A few of the many morsels of nonsense in that article:
Williamson first complains that we spend a lot of money on Medicaid:
we manage to spend a figure approaching a half-trillion dollars per annum on Medicaid
and then asserts that Medicaid is of no benefits to recipients, because health care providers won’t accept it:
… medical professionals who have a choice increasingly refuse to take on Medicaid patients. Subsidized access to a doctor who categorically refuses to see you is of no benefit to poor people who need medical treatment
Of course if there weren’t doctors/clinics/pharmacies/nursing homes/etc. billing for the care they are providing to Medicaid recipients, we wouldn’t be spending $400B/year on Medicaid! It’s logic worthy of Yogi Berra (“No one goes to that restaurant anymore, it’s too crowded”).
competition would draw more resources into health insurance and, more important, into health care itself.
Most people think it’s a problem that we devote 18% of our national economic resources to health care; no other country comes close. And Williamson is arguing that we should spend even more.
there was a role for government activism as well, for instance President Lincoln’s enthusiasm for “internal improvements” but these days such investments too often take the form of payoffs to political cronies such as public-sector unions and politically connected businesses
It’s hard to imagine a more historically ignorant argument. The sort of corruption that Williamson decries was so routine in Lincoln’s day that it wasn’t even considered corrupt. Remember the scene in Lincoln where the Missouri petitioner asks Lincoln for the restoration of his hereditary right to the tollbooth that Andrew Jackson gave his father? Multiply that thousands-fold. The Transcontinental railroad was a complete boondoggle, enriching the politically-connected railroad managers while wiping out their shareholders (every major railroad went bankrupt after its managers had looted the coffers) and requiring massive government subsidies (without which cross-country freight shipments were for years even more expensive than sailing around Cape Horn). And Williamson holds that period up as the good old days when government infrastructure investment wasn’t corrupt!
conservatives interested in such “internal improvements” as expanding domestic energy production or supplementing the existing electricity-generating infrastructure with nuclear power — excellent investments both, requiring very little beyond getting government out of investors’ way — run into adamantine opposition from the very people who claim to be looking for ways to invest in the future of our economy.
The stimulus bill included $8B (that’s 16 Solyndras) in loan guarantees for new nuclear plants, but even with that sort of lavish subsidy the DOE can’t find any takers.
Food stamps did not make food plentiful and cheap; more farmland, better irrigation systems, Monsanto lab geeks, and GPS-enabled combines did that.
Those lab geeks and irrigation system implementors were educated in government-provided schools and universities, assisted by government-paid agronomists and farm extension bureaus, and those combines are guided by government-provided GPS satellites. Where the state’s historic role in economic development is concerned, Williamson has blinders on.
Moving money around, whether the pot says “health care” or “education,” does not expand wealth, wealth being the available supply of goods and services
Does Williamson really want to argue that the government “moving money around” to create universal free public K-12 education and public community colleges and universities did nothing to expand wealth in this country? Wow.
I hope he’ll next tell us about the much wealthier countries who were never so foolish as to move money around for public spending on “health care” or “education”.
Mike Markkula, who was rich enough to be retired at 32, could have paid an extra $250,000 in taxes in 1977 — something closer to “his fair share” as President Obama might put it
What a terrible example. The top bracket in 1977 was 70%. If Markkula’d spent “something closer to his fair share” of his marginal dollar on taxes as defined by Obama today (i.e. 39.6%), he’d have had a lot more money to invest.
And Williamson is arguing that we should spend even more.
My econ class taught that competition drives prices down. Why would you interpret KW’s statement as an argument to spend more?
The stimulus bill included $8B (that’s 16 Solyndras) in loan guarantees for new nuclear plants, but even with that sort of lavish subsidy the DOE can’t find any takers.
Interesting that you would point that out, given the regulatory abuse from other government agencies that are the real obstacle to nuclear plant construction.
Where the state’s historic role in economic development is concerned, Williamson has blinders on.
You are the one with blinders if you think the state’s ever growing role in economic development will generate anywhere near the advances that a freer market delivered in yesteryear.
Does Williamson really want to argue that the government “moving money around” to create universal free public K-12 education and public community colleges and universities did nothing to expand wealth in this country? Wow.
