…
You seem like a smart guy (or girl). Do yourself a favor and empower yourself more to make decisions. Don’t sign over your rights - and your money - to a government employee to tell you what you can do and cannot do.
Ah, once more with the standard, baseless claim of innate government incompetence.
And then when you get injured or sick anyway, make us pay for it, without you ever having paid in. I doubt anyone really believes that you would refuse all care and let yourself die out of libertarian principle. Your noble principled stand for liberty ultimately amounts to a demand that you be allowed to play parasite, to leech off the rest of us while making claims about rugged individualism.
And now the libertarian appeal to ego; only the stupid people need help!
The same difference between the government buying food from farmers to give to hungry people as opposed to trying to grow it themselves. Think of anything the government does…military, space program, housing, whatever. Then consider who actually does the work. By and large, the government bids out this kind of work to contractors, who are, at least in theory, experts in their chosen field, instead of trying to grow food, construct houses, build space craft or military hardware, etc. Even in the contracting and project management aspects, my experience is that it generally costs the government more and they get a worse product than if you had the same thing built for a private company. The problem is that big ticket items get parceled out among as many states as possible, for political reasons, and this generally drives up the costs. In general, government workers are sub-par workers, especially when you get into the higher GS or SCS positions (and the appointed positions are almost uniformly idiots, in my own experience). Couple that with the high levels of inconsistently applied regulation, which while generally Byzantine in it’s complexity usually has all kinds of chinks, holes, and provisions that allow the contracts to abuse or game the system, and you are talking about a system that is set up and even encourages abuse.
That said, the government generally gets a much better product when it buys an existing product off the shelf from industry than it gets either from sending out an RFP, collecting and reviewing bids, awarding a final contractor (based mainly on price, but politics definitely factors in on the big ticket contracts), then overseeing the development of whatever project they are doing…or in building it and running it themselves (which, as I said, they almost never do, and with good reason).
As I see a free market health care system, an individual or group of individuals would be free to buy a health care policy at whatever price they wanted to buy, similar to car insurance. Maybe an individual only wants catastrophic health insurance in case of a bad accident or something like cancer. Others would want routing health care, others would need more care. Since the government and industry wouldn’t be taking out their rather large piece of each individuals pay check for health care, and individual would be able to choose a plan they could afford. The government could then provide support for the group of people who couldn’t afford their health care needs through general taxes, instead of the loopy system we have now (and the system we are about to get). Someone who meets whatever bar is set to get assistance from the government (and I’d go for a graduated bar, starting at full coverage and steadily going down to partial subsidies) would go and acquire the plan of their choice (based on their income and whatever the direct subsidies would be set to), and then submit the plan for reimbursement from the government.
It’s a subtle difference, but I think it would cut overall costs, and it would let people make choices, instead of a one size fits all type solution. It’s funny, but in many UHC countries I’ve seen they continue to have the private option available for people who want more out of their system, because choice is important, and one size really doesn’t fit all. Myself, I think that a free market health care system would cut costs and simplify things, and would let people make more rational decisions about the real world costs of the services they are asking for. The way it is today (and the way it’s going to be under this new plan), people don’t know the difference between a Yugo and a Mercedes, and because that cost is hidden, invariably want the Mercedes, even when the Yugo would work for them just as well. Or, because of how the insurance companies work currently (and I don’t see this changing that much) they get a Yugo when they really need the Mercedes, but because the costs are hidden and the services opaque, they have no idea what the real issues are.
Simply not true, and also doesn’t really bear on the point. The way the current system is, in many cases health care is too expensive for some companies (though I’ve worked for both small and medium companies who have health care). The costs are high though because of the way our health care system is set up, the regulations, the way it’s tied to employment, the quasi-government nature of the system, and the fact that the costs are hidden from the public, who don’t really know whether they need that MRI or whether it’s just padding the bill, or whether they need a generic drug or the brand name…and hundreds of other opaque aspects of the industry, many of which further drive up costs. The maze of regulations and costs, the fact that in some places an insurer has a virtual monopoly on local customers (since it’s tied to employment), that in some cases you can’t cross state lines, etc etc.
