Monday, the eminent left-wing economist, Paul Krugman, suggested that Hillary Clinton’s health-care plan was better than Barack Obama’s because Clinton’s would come closer to insuring everyone “at only slightly higher cost.” Of course, Krugman never questioned whether the left-wing goal of universal health insurance makes sense in the first place.
I remember a couple of decades ago seeing a demonstration in Washington with signs saying, “health care is a right, not a privilege.” At the time, it seemed like a very peculiar thing to say. All the other rights we are used to — freedom of speech, freedom of religion, etc. — are designed to protect people from the government. They are promises that the government won’t interfere in certain aspects of our lives.
To say that health care is a right is just the opposite: it is a promise that the government will interfere in our lives, by taking our money and giving it to people who need health care.
What is so special about health care that makes it a right — that is, that leads people to think that government should have the power to take from some people in order to make sure that other people have health insurance (as opposed to the health care they already have)? Why not food, or housing, or rock and roll music, or any of a thousand other things? To be sure, health care can mean life or death for some people, but so can food and housing. And while we do have food and housing programs for the poor, you don’t hear “universal full bellies” or “universal 1,000-square-feet of housing per person” mantras.
We hear over and over that umpty-ump million Americans (the number is currently supposed to be 45 million) don’t have health insurance, as if that is evidence of some kind of crisis. As the video below points out, the vast majority of those 45 million are either very well off (incomes over $50,000 per person) or between the ages of 18 and 34 and don’t feel spending money on insurance is a good bet.
The video adds that “federal law requires that any hospital must provide care to anyone who comes within 250 yards of an emergency room, regardless of ability or willingness to pay.” So we do, in fact, have universal health care, even if we don’t have universal health insurance.
The Obama plan essentially calls for spending more federal money on health care for low-income people. The Hillary plan, however, is different: she would require that everyone buy health insurance.
Now, I brought some surprising regular lifestyle causes of erectile dysfunction and gynecomastia amongst users of Finasteride.) Fortunately, cialis samples there are natural supplements for this problem too. You take an alternate Pde5 inhibitor (eg, tadalafil, vardenafil) or sales uk viagra an alternate solution that contains sildenafil. How Erections Work? Your penis is soft and loose, when you pills viagra canada are not sexually stimulated. Camel or lemon grass herbal plant can be known as a Malaysian Ginseng Long Jack port, and for that are viagra in dechechland required tests for thyroid function.
Krugman gleefully reports that Hillary’s plan will cost less, per newly-insured person, than Obama’s — less to taxpayers, that is. He doesn’t count as a cost the money that Hillary’s plan would force private people to spend on insurance when they would rather spend it on something else. Nor, needless to say, does he consider the act of coercion as a cost.
Since Hillary’s plan will cover more people, its total cost will be “slightly more” than Obama’s: $22 billion, or more than 20 percent more, to be precise. I guess MIT professors make a lot more money than I thought for $22 billion to be considered a “slight” amount. That works out to about $200 per federal taxpayer. Again, this doesn’t count the amounts that uninsured will be forced to pay for insurance.
It doesn’t take an MIT economist to figure out who really will benefit from the Clinton plan. Not low-income people, who already have adequate health care through Medicaid and similar programs. Not the rest of the uninsured, who will have to fork over money to buy insurance that they believe — in most cases correctly — they don’t need.
The real winners, of course, will be the insurance companies. The Hillarycare plan of the early 1990s favored five big insurance companies and shut out the rest — which led the rest to fund a successful campaign to kill the plan. I am sure Hillary has learned from this experience to share the pork and minimize the opposition. I wonder how much money insurance companies, or their employees, have donated to Hillary’s campaign.
A good case can be made that the real problem with our health care system is not too few insured people, but too many. Those who have insurance tend to overconsume health care, driving up costs. The more who are insured, the higher costs will be — to the increasing detriment of those who are uninsured.
