25 thoughts on “Will The Conservative Spin Machine Inadvertently Set The Stage For ACTUAL “Government Takeover of Health Care?”

  1. Newt says:

    If the private health insurance sector collapses, we would witness an immediate and huge decline in healthcare costs.

    The $15 aspirin suddenly becomes $.50 without an insurer. The $1,200 spinal tap that takes an anesthesiologist 5 minutes suddenly drops to $120.

    Joe has painted a pretty picture for libertarians. A cash-only system that drives down costs and rewards performance.

    1. Joe Loveland says:

      Is there a chocolate waterfall too?

      Snottiness aside, has that kind of libertarian health care heaven actually been achieved in any country? We know a lot about single payer – both the pros and the cons – because single payer exists in lots of countries, in various forms. Has libertarian health care been successful in other countries?

    2. PM says:

      Newt:

      clearly you consider insurers to be bloodsucking middlemen who just skim from both the top and the bottom, driving up prices in the health care market, without really providing any added value.

      Frankly, this position reminds me a lot of a very similar one that is found more often on the left, particularly among the more romantic environmental types, who feel that food prices would fall dramatically if we could just get back to dealing with “our” farmers directly, and cut out the middle man–not only cheaper but better tasting, more nutritious, and good for our souls, too. Probably even organic, once we get rid of companies like Cargill.

      But all of those “middle men” perform a service– they facilitate and allow for specialization. It is Adam Smith’s pin factory all over again–specialization allows us to do more, and do it cheaper. But it takes lots of middlemen, lots of data crunchers and paper pushers to make that happen.

      And risk reduction is exactly one of those classic middlemen functions–people who crunch numbers and notice patterns and create value by finding things out.

  2. Jim Leinfelder says:

    Yup, Newt’s right. Most poor countries that consistently post some of the worst health care stats in the world operate off of Newt’s preferred model.

    Check out T.R. Reid’s book. Here’s a review: http://www.nytimes.com/2009/09/15/health/15book.html

    Here’s an excerpt from the review: “In poor countries around the world, private commerce rules: residents pay cash for all health care, which generally means no health care at all.”

    But it does mean western health care tourists can get a cheaper heart surgery there and then go home. That’s not the same thing as well-functioning health care system that delivers health care in an equitable and humane way to its citizens.

  3. Mike Kennedy says:

    Joe, it’s not at all clear that the law can be struck down in parts. In seems the recent court ruling found the entire law is unconstitutional.

    I think the law was drafted in a way that there is no severing parts of it — it’s really an all or nothing affair.

    1. Joe Loveland says:

      Often legislation can be partially struck, but I don’t know about this particular legislation. I don’t know that you’re wrong, or right. Time will tell.

      However, if all of the reforms WERE struck down, there would be tremendous political pressure to restore the requirement that preexisting conditions be covered. If the Republcian majority in Congress allowed that part to remain struck, I would guess they would have a heavy electoral price to pay. That would be a huge political gift to Obama and congressional Dems in 2012.

      So is a Supreme Court loss a political and policy loss or gain? Again, that old Law of Unintended Consequences could come into play.

    2. PM says:

      the most recent judge cited that–the other judge who also found it unconstitutional apparently disagreed, and felt it could be partially struck down. This is clearly an area of dispute.

  4. PM says:

    Again, i want to emphasize something–one of the things that drives our economy more than the desire for money (self interest) is the desire to reduce risk. The health care law is an example of that (as is the entire insurance industry, and our entire economy!) That is never going away–and that is why I am convinced that the idea of a national health care program is a huge winner politically. Republicans have, temporarily, created opposition to this by manufacturing the idea that it is risky–that it threatens the security (particularly) of seniors, who are the only group that oppose it. And, of course, they oppose it because they are afraid that their existing national health care program (Medicare) might be threatened by it.

    But, ultimately, the party that can show that it’s health care policy reduces people’s risk will win this one–and so far the Republicans do not have an alternative. At all. It is just 24 hours a day, 7 days a week “Repeal”.

    I’m sorry, but that just simply isn’t going to cut it–and it already is failing–people are focusing more on what the bill does, and they are starting to like it more and more.

    Obstructionism is just a stop gap measure–it is time for opponents to put up or shut up.

    1. Joe Loveland says:

      PM, as usual you make a very thoughtful point, this time about risk management. We humans crave peace of mind so that we can enjoy the most important parts of our short lives without constantly worrying about risks. Much to the libertarians’ disappointment, most of us don’t want to live our short lives with our heads on a swivel like our cavemen ancestors did, spotting, avoiding and battling risk at every turn, and consequently living short, brutish and stressful lives. So most of us are okay with paying to reduce risk and purchase a bit of peace of mind.

      That’s why Americans oppose cutting most individual government functions — government food and restaurant safety regulators, government traffic safety regulators, government-run insurance (Medicare), government safety nets (Social Security, SSI), government emergency management (FEMA), government product safety regulators, government drug safety regulators (FDA), government financial regulators (SEC, FDIC, etc.), government security agencies (Homeland Defense, FBI, CIA, etc.), government building code regulators, government environmental regulators, etc.

      Many Americans support the abstract notion of “cutting government,” but when you ask us about whether we support cutting those kinds of individual functions of government, most of us don’t want to eliminate anything off of that list. A big reason why is that we crave peace of mind, or risk reduction, so that we can enjoy our lives…even if it means — grumble, grumble — we have to pay taxes.

      1. Mike Kennedy says:

        Risk reduction? Because of government?

