Tuesday, October 27, 2009

Another example of "Figures lie, and liars figure"

The Bogus Death Statistic That Won't Die:

Democratic Rep. Alan Grayson of Florida has found his calling: death demagogue. First, he accused Republicans of wanting sick patients to "die quickly." Next, he likened health insurance problems to a "holocaust in America." Now, he's unveiled a new website entitled "namesofthedead.com" in memory of the "more than 44,000 Americans [who] die simply because they have no health insurance."

Just one problem: The statistic is a phantom number. Grayson's memorial, like the Democrats' government health care takeover plan itself, is full of vapor. It comes from a study published this year in the American Journal of Public Health. But the science is infused with left-wing politics.

....

How did these political doctors come up with the 44,000 figure? They used data from a health survey conducted between 1988 and 1994. The questionnaires asked a sample of 9,000 participants whether they were insured and how they rated their own health. The federal Centers for Disease Control tracked the deaths of people in the sample group through the year 2000. Himmelstein, Woolhandler and company then crunched the numbers and attributed deaths to lack of health insurance for all the participants who initially self-reported that they had no insurance and then died for any reason over the 12-year tracking period.


This is the sort of data massage the CDC uses to inflate "childbirth" deaths -- they count any death of a woman who was pregnant or recently pregnant as a "childbirth" death, even if she just happened to be on the 98th floor of the World Trade Center on 9/11 on her first day back from maternity leave.

It works for the abortion lobby. Why not for the scaremongers trying to take away all our choices in health care?

46 comments:

Lauren said...

Well, not all our choices. We can still choose to kill our children, and they'll pay for it.

Lilliput said...

What are the numbers then? There are definately people dying in the states due to lack of health care - otherwise there wouldn't be such a big brouhaha. What do u say the numbers are?

Christina Dunigan said...

I don't know that we *have* numbers. There are some statistics that nobody's actually collecting. I get the feeling that, like "people who have died due to cat-related incidents", this is one area where nobody's documented it. And how could you? How could you tell if Joe Blow died from his cancer because he was uninsured, or he died from his cancer for the same reason he was uninsured -- he didn't trust doctors and wouldn't have visited one unless you held a gun to his head.

Kathy said...

Good point, Christina,

I don't know if my grandparents had health insurance or not. They were retired, so maybe had some sort of Medicare or AARP supplement or something, but by and large they didn't like doctors and didn't need doctors. They were frugal throughout their lives and died with ample money in the bank plus more assets in land, etc. Assuming they didn't have insurance, my grandpa's death due to colon cancer may have been counted as being due to lack of health insurance, when that was far from the case (even assuming he didn't have insurance).

Kathy said...

Lilliput, have you ever heard of the term "tempest in a teapot"? Sometimes people get themselves all worked up over something that is actually more fiction than fact. Looking at polling data over the course of the past several months has uncovered some interesting things, and that is, while there seems to be discontent over health insurance, which would seem to prove your point, most people are satisfied with their own insurance -- they just think there are others without choices, and think the system should be changed to help those people. (Even though many of the uninsured are there by choice -- they *could* pay for insurance if they wanted to).

Here's a hypothetical -- one person in a community dies due to lack of health insurance, and the whole community of 1,000 or 5,000 people becomes aware of that case. Well, those people will become more likely to start a brouhaha about "people dying due to lack of health insurance", and may make a big brouhaha, because they're the voices of thousands, when the total number of "people dying due to lack of health insurance" was just one.

You asked "what are the numbers?" I'd ask the same thing. Christina asks the same thing -- we're *all* asking the same thing. Nobody really knows how big the teacup is -- how many people are up in arms about themselves, or are carrying the banner for other people.

My gut feeling is that we've got a bunch of people at the top fomenting this tempest, getting people riled up, like you, over a situation which you don't really know much about, but they keep in the news as much as possible. And it sounds so altruistic -- "I'm ok... I'm just worried about my neighbor," -- which is where I think they're getting a good deal of their support -- from appealing to people's good nature, their soft side. It's like why you support abortion -- you'd rather have babies killed before they're born than to be left to die of exposure afterwards. It sounds good, somehow, to offer to kill a woman's baby so that she's not a single mother, held back by her baby from achieving educational or economic benefits. I will admit that there is a pull and an appeal to the "oh, these poor people dying without health insurance" mantra, but I don't think that going to socialized medicine is the answer. Which goes back to the people at the top fomenting this -- why are they fomenting it? You think it's because they love their fellow man, and are upset that there are people who are dying unnecessarily. I don't. I think they want America to be socialized, and they're breaking up their big agenda into smaller, more palatable, more acceptable bits, so that we'll swallow it one piece at a time, and wake up in the future completely socialized, without even knowing how we got there. And it's so the people at the top who are fomenting discontent now, can be the ones in control when power is all at the top, instead of being "of the people, by the people, and for the people" like our country used to be. It's all about power.

We don't want the government not to take over health insurance because we're mean and hateful and want our fellow citizens to die early deaths from not having health insurance (as I've pointed out previously, no health insurance does not equal no health care); we don't want the government to take over health insurance, because we don't want the government to be any bigger, but instead want it to be smaller.

Our Founding Fathers were very wise, and understood the nature of man, and the necessity of setting up a system of checks and balances, so that one branch of government couldn't get too much power, and also so that the government couldn't gain too much power over its people. That system is fast eroding, and rendering our Constitution worthless. And that bothers me. Not only because I'm patriotic, and value the Constitution, but also because of what the Constitution means, and what trampling on it does, to me, and to my whole country.

