The rhetoric of choice

“Invest in property and a business”? No, they bought a house that they live in, and the dad works for himself. This is not “investing in property and a business.” This is providing for a family.

While there are so many aspects of this affair one could zero on, there is the argument of the wingers that if a 12 year old inserts himself into a policy debate, he should be expect to be attacked. But when General David Petraeus inserted himself into a policy debate, the same crew viewed attacks on him as off-limits. Indeed, requiring Senate denunciation.

At long last, no sense of decency . . .

It’s not even a subtext, Brett. Michelle Malkin herself has now stalked the family at their home.

One only hopes these vile people are in their last throes.

“One only hopes these vile people are in their last throes.”

Hope is not a plan.

Michael: I stand corrected.

I hope that no one is seriously harmed – emotionally or otherwise – by this Army of Davids coven of poo-flingers.

There is an opportunity here that the Democrats will usually pass up.

When someone proposes to raise taxes on people with six figure incomes, the wingnut objection is that someone making $100,000 a year isn’t necessarily “rich” and may have serious expenses. And there are enough upper middle income people that are part of the electorate that this gains traction.

Well the Republicans now are taking a middle class or upper middle class family, and calling them “rich”. This is precisely the sort of behavior that they have charged the Democrats with doing. And they are doing it in a particularly nasty, sneering way.

I’m actually quite worried about the future of elections in the U.S., because the governing party has evidently decided to piss off as many people as possible. They obviously hope to get away with something, and I can’t imagine that whatever they hope to get away with is a good thing.

“Uh, actually, in the US, hope is our official national health policy.”
This may be official national health policy, but as someone who was without health insurance for quite awhile the official response was despair.

“Sadly, of course, this dare also undermines the Democrat’s proposed plans, which like the MA one, rely on coerced insurance purchases (it’s not like auto ins.; I can choose not to drive). In MA, those who cannot offer proof of insurance by the end of 2007 start to get fined. In Jan. 2008, expect the healthcare debate to get ugly.”

There aren’t that many options for universal health insurance. All of them are coercive in some respects: individual mandates, employer mandates, single payer, etc. I’m not sure, though, that there’s any bluff to call here. A properly implemented individual mandate provides ample subsidies to those who can’t afford to buy health insurance at all. It does lead to some employers dropping health insurance, but it should *massively* bring down insurance costs by expanding the risk pool to everyone. Most employer mandate systems allow small business to opt out or otherwise subsidize their costs and, as with individual mandates, would bring down the cost of health-care insurance pretty significantly in the same way.

And the relevant analogy isn’t mandated automobile insurance, but other social insurance programs which you pay for out of your tax dollars without so much as a “by your leave” *except* when you get to vote for people who support or oppose them.

A properly implemented individual mandate provides ample subsidies to those who can’t afford to buy health insurance at all. It does lead to some employers dropping health insurance, but it should massively bring down insurance costs by expanding the risk pool to everyone.

What stops the health insurers jacking up prices every year once they are guaranteed a captive audience of people that cannot legally stop buying their product? It isn’t as if there is a whole lot of competition in the market to keep prices down that way.

To Jim, in #18: it always amazes me that there’s a huge army of volunteers eager to work hard to screw themselves over. Frankly (and shamefully) I wish I could get a piece of that action. Those people *deserve* to get what they’ll get. I just wish that they wouldn’t drag us down with them.

Yes, no commercial real estate investor left behind. That’s right, and as the former CEO of Goldman Sachs tells us, $60,000 a year is poor in NJ. Nevermind that $60,000 is above the New Jersey median household income for 2004. Half of NJ is in poverty, and the other half is paying them rent. America: where the poor are always checking the LIBOR.

Ummm…. Federal legislation?

Right, so take a screwed-up, uncompetitive industry and make it more screwed-up and uncompetitive – but put federal legislation in place to limit how much those companies can abuse everyone before the government steps in.

Public-Private hybrid markets can work best in some cases, but setting the incentives up for the private part of the market wrongly means you are fighting against the advantages that having private enterprise bring in the first place. That will always tend to be the worst of all possible solutions.

A lot of the anxiety caused by the prospect of universal health care is the anxiety of the vengeful peasant who doesn’t want to have anything to do with a benefit to himself that would also help his despised neighbors. We may be willing to bore the world with nonstop displays of patriotism, but Americans evidently don’t feel a great deal of solidarity with one another outside of flag waving. If we did, we’d be more willing to look after one another.

