Airline Pilot Central Forums

Airline Pilot Central Forums (https://www.airlinepilotforums.com/)
-   Money Talk (https://www.airlinepilotforums.com/money-talk/)
-   -   One Economists take on Healthcare (https://www.airlinepilotforums.com/money-talk/41766-one-economists-take-healthcare.html)

FighterHayabusa 08-03-2009 08:53 PM


Originally Posted by Winged Wheeler (Post 655754)
Beans and rice. Rice and beans. I've heard him before--not a bad show, at least the couple I've listened to.

I'll get back to your trucker, by and by. There are two big problems with health insurance: one is that the government is involved in it to the extent that the market forces acting in it are badly distorted. The other problem is that health insurance isn't doing what insurance is supposed to do.

Insurance is purchased by consumers to cover big, unexpected, or necessary expenses if you become unable to pay these yourself. You take out mortgage insurance to pay off your mortgage should the collateral (your house) be destroyed. Same with auto insurance. If you finance your car you might carry insurance to repair it if it is damaged. Once you own it, you might reduce your coverage to liability only.

Health insurance, as it is used today, is used to pay for routine checkups, innoculations, simple prescriptions, etc. What if car insurance paid for your full service oil change (with just a $15 copay)? And the government, through the motorcaid program paid seniors oil changes at no expense to them. How much do you think the jiffy lube would be charging?

This model is imperfect as people, and their bodies, are not cars. But I think the economic point here is valid.

I'll try later to suggest what I would do to improve this system.

WW

If I had my way:
1. Caps on medical liability payments. Gross malpractice lands the doctor in jail, not just without a license. This could save 5% off the top and possibly encourage more into the field.

1b) New degrees in between nurses and doctors that can provide for most primary care without needing a doctor supervisor. Incentives for new doctors (one of Canada's biggest problems is a doctor shortage).

2. Term limits for all politicians.

3. Mandatory emergency and catastrophic coverage - subsidies for those who REALLY can't afford it.

4. Non profit co-ops backed by government in case the worst happens, or government money with private administration for high risk pools. Basic coverage only, but consumers can buy-up higher tier care with private insurance on top of this.

5. Term limits for all politicians.

6. Move the cost of health care back to the consumer, replacing employer based coverage with individual tax credits. Let the consumer know what they are really paying and they will get angry if the doctor opens a $500 "suture kit" to give you two stitches.

7. Laws preventing insurance companies from dropping customers if they become sick. No lifetime maximums. Maybe disallow pre-existing condition screening... not sure about this one.

8, 9, 10 Term limits!

I don't know what to do about Medicare and Medicaid. I just don't see the private insurance market clamoring to cover people that a) can't pay for it or b) are very likely to be sick very soon. Medicare could probably start later now that people are healthier longer.

FighterHayabusa 08-03-2009 09:46 PM


Originally Posted by jungle (Post 655865)
Actually, the only way incentive is removed is by creating a monopoly and by killing any motive to conduct business with profit. It is blatant folly to proclaim that a government run monopoly created by fiat takes the place of honest competition.

Government has a function, unfortunately it has expanded that function well beyond all reasonable bounds and stiffled the private sector in direct proportion to it's expansion of monopolies. Many states have allowed private MVDs with very good results.

What we are seeing is redistribution and confiscation, not an honest effort to provide better service. Your public schools may be fine, but are all held to the same standard, is performance and merit equal to cost across the system? Could a private option do better? Why limit the right to choose?


How many of us would buy into the Social Security plan if not forced into it? How fast would the private company that offered such a plan be convicted of a felony and shut down?

To bring back an old argument though - private schools have not been killed by public education, and social security has not killed private investment in your own retirement. I think Social Security strikes a nice balance in this country: not saving for retirement should hurt, but it shouldn't be a death sentence. I don't mind at all that it is the least generous public retirement system of any western country, but I don't think we'd be better off without it at all. I also think public education is a big factor in the growth of the middle class in this country, and that a healthy middle class is necessary for sustained economic prosperity. Does that mean government can't go too far? Absolutely not. But the whole thing is an experiment, and some things just need to be tried out to see if they work over time.

I think laissez-faire capitalists are no less Utopian than Socialists. The reason things work so well in this country is not because of the existence of one or the other, but that the system forces moderation so neither could ever get their way, and change must occur slowly.

"It has been said that democracy is the worst form of government except all the others that have been tried."