Tonal Bliss said...

OC, we are not ALL blind defenders of former President George W. Bush... There are certainly things that he has done that I disagree with.

OperationCounterstrike said...

Yes, SegaMon, but you (or at least some of you) are already trying to blame things on President Obama.

Regarding the number of deaths: frankly, I'm more interested in the three-quarters of a million people who are going bankrupt per year because of catastrophic illness.

We are pretty much the only industrialized nation where a series of heart attacks or a recurrent cancer or a traffic injury or an encounter with a tribe of street-goblins is a bankruptcy-risk as well as a disability-risk. We are also pretty much the only industrialized nation which allows health insurance to be a for-profit business. I don't think this is a coincidence (although statistics are not available, because we are alone in both categories). People of other industrialized nations, Canada and so forth, are afraid to vacation in USA, knowing that a hospitalization could bankrupt them.

Kathy said...

OC,

I'm going back to the 30s in the long discussion on socialism. Look up Fabian Socialists, if you're unfamiliar with the term. They've been at work for decades and will continue for decades, hoping to be the ones in power when their dreams are finally realized.

But since you bring up Obama -- the only good thing I can say, is that his feverish pace at dismantling the capitalistic system is fueling a conservative backlash, which I hope will restore the country to some sense of its roots. Many conservatives (probably including myself) were "asleep at the wheel" when RINOs ("Republicans in name only") came to power -- preferring the slower slide of liberals who happened to have an R after their name, rather than the quick slide of liberals who happen to have a D after their name. You can see the effect of this happening in the NY special election, in which many top Republicans are endorsing a 3rd-party candidate, rather than the liberal Republican candidate. I'm expecting this to go nation-wide soon.

Unknown said...

OC wrote:
People of other industrialized nations, Canada and so forth, are afraid to vacation in USA, knowing that a hospitalization could bankrupt them.

Which people? Who are they? What is the data to support your claim?

I work in Washington, DC. I used to work for the DC bureau of an international news agency. Now I work for a university. In both cases, the office was like a miniature United Nations. I have worked with people from India, England, Australia, Germany, New Zealand, Pakistan, and probably a few other countries that I'm forgetting. And none of them were fussing about the American healthcare system, at least not enough to make them want to leave the USA for another country. In fact, we have a lot of people coming here from other countries every day.

Your claim flies in the face of my own personal experience. I'm not saying that you're wrong for sure, because my own experience might not be typical. However, I'll need to see some proof.

army_wife said...

And what of the many people who come to the U.S. FROM Canada and other countries to obtain healthcare that they can't get in their own countries (or wouldn't be able to get in time to help them, due to long wait times etc.)?

Anonymous said...

The article Christina posted is written by Michelle Malkin, so it makes no attempt to rationally evaluate the research it purports to critique. In fact, Malkin misunderstands the distinction between cross-sectional and longitudinal analyses, so her criticisms about methodology are without any merit.

Kathy – you make several interesting claims:

My gut feeling is that we've got a bunch of people at the top fomenting this tempest, getting people riled up, like you, over a situation which you don't really know much about, but they keep in the news as much as possible.

Ok, so you think the facts that health care now consumes 16-18% of the GDP, and will likely double by 2020 are being fabricated, or not important. I would respond that it is you who are not fully aware of the problems with our current health care financing system.

I think they want America to be socialized, and they're breaking up their big agenda into smaller, more palatable, more acceptable bits, so that we'll swallow it one piece at a time, and wake up in the future completely socialized, without even knowing how we got there.

First, I don’t think you understand the difference between socialism (which is an economic system) and social insurance (which is a political system). Social insurance is NOT socialism. Not even close. Second, much of the US government has been a form of social insurance who a very long time. Social security for example.

We don't want the government not to take over health insurance because we're mean and hateful and want our fellow citizens to die early deaths from not having health insurance; we don't want the government to take over health insurance, because we don't want the government to be any bigger, but instead want it to be smaller.

I appreciate your honesty here. You admit you are driven by ideology, rather than any rational analysis of the current problem. Very few of your allies seem willing to admit that, and prefer to hide behind smoke screens using scare words like “socialism” and “death panels.”

chad

OperationCounterstrike said...

Michele Malkin--HAHAHAHHAA

Even Christina Dunigan should be embarrassed to cite her.

More later; now I have to go to work my own self.

OperationCounterstrike said...

You're telling ME about Fabian Socialism? Hey, I was arguing with Fabianists before you were conceived. Do you know the expression "You can't teach your grandmother to suck eggs"?

Kathy said...

Ok, so you think the facts that health care now consumes 16-18% of the GDP, and will likely double by 2020 are being fabricated, or not important.

I don't think it's unimportant; but I think what is important is finding out what is the reason of the high health care costs, and chipping away at the problem, not creating a bigger problem. What has caused heath care costs to skyrocket like they have since, say, the 1950s? One factor is undoubtedly better and more advanced health care, which is more expensive -- chemotherapy, MRIs, bypass surgery, heart transplants, etc. These things took money to develop, and take money to use.

Costs were lower when we died easier and younger. When Social Security was introduced in the 1930s, the age when benefits started was 65, because few people lived beyond that; now, life expectancy has risen quite a bit, and keeping our seniors healthy and alive is expensive. At the other end of the life spectrum, we're able to save babies who are born extremely premature, but not without a price tag.

