In article <11nvgcv53k6jn56@corp.supernews.com>,
Vic Vega wrote:
>
> wrote in message news:3s29kiFltm9lU1@individual.net...
>> It is very common. If you have a chronic health condition like many
>people in
>> the 50's and 60's and you do not have GROUP health insurance (decent
>individual
>> insurance would cost $3000.00/month) it is nearly impossible for middle
>class
>> people to get proper treatment. You can also get screwed very easily even
>if
>> you do have group insurance. The US health care system is totally .ed
>up by
>> the standards of the rest of the industrialized world and gets worse and
>worse
>> every year.
>
>So don't let the door hit you in the ass on your way out, you whiny bitch.
>
I have group health insurance, idiot. But 80 million Americans do not have
group insurance, and they're screwed by a shitty health care system that
is fundamentally flawed. Thanks for providing evidence that archconservative
nutjobs are so self-centered and selfish freaks that someone caring about their
fellow citizens is completely beyond their comprehension.
It is outrageous that Americans are still stuck with a health care system that
is a piece of shit while every other industrialized country has a far more
efficient universal system and usually have better health statistics and longer
life spans. Polls consistently show that Americans would prefer to have a
universal health care system. And since the current US system gets worse and
worse every year, it is only a matter of time before the US catches up to the
rest of the industrialized world.
*Health Economics 101*
By Paul Krugman
The New York Times
Monday 14 November 2005
Several readers have asked me a good question: we rely on free
markets to deliver most goods and services, so why shouldn't we do
the same thing for health care? Some correspondents were
belligerent, others honestly curious. Either way, they deserve an
answer.
It comes down to three things: risk, selection and social justice.
First, about risk: in any given year, a small fraction of the
population accounts for the bulk of medical expenses. In 2002 a mere
5 percent of Americans incurred almost half of U.S. medical costs.
If you find yourself one of the unlucky 5 percent, your medical
expenses will be crushing, unless you're very wealthy - or you have
good insurance.
But good insurance is hard to come by, because private markets
for health insurance suffer from a severe case of the economic
problem known as "adverse selection," in which bad risks drive out good.
To understand adverse selection, imagine what would happen if
there were only one health insurance company, and everyone was
required to buy the same insurance policy. In that case, the
insurance company could charge a price reflecting the medical costs
of the average American, plus a small extra charge for
administrative expenses.
But in the real insurance market, a company that offered such a
policy to anyone who wanted it would lose money hand over fist.
Healthy people, who don't expect to face high medical bills, would
go elsewhere, or go without insurance. Meanwhile, those who bought
the policy would be a self-selected group of people likely to have
high medical costs. And if the company responded to this selection
bias by charging a higher price for insurance, it would drive away
even more healthy people.
That's why insurance companies don't offer a standard health
insurance policy, available to anyone willing to buy it. Instead,
they devote a lot of effort and money to screening applicants,
selling insurance only to those considered unlikely to have high
costs, while rejecting those with pre-existing conditions or other
indicators of high future expenses.
This screening process is the main reason private health
insurers spend a much higher share of their revenue on
administrative costs than do government insurance programs like
Medicare, which doesn't try to screen anyone out. That is, private
insurance companies spend large sums not on providing medical care,
but on denying insurance to those who need it most.
What happens to those denied coverage? Citizens of advanced
countries - the United States included - don't believe that their
fellow citizens should be denied essential health care because they
can't afford it. And this belief in social justice gets translated
into action, however imperfectly. Some of those unable to get
private health insurance are covered by Medicaid. Others receive
"uncompensated" treatment, which ends up being paid for either by
the government or by higher medical bills for the insured. So we
have a huge private health care bureaucracy whose main purpose is,
in effect, to pass the buck to taxpayers.
At this point some readers may object that I'm painting too dark
a picture. After all, most Americans too young to receive Medicare
do have private health insurance. So does the free market work
better than I've suggested? No: to the extent that we do have a
working system of private health insurance, it's the result of huge
though hidden subsidies.
Private health insurance in America comes almost entirely in the
form of employment-based coverage: insurance provided by
corporations as part of their pay packages. The key to this coverage
is the fact that compensation in the form of health benefits, as
opposed to wages, isn't taxed. One recent study suggests that this
tax subsidy may be as large as $190 billion per year. And even with
this subsidy, employment-based coverage is in rapid decline.
I'm not an opponent of markets. On the contrary, I've spent a
lot of my career defending their virtues. But the fact is that the
free market doesn't work for health insurance, and never did. All we
ever had was a patchwork, semiprivate system supported by large
government subsidies.
That system is now failing. And a rigid belief that markets are
always superior to government programs - a belief that ignores basic
economics as well as experience - stands in the way of rational
thinking about what should replace it. |
