One of the major, if not most major, themes of this endeavor is externalities. Microeconomists, the Rand-ians to make a label, studiously ignore the issue, since it messes up their "freedom" meme. But, the fact remains, that the more laissez faire the government, the easier it is for actors to avoid paying for their evil.
In economists' jargon, an externality is a cost (though, rarely, a benefit) imposed on others for one's decisions. Class action lawsuits are one mechanism most often cited as a barrier to unrepentant externalities. Air and water pollution are likely the best known externalities, although most mainstream press doesn't often get that explicit.
So, Yahoo! News offered up this morsel today. The people of Florida have been paying, in many ways, for the evil shit who (intentionally?) loosed these critters. That's a real externality.
The same can be said of Obamacare. Huh? It works this way. Insurance, as defined in the economics profession, is shared risk. Insurance companies have been subverting that for decades, being permitted to segregate identifiable groups with differing premiums. Pre-existing conditions is one such. By doing so, coverage is no longer insurance, but pre-paid consumption. The externality here is that, without a mandate to cover, people will not buy until they think they'll get sick. Thus, to the extent America bothers to do so, more people get "coverage" through minimalist government programs, while the 1% pay little for Cadillac health care. Those who need coverage can no longer afford the distorted premium, since all the healthy folks have opted out or been pooled into a tightly moated group.
The 1% really are evil.
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Lyn LeJeune
Ernesto Che Guevara
Ablonde
Tom Cordle
Peter Breschard
Alan Nothnagle
Salon.com
Comments
As to 200 year old law, it's just such mastery that the Right Wingnuts use all the time. Payback's a bitch.
Take nuclear energy, please! Btu cost of energy is one standard of measure, but it is impossible to determine the per btu cost of nuclear energy. Why? Because NO ONE has a clue as to the cost of storing nuclear waste with a half-life of 100,000 years or more. Does anyone believe the Japanese factored in the costs of their nuclear disaster? And here we sit with forty-year-old plants, some of which are up for recommissioning. And when of them blows -- as it surely will -- the "experts" will whine "no one could have foreseen this." Yeah, right.
Similarly, NO ONE knows the btu cost of natural gas derived from fracking, as the consequences can't be known and won't be known for some time to come. The appearance of earthquakes in formerly earthquake-free areas of Ohio does offer a clue as to those costs, however. But instead of proceeding with caution, we are deluged with ads promoting "natural" gas.
Even in cases where ancillary costs are known, they are often hidden, as is the case with oil and global warming, and coal with its attendant social costs. Since those costs are mostly dumped on the poorest among us, they can be easily ignored by the rest of us.
BA makes a typical false analogy with auto insurance premiums. Healthcare is not like any other product, and therefore, it doesn't lend itself to the Free-Market model. Who among us willingly would choose the cheapest brain surgeon?
I offered a lengthy comment on another post concerning Dick Cheney's heart transplant, a procedure that speaks volumes about the unjust nature of our current healthcare "system". To wit:
"First, let me say I am very glad things worked out well for your daughter, but healthcare for the indigent often doesn't have such a positive outcome. And as I said, typically it is nothing like the treatment I'm quite certain Dick Cheney received.
We can debate that endlessly, but perhaps it would be more constructive if we left Mr Heartless out of this discussion for the moment. I get ill just thinking about the greedy bastard.
I have no brief against the healthcare community -- other than Big Pharma and insurance companies, and they richly deserve my enmity. The sooner we escape the talons of those vultures the better.
When it comes to insurance, the govt already insures the elderly, the disabled, veterans and children of the poorest -- so just who are insurance companies insuring? Mostly those who are not likely to need healthcare, and they do so at exorbitant rates. And up until some provisions of Obamacare went in effect, they denied, capped or canceled anyone who needed or came to need healthcare. That's quite a risk-free business model.
As for the medical profession, I have many friends and family members in it, and for the most part, they have earned my respect. For the record, my wife was a nurse for forty years until her lung cancer put her out of business. Her experience did help us find and secure treatment from some of the best practitioners in this area.
Based on my personal observation, doctors and nurses are some of the most dedicated workers I've met in any industry. I think too many practitioners push to many pills, but that problem begins with Big Pharma. And why in the name of all that's good and decent are they permitted to advertise prescription drugs on television? Oh, that's right -- as a court recently ruled in defense of tobacco companies -- freedom of speech. Utter nonsense on a par with the Citizens United ruling.
What does any of this have to do with whether a 71 yr-old scumbag should get a heart transplant? Only this -- if we want to provide decent healthcare to everyone, we are going to have to set limits on who receives what -- like it or not.
And that's even more the case if we continue to operate healthcare as a for-profit system. Cost/benefit analysis is the very heart of the capitalist system. But let's not continue down that foolish path. As I wrote the White House during the healthcare debate, let's have Medicare for everybody or nobody -- I'd like to see single-payer opponents squirm when faced with that vote.
I know the arguments about limits on healthcare being a slippery slope that leads to Soylent Green and Death Panels. But on the whole, those arguments amount to an abdication of responsibility of citizens and legislators.
So who draws the line? Frankly, medical practitioners and family members already do draw such lines every day in this country. And so do insurance company actuaries and case workers.
Surely the example of Dick Cheney makes all-to-obvious the need to draw such lines. Let me bring this home, hopefully without offending you. If we can all agree that healthcare resources are of necessity limited, wouldn't it be far better that those resources be saved for people like your daughter with their whole life in front of them, rather than divert those precious resources to an old man selfishly clinging to life at the expense of others far more deserving of care?"