Friday, June 30, 2017

Economics of health care and the soul




CBS this morning, Rand Paul discusses the health care bill. He said a lot about the economics of it but the one thing missing from hi equation is the fact that it's about helping people who need medical care. One would think it;s about people buying a car, That's because Republican senators look at money differently than the rest of us. Take one example isolate one aspect of the bill. Let's take the issue of the 22 million who will lose their insurance under ''trump care."[1]

The republican's major  argument is that these guys will drop out because the Obama requirement to have insurance will be lifted.They wont be forced to buy it so they wont buy it.That means they are consumers making a decision not people in need of care who can't afford something. Here we see the fundamental difference in the way Republican senators look at money and the way ordinary people do,For Republican senators money is a tool which enables one to increase personal power, gain security agaisnt the trammels of the world, and procure pleasure for oneself. For working people ad poor people money is more like blood in your body or breath in your lungs. For the Senators one is makimng choices between options, choosing to spend. The issue is about choosing to spend. For the parents with a child who has cancer who owe $200,000 in meds there are no options either they have the money or they do not. That kind of money for most people can only come from insurance, and without a requirement to make the insurance people accept  pre-existing conditions a lot lot of kids will die, It's not a matter of choosing. They are not shoppers they are not medicals consumers.

The Senators heads are in economics text books and business culture that just does not view human need as part of the equation, It assets the spending of money is always a choice made by consumers who can choose between alternatives but for real people whose child will die the alternative is not there there. Two other attitudes of Paul's related to this issue also serve to illustrate the consequences of this kind of thinking. one is his assertion that they are not really cutting back medicaid. The other assertion he makes is that regulation increases cost of medical care and to get cost down and create the alternatives we have to end regulation. The lie that they are not cutting medicaid is because they don't count the medicaid expansion created when Obama care was past as really part of medicaid "proper." But this is just another example of how their thinking lacks real humans in the equation, read people are part of that expansion and they need it. Here they assert the tax incentives will help them to buy new insurance but most poor and working class people can't do anything with a tax incentive, you don't pay tax you have no tax incentive.

The idea that regulation increases cost is the result of that kind of negative thinking that comes from business culture. It's based upon money not made which is counted as lost. I estimated that I should make $40 million on some venture but undertaking it would mean regulation  will reduce my profit to 30 million,I've lost 10 million due to regulation. So i will run the price up to make up for the "loss." The truth is I didn't lose anything because it's not even done yet. The bottom line is real people are not shoppers they need medical care and that means they need issuance like we need blood. If we take away the mandate to buy insurance of course they will choose not to buy it because they need that money for other things. But they are not merely making an economic decision they are doing what they can to survive, often at the risk of dying due to illness. They are gambling with their health because they have no choice. The bill leaves things like pre existing condition up to the states,fora lot of states,such as my beloved lone star disaster, that means less money to cover people. Our governor just refused medicaid money. let them die.

It makes much more sense to fix Obama care and keep it than to scrap it and try to start over and please all the contradictory views, or as the Publicans have opted just leaving real human need out of the equation. They are really using the excuse of eliminating Obama care (a promise no one cares about now) as a cover for making more  tax relief for the rich. When questioned about that option it's really hiding tax relief in health care Senator Paul essentially admitted that's the case,




[1] Removing the mandate is not the only reason, others are given increased premiums

"But the budget office put Republicans in an untenable position. It found that next year, 15 million more people would be uninsured compared with current law. Premiums and out-of-pocket expenses could shoot skyward for some low-income people and for people nearing retirement, it said.
The legislation would decrease federal deficits by a total of $321 billion over a decade, the budget office said."

NYT 
https://www.nytimes.com/2017/06/26/us/politics/senate-health-care-bill-republican.html

2 comments:

Jimmy S. M. said...

I don't know how to convince people that they should care about other people, and I'm at a loss for why they don't. I don't see how they can't imagine being in the position of the parents who have to pony up $200k or watch their kid die, and not want to make sure that no has to face that choice, in a country with this many resources. I don't get it Joe.

Joe Hinman said...

I know I feel that way too,It just floors me that people dom't care about others,