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View Diary: Lying, ignorant blowhard of the week award (22 comments)

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  •  Two people get it a little wrong, a little right (0+ / 0-)

    Both Stossel and "therealcervantes" have it wrong... and a little bit right.

    Stossel is absolutely correct to note that insurance creates "moral hazard" ... insurance means that risky behaviors and their consequences are cheaper... the analogy to grocery shopping and travel is quite apt.   Insurance makes stuff cheap, and hides prices, and people consume stuff that is cheap, and they consume without regard to price if they don't know the price or pay it.

    therealcervantes has it all wrong when he says

    "Health care is nothing like groceries.  I'm not going to go out and get a Coronary Artery Bypass Graft or a bowel resection just because my insurance pays 80% of the cost -- I'm going to get those operations because I have heart disease, or cancer.  And I'm not going to decide on my own that I need them -- my doctor is going to tell me.  "

    There are thousands of procedures and medical choices that are not either/or necessary/not necesary binary decisions, but involve tradeoffs of quality and price, and insurance obscures all of that.

    But therealcervantes is quite correct that medical-insurance complex is a  heartless bureacratic machine.... every bit as heartless as any  universal insurance scheme.

    The reason we need universal insurance is least of all because of the uninsured.... although that is very important.

    The reason  we need universal national health insurance is because we need to restrict total health care spending, and the ONLY way to do that ethically is through a democratic consensus process... in other words health care is too important to be left to the market... and too dangerous to be left to the market.

    Health care is dangerous because there is almost no end to what people are willing to spend to preserve life and limb, and no end to physicians and health care systems who are willing to facilitate their spending, and ultimately this mad rush to optimize the last few percent of life years eats away at resources that could be spent for other productive and environment saving and city building and other uses that would benefit everyone's health and well being.

    Even dying a little early in a society that takes care of everyone is preferable to eeking out a few extra weeks of life on the backs of the health of millions impoverished by an economy that spends too much on health care and not enough on all the other things that make people healthy.

    So, yes, we absolutely need national health care as part  of a democratic consensus.... but your argument against the economic  dangers of insurance is completely misguided, and the article you critique has THAT part much closer to the truth.

    How do we avoid the moral hazard with  universal health coverage?

    We ration care.   We invest in some research but not in every research opportunity.  We focus on low hanging fruit.   We invest, but not to the extent that we slow economic growth (which also creates healthy people!)  

    Why can we get away with rationing care?  For the same reason that European social democracies do... they forge a social consensus.   We create a democratic consensus that supports a just allocation system, in which everybody understands they will have their basic health needs met, but people also understand that we won't support every expensive health care option that might exist.

    We can't eliminate moral hazard from any insurance scheme, but we can reduce it by limiting the total pool of dollars available to everyone, while building a more consensus based solidarity oriented society.   That's much smarter and more just than the free market approach to reducing moral hazard by eliminating insurance altogether....

    When people get that rare disease or require an expensive unresearched treatment they will of course scream.  And  they may be able to pay for it, but not on the public dime.   And if they cannot mortgage the house they may die.   And that will be tragic.   But so is the current mess... every single day.

     

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