The government best expands wealth by getting out of the way. Education is about the best example anyone could provide that government involvement stymies real improvement. But I am sure that Obamacare will eclipse the education example pretty fast.
The top bracket in 1977 was 70%
There were a LOT more deductions allowed in 1977, and I would expect that this individual hired someone to legally minimize his tax bill according to the law, and I bet the percentage he paid then is still lower than what he would have to pay with today’s tax code.
Why would you interpret KW’s statement as an argument to spend more?
Because he wrote that his preferred policies would “draw more resources” into health care.
The government best expands wealth by getting out of the way.
If that simple rule of thumb was really true the wealthiest countries would be the ones with the least intrusive governments. That isn’t the case today, and hasn’t been the case historically.
You seem to have forgotten about the first 100 or so years of this country.
Nobody believes your BS talking points Jim.
Here’s an example why:
You say:
“and then asserts that Medicaid is of no benefits to recipients, because health care providers won’t accept it:”
And then you quote the guy…who never said that:
“… medical professionals who have a choice increasingly refuse to take on Medicaid patients. Subsidized access to a doctor who categorically refuses to see you is of no benefit to poor people who need medical treatment”
“..because health care providers won’t accept it.” is a blanket statement and the guy didn’t say that. Not in the least.
Strawmen is reason number 273 why no one believes your BS talking points any more.
“..because health care providers won’t accept it.” is a blanket statement and the guy didn’t say that. Not in the least.
“No health care providers will accept it” is a blanket statement. “Health care providers won’t accept it” isn’t.
Williamson wrote that providers “increasingly refuse to take on Medicaid patients”. He thinks it’s a problem that health care providers won’t accept Medicaid. He also thinks it’s a problem that Medicaid sends $400B to health care providers that do accept it. He wants it both ways, like the women in the Woody Allen joke who complain that their food is terrible, and the portions are too small.
If it really is a problem that Medicaid recipients can’t get treatment because doctors won’t see them, then fixing that problem would mean more Medicaid spending. If Medicaid spending was reduced, recipients would find it even harder to get care. So does Williamson want less Medicaid spending, or for Medicaid recipients to have better access to care? His critique is incoherent, because he wants it both ways.
No matter how you spin it, he didn’t say what you claimed he said. As to Medicare and Medicaid, I think for most of the US, except possibly some low living cost areas, it will be a race to the lowest common denominator, leaving only the businesses that will specialize in milking such patients. Bottom line, if you’re poor, you still will get the worst care and Medicaid/Medicare will be the new uninsured.
“and then asserts that Medicaid is of no benefits to recipients, because health care providers won’t accept it:”
A lot of doctors don’t accept Medicaid patients because the government keeps jerking them around. It is hard to find healthcare while on Medicaid. Your options are very limited.
I am sure a lot of people who were recently forced onto Medicaid would rather have regular health insurance but due to rising Obamacare premiums, they were priced out. I bet a lot of these people had insurance prior to Obamacare too. If you go through the Obamacare exchanges, you have to take what they give you. The only other option is to buy insurance direct from an insurer. The prices of low end plans skyrocketed and why wouldn’t they? These are the ones that are supposed to get that free government money.
Remember the base price of any commodity will rise to the minimum subsidy.
Sigh. Others have fisked this well, but a comment:
My biggest complaint about today’s liberals is that they have not had an original thought in fifty years. If universal education is a good idea, then it cannot be that doing more of what we’ve been doing can possibly make it worse. If providing health care to those who can’t afford is a good idea, it can’t possibly be that Medicaid may create a situation where good doctors won’t treat poor people. If in the 60s racists were trying to stop blacks from voting, that must be what’s happening with voter IDs as well. Etc.
A question: Can someone believe in both these statements, or are they contradictory? 1) It is appropriate for the US federal government to run the Coast Guard and help build the interstate highway system. 2) The United States federal government is currently controlled by politically connected special interests, is acting as a conduit to funnel money from middle-class taxpayers to the special interests that control it, and is right now more barnacles than ship. It is currently very difficult for that government to get anything worthwhile done.
Is it possible for a rational person to believe both of them? In fact, don’t most rational people conservative or liberal believe both?
