From a segment on the Russian station for Radio Liberty. (Transcript, plus audio link.) For those of you who don’t read Russian, the short explanation is: The desire of voters to send a message of their disapproval of George Bush is considerably less significant than it was in 2006. Generally speaking, American prefer divided government.
Gordo says:
My hope is that the obviously unfit Ms. Coakley is defeated.
I then hope that the House of Representatives will pass the Senate version of health insurance/care reform and we can start preventing the needless deaths of almost 45,000 people in the U.S. each year.
January 19, 2010, 6:09 pmCato The Elder says:
Why Is This Democrat Handing Out Absentee Ballots? (Youtube link)
January 19, 2010, 6:18 pmBruce Hayden says:
Of course, that study ignores the number of deaths each year caused by the rationing built into ObamaCare.
Also note that the 45,000 figure apparently includes illegal aliens, which make up about 1/3 of the 46 million w/o health insurance. So, it is likely that the 45,000 figure should be reduced to around 30,000. There are other objections to this study that I don’t have at my finger tips.
So, what we have here is likely a lot more than 30,000 people paying for their health care insurance dying so that those 30,000 uninsured will not die. One reason that the 30,000 people dying as a result of ObamaCare is likely low is that a lot of those most vulnerable to ObamaCare are the elderly, due to its cutting of Medicare to pay for everything else. They are vulnerable to the rationing, but also to health care providers dropping Medicare patients due to the scheduled cut in reimbursement rates.
January 19, 2010, 6:30 pmMark Buehner says:
The study is broken in its conception. Uninsured people are more likely to die. True. So are lottery players. Does lottery kill people? Or is something in the decision making history of many lottery players the same kind of decision making that leads to bad survival decisions? Correlation does not imply causation.
January 19, 2010, 6:52 pmptt says:
Generally speaking, Republicans claim to prefer divided government but only during Democratic administrations.
January 19, 2010, 7:00 pmGordo says:
Bruce Hayden: Rationing is not built into “ObamaCare” (a.k.a. “providing better health care to all Americans just like every other civilized nation in the world has”) in any conceivable way except perhaps for medicare. And there is some dispute about the effect of that, which discounts your claims of additional deaths.
January 19, 2010, 7:04 pmGordo says:
Basically your argument is that uninsured people are naturally unhealthy. Which on the face of it is a ridiculous statement. Especially since many of the uninsured, at least those who could afford insurance but refuse to get it, are doing so because they are, at this time, healthier than the average person, and thus think they don’t need health insurance.
January 19, 2010, 7:06 pmOren says:
No, it’s the non-insurance and unhealthiness are correlated because they are both the result of an underlying cause — to wit, poor decision making. Those that chose to sacrifice their long-term financial stability by buying a car instead of health insurance are plausibly the same people that might sacrifice their long-term health by smoking or drinking. They might also be the same people that chose to sacrifice their long term earning potential (and hence employer-provided healthcare) by forgoing difficult educational or training opportunities.
Of course, this doesn’t apply to everyone with poor health or without health insurance and one can argue around the margins but both extreme positions (it’s all personal decisions / it’s all external factors) are implausible.
January 19, 2010, 7:31 pmCrunchy Frog says:
Okay, so we have (at least) groups of uninsured people. The first consists of people, through poor decision making, lifestyle habits, inadequate education etc. have found themselves without jobs that provide health insurance (not talking about the recently downsized here – they have cobra coverage). These people do not lack for health care; they get it at the emergency room for “free”. This group also includes the 1/3 that are illegal aliens.
The other group consists of healthy twentysomethings that do not carry health insurance because they are not consumers of health care. You want to make these people subsidize everyone else?
January 19, 2010, 7:31 pmbogden mash says:
Severe head trauma doesn’t kill people. Obviously the high mortality rate among this group is traceable to other common factors because correlation is not causation.
January 19, 2010, 7:36 pmGordo says:
Crunchy Frog: The “emergency room” argument doesn’t appear to hold water either.
As for the “young people shouldn’t have to subsidize others” argument, the problem is that healthy young people don’t stay healthy, and when they need insurance it isn’t available. Now you can argue that they are making that choice, and they should live with it, but when something happens to them they show up at the emergency room and we all end up paying for them anyway. To that you might reply, “turn them away and let them die,” but that is an impractical and immoral statement to make.
Most, if not all, states require motorists to buy auto insurance, whether they are good drivers or not. This is because of the potential impacts their lack of insurance has on others. The same applies to health insurance.
January 19, 2010, 7:43 pmzuch says:
Dead illegal aliens aren’t dead.
And what part of the law says anything about “rationing”? Would this be anything like the “rationing” of not giving some people any health care at all?!?!?