        Wow, there is an liberal optimist for you. How in the world did people manage to live before all that “reduction in risk?”

        From financial scams like Madeoff to oil rig blowouts to natural disasters to 9/11, most people are living in a fantasy world if they rely on government to protect them.

        There is no avoiding risk in life. A 200 page prospectus than no one reads with 1,000 disclosures isn’t going to help anyone (except maybe an engineer who enjoys reading) get snookered.

        Government has many useful functions and does some well and others……..well, not so good.

        The amount of good that 75,000 plus pages that the Federal Register does is highly debatable.

      2. PM says:

        Mike: do you care what are in those brats? in any of the food you eat? Do you care if there is bacon in that package that has bacon in very large letters all over the box? How do you feel having to compete with the trevor cooks and Bernard madoff’s of the world, who guarantee 25%+ annual returns, and do so via ponzi schemes, when you are playing by the rules?

      3. Mike Kennedy says:

        PM:

        You just made my point.

        People who are unethical or do things illegally are going to do it whether there is government regulation or not. It didn’t stop Madeoff and it won’t stop anyone in any industry.

        The honest ones will always play by the rules and most do. The incentive to produce things people will buy is sometimes far stronger than the incentive of punishment.

        I’m not saying government is not needed. I’m saying we need to recognize its limitations and faults. Regulators are corrupted by money, by influence, by power, by publicity etc….the same things that can corrupt business people.

        Regulators don’t find people like Madeoff because they are too busy chasing after big companies that will garner them big publicity. Goldman, AIG and others will get a lot more headlines than busting one individual.

        To think that government always wears the white hat just isn’t realistic.

      4. PM says:

        Mike:

        seriously, you do not understand. We are not talking about people who don’t follow rules–we are talking about there being no rules at all.

        The government and the law and the Federal Register–those are the rules.

        Cops and courts and the SEC–that is enforcement of the rules. Enforcement is never complete, of course–but that is no reason to throw out the rules!

        Without rules, you would have madoff and no jail time for him. probably would not have been caught for a while yet–and certainly no way for people to get anything back (not that they are going to be getting back a lot as it is).

      5. Mike Kennedy says:

        PM: I’m not saying throw out all the rules, just re-evaluate what we are doing by adding about 5,000 pages in each of the last several administrations.

        My point is that more and more and more rules don’t necessarily do anything to make anyone safer or reduce risk for many of the reasons I mentioned.

        There are laws of diminishing returns in everything, including the size of government.

      6. PM says:

        I disagree Mike

        how long have financial derivatives been around? how long does it take to create a good system to regulate them? (to create rules so that they are not used to fleece suckers like me?) What about Collateralized debt obligations? What about whatever those clever folks at goldman are thinking up now?

        there is an evolutionary contest going on in our economy–people are always thinking up new ways to make money (this is what makes our economy so dynamic), and some of those new ways are nothing more than a new twist on an old game–never give a sucker an even break. part of the role of government is to prevent too many people from being taken advantage of–because, if we don’t do that, then people as a whole will want to end the entire game. Support for the free enterprise system will evaporate if the public becomes convinced that the game is rigged. And if the government isn’t out there trying to keep it from being rigged, then the really motivated and smart people will rig it. Government is necessary to protect capitalists from themselves–from their own best/worst instincts.

        this is the conflict between short term thinking and long term thinking. capitalism is all about capitalizing short term results. Do too much of that, and the system will implode (tragedy of the commons and all of that). There is a long term necessity for government regulation to keep capitalism healthy.

      7. Mike Kennedy says:

        Again, PM, I’m not opposing government regulation. I live it every day, in every piece of paper I sign, every dealing I have with a prospect or client, nearly everything I write — even thank you notes. I have an up close and personal view.

        Then there is the business side of regulations that affect me — tax reporting, monthly reports, quarterly reports and withholding, state reports, unemployment……….on and on and on. Being a one person business is doable. Add employees and it become exponentially complicated.

        The broad point I am making from someone in the system is that layering on more rules and regulations at some point discourages people from growing and might even encourage them to depart. It also discourages people from starting.

        That’s a fact. Business owners are my best clients. I talk to hundreds. I don’t need a Gallup survey to find out how overwhelmed they feel.

        In your example, you used derivatives. They have been around for ages. Originally CDOs were used in the late 1990s to great success. They morphed from corporate credits to home mortgages and regulators went along every step of the way.

        The government couldn’t even prevent its own entities (Fannie and Freddie) from participating nor did it see the danger.

        The next Black Swan event that occurs will not be giving government regulators a “heads up.”

        As in the past, by the time regulators usually figure something out, he cows have long departed the barn.

        Try to regulate and legislate everything that could and might go wrong isn’t the answer. It isn’t going to prevent the next explosion. It never has. It never will.

        I’m not saying we don’t need regulations. I’m saying we need ones that effective, efficient and that don’t drive honest people away and allow dishonest ones to profit. And we’re not getting it. That’s what I’m saying.

  5. john sherman says:

    After years of being told, “If you don’t like here, why don’t you go live in Russia or France or Canada or whatever was the right wing bogey-nation of the moment,” I think I have earned the right to ask at least some conservatives why they don’t go live in Somalia. It hasn’t had a government in two decades and everybody has a gun; isn’t that their idea of paradise?

    And now for something completely different, what’s the Rowdy Crowd take on the demise of the News Council? Death of accountable journalism or just another obsolete institution?

      1. john sherman says:

        Thanks for finding that; it’s great to see what the idea looks like done by someone with talent and skill.

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