If Democrats ignore health-care polls, midterms will be costly

[Denny Crane]

Luckily, health care innovations don't cost $100B, nor are they funded by health insurance companies. So if government "takes over" health care insurance, I'm not sure I see the impact on innovation.

barfo

They do cost $100B.

Healthcare investment outpaces IT investment for the first time




(That's for just one year of venture capital, doesn't include R&D)

 

[blazerboy30]

I don't think that necessarily follows. Innovation isn't something you put in a budget, so it isn't something that gets cut from a budget to fund other things (including waste).

In fact, I'd argue that smaller budgets may lead to greater innovation - if you need to do more with less, you'll try harder to find new solutions than if you have unlimited funds. Therefore, government waste drives innovation

barfo

I'm working with the assumption that greater incentive leads to greater innovation. Do you disagree with that, in general?

 

[MARIS61]

The bulk of those opposed to the health reformless bill are opposed because it has been over-compromised to the point of impotence.

While the Dems will suffer for not supporting the President and the people, the Reps will suffer hand-in-hand with them for offering no solution and no cooperation at all.

3rd parties have an enormous oportunity coming up in 2012.

 

[barfo]

They do cost $100B.

Healthcare investment outpaces IT investment for the first time




(That's for just one year of venture capital, doesn't include R&D)

It's also not $100B, it's $7.7B, and it's healthcare VC money, total, for the year. Now you are suggesting that VC money will dry up if the government spends more money than it planned to on the uninsured???

barfo

 

[barfo]

3rd parties have an enormous oportunity coming up in 2012.

Agreed. They'll fail to capitalize though, just like they always do.

barfo

 

[barfo]

I'm working with the assumption that greater incentive leads to greater innovation. Do you disagree with that, in general?

I don't disagree with that generally. However, it isn't an on-off switch.

If I raise the reward for building a better mousetrap from $1 trillion to $1.001 trillion, it won't matter because everyone will already be working on the better mousetrap as hard as they can. Likewise if I lower the incentive by a tenth of a percent it does not follow that everyone will quit working on mousetraps and go flip burgers instead.

barfo

 

[Sug]

Fuck the polls. Fuck the cost of the 2010 elections. The citizens of this country elected Obama and the Dems to pass healthcare, and when they do there is a good chance they will gain a ton of mojo as well. Worrying about polls is what got us to having a terrible government in the first place because all the parties are worried about is holding office. Do your job.

 

[Denny Crane]

Fuck the polls. Fuck the cost of the 2010 elections. The citizens of this country elected Obama and the Dems to pass healthcare, and when they do there is a good chance they will gain a ton of mojo as well. Worrying about polls is what got us to having a terrible government in the first place because all the parties are worried about is holding office. Do your job.

They elected him because he's not GW Bush, and that is all there is to it.

 

[jlprk]

If you've read the objective news media for a few presidencies, you'll notice a coincidence in history. It's strange. When a Republican is elected President, polls are just politics, because elections are the hard count. When a Democrat is elected President, the next election will spell his doom, because polls show an angry anti-incumbent mood. It's the liberal media at work again.

 

[barfo]

They elected him because he's not GW Bush, and that is all there is to it.

Some people claimed that old what's-his-name wasn't GW Bush either, but he and his creepy sidekick weren't elected even so. Pretty sure Hillary wasn't GW Bush, too.

McCain. McCain was his name.

barfo

 

[Denny Crane]

Some people claimed that old what's-his-name wasn't GW Bush either, but he and his creepy sidekick weren't elected even so. Pretty sure Hillary wasn't GW Bush, too.

McCain. McCain was his name.

barfo

And Obama ran on McCain being a continuation of Bush.

http://www.nytimes.com/2008/08/29/us/politics/29dems.html

DENVER — Barack Obama accepted the Democratic Party presidential nomination on Thursday, declaring that the “American promise has been threatened” by eight years under President Bush and that John McCain represented a continuation of policies that undermined the nation’s economy and imperiled its standing around the world.

 

[barfo]

And Obama ran on McCain being a continuation of Bush.

http://www.nytimes.com/2008/08/29/us/politics/29dems.html

DENVER — Barack Obama accepted the Democratic Party presidential nomination on Thursday, declaring that the “American promise has been threatened” by eight years under President Bush and that John McCain represented a continuation of policies that undermined the nation’s economy and imperiled its standing around the world.