Cheers,
January 19, 2010, 7:45 pmrbj says:
Here’s a question:
Art. V. of the US Constitution says “. . . and that no State, without its Consent, shall be deprived of its equal Sufferage in the Senate.”
Now the Franken delay was due to MN law that required a recount due to the razor thin vote difference (sensible law, IMO) so presumably that could be viewed as MN’s consent.
January 19, 2010, 7:45 pmIf 1) Kirk is out after today, due to the election happening, 2) and Brown wins with a typically large enough difference (say 53%-47%) that there’s no recount, could Brown demand to be seated immediately, as is typically done? Otherwise MA is deprived of its equal vote. Now yes, Art. I, s5, [1] gives each house the power to judge who is a member, but aren’t these two parts of the Constitution in conflict?
zuch says:
“My boss’s decision to fire me is the cause of both my lack of insurance and my substandard diet….”
Cheers,
January 19, 2010, 7:48 pmGuy says:
Poor decision making? Or just plain being poor? I suppose both are influences, but I suspect the latter is more significant.
January 19, 2010, 7:50 pmLaura(southernxyl) says:
I will have to send this to my daughter. She started collecting these in her high school health class, when a student gave a presentation in which he said: “Half of those suffering from osteoporosis will die.” She told me about this, and then said – “Let me get osteoporosis! I’ll have a 50/50 chance of living forever!”
January 19, 2010, 7:52 pmzuch says:
“… when they’ve gotten to the point of being critically ill.”
BTW, have you been through an inner-city ER lately? I think there were around six Code Blues (and one person dying in the hallway) the one night I spent in one. FWIW, they had one doctor on call, and I didn’t see them in the 10 hours I was there, and eventually I walked out AMA, got on a plane for home, and got treatment there.
Cheers,
January 19, 2010, 7:53 pmLaura(southernxyl) says:
Seriously, Prudential funded a study years ago in Memphis. I used to be able to find it on the internet, but I can’t anymore. It was intended to discover why pregnant women who had insurance through TennCare weren’t getting prenatal care. Lack of prenatal care, leading to premature and/or low-birthweight babies, is one of the contributors to the high infant mortality rate in Shelby County. The study concluded that the biggest factor was lack of emotional support from the husband or boyfriend. You can’t fix that with insurance.
January 19, 2010, 7:55 pmBruce Hayden says:
So, you accept a bogus report, but then seem to be saying that since some unnamed persons are questioning the effect on Medicare, we can ignore my claims to the contrary.
I would ask though what the purpose is for all of the effectiveness, etc. panels, commissions, etc. if it isn’t ultimately for rationing. The only real reason that I see for including them in ObamaCare is just that, to justify refusing to pay for treatments based on the views of those panels, commissions, etc.
But I will agree that initially the rationing will fall most heavily on Medicare and Medicaid patients. Their legal redress for their insurer (government) refusing treatment is much diminished as compared to those with private policies, at least right now.
And, frankly, I do not want the sort of health care that you (mistakenly) think that the rest of the world already has. I am frankly unwilling to give up the quality and immediacy of care that I have right now so those who won’t work for their health care will have as good of care as I have now, despite my paying for it, and them not. I work hard for what I have, and don’t want to lose the fruits of my labors to your idea of equality of results.
January 19, 2010, 7:57 pmJmaie says:
Most, if not all, states require motorists to buy auto insurance, whether they are good drivers or not. This is because of the potential impacts their lack of insurance has on others. The same applies to health insurance.
Rather it is their impacts while uninsured which causes the harm.
January 19, 2010, 7:57 pmLaura(southernxyl) says:
Here it is. I got part of it garbled, which will teach me to try to remember anything.
January 19, 2010, 8:00 pmBruce Hayden says:
But why are they poor? Often, it is a result of poor decision making. Dropping out of high school? Having kids as a teenager? Having them out of wedlock? Getting into drugs? Gangs? All bad decisions, but also likely causes of being poor.
January 19, 2010, 8:02 pmscattergood says:
Well, since tens of thousands of people die from doctor’s mistakes and mistaken drug overdoses and adverse reactions to drugs, I am not sure concluding that 45,000 less people will die if the all GET medical care is reasonable.
But, what the we really have isn’t ‘health care reform’ it is ‘insurance reform’ and not a very good one at that.
The basic question, stripping out insurance and accidents and nice stories is this:
Assume you have 10,000 people with an incurable, non-infectious disease who whill die relatively soon. And assume in the area they all live you have 9,000 pills that can cure them and save their lives. No other pills can be producedor acquired before they succumb to their disease By what method do you determine who gets to take the pill?
How you answer that question will determine how you imagine the health care system should run, how health care resources should be distributed, and how you feel about health care ‘reform’.
