Congressman Admits ObamaCare a Platform for Single Payer

[Greenbeard]

Forget deductibles. What I'm talking about is, you break your arm, you go get it fixed, you pay the doctor for fixing your arm. Done. No dealing with co-pays, no deductibles, no insurance.

What happened to "My vision is to address the cost of services so that insurance is only used for the most catastrophic of issues"? The implication there is that there is a line below which the individual pays, and above which additional costs are borne by an insurer (i.e. a deductible).

Car mechanics don't run credit checks for people that need their cars fixed so I think you're making something out of nothing there.

If you're wondering why I explicitly included a link to a news article explaining "Hospitals often use these services when patients are uninsured or have big out-of-pocket costs despite having health insurance," it's because I thought you might not be aware that hospitals already do this with people who have to pay in the manner you're describing. Well, and also because I hoped you would click it.

What's your point? Of course health care costs are burdensome.

My point was twofold: 1) costs and expenditures are highly concentrated, they're not distributed uniformly over the population, and 2) among those that are consuming the most health resources (i.e. are responsible for a disproportionate share of our national spending), the costs of their care are directly affecting them. Their problem can't be summed up simply as overspending due to insulation on their part from the costs of their conditions/treatment.

This is what I meant by you really think. And we can't solve this problem if you don't admit it. That problem is a lot of people, including you, want to treat the service of health care like it is different than any other service that someone may need.

Health care is different from most other services in many respects. If you're going to try and lecture others about economics, at least familiarize yourself with some of the classics in the field; you can start with Arrow's Uncertainty and the Welfare Economics of Medical Care.

Paying for emergency car repairs is burdensome and expensive too. Does that mean I should expect that I don't have to pay my mechanic? Of course not.

As is generally the case in these threads, I don't know what it is you're arguing against--you seem to be operating from a very specific conception of how a single-payer system must work that seems to color every statement you make.

That also defies basic economic logic. You think when costs more directly affect the consumer they don't figure out what a necessary expenditure and what isn't?

The behavioral economics at play here--particularly on the demand side--is significantly more complex than you're letting on.

 

[Bern80]

So you are saying no insurance at all, no catastrophic insurance. Who pays for the $100,000 hospital bill. I can put enough money away to replace my transmission or even replace the vehicle, but I can't save enough money to pay for an undefined medical cost that may or may not occur.

No, not no insurance. Just no insurance for routine medical procedures and check ups.

If you're talking about a single payer system that pays for large medical bills, I think that has merit. However, defining large is a problem.

Hadn't thought of that, but would agree.......might have merit.

 

[Bern80]

What happened to "My vision is to address the cost of services so that insurance is only used for the most catastrophic of issues"? The implication there is that there is a line below which the individual pays, and above which additional costs are borne by an insurer (i.e. a deductible).

Nothing happened to it. One of my goals is to make this simple. And isn't it most simple for people to go to the doctor, get done whatever they need done and pay their bill? No hassling with insurance companies. You have to stop thinking about this in terms of assuming we just gotta have insurance or we just gotta have some third party payer involved somehow.

If you're wondering why I explicitly included a link to a news article explaining "Hospitals often use these services when patients are uninsured or have big out-of-pocket costs despite having health insurance," it's because I thought you might not be aware that hospitals already do this with people who have to pay in the manner you're describing. Well, and also because I hoped you would click it.

Wasn't wondering.

My point was twofold: 1) costs and expenditures are highly concentrated, they're not distributed uniformly over the population, and 2) among those that are consuming the most health resources (i.e. are responsible for a disproportionate share of our national spending), the costs of their care are directly affecting them. Their problem can't be summed up simply as overspending due to insulation on their part from the costs of their conditions/treatment.

And my point was that would be exactly what coverage for catastrophic insurance should be for. For when the costs of your care are no longer financially manageable for you. As you alluded to above I really don't see why one possibility isn't to have an insurance scheme that provides benefits on strictly the basis of personal expense as opposed to the condition.

Health care is different from most other services in many respects. If you're going to try and lecture others about economics, at least familiarize yourself with some of the classics in the field; you can start with Arrow's Uncertainty and the Welfare Economics of Medical Care.

It's different and more complicated because we made it that way. If the free market were allowed to rule and their were no insurance companies the cost of sewing up a minor cut would be relatively minor, while the cost of brain surgery would be astronomical. What is in demand and rare is going to fetch the highest price. That is a fundamental rule of economics. So another way to look at this is that most people are going to need insurance of some type should they happen to demand a skill that the market says is valued more than they can afford to pay.

Paying for emergency car repairs is burdensome and expensive too. Does that mean I should expect that I don't have to pay my mechanic? Of course not.

As is generally the case in these threads, I don't know what it is you're arguing against--you seem to be operating from a very specific conception of how a single-payer system must work that seems to color every statement you make.

I'm arguing against what seems to be a notion on your part that you're life is supposed to be insulated from burden. This notion that seemingly when things get too tough in life you have the right to shift that burden to others. Sure it may suck, but the fact that something is difficult doesn't absolve of responsibility for it. The issue with single payer as it relates to that is that it incentivizes people to take less responsibility.

The behavioral economics at play here--particularly on the demand side--is significantly more complex than you're letting on.

Never assume something is complicated because it has to be. That's half your problem.