Sunday, March 28, 2010

Health care reform passes

Although I had thought it was dead, the Democrats this week managed to pass their health care reform package.

I don't like the bills as they basically establish a massive new welfare entitlement program. I don't like welfare in general and this is a particularly inefficient form of welfare as most of the benefit will accrue to the health care industry rather than to the poor, who given a choice would largely spend the money on other things. In my view the main problems with health care in the US are that it costs too much and that it is over utilized. The bills will make both of these problems worse.

Some Republicans have been whining about the process by which the bill was passed which seems silly to me, given that the Democrats have significant majorities in the Senate and House and control of the White House, it is reasonable that they should be able to pass this package, wrongheaded as it may be. And one should remember it was the Republicans disastrous performance when they were in control which directly led to the current Democratic majorities.

Also much of the Republican opposition seemed off point to me. If you accept that no American should ever be denied any health care treatment because of cost it is hard to construct a plan that doesn't have most of the problems of the Democrat's package. Hence Romney's embarrassment over the fact that the program he helped establish as Governor of Massachusetts was not all that different. I don't accept the above principle but this doesn't appear to be a position that politicians are willing to argue.


  1. A serious problem with health care in the United States is that it is inequitably allocated: Not everyone is given the same opportunity (before developing pre-existing conditions) to buy insurance with comparable coverage at comparable rates and with no penalties for future illnesses or injuries. I wonder why you ignore this problem. Do you suppose that inequality of opportunity is not a fact, or do you think that it is nothing to be concerned about?

    Regarding the two problems that do concern you: Health care is surely costly, but on what basis do you say that it "costs too much"? What is the evidence that it "is over utilized"?

  2. What kind of question is this? Look at any one of the bills for any of your primary physician visits - you are paying way too much because your payments (or your insurance company's payments) need to cover hundreds of thousands the doc has to pay for his malpractice insurance as a protection against lazy bums who make living of suing (being just one of many things in the sum.)
    It is clearly over utilized because providers need to make money and nothing is stopping them from recommending unnecessary treatments. Just read a few articles about the amazing cesarean section rates in the US exceeding 30%, while virtually all professional organizations agree it is unnecessary to bring 30% of children to world via c-section (and it should be more like 15%).
    Cut through the philosophy of equality - the current bill STINKS, it solves none of the major cost problems, and brings this country one step closer to bankruptcy similar to what is happening to European countries (most notably Greece).

  3. Of course everything "costs too much" and "is over utilized", because nothing is completely efficient. I was looking, not for single examples (malpractice insurance fraud, too many caesareans), but for good scientific studies indicating how significant these problems really are overall.

    In particular, are they more important than equality of opportunity? I gather that "Cut through the philosophy of equality" is your long-winded way of saying, "Ignore equality." Having said that, then rather than argue why it should be ignored, you introduce a different topic, namely your low opinion of the present "bill" (which by the way is now a law, not a bill).

    So the answer to your query, "What kind of question is this?" is, "One that you did not answer."

  4. Awh, awesome writing, or shall we say: "I gather I am significantly wet merely from reading"
    While we look for a scientifically significant study on how significantly bad this bureaucratic expansion is, may I suggest professor noknot spend some time on a sabbatical in Venezuela?