Tuesday, August 25, 2009

A letter to the Sioux Falls Argus Leader has me seeking Dr. Kevorkian in my health plan.

From a real “Voice of the People” letter published in Tuesday’s Sioux Falls Argus Leader. I am leaving out the author’s name – s/he was arguing in favor of government health care reform, and making some decent points – but then wrote the following:

“Insurance companies follow the precept of ‘spread of risk.’ All insureds pay into the pot, and when financial disaster occurs such as a fire, the damaged party is rescued by having his or her loss paid from the pot. Sounds like socialism, doesn’t it? Or is it just socialism when the government is involved?”


Pant pant. Huff huff. OK, OK. I’m calmer now, dear writer. A privately chosen insurance plan that you can quit is not socialism. The worst it could be is a monopoly, if one company gets away with being the only one available, or a trust if there are several companies but they conspire to rig their rates. But we have laws against those anti-free market antics (laws which are a proper and useful function of government).

Are the American people as far gone as this example? Do we really believe that government – GOVERNMENT – is just a little mom & pop enterprise struggling to find its humble niche in the marketplace?

I really might need that Dr. Kevorkian visit if it’s covered… or maybe just a reread of the Bill of Rights is sufficient.


caheidelberger said...

Funny: my insurance company punishes me after I pay my money and I decide to use the service I've paid for. They jack up my premium or kick me out... and then I ahve no choice for getting a new policy thanks to my pre-existing condition.

You're right that private insurance is not technically socialism. But I'll take the reader's point that insurance is based on the idea that very few of us short of Denny Sanford can really afford our own medical care, and that bunches of us agree to solve the problem by throwing our money into collective pots. I'd just like the chance to create a big public collection pot. Heck, I'll even meet you half way and let you keep choosing your private insurance (funny, that's exactly what the current House bill, HR 3200, would let you do) while I and millions of my neighbors buy into a public option, Uncle Sam Insurance, that would give us more health care for the money (that 4% public overhead vs. 20-30% private overhead thing).

TLF+ said...

I get help that's only available because of Federal law. I don't think the market, left to itself, would respond effectively to our kid's autism (unless the expectation was that all families with autistic kids moved to a few clustered locales where private services emerged.) Granted, it's mostly an unfunded mandate that dumps the costs locally, but I have to admit that much of his care in life came via law passed in DC and carried out by government employees (poorly paid ones at that - Special Ed. teachers).

It doesn't change my reaction to the paragraph, though. The mechanism by which private companies conduct business with voluntary customers is not the same as a government program. The government can take money from other programs (eg from non-participants in a given program) to keep things artificially funded (nobody believes in a Social Security "lock box"... its as pourous as, well, a church budget!).

T. Denny can't go take money from Avera Heart Hospital to build his new Sanford Heart facility. That's one of several differences that makes "spread of risk" an apple and socialism an orange.

And why are we up so late?

TLF+ said...

PS - I hope you caught my earlier "death tax" post, which wasn't really about estate taxes at all but the confiscatory medical costs for end of life care. So, I'm not ideologically oppossed to reform.

The private coverage I have is good because there's a large shared risk pool of folks paying in. I understand your desire to create the same and, for places like SD with small, spread out population, a govt. plan would seem to make some sense.

I'm not one of his camp followers, but I have to agree with O'Reilly's recent point: the Administration has failed to come out with a compelling bullet-point list of what reforms it is after. "Reform" tells me no more than did "Change." And after the Stimulus bills were found packed with absurd portions of pork by this absurd Congress, we can't really expect the public to be as trusting on a bazillion page health act.

Anonymous said...

I keep hearing of the huge profits insurance companies make on health insurance and wonder where they get this figure. In almost every state the insurance commisioner requires the health insurance companies to pay out 85% of premiums collected on claims that leaves 15% for employee salaries and benefits and what ever profit they can achieve.

TLF+ said...

Hi, Art+,

Thanks for pointing that out.

Also, in response to Cory's first post about private medical overhead, a govt. plan won't have research and development or any number of other costs built in. I do p/t parking valet work for a hospital (it's how I have my medical coverage, which is better than the church plan relative to our family needs.) Valet parking makes life easier for the patients and families, esp. in harsh weather. How are valets paid? From that overhead that Cory mentions - and yet what we do is a valuable part of the patient care.

Yes, American CEOs are notorious for huge compensation packages compared to their counterparts in other places, so Cory has a point there.

Art+ and Cory combined do a good job showing that blanket condemnations of government or business are unhelpful to the health care debates. We need much more detail and less sloganeering, and the Administration and Congress have done very little to help.

If the politicians want the Town Hall antics to end, just put forward an understandable plan that can be debated on its specific provisions, not a murky appeal to "reform."

caheidelberger said...

Agreed, insurance ≠ socialism. And I did catch that earlier "death tax" post.

It's a complicated problem, requiring a complicated solution. Can you really fault the Democrats for not offering a simple bullet-point solution? Maybe it just won't boil down into a simple slogan or narrative... although if you want understandable, how about George McGovern's proposal for health coverage reform in one sentence: "Extend Medicare to everyone"?

TLF+ said...

I think multiple choices is the best solution, and I understand that in some settings, a government option will be the best available (and probably most realistic) choice.

What the Administration (I'm not sure I would say the Dems... I'm not convinced that Congress is working very cooperatively with the Pres. on this) needs to do right off is a better job of communicating the optional nature of the plan. I think you've done pretty well getting that across in these little comment boxes - the Pres. should be able to do the same!