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The Democrats Eliminated Health Insurance
What “health insurance” means–or used to mean, or at any rate should mean–is something like this: a financial product insuring against future medical problems, and having enough money to cover them at fair prices because it does not insure against past and current medical problems for the same price.
Democrats banned health insurance in America. (To be fair, some Republicans helped move things in that direction; see comment # 19 below.)
We can talk about how wonderful it is to have pre-existing conditions covered, but that doesn’t change the fact that requiring their coverage means banning health insurance.
Look at it this way:
Imagine a financial product people use to help with the expense of medical care. It’s called “health insurance” because it is a financial product insuring against possible future problems, not paying for existing problems. That’s why it is an efficient product: The money going out of the pool is less than the money going in, since people buy into the pool as insurance against merely possible future problems, and not all possible problems become actual.
America has a long history of using financial products to pay for healthcare which are not health insurance but which we keep calling by that name. (See comment # 33 below.)
But, once upon a time, real health insurance was at least tolerated by law.
Back then, healthcare was getting more expensive in America. America liked the idea of health insurance–or at least the idea of what we called “health insurance”–so much that we fell in love with the idea of a financial product that finances healthcare. We wanted to make sure that everyone had such a financial product–a worthy thing to want. Sadly, there was no easy way to make that happen, because some people already had actual problems. So health insurance, probably the best reason we ever had to like these financial products in the first place, was restricted and, ultimately, banned.
In its place we set up a different product which did not insure against future problems. This new product bore the name “insurance” by a misnomer, or perhaps by a change in the English language.
This new product, alas, was doomed to inefficiency; the money going out of the pool could easily exceed the money going in because it was not an insurance against possible future problems. Hence the need for the unConstitutional mandate to purchase the product, the solution to which is not just to kill the mandate, but to legalize health insurance all the way. Repealing Obamacare in whole would be a good start. (See # 19 for a hint at another good idea.)
But what about those pre-existing conditions? Don’t those people deserve help? Yes, they do. And that fact does not make a good argument for banning health insurance.
It’s not fair that some people have trouble getting a nice cup of tea whenever they want it. But that is a terrible reason to ban all tea and require everyone instead to drink something “almost, but not quite, entirely unlike tea.”
That does not make a better world.
Neither does banning health insurance for everyone so that some people can have a very different financial product.
Maybe this problem has, as Thomas Sowell says, no solutions, only trade-offs. But banning health insurance, I’d say, was the wrong trade-off.
Still, there are other ways to help people with pre-existing conditions, up to and perhaps including government assistance. And down to and including fixing all the problems that were making healthcare so expensive in the fist place. E.g., allow purchasing across state lines, do some more lawsuit reforms, and end federal action forcing big employers to shove thousands of very different people into the same one-size-doesn’t-fit-all policies.
Note:
This post has been edited in light of insights from commentators better informed than I! See, particularly, comment # 19, comment # 16, and comment # 33.
Published in Healthcare
Aug,
Obamacare is what you get when people who live in a socialist fantasy world monkey with health insurance. They have done more damage to more people with their grotesque failure than I would have imagined possible. No big government Humphrey Democrat from the 1960s would have done anything so stupid. Back then they had real shame over failed programs. Nowadays they just intend to lie their way through anything.
Leave the free market health insurance system alone. In fact, increase the “free” part by allowing interstate competition and then address the extreme concerns on a case by case basis and be willing to work ad hock solutions that don’t adhere to the market. They might waste some money but incredibly less than the idiocy and destruction of Obamacare.
You’re right on target.
Regards,
Jim
Just about everything you said is really good. However, I will point out that if you mean removing the so-called prohibition on buying insurance across state lines, that means letting the feds take over state regulation of insurance. That is not decentralization. It will lead to competition of the sort that allowed amazon to take over a large portion of the nation’s commerce and drive out many of the little guys who don’t want to use amazon to sell their stuff. In other words, it will oligarchize the medical insurance business even more than it already is and will make the problem worse, not better.
According to John Steele Gordon, health insurance in the United States never worked that way:
https://imprimis.hillsdale.edu/short-history-american-medical-insurance/
I’d say you’re wrong. I’m not calling for Medicare to be disbanded or converted into a defined-contribution system (although I favor defined contribution systems) and I am extremely unhappy with government controlling people’s medical care. I am in favor of a welfare system for those things that cannot be covered for everyone through defined-benefit plans and insurance, and I am in favor of drawing the line at a place to make the latter methods predominate. I’d say nobody is happy with government controlling their medical care.
