dagblog - Comments for "Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims"

This was supposed to be a

miguelitoh2o — Tue, 17 Mar 2009 04:41:05 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

This was supposed to be a reply to ncsteve above.

Thanks again. Why isn't the

Obey — Mon, 16 Mar 2009 22:02:45 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Thanks again. Why isn't the easy answer to your last question just 'unionization'? good easy market-mechanism...

Note that the German system

artappraiser — Mon, 16 Mar 2009 21:58:28 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Note that the German system is still heavily tied to employment (as are others--Japan?) The self-employed have to get insurance on their own. More and more, if we have to do incremental (and like it or not, I think the reality politically is that we are going to get incremental change,) I'd like what to see delinking from employment as a priority. It's just suggested by the economic situation, a seize the day sort of thing. (And if you've followed economic news past, Germany has had problems with past high unemployment and small business complaints of too many onerous government requirements.) But there's problems with that, too, though---makes my head hurt--if you take the burden of insurance off of employers, how do you make them transfer some of the money saved to higher wages, so that the wage earners can afford whatever they are required to pay towards their own insurance, whether co-pays, deductibles or premiums? There's a whole "rob peter to pay paul" situation with all these plans that's over my brain capability....

Valid points, particularly

miguelitoh2o — Mon, 16 Mar 2009 20:36:02 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Valid points, particularly when viewed as part of a overall political strategy. Nonetheless, many of us who are not directly involved in the politics of writing and shepherding legislation through the legislature, consider it a duty to push for the policy that we feel best reflects our desire for solving social and economic problems as well as our values. There is 'pushback' now, because, in theory at least, these policy changes that are being set in motion, have not yet been set in stone. If not now, when? We will inevitably accept whatever policy comes out of Washington. What choice do we have? In the end we will even support a policy we don't agree with if it comes down to some change or no change. In the meantime I'll be arguing for the policy that I, (and the majority of health economists that I know - and I know a few), think best addresses the issue of out of control health care costs in the US.

Between the comment I'm about

The Commenter Formerly Known as NCSteve — Mon, 16 Mar 2009 18:08:53 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Between the comment I'm about to post here and the one on AIG I'm working on, I suspect I'm not going to be making myself very popular around here today anyway, so I'll just say it: take a breath, people! Take a breath and take a look at the following interesting post at 538.com on Obama's "code" by George Lakoff, author of "The Political Mind."

I draw your attention to one quote, in particular, that I think is relevant:

Behind the Obama Code are seven crucial intellectual moves that I believe are historically, practically, and cognitively appropriate, as well as politically astute. They are not all obvious, and jointly they may seem mysterious. That is why it is worth sorting them out one-by-one.
1. Values Over Programs

The first move is to distinguish programs from the value systems they represent. Every policy has a material aspect—the nuts and bolts of how it works— plus a typically implicit cognitive aspect that represents the values and ideas behind the nuts and bolts. The President knows the difference. He understands that those who see themselves as “progressive” or “conservative” all too often define those words in terms of programs rather than values. Even the programs championed by progressives may not fit what the President sees as the fundamental values of the country. He is seeking to align the programs of his administration with those values.

The potential pushback will come not just from conservatives who do not share his values, but just as much from progressives who make the mistake of thinking that programs are values and that progressivism is defined by a list of programs. When some of those programs are cut as economically secondary or as unessential, their defenders will inevitably see this as a conservative move rather than a move within an overall moral vision they share with the President.

This separation between values and programs lies behind the president’s pledge to cut programs that don’t serve those values and support those that do — no matter whether they are proposed by Republicans or Democrats. The President’s idealistic question is, what policies serve what values? — not what political interests?

[Emphasis mine.]

I've thought of this every time I see some raging comment from the single-payer absolutists.

I want decent health coverage for everyone with premiums adjusted on the basis of means but with no adjustments on the basis of age, health or pre-existing conditions. That's the value I am for. There are other things I also want. Things like, just to name a couple, the complete computerization of medial records, comprehensive preventive care and the creation of some effective incentive mechanism(s)for making medical technologies cheaper. And my defintion of "decent" would probably take a couple of thousand words.

That's the value I am for. Single-payer is not a value, it is a program.

Maybe its the best way to deliver on the value. However, though I question whether it is possilbe, if, through regulation and legislation, someone can figure out how to deliver on my value while making a profit, I am not going work myself up into a frothing rage about it. Profit motive creates perverse incentives that can result in undesirable outcomes in health care. No question. But anyone who thinks the magic words "single payer" elminate perverse incentives that result in undesirable outcomes is being almost GOP-like in their resistance to empirical input.

BJ - thanks for the anecdote.

Obey — Mon, 16 Mar 2009 13:51:57 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

BJ - thanks for the anecdote. Good to know.

Obey, I'm in Europe atm and

Mon, 16 Mar 2009 13:31:18 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Obey, I'm in Europe atm and have a private insurer thru my employer and I find it's sux. I have to pay for all services,in euro(that's a 30% to 40% increase for services due to the dollar devaluation), submit paperwork for each action, and wait a few months for a refund that may range from 50% to 70% of the total costs paid. Also, the insurer doesn't give me a clue as to the doctors and specialist in my local area who will take patients with their insurance - I have to wing it on my own. There needs to be regulations on health insurers to make them more responsible for their members. One shouldn't have to make out-of-pocket payments if they have insurance, especially if the insurance is labeled International.

Let me clue you in on a

Mon, 16 Mar 2009 13:14:45 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Let me clue you in on a little known fact about health insurance. I was paying about $300 a month for personal health insurance until I reached 50. That was when I received a new monthly premium bill for close to $900. I called the governor's office to make a complaint and was told the insurance company was within their right's to increase my premium payment. Turns out many personal medical problems begin to appear after age 50. So the insurance companies have wrangled out a deal with states to increase premium payments to cover their costs for increased services for that age group. I was told by the governors office to go find a job that included medical coverage if I didn't like the new premium payment. Problem was, I had the personal health insurance because it was better than the one offered by my employer.

That's the free market

Mon, 16 Mar 2009 13:06:05 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

That's the free market concept. Public services are privatized then the corporate system places a price tag for the service and the public has no choice but to pay. It's a take-it-or-leave-it system without the government interfering on the public's behalf because it's a private concern now - not public.

Your comments have been very

TheraP — Mon, 16 Mar 2009 05:37:49 +0000

In reply to Surprise! Surprise! Health Insurance Parasites Going for the Kill on Capitol Hill and the Democrats are Willing Victims

Your comments have been very helpful. But I persist in fearing that here in the US, they would deregulate eventually - or bit by bit. I'm just beyond the point where I can trust the repubs any longer. They are so in bed with the corporations. And they work together to hoodwink the populace.

I don't doubt that other countries can successfully regulate. They can also successfully provide social services to an extent we can only dream of. I think of daycare in France, for example.

I think most people want single payer out of too many horror stories due to insurance. Many corporations seem to have become so greedy that they finally undid the public's good will. You can see this in finance in addition to health care. They shot the golden goose that was laying eggs for them for so long by becoming too greedy, too grasping, too willing to let go of responsibility to the public - in order to put profit over providing services in an ethical manner. Now people are up in arms.

Do you know if corporate personhood is entrenched in these other countries where they have a regulated health insurance system? Because to my mind, that is at the core of our problems with getting substantial regulation here.