Further, more government (and, to a certain extent, more private insurance) means more bureaucracy and red tape. Just as in education, the benefits of federal funding for health care are partly offset by the increased red tape that doctors and hospitals must fill out to get that funding. Since the feds won’t pay extra for the red tape, the care providers have to pass those costs on to everyone by increasing all their fees — which makes health care less affordable for those who don’t have a federal safety net.
These problems will only be made worse by increasing federal spending or mandating more insurance. I am not an expert in health care and I can’t really debate the merits of, say, Canada’s health care system vs. that in the U.S. However, I can’t support the idea of forcing people to buy health insurance.
On a more technical level, Krugman’s economic reasoning is flat-out wrong when he only counts costs to taxpayers and not the costs to others when he compares Hillary’s plan with Obama’s. A real economist would consider all the costs to everyone in society; Krugman knows this, and his article is just plain dishonest.
Antiplanner,
I am about to start a long and busy day earning a paycheck, so I will make my comment on the immensely complicated issue of health care brief.
Essentially you are speaking to the issue of what some call “positive rights” and “negative rights”. A visit to the Wikipedia entry will be a start for those who are interested.
http://en.wikipedia.org/wiki/Negative_and_positive_rights
A simple argument is that a negative right is where you are entitled to general freedoms which are enshrined in most wealthy countries – freedom to worship, freedom to speak, etc. The idea here is that others cannot interfere with your desire to do something.
A positive right is thought to be something where others are compelled to help or assist someone else. In otherwords, if you have a “right” to healthcare, then others must give it to you.
Read the wiki entry and other places as to other arguments that delve more deeply into the philosophical distinctions and debates regarding these kinds of matters.
Have a great day everyone – and that includes our planner friends!
Randal,
Please stick to what you know. You are leaving out quite a few facts when talking about the shoddy state of the US healthcare system.
First, the US spends more per capita than any other country in the world on health care, by over 53% in 2005. We are also spending the most as a percent of the GDP.
Second, we are the only country in the developed world that does not provide health care for all of its citizens.
Third, we have the highest infant mortality rate in the developed world.
Fourth, we are one of the lowest in terms of life expectancy (although the gap is not huge).
See here:
http://tinyurl.com/2rke57 (pdf) These numbers are from 1998, but are detailed.
http://www.possibility.com/epowiki/Wiki.jsp?page=ComparativeHealthCareCosts These numbers are from 2005, but less detailed.
You seem to be saying that a universal health care would be too expensive and quality would go down, but the facts seem to say just the opposite.
Oh, and I forgot…wait times. No data is tracked on this because the US is not a single payer system. But, this Business Week article says:
http://tinyurl.com/33r244
Things are not looking too good for my adopted country of Canada, but it is a hell of a lot cheaper there and in emergencies, patients can always receive the care they need.
werdnagreb said: “Things are not looking too good for my adopted country of Canada, but it is a hell of a lot cheaper there and in emergencies, patients can always receive the care they need.”
you left out: because we are right next to the US
The writing is on the wall, and we’ll have socialized medicine before long. Why anyone would want to devote 8 yaers to med school and residency under that syatem is beyond me, and I think you’ll see a flight from medicine by the best and brightest. People really need, however, to understand the nature of the “crisis”
” we are the only country in the developed world that does not provide health care for all of its citizens.”
Not really. We have medicaid for the poor, and medicare for the aged. What we are taling about is is changing the entire system into a government program in order to cover people deemed to wealthy for medicaid but who for whatever reason don’t buy health insurance. I’ve been one of those people when I decided not to buy insurance between jobs. I was one of the 40 million (or is it 40 billion, I forget) uninsured. Anyway, I find covering this slice of the population an odd justification for making every doctor a government employee (de jure or de facto) and making one’s access to health care dependent on one’s standing with the government. No doubt the truly wealthy and connected will insulate themselves from this new system in much the smae way that they are insulated from the public school system.
The title of this thread begs the question: should we be forced to buy car insurance?
It is rather disingenuous to claim that because everyone can get care at an emergency room, everyone has care. The federal law only mandates emergency care. One cannot get non emergency care that way.