And he was right. McCain would have continued Bush policies even more than Obama has (which is a little too much for my tastes).

barfo

 

[Denny Crane]

So you agree with Obama as quoted in the NYT. He's not GW Bush, 'tis true. He's Jimmy Carter reincarnate.

 

[barfo]

So you agree with Obama as quoted in the NYT. He's not GW Bush, 'tis true. He's Jimmy Carter reincarnate.

Jimmy Carter aint dead yet, no need to reincarnate him. I think it is a little early to say who Obama will turn out to look like the most. But yes, I agree with that quote from Obama.

barfo

 

[Sug]

They elected him because he's not GW Bush, and that is all there is to it.

McCain was not Bush either therefore you are wrong.

 

[MikeDC]

I don't find this argument convincing. Healthcare, no matter what, will continue to be a huge, huge industry, and thus there will be lots of opportunities to make money via innovation.

Look at the military. 100% government owned and controlled, and yet there is lots of innovation there. Lots of private companies thinking up new ways to help the government kill people more efficiently. [Insert death panel joke here]

barfo

Huge != Innovative.

Governments, like people, tend to spare little expense when providing for themselves and decry most expense when providing for others. In military purchasing, the government is the customer. In health insurance provision, it pays but the insured is the customer.

Of course, it's sort of beside the point, because it's so hard to take seriously this argument in the first place because it's so ludicrously at odds with what folks (especially folks who are serious about health reform) actually believe.

But, perhaps its instructive to spell it out. It's actually a wonderful template to understand just how soul-crushingly horrible a government takeover of health care will be. Most folks, regardless of political stripe, will recognize that national defense is a reasonable goal.

Yet most folks seem pretty confident in the belief that the actual, in-practice government run and controlled military industrial complex is absurdly wasteful and, while good at killing people when called upon, is frequently counterproductive to actual the goal of national defense. Which is, you know, the point. Not killing folks.

It's positively swimming in irony that the sort of folks who most complain about this in the defense realm are so apt to entirely miss the point of their argument when it's applied in another context. Especially a context in which governmental institutions have much weaker incentives to get the basic point and to get things right.

So I thought you were being sarcastic with this post, but to follow up on a couple things:

Luckily, health care innovations don't cost $100B, nor are they funded by health insurance companies. So if government "takes over" health care insurance, I'm not sure I see the impact on innovation.

barfo

People "innovate" because they expect to sell their products. Innovation is expensive, uncertain and mistake prone. The government will be the buyer in this case, and the major argument for this government takeover is to "control costs".
A few highlights from the debate on whether government insurers promote innovation.
* Megan McArdle
* Tyler Cowen
* Me

I don't disagree with that generally. However, it isn't an on-off switch.

If I raise the reward for building a better mousetrap from $1 trillion to $1.001 trillion, it won't matter because everyone will already be working on the better mousetrap as hard as they can. Likewise if I lower the incentive by a tenth of a percent it does not follow that everyone will quit working on mousetraps and go flip burgers instead.

barfo

It absolutely follows that more or less effort will be applied to a problem. If my expected reward is higher, even if I work 80 hours a week, I can apply more work by hiring more employees. If my expected reward goes down, I hire fewer, and if it goes to less than I could make doing something else, I go do something else. For a medical researcher, for example, perhaps a few more doctors give up medical research for medical practice. Or nanotech. Or any of the myriad of non-medical scientific applications you can apply yourself to.

 

[barfo]

Huge != Innovative.

Of course not. But huge financial opportunity does cause innovation. And healthcare is going to continue to be a huge financial opportunity.

It's positively swimming in irony that the sort of folks who most complain about this in the defense realm are so apt to entirely miss the point of their argument when it's applied in another context. Especially a context in which governmental institutions have much weaker incentives to get the basic point and to get things right.

I think you are assigning me a position and an argument that I haven't made here. I don't recall complaining about wasteful defense spending.

That aside, I have no idea why you say that the government would have much weaker incentives to get healthcare right than defense. Most voters don't know or care how defense money is spent. Most voters will notice if their healthcare is messed up. It seems to me there would be considerably more pressure to get it right with healthcare.

