Here’s a discussion going on back on this post that I think is worth elevating to a separate post, to bring in some more voices.
Someone named "msbobbie" wrote the following in response to this:
This legislation has two aims. The first being to encourage more
people to become dependent on government. Have you not heard anyone say
"The more I do for myself, the more they take away from me"? The second
being a continued push by the Democrats to paint Republicans as
uncaring and mean spirited. Have you not watched the way they smirk
every time they introduce something like this?I have no problem with helping people who need a helping hand, but I
think it should be temporary so they will be encouraged to do more for
themselves instead of remaining dependent on the taxpayers.Posted by: msbobbie | Oct 1, 2007 9:02:17 AM
Here was my response:
What "msbobbie" says SOUNDS very sensible, which is why a lot of people say it.
But I’ve never been able to subscribe to it, if only because of personal experience. My entire adult life, I have been right up against the ragged edge of not being able to pay medical bills — no matter how much money I was making or how hard I was working, and that’s WITH medical insurance every step of the way.
I have therefore always been acutely aware of how easy it would be to be caught perpetually in a cycle of NEVER being able to pay for necessary medical care, as opposed to it being a temporary condition.
This doesn’t sound right, but I’ll go ahead and say it to make my point: If you go by just about any objective measurement you choose (educational attainment, scores on standardized tests, etc.) I have more on the ball than the average person. That means the MAJORITY of people in this country are a little less able to cope with the complex challenges of maintaining health and paying for it.
If you take those factors, and then take away any kind of private insurance coverage, it boggles the mind. How on Earth can people in that situation EVER expect to get their heads above water?
Mind you, I’m assuming a certain amount of medical costs. People who spend their lives in good health, never needing a doctor (a situation as alien to my experience as being from another planet), often don’t understand what I’m talking about. Maybe they have one big crisis in their families, they get through it, and put it behind them. I’ve never been blessed that way, and there are an awful lot of people like me. We work hard, we contribute, but we have medical expenses ALL THE TIME, and they get heavier and heavier year after year, WITH insurance. Anybody in a similar situation — and there are so many, many people who are MUCH worse off than I have ever been, thank God — who doesn’t have insurance is likely to be stuck in a financial hole for a lifetime.
Now, what say you?
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Brad, I agree with your main point about health care. But I do have serious concerns about paying for it. We’re really getting burdened with 7% sales tax, high property taxes very expensive military operations that will eventually have to be paid for and a host of other stuff. Sure we can and should raise the cigarette tax but I’m not convinced other taxes won’t be increased as the cost of health care rises.
You’re highlighting the issue of chronic conditions (birth defects, asthma, diabetes, and the like) and what’s fair for others to pay. The “others” may be the “group” as insurance companies define those whom they cover or “society” as a policy wonk might describe it.
For the purpose of discussion, let’s eliminate any discussion of insurance and just focus on costs and how to pay them fairly. I’m not wise enough to figure that out and seek enlightenment. In this context can we discuss the practicalities of forcing some folks to pay for the care provided others? The basic policy, economic, and political question is this: how much should others pay for my medical necessities?
Implicit in this question are the following issues:
I don’t know how one determines “fair” compensation for folks who undergo a boatload of training to develop specialized and rare skills while caring about what they do. Nor do I know how to determine how much folks can afford, since that’s quite a subjective call. As Dr. Dean Edell told his audience at least once, folks will complain to him about paying $3.00 per day for allergy medication that’s changed their lives while sipping on their daily Starbucks fix.
One can create a czar or some body to regulated all this, but in the end they will resort to rationing care to the general population, restricting practitioners’ numbers and salaries, increasing waiting times, thus killing folks indirectly. Should the US do so, where would the Canadians go for timely treatment?
I’ll agree that our current healthcare financing is a mess; we all should insure only for catastrophes, not for regular care. Moreover, insurance reimbursement for regular care is driven indirectly by Medicare / Medicaid reimbursements for procedures, a system that, as currently configured, screws the internists / general practitioners / family docs.
How do we properly distribute the cost of care for the sufferers of chronic conditions? A top-down mandate introduces all sorts of bickering, little things like what really is a chronic condition. High blood pressure is a great example because it can be controlled by drugs or diet. Don’t we want an incentive for those who can control their blood pressure by losing weight to do so? Heck, the old and morbidly obese qualify for Medicare-provided electric scooters! Talk about unintended consequences.
Assuming we could define a “catastrophic pool” that all should fund, would we have the guts to enforce that by denying coverage to those who did not contribute? Aside from that, could such a pool provide the sort of subscription service that “selected” chronic suffers could use for their healthcare needs?
Wow! I just spent almost 500 words telling you how little I know.
Mike you make some good points, particularly about how people don’t take health care decisions seriously, but I think the following statement really shows how out of touch the conservative view of health care is in America:
Don’t we want an incentive for those who can control their blood pressure by losing weight to do so?
-Mike
There is already an enormous incentive for people to control their weight and blood pressure that goes far beyond any cost incentive. It’s called a desire to feel good and live a long time. Many folks on the conservative side of the ledger put far too much weight on financial incentives to solve problems.
bud –
There’s no indication that the desire to feel good and live a long time works. Just look at all the obese folks out there. They’ve the notion that they can eat whatever they want and that modern medicine will do the rest.
Today’s Wall Street Journal has another great column by Holman W. Jenkins, Jr.; this one on the recent GM / autoworkers’ settlement that starts of like this:
Here’s a temporary link to Jenkins’ column. It will last about seven days.
Here’s the permalink .
Brad –
I was thinking of your situation as I was putting together today’s post on Bull SCHIP. The Frost family is well off — old man owns own business and the building it’s in, two to four kids in private school at $20K / kid / year, nice house in historic Baltimore suburb — yet is able to get a federally funded state program to pay for their onerous medical bills.
I really wish that some reporter would dig up the details. Did the family misreport its financial situation to the state agency, was this political dealing typical of Baltimore / Maryland politics, could it be that the family never did benefit from SCHIP but lent its kids to the cause for good (or bad) reasons?
This kind of crap bolsters conservatives’ mistrust of big gummint. What looks like a worthy program turns out to be an assistance program for those with real means. Rather like the agricultural programs…