Entire post here (by Kendra Lubalin):
On Thursday afternoon, in Washington D.C., Paul Ryan, 45, entered his place of work in a murderous frenzy, killing thousands and injuring millions more, before he was finally stopped by the Senate.
Now, to be sure the numbers are not certain. The AHCA was scored earlier, with the end result being a reduction of coverage of 24 million by 2026. The bill passed last week, incorporating the new amendments, has not been scored by the CBO. However, estimates suggest similar, if not larger, impacts.
A 2016 CEA study indicated that 24,000 additional mortalities for a 20 million reduction in coverage (see additional discussion at Vox).
Based on the scored version of the AHCA, we can conjecture that slightly under half a million non-elderly in Wisconsin would lose their coverage, based on estimates provided by David Cutler and Emily Gee. 50,000 would be lose coverage in Speaker Ryan’s district alone. Assuming Wisconsin’s demographics are similar to that of the Nation, then mortalities in Wisconsin would be elevated by about 600 per year (Wisconsin per capita income is slightly lower than the Nation’s, and population somewhat older, so I’m being conservative here — and being poorer and older places one in the cross-hairs of the AHCA.)
Of course, these are merely estimates. One could just go on faith, and believe Representative Labrador’s assertion ‘Nobody Dies Because They Don’t Have Access to Health Care’.
It’s ridiculous to blame Paul Ryan for trying to fix a broken system created by government.
Even before Obamacare, doctors spent about one-third of their time dealing with red tape rather than treating patients. And, there’s tremendous waste, fraud, and abuse in Medicare and Medicaid. Obamacare is partly responsible, along with the slow recovery, for the drop in life expectancy, since demand for health care fell. Lawyers have been the biggest beneficiaries.
PR is not making any effort to fix a broken system – he is making an effort to cut taxes for wealthy people and cut health related spending for lower income people.
And please, cite one ounce of proof that the ACA is responsible for a one-time, extremely small drop in life expectancy (which included effects of opiods, alcohol abuse, alzeihmers disease, etc.). By the way, the fastest recent increases in U.S. life expectancy, especially for 65 year olds and older, came immediately after the passage of Medicare.
The system is broken and there’s an effort to fix it.
Shoveling more money at a problem may not be the best solution.
I stated before, there’s a positive relationship between income and life expectancy.
I guess, you believe 2% annual real growth over eight years from a severe recession had no influence on life expectancy.
And, I’ve explained before how Obamacare reduced discretionary income.
WAY less expensive insurance! LOWER deductibles! Cheaper meds! Everybody’s covered! More face to face time with your doctor chosen by YOU, not a faceless bureaucrat! NO worry about pre-existing conditions! Step right up, folks, you ain’t seen nothin’ yet!
And you were worried that Barnum and Bailey was going out of business.
“Obamacare is partly responsible, along with the slow recovery, for the drop in life expectancy, since demand for health care fell.”
seriously, are you delusional or a professional hack?
but since we are in a spin free zone.
conservatives effectively created a high risk “death pool” with the latest healthcare legislation. who needs death panels, when we can be more efficient with the large scale death pool created by the AHCA. certainly one way to control health care costs, at least for those not in the death pool.
You continue to deny reality.
so i take it we have one strong supporter of the death pools in peaktrader. we could save even more, if we extend the idea of death pools to medicare as well. would you support that as well?
PeakTrader: “It’s ridiculous to blame Paul Ryan for trying to fix a broken system created by government.”
So Paul Ryan is trying to fix things by taking away 24 million people’s health insurance which just coincidentally gives rich people a $1.1 trillion tax cut?
The fix is in all right. Fix it for the rich, no matter how many people have to die to do it.
What good is health care insurance without health care?
How much of that $1.1 trillion is wasted?
I think, Democrats done enough damage turning health care into a luxury good and wasting people’s time.
Now, it’s the Republicans turn.
So far, they’ve been very good at wasting people’s time.
PeakTrader: Are you in favour of a single payer system?