Hmmmm,
The U.S. spends more on health care, has a smaller percentage of its population covered, and shows worse health among its citizens than many other developed countries. ‘That sure looks like an efficient way to orgainize health care, doesnt it?’ If you are completely irrational and want to organize a system that results in costs greatly exceeding benefits, that is. Now what are the costs to ‘socialized’ medicine? Longer wait times for non-life threatening injuries. Wow horrible, so so horrible! Can someone please explain to me why the U.S. systems is somehow better, even though the data say otherwise?
Where will canadians go to get operations? What a joke. As if there are not Americans going to other contries to get health insurance. But, I guess we will ignore all the Amercian medical refugees (health care tourism!) going to foreign countries, such as India, to get cheaper health care.
Notice, also how mr o’toole says he cant debate the merits between the U.S. and other systems, thus he does not know whether data suggests the U.S. system is betterm but he nevertheless states that any type of universal insurance would be a bad idea. Didnt Mr. O’toole have an article not too long ago about how it would have been better to pay for slaves freedom than to go to war over slavery. He noted that the moral reasons didnt outweigh the horrors brought on by the civil war. But now he takes a moralistic approach to “forcing” people to get health care. O’toole, you merely make arguments to fit your ideological dogma. You flip-flop more than John Kerry. One day the greater good trumps morality, the next day morality (an individualized, Randian type of morality) trumps the greater good. Make up your mind, you seem to be flip-flopping more than John Kerry!
werdnagreb says, “we are the only country in the developed world that does not provide health care for all of its citizens.” This is confusing “health insurance” for “health care.” Those are two different things.
gpasha says, “It is rather disingenuous to claim that because everyone can get care at an emergency room, everyone has care.” It is not disingenuous; 99.99 percent of all Americans have access to better health care than the vast majority of the rest of the world’s people.
D4P asks, “should we be forced to buy car insurance?” If you are an uninsured motorist, you can inflict real damage on strangers. If you have no health insurance, you may lose, but few others and certainly no strangers.
sustainibertarian says, “now he takes a moralistic approach to “forcing†people to get health care.” I just said I can’t support such force (any more than I would support slavery). But my big complaint was Krugman’s dishonesty.
If you are an uninsured motorist, you can inflict real damage on strangers. If you have no health insurance, you may lose, but few others and certainly no strangers
So, Big Government should step in and force people to buy car insurance? Under what conditions does causing harm inspire you to conclude that Government needs to be involved? You don’t seem to reach that conclusion on a consistent basis…
Health INSURANCE is not the same thing as heath CARE. No candidate is proposing universal health care … they daren’t.
What is being proposed is a massive funneling of tax monies to insurance companies … who won’t have to worry about competition. Guess how the few chosen insurance companies will get on this gravy train?
For example of how well ‘single payer’ works, we have ‘single payer’ for defense contracts. No problems there, eh?
Antiplanner says:
Yes, they are different things, but intimately related. Isn’t it just possible that the reason why the US health care system is so shoddy is that there is no mandate from the government to provide everyone with reasonable care?
The US has the most number of hospital beds per capita in the world, the best technology, the best medical schools, and the highest paid doctors, yet why do we have some of the worst healthcare?
As an American, I would like to take this opportunity to thank Canada for its contribution to our health care system.
Re “rights”–bureaucrats never learn that when one defines rights in terms of economic needs and wants (i.e., I need something really, really important but can’t or don’t want to pay for it), compelling the terms of employment of those that have the ability to satisfy those needs may result in those persons saying “good bye.”
I defer to freedom.
We should be free to not have to be forced into universal health care.
I prefer my health saving account.
If you think heath care is expensive now, wait until it is free
PJ O’Rourke
Antiplanner says: “99.99 percent of all Americans have access to better health care than the vast majority of the rest of the world’s people.”
Sure, “the vast majority of the world’s people” live in Third World squalor and have
definitely worse health care. Now, is that the standard we are using in this debate to
make the US system look good?
