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Saturday, September 12, 2009

Some of the more sticky questions about my health care plan...

Ok. Many of you probably think that MediaMatters is nothing but a bunch of pinko, commie, liberal, lefties. Well, they are a lot of them over there, and I fit right in with 'em! But they also have more than a couple regular posters who lean sharply conservative. I've locked horns with many of them over the past couple years, and some of them have posed some very reasonable questions that deserve answers.

So here goes.

Why should abortion be covered? You say you don't cover other voluntary procedures, why cover abortion? Isn't abortion a 'voluntary procedure'?

First off, let me say that if you feel abortion is IMMORAL, I'm with you! The thing is... so are most liberals and pro-lifers! MORALITY isn't the really key issue here, it's LEGALITY. And the difference between a liberal (like me) and a pro-lifer is that while I BELIEVE (meaning, IN MY OPINION) that abortion is immoral, I DO NOT feel the need to infect my opinion onto anyone else. If you don't like abortions? DON'T HAVE ONE. No one will ever force you to and whatever anyone else does is none of your business to tell them one way or the other.

Second... There is more to excluding voluntary procedures than just the fact that they're voluntary. It's also because they're EXPENSIVE and there's no reason anyone else should have pay for them! The alternative to having a boob-job is NOT having one: Which costs nothing. The alternative to abortion is BIRTH, which always costs MORE. I'm not begrudging those who wish to have children (another voluntary decision, mind you!) BIRTH will always be fully covered, but if a person wants to ASK LESS of the system by terminating the pregnancy early, as long as the procedure remains legal there is no rational reason not to do this! (Fair enough: If you managed to OUTLAW it, it won't be covered. Of course, in theory, it won't be PERFORMED either, so the question of coverage is moot either way.

Which brings me to the next part of the question:

What if I don't want to subsidize someone else getting one?

This is just stupid for many reasons. First of all, if you currently buy private insurance, chances are you're already doing this. You are not paying for anything other than YOUR COVERAGE and YOUR FAMILY'S. So mind your own business and stop worrying about the choices other people make with theirs! And again, we can't have individuals deciding what they do and don't want to cover for themselves, or you lose all the benefits of risk pooling - which is how our CURRENT SYSTEM works! I'm sure 90% of AIDS patients didn't think they'd ever get AIDS, and thus may have been tempted to exclude AIDS coverage if they could save a few bucks a months. And while SOME may have changed their behaviors, most would still eventually get the disease. (And where would THAT leave them now?)You can't have people estimating their own chances of getting something. That's what insurance companies are for and they have thousands of experts crunching reams of data all day long to figure it out. So let THEM figure that out. Just take you gold-star, universal coverage and stop whining about it!

This same line of reasoning, BTW, applies to pharmacists who refuse to fill prescriptions for birth-control pills (for example) for religious reasons. This is BULLSHIT. Anyone pharmacist who refuse to fill a doctors prescription for moral reason should lose their license and business. PERIOD. Why, you ask? What about respecting people's beliefs, you ask? Again, BULLSHIT. If you're Catholic (for example) and you believe the use of birth control is a sin, then YOU can't use, and YOU can't be partners with someone else who does! The Catholic Church's prohibition of contraception DOES NOT (and by the First Ammendment to the Constitution, CAN NOT) APPLY to non-Catholics, and isn't observed by 99% of practicing Catholics anyway! A pharmacist refusing to let SOMEONE ELSE use contraception is nothing more than him or her forcing their religious beliefs onto another person. Someone else's sin is not theirs and don't give me any hogwash about enabling it, either. What's next? Holding gun manufacturer's responsible for every murder that's committed? Not THIS liberal!

Why do we even need this? What wrong with the FREE MARKET setting the price? Wont this lead to RATIONING?

First things last. The 'free market' IS a system of rationing. That what market forces DO. They give resources to those willing (and able) to pay the marker price for a given good or service. Those that aren't willing (or able) to pay DON'T GET the good or service. And the volume available (supply) is only a function of the market price. It is not a function of actual need - the opposite in fact, the more something is needed, the HIGHER the price. In this way the free market serves to ration EVERYTHING.

And that is EXACTLY why it's a lousy way to manage HEALTH CARE: Because the demand curve for health care is essentially flat. Here's what that means in English: Let's say a bag of Doritos cost $100. What would happen? First of all, a WHOLE LOT of people would start making Doritos! But who would pay that much when POTATO CHIPS still cost $1? You see? There a diminished demand for certain goods at higher prices because I have COMPETING CHOICES. And thus the price is kept low, to compete with those alternatives. If I can't afford a Mercedes, I can buy a Chevy. If I can't afford a house, I can rent an apartment. If I can't afford fillet, I can buy chuck.

But if I can't afford chemo... (and I'll give you a clue: nobody can)... then I DIE.

