I want to discuss why a single payer system for health care is better than insurance. I am not going to go into ethics or what people deserve. Instead, I am going to focus on value and efficiency.
First, it is important to fully understand what insurance is. On an individual level, insurance is a bet. The house bets that an event will not happen. The gambler bets that it will. For the customer, flood insurance is a bet that there will be a flood that causes more damage than the cost of the insurance. For the insurance company, it is a bet that such a flood will not happen. On a group level, insurance is a form of welfare. It is essentially a means for distributing costs (you have probably heard of distribution of wealth; well, insurance is a way to balance distribution of debt). When the insurance company looses a bet, the money used to pay for the losses comes from the money all of the other customers are putting into the pot. As gambling, insurance is no different from any other kind of gambling. The house always wins, and they want you to spend as much as possible, which is why they offer so many different options. As welfare, insurance is actually pretty awful. Imagine a welfare system where those administrating it constantly skim the poor box. This is more than just compensation for work. Insurance companies have CEOs, other extremely highly paid management, as well as shareholders who walk away with the house winnings. No well designed welfare system goes to such extreme efforts to avoid helping anyone, just to walk away with the unused funds.
In short, insurance makes extremely poor and inefficient welfare. It makes excellent gambling, at least for the house, but unless gambling is the whole point, insurance is actually pretty awful. Economically, there is one useful thing that insurance provides: jobs. Of course, paying people to spend 40 hours a week digging random holes would provide jobs as well, and those jobs might actually produce real value (good exercise for the employees, if nothing else). Work for the sake of jobs is just plain stupid. If work does not generate actual value, then it is not worth doing.
The better solution is real welfare. Real welfare is not gambling. Done well everyone wins. Real welfare minimizes work, to maximize the help it can provide. Real welfare does not have executives that are paid more in a month than most people make in a lifetime, and it does not have investors who ultimately get paid from the work of others.
It is very clear that our current health care situation in the US is unacceptable (despite Obamacare). Aside from reducing costs (which not even the government seems interested in), the only way to fix this situation is to spread the cost of health care out. Insurance is a very poor way of doing this, because insurance is more about gambling than welfare. Long term, the costs of insurance on the economy are far worse than the long term costs of welfare, despite the loss of jobs associated with eliminating health insurance companies. Economically, a single payer system is superior in almost every way to what amounts to mandated gambling.
Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts
07 August 2015
23 March 2015
Obamacare 5th Birthday
Today is the 5th birthday of Obamacare, and many of its supporters are excited about recent data showing how successful it has been. Over 16 million Americans have managed to get health insurance through the programs it created, and the estimated percentage of uninsured adults in the U.S. has dropped from 20.3% to 13.2% in the last two years. By these metrics, Obamacare has indeed been a success (assuming we can find evidence that attributes these gains to Obamacare; no such evidence currently exists).
The problem with all of this excitement is that the rate of insured Americans is not the important part. Obamacare was designed, according to its supporters, to help the poor get better access to health care (which is why its official name is "Affordable Care Act"). More Americans may be insured, but what do the numbers specifically for the poor look like? Has the percentage of insured poor Americans improved as much as the national average, or is that 13.2% almost exclusively the poor? Really though, even this is not the important metric. It is the Affordable Care Act, not the Affordable Insurance Act. The real question is: Are the poor in the U.S. actually receiving improved health care? In corollary to that, are the U.S. poor significantly healthier than they were before?
The success or failure of Obamacare has nothing to do with health insurance. The only guarantee with increased numbers of Americans being insured is that the insurance companies are making more money. The long standing quality problem with U.S. health insurance was not really addressed by Obamacare. High deductibles are still a major problem, and there is no reason to believe that Obamacare has solved this problem, especially for the poor who still cannot afford the high premiums required for lower deductible plans. It would be quite interesting to see the data on how much more money health insurance companies have paid out in claims to their poor customers. This would at least be an indicator of whether the poor are even benefiting at all from Obamacare. If the payouts are not rising at the same rate that insured Americans are, then Obamacare is essentially scalping the poor for the benefit of the rich insurance companies.