And if they do, what are they arguing about? It isn’t proposition (1) (which makes it seem odd that so many liberals quote it as proof of something). It isn’t even (2), as everyone basically agrees on that as well. It’s a corollary of (2): Given that that is so, we should be very reluctant to put the US federal government in charge of anything important.
I am sorry. I share your concern for the sick poor people of America. You aren’t going to be able to help them this way. Regardless of your plans and intentions, what you _actually end up with_ will be far more costly, far more cumbersome, and will kill far more people than it helps. The rules created will all be the result of political deals somewhere in Washington, nothing to do with what American health care needs. Perhaps you’ve noticed that this is happening already. I work at one of the premier teaching and research hospitals in America, and I can already see how we are diverting resources to handle edicts from Washington that force us to do things that aren’t good ideas for us. And we’re huge; we can handle it. Smaller hospitals will get killed, and so will medical practices. Doctors will shift to concierge practices where the patients are 100% responsible for dealing with insurance. Some of my doctors already have. All the lucky people who can now get insurance for the first time may find that they simultaneously cannot get doctors or hospitals.
That’s all assuming that they eventually get their system working properly. Have you noticed yet that they are incompetent?
what are they arguing about? It isn’t proposition (1)
If so, Williamson could use a reminder. His blanket dismissal of any “moving money around” is an argument against proposition (1).
It isn’t even (2), as everyone basically agrees on that as well
I’d say that it’s wildly overstated. The federal government’s three biggest spending items are Social Security, defense, and Medicare. SS and Medicare aren’t “conduits to funnel money from middle-class taxpayers to the special interests that control it”. Being over 65 isn’t special, almost everyone does it eventually. Defense is a closer call, but the people most inclined to believe proposition (2) are probably least inclined to consider defense a special interest. And if those three items, making up most of the federal budget, are not “conduits to funnel money from middle-class taxpayers to the special interests that control it”, proposition (2) is unsupportable.
It’s a corollary of (2): Given that that is so, we should be very reluctant to put the US federal government in charge of anything important.
Rational people can and do disagree. If a goal is important, the question is who can do it best. If the goal is: develop consumer products that people want to buy, the answer is the private sector. If the goal is: defend the country, or reduce elder poverty, or give poor people access to health care, the answer is probably the government. Both have their strengths and weaknesses, both have their place.
Now that the US is mostly out of Iraq we may need a new name for Bagdad Jim, but then again who cares? Just more straw men.
Jackboot Jim.
Rand links to some real whoppers, but this one takes the cake.
KDW decides his job is to attack Asaf Mondvi and Medicaid.
That’s okay, but, 30 seconds of google kind of pokes holes in his argument.
Tennessee Medicaid won’t cover you if you are over 19 or without cancer if you have any sort of job.
so making Minimum wage puts you over the Medicaid limit.
I’m not sure what point you’re trying to make as you never state what is Willaimson’s whooper. However your comment about Tennessee not covering someone over age 19 with any sort of job is disproven in the first table at the link you provide. Again, I don’t know what that has to do with Rand’s linked article, but it wasn’t difficult to find a fault in your assertion.
The reason we spend 18% is because it’s an unlimited sink.
People can reach saturation on food, clothing and housing. Not that you -couldn’t- spend more, but that you don’t feel a burning need to eat like the President, dress like the First Lady, etc.
But presented “There’s an operation that might extend your life a year or two – that someone else will pay for”, people say yes. Even when it’s mind-bogglingly expensive.
And we’re approaching even deeper plausible spending. While disassociating any possible pricing disincentives. Like complete morons.
Which just goes to show that medicine isn’t a free market. Only licensed MD’s can participate.
There is no price transparency. Consumers know very little. There is very
little substitution.
People can reach saturation on food, clothing and housing. Not that you -couldn’t- spend more, but that you don’t feel a burning need to eat like the President, dress like the First Lady, etc.
Ever seen a woman’s shoe closet? Or her purse collection?
I’m not sayin’, I’m just sayin’…
” – that someone else will pay for”
That’s at the core of the problem. Many of us would spend a lot more on food, cloths, [fill in the blank] if someone else were footing the bill. When we pay out of pocket we make choices about price vs. value. When we get value without (visible) cost, demand goes up insanely.
but medicaid doesnt cover the working poor.
Do you understand what insurance is? I don’t think you do.