People "innovate" because they expect to sell their products. Innovation is expensive, uncertain and mistake prone. The government will be the buyer in this case, and the major argument for this government takeover is to "control costs".

So do you agree that healthcare reform will cut costs? If so, great, I am happy to concede that a smaller amount of spending on healthcare will lead to lower financial opportunity for innovators. On the other hand, if you don't actually believe that it will cut costs, then you can't really honestly complain about cost cutting, can you?

It absolutely follows that more or less effort will be applied to a problem. If my expected reward is higher, even if I work 80 hours a week, I can apply more work by hiring more employees. If my expected reward goes down, I hire fewer, and if it goes to less than I could make doing something else, I go do something else. For a medical researcher, for example, perhaps a few more doctors give up medical research for medical practice. Or nanotech. Or any of the myriad of non-medical scientific applications you can apply yourself to.

Like I said, I agree with that generally, but it is not an on-off switch. It's not all or nothing. It's not black or white. And innovation is not the one true good which must be maximized at the cost of all other variables.

barfo

 

[Sug]

The best innovation over the last 100 years has come from the military industrial complex which is 100% government funded.

 

[MikeDC]

Of course not. But huge financial opportunity does cause innovation. And healthcare is going to continue to be a huge financial opportunity.

I think you are assigning me a position and an argument that I haven't made here. I don't recall complaining about wasteful defense spending.

That aside, I have no idea why you say that the government would have much weaker incentives to get healthcare right than defense. Most voters don't know or care how defense money is spent. Most voters will notice if their healthcare is messed up. It seems to me there would be considerably more pressure to get it right with healthcare.

A couple points:
1. Total amount spent doesn't mean financial opportunity. Altria, for example, is a huge company, and a very profitable one, but the antithesis of a growing, innovative one. Likewise public utilities, which are probably a fairly comparable equivalents to the sort of "private sector" that will be left after this mess, are rarely described as "innovative" despite basically having license to print money.

2. Regarding defense, no, I wasn't saying you make that argument per se, I'm just furthering the parallel you raised.

3. Government has much weaker incentives to provide good health care than defense because the latter is a (mostly) public good and the former is a (mostly) private good. In plain English, when we collectively purchase "defense", we all become more secure. Some of us may value the security differently, but my use does not diminish yours. In health care, expending resources on my care does no obvious benefit to you, but comes at an obvious cost. We'd all like lots of health care spending for ourselves, our friends and our family, but we're quite a bit less willing to spend on the health of others. Especially if it comes at the cost of spending on ourselves.

So do you agree that healthcare reform will cut costs? If so, great, I am happy to concede that a smaller amount of spending on healthcare will lead to lower financial opportunity for innovators. On the other hand, if you don't actually believe that it will cut costs, then you can't really honestly complain about cost cutting, can you?

I don't know, but I can certainly honestly complain about reducing financial incentives to innovation regardless, because, as I noted above, purely "spending a lot" is not a financial incentive to innovation. If I agree to purchase every $10 pepperoni pizza you produce, but specify it must be a 14" pizza with X amount of crust, Y amount of cheese, Z amount of sauce and no less than 1 pepperoni per square inch of pizza, and I refuse to buy any other sort, it doesn't spur a pizza maker to go out and make a tasty Kentucky Country Ham and Fig pizza. Especially if I'm in charge of collecting everyone's funds for then paying for everyone's pizzas, because then there are that many fewer people who have the available funds and choice to go out and try the new kind.

Like I said, I agree with that generally, but it is not an on-off switch. It's not all or nothing. It's not black or white. And innovation is not the one true good which must be maximized at the cost of all other variables.

As a long run proposition, I'm fairly confident it is. From any sort of principle of maximizing human well-being at least, we get more benefit from improving our lot than trying to redistribute the benefits in a manner that freezes ourselves in time. Pick any moment in history, and the average person is certainly better off today than the moment you pick. For most of history it's not even a remotely close comparison. Even going back 20 or 30 years, people routinely live now from things people routinely died from. Today's poor are generally demonstrably wealthier than yesterday's poor. Slowing this process is always a danger because 2-3% increases in productivity aren't easily noticeable in an immediate basis, so it tends to be discounted and taken for granted. In reality, however, they make big and fairly noticeable improvements to folks' lives over slightly longer periods of times.