Aside from general success or failure, which depends solely on how the law has affected the actual health of the poor, the question of payouts is very important. Is Obamacare really a law the helps the poor, or is it legalized government extortion that only profits health insurance companies? If it is not helping the poor significantly, then its costs are not justified, and it should be abolished as quickly as possible. If it really is providing significant help to the poor (which I doubt, though I am prepared to be proven wrong), then the evidence of that should be made public. Currently, however, the evidence we have only indicates that more people are giving money to insurance companies. There is no evidence that this is actually benefiting anyone else.
The problem with all of this excitement is that the rate of insured Americans is not the important part. Obamacare was designed, according to its supporters, to help the poor get better access to health care (which is why its official name is "Affordable Care Act"). More Americans may be insured, but what do the numbers specifically for the poor look like? Has the percentage of insured poor Americans improved as much as the national average, or is that 13.2% almost exclusively the poor? Really though, even this is not the important metric. It is the Affordable Care Act, not the Affordable Insurance Act. The real question is: Are the poor in the U.S. actually receiving improved health care? In corollary to that, are the U.S. poor significantly healthier than they were before?
The success or failure of Obamacare has nothing to do with health insurance. The only guarantee with increased numbers of Americans being insured is that the insurance companies are making more money. The long standing quality problem with U.S. health insurance was not really addressed by Obamacare. High deductibles are still a major problem, and there is no reason to believe that Obamacare has solved this problem, especially for the poor who still cannot afford the high premiums required for lower deductible plans. It would be quite interesting to see the data on how much more money health insurance companies have paid out in claims to their poor customers. This would at least be an indicator of whether the poor are even benefiting at all from Obamacare. If the payouts are not rising at the same rate that insured Americans are, then Obamacare is essentially scalping the poor for the benefit of the rich insurance companies.
Aside from general success or failure, which depends solely on how the law has affected the actual health of the poor, the question of payouts is very important. Is Obamacare really a law the helps the poor, or is it legalized government extortion that only profits health insurance companies? If it is not helping the poor significantly, then its costs are not justified, and it should be abolished as quickly as possible. If it really is providing significant help to the poor (which I doubt, though I am prepared to be proven wrong), then the evidence of that should be made public. Currently, however, the evidence we have only indicates that more people are giving money to insurance companies. There is no evidence that this is actually benefiting anyone else.
27 January 2015
Hobby Lobby and Mandatory Benefits
The Hobby Lobby case was an extravagant law suit. Of course religious freedom should have won. There should never have been any question. The problem was not with Hobby Lobby, and it was certainly not about human rights. The problem is with who carries the obligation to enforce those rights.
Consider how this would play out: The government decides to enforce the right to own property by putting businesses in charge of it. Now, businesses are legally required to handle things like evictions and property deeds for their employees. If an employee is robbed, the employer is required to investigate and bring the thief to justice. Oh yeah, and this only applies to full time employees.
Now, considering the following: The government and the majority of Americans establish that adequate medical care is a fundamental human right. The government comes up with a list of medical care related things that every person should have free access to. Now, to enforce this the government does two things. First, it puts enforcement in the charge of for-profit businesses. Businesses are now required to provide their employees with the list of things that every person should have free access to. Now, we cannot forget though, this only applies to full time employees. The second thing the government does is to mandate that anyone who is not a full time employee must pay, out of their own pockets, for insurance. This is great. Now, the government says that adequate medical care is a fundamental human right, so we are forced to enforce this right ourselves on an individual basis. That makes perfect sense. Imagine if this was applied to freedom of speech. If the government tries to shut us up, our only recourse is to fight the government as an individual. Appealing to the law would not be an option, because it is our own problem, not the government's. This applies equally to medical care. The government is pretending to provide what has been established as a fundamental human right by saying that for-profit businesses and individuals have to enforce this right.
