Many of the illegal immigrants leaving Great Britain are citing lack of sun and poor health care. I can’t think of anything else to add. Read it here.

This is an interesting site about Free-Market medicine.

I particularly like this article where David Gratzer (author of The Cure) explains what the real problem is, and why socialization is not the answer. It begs the question: if we ARE in a market-driven system, why is it that costs don’t go down like other high-tech fields? The answer is: we’re NOT in a market-driven system. And it’s tough to argue that a truly market-driven system definitely wouldn’t work. So shouldn’t we try it first?

A lot of the rest of the site has videos that dispel some myths about the current system…like the number of people that are uninsured by choice, and the extent of the safety net for those who don’t have a choice.

A sister site, On the Fence Films, has a video about a brain surgery patient from Ontario which illustrates the flaws in a single-payer system.  Many of the arguments for “rationed care” simply comes to this:  only poor people are important, and those with jobs and money should have to wait just like everyone else.  Tell that to this gentleman.  The dirty truth is…even a poor person in the U.S. with no “coverage” would have better “access” than this middle class family in Ontario.  And our private system would eat the bill.

I remember during some townhall forum where “normal people” (i.e. handpicked by Dan Rather or the like) asked questions to GOP and the Democratic candidate. This may have been in 2004. Bush said that the biggest concern for the average American small business owner was taxes. The questioner said that his biggest concern as a small business owner was health care, and what was government going to do to make it easier. I noted back then that health care is a tax policy issue, and that Bush for all his ham-fistedness had it right. Ramesh Ponnuru highlights this fact in Time.

That’s how we ended up with the health-insurance system we have now, based on employers. You get a tax break if you get your insurance through your job. If you get a raise and use it to buy your own insurance instead, you have to pay taxes on that money. (Ditto if you use your raise to pay doctors directly.) Almost everyone takes the tax break. The market for insurance bought by individuals is, as a result, small and stunted, which is all the more reason to stay in the employer system.

Good news for common sense, and good job by the citizens of Oregon to look past simplistic populist rhetoric. WSJ notes the important lesson here for Arnold Schwarzenegger and the 2008 election.

There are political lessons here, in case anyone in Washington is paying attention. Voters are rightly concerned about health care and would like everyone to have insurance, but they realize that government programs are very expensive. Americans also don’t seem to want to pay for health-care reforms directly through higher taxes. That accounts for the reliance by politicians on the easier sell of tobacco taxes, and it also explains why Congress has disguised the real cost of its Schip contraption with a $30 billion budget gimmick. (No thanks to GOP Senators Orrin Hatch and Chuck Grassley.)

Here’s my step-by-step take on HillaryCare. I’ve been putting it off for two reasons:

1) I’m busy trying to make money damnit.
2) I found the “plan” so confoundedly confusing and poorly written that I just didn’t know where to start. To be honest, I actually was taken aback by the lack of sophistication in the details.

So here you go. Unfortunately, my commentary is almost as poorly organized as the original work…but, well, I’m not running for President:

“Affordable: Unlike the current health system where insurance premiums send people into bankruptcy, the plan provides tax credits for working families to help them cover their costs. The tax credits will ensure that working families never have to pay more than a limited percentage of their income for health care.”

Insurance premiums have never bankrupted anyone. Medical costs have, though. Medical insurance premiums calculated as a percentage of income is ABSOLUTELY the most inefficient economic model I’ve ever heard of.

“Available: No discrimination. The insurance companies can’t deny you coverage if you have a pre-existing condition.”

States have tried this. In these states, the health insurance market is completely gone, now. People wait until they’re sick to get coverage. If you’re going to go 100% guaranteed issue, don’t pretend that you’re going to keep it private.

“Reliable: It’s portable. If you change or lose your job, you keep your health care.”

Believe it or not, this is true with individual health insurance. Isn’t that odd?

“If you have a plan you like, you keep it. If you want to change plans or aren’t currently covered, you can choose from dozens of the same plans available to members of Congress, or you can opt into a public plan option like Medicare. And working families will get tax credits to help pay their premiums.”

This is a myth. So you can keep your current plan. Sure, but you’re going to get free money to sign up for the “good” plan the government offers. It doesn’t say anything about letting you use said tax credits to pay for insurance you want.

“Good for small business: Small businesses are the engine of new job growth in the U.S. economy but face bigger challenges when it comes to providing health care for their employees. Hillary would give tax credits to small businesses that provide health care to their workers to help defray their coverage costs. This will make small businesses more competitive and help create good jobs with health benefits that will stay here in the US.”

Completely contradictory to the portable concept. Lifting the financial burden from the backs of small businesses is great, but keeping administration of medical coverage in employer’s hands would not improve the situation.