This article, though very long, is very interesting -- "The Cost Conundrum: What a Texas town can teach us about health care." The author, Dr. Gawande, looks at McAllen, TX, which spends nearly double the national average on health care, and not only are the citizens not any better off, but they actually score worse in many measures of health. Some of the reasons for that are unprincipled doctors who order unnecessary tests because they get a fee for it; doctors fearful of getting sued for a test they didn't do; and patients feeling like they need to take advantage of every test available, "just in case."

Having "the insurance pay for it" has probably also increased the costs of health care -- there is no reason for them to forgo any test or intervention when "someone else" pays for it. My sister, as an example, had an ultrasound every prenatal visit with her 3rd child -- not because there was anything close to a medical reason for it, but because her health insurance paid for it, and it didn't cost her anything. Multiply $250 per u/s times 13 prenatal visits times 4 million births and you get $13 billion. *Some* ultrasounds are beneficial, identifying babies who need to be born early, or will need special care immediately after birth; but most are not. Even if you find a "need" for all these u/s, you can at least admit that that is a very large new expense that our country just did not have 30+ years ago. (U/s were done then, but it was uncommon unless there was a reason to suspect something was the matter.)

...much of the US government has been a form of social insurance who a very long time. Social security for example.
I include SS in socialism. They go hand in hand.

You admit you are driven by ideology, rather than any rational analysis of the current problem.
No, my ideology and rational analysis of problems work together to come to a solution. I doubt there is a thinking adult without an ideology, and anyone who claims otherwise is deceiving himself.

OperationCounterstrike said...

Kathy, two points.

1. You left out the MOST important reason health-care costs in USA keep going up: the baby-boomers are aging into their big-medical-spending years.

2. I'm glad you like Dr. Gawande's article. Can we agree that a President who likes that article enough to publically praise it and to make his entire health-care staff read it, is probably a good, smart President, and ought to be supported in his efforts, and re-elected? Since you like the article, you'd support the efforts of a President like that, right?

Oh, by the way, PRESIDENT OBAMA has made that article required-reading for his health-care staff, and publically called it his "favorite article on health-care".

OperationCounterstrike said...

Kathy, one more point. You wrote: "Many conservatives (probably including myself) were "asleep at the wheel" when RINOs ("Republicans in name only") came to power -- preferring the slower slide of liberals who happened to have an R after their name,"

Are you really unaware that the Republican Party used to contain a great many more moderates and liberals than it does today? In Ronald Reagan's time the moderate-to-liberal wing of the GOP was fully as big as the radical-right wing. Warren Rudman, Lincoln Chafee, William Weld, Pete Wilson, Arlen Specter, Al d'Amato, Slade Gordon, Jack Kemp, David Souter, even George Herbert W. Bush, before he flip-flopped in order to run with Reagan, was a pro-choice moderate. All gone now; the only reasonable Republicans left are the two Senators from Maine (Olympia Snowe and Susan Collins). The Republican Party is more monolithic, more extreme-right-only than at any other time in my lifetime. (The Republican Party is also SMALLER than at any other time--now only ONE IN FIVE Americans is Republican. Twenty percent. Rots of ruck on your comeback!)

Kathy said...

OC,

I figured you were familiar with the term, but there's only so much I know about you. You know the phrase, "You learn something new every day"? Well, there's always the possibility that Fabian socialism would be your "something new" for the day. I did say "if."

Re: point #1 -- correct, except I didn't totally leave it out. It's more or less comprehended in, "life expectancy has risen quite a bit, and keeping our seniors healthy and alive is expensive," although I did not mention Baby Boomers by name.

Re: #2 -- not necessarily. It's one thing to agree with information presented; it's another thing to agree on what to do about that information. You and I both agree that abortion is killing a human; you think it's justifiable homicide while I think it's murder.

Many smart people can have dumb moments; and many dumb people can have flashes of brilliance. Many smart people can be very evil, and be better at doing wrong because of their intelligence, than can an equally evil but less mentally astute person. Saying someone is smart does not make him good; and good does not equal smart. And even were the President correct in this instance, that does not mean he should be re-elected, just for one issue.

I like John Mackey's 8 suggestions for reducing health care.

Tonal Bliss said...

Naaman, OC doesn't like providing proof for anything.

Kathy, thanks for the insight that you have been providing.

Anonymous said...

Kathy

Thanks for your reply. It seems we agree on some points.

Having "the insurance pay for it" has probably also increased the costs of health care -- there is no reason for them to forgo any test or intervention when "someone else" pays for it.

You’re exactly right. All insurance has built-in inflationary forces. And you are also right about new technologies driving up costs. I’m glad you've read Gawande’s article, and you gave the reasons for costs rising. However you left out the major point he was making – namely, it is the disorganization of our health care financing system that is behind all of these reasons.

I include SS in socialism. They go hand in hand.

How, on God’s green earth, can you claim that SS is socialism? That is one of the most absurd claims I’ve ever heard. Please explain.

No, my ideology and rational analysis of problems work together to come to a solution.

OK, so what are your proposals to control costs?

Chad

Kathy said...

Chad,

There is no single, set definition of "socialism," and people use the term in different ways. As Wikipedia notes, "Many social democrats, particularly in European welfare states, refer to themselves as socialists, introducing a degree of ambiguity to the understanding of what the term means." We're probably just using the term in different ways.

