Say Anything Blog

Greetings:

Back in the ‘70s, I spent some time studying Public Administration.  One of the concepts that was addressed almost “ad infinitum” was “incrementalism vs. fundamentalism.” The iconic example of fundamentalism was when FDR & Congress first established the Social Security system.  An good example of incrementalism would be the addition of the drug benefit to Medicare.

The way I see it, the healthcare system in this country needs to first address this question. What we now have is such a hodgepodge of complementary and conflicting aspects that there is almost no room to operate without goring someone’s ox.  I think that it would be analytically useful for some appropriate body to approach the problem from the aspect of if we had no health insurance program at all what would we want it to accomplish in order to deliver the most good to the most people.

As to the specific issue you raise, it’s an economically rational decision for young and/or healthy people not to want to spend their available “discretionary income” on health insurance. Yet again, there maybe an analogy to mandatory automobile insurance.  But, I think we would all benefit from a zero-sum, blank sheet of paper, from the bottom up analysis of the whole health care system.

It all started with the govt giving monopoly power to control the supply of doctors and nurses to the AMA.  The intention was to codify medical practice to protect the public from “quack doctors”.  On a cost/benefit basis, it hasn’t worked very well at all.  We still have bad doctors and lots of people dead or injured from bad medical practices, and it also costs us a whole lot more.  Not such a good bargain.

We can’t afford social engineering.

"Give the lefties a pile of money, and they’ll spend it buying votes.” - Rush Limbaugh on the “bailout”.

Until we solve the following problems, there is no Health Care System which would be economically viable, or technologically efficient for the American people.

1) Insurance Companies supply an Inferior, Insuficient Product.

2) Doctors have Institutionalized the practice of Double and Triple Billing.

3) Doctors cannot obtain Malpractice Insurance without incurring a very damaging expense.

4) Medical expenses are not 100% Tax Deductable.

One more: Employer plans are paid out of pretax income, individual coverage is paid out of after tax income.

"Give the lefties a pile of money, and they’ll spend it buying votes.” - Rush Limbaugh on the “bailout”.