The Hobby Lobby case should not have been about religious freedom. That should have been a given. The Hobby Lobby case should have been about responsibility. If the government is not responsible for enforcing human rights, then no one is. Enforcing rights is the purpose of the government. The reason health care has become a problem in the first place is that the existing system, including mandatory benefits and health insurance, is entirely inadequate. Forcing people to subscribe to the current system can hardly be considered enforcing a fundamental human right to adequate medical care. In fact, it is little more than another way for the government to control us and subject us.
The big problem with requiring businesses to enforce human rights is that it forces people to work for them. This is a rather foul case of discrimination against freelancers and business owners. Human rights do not just apply to those who work for someone else. If something is a right, then, by definition, it applies to everybody. Further, allowing businesses to get out of this obligation for part time employees is even worse discrimination against the poor. Clearly, the American lower class does not have the right to adequate health care, based on the precedents set by the law. This also gives businesses far too much power. A business can decide who has the right to adequate medical care merely by setting schedules and employee classification. If my employer does not like my religion, my political ideology, my race, or even my hair color, a simple reduction in hours can change my classification to part time, exempting me from the right to adequate medical care. Even worse, now I am legally required to go buy insurance (which, just for the record, does not provide adequate medical care), even though my pay check just got substantially reduced. Choosing who human rights apply to is not the responsibility of for-profit businesses. In fact, even governments have no business discriminating in this area.
Enforcement of human rights is the job of the government. It is not the job of businesses, and it certainly is not the job of the individual. If individuals have to enforce their own fundamental rights, then the government is obsolete. A government that puts the burden of enforcing human rights on businesses and individuals is lazy and corrupt. If adequate health care is truly a fundamental human right, the government needs to get off of its lazy butt and take care of the problem. This is the government's job. It is not the job of businesses or individuals. Further, if adequate heath care is a human right, it should apply to everyone, not just those who work full time and not just those who are willing and can afford to buy into the system.
Hobby Lobby should never have needed to defend its religious rights. The government never had any business placing the burden of providing a fundamental human right on the business in the first place. There are certainly cases where religious freedom must be balanced with other human rights, but it was entirely wrong of the government to place Hobby Lobby, or any other business, in this position in the first place. Not only could this pitting of religious freedom against the right to adequate health care have easily been avoided, it should have. If the government had done the right thing in the first place, this issue would never have arisen.
Consider how this would play out: The government decides to enforce the right to own property by putting businesses in charge of it. Now, businesses are legally required to handle things like evictions and property deeds for their employees. If an employee is robbed, the employer is required to investigate and bring the thief to justice. Oh yeah, and this only applies to full time employees.
Now, considering the following: The government and the majority of Americans establish that adequate medical care is a fundamental human right. The government comes up with a list of medical care related things that every person should have free access to. Now, to enforce this the government does two things. First, it puts enforcement in the charge of for-profit businesses. Businesses are now required to provide their employees with the list of things that every person should have free access to. Now, we cannot forget though, this only applies to full time employees. The second thing the government does is to mandate that anyone who is not a full time employee must pay, out of their own pockets, for insurance. This is great. Now, the government says that adequate medical care is a fundamental human right, so we are forced to enforce this right ourselves on an individual basis. That makes perfect sense. Imagine if this was applied to freedom of speech. If the government tries to shut us up, our only recourse is to fight the government as an individual. Appealing to the law would not be an option, because it is our own problem, not the government's. This applies equally to medical care. The government is pretending to provide what has been established as a fundamental human right by saying that for-profit businesses and individuals have to enforce this right.
The Hobby Lobby case should not have been about religious freedom. That should have been a given. The Hobby Lobby case should have been about responsibility. If the government is not responsible for enforcing human rights, then no one is. Enforcing rights is the purpose of the government. The reason health care has become a problem in the first place is that the existing system, including mandatory benefits and health insurance, is entirely inadequate. Forcing people to subscribe to the current system can hardly be considered enforcing a fundamental human right to adequate medical care. In fact, it is little more than another way for the government to control us and subject us.
