Thursday, January 26, 2006

And bankrupt it is 

I sent a couple of comments this morning to Craig Westover on a piece in the morning paper he had read, and El Capitan Palito de pescado has used it to work over Laura Billings. It concerns her use of a study I find pretty crappy to make a case for single-payer health insurance. You can go read what I said, but first read what Craig said:
Medical bankruptcies hardly justify the call for Universal Health Care. Some quick calculations indicate that the total cost of the bankruptcy problem for individuals ($13,460 average outlay in medical bankruptcy filings times approximately 750,000 medical bankruptcies) means we're looking at about a $10 mbillion bankruptcy problem. That�s a far cry from the billions of dollars that Universal Health Care would cost, not to mention the inflationary effect on medical costs of �free� service.

As a country, we�d be better off cutting checks to seven-tenths of one percent of the population that are (a big leap here for the sake or argument) victims of market failure than we would be to turn everyone�s health care over to the same government implementing a square-wheel rollout of the prescription drug program.
And as I should have noted to Craig before, to get 750,000 bankruptcies requires extrapolating from a non-representative sample. It could be and probably is much less than a $10 mbillion problem. In no small part, it's because those who probably are most harmed by the lack of health insurance options never file bankruptcy anyway, because they have nothing to protect. It's a silly way to make the case for single-payer; a bankrupt idea.

Robert Samuelson hits the nail on the head: For most people, the system really isn't broke.
The reason is that most Americans don't want to fix the system in that sense. Most are satisfied with their care. Most don't see (or directly pay) the vast majority of their costs. Because politicians -- of both parties -- reflect public opinion, they won't do more than tinker.

Unfortunately Samuelson goes down the road of saying "experts know it really is, and our indifference is dangerous." Why? Because he says we want incompatible things: "(1) provide needed care to all people, regardless of income; (2) maintain our freedom to pick doctors and their freedom to recommend the best care for us; and (3) control costs." That idea, too, is bankrupt. I do not really want to provide you with needed care regardess of income, because to do so means I obligate others to take care of you. I don't have that right. I only want it because I don't bear the costs myself. Samuelson is correct in saying that "We need to reconnect people with the public consequences of their private acts." That's exactly right. Himmelstein's idea goes in the opposite, wrong direction.

CORRECTION: Doug S. points out that it should be billion, not million. I didn't review Craig's calculation but just copied it over. My bad, but it doesn't change how I think of this issue at all.

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