I just don’t believe that the root of opposition to health care reform is deadly fear of moral hazard or some other wonky consideration.

That will always tend to be the worst of all possible solutions.

We don’t think that a UHC system would be “better and cheaper.”

This is the solution the rest of the world is already using, and it is delivering cheaper healthcare across the board.

There is no evidence, whatsoever, supporting your contention that UHC is more expensive. Every country – every single one – with UHC pays less than the US. The argument that UHC is more expensive is nothing more than dogma.

Michelle Malkin may be stalking the Frost family, but she feels their pain.

Jim, we disagree with you about the facts. We don’t think that a UHC system would be “better and cheaper.” We think that there would be less anxiety for some, maybe for many, but at the cost of increased anxiety for others.

Thomas, the only people in Australia, under Universal Health Insurance, who would be paying more than the quote given for health insurance by the wingnuts for this family (about $600 a month) would be earning more than $480,000 per annum. That isn’t a very large slice of the Australian population.

As for anxiety, no-one in Australia has to worry about being refused insurance for pre-existing conditions, because of their weight, sport or other lifestyle habits, or any reason at all. No-one has to scrabble for insurance. There are no minimum waiting times before you can use it. No-one ever has to worry that if they go to hospital they might cop a huge bill even though they are insured. And in Australia if you lose your job you don’t lose your coverage.

So please, pray tell, who exactly would have “increased anxiety” under our universal system?

32, Thomas, do shut up.

Everybody uses children in their ads without the opposing party feeling the need to stalk their family for “factchecking” (with an oh so subtle undertone of “we know where you live”).

This behaviour is inexcusable and you should be ashamed of yourself for trying to defend it.

thomas, perhaps you are missing some points here, particularly the part where everyone else is paying less and living longer?

As I understand it there are 40 million people in the US without health insurance, and a considerable number more on plans which give far inferior service to the UHC of other countries at a considerably higher cost. I don’t think many people will experience quite the anxiety you describe – or do you consider paying $200 a month for health care with no costs, no waiting lists and no conditions to be a source of anxiety? That is what I paid in Australia. My only expense was the $16 cost of scripts. Everything else was covered, with my choice of doctors and my own room.

And of course my fellow Australians, paying less than Americans, live longer…

thomas wrote: “SG, I think people who now have very good insurance and access to care—a great many people, if not most people—would have increased anxiety under UHC”

These people with good care already have anxiety because they can easily – very easily – lose it. It is not under their own control. People lose jobs all the time, for no fault of their own. Companies fail, or are bought out and downsized. Then, if you find a new job, any preexisting conditions may not be covered. If you have a problem severe enough, you won’t be covered at all.

Also, you only find out how ‘good’ your coverage is when you try to use it for something big. That’s when the insurer will try to stiff you.

I’ve no dog in the health insurance fight as above so just this:

“he doesn’t seem to get the fact that the ‘choice’ between a chance at economic security and your kids’ health isn’t one that anyone wants to make.”

I agree that’s a choice no one wants to make, I just consider it an odd statement from someone, like Henry, who knows his economics. As we all have limited resources, by definition, we’re always making choices that we wish we didn’t have to make. Where to allocate those limited resources?

The desire, the choice, to persue economic security (make a chunk of money by building and cashing out a business…and no, I haven’t read the linked pieces) does indeed involve making said choices, for in the years of building your income will be lower and more variable than if you’d gone to work for someone else.

I agree that some form of single payer would remove the specific health care issue, but not the more general point, that choices about what economic goal to pursue mean other desirable things foregone.

I write as someone who has been running small businesses since I stopped waiting table: and boy, are there some desirable things we’ve foregone (including, for a decade, health insurance).

For a great many, this means that less will be spent on their health care—fewer tests, fewer procedures, more waiting, less talented doctors, etc.

The French have had to accept no such tradeoff in their superior-quality AND less expensive system. Why do you assume that this has to be true in the US? Though I’ll grant you that it probably WILL be the case if the job isn’t done properly, which would need to include putting the current, parasitic private health insurance industry completely out of business- something that isn’t yet politically possible but will become so, I believe, when- not if- the current clusterfuck of a “system” collapses of its own weight.

It could be an important part of ours as well; I’m agnostic about that. But not in its current form and not with the current bloodsucking companies.

Thomas, by “drivers of health”, do you mean risk factors like obesity and smoking? All this stuff is very similar between Australia and the US.