And of course, we're talking about improvements to billions of peoples' lives. In contrast, the proponents of government takeover have, frankly, not demonstrated much in the way of tangible benefits to their proposal which comes at tremendous costs in both the short run and long run. At best, most of the problems they seem to (potentially) remedy are problems due to existing efforts of government to improve and control the situation. But as is usual with government, the only solution is more cowbell.

 

[barfo]

A couple points:
1. Total amount spent doesn't mean financial opportunity. Altria, for example, is a huge company, and a very profitable one, but the antithesis of a growing, innovative one.

Yes, but their market - cigarettes, is a huge market, and a huge opportunity for innovation. If you invent a cigarette that keeps the addictive properties of Altria's product, but leaves out the cancer, you'll be able to capture a large amount of money. The fact that Altria itself isn't innovative is pretty normal. It's just an extreme case of getting fat and lazy, but getting fat and lazy is something that happens to most successful companies.

Likewise public utilities, which are probably a fairly comparable equivalents to the sort of "private sector" that will be left after this mess, are rarely described as "innovative" despite basically having license to print money.

Considering they have a monopoly, they are somewhat innovative within their restricted market. They don't invent new frisbees or self-warming socks, but for example a month or two ago my electric company replaced my meter with one that they can read remotely, eliminating the need for someone to tramp into my backyard every month. It is true, however, that I, not being an electric company, am barred from figuring out a cheaper way to deliver electricity and stealing their customers.

I don't agree that public utilities are akin to health care insurers though. There's a big difference between a monopoly and a regulated industry.

3. Government has much weaker incentives to provide good health care than defense because the latter is a (mostly) public good and the former is a (mostly) private good. In plain English, when we collectively purchase "defense", we all become more secure. Some of us may value the security differently, but my use does not diminish yours. In health care, expending resources on my care does no obvious benefit to you, but comes at an obvious cost. We'd all like lots of health care spending for ourselves, our friends and our family, but we're quite a bit less willing to spend on the health of others. Especially if it comes at the cost of spending on ourselves.

So the taxpayer thinks, hey, I wouldn't mind if my healthcare got worse, as long as my tax bill was a little lower? The taxpayer thinks, these long lines and shitty care suck, but I'll be damned if I'll pay a penny more to improve the service because others would benefit in addition to me? If that were true, wouldn't such systems die out instead of thrive? There wouldn't be any need for you to be concerned about 'takeovers' if the taxpayers aren't willing to fund the system.

I don't know, but I can certainly honestly complain about reducing financial incentives to innovation regardless, because, as I noted above, purely "spending a lot" is not a financial incentive to innovation. If I agree to purchase every $10 pepperoni pizza you produce, but specify it must be a 14" pizza with X amount of crust, Y amount of cheese, Z amount of sauce and no less than 1 pepperoni per square inch of pizza, and I refuse to buy any other sort, it doesn't spur a pizza maker to go out and make a tasty Kentucky Country Ham and Fig pizza. Especially if I'm in charge of collecting everyone's funds for then paying for everyone's pizzas, because then there are that many fewer people who have the available funds and choice to go out and try the new kind.

That is a perfect reasonable point, and it is true that if the gummint over-regulates things it can kill innovation. I don't believe that is bound to happen, but it is a concern.

As a long run proposition, I'm fairly confident it is. From any sort of principle of maximizing human well-being at least, we get more benefit from improving our lot than trying to redistribute the benefits in a manner that freezes ourselves in time. Pick any moment in history, and the average person is certainly better off today than the moment you pick. For most of history it's not even a remotely close comparison. Even going back 20 or 30 years, people routinely live now from things people routinely died from. Today's poor are generally demonstrably wealthier than yesterday's poor. Slowing this process is always a danger because 2-3% increases in productivity aren't easily noticeable in an immediate basis, so it tends to be discounted and taken for granted. In reality, however, they make big and fairly noticeable improvements to folks' lives over slightly longer periods of times.