Social Security is taking money from workers to give to those currently not working. Perhaps it's more communism than socialism; but then, the USSR, a communist country, has "socialist" as one of the S's. Supposedly, workers pay into SS throughout their working careers, and then draw from that money throughout their retirement or disability, but we know that's not exactly the case, with many people drawing much more than they ever put in.

OK, so what are your proposals to control costs?
I linked to John Mackey's 8 suggestions for reducing health care costs in my previous comment.

Also, I will include something I heard recently on the radio (it may have been a local station, so you probably didn't hear it), likening health insurance to car insurance. It seems that originally, health insurance covered major catastrophes (health savings accounts still do that today), with patients paying smaller costs out of pocket (prescriptions, doctor's visits, etc.). That's sort of like car insurance covering a car wreck or some other major body work. What health insurance is doing now, in trying to cover everything, is analogous to car insurance picking up oil changes, tire changes, tune-ups, etc. If your auto insurance covers all that piddly stuff, it will drive the cost of insurance up.

An article I read a few months ago showed that out of every dollar spent on health insurance, 87 cents went to pay for actual health care (tests, procedures, doctor visits, prescriptions, etc.), 4 cents went to profit, and the remainder was taken up with overhead (pencil pushers filing claims, etc.) So, the overwhelming majority of the money people pay out in premiums goes to pay for actual health care. Somehow I sincerely doubt that the government will have less in overhead than a private company. If you look at current levels of waste and fraud already in government, particularly in Medicare and Medicaid (since they are health-related bureaucracies, so would reasonably be more similar to an insurance bureaucracy than would the Post Office or the DMV), you see that there are already tremendous losses through fraud and wasteful, red-tape spending. It seems that Washington should focus on reducing these costs first, before looking to incur more.

There are specific things that could reduce costs (like lowering the C-section rate, which is at least twice what it ought to be, and each C-section costs twice a vaginal birth, so we're talking billions of dollars wasted there; increasing the number of home births and birth center births would also reduce costs and improve outcomes) without sacrificing quality, and indeed if Dr. Gawande's article is correct, could actually improve quality. But being able to do that, without sacrificing *necessary* screenings and tests will be a fine line to walk. You can't just give a doctor a quota, and say, "Ok, no more than 20% of your patients can end up having a C-section," because if he meets his quota, and then someone comes in with a prolapsed cord or uterine rupture or severe fetal distress, he could be punished for saving the baby's life because by so doing he went over his quota. Something similar probably goes for every other sector of health care, but I'm most familiar with birth, so I draw analogies from that. One of my liberal friends weighed in with the suggestion that doctors make the same amount regardless of how many procedures they do. That would certainly provide a disincentive for doing unnecessary procedures; but it might harm patients by providing a disincentive for doing *necessary* procedures as well.

Kathy said...

Unfortunately, the real solution is a return to integrity, but you can't mandate that, legislate that, nor force it. Looking back at my previous comment, capping doctors' income would help lower the number of unprincipled doctors who order unnecessary tests for a fee; enacting tort reform will help doctors by allowing them some legal protection even if they don't do every possible test, which would lower the number of unnecessary tests; and patient education would help the average citizen to understand that just because a test exists, doesn't mean you should take it; plus, if patients have out-of-pocket costs that are directly related to their own consumption of health care, that will give a double incentive not to undergo unnecessary procedures and also to make choices that lower their health risks. If a person eats right and exercises and is healthy, why should he not benefit from that?

It has been some time since I read the Gawande article, so I don't necessarily remember everything in it. There are undoubtedly things I left out. Besides, I'm loquacious, and there is a character limit for comments which I frequently exceed anyway (as I did in this post, and was forced to split it into 2 parts), so sometimes I have to leave stuff out I'd otherwise talk about. Other times, I don't feel like taking the time to research just for an internet argument. {shrug}

Kathy said...

I may not use the term "socialism" exactly properly (although, again, many people use it in different ways without necessarily being "wrong"); but I do think that Social Security, if not technically socialism, is creeping socialism, a la Fabianists. It's the camel's nose under the tent. It was among the first (if not the first) major change which got large portions of the populace onto government handouts. Now, it's become sacred; and this whole idea has expanded under "The Great Society" (which is a colossal failure!! Sure, some people were helped, but it was "winning the battle and losing the war" -- we've more poverty than before "the war on poverty," and more single moms and fatherless children than the politicians of the 60s could have ever imagined), with Medicare, Medicaid, Welfare, etc. The idea is to get as many people on the government dole, or otherwise drawing their livelihood from the government (bureaucrats? teachers? CPAs who depend on complicated tax forms for their jobs? government contractors who build war machines?), to farm votes from the people who get some sort of benefit from the system. You think not? Nearly every election cycle there are candidates who accuse their opponents of wanting to cut Social Security, Medicare, etc., and the ads are always intoned against the backdrop of a little old grandmother sitting alone in her house looking forlorn, while the voice-over accuses the opponent of not having any compassion, and wanting to force this old lady out of her home or kill her dog or something -- you know the scaremongering ads. And the AARP jumps in with both feet to defeat the candidate who hates retired people (sarcasm). Seniors vote; and often they vote out of fear that someone will cut their already small SS checks -- they vote for the guy that promises the brightest future for them.

