05 September 2009

you are on the wrong side when

My view on healthcare has been changing. To understand why, this quotation from Investors' Business Daily needs to be preserved and studied. It was brought to my attention by that vigilant guardian of orthodoxy and conservative thought, Fr. Christian Troll whom I thank.
“People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless,” 1
The problem here of course is that Dr. Hawking was born, grew up, was educated and has always lived as an adult in the UK. Yes that UK, the one with the socialized medicine system that IBD said killed him as a worthless baby. oops.

It gets better, these idiots when called on this stupidity by bloggers proceeded to "revise" the editorial with this comment.
This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.2
Implied? Really? You mean arrogantly assumed he is American because obviously he could not live in the fantasy UK the author wants us to think exists. "Implied" is one way easy way to duck. The writer is an early favorite for the 2009 Bob and Weave Awards.

One way to realize you are on the wrong side of an argument is to notice that those who agree with you are idiots. IBD has convinced me: I am wrong on healthcare. If those whose writing can reach tens of thousands are putting out things this stupid; then it is time to re-examine my opinions.

First thought in doing so is this - we ration healthcare right now. Accept that truth and a lot of things begin to look a bit different.

  1. The healthcare available to unemployed is limited by their finances.
  2. The healthcare available to employed persons is limited by what the company plans cover.
  3. The healthcare available to the elderly is limited in two ways -- first what Medicare pays and second by their ability to pay for supplemental coverage.
The simple fact is that our various systems impose limits and ration the care dollars available.

Second thought in doing some rethinking - what is the fight about? I think there are two answers.

First there is a lot of business profit at stake. Insurance carriers make a lot of money, as do for profit hospitals and some doctors. Not all doctors get rich but with average competence the money is very good and if one is looking for opportunities to maximize income they exist.

Second any rationing system has winners and losers. Guess who is screaming to keep the status quo? If one has a valid insurance card from a good carrier with a good plan, everything is good now. Changing plans, adding poor people and thereby making care costs rise or availability decline is not rationing, it is changing the rationing system so the winners do not win as much.

Third thought in doing some rethinking - Congress just will screw this up. One item I do like is the requirement that whatever passes must take over Congressperson's healthcare.

Unlike many of my liberal friends, I believe in States. Here is my suggestion.

As a condition for every dime of Federal health subsidy money, require that each State provide its residents with a de minimus healthcare plan. Permit each State to do so by putting its coverage needs out to bid -- let the various carriers compete to be each State's provider. Fund on a level per-capita basis from the Federal treasury. Permit States to offer more coverage for their residents either as a tax supported benefit, as an insured pays benefit or as a subsidised co-payed element.

Insurance companies can profitably write policies that are based on an entire State's population if they know they are getting all of it. Are California's residents more likely to lung diseases because of the polution of their air? OK, the pricing should reflect that. So to if the South Carilina residents smoke more. Some States may decide to institute preventative or intervention (stop smoking or weight loss) benefits to get better rates. OK, that is fine.

The point is that we are really somewhat different -- Californians are not Ohians. Let that be reflected in the option choices and costs. That is why we have States. At the same time we could have universal basic care.

Yes this will cost something. No I have not got the resources to cost it out. But Congress does. Congress could ask the budget office for several desings for the basic care with revenue and cost projections. Then it could write and read a reasonable law. All of this might take time, but if we are going to do this, and the opposition has convinced me we should, then let's stop and think.
That is my now current view. Oh, I have one other thought. Dropping your subscription to Investors Business Daily is probably very good financial advice.

FWIW
jimB

    1 as quoted at: nhttp://blogs.ajc.com/jay-bookman-blog/2009/08/10/it-doesnt-take-stephen-hawking-to-figure-this-one-out/ Linked: Jay Bookman
    2 From Investors' Business Daily at: http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877 linked: IBD

11 comments:

Anonymous said...

well if u coose anyside thier undoubtobly will be fools on it. fools are everywhere. health care by state macks since to me, taz credits and discounts for not smoking and not being obeese make sense to me as well. If the states choos to to it that way. Congress might look into giveing stats incentives to have thier state covered. rather than haveing a onesize fits all solution SB

Jim said...