Funding it, yes, but controlling it, no. Of course you can’t have the one without the other.
Thanks for the link to that article. There is history in there about pre-WWII insurance that I had not known. I had run into some aspects of it when reading a book about the rise and fall of mutual aid societies in America, a book that had been recommended to me by someone on Ricochet. But this provides more background. (The book is somewhere in my office, but I don’t recall the title.)
Ha. The book was properly shelved. Imagine that!
It’s From Mutual Aid to the Welfare State: Fraternal Societies and Social Services, 1890-1967 by David T. Beito (2000)
A timely essay, as we are in the season for “choosing” healthcare plans, if we really have any choice.
This conversation is part of our Group Writing Series under November’s theme of Elimination. There are plenty of dates still available. Perhaps someone will even offer a page from the diary of a hitman, purely fictional of course. Or maybe we will read about eliminating excess inventory. Hmm, inventory control specialist by day, hitman by night? Sounds like a TV drama? What about those ads? You know what I’m talking about—even the Charmin bears! The possibilities are endless, Ricochet cool cats! Why not tell us about it and start a conversation. Our schedule and sign-up sheet awaits. Caveat: Given the theme, please keep in mind the basic rules of R>. As you polish your little masterpiece, do ensure that it stays within the refined edge of tacky. As a heads’ up, our December theme will be Veneration. I’ll post the sign-up sheet mid-month.
I don’t want to quibble with you about the meaning of insurance. That part of the discussion does have some merit.
For one thing, I was totally willing to let the Big Insurer take my $ 550 a month and tell me that going forward, they would not treat me for any of the remedies for my wrecked spinal column regarding the area of the back where I’d been injured. No chiropractic, no surgery to correct it, etc.
As I got that the damage done was pre-existing. I really did.
But the idea that I could be in a car accident again and have another entirely different part of my back affected, perhaps being paralyzed or worse, and they could say, “Nope, so sorry but we already ruled your entire spinal situation out of bounds even if it is a new situation.”
Why would any rational consumer purchase health insurance before developing a significant health problem or getting a bad diagnosis when one could always sign up when such a policy is needed thereby saving many thousands of dollars in premiums-this is the flaw in prohibiting coverage for pre-existing conditions that one one wants to acknowledge.
I like that article and was especially grateful that the author decided to discuss this part of health care and insurance:
The most important thing to do, by far, is to require medical service providers to make public their inclusive prices for all procedures. Most hospitals keep their prices hidden in order to charge more when they can, such as with the uninsured. But some facilities do post their prices. The Surgery Center of Oklahoma, for instance, does so on its website. A knee replacement there will cost you $15,499, a mastectomy $6,505, a rotator cuff repair $8,260.
Once prices are known and can be compared, competition—capitalism’s secret weapon—will immediately drive prices towards the low end, draining hundreds of billions of dollars in excess charges out of the system. Posting prices will also force hospitals to become more efficient and innovative, in order to stay competitive.
Any politician who pontificates about reforming health care without talking about making prices public is carrying water for one or more of the powerful lobbyists that have stymied real reform, such as the American Hospital Association, the American Medical Association, and the health workers unions.
And then there are families like ours (Note: I haven’t read the comments). We are heavy users of the medical/insurance system. My youngest is currently having a two-hour MRI of the brain and spine as I type. Thousands and thousands of dollars worth.
But, it wasn’t always so. We were older parents (married 14 years before our first). DINKs who paid into the insurance system our entire careers with almost no claims of consequence.
Without a “pre-existing” condition clause for our two daughters (both with rare, expensive to treat, genetic conditions unknown in our families previously), we would be uninsurable. No one would be crazy enough to take on a family consuming the medical resources we do at the costs we incur. We’d be broke by now if we had to pay out of pocket, no matter how much we earned.
And it’s a huge worry for us going forward as our kids approach age 26 when we won’t be able to insure them under Mr. C’s employer plan. We’re not even sure they’ll be able to work jobs that will provide coverage, so we might be spending our retirement/their inheritance to pay for their care.