Winged Wheeler 08-04-2009 09:37 AM

another economist
 
Thomas Sowell is one of the most brilliant men alive. Here is his column from today:

RealClearPolitics - Utopia Versus Freedom



"Eternal vigilance is the price of freedom." We have heard that many times. What is also the price of freedom is the toleration of imperfections. If everything that is wrong with the world becomes a reason to turn more power over to some political savior, then freedom is going to erode away, while we are mindlessly repeating the catchwords of the hour, whether "change," "universal health care" or "social justice."

If we can be so easily stampeded by rhetoric that neither the public nor the Congress can be bothered to read, much less analyze, bills making massive changes in medical care, then do not be surprised when life and death decisions about you or your family are taken out of your hands-- and out of the hands of your doctor-- and transferred to bureaucrats in Washington.

Let's go back to square one. The universe was not made to our
specifications. Nor were human beings. So there is nothing surprising in the fact that we are dissatisfied with many things at many times. The big question is whether we are prepared to follow any politician who claims to be able to "solve" our "problem."

If we are, then there will be a never ending series of "solutions," each causing new problems calling for still more "solutions." That way lies a never-ending quest, costing ever increasing amounts of the taxpayers' money and-- more important-- ever greater losses of your freedom to live your own life as you see fit, rather than as presumptuous elites dictate.

Ultimately, our choice is to give up Utopian quests or give up our freedom. This has been recognized for centuries by some, but many others have not yet faced that reality, even today. If you think government should "do something" about anything that ticks you off, or anything you want and don't have, then you have made your choice between Utopia and freedom. Back in the 18th century, Edmund Burke said, "It is no inconsiderable part of wisdom, to know much of an evil ought to be tolerated" and "I must bear with infirmities until they fester into crimes."

But today's crusading zealots are not about to tolerate evils or infirmities. If insurance companies are not behaving the way some people think they should, then their answer is to set up a government bureaucracy to either control insurance companies or replace them.

If doctors, hospitals or pharmaceutical companies charge more than some people feel like paying, then the answer is price control. The actual track record of politicians, government bureaucracies, or price control is of no interest to those who think this way.

Politicians are already one of the main reasons why medical insurance is so expensive. Insurance is designed to cover risks but politicians are in the business of distributing largesse. Nothing is easier for politicians than to mandate things that insurance companies must cover, without the slightest regard for how such additional coverage will raise the cost of insurance.

If insurance covered only those things that most people are most concerned about-- the high cost of a major medical expense-- the price would be much lower than it is today, with politicians piling on mandate after mandate.

Since insurance covers risks, there is no reason for it to cover annual checkups, because it is known in advance that annual checkups occur once a year. Automobile insurance does not cover oil changes, much less the purchase of gasoline, since these are regular recurrences, not risks.
But politicians in the business of distributing largesse-- especially with somebody else's money-- cannot resist the temptation to pass laws adding things to insurance coverage. Many of those who are pushing for more government involvement in medical care are already talking about extending insurance coverage to "mental health"-- which is to say, giving shrinks and hypochondriacs a blank check drawn on the federal treasury.

There are still some voices of sanity today, echoing what Edmund Burke said long ago. "The study of human institutions is always a search for the most tolerable imperfections," according to Prof. Richard Epstein of the University of Chicago. If you cannot tolerate imperfections, be prepared to kiss your freedom goodbye.

FighterHayabusa 08-04-2009 01:51 PM


Originally Posted by Winged Wheeler (Post 656099)
Thomas Sowell is one of the most brilliant men alive. Here is his column from today:

RealClearPolitics - Utopia Versus Freedom



"Eternal vigilance is the price of freedom." We have heard that many times. What is also the price of freedom is the toleration of imperfections. If everything that is wrong with the world becomes a reason to turn more power over to some political savior, then freedom is going to erode away, while we are mindlessly repeating the catchwords of the hour, whether "change," "universal health care" or "social justice."

If we can be so easily stampeded by rhetoric that neither the public nor the Congress can be bothered to read, much less analyze, bills making massive changes in medical care, then do not be surprised when life and death decisions about you or your family are taken out of your hands-- and out of the hands of your doctor-- and transferred to bureaucrats in Washington.

Let's go back to square one. The universe was not made to our
specifications. Nor were human beings. So there is nothing surprising in the fact that we are dissatisfied with many things at many times. The big question is whether we are prepared to follow any politician who claims to be able to "solve" our "problem."

If we are, then there will be a never ending series of "solutions," each causing new problems calling for still more "solutions." That way lies a never-ending quest, costing ever increasing amounts of the taxpayers' money and-- more important-- ever greater losses of your freedom to live your own life as you see fit, rather than as presumptuous elites dictate.