This health care thing is the next step. There will be more and more and more. Eventually, the government will own or control nearly all of the economy. That is what I meant when I said that SS goes "hand in hand" with socialism.

Anonymous said...

Kathy

Thanks for your replies. There are several problems with what you wrote. I’ll start with your claims about socialism and politics, and then to your claims about health insurance

There is no single, set definition of "socialism," and people use the term in different ways

People use every single word in different ways. This does not mean there are not better or worse definitions of socialism. The best is: socialism is the ownership and decision making capability of the means of production (factories, agriculture, industries, etc.) by the workers themselves of those sectors. You also seem to be confusing socialism as an economic system, and people that identify with the socialist party, which is more common in Europe given history and the parliamentary structures of their national assemblies. Historically, socialist and social democratic parties have been arch-enemies, for a variety of reasons largely ideological (in a simple sense, socialists are revolutionaries, and social democrats are reformers).

I do think that Social Security, if not technically socialism, is creeping socialism, a la Fabianists.

That’s not correct. Social security has its roots in Weimar Germany, and the early German state’s attempts to unify a contentious group of fiefdoms into a cohesive whole. So it really has more to do with nationalism than socialism. Social security has nothing to do with the means of production – it is essentially social insurance underwritten by the state. Social democrats supported early social insurance, while socialists in fact opposed these plans (seeing them as compromises made with the ruling class, which they were.) The USA story is slightly different, but that’s a separate post.

Now, it's become sacred; and this whole idea has expanded under "The Great Society" (which is a colossal failure!!

If by “sacred” you mean wildly popular among US citizens, then yes, it is definitely sacred. One of the important aspects about social insurance which you are missing is the inter-generational aspect of these policies. Younger folks like you and I pay into an insurance pool to support frail elderly who can no longer work. I’m not clear why that idea is so evil. What is so wrong with organized support of those who are excluded from the market?

Second, I’m not sure you’re in a good position to evaluate the success or failure of Great Society welfare programs, which are now approaching 50 years old. You would need to take quite a few variables into account, much more than comparisons of cross-sectional absolute poverty numbers. But again that’s a separate post.

Chad

Tonal Bliss said...

Chad stated: "...[SSI is used] to support frail elderly who can no longer work. I’m not clear why that idea is so evil."

The elderly that can work without difficulty or have enough money to support themselves are not given an option to refuse SSI checks.

Anonymous said...

The elderly that can work without difficulty or have enough money to support themselves are not given an option to refuse SSI checks.

That's because they've paid into it their whole lives. Why on earth would they refuse?

Anonymous said...

Kathy,

Now onto your comments about health insurance:

I’m not sure what you were getting at with the analogy with car insurance. Health insurance has many different types, ranging from policies that cover everything (from routine clinical visits to complex, exotic procedures) to very basic coverage with a high deductable designed to protect an individual from catastrophic expenses. There is no equivalent with auto insurance, which is designed to prevent loss due to accident, or financial liabilities associated with injuring others in a car accident. So the analogy does not hold.

Insurance (of anything) is simply a procedure by which risk is pooled and loss (to individual members) is mitigated. The major issues with private market health insurance have been medical underwriting, experience rating, and risk segmentation. That is, the private market health insurance companies that you seem to love so much do everything possible to lower their costs. One of the most pernicious of these practices is to pool healthy people together, and exclude sick people (generally done under the auspices of a “pre-existing condition” clause).

One of the most important aspects of health reform should be to stop these practices. What many people like yourself confuse is (1) government run health care, and (2) government organized health care financing (or social insurance). The Obama administration is proposing 2, not 1 (although we do already have that in the VA system). The VA system is one of the best-run health care systems in the world – it takes care of very complicated patients, and has incredibly low overhead (around 2-4% percent). I’m happy to say more about that if you like.

So, health care reform is basically social insurance reform (see my previous post) and has nothing to do with socialism. In fact social insurance is a central plank in what is commonly called classical liberalism (or welfare state capitalism).

Chad

Tonal Bliss said...

Chad: "Why on earth would they refuse?"

Because they didn't choose to pay into it either. No freedom to choose here.

Kathy said...

I'll try to be clearer on the auto/health insurance analogy, since you didn't understand me. You actually hit on it yourself, when you talked about the "very basic coverage with a high deductible designed to protect an individual from catastrophic expenses." That's sort of what car insurance is now -- very basic coverage with a (sometimes) high deductible designed to protect an individual from catastrophic expenses. It does not cover "everything (from routine [maintenance] to complex, exotic procedures)." IF car insurance added routine maintenance procedures to what it covered (as opposed to just the big stuff from an accident), costs would certainly escalate, just as health insurance that covers everything is much more expensive than basic coverage that only kicks in for major problems.

What do you think about this article? I especially noted the unsustainability of the current health care system, as well as the current Social Security, Medicare, and Medicaid systems... as well as the proposed health care reform.

Anonymous said...

Kathy

IF car insurance added routine maintenance procedures to what it covered (as opposed to just the big stuff from an accident), costs would certainly escalate, just as health insurance that covers everything is much more expensive than basic coverage that only kicks in for major problems.

So what I’m not clear on is what you are claiming with this analogy. Are you thinking that health insurance should be more like car insurance? If that were the case, then some serious problems would arise. First and foremost, human bodies are not like cars. We can’t really do a cash for clunkers tradeoff. Second, car insurance is paid by the beneficiary. In many cases, health insurance is paid for by another entity (employer or government).

