Thursday, August 06, 2009

HEALTH CARE LOTTERY

Why our congresscritters won't commit to the public plan.



Play often; you could be dead before you win!

Originally found here; believed to have been created by Jerry Ballard USNRet.

PLEASE REPORT ME

The White House is disturbed that disinformation about its "ObamaCare" reform is being bandied about the internet.

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.

Since it's almost certain that the White House will believe that I have posted, or linked to, disinformation about Obama's healthcare - oops, excuse me, health insurance - program, it follows that I should be reported. In order to make things easier, here are some of my posts that should be reported to the White House:

WRONG,
BUT FOR ALL THE RIGHT REASONS
l

THE
POTEMKIN PRESIDENCY


HEALTH
CARE AGAIN


AGAINST
OBAMACARE? IN AUSTIN?


PAJAMAS
MEDIA HEALTH CARE FORUM – THE VIDEOS


FIX
MEDICARE FIRST


OBAMACARE?

MANASSAS
INDEPENDENCE DAY TEA PARTY


AN
INTRODUCTION TO OBAMACARE


Please report me; I need the traffic.

OBAMA IN TROUBLE?

Some anecdotal evidence. Driving down the freeway into work this morning, I was passed by another car. Nothing interesting about that; I drive slowly enough for that to be common.

But as the car passed me, the driver waved, stuck his hand out the window, and gave an enthusiastic "thumbs-up" signal. I have a TEA (Taxed Enough Already) party and a "I miss W" (as in George W. Bush) sticker on the back bumper.

In Washington D.C.

WRONG, BUT FOR ALL THE RIGHT REASONS

From an editorial in our local newspaper:

Denise Oppenhagen, the editorialist, “supports universal health care,” believes that such will lead to “healthier communities,” argues there needs to be “a buy in of all parties,” and that it should be “fair.” Sounds reasonable enough. Then there’s this:


Right now, insurance companies charge a set price for everyone that gets insured. That means it costs the same for a company to insure the young, healthy, health-conscious worker as it does the older, sedentary, smoking worker .... [T]he insurance company is doing is having the healthy person pay for the unhealthy one [which isn’t fair].

Umm ... does Ms. Oppenhagen realize that that is exactly the purpose of insurance – to spread the risk? Otherwise it isn’t insurance; it’s prepaid medical care. Prepaid medical care was the rationale for health maintenance organizations (HMO’s); which have mostly crashed and burned.


[And then there’s] Canada [which] does have universal health care. Do I want to go the Canadian route? Not a chance. While it’s great that everyone gets coverage, there is a long wait to get seen for the most routine of matters. [T]alk of universal health care goes hand in hand with talk of rationing .... I cringe at the idea of rationing health care. [I]s it fair that someone with the financial resources to pay for medical services on their own gets treated for a disease that someone without the resources would have to do without?

“Long waits” are a form of rationing. Is it fair to deny medical care solely because someone can afford to pay? And is it fair to force Ms. Oppenhagen to pay for someone else’s care (e.g., via taxation) and thus deny herself care that she could otherwise have afforded?


All the talk of expanded coverage for health care ignores one critical aspect: personal responsibility.

Well, something I can almost agree with – but doesn’t personal responsibility include the responsibility for paying for one’s own health care?


There is no reward system in place for being healthy. Insurance companies are starting to acknowledge personal responsibility in that some are paying for gym memberships or weight loss services for the overweight.

So the solution for personal responsibility is coercion (by the government) or bribery (by the insurance companies)?

So what does Ms. Oppenhagen recommend?


First, reward general practice physicians. That would create a greater supply of doctors providing basic care.

But if we’re all personally responsible and healthy, doesn’t that obviate the need for general practice physicians?


Then, insure everyone at a basic rate. Include in that rate the cost of an annual physical and routine screenings for blood pressure, cancer and diabetes — the things that a perfectly healthy person would need to stay healthy.

But the cost of an annual physical and routine screenings is peanuts in the grand scheme of health care. And mostly unnecessary.