The best Anti-poverty agenda is:
1) Heavy advertising exhorting people to:
– finish high school
– do not make any babies unless you are established in life
– Stick with the family if you do make a baby
– Point out that no matter how terrible the school system is, if you work at it you can get straight A’s
– that will get you accepted into any community college – maybe even with a scholarship
– cycle of poverty for you and your family is over
2) Take care of the people who are truly needy
A push away from over-priced colleges and universities, in addition to a reduction in the insane student aid policies (Obama’s FAFSA speech the other day irritated me to no end), would be a good addition to point #1 in your 2-part plan.
See also: just about any recent article about skilled labor shortages, interviews with Mike Rowe, etc.
Johnny,
You make good points. I spent 6 years in a 4 year University getting a Bachelor’s in Aerospace Engineering and a Bachelor’s in Computer Science. I’ve written in this blog, previously, that if I had it to do all over again, I would have gone to a Community college to get those first two years checked off. Then completed the last 4 at the University. Would have been cheaper and less pressurized.
And yeah there’s a whole other aspect of which I’m less familiar with:
It seems we need better trade schools and also to disabuse the populace of the notion that the only way to make a good living is with a 4 year University degree. IIRC, Germany has a pretty good trade school system but I’ve not read much about it.
Also, don’t smoke.
Williamson’s comments on agriculture and health care are particularly ridiculous. Food is plentiful and cheap because agriculture has become fantastically more productive: we grow much more food than a century ago, with a tiny fraction of the number of agricultural workers. Per-worker food production has skyrocketed.
To translate that example to health care would mean making doctors and nurses dramatically more productive, able to care for hundreds of patients in the time it currently takes them to care for one. If someone could figure out how to do that (robotics, miracle drugs, nanotech, …) that’d be wonderful, but it’d mean many fewer doctors, nurses, etc. So it makes no sense that Williamson calls for health care “abundance” with more highly-paid doctors, and more spending on health care.
The thing we actually want to be abundant is good health. Sometimes that means spending less — if everyone stopped smoking tomorrow, we’d spend less on tobacco, cardiologists, oncologists, surgeons, etc., but we’d have more good health. If someone came up with a miracle drug for Alzheimer’s we’d spend a bit more on that drug, and a lot less on neurologists, nursing homes, personal care attendants, etc., but we’d have more good health.
The most productive medical system in the US is the VA.
The doctors don’t worry about malpractice or billing.
A patient comes in, they treat as they see best, they use computerized records.
It’s very star trek.
The doctors don’t worry about malpractice or billing.
Indeed. When you remove the harm of malpractice lawsuits, the cost of care goes down. This is why Republicans wanted Tort reform rather than Obamacare. When you point to any socialized program in any other country that supposedly “works”, at its heart is a modification of malpractice laws that allow a board to determine settlements and not a jury. This prevents multi million winfall lawsuits that enrich lawyers like John Edwards but do little for patients. Without Tort reform, healthcare providers at all levels (nurse, doctor, hospital, insurers) will hedge against lawsuits by taking extra precautions which are often unnecessary to prevent the 10% or less scenario that a bad outcome will occur and turn into a lawsuit.
One reason Obamacare is destined to fail (and it was always designed to fail) is it doesn’t indemnify doctors or insurers the way other nations with socialized healthcare do. So you can have Sandra Fluke’s suing for care that doesn’t need an insurance to provide, and lawyers can still sue gynecologists that didn’t prevent the birth defects of a child born to a drug addicted mom.
Nobody here believes your BS talking points any more.
You skew the content of the articles you cite.
When I first saw this post, without looking at the comments, I knew the Footie Pajama Brigade of Ever-Loyal Serfs would be checking in And sure enough: Baghdad Jim was the first person to post! Anything that even seems to threaten the rob-Peter-to-provide-free-stuff-for-Paul racket gives them conniptions.
Imagine you’re 18 years old. You have the grades. You have the inclination. You choose to go to business school instead of pre-med. Someone asks you: would more government spending on healthcare change your mind?
What would you say? How could you possibly explain to this ignoramus that that’s exactly why you’re not going into medicine?
Note: this is not meant imply that one choice is somehow inferior to the other. You’re just more likely to find economically literate people going to business school.