I generally don’t look at material produced by the JBS, as it is an extreme-fringe group with white supremacist leanings. I did read the article, and while the tone is not to my liking, I do agree with some of what the author was arguing. I would agree that we should make commodities that are detrimental to health (fast food, cigarettes, alcohol) difficult to get – so one way this has worked in anti-tobacco campaigns is through raising excise taxes on cigarettes.

However, these appeals to personal responsibility on their own are not enough. Health care costs are a result of system-level issues, not individual-level causes alone. Therefore any call for personal responsibility must be accompanied by policy changes as well.

Chad

Tonal Bliss said...

Taxing to encourage healthy habits doesn't work very well. A deep rooted cultural change in health habits is what this country needs. However, that will hard to accomplish.

OperationCounterstrike said...

Cathy, do you consider the idea of having government regulate industries like nuclear power, manufacture of medicine, and science education, to be "creeping socialism"? If not, why not?

What about funding basic science research, which cannot be done in the free market? Is having an NSF or a NIH "creeping socialism"?

What about putting a man on the moon? Creeping socialism?

Just curious.

Lilliput said...

Segamon, should we have a choice to pay taxes?

This is what I can't inderstand about the healthcare in America - the fact that American's think that they have a choice of wether they need medical insurance or not? The only thing we can be certain of is that we will get sick and die (maybe not in that order)and accidents will happen. What happens if you're sick or you have an accident and you have no insurance - you are forcing other people to pay for you because the rest can't leave you dying in the street. That's what you don't understand - we don't have a choice!

Everytime I go abroad, I happily pay my travel insurance and then pray to God I don't need to use it. I don't pray to God that nothing happens and then if it does, force people to take care of me.

Anonymous said...

Taxing to encourage healthy habits doesn't work very well.

This is a completely false assertion. Increasing excise taxes has worked incredibly well lowering cigarette consumption for example.

A deep rooted cultural change in health habits is what this country needs.

I agree, but more importantly, we need a multi-pronged approach: carrots (tax breaks for making good decisions) and sticks (high taxes on unhealthy commodities). Arguing that cultural change is hard is stating the obvious, and should never be an excuse for inaction.

Tonal Bliss said...

I never mentioned inaction. Rather than assume inaction, you should have assumed active and proactive action to be taken in our personal communities of families, friends, and neighborhoods.

An ideology that I despise is that government should be making all of the choices for us. Increasing taxes on unhealthy items doesn't change the mindset of people. It only slightly changes consumption. People will buy what they want unless it is altogether taken away from them.

My wife's family used to own a tobacco shop. Upwards of around 80-90% of the people that they sold cigarettes to were the very poor. I worked as a cashier at a Rite Aid. The majority of people that bought cigarettes at this store was also usually quite poor. With or without taxes, smoking cigarettes is an expensive habit. Yet... these poor people do not quite smoking. They continue to smoke because of a prevailing mindset that it doesn't matter to be healthy.

Primary prevention is certainly key. I'm a nurse and I am considering to one day work in the field of school nursing. In that job I can directly help change the prevailing habits of health in our culture. This wouldn't require huge excise taxes. This wouldn't require banning cookies from school yards either (yum!! cookies!!). It's a problem with culture, not with dem cookies! :)

Tonal Bliss said...

Lilliput, I pay taxes whether I agree with them or not. However, I do have a choice to disagree with them. Duh.

Unknown said...

yeah, but you don't disagree with what the taxes provide for you? Roads, police, justice etc

Kathy said...

OC said: Kathy, do you consider the idea of [various things] to be "creeping socialism"? If not, why not?

Our founding fathers understood well human nature, which is why they set up our government as they did, with checks and balances. They recognized the faults and frailty of human nature, and understood that everyone needs someone or something else to keep them accountable. What has gone wrong in this past century, especially, has been an imbalance of government, and a weakening of the restraints of governmental power, which has led to corruption on many levels. "Power corrupts, and absolutely power corrupts absolutely." The more power a single person or institution has, the more vulnerable it is to corruption and the more liable it is to become corrupt.

Some regulation, therefore, is necessary, to keep the powerful from abusing the weak. Market forces can be this regulatory agency in large part -- if a car mechanic is dishonest, it will be found out sooner or later, no one will get their car repaired by him, and he will be forced to find another occupation. Likewise, a mechanic who has a reputation for honesty and plain dealing will build his business. There may be some place for governmental regulations in some of the above-mentioned areas.

Actually, many scientific studies are funded by private individuals and/or foundations. Perhaps more money would be available for such if the government didn't tax us so much.

Other than national pride, I'm not sure what benefit there was to putting man on the moon, although I daresay there was some; whether it was enough to justify the cost of NASA for decades, I cannot say. History shows that students learned more with less governmental interference -- an 8th-grade education of yesteryear is the equivalent of high-school graduation of today. You like "science education regulation" because it enforces evolution indoctrination, rather than true science.

Is it creeping socialism? I would not say that all of them are. Perhaps in another 20 or 50 years, I might look back and say, "yeah, that one was, although I didn't recognize it at the time."

Now, bringing in what "liat" said, "yeah, but you don't disagree with what the taxes provide for you? Roads, police, justice etc"
If that was the extent of what our tax money was used for, I daresay that few people would complain about taxes! These are real and tangible benefits to everyone. The problem comes with all the other billions of dollars of fraud and waste and trillions of dollars of money spent on questionable programs.