Reimburse the doctor at a rate that allows them to spend time with their patient. That should make premiums low enough for everyone.

Huh? Paying doctors more lowers premiums? Not in any economic system I’m familiar with.


Then add a surcharge, if you will, for unhealthy habits — smoking, alcohol abuse, obesity, etc. This way the people who will statistically use more services are paying their fair share.

And I’m going to go to my doctor and say I’m a fat, smoking, drunk; I want to pay more? Again, Ms. Oppenhagen misses the difference between insurance and prepaid medical care.


And if someone is overweight, for example, the insurance company can offer incentives if the person agrees to engage in healthier activities, such as paying for a dietician to follow an eating plan.

See above; coercion and bribery.


This column has nowhere near enough space to discuss all the little nuances that would be involved. It is also one that the government needs to spend time on doing right, not just doing for the sake of doing.

At least the last sentence is right.

Look, it’s health insurance, for chrissake. Insurance. You pay a fee in order to reduce the risk of something catastrophic happening and pray the money paid is wasted. Routine stuff you pay out of pocket.

That’s the responsible approach - and it doesn't involve the government.

THE POTEMKIN PRESIDENCY

With respect to healthcare, Roger Kimball calls it the Potemkin Presidency – “It has an impressive façade, propped up by some high-gloss rhetoric and a formidable public relations machine. But at bottom, President Obama and his ideological confrères are totally out of their depth.”

If only, they reason, they can turn over enough of the productive capacity of the country to the government, then (so they think) they will be in a position to eradicate the age-old irrationalities and inequities that have beset our capitalist society from the beginning.

In his assessment of President Obama’s “public option” for health insurance, Kimball quotes Greg Mankiw, an economist and former Bush adviser:

An important question about any public provider of health insurance is whether it would have access to taxpayer funds. If not, the public plan would have to stand on its own financially, as private plans do, covering all expenses with premiums from those who signed up for it.

But if such a plan were desirable and feasible, nothing would stop someone from setting it up right now. In essence, a public plan without taxpayer support would be yet another nonprofit company offering health insurance. The fundamental viability of the enterprise does not depend on whether the employees are called “nonprofit administrators” or “civil servants.”

What leads anyone to believe that the U.S. government (in Kimball’s words,”the granddaddy of all insurance companies”) would be more honest, or efficient, than the 1300 or so companies that now compete for your business?

Like so many “community organizers” before him, Obama is a friend of humanity. He wants to make the world a “better place” — better, that is, according to his lights. The problem is, he knows almost nothing about the way the world actually works.

Continuing to quote Kimball, “It may sound noble to say, ‘Damn economics, let us build up a decent world’ — but it is, in fact, merely irresponsible.”

COGNITIVE DISSONANCE

They never really mended it, so they may be forced to end it. California has proposed the previously and supposedly unthinkable: ending welfare.

Under welfare reform [in 1996], the country’s bloated caseload dropped very quickly. In its first four years, about 2.5 million families came off the dole ... This unprecedented mass transformation is an important but underappreciated element of the prosperity of the late 1990s.

The state’s political establishment and social services bureaucracy have resisted the reforms of 12 years ago at nearly every possible turn, as shown here.



And yet in a recent speech on energy policy, President Obama chose an especially odd example:

In the late 1970s, the state of California enacted tougher energy-efficiency policies. Over the next three decades, those policies helped create almost 1.5 million jobs. And today, Californians consume 40 percent less energy per person than the national average--which, over time, has prevented the need to build at least 24 new power plants. Think about that. California--producing jobs, their economy keeping pace with the rest of the country, and yet they have been able to maintain their energy usage at a much lower level than the rest of the country.

I recall California’s "rolling blackouts" in 2000-2003. Today, with unemployment approaching 12%, California's economy is hardly "keeping pace" with the rest of the country.

The fact is that California should serve as a warning to Washington political elites, as well as to the rest of us, about the efficacy of big government.