Yes Healthcare is Different and Can’t be Sold Like Bread
As I argued in my last post, Senate Trumpcare is worse than even the House version-indeed it’s the worst bill since the Poor Laws. There truly is nothing like this in our history-it would take us not back to the pre 2009 status quo but the pre 1965 status quo.
Senate Trumpcare is the worst bill since the Poor Laws, It takes us back to not pre 2009 but pre 1965 LBJ Medicaid
The GOP is, of course, putting out all kinds of zombi arguments to defend this terrible, awful, bad, very bad, no good so-called healthcare bill.
“Avik Roy, a conservative health expert who serves as president of the Foundation for Research on Equal Opportunity, said the legislation’s proponents need to show “that competitive insurance markets can work for the poor and the vulnerable and the sick.”
“People too often equate federal spending with establishing a safety net, when greater competition and a free market could produce better results at a lower cost, in Roy’s view. The Senate bill would extend “quite robust” tax credits to many people, he said, even to those living in poverty who were not eligible for Medicaid: “Republicans have a different view of what a safety net should look like.”
I love Joy Reid, but was a little irritated by Avik Roy’s appearance on her show yesterday in that nobody contradicted his false claim that about 18 million out of the 23 million the CBO projects to lose healthcare in Trumpcare are just young people forced against their will to buy because of the individual mandate.
There are some that fit this description but nowhere near 18 million. Caroline Orr:
“Like the House version, the Senate bill proposes drastic cuts to spending on healthcare for low- and middle-income Americans in order to fund a tax break for those who earn more than $200,000 a year – which is immediately problematic. Among other fundamental changes to the healthcare system, the bill undermines consumer protections and proposes draconian cuts to Medicaid, the government-run health insurance plan that provides coverage to pregnant women, single mothers, individuals with disabilities, and low-income seniors. While the Senate version has not yet been scored by the Congressional Budget Office (CBO), the CBO’s analysis of the AHCA estimates that of the 23 million people who will lose insurance coverage, about 60% –or 14 million people—will lose it because of AHCA’s massive cuts to Medicaid.”
I would also recommend, incidentally, that you follow Caroline O. @RVAwonk on Twitter. She does some great analysis IMHO.
In her above post itself, she also makes the good point that Trumpcare is also a bad deal for the young-despite the GOP’s glib pretense that the young have no need of healthcare. Unfortunately not all young people are healthy either.
But, in any case, we see that most of those who lose their healthcare lose it not because they bought some skimpy plan to placate the individual mandate, but recipients who stand to lose their Medicaid:
But Avik Roy’s Washington Post quote is just as risable-‘competitive insurance markets can work for the poor and the sick.’
No they can’t. But there is this illusion that healthcare should be treated the same way as the market for bread or apples.
“Yet conservative Sen. Patrick J. Toomey (R-Pa.), one of the bill’s champions, said it would establish “a very, very gradual and gentle transition to a normal inflation rate” for a program in which he said costs were spiraling out of control. Beyond Medicaid, it would permit private health plans to cover fewer services and would allow individuals and employers to eschew coverage without penalty — elements that its authors say could lower how much consumers pay for their insurance.”
“The idea that there’s a sector of our economy that has to permanently have a higher inflation rate than the rest of our economy is ridiculous,” Toomey said Thursday. “I think that it’s absolutely essential to putting [Medicaid] on a sustainable path so that it will be there for future generations.”
This comes from an important error-that healthcare is just like any other market or should be treated as such.
Kenneth Arrow-who forgot more about free markets than a Tooomey or an Avrik Roy would ever know-understood that healthcare is different.
Paul Krugman documented this in 2009.
“One of the most influential economic papers of the postwar era was Kenneth Arrow’s Uncertainty and the welfare economics of health care, which demonstrated — decisively, I and many others believe — that health care can’t be marketed like bread or TVs. Let me offer my own version of Arrow’s argument.”
“There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.”
“This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.”
“This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.”
“The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.”
As for the constant GOP peons to ‘consumer choice?’ A total canard in a discussion about the health insurance market. It’s never the consumer’s choice-the free market version just means private insures get to decide.
P.S. So the Gravis poll against Peter King NY2 and it has good news-almost too good to believe.
In my March poll I trailed King by 11 and thought that was very good news. Now Gravis has me up by 10? Still, the moment of truth is next week when Gravis writes up the press release.
I can use any help I can get at this point-volunteers or supporters who live in NY 2. Donations whatever your zip code. These days we can’t just support a local Dem we need a Dem Congress. Which is why I’ve donated few hundred to Jon Ossoff.
Please donate to help me in my part of the effort to fight for a Dem House-$5 or $10 can do so much.
If you feel that you can’t I, of course, understand-who is rich these days? But please do me one favor: ask yourself privately, mentally, if you really can’t spare $5 dollars. If you can honestly say you can’t, no worries.
We can have a Dem Congress, we must have a Dem Cogress, and we will.
Thank you. We must have a Dem House. And so, we will.