As to value, you could ask the same thing about any kind of insurance. What value does a private car insurance company give you? Why not have the government insure all cars? How about private home insurance? Again, why not have the government do that to? Boat insurance? Plane? What value for any private company…why not have the government do everything? I mean, if the government is the optimal choice for health insurance, why wouldn’t they be for everything?
Well, as IdahoMauleMan pointed out, those stats can be looked at in several ways, and they don’t necessarily equate. As to your first point, as I’ve said in other threads (and been dismissed), their political systems aren’t the same as ours. People seem to think this means America is ‘special’ or ‘exceptional’ (and, of course, we are :p), but what it really boils down to is we are different. If you think of any big ticket government program, you will see what a political football it becomes. Want to build a state of the art jet fighter (that we don’t need)? No worries…just offer to build it in enough states with enough on the side political support in the form of campaign funding and there you go…problem solved. Oh, it will cost several times more than originally projected, and while it will probably be a fine airplane it won’t be the optimal plane that was actually needed, but we’ll get something out of the deal. Some time take a look at the Space Shuttle program, what it was originally supposed to be (and cost) and what it turned into…and then think about where this new heath care entitlement may be going to.
Other countries don’t have these same kinds of problems because other countries don’t have the same political system we do, and their citizens are more homogeneous and less contentious than ours are…and, IMHO, they are more willing to let their governments do what they think is best than our citizens are, or their governments are in better positions to DO stuff that they think is ‘best for the people’, despite what the people necessarily think of that in the short term. Consider France and it’s nuclear power system (which isn’t all that popular with a lot of French citizens)…then consider our own languishing nuclear power industry here in the US. Huge difference, no?
Actually, I think just about any system would be better than what we currently have. Myself, I think that a ‘real’ free market system would work better in the US than either what we had and what we are seemingly getting with this new bill, but it’s as likely as us getting European style UHC (which this bill definitely is NOT giving us), because of the way American’s and American politics works. So, of the things we actually COULD do (in the real world), then this new system we are getting is probably about as good as it gets. It’s costly, will probably be more so as it bloats up, but it does fix a number of problems…and who knows? Maybe it will pave the way for an even better system. I’m just not going to hold my breath, because at the end of the day, it’s going to be deformed and changed by our system (at some point the Republican’s will gain more power and start to change it, the voting public will either love it and vote for more or hate it and scream for budget cuts and savings, etc) because that is the American way.
At any rate, I think I’ll leave you all to it as I don’t have much more to add and RL is seriously hammering me atm.
-XT
IMM claims that the homicide rate in the US is a major factor in our lower life expectancy as compared to Europe. He of course offers so cites - the reason for which will soon become clear.
First, the mortality rate in the US from all causes is 810.4 per 100,000 population. Cite. The homicide rate for the US averaged 8.8. Cite. Puerto Rico brings up the average a lot, as you can see from the table a bit lower down in the page. The South is much higher than New England (only 2.4). Thus, murder rates won’t have much of an impact on mortality rates, even if Europe is 0.
However, there is another source of mortality - suicide. This cite has a graph of murder and suicide rates by region, with European murder rates much lower than those of the Americas, but suicide rates much higher. Now, Latin American countries have a much higher murder rate than we do, but a lower suicide rate. You can find a table of suicide
rates per country here. It is split by male and female, since these rates are significantly different. The rates in the US are 17.7 and 4.5 respectively (per 100K) or averaging about 11 assuming roughly equal distributions. In France it is 25.5 and 9.0, averaging 17. If the homicide rate in France is above 2 per 100K, they lose more to violence than we do, but even if it were 0 the difference of 2 per 100K is not enough to affect much of anything.
Thus, murder rates cannot explain the difference in mortality rates. You’d be much better off going with the fatty defense, which isn’t so obviously bogus.