“Reins in insurance companies–Insurance companies won’t be able to deny you coverage or drop you because their computer model says you’re not worth it. They will have to offer and renew coverage to anyone who applies and pays their premium. And like other things that you buy, they will have to compete for your business based on quality and price. Families will have the security of knowing that if they become ill or lose their jobs, they won’t lose their coverage.”

This is complete poppycock, especially the “compete” part. Insurance companies allowed the honor of participating will be at the mercy of Government subsidies and not the will of the patient and their money, so where is the incentive for them to “compete?” Simultaneously subsidizing group coverage and individual coverage is just weird. The security is knowing you will be bailed out by the government, when a better idea is to have individual coverage in the first place so you’re not dependent on a job for coverage.

“Insurance and Drug Companies: insurance companies will end discrimination based on pre-existing conditions or expectations of illness and ensure high value for every premium dollar; while drug companies will offer fair prices and accurate information.”

OK…as long as you simply stop calling them insurance companies. At what point did “insurance” not mean pooling and managing risk? Are we going to outlaw car insurance companies from discriminating against bad drivers?

“Individuals: will be required to get and keep insurance in a system where insurance is affordable and accessible.”

This is their only responsibility? Not managing their health or helping manage usage or costs?

“Providers: will work collaboratively with patients and businesses to deliver high-quality, affordable care.”

How? Admittedly this is a problem. This will be solved by providers being assigned by the Fed instead of insurance companies? How is this “plan” going to make this happen?

Employers: will help finance the system; large employers will be expected to provide health insurance or contribute to the cost of coverage: small businesses will receive a tax credit to continue or begin to offer coverage.

This is exactly the direction that creates problems. This whole employer thing is just confusing. Why help employers fund it? Why not let them pay their employees more? When you can just let the individual fund it, and give them direct tax subsidies?

“Government: will ensure that health insurance is always affordable and never a crushing burden on any family and will implement reforms to improve quality and lower cost.”

How would the government improve quality? Lowering administrative costs is only part of the battle. Slowing down increases in costs is the bigger problem.

“Provide Tax Relief to Ensure Affordability: Working families will receive a refundable tax credit to help them afford high-quality health coverage.”

I’m all for it. Define “high quality”. What is a “refundable tax credit?” Is the government going to get a refund?

“Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans.”

This is a little vexing. The credit will make people more price conscious about choosing plans? So is this an incentive to earn more or less?

“Create a New Small Business Tax Credit: To make it easier-not harder-for small businesses to create new jobs with health coverage, a new health care tax credit for small businesses will provide an incentive for job-based coverage.”

Incenting job-based coverage, still, is the wrong idea.

“Strengthen Medicaid and CHIP: The Plan will fix the holes in the safety net to ensure that the most vulnerable populations receive affordable, quality care.”

“Most vulnerable” is virtually everyone. Everyone is affected by the high cost health care. What we’re talking about here is the beginning of socialized medicine. Period.

“Launch a Retiree Health Legacy Initiative: A new tax credit for qualifying private and public retiree health plans will offset a significant portion of catastrophic expenditures, so long as savings are dedicated to workers and competitiveness.”

Admittedly, I don’t even know what that means.

“Most Savings Come Through Lowering Spending Due to Quality and Modernization: Over half the savings come from the public savings generated from Senator Clinton’s broader agenda to modernize the heath systems and reduce wasteful health spending.”

Modernizing only reduces costs temporarily (arithmetically). If over half the savings comes from this…then there is virtually no savings. The cost INCREASES (geometric…even exponential) are not due to lack of technology, but increased demand, and a lack of access to cost vs. quality demand by the consumer.

“A Net Tax Cut for American Taxpayers: The plan offers tens of millions of Americans a new tax credit to make premiums affordable-which more than offsets the increased revenues from the Plan’s provisions to limit the employer tax exclusion for health care and discontinue portions of the Bush tax cuts for those making over $250,000. Thus, the plan provides a net tax cut for American taxpayers.”

Classic. Tax the rich and give “health care” to the poor. A net tax cut…unless of course you pay the majority of the taxes.

“Making the Employer Tax Exclusion for Health Care Fairer: The plan protects the current exclusion from taxes of employer-provided health premiums, but limits the exclusion for the high-end portion of very generous plans for those making over $250,000.”

This is insane. Health Insurance, and health care, is not any more expensive for rich people than it is for poor people. It’s health that dictates rates, not income. This makes no sense. So rich people would get less tax incentives from buying health care. This keeps healthy rich people off the insurance rolls, because they’ll find a better place to shelter their money from taxes.