So, putting these two things together -- it's not necessarily "all taxes are bad" or "all regulation is bad and/or socialism," but it's the extent to which these things go, and whether or not there is sufficient checks and balances, to make sure none of these things gets out of whack.

"Every time someone gets something he doesn't pay for, someone pays for something he doesn't get." We all benefit from having safe roads, police keeping bad guys away, and a legal system that makes sure that justice is served. But taking from the rich to give to the poor for some sort of misguided way of achieving "social justice" is creeping socialism -- or should I say, "creeping communism." Either way, it's still an increase in the size and scope of government; and it's beyond the scope of the Constitution, and I don't like it. Our government is "a Republic, if we can keep it," as Ben Franklin said. This video pretty much sums it up.

Anonymous said...

Kathy

I’m not clear what you mean when you say:

Market forces can be this regulatory agency in large part

and then give the example of the car mechanic. First, the market is not “regulatory” the same way that the FDA (for example) is regulatory. Market forces only determine winners and losers. Government agencies, on the other hand, watch out for all of us. Certainly some do better and worse jobs of this, and certainly corruption exists within these agencies. But frankly I find it laughable that you claim the government is more corrupt than free market actors in the wake of recent economic events. Two words: Bernard Madoff.

What I’m not clear about is this overwrought concern you have with government power. Why are you so obsessed with this? Given the aggressively conservative history of this country, why do you claim:

Either way, it's still an increase in the size and scope of government; and it's beyond the scope of the Constitution, and I don't like it.

There’s nothing in the Constitution that mandates the “size and scope” (whatever that means) of the federal government. In any case, the late 18th century (when the writers of our Constitution developed their political philosophies) is light years away from our present condition. We might want to update our thinking.

Chad

OperationCounterstrike said...

Wow. It's amazing, the things some people DON'T know. Kathy, you wrote: "Other than national pride, I'm not sure what benefit there was to putting man on the moon, although I daresay there was some; whether it was enough to justify the cost of NASA for decades, I cannot say."

The space program served as a DRIVER, a coordinating, motivating, unifying GOAL for the development of new technologies, mostly in electronics and materials science. This gave us, among other benefits, a ten-year head start over the rest of the world in creating computers. A near-monopoly on the single most important market of the 1980s and 1990s. Is that enough benefit for you???

You wrote: "History shows that students learned more with less governmental interference -- an 8th-grade education of yesteryear is the equivalent of high-school graduation of today."

That's (mostly) because today, there's so much more that we need to know. "Yesteryear", you could get a good, midlevel, tech-literate job with a high-school degree. Now the tech is much more techie, so you need a masters degree.

You wrote: "You like "science education regulation" because it enforces evolution indoctrination, rather than true science."

HAHAHAHAHA! Ooops--gut just burst, must go get hernia repaired.

Seriously, Kathy, you really need to take a course on history of science and technology in the Twentieth Century. No offense meant, but you are appallingly ignorant about what makes the USA the world's problem-solver.

OperationCounterstrike said...

Kathy, let's suppose you were right and evolution were not "true science". OK, now one question please:

How would YOU know?

Kathy said...

But frankly I find it laughable that you claim the government is more corrupt than free market actors in the wake of recent economic events.
Have you researched the government's role in the "wake of recent economic events"? Surely both Reps & Dems got their hands dirty; but I know that many Democrat Congressmen coerced banks into what would now be called "predatory lending" -- i.e., lending to people who could not repay -- in the matter of mortgages. This caused a large part of the housing bubble, the inflation of home prices, and subsequently the number of foreclosures as people could no longer keep up with payments. Since many these people bought on the upswing if not the top of the bubble, when it burst, they found themselves owing more on their homes than they were worth, which undoubtedly lead many to foreclosure and/or bankruptcy. There are always loan sharks and stupid lenders; but back in the 80s and early 90s at least, there were some fairly strict requirements in order to qualify for a mortgage (ones I know include at least 20% down, plus not having more than 35% of your monthly income as a mortgage payment). I don't think those were government regulations, but were merely wise industry practices, because it's stupid to lend too much money to people than they can ever hope to pay back. With government pressure to make risky loans, combined with government deregulation, it was a perfect storm. Caused by the government. Bernie Madoff may be a good example of private corruption, but it was the housing crisis that caused the current problems. And, frankly, the people who invested with Madoff should have known that there was something fishy, but I think their greed outweighed their sense.

There’s nothing in the Constitution that mandates the “size and scope” (whatever that means) of the federal government.
*cough*cough* Tenth Amendment *cough*cough*
"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

In any case, the late 18th century (when the writers of our Constitution developed their political philosophies) is light years away from our present condition. We might want to update our thinking.
Or we might not. If you don't like our founding documents, why don't you go find another country to live in and ruin?

Anonymous said...

Kathy

Thanks for your replies, but you are confusing cause and effect in the recent economic crisis. This crisis was fundamentally a financial crisis, which means it has its origins in financial markets. The housing market bubble was an effect of finance, not a cause.

With government pressure to make risky loans, combined with government deregulation, it was a perfect storm. Caused by the government. Bernie Madoff may be a good example of private corruption, but it was the housing crisis that caused the current problems.