January 19, 2010, 8:08 pmRuss says:
“Most, if not all, states require motorists to buy auto insurance, whether they are good drivers or not. This is because of the potential impacts their lack of insurance has on others. The same applies to health insurance.”
I can choose not to drive a car, and, therefore, not buy insurance. I can’t choose not to live.
January 19, 2010, 8:08 pmGuy says:
And those of us with health insurance pay for their care through increased premiums, why shouldn’t we eliminate the free-rider problem by requiring them to buy their own health insurance?
January 19, 2010, 8:10 pmGuy says:
And often it’s the result of having poor parents who can’t afford to help them get off to a good start. You can’t seriously deny that being born into a wealthy family is an enormous advantage.
January 19, 2010, 8:12 pmloki13 says:
Okay, so we have (at least) groups of uninsured people. The first consists of people, through poor decision making, lifestyle habits, inadequate education etc. have found themselves without jobs that provide health insurance (not talking about the recently downsized here — they have cobra coverage). These people do not lack for health care; they get it at the emergency room for “free”. This group also includes the 1/3 that are illegal aliens.
The other group consists of healthy twentysomethings that do not carry health insurance because they are not consumers of health care. You want to make these people subsidize everyone else?
How many ways can a person be wrong?
Starting with the second group-
1. On the aggregate, yes, they might be subsidizing other groups. However, for any given individual, it is often a poor choice to make. A young woman might find herself pregnant (good luck getting health coverage then!) and facing astronomical bills from a routine, let alone a complicated pregnancy. Someone, thorugh no fault of their own, could be injured in an accident. And so on. That’s why it’s called insurance. They’re taking gamble that they hope pay off- and if they don’t, the rest of us (either through “free” emergency care, or through bakruptcy proceedings) cover it.
2. As to the first group- what? First, you have not looked at Cobra premiums lately. As someone who had to (some time ago) they can be quite ruinous to an individual who has just lost their job. Then you discount, oh, the self-employed? How about those with pre-existing conditions?
I really hate arguments like this. If anything, the way our health-care coverage exists today (which is an artifact of WW2 and post-war GM/UAW negotiations) is ruinous to our free market. We have a severe misallocation of talent because of health-care system. People stay in jobs they are over-qualified for because they need the health care. Risk-takers are dissuaded from starting their own businesses because of health care. Indidiviuals are dissaded from leaving jobs and re-training (going to school) because of health care. Our health care system is the single largest drag on worker mobility. Once people have a base level of adequate health care, they will be freed up to make the decisions to “selfishly” improve themselves and improve our economy. That yahoos don’t get it and keep trotting out the same old tired canards (life-style choices? yeah, that’s what causes pre-existing conditions, not genes) is sad. There’s a lot of work, and debate, over what needs to be done- it’s unfortunate that some individuals refuse to participate.
January 19, 2010, 8:15 pmzuch says:
Do you see your error?
Cheers,
January 19, 2010, 8:32 pmorca says:
“American prefer divided government.”
Perhaps it would be best for the Dems to get that out of the way today rather than having to face it in November.
January 19, 2010, 8:34 pmOwen H. says:
And this is supposed to be ok? Wouldn’t it be better if more of those people had access to affordable health care before it became necessary for them to go to the ER, saving space for the more critical emergencies?
January 19, 2010, 8:44 pmCato The Elder says:
It’s amusing how schizophrenic the liberal worldview is, on one hand you can endorse a very strict hereditarian-type philosophy for one human modality (comparative health) and at the same time reject that thinking for another (educability). Yeesh, pick one of two.
January 19, 2010, 8:53 pmLN says:
How exactly do liberals endorse a very strict hereditarian-type philosophy for health? I didn’t realize that the argument for universal health care was based on the idea that your genetics determine your health outcomes. Oh the hypocrisy!
January 19, 2010, 8:57 pmLaura(southernxyl) says:
Zuch:
No.
January 19, 2010, 9:01 pmCornellian says:
Generally speaking, American prefer divided government.
It would be interesting to see whether people would prefer their party to control the White House and the other party to control Congress, or the reverse.
January 19, 2010, 10:53 pmSuperSkeptic says:
Are we also to assume that our two choices are the government decides who gets the 9,000 pills OR the first 9,000 people that can afford it get it?
January 19, 2010, 10:57 pm11-B.2O/B4 says:
Free market method: Whoever produced the pills sells all 9k for whatever they can get for them, and only those who can afford them get the pills. A thousand people (give or take), mostly poor, die.
Government method: Government seizes the pills, puts them in a warehouse while a committee is formed to investigate the best method of distribution, but a combination of personnel scandals, opposition party politicking and straight up lobbyist corruption keeps the committee in session until all 10k people are long dead and in their graves. Then they investigate the company that made the drug. Charges are dropped after the CEO makes a few mill worth of campaign contributions.