I ask because it is the only institutional arrangement that would allow President Trump to deliver on his health care promises.
Erik Poole, I’m in favor of the free market system. Government should have a limited role, e.g. providing a safety net, setting minimum standards, and correcting market failures.
The ACA, Medicare, Medicaid (not to mention SS, EPA, etc.) are all designed to provide a safety net, set minimum standards and correct market failures. They may not do it perfectly but they have been put into law to fix a problem with the free market system.
Perfect free market systems, like perfect communistic systems work fine. Unfortunately neither work because there is not such thing is perfect and government needs to step in and fix the problems.
Government does not create legislation – it is the people whom we elect and send to Washington to represent us – like Mr. Ryan – who are most responsible for what our government does or doesn’t do. It is equally misleading to suggest that Medicare/Medicaid fraud is some how the fault of the ACA, or that such fraud could be easily fixed and/or would solve all of our health care problems. Medical fraud knows no boundaries and has been estimated to be as much as 10% of total health care spending – an amount several times greater than estimated Medicare fraud. There is also no evidence that the ACA has caused a decline in life expectancy, which has largely occurred in southern states due to poverty, drug abuse, aging and a lack of available health care, which was in many cases, fueled by states who refused Medicaid expansion funds under the ACA. The ACA is not perfect, but the AHCA is little more than a tax cut for corporations and the wealthy in the guise of health care reform.
Massive Medicare and Medicaid fraud existed before and after Obamacare. There’s a positive correlation between income and life expectancy. Also, if you can’t afford deductibles, you may not use your health insurance.
Way over the line.
I keep having to remind myself that this is supposed to be an economics blog. But here we find Kendra Lubalin’s non-economist fallacy being held up as a justification for keeping Obamacare. The fallacy is that since you can’t put a value on human life, you must support any policies that saves any human lives, regardless of the cost. If you don’t, you are a moral monster.
OK, let’s take that reasoning a little further. Shouldn’t everyone be covered by a national policy that guarantees health care as a basic human right? That’s the conclusion that Lubalin and her fellow progressives want us to get to of course. But why stop there? Shouldn’t that policy guarantee that all available tests should be run upon any suspicion of the doctor, regardless of the cost, as long as any lives are saved? Why even require the doctor’s input? Shouldn’t we run all possible medical tests on all people, regardless of the cost, as long as some lives are saved? Aren’t you a murderer if you oppose this?
In fact, there are many ways to save further lives. Alcohol consumption kills people in auto and boating accidents as well as contributes to liver problems, cancer etc. Cigarettes kill too. Shouldn’t alcohol and cigarettes be outlawed in the new health plan. Aren’t you a murderer if you disagree? Why should people be allowed to be overweight? Excess weight contributes to diabetes, heart disease, strokes, and other maladies that kill people. Shouldn’t the government forcibly put people on diets in the new health plan? Aren’t you a murderer if you disagree? In fact, why not mandate that the national speed limit be 25 mph, that all cars must be equipped with roll cages and crash seat belts, and that all occupants must wear crash helmets. And all motorcyles should be illegal. Lives would be saved. Are you are a murderer if you disagree with these policies? Really?
Of course Lubalin’s reasoning is absurd. The mistake the non-economist makes is to confuse the value of a life that you lose with certainty with the value of a life that you lose with some small probability. If someone is threatening to shoot you, you’d give all you own and then some to prevent it. But how much are you willing to pay to reduce the probability of your death by 1 percentage point? You’d pay much less of course. And there are always tradeoffs. Benefits as well as costs have to be considered.
A parable may illustrate the point. Imagine a town of 100 households of 2 people each with the most each household would pay to reduce the probability of their deaths by 1 percentage point is $1,000. Mayor Obama points out that statistics show there will be one fire over the course of the lifetime of the current citizens and one household will die in that fire. The mayor proposes to raise each household’s taxes $100 per year to create a new fire department. The average household will pay that tax over 30 years, and so will pay $3,000 (interest rates are zero in this parable). This is a policy that will save two lives for sure. Since the mayor is only using the benevolent power of government to help, he rams the policy through over the objections of the majority of the citizens.
