January 08, 2007
Insurance, or Insulation?
Posted by scott at January 08, 2007 02:26 PM
It's actually 90% of Americans who lack health insurance. All depends on what you mean by "insurance", donchaknow? While his arguments about allowing market forces a freer reign in the health care space are quite well-reasoned, to me he still avoids what I consider the ultimate uncomfortable truth about such an approach: if I can't afford the latest Widgetmaster 3000, I don't buy it, making due with my widgetmaster 200 instead. If I can't afford the latest heart medication, I freaking die.
Now, I imagine Mr. Kling has very good arguments to make about the effectiveness of the latest meds versus their cost. He makes several in the article. But in my opinion it's the perception that the latest and greatest is what might just keep us alive that drives a lot of the demand for "premium" health services. When the consequence of not being able to afford something is death, it seems to me the market gets warped all out of shape, and I've yet to read an economist who has addressed this (to me) central point adequately.
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A couple of things I noted from this article: He also doesn't take into account "Wellness" visits, such as yearly physicals, breast screen, gyn visits, etc. These, if done properly, catch a large number of diseases and conditions early and allow for much less expensive treatement.
A second note, and this is on your "death" alternative. Many of the newer drugs that people pay a premium for are simply controlled or extended release versions of the original, which has gone generic. While it's a pain to take the drug more often, it's not impossible.
Another issue to consider is the rising level of obesity (or the cure for starvation) in our country, which coupled with a more sedentary lifestyle, is leading to all sorts of health issues (diabetes is an expensive one). Oddly enough, I've read evidence that switching to a very high-protein/low carb (5% or less) diet can actually cure many cases of diabetes. Pretty damn amazing and very, very cheap.
Maybe the idea would be to promote some sort of discounts for healthier people. Many programs already give discounts for folks who don't smoke, so why not give additional discounts for those who exercize regularly (though proving that might be unworkable), or who maintain low heart rates, keep their weight down, eat healthy, etc.
And offer additional reductions for those who actually have their yearly Wellness stuff done. If it catches things early and costs less, why not pass that on?
For Christ's sake, it's free rein, not free reign.. No "G". The expression comes from the days of horseback-riding and horse-drawn carriages, and it means that you release all control over where something is going (and it usually is carrying you along with it.) It doesn't have anything to do with "reign" the way a king would.
Yes, I know that "free reign" parses, and that it usually winds up meaning something similar. That doesn't make it right; the same way that you can't "clean up a room" by cramming everything under the bed.
As for the article: I like how he claims that there's no need to screen for colon cancer since most of those people afflicted by it die of something else. Well, I suppose he's right; after a few years of needing a colostomy bag because cancer ate my bowels, I'd probably shoot myself in the head. It wouldn't be the cancer that killed me, though!
Heh. Oops. Geeze man, who peed in your cheerios today?
"free reign" is one of those meme/spelling-errors that drives me right up the freaking wall. It's like ordnance/ordinance, or turret/turrent, or site/sight. I remember someone claiming that he'd found a web sight about laser sites...
DD, don't feel bad. I'm on a football forum constantly and see many things like that. Nothing worse, IMO, than screwing up cliches. Seriously, get them right 'cause if you don't, that duck ain't gonna hunt.
It's like when you shoot your own foot into your mouth. Or how when the going gets tough, the tough get gone.