Monthly Archives: March 2010

A Mild-Mannered White Guy Tells the Facebook Community What’s What 

Facebook User:

@XXXX, Social Security was supposed to pay for itself too… how’s that going?

@XXXX, have you tried to purchase your own heath insurance? I just googled “buy health insurance” and it appears to me there are a lot of different places selling health insurance (for as little as $50 / month). When I was a college student, my wife and I bought our own health insurance to cover her just in case of pregnancy. We didn’t need it for that, but it helped when she broke her toe. One of the companies I worked for was a small business (less than 20 employees) and they managed to provide health insurance for all their employees. I don’t believe you have to be wealthy; you just have to make it a priority.

Mild-Mannered White Guy:

@XXXX – It’s going great, actually.

1. Social Security has been taking in more money than it’s been paying out for decades, and will continue to do so until 2016, when outlays become greater than revenues. But that’s OK, because there’s a huge surplus we’ve been building over time (and which has been accruing interest).

2. Based on a bunch of assumptions about growth and demographics, The Social Security Trust Fund doesn’t run out until 2037, and that’s according to this year’s trustee report which accounts for the current downturn. That’s 27 years.

There is no social security crisis. If, in 2030 the picture looks the same (i.e., demographics haven’t surprised us again), we can deal with it then by adjusting the rules, just like *Reagan* did in 1983 when we raised the retirement age to account for increasing life expectancies.

Social Security is an unmitigated success and has done so much to improve elderly quality-of-life that it’s hard to imagine our country without it. We can only hope the current reform does so well!

Regarding your $50/mo coverage –

I think those health insurance premiums you found are incredibly optimistic – to the extent a policy like that is available, it seems to have sky-high deductibles, and the kind of annual limits on benefits that make it all but worthless to its owner (and, incidentally, illegal under the current bill).

Even for young healthy men, the internet consensus seems to be you can scrape by on maybe $150/mo (which is an awful lot for somebody working part time or making minimum wage). If you’re older, or a woman, or (god-forbid) sick, the numbers spin out of control really, really fast. If you can get care at all.

But even if you’re right – even if health coverage can be purchased for $50/mo – that’s not an argument against this plan! It’s great news! It means freeloaders like you imagine @XXXX to be (which he’s not, incidentally) will have to finally chip into the pot and not take a free ride on the health care infrastructure you’re paying for. And to the extent that real-life premiums are higher than people can afford, they get some subsidies, but still have to pay the rest. Even your heroic small business owner will find it easier to give his employees insurance under the generous subsidies that kicked in today, and are designed to encourage entrepreneurialism and growth. Hooray!

Amongst other things, this bill is about accountability. It’s not OK anymore to not buy health insurance knowing you can always just go to the ER for treatment, or to wait until you get sick to start looking for coverage. Everybody is accountable. Everybody shares risk. This is a well-regulated insurance *market*. A risk-sharing pool that ensures universal access to basic health care, is fair to you and me (no moral hazard!), and cuts costs across the board.

Or at least it’s a really big step towards that. I, for one, am excited to build on this reform and make even more progress.

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A Mild-Mannered White Guy Tells the Facebook Community What’s What

Respondent:

@XXX are you on crack ! Socialism and Monopolies are two totally dif things. Guess you think deem and pass, was a good idea to, if it had come to that. How about fix the freeloader problem lane. And not start a new form of Welfare. Just about everything this Goverment runs is Broke or in the red, because they dont know how to manage it . O yea, but they got this.! Now they are going to sign this into law, and nobody fully understands how this will work, or if it will work. WTF its only 1/6 th of our nations economy they are playing with. Healthcare does need reform, but the Fedreal Gov should not be running it. Obama should have looked at fixing problems that this country already has, and less time on making new ones.

Mild-Mannered White Guy:

@XXXXX – to take your points one at a time.

1) There are only two ways I can think of to solve the freeloader problem. The first is to deny emergency healthcare to people (a) whose insurance does not cover it, or who (b) cannot afford insurance. The second is to ensure that everybody buys into the insurance pool, plus subsidies to help those who can’t afford the cost on their own (remember that we’re paying much more when we pay for uncovered treatment under the current system). The debate is basically whether or not you think basic healthcare is a right or a commodity. I believe it’s a right. If you believe it’s a commodity – i.e., that people should only be able to have it if they can afford it – then I am happy to have that debate with you.

2) What are you talking about when you say government will be running healthcare? In what way? The same exact companies and hospitals that administered care before will continue to do so now, as part of the same system. This is a law that says (a) we’re expanding the insurance pool because it’s more fair *and* more efficient, and (b) establishes a list of ways that insurance companies are no longer allowed to screw people. All of this is totally in line with the same regulatory role of government that keeps lead out of your water and unmaintained planes out of the air. The only thing the government is managing is a series of state exchanges that exist only as clearinghouses to help *you* shop for the cheapest plan. This is neither redistributive or top-down. It’s a market solution. It’s. Not. Socialist.

3) But while we’re on the subject, your conviction that the government is terrible at everything is a point of faith that too often goes unchallenged. Actually, the government is great at providing universal goods. To take your healthcare example: Medicare and the V.A. achieve superior patient outcomes for far less money than the private sector has ever managed. True, Medicare faces some financial challenges in the years ahead, but that has much more to do with demographics, the fact that we limit its ability to negotiate its own prices, and the overall cost of healthcare in America (all issues that this bill is intended to help address) than with any kind of mismanagement. In fact, Medicare “Advantage” plans, which are run by corporations for profit, are %17 *less* efficient than government-run Medicare.

4) Congress didn’t use deem and pass. This is a bill that passed with 60 votes in the Senate and 219 in the House. Attacking a hypothetical is unhelpful.

5) Yes, healthcare is 1/6 of our economy. That’s why this problem is so urgent! France’s healthcare system is far superior to ours by almost any reasonable measure (including customer satisfaction), and they spend less than 1/10. Can we do even better? Damn right we can. Does this plan fix everything? Absolutely not. But Obama is doing exactly what you say – trying to fix one of the biggest problems we have. This was a helluva start, and I’m fucking proud of it.

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