Redstate

Government run healthcare is a nightmare for those at the receiving end. Here in the UK I've recently had the unfortunate opportunity to sample both the government NHS and the private system.

What really strikes you is the utter wastefulness of the state system, the queuing, the bureaucracy and the general incompetence of a system where despite highly trained professionals, service is nightmarish due to a conviction that every problem can be solved by more rules or more money.

I remember the Carry ad last time around, with His Pompousness intoning "Healthcare should be a RIGHT!". I'm not sure which scared me more, the idea that a presidential candidate would say this, or how few people were outraged by this.

Look, there's no way you can ever consider making a good or service a "right". Once you start beleiving that some people have a "right" to something that someone else needs to pay for, the whole notion of freedom begins to collapse. We had a little war about a hundred years ago to disabuse certain people of the notion that they had a "right" to the fruit of someone else's labor, and slavery is just as immoral today as it was back then.

This is one of those line-in-the-sand, "THIS far and no further" issues. There's no compromise with the notion that people have a "right" to government-provided ANYTHING.

So, yeah, we should take our lumps on this, and maybe minimize the damage by explaining to people that they really don't want thier health care experience to be provided by the same people who brought us the DMV. Then we need to be the adults, and explain that people have a "right" to all the healthcare that they can pay for, no more and no less.
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"You can't save the Earth unless you're willing to make other people sacrifice" - Scott Adams (speaking through Dogbert)

We shouldn't just work on minimizing the political damage. We need an effective counter-attack. Fighting against government-run health care (or a government takeover of any industry) is a core conservative value.

In this country, BY LAW, everybody has a right to receive health care at the Emergency Room of their local hospital. BY LAW, you cannot be turned away by the hospital, even if you cannot pay and even if you're an illegal alien (that was already decided in the courts).

Thus that issue is moot, OK? The issue is who pays for the health care, not who can qualify for health care. The answer to the latter question is "Everybody"--that was answered years ago.

And right now, those Emergency Rooms are full of indigent or unemployed poor patients, who don't have health insurance and get treated at the hospital's expense. That expense is then carried back to all the other patients, who pay for it through much higher health insurance premiums for themselves. Much higher, because Emergency Room medicine tends to be more expensive than getting treated when possible by a primary-care or family physician.

So the issue is how should a humane, efficient society socialize that health care burden. Since the alternative is to just turn away people who can't afford care, and that we are not going to do as a society.

Even I, a conservative, know full well that the McCain plan won't do anything to relieve this problem. If anything, it will make it worse, because there will be a huge new market for inexpensive interstate health plans marketed to young healthy policyholders who don't need much care and won't file many claims. The result is to leave the other insurance policies stuck with sicker, older policyholders on the average. They will soon face bankruptcy and we'll be right back where we started from with lots of uninsured people.

That's why we have never had such a thing with automobile insurance. There are no separate inexpensive policies offered to safe drivers. Because the auto insurance companies would go bankrupt if they had to maintain a pool of high-risk drivers only. Everybody gets forced into the same pool, resulting in safe drivers paying higher premiums than they deserve to, because that's the only way the insurance company can make a profit and stay in business.

There is simply no way to bring everyone into the same pools unless somebody, whether it's Government or some faith-based organizations, subsidizes the policies of those who are simply unemployed (or who are illegal aliens) and unable to pay. Tax credits are useless to the unemployed--if your income is nearly zero, your tax credits are too and that's not enough of a saving to pay for a policy that costs thousands of dollars a year. And those people who are unable to pay will simply go to Emergency Rooms for "free" (to them) care.

For my entire adult life, which began in the late 1980's, it's always been true that the Hippocratic Oath applies in the emergency room and it's also always been true that one can work something out with the hospital for the expense, even if it's only $20 or so a month. Administrators will always take a low sale over a no-sale.

lesterblog.blogspot.com

There ARE separate insurance policies for safe drivers. There are companies that will not insure unsafe drivers (and don't confuse companies with agents). Everything on my driving record affects my insurance rates. The more tickets I have on my record the higher my premium. The more wrecks on my record the higher my premium. And no, maintaining a pool of unsafe drivers would not result in bankruptcy. All that the company needs is to keep the premiums high enough to offset the costs. (That's what actuaries are for.

Tax credits are NOT useless to the umemployed or those with low income, if they are refundable. Just look into the Earned Income Credit and the additional child tax credit. I believe the McCain plan calls for a refundable credit.

The reason why auto insurance works at all is because it is MANDATED.

By state law in most states, you must have insurance if you drive your car on an interstate highway. Even if you have a lot of accident claims, you are forced into an "assigned risk" pool--you are NOT denied coverage no matter how many prior claims you have filed.

Additionally, your car is MANDATED to be inspected every year, at YOUR expense, to get an annual inspection sticker that allows you to keep driving it on public roads.

Auto insurance was mandated specifically to reduce the number of uninsured motorists who are involved in accidents. Uninsured motorists (who these days seem to include a whole lot of illegal aliens who don't even have drivers' licenses) are causing a lot of accidents and driving up claims for everybody else who is playing by the rules.

That's my point. To make insurance work, you need either subsidies or mandates or both, to maximize the size of the insurance pool. Otherwise the whole thing falls apart.

Under McCain's plan, there is absolutely no incentive for any insurer to insurer anybody with a pre-existing condition, something McCain does not mention. Right now, by law, health insurance from an employer cannot refuse to cover anyone with a pre-existing condition, but individual insurance policies for the self-employed can and do (I got caught with that when I became self-employed). McCain doesn't even seem to realize that's a problem.

If you did health insurance the way you did auto insurance, then you would be required to get a physical examination every year. And if you failed "inspection," you would be required to do whatever it took to bring your body back up to state standards--otherwise you wouldn't be allowed to leave your house. And health insurance would be MANDATED, similar to the Romney-Massachusetts plan and the Hillary plan.

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"If we want to take this party back, and I think we can someday, let’s get to work." – Barry Goldwater

That's my point. To make insurance work, you need either subsidies or mandates or both, to maximize the size of the insurance pool. Otherwise the whole thing falls apart.

So you're saying that Life insurance doesn't work? What about STD, LTD ADD, Renter's insurance, Home owners insurance and auto insurance other than liability? Do none of those work?

And by the way not all states require annual inspection, Wisconson doesn't.

after promising as much in his first State of the Union address. The "feel-good" stuff always gives way to the "git-R-dun" stuff.

lesterblog.blogspot.com