I’d rather her just come out and say, “Hey. Everyone is going to be on Medicare.” She can’t do that, though, because she would lose the social argument as well. Americans really don’t WANT the Government to control their healthcare, they’re just desperate to be able to afford it, so those who are big fans of Government-run healthcare are attempting to wrap a social argument with an economic rationale. It just won’t fly, though, because there IS no economic rationale for the U.S. converting to single-payer or socialized medicine. The only rationale that’s left at the end of the day is:

Everybody else is doing it.

And that’s simply not an economic argument…

HillaryClinton.com - American’s Health Choices Plan

Benjamin Zyncher makes a compelling case against single payer universal health insurance based on economic theory. Remember my statement earlier about the difference between “complimentary” and “free”. If you get a service comped by a hotel, the profit comes off the back of another guest. This idea is called “cross-subsidization” by Zyncher. In a definitive statement:

Government is an institution that exists explicitly for the purpose of engendering cross-subsidies among groups, whether through the tax/expenditure system or the regulatory mechanism. Single-payer health insurance, by its very nature (because it accepts all those eligible, and does not base taxes and fees on health status), must create such subsidies, and the tax system prevents competition on the basis of price.

So what, right? All this theory is too abstract? Insurance companies are the bad guys, according to the media and the democratic party. The only way out of this Gordian knot is to let the government take over the industry. The debate that then remains is how quickly or slowly do you want government to encroach on an already highly regulated industry. Hillary and her myrmidons have decided to do this incrementally, by increasing the funding of S-CHIP, which defines children upward to 25 years of age, and defines poverty upwards to an annual income of $75K/year per household. It may sound good to mandate everyone to pick up the tab on health insurance for the poor, but the problem is that rationing services, especially artificially, always has a price. If not in actual dollars, then in time.

In practice, mandating coverage is a slippery slope to price rationing, which quickly becomes wildly unpopular. Sally Pipes explains.

We have a large number of uninsured because insurance is expensive. Insurance is expensive because the product for which it pays — the world’s most advanced medical interventions — doesn’t come cheap. It’s also expensive because regulations severely limit the free-market’s ability to develop inexpensive, less comprehensive plans.

Few politicians are willing to deregulate.

The only levers left to pull are the ones bureaucrats love: price controls and rationing. This is why Hillary speaks of “fair prices.”

Once you get beyond the rhetoric of “40 million uninsured”, the argument for universal health insurance is fairly weak.

I received an email from my good friend Tom regarding the new movie Sicko.

John,

I watched Sicko earlier today; it was really illuminating (and sad). Have you heard of it? It’s Michael Moore’s new piece about the health care industry in the US.

Yes, I know how you feel about him. Yes, he uses a lot of his usual antics and rhetoric. Yes, you will likely find some and perhaps even most of them irritating.

With all of that said, there is a one big shock: for the most part he is fair and non-partisan, perhaps for the first time ever. He mostly avoids partisan issues, choosing to focus his attention elsewhere, but, being Moore, he of course can’t resist a few digs, especially against politicians bought too easily (and cheaply) by lobbyists. But, believe it or not, one of those receiving the harshest smack-down is his previously beloved Hillary. Apparently, hell has frozen over. Or maybe Moore has finally sobered up and looked around. (I confess while finding Hillary irritating and irksome at times, I once admired certain aspects of her platform long ago– especially regarding health care reform– but I feel she has long since lost her way).

The movie unabashedly makes a case for socialized health care, so you deserve to know that in advance, since I have gathered you are opposed to it. With that said, I hope you might be willing to watch the movie regardless. If nothing else, it pays to know what your enemies are up to.

The movie opens next Friday, and I am seriously considering footing the bill for anyone who wants to see it.*

I will likely see it and you are invited, although I suspect your interest might be limited because it’s a Moore film. If so, I cannot entirely fault you for that–his usual antics are on full display, and while I find a lot of his orneriness amusing, I well understand you and many others find his antics (and him) obnoxious. These days, I think many perceive Moore as more of an entertainer that panders to the left than as a bona fide journalist. I would, in fact, largely agree with this assessment.

Consequently, in many ways I wish someone else had made this film, because the issues it raises are important for everyone, regardless of which way a person leans politically. The whole nation needs to be having some sort of dialogue about these issues, and Moore is so thoroughly branded as a left-winger (or maybe even as a left-wingnut?) that I think the fact his name is attached to the movie will just polarize the issue politically, which would be a shame. Health care reform deserves bipartisan discussion and support–as a nation, we have got to transcend political differences on this issue. I can tell you firsthand that the current system destroys families and lives in a brutal and vicious way.

Too many people will miss this documentary because of who made it, and that is a shame and makes me wish almost anyone else had filmed it. But, with that said, I am glad that at least someone made this movie, even if it had to be done by Moore.