Anger lingers over the policy and the people elect a new mayor who promises to eliminate the fire department and the tax. The mayor asks Ryan to put together the repeal policy. But citizen Lubalin accuses Ryan of having blood on his hands. She says that the mayor, Ryan, and anyone who agrees with them is guilty of murdering two people if they get rid of the fire department.
Lubalin and her progressive friends are spreading nonsense (and owe Ryan an apology). Ryan is not murdering anyone. Mayor Obama’s fire department policy forced the citizens to pay 3 times what the benefit is actually worth to them. At a price of $3,000, each household would rather take the chance that they will be the unlucky duo caught in the fire. What people actually want is a policy that is much less expensive. Of course, the new mayor and Ryan want to put in a new fire department policy that is much cheaper (< $1000) but they are being stymied by the progressives in town. For now, all the mayor and Ryan can do right now is repeal the policy.
When people talk about health care or any other policies saving lives, they generally mean statistical lives, i.e., reducing the probability that people will die earlier than expected. Just as in the fire department parable, if you reduce the probability of an early death even a little bit, you can point to lives you saved in a large population. But there are always tradeoffs that must also be considered–costs and benefits. No one puts an infinite value on reducing the probability of an early death. Lubalin’s charge that Ryan is a murderer is a dishonest attempt to avoid that discussion of costs and benefits, and to avoid facing up to the very real problems of Obamacare.
There is already a single payer/single provider system in the U.S. that should be expanded to include all government employees including Congress and the Administration, plus all who receive government assistance.
No, I’m not referring to Medicare, I write of the Veterans Administration. This glowing example of egalitarian medicine has a long track record that few can or would dispute. So, why not go right to the end game? Enough of these ridiculous half-baked approaches.
Of course, if you don’t like it, you can pay for treatment yourself. I envision a booming business opportunity for medical cruise ships located 13-miles offshore.
Bruce Hall,
The VA actually gives terrific healthcare…that’s why people were willing to wait when they didn’t necessarily have to if they were willing to go to a private hospital. There was strong demand for VA services. The recent horror stories involving the VA are because of the recent surge in demand for VA services, not because the VA doctors don’t know what they’re doing. The VA kept my grandfather alive for many years after he was severely wounded several times in WW1. The artificial veins they created were years ahead of the rest of the medical world at the time. The VA was also a godsend to my brother after the First Gulf War. There’s also Tri-Care for retired military. And of course there are also the hospitals and clinics run by the services. Full disclosure…my niece is a surgeon at Walter Reed.
Let’s just say that the VA diagnosed my father’s stage 4 throat cancer (after a year of him going in complaining of a sore throat) as a chronic cold. Then they cut out his larynx and neglected the required chemotherapy and radiation treatments. He died within six months.
The doctors at the University of Michigan where I took him after the Minnesota VA screwed things up, were dumbfounded that any doctor or facility could be so inept.
Your “recent” horror stories were happening 20-years ago as well. BTW, the Minnesota VA was supposed to be “state of the art”. Obviously, the SOTA in government parlance is “for shit”.
PeakTrader
You really jumped the shark this time. This turkey GOP healthcare plan is Paul Ryan’s baby. He’s responsible. Ryan is not trying to fix a “broken system.” For one thing the ACA is hardly broken; it just needs some fairly easy fixes. Healthcare is complicated, but fixing the ACA’s problems is not. What Paul Ryan is really trying to do is find a tax cut for the super rich who fund the GOP while simultaneously pretending that less is more and lousy is GREAT. And that kind of double-talk will make your head spin.
Your comment is so wrong that it’s hard to know where to begin.
First, the only drop in life expectancy has been for non-Hispanic whites. And if you dig into the Case-Deaton data it’s pretty clear that it’s uneducated, lower income whites. In other words, Trump voters. But that trend started more than10 years before Obamacare was ever proposed, so your comment is irrelevant. You really stepped in it here. Strike one.