Ultimately, our choice is to give up Utopian quests or give up our freedom. This has been recognized for centuries by some, but many others have not yet faced that reality, even today. If you think government should "do something" about anything that ticks you off, or anything you want and don't have, then you have made your choice between Utopia and freedom. Back in the 18th century, Edmund Burke said, "It is no inconsiderable part of wisdom, to know much of an evil ought to be tolerated" and "I must bear with infirmities until they fester into crimes."

But today's crusading zealots are not about to tolerate evils or infirmities. If insurance companies are not behaving the way some people think they should, then their answer is to set up a government bureaucracy to either control insurance companies or replace them.

If doctors, hospitals or pharmaceutical companies charge more than some people feel like paying, then the answer is price control. The actual track record of politicians, government bureaucracies, or price control is of no interest to those who think this way.

Politicians are already one of the main reasons why medical insurance is so expensive. Insurance is designed to cover risks but politicians are in the business of distributing largesse. Nothing is easier for politicians than to mandate things that insurance companies must cover, without the slightest regard for how such additional coverage will raise the cost of insurance.

If insurance covered only those things that most people are most concerned about-- the high cost of a major medical expense-- the price would be much lower than it is today, with politicians piling on mandate after mandate.

Since insurance covers risks, there is no reason for it to cover annual checkups, because it is known in advance that annual checkups occur once a year. Automobile insurance does not cover oil changes, much less the purchase of gasoline, since these are regular recurrences, not risks.
But politicians in the business of distributing largesse-- especially with somebody else's money-- cannot resist the temptation to pass laws adding things to insurance coverage. Many of those who are pushing for more government involvement in medical care are already talking about extending insurance coverage to "mental health"-- which is to say, giving shrinks and hypochondriacs a blank check drawn on the federal treasury.

There are still some voices of sanity today, echoing what Edmund Burke said long ago. "The study of human institutions is always a search for the most tolerable imperfections," according to Prof. Richard Epstein of the University of Chicago. If you cannot tolerate imperfections, be prepared to kiss your freedom goodbye.


Do you think insurance companies are being dragged kicking and screaming into providing checkups and the like? I doubt it. The more money that flows through them, the better. If you don't believe me, try dropping the property tax and mortgage insurance escrow from your mortgage. Why do they want it? It's just money going in and out... or is it a free 0 interest loan to the mortgage company... hmmm...

Trying to end the practice of providing checkups will run you up against the same insurance company lobbies that are buying the "Canadian Style Health Care" commercials.

As far as the slippery slope to tyranny, I know I've seen that argument used before somewhere ...
Legislating Tyranny by Paul Craig Roberts and Lawrence M. Stratton

jungle 08-04-2009 05:04 PM


Originally Posted by FighterHayabusa (Post 655919)
To bring back an old argument though - private schools have not been killed by public education, and social security has not killed private investment in your own retirement. I think Social Security strikes a nice balance in this country: not saving for retirement should hurt, but it shouldn't be a death sentence.

I think laissez-faire capitalists are no less Utopian than Socialists. "

Why not allow vouchers for schools and let the public make a choice? Public schools have killed private options for most Americans. Forcing people to pay for two systems to attend a private school is really not a choice.

SS differs fom a Madoff scheme in which way? Forty trillion or so in unfunded liabilities makes Madoff look like a duffer. Why not allow the public to hold their own contributions and invest them as they see fit?

Laissez-faire capitalism has not existed in this country for a very long time. The politicos have had eighty years to regulate things to their satisfaction since the last great depression. The problem is that the regulators have gone completely unregulated and cause more mayhem then they prevent.

So again, I have to ask, do you actually think anyone would buy Social Security if it was not forced on them, but offered as a financial investment or product by free enterprise? Could such a thing be offered without criminal charges against the business?

FighterHayabusa 08-05-2009 08:19 PM


Originally Posted by jungle (Post 656322)
Why not allow vouchers for schools and let the public make a choice? Public schools have killed private options for most Americans. Forcing people to pay for two systems to attend a private school is really not a choice.

SS differs fom a Madoff scheme in which way? Forty trillion or so in unfunded liabilities makes Madoff look like a duffer. Why not allow the public to hold their own contributions and invest them as they see fit?

Laissez-faire capitalism has not existed in this country for a very long time. The politicos have had eighty years to regulate things to their satisfaction since the last great depression. The problem is that the regulators have gone completely unregulated and cause more mayhem then they prevent.

So again, I have to ask, do you actually think anyone would buy Social Security if it was not forced on them, but offered as a financial investment or product by free enterprise? Could such a thing be offered without criminal charges against the business?

