Re: David Cross on Health Care

On Wed, Oct 27, 2010 at 1:50 PM, Karl <[email protected]> wrote:
> > constituted, proceeded quite heedless of what their ersatz original
> > raisons d'ętre were, and which now constitute an ungovernable,
> > boundless, self-sustaining, self-referring system of unimaginable
> > complexity. " [0]
> >
> > So yeah, *that's* what I think the military is primarily effective at.
>
> **and that is good?

Oh, no.  Of course not!  ;-)

> > And our *current* health care system is not one that I'd like
> > to defend.
>
> **sure.  But it is much more effective than the detractors will admit.

Effective?  Effective at what?  If you mean in the same sense that the
Pentagon is effective, then I agree.  ;-)

It's certainly not more cost efficient than nearly all other western
systems (including some which are principally privatized) at
converting dollars into healthy people, as evidenced by some
data/analysis linked to by Jeremy Laden, earlier.  Here[0] is another
interesting analysis of (I believe) the same OECD dataset.  Reason
Magazine's editor-in-chief's stated that "ObamaCare opponents often
warn that a new system will lead to long waiting times, mountains of
paperwork, and less choice among doctors. Yet on all three of those
counts the French system is significantly better, not worse, than what
the U.S. has now." [1]  I wouldn't even say that what we have is a
better example of a "free market" than certain countries which do
provide some form of "universal" health care system.

[0] http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/
[1] http://reason.com/archives/2009/12/07/why-prefer-french-health-care

Also, there are a few actuarial difficulties which distinguish health
care and insurance from property insurance; the math and ethics don't
work quite the same.  E.g. with house insurance, you can ethically say
"just don't live there" or "pay gargantuan premiums to live there"
(unless you live on the Florida coastline, where the politicians price
insurance without needing any actuary's approval).

Universal health care (for most values of "universal health care")
just won't work with any actuarial model in a purely free market with
short-sighted selfish participants.  It needs an enforced buy-in of
some sort (or market participants who are considerably more selfless
and charitable in aggregate than humans).  That could be taxation, or
it could be a mandatory insurance requirement, or (to get back to
Paul's original post) it could be an enlightened self-interest
movement of Christians and other ethically-minded individuals to
voluntarily fill charitable health care funds (and keep them filled)
to previously unprecedented levels.

> > as I'd like to move towards a stateless society, I'd prefer to remove
> > the state provided crutches first from those that don't need them, and
> > continue to provide them to those who aren't (yet?) being provided
> > them through stateless means.
>
> **I see all of that.  My problem is that I think we already do both, we provide
> more crutches than needed because we live in a victim centric society, and that
> combination concerns me.

Understandably so.

I personally know more people who qualify as legitimate victims and
don't get the health care they (arguably) should than fakers and
moochers.  But I don't deny that the moochers exist and are a drain on
any system.  But in this particular debate, anyone with a debilitating
chronic illness is technically a drain on the system.  Even for the
moochers, the money would at least be going towards creating societal
value (e.g. healthier individuals who might one day be productive,
funding research towards making non-mooching individuals healthier),
which is better than half of our military budget can justify.

-- 
Nick

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