Now, death may be the low-cost alternative to most health care procedures, but it's not one I'm ever likely to choose, is it? It's basically not an acceptable alternative for anyone. So HOW MUCH will your triple-bypass cost? Well... How much do you have?! Since I know that you won't go without, and I know that there's no competing alternatives, there's nothing to reign in my cost. 'Give me all you got and more!' is therefore the only answer one can expect from a free market. (Thankfully, most hospitals are non-profits entities!)

AND not only is the demand curve FLAT, but the SUPPLY curve is unique as well. You see, the supply of oil, potato chips, cars or beef can fluctuate. If demand for something goes UP, we can usually just make more. But the number of DOCTORS we have at any time doesn't really go up with demand, because doctors come from MEDICAL SCHOOLS and med schools take only a very small percentage of applicants. And medical fellowhips (needed for specialties) only take a small percentage of applicants from that pool! And they're not about to lower their standards just because doctors salaries have gone up and more people want to be doctors. So we can't really allow the supply to fluctuate like a regular commodity does, because it takes to long to increase the supply!

What about the unemployed? Or illegals aliens? Why should I pay for them?

First off, you already are. The unemployed already get coverage: Medicaid. And you already pay for that. You still will, but in a less dysfunctional system. You also already subsidize the UNINSURED (which includes illegal aliens) in exactly the way I've already described. SO get over it. Better they get GOOD TREATMENT that costs everyone LESS than get lousy treatment that costs everyone more.

And we REALLY don't want hospitals to put off treatment until they verify legal status, do we? Imagine you've had a stroke or heart attack. Every second counts. Do you really want there to be ANY possibility that your treatment is delayed? That could be fatal! So, just as they are now, hospitals will treat their patients according to medical need, NO QUESTIONS ASKED. They don't have to worry: THEY'LL GET PAID. And is there really any benefit to saying, "Sorry, that guy was an illegal, so we won't pay you for treating him?" NO! Now we're right back to the hospitals baking in unreimbursed expenses, just as they do now, and WE END UP PAYING ANYWAY!!! So get over it. There's no way to avoid it without screwing everything up with red tape and you won't save a single penny anyway!

JUST TAKE YOUR UNIVERSAL COVERAGE AND STOP WHINING!!!

BTW, this is one of my pet peeves with conservatives on a lot of things... They're always more concerned about making sure that the WRONG PEOPLE (whoever they are) don't benefit, than they are are making sure that the RIGHT PEOPLE (whoever they are) don't get hurt. In this case, they'd create a whole system of gov't bureaucracy that will end up killing someone who was entitled to care just to stop someone who isn't from receiving it. Not only is this a senseless trade off, going against the very conservative Principal of limited gov't and making the conservative's fear of a gov't bureaucrat getting between you and your health care a reality, but WHAT IS SO WRONG with saving a life?! Why should the HOSPITAL get punished, by not being paid for services rendered (and costs incurred,) just because they saved the wrong person's life. That's just... psychotic. So get over your xenophobia, conservatives. And besides, there's no reason that the Mexicans would flood over our borders just to get free health care... THEY ALREADY GET PUBLIC HEALTH IN MEXICO!

SO let me knwo if you have any other questions. I'll do my best to satisfy you. I've spent a lot of time thinking about this from many different angles, and I'm confident it's the best way to go. So I'll take all comers!

Now let me have it!
LOL

8 comments:

  1. Just wanted to say "first".

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  2. A liberal who DOESN'T believe in holding gun manufacturers liable for murders committed using their products? A rare breed!
    Still have reservations about the whole abortion/healthcare dust-up... should not have to subsidize abortions regardless of recipients ability to pay or legal status. Like you say, I know we already are to a level, and I want to get rid of that monetary waste and encumbrance! bluhawk

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  3. Bluehawk! Welcome! Thanks for stopping by!

    I do relaize that coverage for abortion is bound to be a sticky point. But you say you want to end the "monetary waste and encumbrance." And that's EXACTLY why abortion IS covered: BIRTH COSTS MORE. I'll gladly pay for BIRTH, no issue there, but if someone doesn't want to carry the pregnancy to term, HAVING the ABORTION will REDUCE the "monetary waste and encumbrance!" (And give them what they want anyway.) I suspect it more of a moral issue with you, to which I say: Until it's a LEGAL issue, there's still no reason not to cover it.

    I think I'll do a post on abortion, both moral and legal as well as what restrictions I'd apply relative to my proposed health care plan, becuase I would have some, POSSIBLY eneough to even bother some liberals!

    As for the GUNS... Well Gun Control is just one of the few issue I lean conservative on. MODERATELY: I'd still have a national registry, and a better background check system (I'm a Va Tech alum, after all!) but otherwise I lean libertarian on weapons in general and I'll call "liberal bullshit" on anyone who thinks there would be significantly less crime if there were no guns. (Or that there even be fewer guns just by passing a few laws!) I truly believe the 2nd ammendment is an INDIVIDULA right, not a COLLECTIVE right and deciding that is on of the few things (the only thing?) the Roberts court have decided correctly, IMHO.