A few of the many morsels of nonsense in that article:
Williamson first complains that we spend a lot of money on Medicaid:
we manage to spend a figure approaching a half-trillion dollars per annum on Medicaid
and then asserts that Medicaid is of no benefits to recipients, because health care providers won’t accept it:
… medical professionals who have a choice increasingly refuse to take on Medicaid patients. Subsidized access to a doctor who categorically refuses to see you is of no benefit to poor people who need medical treatment
Of course if there weren’t doctors/clinics/pharmacies/nursing homes/etc. billing for the care they are providing to Medicaid recipients, we wouldn’t be spending $400B/year on Medicaid! It’s logic worthy of Yogi Berra (“No one goes to that restaurant anymore, it’s too crowded”).
competition would draw more resources into health insurance and, more important, into health care itself.
Most people think it’s a problem that we devote 18% of our national economic resources to health care; no other country comes close. And Williamson is arguing that we should spend even more.
there was a role for government activism as well, for instance President Lincoln’s enthusiasm for “internal improvements” but these days such investments too often take the form of payoffs to political cronies such as public-sector unions and politically connected businesses
It’s hard to imagine a more historically ignorant argument. The sort of corruption that Williamson decries was so routine in Lincoln’s day that it wasn’t even considered corrupt. Remember the scene in Lincoln where the Missouri petitioner asks Lincoln for the restoration of his hereditary right to the tollbooth that Andrew Jackson gave his father? Multiply that thousands-fold. The Transcontinental railroad was a complete boondoggle, enriching the politically-connected railroad managers while wiping out their shareholders (every major railroad went bankrupt after its managers had looted the coffers) and requiring massive government subsidies (without which cross-country freight shipments were for years even more expensive than sailing around Cape Horn). And Williamson holds that period up as the good old days when government infrastructure investment wasn’t corrupt!
conservatives interested in such “internal improvements” as expanding domestic energy production or supplementing the existing electricity-generating infrastructure with nuclear power — excellent investments both, requiring very little beyond getting government out of investors’ way — run into adamantine opposition from the very people who claim to be looking for ways to invest in the future of our economy.
The stimulus bill included $8B (that’s 16 Solyndras) in loan guarantees for new nuclear plants, but even with that sort of lavish subsidy the DOE can’t find any takers.
Food stamps did not make food plentiful and cheap; more farmland, better irrigation systems, Monsanto lab geeks, and GPS-enabled combines did that.
Those lab geeks and irrigation system implementors were educated in government-provided schools and universities, assisted by government-paid agronomists and farm extension bureaus, and those combines are guided by government-provided GPS satellites. Where the state’s historic role in economic development is concerned, Williamson has blinders on.
Moving money around, whether the pot says “health care” or “education,” does not expand wealth, wealth being the available supply of goods and services
Does Williamson really want to argue that the government “moving money around” to create universal free public K-12 education and public community colleges and universities did nothing to expand wealth in this country? Wow.
I hope he’ll next tell us about the much wealthier countries who were never so foolish as to move money around for public spending on “health care” or “education”.
Mike Markkula, who was rich enough to be retired at 32, could have paid an extra $250,000 in taxes in 1977 — something closer to “his fair share” as President Obama might put it
What a terrible example. The top bracket in 1977 was 70%. If Markkula’d spent “something closer to his fair share” of his marginal dollar on taxes as defined by Obama today (i.e. 39.6%), he’d have had a lot more money to invest.
And Williamson is arguing that we should spend even more.
My econ class taught that competition drives prices down. Why would you interpret KW’s statement as an argument to spend more?
The stimulus bill included $8B (that’s 16 Solyndras) in loan guarantees for new nuclear plants, but even with that sort of lavish subsidy the DOE can’t find any takers.
Interesting that you would point that out, given the regulatory abuse from other government agencies that are the real obstacle to nuclear plant construction.
Where the state’s historic role in economic development is concerned, Williamson has blinders on.
You are the one with blinders if you think the state’s ever growing role in economic development will generate anywhere near the advances that a freer market delivered in yesteryear.
Does Williamson really want to argue that the government “moving money around” to create universal free public K-12 education and public community colleges and universities did nothing to expand wealth in this country? Wow.