Right, so let's take the entire defense budget and put it into R&D. Also all social security payments, medicare, etc. In the long run that will be better for us. Assuming we survive the short run.

barfo

 

[MikeDC]

1. Indeed "Getting fat and lazy" happens to many successful companies. The nice thing is that different companies in a losely regulated industry can emerge and take business away from the fat and lazy. By creating barriers to entry via regulation, industries tend to remain fat and lazy at the protection of the government. Interestingly enough, the example you give of an addictive but much healthier cigarette, is a reality. You don't know about it because the FDA is regulating it out of existence. Which, of course, is why fat and lazy Altria is willing to play both sides of the issue. They've simultaneously supported FDA regulations that make it difficult to discuss the health benefits of smokeless tobacco and e-cigarettes and then bought up a smokeless competitor, to either use it if they must or kill it if they can.

The basic concept here is regulatory capture, and it's not a matter of pure monopoly power or pure regulation, but generally one of government repeatedly favoring "business", meaning particular businesses it wants to keep alive, rather than market processes, which break down the more barriers are thrown up against it and in favor of entrenched interests.

2. In that sense, the difference between a pure monopoly and a heavily regulated industry is of a degree and not a kind. Especially where the firms are few, large sizes are mandated, and regulatory requirements effectively dictate non-competition across geographic areas. In plain English, the non-competitive conditions the government complains about and the current proposals seek to mitigate via regulation are largely the result of regulation.

3. No, taxpayers individually wish for the most for themselves at the least cost. Suppose N people go to a restaurant. You encourage everyone to get whatever the feel like eating, and at the end, everyone pays 1/Nth of the total bill. That is both an extraordinarily shitty way of doing things, and not going to be workable forever. So how to resolve it? Well, it appears the proposal is to limit the menu everyone can order from, rather than allowing everyone to choose the meal they'd chose if they paid for themselves. Everyone gets pepperoni, nobody can have the Kentucky Ham and Fig. Folks grumble about it, but continue to go along with it because they need to eat. Interestingly enough, you'd be willing to pay more to get your fill, but in fact shortages seem to develop because the big fat guys (who you're splitting the bill equally with) all rush to the restaurant the moment it opens. Paying more no longer benefits you as much as it benefits other folks.

 

[barfo]

1. Indeed "Getting fat and lazy" happens to many successful companies. The nice thing is that different companies in a losely regulated industry can emerge and take business away from the fat and lazy. By creating barriers to entry via regulation, industries tend to remain fat and lazy at the protection of the government. Interestingly enough, the example you give of an addictive but much healthier cigarette, is a reality. You don't know about it because the FDA is regulating it out of existence. Which, of course, is why fat and lazy Altria is willing to play both sides of the issue. They've simultaneously supported FDA regulations that make it difficult to discuss the health benefits of smokeless tobacco and e-cigarettes and then bought up a smokeless competitor, to either use it if they must or kill it if they can.

I think your info is out of date; ecigarettes are currently available for purchase in the US of A. It is true the FDA wants to ban it; so far they have been unsuccessful.

As a cigarette alternative, I think it falls a little short in the coolness factor. There's currently no motivation for 18 year olds to start using the things. Perhaps marketing could cure that deficiency, however.

The basic concept here is regulatory capture, and it's not a matter of pure monopoly power or pure regulation, but generally one of government repeatedly favoring "business", meaning particular businesses it wants to keep alive, rather than market processes, which break down the more barriers are thrown up against it and in favor of entrenched interests.

2. In that sense, the difference between a pure monopoly and a heavily regulated industry is of a degree and not a kind. Especially where the firms are few, large sizes are mandated, and regulatory requirements effectively dictate non-competition across geographic areas. In plain English, the non-competitive conditions the government complains about and the current proposals seek to mitigate via regulation are largely the result of regulation.

I agree with that, in part. Certainly the no-selling-across-state-lines seems like a stupid regulation and should be abolished.

3. No, taxpayers individually wish for the most for themselves at the least cost. Suppose N people go to a restaurant. You encourage everyone to get whatever the feel like eating, and at the end, everyone pays 1/Nth of the total bill. That is both an extraordinarily shitty way of doing things, and not going to be workable forever. So how to resolve it? Well, it appears the proposal is to limit the menu everyone can order from, rather than allowing everyone to choose the meal they'd chose if they paid for themselves. Everyone gets pepperoni, nobody can have the Kentucky Ham and Fig. Folks grumble about it, but continue to go along with it because they need to eat. Interestingly enough, you'd be willing to pay more to get your fill, but in fact shortages seem to develop because the big fat guys (who you're splitting the bill equally with) all rush to the restaurant the moment it opens. Paying more no longer benefits you as much as it benefits other folks.