This is incorrect. There was no “government pressure” to make risky loans. The only “pressure” to make loans by lenders was the huge profit margins they were taking down. To understand the real cause of the economic crisis, you need to understand how financial markets operate, how risk is evaluated, and how instruments like credit default swaps and collateralized debt obligations work.

*cough*cough* Tenth Amendment *cough*cough*

My, what clever snarkiness. But of course we both know that the 10th Amendment alone says nothing about either size or scope of the federal government. It refers to “federalism,” or the relationships between the feds and state governments. The actual meaning of federalism has been worked out in the courts over time.

If you don't like our founding documents, why don't you go find another country to live in and ruin?

Um, no. That’s a pretty tired question. And it’s white flag. When you resort to personal attacks, it pretty much means you’ve run out of reasonable things to say.

Chad

Kathy said...

OC --

Wow. It's amazing, the things some people DON'T know.
I know, but don't be so hard on yourself! You learn something new every day -- maybe you'll catch up. ;-)

The space program served as a DRIVER, a coordinating, motivating, unifying GOAL for the development of new technologies, mostly in electronics and materials science...
So, there was no actual benefit from man walking on the moon and collecting a few moon rocks, although the process of getting him there was beneficial. An example of real benefit of man going somewhere, would be the discovery of the New World, and Europeans getting potatoes, tomatoes, gold, and silver. The discovery of the New World, as well as the space race, were catalysts in advancements in ships and spaceships; but these advancements *could* have taken place without actually setting foot on the moon, or setting foot in the Americas. Perhaps that's too fine a distinction for you, but that's what I was aiming at.

You wrote: "History shows that students learned more with less governmental interference -- an 8th-grade education of yesteryear is the equivalent of high-school graduation of today."

That's (mostly) because today, there's so much more that we need to know. "Yesteryear", you could get a good, midlevel, tech-literate job with a high-school degree. Now the tech is much more techie, so you need a masters degree.

Um, wrong answer. Ever hear of "the dumbing down of America"? My father was a college teacher back in the 70s and 80s, and the longer he taught, the worse grades the students got, because they had a poorer education out of high school. Between the time my oldest sibling graduated high school and I did, college tests (including the ACT) were made easier, so more students could get higher grades, because so many people were having such low grades. A few centuries ago, one of the basic requirements of many colleges was the ability to translate Latin and Greek. Today, seniors at leading colleges and universities, including Harvard, Princeton and Brown couldn't correctly answer 34 "high-school level" history questions -- only one student got them all right, and the average score was 53%. Also, I remember Jay Leno used to have a segment pretty regularly, in which he would stop people on the street and ask them various questions (like, who is the current President, how many branches of government are there, and other historical, governmental, social, and political questions), and the results were astounding, in a negative way.

Sure, there have been some increases in knowledge, and requirements for higher learning -- the "more techie" part -- but basic, core knowledge is greatly lacking; and our high school seniors of today probably couldn't pass the 8th grade final exam of 1895.

let's suppose you were right and evolution were not "true science". OK, now one question please: How would YOU know?
Ah, the real question is, would YOU know?

Kathy said...

Chad,
"You don’t have to be a right-winger to see that government regulation caused, rather than mitigated, the mortgage crisis. An August 5 article in the liberal Village Voice explains how Clinton’s Secretary for Housing and Urban Development, Andrew Cuomo helped pave the way for the mortgage meltdown by ratcheting up federal affordable-housing mandates. Cuomo and HUD forced Fannie and Freddie to buy more sub-prime morgages, as part of Cuomo’s crusade to increase the number of minority homeowners. Now, of course, the crusade has backfired. Many minority homeowners have suffered financially as a result of recent falls in home value that wiped out their homeowners’ equity — a fall that resulted from buying homes during a mortgage bubble fueled by HUD’s pressure on lenders to make risky, high-interest loans to people with little savings (many of whom have defaulted, helping to drive lenders into bankruptcy). And they’ve ended up with costly high-interest mortgages in the process. (Ironically, Cuomo, now New York’s attorney general, blames lenders for causing the mortgage crisis through “predatory lending” — lending he helped promote as HUD secretary)." Entire article with multiple links from here.

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."
But of course we both know that the 10th Amendment alone says nothing about either size or scope of the federal government.
You're right. You have to look at the rest of the Constitution, to see which powers are NOT DELEGATED to the federal government, which then shows which ones are reserved to the States or the people. And *that* DOES say quite a bit about the size and scope of the federal government. Just because people have chosen to read into the Constitution things that were never included in it, does not make it Constitutional.

Kathy said...

Hot off the presses on the topic of our current bad education system -- 90% of college freshmen in NY couldn't do basic algebra.

Anonymous said...

Kathy

You’re missed the point. Certainly the government had something to do with the mortgage crisis, and there were questionable lending practices by many. However that’s not the point – your original claim was that the mortgage crisis was at the heart of the economic problems we are currently facing. In fact, here’s your direct quote:

Bernie Madoff may be a good example of private corruption, but it was the housing crisis that caused the current problems.

As I stated before, this is incorrect. You have yet to provide a coherent explanation about how the mortgage crisis CAUSED (your words) the financial crisis.

And *that* DOES say quite a bit about the size and scope of the federal government..

Interesting quote. Perhaps you want to share with us where the Constitution says how large the federal government should be?

Just because people have chosen to read into the Constitution things that were never included in it, does not make it Constitutional

Also interesting. So does that mean the amendments to the Constitution are unconstitutional since they were never originally included in it?

Chad