Second, there has always been some degree of waste, fraud and abuse in just about any human endeavor. That’s true with just about everything, including (especially) private insurance markets. News flash…there’s waste, fraud and abuse in the used car market too. Also, dog bites man. If anything the ACA has reduced fraud because insurers can no longer sell fraudulent policies. Obamacare has also reduced waste because it funded much of the cost to establish digital medical records. As a result, hospitals were able to shed a lot of low productivity clerical jobs. Obamacare has also resulted in more efficient pricing because hospitals and doctors no longer have to overcharge insured patients as a way to recover costs from uninsured patients. There’s something bizarre about your concern for waste, fraud and abuse, but yet you have been a stout defender of Wells Fargo and the financial sector. Strike two.
Third, Obamacare is not responsible for the slow recovery. If anything Obamacare has made employees more mobile. We’ll count that as a foul ball on your part, so that will give you another swing at the ball.
Finally, government did not create our broken healthcare system. Other countries have far more government involvement than we do and they have better outcomes at less cost. Hell, even the Trumpster praised Australia’s single payer system. If you don’t understand why healthcare is not a natural private market commodity, then perhaps you should go back about three generations and read Arrow’s famous paper. Strike three, you’re out. Thanks for playing. I’m sure you’ll be back with more nonsense.
2slugbaits, I’m sure, if a poll was taken, Veterans would choose private care over VA care.
For example, I’ve used VA care, at the Long Beach VA – one of the largest VA hospitals, and had to pay a private doctor to clear up a skin problem, which the VA repeatedly failed to do.
Insurers have been pulling out of exchanges and many doctors refuse to see Obamacare patients.
It’s been established there’s a positive relationship between income and life expectancy. In the last eight years, Americans became poorer than otherwise.
There is much more waste and inefficiency in government than in the private sector.
Excessive regulations and more taxes have made U.S. health care more expensive than other countries. Moreover, you need to take into account differences in how infant mortality rates are measured and the lower life expectancy of blacks, along with traffic accidents, murders, etc..
Have you paid any attention to doctors’ offices that provide lists of private insurance they WON”T accept? I’ve been going to the same urologist for seven years. In January, I received a form letter letting me know he would no longer accept my insurance, but that he’d be happy to assist me in finding another specialist. Swell.
A month later, I received another letter stating that his medical group had finally reached an agreement with my insurance company–one of the largest private insurers in the country–and that all is now well.
But, no worries. Maybe if I’d been able to buy insurance from a company in Mississippi or North Dakota or Puerto Rico, no such problem would have occurred. Of course, if you believe that, you might be doing some peak trading for some prime ocean front property in Death Valley.
PeakTrader
We don’t need a poll. Veterans voted with their feet and chose the VA over private practice. That’s why the VA has such a huge backlog of cases. No one is compelling veterans to use the VA. They choose to use it even if it means having to wait. The VA has a capacity problem, not a quality problem.
Insurers have been pulling out of exchanges and many doctors refuse to see Obamacare patients.
Think about what this means. It means doctors have significant pricing power. That fact alone undoes any argument you might want to make about allowing the free market to allocate healthcare. You’re undercutting your own argument and you don’t even seem to know it.
It’s been established there’s a positive relationship between income and life expectancy. In the last eight years,
You are completely confused about the demographic data. The data shows that all groups except non-Hispanic whites are seeing longer lifespans. Yes, there is a correlation between income and life expectancy, but that’s because high income people are disproportionately enjoying longer lives. It does not mean low income people are not living as long. You don’t seem to understand how to interpret the Case-Deaton data. Instead you’ve concocted this preposterous theory that Obamacare made people poorer and therefore Obamacare is killing people. That’s some sloppy reasoning.
Excessive regulations and more taxes have made U.S. health care more expensive than other countries.