I'm not sure who the big fat guys are in this analogy.

Where we started this conversation was with the idea that people who live with these healthcare systems *like them*. You seem to be explaining why people don't like them. You may feel constrained that you don't get caviar, but apparently most people are ok with everyone getting a decent meal and no one starving, even if that limits their own choices a little.

barfo

 

[MikeDC]

By the way, if everything I've said is way too meandering (it probably is) I think the most likely outcome of a health care takeover is that it both fails to reduce costs and does not fail to limit innovation. We're talking about these things as if they're a trade-off, but history tends to indicate that a government run plan will fail to cut costs, but create a vast set of (additional) disincentives to innovation and provision of high quality health care.

The latter article is pretty interesting because it sort of parallels the whole military issue. Government run defense tends to conflate killing the enemy with good defense. They're not mutually exclusive, but not the same either. Likewise, government policies toward health care tend to conflate paying for treatments and spending money with providing good quality health care. In short, the measure becomes a body count, in one way or another, rather than furthering the actual goal. And it's going to suck if it happens.

 

[MikeDC]

I'm not sure who the big fat guys are in this analogy.

Where we started this conversation was with the idea that people who live with these healthcare systems *like them*. You seem to be explaining why people don't like them. You may feel constrained that you don't get caviar, but apparently most people are ok with everyone getting a decent meal and no one starving, even if that limits their own choices a little.

barfo

Well, that was one of several issues, and one of several reasons that, although people who live in those systems like them, it shouldn't be a factor for our consideration in adopting their plan.

Interestingly, since you seem to at least partially concede the innovation point, it further explains why they might like their system so much. They're also free riding off ours. If we adopt their system, their system doesn't exist any more. Which is the original point.

As an aside, the same sort of "coolness factor" at play in cigarette smoking seems an appropriate explanation too (for health care beliefs). Cigarette smokers often demonstrate strong ingroup morality preference, but we wouldn't say that should make us rationally want to smoke. Likewise, British demonstrate preferences for British health care and wouldn't want to adopt US health care. That doesn't necessarily make them rational. I don't expect they'd wish to adopt French or Swiss or Singaporean health care institutions either.

At what point should we consider everyone is getting a decent meal anyway? To the extent we're underwriting health innovation for folks in, say, France, an uninsured American (who typically gets fairly good actual health care, statistically speaking, might be considered to be going without so they can have caviar. Or at least a decent meal at a lower cost.

All of that sort of gets back to something I touched on earlier. It's easy to see faults and potentially disastrous consequences for the US, the world and the future. Strangely, however, the conversations I see rarely turn to the benefits of a government health care takeover in, again, very tangible ways. In fact, the various studies I have seen indicate these benefits to be, well, vanishingly small to immeasurable.

 

[barfo]

By the way, if everything I've said is way too meandering (it probably is) I think the most likely outcome of a health care takeover is that it both fails to reduce costs and does not fail to limit innovation.

I can certainly understand why you'd think that, and I don't rule out the possibility that you are right. Obviously, I'm a little more optimistic than you at least about the latter if not the former.

We're talking about these things as if they're a trade-off, but history tends to indicate that a government run plan will fail to cut costs,

Those links don't actually seem to address the point you are making, although they are interesting.

but create a vast set of (additional) disincentives to innovation and provision of high quality health care.

The latter article is pretty interesting because it sort of parallels the whole military issue. Government run defense tends to conflate killing the enemy with good defense. They're not mutually exclusive, but not the same either. Likewise, government policies toward health care tend to conflate paying for treatments and spending money with providing good quality health care. In short, the measure becomes a body count, in one way or another, rather than furthering the actual goal. And it's going to suck if it happens.

I like that article - it has been brought up more than once here. I'd be completely fine with a much more radical reform like the article suggests. But radical reform is more than extremely unlikely.

The current reform proposal is quite limited by comparison. It's not a "takeover". Thus I don't see the reason for claiming the sky is going to fall if it is enacted.

barfo

 

[barfo]

Well, that was one of several issues, and one of several reasons that, although people who live in those systems like them, it shouldn't be a factor for our consideration in adopting their plan.

