Thursday, August 13, 2009

Health Care

I'm rather fascinated and perplexed by the ongoing health care debate in the United States. Neither side seems to be willing to accept any kind of middle of the road, much less have a civilized debate on it. As far as I can tell from down here in single payer land, the country is polarized. Why can't people sit down and have a meaningful discussion about the pros and cons of each side?

Despite it not being any tremendous secret where my political feelings fall, in some respects, I think the Right has a point. It's not right to subsidize people who wantonly increase their risk factors and don't contribute to the pool. And I certainly agree that fraud shouldn't be rewarded. But might there be any truth to the idea that people might want to lie less on their health insurance forms if they weren't worried of being denied coverage? I'm talking about people that actually have jobs.

Or what about, for example, a family that has health coverage through an employer for a kid with Downs. That parent is probably worried about looking for other jobs (or rocking the boat at the current one), lest they have to then explain a pre-existing condition to a new insurance company.

Being an engineer (of sorts), I enjoyed reading this article (thanks Adam), which discussed some of the probabilistic aspects of insurance, specifically the focus on the top percentages. I'd encourage everyone to read it. It's not gospel, and there are some potential holes in the logic (just as it appears CEOs twist math in their favor, I'm sure this guy does too, to help his case).

Lest you think that the bill (HR 3200) is perfect in it's current form (full text, PDF), I don't know that I agree with levying a tax on people who choose to not participate. I might suggest something more petty, like giving everyone a window to participate, and then making it prohibitively expensive (or allowing private insurance) for those who choose to not join the pool from the start (who aren't in a grandfathered program). But that's just me. I'm fine with letting people make their choice (just don't come whining when it bites you).

I guess what really frustrates me is that most people won't even take the time to read the summary, much less the full text (at nearly 1100 pages, who has the time?), and yet will go into a diatribe one way or the other.

I'm all for open, mature debate. I'll even encourage it here, to my extremely meager readership. But if anyone suggests that we need to keep the government's hands off Medicare, or that a government bureaucrat is going to be worse than a commercial one (or fails to realize that insurance companies are massive bureaucracies), I'll toss you from the debate. After all, this is my bully pulpit.


Giant Brain said...

Here are just a couple of quick reactions:

1. There are apparently four House bills, not one. The process is being rushed, and most legislators admit to not having read the bills.

2. I haven't heard the right complaining about subsidizing risk factors. To the contrary, I hear complaints that the government will intrude into private matters at the expense of liberty, telling people what and how much they may smoke, eat, drink, etc., through regulation and/or punitive taxation.

Brendan said...

1. Didn't realize that. Feel free to link to the others. As for the legislators, that's pretty pathetic, but I would imagine it's par for the course in most lawmaking.

2. Isn't there already (to a degree) punitive taxation when you disclose risk factors? I can't recall what I had to disclose when I joined my current group health plan, but I do recall questions of smoking when I signed up for individual coverage between uni and employment (lest I get hit by a car). If you're a smoker and you're honest, you have higher premiums. If you're dishonest, and then get caught later, you get dropped (possibly), which leaves you footing the bill. It's not exactly the same, but it's similar.

Giant Brain said...

I spent some time trying to locate the four House Bills today, and could not. I did find a column by Camille Paglia which referenced five competing draft bills. also says there are five). The column was dated August 12, but also seemed to be a revision of an older column. Perhaps the drafts have been melded into one bill, HR 3200. Nevertheless, Rush says there are four competing bills, and he is "almost always right, 99.1 % of the time."

Oh, government servers are slow and near overload today. Lots of interest.

Insurance rates and taxation are not the same thing. You don't pay your premium, your insurance is cancelled. You don't pay your taxes, you end up in a cell with Wesley Snipes.

Giant Brain said...

Last entry was truncated slightly after I tried to insert the Paglia web address. It should have said (Hannity also says there are five).

Brendan said...

I'm glad that people are taking interest. I'd rather they get their information from reading legislation than taking biased garbage from either side of the talking heads.

As for the differences between taxation and premiums, you're right. I meant it in that there is a financial penalty. But who knows. Maybe Mr. Snipes has good stories?