The big problem with requiring businesses to enforce human rights is that it forces people to work for them. This is a rather foul case of discrimination against freelancers and business owners. Human rights do not just apply to those who work for someone else. If something is a right, then, by definition, it applies to everybody. Further, allowing businesses to get out of this obligation for part time employees is even worse discrimination against the poor. Clearly, the American lower class does not have the right to adequate health care, based on the precedents set by the law. This also gives businesses far too much power. A business can decide who has the right to adequate medical care merely by setting schedules and employee classification. If my employer does not like my religion, my political ideology, my race, or even my hair color, a simple reduction in hours can change my classification to part time, exempting me from the right to adequate medical care. Even worse, now I am legally required to go buy insurance (which, just for the record, does not provide adequate medical care), even though my pay check just got substantially reduced. Choosing who human rights apply to is not the responsibility of for-profit businesses. In fact, even governments have no business discriminating in this area.
Enforcement of human rights is the job of the government. It is not the job of businesses, and it certainly is not the job of the individual. If individuals have to enforce their own fundamental rights, then the government is obsolete. A government that puts the burden of enforcing human rights on businesses and individuals is lazy and corrupt. If adequate health care is truly a fundamental human right, the government needs to get off of its lazy butt and take care of the problem. This is the government's job. It is not the job of businesses or individuals. Further, if adequate heath care is a human right, it should apply to everyone, not just those who work full time and not just those who are willing and can afford to buy into the system.
Hobby Lobby should never have needed to defend its religious rights. The government never had any business placing the burden of providing a fundamental human right on the business in the first place. There are certainly cases where religious freedom must be balanced with other human rights, but it was entirely wrong of the government to place Hobby Lobby, or any other business, in this position in the first place. Not only could this pitting of religious freedom against the right to adequate health care have easily been avoided, it should have. If the government had done the right thing in the first place, this issue would never have arisen.
29 December 2014
Mandatory Benefits Enforce Slavery
Freelance work is becoming a big deal in the U.S. for several reasons. One reason is that the currently very poor economy (yeah, they claim it is improving, but really it is only getting better for the wealthy but no one else) is still making it extremely difficult to find decent work. Right, you heard on TV that unemployment is decreasing, but did they bother to mention that most of the new jobs are low paying jobs? Did they even point out that wages are staying stagnant while inflation is still increasing? A lot of Americans are finding that freelance work is easier to get than permanent employment. That is not the big driver of freelancing though. Over half of freelancers are doing it entirely voluntarily. They have chosen freelance work over long term full-time work because they like being their own boss. They like setting their own hours. They like the ability to choose what work they will do and what work they will leave to someone else. Many even like the fact that they do not have to work a full 40 hours a week to get by. Freelancing comes with a cost though: No benefits.
Aside from social pressure, wage slavery is primarily driven by mandatory benefits. I know many people who would like to start their own businesses, but they cannot, because they cannot afford private health insurance. Other benefits are a problem as well, but health insurance is, by far, the biggest problem. I even know a few people who have their own businesses and work a regular job for the health insurance. Businesses, like Lowe's, that offer these benefits even to part-time employees are a great blessing to business owners who cannot afford private health insurance. (Years ago I worked at a Lowe's store, and at least two other employees there owned their own businesses, but worked 10 hours a week at Lowe's for the health insurance package.) This is a problem, because it discourages freelance work and the creation of new businesses. For the most part, only independently wealthy people can really even afford to start their own business, and I am not just talking about businesses with really expensive startup costs. I have several computers, I have access to all of the tools I needed, I have all of the necessary knowledge and training, but I still cannot afford to start a software company, because I am stuck spending nearly all of my time working for someone else. Even most middle class employees are stuck in this situation.