Healthcare costs were rapidly rising before coverage of pre-existing conditions was mandated. Generally, I’m not a fan of government interference in markets, but this is a complicated problem. One thought I’ve had is mandating coverage of pre-existing conditions for people born with genetic conditions through no fault of their own. Everyone else should have catastrophic coverage for things that come up later.
But, I don’t claim to have a solution. Right now, I just have to trust God and not insurance companies, politicians, or bureaucrats.
Your situation is one that many people experience. We are all just one slip in the shower away from needing lots of medical care. In terms of damage done to an individual while he or she is still in the womb, this is a societal problem.
Few people are able to live a healthy life, drinking the necessary clean water and eating decent food and breathing untainted air. Our society has encouraged most households to blast away the clean air inside their homes with Febreeze, Lysol, Glade and other products. These things contain benzene, formaldehyde, limonene, chloroform & other nasty items.
The rise in popularity 0f these items has occurred at the same time that major companies were sick and tired of paying to have their toxic waste sent off to super funds, an expensive process if ever there was one. So it is much easier to just throw minor amounts of various toxins into these products, advertize the products on TV & let the consumer dispose of them by aerosolizing the nursery & family room with the toxins.
Even families that avoid such products find they’ re living down wind of a coal burning plant or an incinerator. A pregnant woman working inside an office has no control over what the cleaning crew did inside her cubicle at 5Am that morning. All she knows is she feels headachey while at work, much better when on holiday for the weekends, and then sick again on Monday morning.
The statement that our nation spends so much on social programs overlooks this pertinent fact: that the social programs that allow that statement to be made include Social Security, for which working human beings have 15% a year paid into their account, starting at whatever age in their teens they join the work force and not use-able until the person reaches age 67.
The Social Security fund currently has a surplus of 2.1 trillion in reserves. And 13 % of all baby boomers have generously decided to die before they collected one dime of their Social Security earnings. MediCare is another program where working people & employers pay into the fund. Due to the fact that with MediCare you only need to have lived in the USA for ten years and paid into it for five means it might be the less well off of these two programs.
That is at least a choice yet. You would rather make it so that nobody has a choice about how they handle their healthcare so you and others with pre-existing conditions will have those uninsurable conditions covered, then you won’t face the unusual opportunity to find a way to deal with your health issues. As a matter of fact, I’m not against government providing ways to alleviate your need, I just don’t like mandating limits on what everyone else is able to do.
Oh, wow! I didn’t realize. (I was probably a ten-year-old kid in rural Zimbabwe at the time.)
Wow. This thread is a gold mine of reasons the healthcare system had been broken by government action long before Obamacare.
Or at least–reasons the healthcare system in America has not been anything like a free-market system since basically forever ago.
Nice comment!
Amen.
Yes!
(Thus comment # 7.)
Great work, you two!
I thought it was about a literal truth.
Or nearly there–in need of your correction in comment # 19.
You’re preaching to the choir. (And the choir says, “Amen!”)
Ouch. You may be onto something!
Thanks. Yes, I think I will read this eventually.
If so, the Opening Post’s general idea would seem to be right, but there would seem to be some mistaken details or imprecisions–like those noted in Mendel’s comment # 19.
Well luckily for humanity, 52% of all Republicans are waking up to notion of something like MediCare for all. Perhaps they arrive as that philosophy due to feeling the pinch of how they cannot actually deal with vast expenses due to pre-existing conditions unless they are rich and they have unlimited means at their disposal.
In the future, we human beings will have our DNA examined by the time we are a week old. And then no one will get insurance – as the genetics people can examine DNA and see many probable health problems in the future of any individual. That would mean most of humanity if not all of humanity will end up being nothing but a huge collection of “pre-existing conditions.”
Also I did posit a question in my opening remark – how was it that the Big Insurer couldn’t include all my bodily organs as they felt the need to stipulate no coverage for “pre-existing” conditions? (Two of which were non-existent, BTW.) Yet my insurance plan that came about when the firm I worked for was acquired by another entity and that entity then provided health insurance coverage offered coverage for all of me, not only the parts of me that were deemed “pre-existing, non insurable items.” I doubt it was that expensive an item for the employer.