I don't know about vouchers. I'm sure it would work fine in middle class neighborhoods, and mean death to schools in say, West Baltimore (just finished the last season of The Wire - great show). Unfortunately I think the system needs people to pay more for the people who can't pay at all. Some of those people who had no money will take that education and end up being the people to pay more later. Take away all the people who pay more and there's no way that school is getting better when all they have is the poor kids with no parents. No I'm inclined to try to figure out a way to fix the system incrementally.

Social Security differs from Madoff BECAUSE we are forced to pay into it. The government can lower benefits or raise taxes, Madoff can't create something out of nothing. Also Social Security isn't really an investment vehicle at all, it's a tax that's spent immediately on today's old people so it's kind of silly to calculate a return on it. The government is quite open about this, whereas Madoff wasn't.

I disagree that regulators cause all the problems - yes, usually the regulators are always late to the party, and a lot of regulations don't seem to make sense because they were knee jerk reactions. But we also haven't had another Depression since the 30s. Laissez-faire capitalism was characterized by regular bubble and bust - huge depression style busts every 13- 15 years because of over-exuberance and then overreaction. I'm inclined to go with a compromise on this one and will sacrifice part of the bubble for a little softer landing in the bust. I'll be the first to complain about OVERregulation, but not regulation as a whole. I'd never put my 6 months of expenses emergency fund in a non FDIC insured bank, would you?

If Social Security WERE an investment, it might be part of a lot of people's portfolios. It is a very low risk, inflation indexed investment like TIPS which people buy all the time. But again, it only "works" BECAUSE we are forced to pay into it, not that we get to opt out. The fact that we have members of a giant population boom reaching retirement, and they decided not to have a lot of kids is kind of an anomaly that I don't think it indicates a completely broken system. We should import a million doctors and it would go a long way toward fixing two problems :D

A lot of people wouldn't have paid for the Iraq war, either. Should we give them the option of opting out of paying for the war? Wouldn't really work would it? It's kind of an everyone or no one deal. Social Security isn't for YOUR benefit as a payer, it's for the old folks that are receiving your money NOW. Someone deemed it necessary to not have a lot of old broke folks littering the streets and that everyone should be involved in paying for it. You should count yourself lucky that we live in the least generous Social Security country and be glad the idea of expanding benefits seems ludicrous in our present situation.

jungle 08-06-2009 12:40 AM


Originally Posted by FighterHayabusa (Post 657036)

Social Security differs from Madoff BECAUSE we are forced to pay into it. The government can lower benefits or raise taxes, Madoff can't create something out of nothing. Also Social Security isn't really an investment vehicle at all, it's a tax that's spent immediately on today's old people so it's kind of silly to calculate a return on it. The government is quite open about this, whereas Madoff wasn't.

.

May I suggest you do a little reading on the history of SS? What it started as and what it mutated into are two different animals. What some bought into has had the terms changed so often that it has become a huge shell game.
Madoff couldn't create something from nothing, and guess what, neither can any other individual or entity.

In the end, if we wish to create charities, and lets face it these programs are just that-why not focus on the needy? Unless of course you start with the assumption that everyone is needy, which would bring us to our present situation.

Winged Wheeler 08-06-2009 08:45 AM


Originally Posted by FighterHayabusa (Post 657036)
I don't know about vouchers. I'm sure it would work fine in middle class neighborhoods, and mean death to schools in say, West Baltimore (just finished the last season of The Wire - great show). Unfortunately I think the system needs people to pay more for the people who can't pay at all. Some of those people who had no money will take that education and end up being the people to pay more later. Take away all the people who pay more and there's no way that school is getting better when all they have is the poor kids with no parents. No I'm inclined to try to figure out a way to fix the system incrementally.

Social Security differs from Madoff BECAUSE we are forced to pay into it. The government can lower benefits or raise taxes, Madoff can't create something out of nothing. Also Social Security isn't really an investment vehicle at all, it's a tax that's spent immediately on today's old people so it's kind of silly to calculate a return on it. The government is quite open about this, whereas Madoff wasn't.

I disagree that regulators cause all the problems - yes, usually the regulators are always late to the party, and a lot of regulations don't seem to make sense because they were knee jerk reactions. But we also haven't had another Depression since the 30s. Laissez-faire capitalism was characterized by regular bubble and bust - huge depression style busts every 13- 15 years because of over-exuberance and then overreaction. I'm inclined to go with a compromise on this one and will sacrifice part of the bubble for a little softer landing in the bust. I'll be the first to complain about OVERregulation, but not regulation as a whole. I'd never put my 6 months of expenses emergency fund in a non FDIC insured bank, would you?