The government best expands wealth by getting out of the way. Education is about the best example anyone could provide that government involvement stymies real improvement. But I am sure that Obamacare will eclipse the education example pretty fast.
The top bracket in 1977 was 70%
There were a LOT more deductions allowed in 1977, and I would expect that this individual hired someone to legally minimize his tax bill according to the law, and I bet the percentage he paid then is still lower than what he would have to pay with today’s tax code.
Why would you interpret KW’s statement as an argument to spend more?
Because he wrote that his preferred policies would “draw more resources” into health care.
The government best expands wealth by getting out of the way.
If that simple rule of thumb was really true the wealthiest countries would be the ones with the least intrusive governments. That isn’t the case today, and hasn’t been the case historically.
You seem to have forgotten about the first 100 or so years of this country.
Nobody believes your BS talking points Jim.
Here’s an example why:
You say:
“and then asserts that Medicaid is of no benefits to recipients, because health care providers won’t accept it:”
And then you quote the guy…who never said that:
“… medical professionals who have a choice increasingly refuse to take on Medicaid patients. Subsidized access to a doctor who categorically refuses to see you is of no benefit to poor people who need medical treatment”
“..because health care providers won’t accept it.” is a blanket statement and the guy didn’t say that. Not in the least.
Strawmen is reason number 273 why no one believes your BS talking points any more.
“..because health care providers won’t accept it.” is a blanket statement and the guy didn’t say that. Not in the least.
“No health care providers will accept it” is a blanket statement. “Health care providers won’t accept it” isn’t.
Williamson wrote that providers “increasingly refuse to take on Medicaid patients”. He thinks it’s a problem that health care providers won’t accept Medicaid. He also thinks it’s a problem that Medicaid sends $400B to health care providers that do accept it. He wants it both ways, like the women in the Woody Allen joke who complain that their food is terrible, and the portions are too small.
If it really is a problem that Medicaid recipients can’t get treatment because doctors won’t see them, then fixing that problem would mean more Medicaid spending. If Medicaid spending was reduced, recipients would find it even harder to get care. So does Williamson want less Medicaid spending, or for Medicaid recipients to have better access to care? His critique is incoherent, because he wants it both ways.
No matter how you spin it, he didn’t say what you claimed he said. As to Medicare and Medicaid, I think for most of the US, except possibly some low living cost areas, it will be a race to the lowest common denominator, leaving only the businesses that will specialize in milking such patients. Bottom line, if you’re poor, you still will get the worst care and Medicaid/Medicare will be the new uninsured.
“and then asserts that Medicaid is of no benefits to recipients, because health care providers won’t accept it:”
A lot of doctors don’t accept Medicaid patients because the government keeps jerking them around. It is hard to find healthcare while on Medicaid. Your options are very limited.
I am sure a lot of people who were recently forced onto Medicaid would rather have regular health insurance but due to rising Obamacare premiums, they were priced out. I bet a lot of these people had insurance prior to Obamacare too. If you go through the Obamacare exchanges, you have to take what they give you. The only other option is to buy insurance direct from an insurer. The prices of low end plans skyrocketed and why wouldn’t they? These are the ones that are supposed to get that free government money.
Remember the base price of any commodity will rise to the minimum subsidy.
Sigh. Others have fisked this well, but a comment:
My biggest complaint about today’s liberals is that they have not had an original thought in fifty years. If universal education is a good idea, then it cannot be that doing more of what we’ve been doing can possibly make it worse. If providing health care to those who can’t afford is a good idea, it can’t possibly be that Medicaid may create a situation where good doctors won’t treat poor people. If in the 60s racists were trying to stop blacks from voting, that must be what’s happening with voter IDs as well. Etc.
A question: Can someone believe in both these statements, or are they contradictory? 1) It is appropriate for the US federal government to run the Coast Guard and help build the interstate highway system. 2) The United States federal government is currently controlled by politically connected special interests, is acting as a conduit to funnel money from middle-class taxpayers to the special interests that control it, and is right now more barnacles than ship. It is currently very difficult for that government to get anything worthwhile done.
Is it possible for a rational person to believe both of them? In fact, don’t most rational people conservative or liberal believe both?
And if they do, what are they arguing about? It isn’t proposition (1) (which makes it seem odd that so many liberals quote it as proof of something). It isn’t even (2), as everyone basically agrees on that as well. It’s a corollary of (2): Given that that is so, we should be very reluctant to put the US federal government in charge of anything important.
