The most sense I’ve heard anyone make yet about health care reform

A Facebook friend posted the link to this article, and because my friend leans leftward, and the piece is in the Atlantic, and ran six pages, and is entitled “How American Health Care Killed My Father” (here we go with a diatribe about the evils of health care being a commodity not a right, I thought) I almost didn’t read it.  After I began reading, and discovered the author, David Goldhill, was a Democrat, I almost stopped.  I’m really glad I didn’t.

I quote extensively from it in my New Mexico Independent column, but the whole thing really is worth a read.  It elaborates lucidly and persuasively on his point that

Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no?

Is this really a big problem for our health-care system? Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves.

His solution is not just a libertarian “pay for it yourselves, guys, tough luck if you can’t” approach, and does include a safety so that the destitute do not fall through the cracks.  As I wrote at NMI,

Despite what you might think, I am not opposed to this.  Our tax dollars already pay for the health care of the destitute.  I am all in favor of a system that would require fewer tax dollars to achieve the same — or in all likelihood far better — results.

Nobody — not even Republicans — wants poor people dropping dead in the streets because they can’t pay a doctor.  Okay, maybe some Libertarians do.  But I’m not a Libertarian.  I’m not opposed to all taxatation and all government.  But I am opposed to the disastrously misguided attempt by Congress to “reform” our system of paying for health care.  If that bill, or some slightly modified facsimile, passes, our health care system is going to get worse, not better.

Don’t take my word for it.  Take Democrat David Goldhill’s.

Or you can admit Goldhill is mostly right, but advocate the passage of an asinine bill anyway, as Matthew Yglesias does with tortuous…what?  You can’t call it logic, even tortuous logic:

Defeat of the current legislative effort will demoralize proponents of health reform, teach politicians that any talk of modifying Medicare is politically toxic, and basically result in another 10-15 years of the status quo followed by some kind of budget crisis.

Passing the kind of ideas that are currently on the table would still leave us with a system with a lot of problems. But it would ameliorate several of those problems, and solve a few. It would also, I think, teach politicians the lesson that it’s possible to change the health care system. And that might lead to more and better reforms down the road.

My head spins at the irrationality.  The bill will not fix the underlying problems anyway, but we need to pass it so that those who want change won’t be demoralized, and legislators can be taught the lesson tha it’s possible to change the health care system.  Um, they’re legislators.  They make laws.  Laws that change things.  They know that already, and don’t need to be taught this obvious fact by the passage of a stupid and pointless law.

I thought people who went to Harvard were suppsed to be smart.  Matthew Yglesias went there, and so he can impress people by dropping the H-bomb at cocktail parties.  But if his brand of deluded irrationality is what Harvard is producing these days, I think I’ll save my money and send my kids to UNM instead.

Not that my family will necessarily have a choice, mind you, since by the time I’m old enough to have chronic health problems, there won’t be any money left for Medicare, and our children’s college fund will have been sucked dry by the maladies of our old age.

Comments 4

  1. Rob wrote:

    You qoute some good points that not many people have talked about during the healthcare reform debate.

    Healthcare is a business. A business exists to make money. A hospital is a business just like Wal-Mart or even McDonald’s. For profit, not for profit, whatever. Does anyone really think those doctors and nurses are working out of their own goodwill? Does anyone think a hospital does not have overhead costs? Electrical bills, water bills, cable bills, etc.?

    When someone without insurance has a life threatening injury and goes to St. Vincent-or any hospital- they will get treated. That is the law now. Whether the person is black, white, straight, gay, citizen, illegal, etc., the hospital is required to give them medical treatment to stabilize them. The hospital will then attempt to collect their fees (price of a service) from the patient (customer).

    Sometimes the hospital can collect their fees, sometimes they cannot. Sometimes they do not collect due to an inability to pay, or even an unwillingness to pay on behalf of the customer. The hospital needs to make money to be able to stay in business. Imagine going to the grocery store, filling up your cart with food, then telling the cashier “I can’t pay, but I need this food.” At that point, you walk out the door with a cart full of food you did not pay for. That is EXACTLY what happens in healthcare today.

    From the conversation I had with a hospital CEO, they do not receive compensation for as much as 30-40% of the services performed at his hospital. From either the customer, Medicaid, Medicare, or the government. How many businesses can stick around with write-offs like that? None that I know of.

    How do they stay in business? The people who end up paying for the uncompensated amount are those of us who already have insurance. The hospitals inflate their costs to insurance companies, but, insurance companies have a cap on what they pay out for a service. So the hospital sends us a bill for the difference. Of course, we pay that bill in order to protect our credit rating. Nevermind the fact that our taxes already pay the medicare/medicaid programs.

    In essence, we already have a socialized (bordering on national socialist) form of healthcare. The only reason politicians want to change it now is to centralize it and expand the role of government in our lives. I wonder if there are people who really believe congress cares about their physical well being? They only care about power. The healthcare reform bill will give it to them.

    I think we need healthcare reform. Just not the way it is being proposed.

    (OK, maybe I’m biased because I make my living off the healthcare industry.)

    Posted 19 Aug 2009 at 11:49 pm
  2. Brigette Russell wrote:

    You’re absolutely right, Rob, which is why my bill for having Portia in the emergency room was insanely high — had to cover all those people who can’t or won’t pay for their emergency care and get it for free. And, as you so astutely observed, I did indeed pay it so as not to wreck my credit rating.

    Posted 20 Aug 2009 at 3:07 am
  3. Bill wrote:

    As concerns the Harvard comment, it is interesting that David Goldhill, author of the first article you wrote about, also went to Harvard. So at least there is a diversity of opinion from there…

    Posted 03 Sep 2009 at 9:00 pm
  4. Brigette Russell wrote:

    Well, that’s reassuring.

    Posted 03 Sep 2009 at 9:08 pm

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