SB,

I suppose it is true one can always find idiots. Lest we forget, we are dealing with Congress. ;-)

But what I am noticing is that there is little voice for moderation. We have Ms. Pelosi's view that it must be her way, and the opposition view that nothing can change.

There must be another way.

FWIW
jimB

Göran Koch-Swahne said...

A very good and calm Summa!

drew said...

So why is it that a goverment sytem designed for comprmise and negotion has been less inclined to do so over the decade? Maybe too far off topic but arent we mimicing a winner take all parliment path when our local congressmen only ride national coatails? With out the extrme and moderate voices heard a lasting comprise wont be made or issues resovled.But frist we'd need to not only meet but listen. In a atempt to get back in"musket shot" this is anolgous to the Anglican skismatics.

drew

Jim said...

Drew,

"Musket shot" refers to the topic of the post. The blog as a whole (assuming I can claim it is one) has no topic except what motivates me to write. So your post is fine.

I do not know why. I can observe that over time the politics of America in general has become very ideological. I have also written here of the "sin of ideology." :-)

FWIW
jimB

Claudia Royston said...

Hi Jim - Check out this article in the atlantic monthly - it's quite interesting and illustrates how our health care crisis is so much more than lack of coverage.

http://www.theatlantic.com/doc/200909/health-care

I am becoming less keen on spending $1 trillion without changing how we pay for health care - e.g. we still pay $1,200 for an MRI, 35-yr-old technology, takes 20 minutes and two staff (tech and radiologist). If a DVD player still cost $100, no one would buy them.

Jim said...

Claudia,

Agreed. That is why I would like to see a State by State system based on a per capita national subsidy. It would shake the system up and place the adminestrative ability to change at a more local level. Unfortunately I don't think our Congress is thinking creatively if at all.

::sigh::

FWIW
jimB

RonF said...

Hm. Lots of talk about how Stephen Hawking is nor is not a prime example of the good that the British NHS does. Here's a detailed look:

#################

In the mid-1960s, Hawking's father became disillusioned with the care Hawking was getting from NHS and took over his son's treatment himself, doing his own research and prescribing vitamins.

On his own Web site, Hawking recalls that private help was also critical. "I caught pneumonia in 1985," he says. "I had to have a tracheotomy operation. After this, I had to have 24-hour nursing care. This was made possible by grants from several foundations."

White and Gribben describe what that meant: "The best the National Health Service could offer was seven hours' nursing help a week . . . They would have to pay for private nursing. It was obvious they would have to find financial support from somewhere.

"Jane (his wife) wrote letter after letter to charitable organizations around the world and called upon the help of family friends in approaching institutions that might be interested in assisting them.

"Help arrived from an American foundation aware of Hawking's work and international reputation, which agreed to pay £50,000 a year toward the costs of nursing. Shortly afterward several other charitable organizations on both sides of the Atlantic followed suit with smaller donations.

"Jane feels bitter about the whole affair. She resents the fact that, after paying a lifetime of contributions to the National Health Service, they were offered such meager help when the need arose. She is very aware that if her husband had been an unknown physics teacher he would now be living out his final days in a residential home.

" 'Think of the waste of talent,' she has said of the situation."

###################

Seems to me that one of the NHS's most famous examples of good care look more like a failure.

Jim said...

Ron, could be. But without that, implying that he is an American or that NHS would have killed him is still pretty bad reporting. If he did not get what he needed from NHS as the article states, that is a reason for concern. Of course the other problem is that no one is proposing an NHS here.

FWIW
jimB

RonF said...

I'll grant the bad reporting, and I certainly don't defend it. But this debate has been driven from the proponents of government-run healthcare using, among others, the argument that socialized healthcare works fine in other countries - and in fact, I have seen Stephen Hawking in particular quoted as saying "I'd be dead if it wasn't for the NHS". So in the larger sense it's important to point out that Stephen Hawking's care in particular and the NHS in general is not the great example that proponents of government-run healthcare would have them.

RonF said...

Actually, there are plenty of people who propose an NHS here. They've figured out that it's not something that will get though the present Congress, so they don't expect to see it. But they'd love to have it.

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