I am sorry. I share your concern for the sick poor people of America. You aren’t going to be able to help them this way. Regardless of your plans and intentions, what you _actually end up with_ will be far more costly, far more cumbersome, and will kill far more people than it helps. The rules created will all be the result of political deals somewhere in Washington, nothing to do with what American health care needs. Perhaps you’ve noticed that this is happening already. I work at one of the premier teaching and research hospitals in America, and I can already see how we are diverting resources to handle edicts from Washington that force us to do things that aren’t good ideas for us. And we’re huge; we can handle it. Smaller hospitals will get killed, and so will medical practices. Doctors will shift to concierge practices where the patients are 100% responsible for dealing with insurance. Some of my doctors already have. All the lucky people who can now get insurance for the first time may find that they simultaneously cannot get doctors or hospitals.
That’s all assuming that they eventually get their system working properly. Have you noticed yet that they are incompetent?
what are they arguing about? It isn’t proposition (1)
If so, Williamson could use a reminder. His blanket dismissal of any “moving money around” is an argument against proposition (1).
It isn’t even (2), as everyone basically agrees on that as well
I’d say that it’s wildly overstated. The federal government’s three biggest spending items are Social Security, defense, and Medicare. SS and Medicare aren’t “conduits to funnel money from middle-class taxpayers to the special interests that control it”. Being over 65 isn’t special, almost everyone does it eventually. Defense is a closer call, but the people most inclined to believe proposition (2) are probably least inclined to consider defense a special interest. And if those three items, making up most of the federal budget, are not “conduits to funnel money from middle-class taxpayers to the special interests that control it”, proposition (2) is unsupportable.
It’s a corollary of (2): Given that that is so, we should be very reluctant to put the US federal government in charge of anything important.
Rational people can and do disagree. If a goal is important, the question is who can do it best. If the goal is: develop consumer products that people want to buy, the answer is the private sector. If the goal is: defend the country, or reduce elder poverty, or give poor people access to health care, the answer is probably the government. Both have their strengths and weaknesses, both have their place.
Now that the US is mostly out of Iraq we may need a new name for Bagdad Jim, but then again who cares? Just more straw men.
Jackboot Jim.
Rand links to some real whoppers, but this one takes the cake.
KDW decides his job is to attack Asaf Mondvi and Medicaid.
That’s okay, but, 30 seconds of google kind of pokes holes in his argument.
http://www.tn.gov/tenncare/forms/eligibilityrefguide.pdf
Tennessee Medicaid won’t cover you if you are over 19 or without cancer if you have any sort of job.
so making Minimum wage puts you over the Medicaid limit.
I’m not sure what point you’re trying to make as you never state what is Willaimson’s whooper. However your comment about Tennessee not covering someone over age 19 with any sort of job is disproven in the first table at the link you provide. Again, I don’t know what that has to do with Rand’s linked article, but it wasn’t difficult to find a fault in your assertion.
The reason we spend 18% is because it’s an unlimited sink.
People can reach saturation on food, clothing and housing. Not that you -couldn’t- spend more, but that you don’t feel a burning need to eat like the President, dress like the First Lady, etc.
But presented “There’s an operation that might extend your life a year or two – that someone else will pay for”, people say yes. Even when it’s mind-bogglingly expensive.
And we’re approaching even deeper plausible spending. While disassociating any possible pricing disincentives. Like complete morons.
Which just goes to show that medicine isn’t a free market. Only licensed MD’s can participate.
There is no price transparency. Consumers know very little. There is very
little substitution.
People can reach saturation on food, clothing and housing. Not that you -couldn’t- spend more, but that you don’t feel a burning need to eat like the President, dress like the First Lady, etc.
Ever seen a woman’s shoe closet? Or her purse collection?
I’m not sayin’, I’m just sayin’…
” – that someone else will pay for”
That’s at the core of the problem. Many of us would spend a lot more on food, cloths, [fill in the blank] if someone else were footing the bill. When we pay out of pocket we make choices about price vs. value. When we get value without (visible) cost, demand goes up insanely.
but medicaid doesnt cover the working poor.
Do you understand what insurance is? I don’t think you do.