    Maybe I'll take up my position on gun control at some point as well. It might be fun to argue withg LIBERALS for a change! LOL

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  4. Your point is well taken regarding emergency hospital care and checking immigration status. What if an error occurs? Could someone die because they were denied services because they were deemed to be undocumented? Even if a person is presented with seemingly non-life threatening symtoms, more serious complications can arise. Are we willing to take that chance?
    Also, what if a citizen is presented in the ER and because of one reason or another, cannot produce the correct documentation, could the citizen be denied, even if by mistake?
    Mistakes do happen. An example is our national "do not fly list" I believe there are many citizens who have names similar to terrorists who have been denied seats on airplanes only later , after being denied a seat, found out to have been citizens. If I remember, one or two people in congress have had this mistake happen to them.
    We would not want this mistake in a life or death situation. Great topic on your blog.
    If you like, visit mine @ http://genmanager-dablog.blogspot.com ,for some of my ideas.

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  5. Genmanager, Welcome. I will certainly stop by!

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  6. Why it works in Canada.
    Many components had to be in place in order for the system in Canada to work.They all work together to ensure that in most cases the job gets done.
    1st: Hospitals are owned by the government so no profits.
    2nd: Doctors have a salary cap.Doctors in Canada don't get into medicine to get rich quick. They make a very good living but I think there is a genuine decision to help people not get rich.
    3rd: All drugs can be sold in a generic and cheaper form after 10 years. The drug company has 10 years to make it's big bucks then the monopoly is over.

    These three policies make health care affordable for all Canadians and anyone else who gets sick or injured while visiting here.The main problem is funding.This has led to some waiting to be sure but nothing any reasonable adult could not handle. I don't know how your country can get from there to here but I think you are off to a good start.

    Notice the constant running theme of these policies. They all are concerned with low cost and low or no profit. Yet we survive. I live in a town that borders Detroit and the doctors that want to make more money work in your country after making their cap in Canada. In my town (Windsor) we have a small problem of illegal aliens (Detroit citizens) coming here to get health care but no one is jumping up and down screaming about it. We have a hard time saying someone should not get health care even if they don't live here.
    So that is my take. Good luck USA
    PS Congrats Eddy. I always enjoy your posts at MMFA

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  7. Thanks! And thanks for stopping by, Markg!

    There is certainly a lot we CAN learn from Canada, and admittedly about the most I know about the Canadian system is that it's not nearly as bad as the Limbaugh's of the world say it is! LOL. So admittedly, I'm no expert on it either, basically ingnorant of all the details.

    As for the profit motive... Most hospitals in this country are in fact non-profit entities. They maintain endowments, sure, but these must be spent on providing care or be re-invested in the hospital itself. They can't be distributed to shareholders as profits are in a private comapny. Now, that's MOST not ALL, and while I could see making ALL Hospitals into non-profits, that does kind of screw-over the investors that have put in so far. So it could be a very expensive proposition, for SOMEONE anyway. (Either The gov't to buy them out or the shareholders in terms of losses.) But if they can participate in the plan I've laid it out anyway, I'd let 'em stay the way they are. I won't begrduge a good provider a little profit.

    Doctor's salaries... Believe it or not, becoming a Doctor in this contry is hardly a 'get rich quick' scheme either. They gradate, after 4 years of college and 2-3 years of Med School, typically with massive debts. They then start working 80-hour weeks for less than a schoolteacher gets paid. (Not a lot in this country!) They do this for 3-6 more years, depending on specialty. My Sister is a Doctor. She's 31, makes 35K a years, lives in New YOrk City (expensive!!!) works long weeks (not quite the 80 hours anymore, but still long - maybe 60?) and once she starts actually making a doctor's salary she'll have to get malpratice insurance - no small expense. (And pay off those debts!) So there's plenty of incentive here as well, NOT to go into it for the money.

    As for the Drug Companies... again, I'm not one to begrduge them their profits either. After all, they add value. Without drugs, there wouldn't be much the doctors could do. So I'm OK with that part as well. There are loopholes in the patent law that I'd close, and maybe chaneg soem reg's around, but I'm actually OK with "Big Pharma" making their dough.

    To me, the bulk of the inefficiency and waste lies with the insurance companies, and the massive profits they make, which get bigger the LESS care they cover, and salaries they pay, and the fact that Hospitals need to price things assuming that [some percentage] of their patients won't pay up.

    Lowering those costs (or eliminating in teh case of Hospital bill deadbeats) would give us a better idea of what we actually need to pay, and then we might be better able to identify where the next area of waste really is.

    Plus, while I AM a liberal, I'm still an AMERICAN. And even a liberal American can blanche at the idea of the Gov't OWNING all the hospitals and EMPLOYING all the doctors outright. Maybe that's really the only way it can work, but I'm not yet convinced we need to go that far, and it would never pass legislatively anyway. So I'm trying to take some of what works elsewhere and apply it here in a more "American" way. After all, we're already paying for it, we're just not doing so in a way that gets people what they need, or doesn't bankrupt anyone. :)

    Thanks for the post!

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