If Social Security WERE an investment, it might be part of a lot of people's portfolios. It is a very low risk, inflation indexed investment like TIPS which people buy all the time. But again, it only "works" BECAUSE we are forced to pay into it, not that we get to opt out. The fact that we have members of a giant population boom reaching retirement, and they decided not to have a lot of kids is kind of an anomaly that I don't think it indicates a completely broken system. We should import a million doctors and it would go a long way toward fixing two problems :D

A lot of people wouldn't have paid for the Iraq war, either. Should we give them the option of opting out of paying for the war? Wouldn't really work would it? It's kind of an everyone or no one deal. Social Security isn't for YOUR benefit as a payer, it's for the old folks that are receiving your money NOW. Someone deemed it necessary to not have a lot of old broke folks littering the streets and that everyone should be involved in paying for it. You should count yourself lucky that we live in the least generous Social Security country and be glad the idea of expanding benefits seems ludicrous in our present situation.

A little thread drift here, but the principles are the same (or similar) whether you are talking about schools or healthcare.

In Friedman's Capitalism and Liberty he suggests a system where school taxes are collected and the revenue is divided equally per child. The tax money pays for the school that the parents choose. This honors our cultural value that children have a right to an education as well as our belief that children need such an education to be productive adults. I will not attempt to describe this system--I would not do it justice. The book is still in print if you are interested.

Anyway, that's one idea that would work for west baltimore, as well as for Biff and Muffy's kids out in the suburbs. How well are the children served in West baltimore by the system that they have now?

More later

WW

FighterHayabusa 08-06-2009 01:19 PM


Originally Posted by jungle (Post 657092)
May I suggest you do a little reading on the history of SS? What it started as and what it mutated into are two different animals. What some bought into has had the terms changed so often that it has become a huge shell game.
Madoff couldn't create something from nothing, and guess what, neither can any other individual or entity.

In the end, if we wish to create charities, and lets face it these programs are just that-why not focus on the needy? Unless of course you start with the assumption that everyone is needy, which would bring us to our present situation.

Where it comes from is irrelevant. Are you claiming that what I said it is now is wrong? You pay in, a portion goes into a government bond trust fund for the time when people paying can't meet the pay out obligations, and the rest goes to old people. Where is the government covering this up and playing a shell game? They are perfectly honest in when they think the trust fund has to start paying and when the trust fund will run out (and they will still meet 76% of their obligation if we do nothing). Social Security tax is taken from you and no longer becomes your money. There is no promise to give it back, or provide you a return or even give you Social Security payments in the future.

If you gave someone the option of not paying for Social Security, you'd have to tax them (or borrow it in Bush's solution) the same amount to pay for those currently receiving it. For what it's worth, I liked Bush's plan and disliked the slippery slope smear campaign that was played on that just as much as I dislike the smear campaign on health care reform now.

As far as whether it's a charity or not is a tangent. I'm proving the point that it's different than Madoff because it's wide open for anyone to see.

FighterHayabusa 08-06-2009 01:29 PM


Originally Posted by Winged Wheeler (Post 657269)
A little thread drift here, but the principles are the same (or similar) whether you are talking about schools or healthcare.

In Friedman's Capitalism and Liberty he suggests a system where school taxes are collected and the revenue is divided equally per child. The tax money pays for the school that the parents choose. This honors our cultural value that children have a right to an education as well as our belief that children need such an education to be productive adults. I will not attempt to describe this system--I would not do it justice. The book is still in print if you are interested.

Anyway, that's one idea that would work for west baltimore, as well as for Biff and Muffy's kids out in the suburbs. How well are the children served in West baltimore by the system that they have now?

More later

WW

Actually I'll admit I didn't read about vouchers before posting. I'm a little more educated on them now. If you could prevent "Cream Skimming", where private schools deny all but the best students, and if parents did not have to pay more on top of the voucher to send their students to the private school I could go for it.

Otherwise it seems like a thinly veiled method to sabotage public schooling by taking only the profitable kids and leaving the rest. Then sitting back and saying I told you so when the public school inevitably fails.

Also teachers unions are against vouchers which automatically makes it look good in my eyes.


All times are GMT -8. The time now is 05:36 PM.


User Alert System provided by Advanced User Tagging v3.3.0 (Lite) - vBulletin Mods & Addons Copyright © 2024 DragonByte Technologies Ltd.
Website Copyright ©2000 - 2017 MH Sub I, LLC dba Internet Brands