My reply:

One of the earliest free health care demagogues was Huey Long. Louisiana used to have charity hospitals all over the state, with 14 in New Orleans alone. During the last oil boom of the ’70s (during stagflation for the rest of the country) Louisiana was hopping. Without fail following an increase in oil prices Louisiana would elect a Huey Long style populist that demanded more money for charity hospitals. Even before Katrina the charity hospitals in Louisiana had conditions that were similar to that of the VA system in Washington D.C.

Now, the new populism advocates not for free health care (the results of which is plain to see in Sicko), but free health insurance for all. Somehow this will equate to Doctors not making mistakes or shortening ER lines.

If some health care socialization bill passes I’ll be ok, I can always bolt-hole to Taiwan. They have universal health care, but not the entitlement mindset found here, Canada, Western Europe (yet). Doctors there see 4X the patients and get 1/4 the pay as American doctors. Universal health care didn’t improve things there (the health care system was good already), but it did ratchet up the burden on the doctors I know there.

There is a long list of things the government is in charge of that are run inefficiently, and quite horribly. Public Schools and VA hospitals are two examples I can think of right quickly.

Just because something works for a small, homogenous western European nation doesn’t mean it will work here. Watch and see as those countries become less homogenous (via low birthrates and high immigration), as socialism as risk aversion (between homogenous classes and ethnicities) gives way to socialism as redistribution (from wealthy natives to poor African and Middle Eastern immigrants), you will soon see a change in policy there. The French electorate recently, and overwhelmingly, rejected the nanny state socialism Moore adores. As such, the French are so entrenched in the welfare state it will be hard to reverse course for a while.

And don’t get me started on Britain. They recently passed a law allowing citizens to go to other countries to receive health care on the government dime, acknowledging the severe limitations of their own impoverished system.

In Canada a citizen needed a Supreme Court ruling to allow a citizen to pay out of pocket for health care expenses. A single payer program would provide this kind of monopsony power to our federal government.

So, I’ll spare myself the anecdotal demagoguery this go ’round. There was a time when Huey Long/FDR style populism was what the doctor ordered. I don’t think that is the case today.

*This offer only applies to Logipundit Gold level members. Direct all inquiries about Gold and Platinum level membership with an email to the editor with credit card or routing and checking account number in the subject line.

LOS ANGELES (AP) - When no one would help a woman who lay bleeding on the floor of a troubled Los Angeles hospital’s emergency room, several people called 9-1-1 to get her moved to another hospital.

With the new movie “Sicko” coming out you will hear several horror stories such as this one in an attempt to convince the American public that Hillary care, or some variation, will solve all these problems. But, in essence, this story exemplifies the problem with socialized medicine. Martin Luther King Jr. Harbor Hospital is a public hospital, meaning it is funded by the government. If you want treatment for all Americans to look something like King-Harbor, or the VA system, tell your friends and relatives to watch Sicko and vote for Hillary Clinton for president.

Butch’s post below, which I’ve linked, is pretty interesting. I can vouch for the naps in Taiwan. I’m trying to make that happen here in Columbus, but to no avail. One thing to remember, they work long hours in Taiwan. If you have a 35 hour work-week, what’s the need for a nap?

LogiPundit: How They Do It Better

I will take issue with…uh, Mom with her reasoning behind Costa Rica’s long life expectancy. A quick look at Nationmaster indicates that Costa Rica (pop. 4 million) and the United States (300 + million) have equivalent life expectancies. A quick look at some other stats reveals some interesting findings. Costa Rica has a 50% higher infant mortality rate than the U.S. and a maternal mortality rate (deaths at childbirth) that is 3 times that of the U.S. There is also a greater chance an toddler makes it to 5 years in the U.S., etc.

A fairer barometer may be to compare Costa Rica to other Central American countries, but since Costa Rica has historically been better off than it’s neighbors (hence the name), I don’t think universal health care is the cause of better life expectancy there, but rather universal health care is an effect of relatively well off and small society. I am more inclined to believe the underlying diet of Costa Ricans does play a role in their life expectancy. 30% of Americans are considered obese, whereas Costa Rica doesn’t even have the stat (no doubt it is much lower).

All that to say I don’t think Costa Rica health care systems is necessarily a cause of higher life expectancy, and thus Hillary care/Universal coverage is not the answer here in the US.

I was impressed with the Bush health care proposal mentioned in the SOTU address last night (although $15,000 may be too high for the amount of the deduction) . His plan would hopefully move health-care purchasing decisions from HR departments to the individual level. I believe it would result in a far greater selection of plans and better cost control. Elegantly simple.

Not very impressed with the remainder of his speech, though.