no third solution

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Category Archives: Health Care

There’s No Such Thing as Free Obamacare

September 12th, 2012

A friend of a friend who’s a hardcore Obama supporter through thick & thin and also a stay-at-home mom opines, “I like Obamacare because it means I’ll get free vaccines for my son.”

Oh. You wanted a lesson in life? Here goes:

For starters, no it’s not fucking free. You personally might not have to pay for it but that does not make it “free”. Everything has a cost, and the failure to grasp this concept is failure to grasp the fundamental laws of reality.

Now that we’ve gotten today’s lesson in metaphysics out of the way and we can agree that it’s not “free”, you have some explaining to do. 

You have to explain why someone else has to pay for the things you want, for instance explain why my wife and I (who both work) should be forced to pay to support your choice to not work? You would never dream of holding me as your slave and forcing me to provide for you, yet the policies you favor, and more specifically the political means by which you seek to effect your desired outcomes, are essentially just that.

And don’t give me any crap about the people who “can’t afford it” because:

  1. You’re not in that class and it’s an insult to anyone who is if you’re insinuating that, and 
  2. By and large people can or could afford things but they are prevented or otherwise forcibly deprived means of doing so (cf., Scratching by: How Government Creates Poverty as We Know It, On Breaking Your Legs and Giving You Crutches: A Response To A Liberal) and/or 
  3. They just choose not to because they’ve been conned in to believing, just like you, that these things are “free” and that they are entitled to them without providing for them.

Also, you need to explain why this mentality of yours isn’t exactly the same as the “selfishness” you abhor when a libertarian wants to keep the whole of her own earnings in order to provide for her own family, well-being, needs, etc.

But I’m pretty sure what I’m hearing right now is the sound of deaf ears not listening.

Why Does the U.S. Spend More on Health Care?

September 1st, 2010

The fact that the US spends more on health care is not particularly alarming. The NYT points out that, for the last 50 years the US has always spent more (as a % of GDP) on health care than the rest of the developed world. The problem is the velocity of change: health care expenditures are rising considerably faster in the US.

health care spending trend, OECD nations, 1960-2008

If you want to make something more affordable, you cannot continue to spend more money on it, nor can you continue policies which encourage bloat and bureaucracy. To be quite fair, there are dozens if not hundreds of factors that have contributed to the price increases.

  • The $100B/year tax subsidy given to corporations is pretty pervasive. Anyone who doesn’t work for a large corporation is at a disadvantage, unable to write off their health care expenses as tax-free — and more unfairly handcuffs people to their jobs.
  • The digital age has rapidly accelerated the development of new techniques and new technologies over the past few decades, but many of these procedures are extremely expensive (a problem that is exacerbated by the fact that many people view health care and insurance as a “Free Lunch”).
  • The technological advances have allowed us to live longer than ever before — but there is a price to pay. An aging population will always require more attention as the frailty of old age sets in: everything from reading glasses to new drugs and procedures to elder care and hospice.

But something else happened in the 80s that contributes to this problem: The AMA, an evil cartel the sole purpose of which is to extract the highest possible monopoly rents for its member doctors, with the collusion of congress, began restricting the number of new and potential doctors, in spite of an obviously aging population.

The marketplace doesn’t determine how many doctors the nation has, as it does for engineers, pilots and other professions. The number of doctors is a political decision, heavily influenced by doctors themselves…

The United States stopped opening medical schools in the 1980s because of the predicted surplus of doctors.

— via USAToday

The moratorium on new medical schools was not overturned until 2002 when the damage was already well underway. Thirty-ish years later, despite spending more, the US has fewer doctors, fewer nurses, and fewer hospital beds per capita than the OECD average [source: pdf].

This problem is going to take years to fix. I pointed out the metaphysical problem last time: there is already a shortage problem, and it’s only going to get worse if someone pronounces that medical care (provided by whom? at what costs?) will be an American birthright. A shiny new label that says “Universal Single Payer Awesome Health Care America Fuck Yeah!” isn’t going to work, the entire “system” is broken, and rotten to the core.

Universal Health Care: How?

August 28th, 2010

Take a gander across suburbia. As far as the eye can see: 60′ lots row by row mile by mile. Every single one of us has our own lawnmower, weed whip, edger, two fucking cars and 5 televisions, microwave dinners and central air-conditioning.  For christ’s sake people are wearing $200 Ed Retardy denim (Levi & Strauss probably rolling in their graves) and drinking $5 coffee-flavored milkshakes.

But folks are crying about lack of access to “universal” health care?

This is absurd for all those reasons listed above and then some, and also because it’s not that big of a “problem” that it can be handled other ways*. Everybody wants it, but nobody wants to give up their McWhatever or designer clothes or HDTV or unlimited talk text & web smartphones.

Governments at all levels (which have actively contributed to the health care crisis) have already demonstrated their inability to manage socialized health care programs with specific, limited scope. What makes anyone think that they’ll be able to do any better by expanding the programs and broadening their scopes? More government interference is unlikely to fix it.

But it’s bigger than that:

Exactly where is the capacity, in the current ‘system’ (for lack of better words), to cope with the increased demand for medical care and services which we know with absolute certainty will occur if national health care becomes a reality?

Allegedly there are millions of people who are clamoring for care, wallowing in their own urine, setting their own broken bones, eating Alpo because they can’t afford food, and self-medicating with a handle of Five O’ Clock because they can’t afford their meds. But all the doctors and nurses and practitioners are already working 40 or 50 or 60 hours a week. You aren’t going to get more doctors without a considerable (10+ years) lag unless you open the borders (which incidentally is fine by me), but the last time I checked, that wasn’t on the menu.

Where is it all gonna come from? The capacity is years, if not decades off. And that’s if we were to start now by dismantling all the subsidized oligopolies that are contributing to the current problem, and changing, reforming, or eliminating every sentence of every law or code which disadvantages individuals in favor of corporations. Otherwise, it’s just talk.

It is simply not possibly to will a perfect system in to existence merely by labeling it “universal.”

It’s a lie. Just like everything else they sell you. They get rich, and you get fucked.

+++

*Let me assure you that this is not an endorsement or defense of the current “system” of health & wellness care in the U.S.   There are plenty of things wrong with it, and plenty of things that could fix it overnight, the most apparent of which would be to immediately grant the same tax-favorable treatment to individuals as is had by corporations.  But these are never discussed in the mainstream.

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