Moral: no matter how distasteful you find free market privateering, it’s infinitely more humane than letting the government anywhere in pissing distance of anything.
January 19, 2010, 11:37 pmLN says:
Or the government could tax the richest members of society — even people without the disease — to accumulate the resources to produce an extra 1,000 pills, thus saving all 10,000 people from the disease.
If you multiply the humanity of that policy by infinity, do you get within spitting distance of the humanity of a free-market system?
No wait, that scenario is not even close to remotely plausible, obviously all liberal intuitions are simply based on impossible delusions. The government has never done anything for anyone.
January 20, 2010, 12:46 amRicardo says:
Political philosophy is about what ought to be, not what is. I think in both cases, liberals say that genetics or heredity influence both one’s education outcomes and one’s health outcomes and that government has a role to play in narrowing that disparity.
Whether government can address that disparity is a separate, empirical issue. In terms of worldview or philosophy, though, liberals more or less embrace a consistent Rawlsian view of the world on both issues (public health and universal health care for health, No Child Left Behind etc. for education).
January 20, 2010, 1:09 amOren says:
And his decision happens in a vacuum?
Tell you what, I’m willing to pay for the first 6 months of every American’s COBRA out of my unemployment tax (up to a maximum of 12 months per lifetime per citizen). The productive worker with relevant skills can surely find another job in 6 months.
Poor decision making and poverty are a self-reinforcing spiral. The worse off people are, the more consistently they make decisions that will impoverish them in the future.
It is an enormous advantage because wealthy parents teach their children the very same values habits that lead to their wealth — deferred satisfaction, thrift, hard work and deliberate decision making.
One of my colleagues in undergrad, who is truly a gifted biologist and grew up in rather poor family is just (and I can say this because I have considerable affection for her) totally retarded when it comes to banks and finance to the point where she would complain in exasperation about her state of affairs. On talking to her about the whole thing, it was clear that she just did not consider organizing her income/expenditures to be a worthwhile use of her time and, consequently, didn’t even know where most of her money was going. Even after sitting down and trying to explain how one thinks about these things and how to get a feel for her budget I hit the brick wall of “look, I don’t want to have to deal with this shit” as if managing one’s own finances was not part and parcel of living as an adult.
It’s ironic, actually, because the prevailing attitude on campus was that the rich kids grew up without “an appreciation for money” when, in my observation, they were actually far better at spending it productively. That stands to reason, of course, since spending (as a subset of “life skills”) is partly a matter of experience but it runs counter to the notion that poor really scrimp every dollar to its fullest.
And, if in doing so, the government reduces the growth rate from 3.0% to 2.99995% then, in the long run, society produces less medical science altogether and after a few decades, everyone is worse off.
To me, this seems like a form of the psychological anomaly known as relative measure — if you offer 100 works a choice either (a) they get a $20k bonus and their coworkers get a $25k bonus or (b) they get $15k and their coworkers get $15k, you’ll find that they invariable take (b) against their own interests.
In absolute terms, the greatest contributor to the well-being of the poor has been overall technological advance which is correlated to economic growth, not redistribution of the extant wealth. Ask yourself this, would you rather get the average care given today or the best-in-the-world care given just 20 years ago? Would you rather go to the worst ER in America today or the best one from 1980?
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January 20, 2010, 5:35 amLaura(southernxyl) says:
Oren – not right now, buddy. I’ve been in on the hiring process for lab techs for many years. Last year I put an ad on Craigslist for a tech and was stunned at the number of resumes I got. I’ve never seen anything like it. People with degrees and experience, who are out of work and can’t find it. Things have got to turn around.
For almost anything I can think of, I’d pick the 1980 one. The worst is pretty dang bad.
January 20, 2010, 8:09 amscattergood says:
Nope, I put no limitation on the method of determining who gets the pills and who doesn’t.
January 20, 2010, 9:35 amscattergood says:
This of course ASSUMES that you know what diseases people will get, in what proportion and that you can direct monies to the right producers to produce the right things in exactly the right amounts for the people that you want to help. It also assumes that all production that you direct works perfectly. That at no time do you have a bad batch of pills, or vaccinations, etc.
If you have that knowledge and the ability to guarantee perfect production, then you are a superhero or a demi-g-d.
And what happens when you are wrong? What happens when you produce some vaccinations that don’t work and your numbers are off or you say you are going to produce 10K pills but only 9800 of them are good?
The solution you propose is typical of a command economist. “I can figure out what everybody else will need, so I’ll just take money from them and tell the producers to produce it.”
January 20, 2010, 10:08 amPintler says:
From the second paragraph of the article you link: “The researchers couldn’t pin down the reasons behind the differences they found.”
January 20, 2010, 10:25 am