Politics, open government, and safe streets. And the constant incursion of cycling.

Krugman on Health Care Realities

Well done:

At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”

It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.

And that government involvement is the only reason our system works at all.

He goes on to explain what I think of as obvious, but apparently isn’t.  Check it out.


Maybe Mark Warner Should Pay Attention . . .


AP Fail


  1. bethie

    arrghh…medical insurance is the single biggest check I write each month. 8.5 thousand dollars for 14 people and their families, and it just goes up and up and up. We need reforms, we need a cap on raised premiums. I can only hope the government steps in AND SOON, I could barely afford to offer this benefit this year, who knows what will happen next year.

  2. “And that government involvement is the only reason our system works at all.”

    really? isn’t the govt that only gives employers tax credits for insurance and not individual citizens the same tax credit? as a company owner I was able to choose from roughly 500 different plans but my employees only get to pick from the 2 that I chose for them.

    the biggest piece of misinformation we have on healthcare today is that it is currently a free market system. individuals are restricted insurance mobility because they get insured via employers, govt mandates in insurance prevent young people from getting basic coverage for emergency rooms and yearly checkups, and lack of tort reform allows a few people to drain the system.

  3. It will be painful, but we need to take employers out of the equation so that individuals see the real costs and choices of insurance and so that employers are competing globally on a level playing field.

    Also, when all ~300 million of us suddenly have to look for insurance rather than only ~40 million of us… well – reforms might actually happen. Perhaps a free market might improve things; or perhaps we’ll be happy to have the government stand in and help more…

  4. tx2vadem

    To Scott’s point, employers are a part of the equation in other industrialized nations. So, remaining competitive with those nations does not necessitate removing employers from our system. Though Japan, France, and Germany make individuals share more of the cost than many of our employer provided benefits do.

    It doesn’t seem that Democrats want to change the system radically. So, removing employers from the equation seems highly unlikely. You could still get to what you’re after though through employers. The problem with increasing individuals’ share of the cost is that it would be a career limiting move for most politicians.

    To Amit’s point, agreed on there not being a free market. In most metropolitan areas, the market is controlled by one or two health insurers (this according to AMA’s study). The entire state of Alabama is basically under one insurer: BlueCross BlueShield of Alabama. Changing insurance via the employer doesn’t fix the lack of competition in many private insurance markets across the country.

    I can’t say that I am familiar with uninsured young people being a big issue. My experience was being covered under my parent’s plan until I started work. There was a small gap when I had no coverage, but that wasn’t a big deal in my mind.

    On tort, I have not seen a study that shows that tort costs are a primary driver in health care expenditures. There are many states who have enacted tort reform at this point. And I have not seen than any experienced a substantial decrease in their health care expenditures. Maybe there is a study you can point to that shows differently?

  5. I do believe individuals should have the option to purchase health insurance outside of their state.

    the issue concerning uninsured young adults is more related to emergency rooms visits that are expensive and go unpaid.

    I’ll have to find info about tort reform but some anecdotal evidence is from my friend’s father who is a OBGYN and spends hundreds of thousands of dollars a year on malpractice insurance

  6. tx2vadem

    Texas has one of the most strict tort reform laws on the books. So, for comparative purposes using them would be a good sample. Most states have tort reforms on their books, so I don’t know who would be your control group.

    In any case, I have not seen that either premiums or insurance claims make up more than an inconsequential percentage of heath care expenditures. And couldn’t we achieve some claims reduction by just reducing errors?

  7. tx2vadem

    Oh and just purchasing insurance outside your state would not necessarily lead to competitive insurance markets. I think you would still need to remove the anti-trust exemptions that the insurance industry gets. And you would need the FTC to address market concentration, IMHO.

  8. MB

    I am (and will remain, for the next few weeks) far behind on things here, but I’ll just point out that “tort reform” is an losing argument from the proponents’ side, if we’re focusing on facts.

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