October 18, 2006
Health Wonk Review
I'm hosting Health Wonk Review this week, where health wonks, uh, review each other's posts. Or something. No -- don't leave! It's fun!
We begin with the dashing Matt Holt, who explains how you can get cancer, get fired, become homeless, and lose your health insurance all in a few easy steps! I assume you'll see this one on self-help shelves wherever fine books are sold sometime soon, but you can read it at Spot-On first. Meanwhile, guest-posting over at Holt's blog, health care lobbyist Erik Novack doesn't like bureaucracy. Aye, tis a brave and bold stand the laddy takes! And speaking of bureaucracy, Tony Chen notices some odd maneuverings in the hospital industry.
Next we meet Emily DeVoto, who thinks Tyler Cowen's op-ed arguing that Americans pay out the nose for care because we're subsidizing a massive, world-leading research industry is, shall we say, unconvincing. I've always wondered, incidentally, what would happen if Republicans stood up at the debates and explained that they would, as a matter of policy, keep Americans paying exorbitant prices for pharmaceuticals in order to subsidize advances and discounts for Canadians. We are a generous people...but that generous?
My frequent interlocutor Michael Cannon is earning his Cato corner office by advocating the destruction of Medicaid and its transformation into nothing but block grants. And more block grants. And a couple more block grants. Because if there's anything states, with their inability to deficit spend when times turn bad, are good at, it's providing stable and reliable public services to the unstable and insecure populations that rely on them. While Michael is destroying Medicaid to "save" it, David WIlliams thinks he's got the answer to our health care problems more generally: Information. Julie Ferguson notices that employers think they have the answer too: On-site health clinics. And Jason Shamfrin explains what's right and wrong with everyone's favorite solution: Pay For Performance medicine.
Meanwhile, out in Oregon, the state is taxing smokers to fund health care 4 kidz. If there's anything I'm for, it's kids. If there's anything I'm against, it's smoking. These are brave political stands, I know, but my courage and principles sustain me through even the darkest of nights.
Bob Vineyard helpfully points out that the Citizen's Commission on on Health Care Awesomeness has returned recommendations for more awesomeness in health care. How that awesomeness will work, or who will pay for it, was not mentioned. And I point out, relatedly, that of course the Citizen's Commission is ridiculous, because public attitudes on health care are less coherent than a frat boy at dollar pints night. On the bright side, Americans will accept generous, universal benefits, for free, that don't raise taxes, ask them to exercise more, or in any way lend themselves to negative advertising.
Th-th-th-th-that's all folks. Thanks for coming to Health Wonk Review.
My emphasis is always on the need for a single universal, nationwide, "all-American" insurance "pool."
- The whole point of insurance is to spread the risk
widely and to be even and fair.
- No skimming by risk group (healthy, wealthy,
- No race to the bottom by state or regional (e.g.,
Southern states do less like with Medicaid programs)
- No opt out: everybody pays in (via tax) and everybody eligible. Inevitably can of course opt-plus or buy-plus... buy supplemental or some such; but still pay into system.
- competition on the delivery end, not on the insured pool side.
- Favored is of course "Medicare for All"
Any system that allow for opt-out up front, or any form of skimming, or any form of a non-nationwide pool, is designed to fail. This is in part is the difference between Medicare and Medicaid.
Remember when Clinton’s pre-inauguration policy summit ruled single payer off the agenda from the beginning in hopes of getting “moderate” support, and then Hillary-care still got “swift boated” by the insurance companies?
I know some consider it to far fetched, but “Medicare for All” has a good ring to it.
Posted by: DrSteveB | Oct 18, 2006 12:09:28 PM
To be fair. Eric Novack is a doctor who distrusts lobbyists, not one himself!
Posted by: Matthew Holt | Oct 18, 2006 2:38:35 PM
Nice job, Ezra...Thank you for hosting this edition!
Posted by: hgstern | Oct 18, 2006 3:01:54 PM
Posted by: Jay | Oct 18, 2006 8:44:54 PM
Great post, I see racial self-segregation all the time, and I want to investigate the issue more thoroughly.
I always find something new and interesting every time I come around here - thanks.
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