The best Anti-poverty agenda is:
1) Heavy advertising exhorting people to:
– finish high school
– do not make any babies unless you are established in life
– Stick with the family if you do make a baby
– Point out that no matter how terrible the school system is, if you work at it you can get straight A’s
– that will get you accepted into any community college – maybe even with a scholarship
– cycle of poverty for you and your family is over
2) Take care of the people who are truly needy
A push away from over-priced colleges and universities, in addition to a reduction in the insane student aid policies (Obama’s FAFSA speech the other day irritated me to no end), would be a good addition to point #1 in your 2-part plan.
See also: just about any recent article about skilled labor shortages, interviews with Mike Rowe, etc.
Johnny,
You make good points. I spent 6 years in a 4 year University getting a Bachelor’s in Aerospace Engineering and a Bachelor’s in Computer Science. I’ve written in this blog, previously, that if I had it to do all over again, I would have gone to a Community college to get those first two years checked off. Then completed the last 4 at the University. Would have been cheaper and less pressurized.
And yeah there’s a whole other aspect of which I’m less familiar with:
It seems we need better trade schools and also to disabuse the populace of the notion that the only way to make a good living is with a 4 year University degree. IIRC, Germany has a pretty good trade school system but I’ve not read much about it.
Also, don’t smoke.
Williamson’s comments on agriculture and health care are particularly ridiculous. Food is plentiful and cheap because agriculture has become fantastically more productive: we grow much more food than a century ago, with a tiny fraction of the number of agricultural workers. Per-worker food production has skyrocketed.
To translate that example to health care would mean making doctors and nurses dramatically more productive, able to care for hundreds of patients in the time it currently takes them to care for one. If someone could figure out how to do that (robotics, miracle drugs, nanotech, …) that’d be wonderful, but it’d mean many fewer doctors, nurses, etc. So it makes no sense that Williamson calls for health care “abundance” with more highly-paid doctors, and more spending on health care.
The thing we actually want to be abundant is good health. Sometimes that means spending less — if everyone stopped smoking tomorrow, we’d spend less on tobacco, cardiologists, oncologists, surgeons, etc., but we’d have more good health. If someone came up with a miracle drug for Alzheimer’s we’d spend a bit more on that drug, and a lot less on neurologists, nursing homes, personal care attendants, etc., but we’d have more good health.
The most productive medical system in the US is the VA.
The doctors don’t worry about malpractice or billing.
A patient comes in, they treat as they see best, they use computerized records.
It’s very star trek.
The doctors don’t worry about malpractice or billing.
Indeed. When you remove the harm of malpractice lawsuits, the cost of care goes down. This is why Republicans wanted Tort reform rather than Obamacare. When you point to any socialized program in any other country that supposedly “works”, at its heart is a modification of malpractice laws that allow a board to determine settlements and not a jury. This prevents multi million winfall lawsuits that enrich lawyers like John Edwards but do little for patients. Without Tort reform, healthcare providers at all levels (nurse, doctor, hospital, insurers) will hedge against lawsuits by taking extra precautions which are often unnecessary to prevent the 10% or less scenario that a bad outcome will occur and turn into a lawsuit.
One reason Obamacare is destined to fail (and it was always designed to fail) is it doesn’t indemnify doctors or insurers the way other nations with socialized healthcare do. So you can have Sandra Fluke’s suing for care that doesn’t need an insurance to provide, and lawyers can still sue gynecologists that didn’t prevent the birth defects of a child born to a drug addicted mom.
Nobody here believes your BS talking points any more.
You skew the content of the articles you cite.
When I first saw this post, without looking at the comments, I knew the Footie Pajama Brigade of Ever-Loyal Serfs would be checking in And sure enough: Baghdad Jim was the first person to post! Anything that even seems to threaten the rob-Peter-to-provide-free-stuff-for-Paul racket gives them conniptions.
Imagine you’re 18 years old. You have the grades. You have the inclination. You choose to go to business school instead of pre-med. Someone asks you: would more government spending on healthcare change your mind?
What would you say? How could you possibly explain to this ignoramus that that’s exactly why you’re not going into medicine?
Note: this is not meant imply that one choice is somehow inferior to the other. You’re just more likely to find economically literate people going to business school.