What is the solution? Get rid of mandatory benefits. In fact, ideally, all non-monetary compensation should be prohibited. Someone still has to take responsibility for health insurance, because costs are still too high. Obamacare made health insurance mandatory, but it did not solve the underlying problem, which is that it just plain costs too much. At this point, a single payer system seems like the best option, and the retirement of Medicare and Medicaid would go a very long way in funding it (actually, if you add all the costs of the multiple Obamacare failures, it might make up the difference). Further though, if there was still a deficit, another side effect of this would cover that and then a whole lot more. The single most abused benefit is stock options. Eliminate those and tax revenues (especially from CEOs and such) would increase dramatically.
Taking the burden of health insurance off of employment would release millions of Americans from wage slavery. Of course, they still have to work to survive, but they would have much more control over that work. Without employer provided health insurance, more people would be motivated to start new businesses, and more people would be willing to work for those businesses. More people would be able to go the freelance route. In addition, one more awesome benefit of this is that more people would feel free to choose part-time work instead of feeling compelled to work full-time, making more jobs available for others. More Americans would be free to choose their own paths than ever before.
Now, I am sure you are aware that I endorse a basic income in addition to this, and a basic income would free Americans to a degree never before seen in all of human history (accepted history, anyhow). Even without a basic income though, eliminating all non-monetary benefits would go a long way to increasing freedom in the U.S.. Of course, if stock options were eliminated, the increase in tax revenue would likely cover a large chunk of the costs of the basic income. I just wanted to point that out.
Aside from social pressure, wage slavery is primarily driven by mandatory benefits. I know many people who would like to start their own businesses, but they cannot, because they cannot afford private health insurance. Other benefits are a problem as well, but health insurance is, by far, the biggest problem. I even know a few people who have their own businesses and work a regular job for the health insurance. Businesses, like Lowe's, that offer these benefits even to part-time employees are a great blessing to business owners who cannot afford private health insurance. (Years ago I worked at a Lowe's store, and at least two other employees there owned their own businesses, but worked 10 hours a week at Lowe's for the health insurance package.) This is a problem, because it discourages freelance work and the creation of new businesses. For the most part, only independently wealthy people can really even afford to start their own business, and I am not just talking about businesses with really expensive startup costs. I have several computers, I have access to all of the tools I needed, I have all of the necessary knowledge and training, but I still cannot afford to start a software company, because I am stuck spending nearly all of my time working for someone else. Even most middle class employees are stuck in this situation.
What is the solution? Get rid of mandatory benefits. In fact, ideally, all non-monetary compensation should be prohibited. Someone still has to take responsibility for health insurance, because costs are still too high. Obamacare made health insurance mandatory, but it did not solve the underlying problem, which is that it just plain costs too much. At this point, a single payer system seems like the best option, and the retirement of Medicare and Medicaid would go a very long way in funding it (actually, if you add all the costs of the multiple Obamacare failures, it might make up the difference). Further though, if there was still a deficit, another side effect of this would cover that and then a whole lot more. The single most abused benefit is stock options. Eliminate those and tax revenues (especially from CEOs and such) would increase dramatically.
Taking the burden of health insurance off of employment would release millions of Americans from wage slavery. Of course, they still have to work to survive, but they would have much more control over that work. Without employer provided health insurance, more people would be motivated to start new businesses, and more people would be willing to work for those businesses. More people would be able to go the freelance route. In addition, one more awesome benefit of this is that more people would feel free to choose part-time work instead of feeling compelled to work full-time, making more jobs available for others. More Americans would be free to choose their own paths than ever before.
Now, I am sure you are aware that I endorse a basic income in addition to this, and a basic income would free Americans to a degree never before seen in all of human history (accepted history, anyhow). Even without a basic income though, eliminating all non-monetary benefits would go a long way to increasing freedom in the U.S.. Of course, if stock options were eliminated, the increase in tax revenue would likely cover a large chunk of the costs of the basic income. I just wanted to point that out.
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