Once again you’re undercutting your own argument. The US has less regulation and lower taxes than other countries with better countries. If less regulation and lower taxes were the answer, then why isn’t the US at the head of the pack instead of being behind Cuba?
Moreover, you need to take into account differences in how infant mortality rates are measured and the lower life expectancy of blacks, along with traffic accidents, murders, etc..
Now I know that you’ve not read the Case-Deaton study. They explicitly control for those things. Life expectancy for blacks is increasing. Sheesh…try consulting the data instead of your prejudices and intuition.
2slugbaits: Bruce Hall has an anecdote (admittedly a very sad one, for which I am sorry to hear). Why does he need data?
I’ll admit that hard data is difficult to find comparing apples to apples. The VA does handle cases of severe combat injuries and combat-related conditions that many hospital systems don’t. But great hospital systems such as the University of Michigan or Mayo Clinic will treat disease conditions that seem to get shuffled off to a corner in the VA. Of course, if you want to compare a huge VA facility to a clinic in Burns Flat, OK, you might get a highly favorable comparison for the VA.
Tom Coburn (yes, a Republican senator) spearheaded an investigation into the VA and found systemic issues
https://www.vetshq.com/2014/06/coburn-report-1000-vets-may-have-died-as-a-result-of-va/
… and …
http://www.usjag.org/bad-va-care-may-killed-1000-veterans/
But Menzie, with regard to data: http://www.cnn.com/2014/07/29/politics/va-audit/
https://www.justice.gov/usao-sdga/pr/va-employee-charged-falsifying-medical-records-numerous-veterans
https://www.nytimes.com/2014/05/19/us/politics/obama-angry-over-falsification-of-veterans-affairs-data-chief-of-staff-says.html?_r=0
So, the question is: do you believe the data or your lying eyes?
It’s foolish to compare any health care system to the Mayo Clinic, which is arguably the best in the world. Then again, not everybody’s health insurance will consider them in network either.
However, you are correct when you say the VA will compare very favorably with respect to the run of the mill health care facility in anywhere USA. You want the VA to compare to the Mayo Clinic-then foot the bill. But if it compares favorably to the average facility-and vets continue to choose to go to the VA-then it is not as bad as you describe. The VA excels at vet specific maladies. That is the purpose of the VA, and it meets that mission. For the funding provided the VA, you are trying to squeeze out more than you pay in. You bought a chevy, but you expect it to be a Ferrari.
2slugbaits, you’re the one completely confused. VA care is free, although below average. So, why would Veterans pay for private care?
Insurers don’t want to lose money and doctors want to be paid fairly. You can thank the government for creating the situation.
The positive correlation between income and life expectancy holds even in other countries.
U.S. health care is heavily regulated and taxes are high, particularly for the upper middle class. A lot of time and money is required to comply with all the regulations. Obamacare gave us even more regulations.
The WHO rated U.S. health care below Cuba. Yet, ranked the U.S. #1 in the world both in labor (doctors, nurses, specialists, etc.) and in capital (hospitals, equipment, supplies, etc.). Moreover, the U.S. is best developing new drugs. It was a very biased study.
I didn’t say life expectancy for blacks haven’t increased. It’s lower than whites, for example.
PeakTrader: If as some allege VA has negative value added, then even if free, it would make sense to go elsewhere.
We actually have an example of what Paul Ryan is trying to accomplish. Look at maternal mortality rates in Texas. They doubled in just a couple of years after they pass Ryan like “reforms”. Texas now has the worst maternal mortality rates in the first world. Now the rest of the states can join them.
https://www.usatoday.com/story/news/health/2016/09/10/texas-maternal-mortality-rate/90115960/
Steve
Your article states:
“Across the USA, the rate of maternal deaths also jumped from 18.8 per 100,000 live births in 2000 to 23.8 in 2014 – a 27% jump, the study showed…And no one’s sure exactly why.”
Yet, you’re so sure.
And, there are differences between countries what’s counted as a live birth, which explains why those countries have low infant mortality rates.