Interestingly, since you seem to at least partially concede the innovation point, it further explains why they might like their system so much. They're also free riding off ours. If we adopt their system, their system doesn't exist any more. Which is the original point.

Again, it's not black and white. It isn't the case that all innovation will stop if we pass health care reform. Their system will continue to exist. Maybe there will be marginally less innovation, but to claim innovation is just going to disappear is not realistic.

As an aside, the same sort of "coolness factor" at play in cigarette smoking seems an appropriate explanation too (for health care beliefs). Cigarette smokers often demonstrate strong ingroup morality preference, but we wouldn't say that should make us rationally want to smoke. Likewise, British demonstrate preferences for British health care and wouldn't want to adopt US health care. That doesn't necessarily make them rational. I don't expect they'd wish to adopt French or Swiss or Singaporean health care institutions either.

Similarly, Americans who protest any changes to their health care system are not necessarily rational either.

At what point should we consider everyone is getting a decent meal anyway? To the extent we're underwriting health innovation for folks in, say, France, an uninsured American (who typically gets fairly good actual health care, statistically speaking, might be considered to be going without so they can have caviar. Or at least a decent meal at a lower cost.

All of that sort of gets back to something I touched on earlier. It's easy to see faults and potentially disastrous consequences for the US, the world and the future.

It's easy for you to see. I don't see them. I predict that if this passes, life afterwards will be very much the same as it was before. The sky will not fall.

Strangely, however, the conversations I see rarely turn to the benefits of a government health care takeover in, again, very tangible ways. In fact, the various studies I have seen indicate these benefits to be, well, vanishingly small to immeasurable.

Insuring 20 million more people (or whatever the number is) is immeasurable?

barfo

 

[Denny Crane]

Insuring 20 million more people (or whatever the number is) is immeasurable?

barfo

Again, you confuse insurance with actual health care. DC made his point very well that the uninsured get actual health care.

The Bill on the table is patently absurd on the face of it. It transfers $500B worth of cuts in medicare directly to insurance companies that don't provide health care (doctors, nurses, hospitals, clinics, etc. do).

You seem to be thrilled about paying higher taxes for some number of years in exchange for zero people getting any additional health care benefits. The taxes, again, go directly to the insurance companies, or will mask the size of the deficits without $.01 being spent on health care. This is typical past experience with taxes/programs running a surplus, like Social Security, where the trust fund has nothing but IOUs and the surpluses spent already.

There's no reason to conclude that with ever increasing deficits and debt payments that any of the money taxed will end up being spent on insurance. The net effect would be medicare starved for cash, richer insurance companies, no significant increased in the number insured (if at all), we'll be stuck paying higher taxes for no good reason, and much of those taxes will end up going to China to pay back the IOUs they bought from us to fund our absurd spending levels.

DC can run circles around me about economics subjects, but this is just plain common sense. We've all seen it in the news for over a year now, and for decades (regarding SS).

Maybe DC might comment on my suggestion, which is for govt. to simply hire doctors, open clinics and hospitals, and charge people what it costs for their procedures - plus a bit extra to pool to cover expensive procedures like heart surgery. Govt. already pays for education, so they may as well forgive (a portion of) doctors' loans if they work in the govt. clinics for some period of time at reduced wages. It wouldn't cost $1T+, nor would it mean govt. has to wait to get started. They already run something like it, the VA hospitals... Keep all the simple regulatory features of the Bill, like portability and ability to buy across state lines...

Finally, another obvious thing is that you see insurance company commercials on TV all the time. Telling you that if you switch to them, you'll save $X on your insurance. Auto. WTF? Insurance companies competing with one another for customers with downward pressure on the insurance rates? Why is that! Who's buying the insurance is the answer.

 

[barfo]

Again, you confuse insurance with actual health care. DC made his point very well that the uninsured get actual health care.

Of course. Then why are the rest of us paying health insurance? We should just drop our coverage and get it free like those lucky uninsured people, for whom nothing will change once they have coverage... right?

The Bill on the table is patently absurd on the face of it. It transfers $500B worth of cuts in medicare directly to insurance companies that don't provide health care (doctors, nurses, hospitals, clinics, etc. do).