Best wishes
Gordon
That link Unowho posted is exactly what I’m talking about. Why would anyone fitting a go-getter personality toil for 8 years to become a government service employee. They won’t. More and more the best and brightest go into fields like tax law, not medicine.
I don’t pretend to know the answer to this issue, but the small-minority ideological position needs work:
Using this same logic, we can state that we should be free to not suffer the impacts from people who are uninsured, and we should be free from the economic externalities of a society that is in poor health and thus less productive.
That is: whose freedom? Advanced civil societies arrange themselves to help care for those who can’t help themselves. Because they haven’t solved the basic issue of free-riding doesn’t negate their utility.
And we also can choose to act upon our freedom to choose and Tiebout sort to less advanced societies without health care, where everyone is left to their own devices, or left to the protection of small clans or bands rather than that particular (likely fractured, less advanced and thus poorer) society. Why would we sort to a less-advanced society? Because virtually every advanced society on this planet has some form of the thing the small-minority position doesn’t like very much.
DS
hmmm…br works in preview.
DS
Doesn’t the developed vs. less developed nation argument cut the other way, away from government control? The argument seems to be that nations with relatively wealthy populations need the government to dole out health care. I would have thought that this would have been a more persuasive argument in the case of poor nations. Shouldn’t the government’s vigor in providing for the people inversely correlate with how wealthy the people are?
look at the video what are they saying.
When I moved out of my parents home I could buy insurance for $35.00 a month. About the same amount I’d spend on a night out on the town. I assumed it was not my responsibility and my employer didn’t offer it.
I didn’t and had a uninsured operation and ended up paying $50.00 a month to cover the operation and added insurance at $35.00 a month. I made it work while taking home $400.00 a month living with roommates.
For most young people health insurance is a choice. Cable tv, internet access, cell phone, eating fast food, Starbucks, dvd recorders and dvd’s, cd players I-pods and cd’s, drinking, smokes etc.
We are free to choose
Today a major medical health saving account costs about $70.00 a month for a 20yr old.
I still defer top freedom
I still defer to freedom
Re no. 17:
I don’t think most people that are drawn to a lifetime of service to the ill and infirm would be happy as tax lawyers (excepting, maybe, surgeons). However, when put in the position of lions being led by donkeys, they are always free to put their talents to use outside the reach of said donkeys, e.g. Justine Whitaker.
The loss results not from those choosing tax law over medicine, but the slow and barely perceptible replacement of professionals with time servers.
I’m from the UK. Here in Europe, we have socialised health care, in contrast to the private insurance in the USA.
Nope.
Both the USA and Europe mix private and public funding. The NHS is paid for by public taxation, but although in principle it covers dentistry, in practice I go private. I could take out a dental plan, but I pay as I go. I could also pay for medical care through private health insurance, but I opt not to. Opticians are private businesses, and these are always paid for privately.
At the same time, USA has medicaid and hospitals are required to treat people who turn up at hospital A&E. Some patients, due to low income, are treated for free, just as in the UK, poor people don’t pay for the NHS.
It appears to be more a matter of degree than the stereotypes would suggest.
Of course, arguably the most socialist country in Europe is France. In France, they don’t have an NHS in the same way that we do, and use mixed private insurance/state funded medical care on a regular basis. The French are fed up with how much this is costing, with spiralling health costs, just as in the USA.
From my perspective, the best solution is the UK one – univerals insurance – but with a few important changes. Some private health insurance companies in the UK offer lower fees if the applicant can demonstrate that they are taking care of themselves. Other private insurance companies offer reduced rate or free gym membership.
I think this is the way forwards for the NHS – we are carrying a lot of people at the moment, who believe that they can behave as they like, eat what they like, smoke, drink, forget to do any exercise, and then the NHS fairy will wave her magic wand and make them better again. The costs of treatment are spiralling so fast, and the benefits of a healthy lifestyle are so important for a good outcome, that an increasing number of people are being told that before they are given treatment, they will have to quit smoking, lose some weight, etc.
Universal health insurance without some incentive for good health is not sustainable in the long term. I think that is the message from the UK experience.