But it does seem to repeatedly be the case that should someone get group coverage, there are more options and lower premiums than if it is one individual out on their own attempting to gain health insurance coverage.
Yes, that is wrong.
I’m even happy to agree with the Left that there are some Big Jerks running the health insurance companies getting rich by not helping you when they should.
My disagreement with the Left concerns the other health insurance companies, the ones that would write this particular kind of Big Jerkiness out of their practices by having a better business model.
Why couldn’t those companies help you? Because government regulation made it impossible for them to even exist.
It’s another point from @kevinwilliamson: Unless you go all the way directly to pure, literal Marxism and abolish private property, all that government regulation of business ends up strengthening the position of the big businesses. Why? Because it kills any competitors not big enough to employ hordes of lawyers, lobbyists, and accountants to deal with the regulation.
Indeed.
Hence the universally acknowledged need for a fix–hence the individual mandate.
I guess there was a mandate of sorts already in place for having insurance that covers pre-existing conditions under the Gingrich model–see Mendel’s comment # 19. So Gingrich was, perhaps, less bad than Obamacare.
Yes.
I’m friendly to this idea, and would be interested in hearing objections.
If the parents already have coverage and are just adding the new baby, it seems natural to include genetic conditions.
In fact, on this model the pre-existing conditions situation can disappear over time. Any fix could be temporary–expiring after a few decades.
Another idea I’m willing to consider–even as a federal policy.
It was actually Rush Limbaugh’s proposal, as I recall.
Yes. Follow the model of David–fall into the hands of G-d rather than man.
You know about Samaritan Ministries? It’s great. It’s almost like actual insurance, and it’s way cheaper. (It might not be available for Catholics, but I don’t know. No reason Catholics couldn’t start their own.)
In my humble opinion, juxtaposing the cost of funding our military with the lack of funding for Universal Health Care is not an argument for Universal Health Care, despite the moral outrage some express. The reason why we fund the military is because the Constitution gives Congress the express power to tax for the common defense and to fight wars.
In contrast, Congress has neither the express power to monopolize the healthcare market and to compel people to accept government healthcare, nor does it have the express power to compel all doctors, nurses, and technicians to work for the government. Healthcare spending is justified by implication through the power to spend in the “general welfare” clause.
This is not to say that there isn’t much that could be done to improve health insurance markets. I would like to see Congress devote its energies to passing legislation to do just that. But I’m not holding my breath. Democrats are going to the wall for universal healthcare and they are going to slam right into the U.S. Constitution.
We probably can never have a U.K. style national health service that is constitutional. If people want that, they can call a convention of the states and amend the Constitution to vest Congress with general legislative power. In other words, give Congress unlimited power.
Two things. When I was a kid doctors really were up there in the level of gods or demi-gods in the social strata. And the other thing that today, people want to be treated for everything, now, and with immediate outcomes, (and basically for free) even if it can’t be done. And they want the doctor to take full responsibility for their overall health and for their every illness and every cure, and that’s usually not possible.
And they complain if they don’t get an immediate cure regardless of whether the doctor can even do anything at all. First example coming to mind it that they all want antibiotics for the first day of the common cold, and if they don’t get them they complain to supervisors, or come back the next day to a doctor who will, and then bad-mouth the doctor who didn’t, and complain that they had to pay two co-pays.
Or they have back pain and insist on pain management now, with opiates, and a quick cure. Stuff like that. No?
Exactly the right response. And that list of excluded procedures for people over 50? It gets longer every year here in Germany.
To your first statements, it all depends how you define “happy”. On the one hand, public polling shows that a solid majority of voters (i.e., including Republicans) want more spending on Medicare. On the other hand, there has not been any widespread grassroots movement to seriously reform Medicare in the past few decades, whereas there have been major grassroots movements to reform Obamacare or institute work requirements for Medicaid (to name two examples). And of course, Trump ran on a platform of not touching Medicare….and won. I’d say that’s as close to happiness as you can get in a democracy.
To your second statement – well, that’s the rub, isn’t it? Of course we’d all prefer if Medicare worked by the government simply letting us choose the health care we want and then footing the bill after the fact. But anyone who considers taxation a form of theft must recognize that at a minimum, the government has a fiduciary obligation to taxpayers to ensure their money is not mis-spent. Controlling how Medicare dollars are allocated is part of that process.