Translate

Saturday, July 1, 2017

The dismal health care debate


I don't have a head for numeric concepts and I bore easily, so the details of the health care legislation making its way through the sausage factory elude me. I'm also blessed with good health and income, so I tend not to think about this that much, other than to marvel at how much I pay for coverage which I have never tapped into. Apparently 48.6 million Americans lacked coverage and, since Obamacare, only 27 million do. Obamacare, I am told, is intended to address that gap of people with no available employer-sponsored plan who are too young for Medicare and too affluent for Medicaid.

Individuals who lack employer-sponsored coverage tend not to make a lot of money and will forego insurance, particularly if they are young. They also tend to be less healthy and make poor life choices. So not enough premiums coming in, too many claims paying out, which is the insurance death spiral. Therefore, Obamacare subsidized this scheme with all sorts of taxes including one on "Cadillac" plans offered by large public companies with expensive workforces. Of course, this resulted in regularizing coverage across the board. Health insurance is perforce expensive and not really economical unless you are badly injured or get diagnosed with a chronic illness, and the disincentives and inefficiencies just pile up from there.

This is actually well-trod ground in these parts. I'll summarize by pointing out that there's really no such thing as "health insurance." There are a lot of genetic diseases and pre-dispositions that can't be incentivized away, and everyone is also 100% destined to get older, sicker and more expensive. There's also no such thing as "preventive medicine." Access to medicine does not actually make people healthier.

All that being said, with over $3 trillion in federal tax revenue and 320 million people to spread the costs among, we seemingly should be able to find enough change in the sofa cushions to fund comprehensive medical insurance coverage, which is the norm in the civilized world. The purported horrors of national medical coverage don't seem to be showing up where you'd expect in the metrics. The US actually has lower life expectancy and higher infant mortality for higher cost.

With the election of Trump, largely thanks to the efforts of working class whites who don't seem nearly so squeamish over the prospect of national medical insurance, one would expect some soul-searching and political calculation among Republicans. I personally would be licking my chops over my time at the podium:

"My fellow Americans, today I am proud to announce that from this day forward, no American will ever go bankrupt from a horrible accident or a cancer diagnosis ever again!" [Cue release of a dozen bald eagles, 21-gun salute, and the Sunshine Gospel Mass Choir].



I'll reign for 40 years, and my marble tomb will be ensconced in the Lincoln Memorial.

And after that a lot of things start falling into place: sensible immigration policy--we can't afford net consumers; labor mobility, as people are no longer shackled to a job by medical coverage; moms can choose to stay home or work part-time, lowering the costs of family formation, which is how you grow conservatives; a sense of priorities, and national cohesion finally returning to budgets--war in Bumfuckistan, or medical coverage for US citizens?

Doubtless such Machiavellian calculation is beneath the quiet dignity and rock-ribbed principle of the Republican leadership, but this message is beginning to resonate with some pretty prominent Megaphone Holders:


The difference in the competing visions could not be more stark:



[MR. TRUMP, YOU'VE HEARD THE ARGUMENT THAT YOU ARE NOT A TRUE CONSERVATIVE. TELL THE VOTERS WATCHING TONIGHT WHY YOU ARE. WELL, I THINK I AM. AND I VIEW THE WORD CONSERVATIVE AS A DERIVATIVE OF THE WORD CONSERVE. WE WANT TO CONSERVE OUR MONEY. WE WANT TO CONSERVE OUR WEALTH. WE WANT TO CONSERVE, WE WANT TO BE SMART. WE WANT TO BE SMART, WHERE WE GO, WHERE WE SPEND, HOW WE SPEND. WE WANT TO CONSERVE OUR COUNTRY. WE WANT TO SAVE OUR COUNTRY. AND WE HAVE PEOPLE THAT HAVE NO IDEA HOW TO DO THAT AND THEY ARE NOT DOING IT. IT'S SOMETHING I BELIEVE IN VERY, VERY STRONGLY.

MR. TRUMP, THANK YOU. SENATOR RUBIO, YOU HAVE SAID YOURSELF THAT YOU DON'T THINK DONALD TRUMP IS RUNNING AS A CONSERVATIVE. DID HE CONVINCE YOU? WELL, I THINK CONSERVATISM IS ABOUT THREE THINGS. THE FIRST IS CONSERVATISM IS ABOUT LIMITED GOVERNMENT. ESPECIALLY AT THE FEDERAL LEVEL. THE FEDERAL GOVERNMENT IS LIMITED BY THE CONSTITUTION, WHICH DELINEATES ITS POWERS. IF IT IS NOT IN THE CONSTITUTION, IT DOES NOT BELONG TO THE FEDERAL GOVERNMENT. IT BELONGS TO STATES, COMMUNITIES. IT IS ABOUT FREE ENTERPRISE. IT ALLOWS EVERYONE TO SURVIVE WITHOUT PULLING ANYONE DOWN. THE REASON WHY FREE ENTERPRISE IS THE GREATEST ECONOMIC MODEL IN THE HISTORY OF THE WORLD IS BECAUSE IT IS THE ONLY ECONOMIC MODEL WHERE YOU CAN MAKE POOR PEOPLE RICHER WITHOUT MAKING RICH PEOPLE POOR. IT'S ABOUT A STRONG NATIONAL DEFENSE. IT'S BELIEVING THAT THE WORLD IS A SAFER AND BETTER PLACE WHEN AMERICA IS THE STRONGEST.]
I'll leave the details to the experts. If the Republican Party can pass comprehensive medical insurance coverage, they will hold the levers of power for the next two generations. Then they will have all the political capital they need to close the border, de-fund the colleges and propaganda organs, ignore and ridicule the national media, and trample all over toxic political correctness. The conservative long march through the institutions can begin. This is using the Left's tactics against them to advance conservative goals, as opposed to current conservative ideology which adopts the rhetoric and moral framework of the Left ("Dems r the real racists!"), resulting in tactical impotence.

Remember: the end to be kept in mind is not how to spread conservative ideas, but how to grow conservatives.

7 comments:

james wilson said...

Purely coincidentally, most of these civilized nations with universal care are circling the civilization drain.

The Anti-Gnostic said...

Yes. I encourage counter-points on this. My thought is if the money is going to be spent, as it apparently is, this may be one of the better ends versus overseas wars.

james wilson said...

Overseas wars and socialist health care are not different choices, they are projects of the very same numbing universalist utopian mindset.

The Anti-Gnostic said...

(Sigh) yes, a dismal debate. Thanks for reading and commenting.

lannes said...

Why don't you tell us how much people who now have health insurance post-Obama are paying in deductibles?

The Anti-Gnostic said...

Generally, $7K individual/$14K family.

patrick kelly said...

"My thought is if the money is going to be spent, as it apparently is, this may be one of the better ends versus overseas wars."

I agree, I would much rather my tax dollars go to paying for health care for Americans rather than blowing up and killing poor, brown, third world populations.

Ultimately I would like government to not be involved with paying for either, but I'll take any progress in that direction over the current unsustainable downward spiral.