Dr T:
“From my personal experience and readings, the difference between African-American and Mexican-American infant mortality rates is mostly due to differences in prenatal care. Pregnant African-American women are less likely to get prenatal care than any other racial or ethnic group. Partially because of that, they are more likely to smoke, drink, and use “recreational” drugs throughout their pregnancies. Another problem is the low age for first pregnancy among African-Americans. Preteen girls are more likely to have delivery complications.
I did my obstetrics rotation at Kings County Hospital in Brooklyn. I saw four pregnant eleven-year-olds, a seventeen-year-old delivering her fourth infant, numerous women arriving in labor after no prenatal visits, women on cocaine being admitted to Labor & Delivery, etc. All these cases were among African-Americans. It was rare for a white or hispanic woman to arrive at L&D with no prenatal visits. I never saw any intoxicated white or hispanic women on the L&D unit.
The infant mortality problem directly relates to a toxic inner city African-American culture that condones youthful sexuality, child pregnancies, abuse of drugs, and disregard for health. If that doesn’t get fixed, the high infant mortality rates will continue. This problem is at least thirty years old, and it has not lessened. (No, I don’t have the answer.)”
Dr T:
I am a pathologist, and for years I have told my medical students and residents to disregard the infant mortality statistics from other countries. We use the most stringent reporting standards, so our neonatal deaths are higher than most developed countries. Also, we penalize ourselves by attempting to save premature infants as young as 22 weeks gestational age. Many of those premies die, and the deaths are included in the infant mortality statistics.”
Steven Kopits: “Way over the line.”
Over the line how? Previous to this statement at least I was willing to give you credit for speaking the truth about your beliefs– that you believe that we as a nation cannot afford to provide minimal healthcare for everyone so therefore we need to let some people die. Now it seems you are backing away your previous position. Are you suddenly finding the truth of your beliefs too awful to face in the light of day?
In the US, 5% of the population consumes 50% of the healthcare expenditure. Those are the high risk, pre-ex guys. To call the expenditure on the ‘minimal’ is risible. That’s the whole issue. If the high risk guys cost a little more than the ordinary risk guys, then you could co-mingle the groups. The top 1% consumes 22% of total healthcare expenditure. In what sense is this ‘minimal’? That’s the whole issue. A very few people can destroy the economics of ordinary health insurance.
https://archive.ahrq.gov/research/findings/factsheets/costs/expriach/expriach1.html
Steven Kopits It’s not the same 5%. Your statement makes it sound like 95% don’t consume much at all. In fact, what happens is that most of that 95% comes from people who are under 55. But as a cohort ages the likelihood increases that someone in that cohort will require a significant amount of healthcare. A peculiar kind of survivor bias. Let me put this another way. Each year only 0.8% of the population accounts for 100% of all deaths. But sooner or later everyone joins that 0.8%. You see the same thing with healthcare costs. Someone who is low risk today could easily become high risk tomorrow. Risk tends to get concentrated as cohorts age. The young think they’ll be young and invincible forever. They’re wrong.
There are really only two ways to handle high risk cases. The first way is to let them die. That’s the Trumpcare way. The second way is to spread the costs around. A sensible way to spread costs is to tax those most able to bear it and subsidize those who aren’t.
A third way is allowing the marketplace to choose the best way rather than the central planner.
Therefore, quality and quantity will be maximized and costs minimized.
Then, we can afford a bigger and better safety net.
And, incentives matter when spreading the wealth.
24 thousand? That is it? How many deaths would be averted if politicians had the moral high ground to enact a 10% VAT nationwide and then sent the proceeds to 3rd world countries? Me thinks much more than 24k. But the current heartless lot that we have (both GOP and Democrats) would never enact such a tax and therefore “entered their place of work in a murderous frenzy, killing thousands and injuring millions more” through their inaction.
Peaktrader wrote: “Erik Poole, I’m in favor of the free market system. Government should have a limited role, e.g. providing a safety net, setting minimum standards, and correcting market failures.”
So your approach is ideological, i.e., anti-results based and anti-evidence based?