And those insurance companies will just pocket the entire $500B, right? None of it will be used to pay doctors, nurses, hospitals, clinics, etc.

You seem to be thrilled about paying higher taxes for some number of years in exchange for zero people getting any additional health care benefits.

That's so silly I bolded it. You honestly believe there is no difference between having health insurance and not having health insurance? Seriously?

The taxes, again, go directly to the insurance companies, or will mask the size of the deficits without $.01 being spent on health care. This is typical past experience with taxes/programs running a surplus, like Social Security, where the trust fund has nothing but IOUs and the surpluses spent already.

Right, not one penny will be spent on healthcare. Sure. I think you've gone round the bend on this.

There's no reason to conclude that with ever increasing deficits and debt payments that any of the money taxed will end up being spent on insurance. The net effect would be medicare starved for cash, richer insurance companies, no significant increased in the number insured (if at all), and we'll be stuck paying higher taxes for no good reason.

And look, what's that in the sky? Is it the sky?

DC can run circles around me about economics subjects, but this is just plain common sense. We've all seen it in the news for over a year now, and for decades (regarding SS).

Yes, SS has funding problems. If old people would just die faster, it would solve that problem. Luckily, with GOVERNMENT DEATH PANELS executing citizens, the healthcare takeover will eliminate that problem. With prejudice.

Maybe DC might comment on my suggestion, which is for govt. to simply hire doctors, open clinics and hospitals, and charge people what it costs for their procedures - plus a bit extra to pool to cover expensive procedures like heart surgery. Govt. already pays for education, so they may as well forgive (a portion of) doctors' loans if they work in the govt. clinics for some period of time at reduced wages. It wouldn't cost $1T+, nor would it mean govt. has to wait to get started. They already run something like it, the VA hospitals... Keep all the simple regulatory features of the Bill, like portability and ability to buy across state lines...

I actually think something like that already exists for rural areas. Don't have any idea how well it works.

Finally, another obvious thing is that you see insurance company commercials on TV all the time. Telling you that if you switch to them, you'll save $X on your insurance. Auto. WTF? Insurance companies competing with one another for customers with downward pressure on the insurance rates? Why is that! Who's buying the insurance is the answer.

Well, yes. The employer-based system is pretty stupid. But it seems we are stuck with it now.

barfo

 

[Denny Crane]

If you don't have insurance, you pay the bill out of pocket or via a loan from the hospital (a lien actually). But you get your health care, for certain.

You can pay (directly or indirectly) for insurance for years while healthy and end up paying the same amount. Go figure.

Some of the $500B will be spent on health care, but not all. As it is now, all $500B will be spent on health care. Get it? Those insurance companies take about 8% of that $500B in profit, alone. Plus they'll pay salaries, bonuses, rent on buildings to house 5% (or whatever) more workers, etc., etc.

I know for sure that if this bill passes, the place to put your money is in pharmaceutical stocks, as they're certain to see at least 10% jump in revenues (no wonder they back this Bill).

 

[barfo]

If you don't have insurance, you pay the bill out of pocket or via a loan from the hospital (a lien actually). But you get your health care, for certain.

You can pay (directly or indirectly) for insurance for years while healthy and end up paying the same amount. Go figure.

Ok, I figure that's pretty much the definition of insurance. Some people will pay the insurance and not make any claims. Some will pay the insurance and have claims in excess of their premiums.

Some of the $500B will be spent on health care, but not all.

Well, that's certainly a more realistic view than not one penny on health care.

As it is now, all $500B will be spent on health care. Get it?

Interesting. Now you are arguing in favor of government run healthcare? I thought government run healthcare was evil incarnate. Now it's more efficient than private insurance? Fascinating.

Those insurance companies take about 8% of that $500B in profit, alone. Plus they'll pay salaries, bonuses, rent on buildings to house 5% (or whatever) more workers, etc., etc.

Agreed. Let's get rid of private sector insurance. I'm totally on board with that.

I know for sure that if this bill passes, the place to put your money is in pharmaceutical stocks, as they're certain to see at least 10% jump in revenues (no wonder they back this Bill).

How can that be? You've assured me that everyone who needs health care is already getting it, so why would any more drugs get consumed under the reform bill?

barfo