Your claim that less money will be spent rests on the assumption that the US health care system is efficient, and therefore spending less money means getting worse outcomes. Other countries’ experience suggests that this is not true.

SG, yes, and accidents and violence and racial/ethnic demographics. Are those too similar? (A sincere question, not a rhetorical one.)

SG, do you know that the current public expenditure on health care in the US is greater, as a percentage of GDP, than in most of the comparison set? The only problem, apparently, is removing entirely the private spending.

John, I love you, stay crazy.

Also Thomas, you have engaged in the four standard republican/libertarian tactics in just 4 posts:

1) Fear (changing the system will cause “anxiety”)
2) Lies and misrepresentation (UHC is not “better and cheaper”)
3) Invent or claim dubious facts (There are other drivers of health care, so you can’t compare the systems)
4) Blame minorities

Now you have that out of your system, perhaps you can present some actual information…?

SG, what did I say? That racial/ethnic demographics may make a difference to health outcomes? Is asking that question racist? No. (In fact, it’s a question asked by health care economists.) Your reaction is absurd, and demonstates a fear of debate. Run and hide instead of answering the questions. Good for you.

Quickly:
1. “Anxiety” was first mentioned by jim in 18.
2. is the subject of our disagreement, which you’ve resolved summarily, if not persuasively, in your favor.
3. is about the actual analysis to be done–you claim that comparisons of health care systems demonstrate something, but you shrink from the demonstration, and then complain that it’s asked for.
4. is your absurd attempt to deflect your failings by suggesting racism.

Oh come now Thomas, let’s not be grumpy. I put my little dig in a separate comment with no importance. You could have chosen instead to comment on my little hepatitis C example, eh? But instead you choose to avoid it. Shall we agree to call that “doing a Malkin”?

As to the ethnic/demographic concern. Either

1) the people you allude to are getting private health insurance, in which case they aren’t (to judge by all the quotes being bandied about) poor at all. So they either have such powerful genetic differences that even your efficient highly priced private health care can’t make a dent; or they aren’t really the problem at all.

Or

2) The people you allude to aren’t getting private health insurance, in which case they can’t really be responsible for the high cost of private health insurance.

You can’t have it both ways. So, which is it?

Oh, and if you bother to look you can find some of these differences described in OECD stats. It doesn’t make for encouraging reading though…

SG, 1) are aboriginal Australians covered by Australia’s Medicare?, and 2) are health outcomes for them the same as for nonaboriginal Australians?

Where did I suggest that racial/ethnic demographic differences were the principal difference between the US and Australia? I asked what I described as a sincere question about accident and violence rates and racial/ethnic demographics, to which you responded not with an answer about these three things, but with cries of racism. I would guess that the first two would be more likely to drive diffferences in health outcomes, but it is possible that the third (and many others as well) would too. But I don’t know if there are any differences between Australia and the US on these points. Do you have information about the comparisons there, or are you more interested in demonstrating your bad-faith for your friends?

As for the rest of this, the idea here is that the boy himself is the argument for SCHIP, and that there’s no appropriate response

In point of simple fact, there hasn’t been, only disinformation and character assassination in a mode all too familiar to, and thoroughly beneath the contempt of, anyone who thinks for a living.

The boy’s a living example of something that works. His very existence is therefore hateful to those whose ideology states that such a thing is impossible. Their response, in turn, will continue to be useful as a weapon against them.

There are consequences.
.

Thomas, your argument originally was that ethnic and demographic differences might explain the American system’s poorer health care outcomes. Given that 1 in 4 Australians was born overseas, and 6 million people moved here since 1945, I doubt that the ethnic differences are that significant – both the US and Australia have highly diverse ethnic composition. Demographically America is younger than Australia, so should be healthier.

Alternatively, you can atomise the populations and look at the size and coverage of the most disadvantaged subgroups. This does not work in the US’s favour – according to the OECD only 1% of the Australian population has no health insurance (vs. about 10% of the US), and if you want to trawl the literature you’ll find that the US has the highest proportion of people with poor health care outcomes in the developed world (that ubiquitous statement about “worse than Cuba” springs to mind). Similarly, infant mortality in the US is shocking. (I have pasted links to research on this in other threads – I won’t do it again now, you can do your own homework).

The funny thing is, you can look at OECD historical stats and see how these things changed for countries like Australia after the introduction of medicare. For the US they didn’t. Do you think that constitutes a hint?