Erik Poole, optimization is not ideological. I suggest, you learn some economics. When government was small, Keynes showed limited government was needed in the economy:
““Keynes intended government to play a much larger role in the economy. His vision was one of reformed capitalism, managed capitalism — capitalism saved both from socialism and from itself. The bulk of decision making would remain with the decentralized market rather than with the central planner.”
In 2017, health care expenditure will come in at $10,000 per head. We spend around $3.2 trillion on health care.
Of this, the top 1% most intensive users take 22%, or $704 billion dollars, or $220,000 per head.
The average person in the healthiest 50% will spend about $1,000 per head per annum.
Thus, from the point of view of a healthy person, if I add one top 1% unhealthy person to a 99% healthy pool, then the average premium will rise from $1,000 to $3,200 — with the inclusion of just that one unhealthy person.
The average top 5% most sick will take $100,000 of care per year. If I add the top 5% sick to a 95% healthy pool, then premiums will rise from $1,000 to $6,000. That means, if I am a healthy person, for every $6000 insurance premium I pay, I actually see only $1000 of value. The rest, a phenomenal $5,000 on average, is pure subsidy to someone else.
What part of this don’t you understand? This is why Obamacare destroyed the Democratic Party. It also shows what will happen to premiums when the pre-ex people are taken out of the pool. They will fall — dramatically. So if I do the electoral math, I sacrifice maybe 10 votes in 100, and pick up probably 30-40.
steven, the entire purpose of health INSURANCE is to cover risk. you want to change this concept from health insurance, to a simple health PLAN. you do not want to deal with risk. you simply want a plan that economically deals with average, simple medical issues and treatment.
actually this is reminiscent of the hmo’s from years ago. i had access to average services, but needed approval for anything sophisticated-which was frequently denied and justified due to cost. people did not like that environment very much. they seem to prefer a plan WITH insurance.
We are speaking of the difference between subsidization and insurance.
Insurance involves uncertainty. If an outlay is certain, it cannot be insured. A corollary might be that similar levels of risk belong in similar pools. There are different ways to slice and dice pools, but if you are to use a market-based system, then it comes down to the perception of the consumer. That consumer will ask, “Is this insurance a good deal for me?” Health insurance costing $6,000 for a young person in good health is a bad deal, and consequently you have to coerce them to buy the product. Coercion is related to taxation. Thus, the aggregate difference between what a person would willing pay for insurance and the actual price of coerced insurance may be taken as a de facto tax. Obamacare as such was a massive tax on middle class people in the individual market, and this is exactly the reason the Democrats were voted out of power up and down the country.
The problem, however — as I have said before — is that the Republicans lack any serious policy analysis, and are therefore unable to articulate how much of increased premiums and deductibles actually constituted a tax. Thus, when a commenter was calling for an economic analysis, this analysis should properly include the elevated premiums and deductibles for people in the individual market. The tax, in this case, in not just about what the government collected.
But of course the Republicans are incapable of running the numbers and articulating a case.
If you want to run the insurance idea properly, the rates for older folks should be a function of their age and risk, IN ADDITION to their lifetime effective participation. When you allow young people to avoid the system until they are older, there should a a premium penalty at that time to recoup the time they were out of the system. Otherwise you have two different pools of older people. Those that paid the risk all their lives. And those that skipped their risk. But at age 50, both are treated the same, with the same current premium rate. This is the current model, it is wrong, and it is broken.
Steven Kopits, the problem is it costs too much – $10,000 per head.
Just like the education system costs too much.
There’s substantial room for improvement in health care and education.
Also, foreigners have benefited from the $3.2 trillion U.S. health care industry.
Absolutely. I agree. But on the table right now is the repeal and replace of Obamacare.
There’s a boatload of meaningful conservative policy to do, and these bozos in the WH are getting into who-knows-what hot water with the firing of Comey and stupid stuff like not funding the Census properly.
There’s actually meaningful work to do! It would be nice to get down to it.