Tag Archives: health care

Ron Paul’s Base is the Forever Young

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Main point: Most people don’t spend enough time planning for the turns and twists of life, not because they are “lazy” or “stupid” but because they are human and thus perpetually living in denial.

The idea of smaller government has been popular lately. People have been sold on the vision that there is a bunch of greedy lazy bureaucrats in Washington that inefficiently redistribute the hard-earned tax payer dollar.

I believe this is unfortunately true, but I also believe it’s the best we got and the best that we can have. You have to honestly look in the mirror, and ask yourself: who would you rather trust with drafting a financial plan for your future: (A) yourself or (B) a government bureaucrat.

It seems that A is the obvious choice for a significant group of Americans. Freedom sounds nice. However, I have come to believe that the majority of crappy expensive troubles happen in the impossible never-will-happen future of when we’re “old”, and so the plan we might draft now by ourselves will fail us when the hard reality of the future hits.

80% of medical bills we pay are for services done after we’re 40 years old (source). That’s a simple fact that most of us intuitively understand, but do not sufficiently plan for. That 80% is an average of $300,000. Three hundred thousand on top of whatever saving you have to do for retirement. Are you ready for that?

Personally, I don’t believe the majority of people have the discipline, knowledge, or time to stay informed and to save for something like that . I believe they (and me) need government to force them to save. Before you tell me that you want the freedom to do with your money what you want, please ponder whether you’re really ready to educate yourself on all the things you should save for and then actually put that money aside month after month. If you say you can, I’m sorry if I am slow to believe you.

That said, there are fundamental flaws in social security and medicare programs as they are now. But the existence of these programs is necessary in a society whose moral code cannot turn uninsured patients away from the hospital.

“I hope I die before I get old” is not just a Pete Townshend lyric, it’s also a widespread blind spot in the minds of the young and healthy. Sadly, most of us don’t remain forever young (including the band members of The Who).

The Burden of Responsibility in the Health Care System

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Main point: Either we have to be willing to watch a poor man die or we have to force that man to pay for insurance throughout his life.

Suppose a man is lying in the street, bleeding to death. He has no money, no insurance, but a simple procedure would save his life. The libertarian argument is that this is the cold moment when a man must take responsibility for the decisions he has made in the past and the cruel turn of luck that has led to his current circumstance.

It seems to me that we don’t live in a society that is willing to let such a man die. The alternative is to force the healthy and the fortunate to pay for the sick and the unfortunate. So until we are willing to turn a bleeding man away, I see no other option but to let government step in and force us to be responsible. I purposely phrase it in a way that seems like a contradiction, but one that’s no worse than the contradiction of our moral system.

By the way, the Supreme Court is scheduled (next year) to hear the case of whether Obama’s healthcare overhaul is constitutional:

This case is not as philosophically interesting as at first may seem, but unfortunately it will likely be politicized to a point where it may influence the decision of the judges.

Life Expectancy

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Life expectancy is often used as a measure of a nation’s physical quality of life. Moreover, I have often heard it used in discussing the effectiveness of different types of healthcare systems.

It’s a nice clean number but we have to remember that it’s an average with a very specific property that if you survive your first year of life, your life expectancy increases significantly.

How significantly is a matter of whether you live in a developed or developing nation. The more defining statistic is the infant mortality rate. This is the tide in “a rising tide lifts all boats”. This is the number which we have to focus on when we consider the “threats” our country faces.

The United States is 33rd or 46th on that list (depending which report you believe) with 6.3 of every 1000 infants dying. Sierra Leone and Afghanistan is at the bottom with 1 of 4 children not reaching age 5.

If America could be #1 at anything, this is what I would choose.

Health Care Incentives

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I’ve recently had to pay for a visit to the doctor and realized that I’m afraid to go to the doctor because of what it might cost. It was a basic checkup that I guilted myself into since I’ve been paying for insurance but haven’t seen the doctor for 2 years.

I had nothing especially wrong with me. I told him about having pretty bad heartburn and how taking Zantac helped. He performed a physical, and gave some advice about the heart burn. One month later I got a bill for $53.

I pay a decent amount for health insurance now, and from this experience, it’s clear that the insurance covers (in a real way) neither the minimal preventative treatment nor treatment in catastrophic cases. The latter I found out when I saw that my plan has a $50K lifetime limit.

At this time I don’t want to get into a discussion of healthcare policy in this country. I want to simply say that a good healthcare system, in my opinion, should:

  • Incentivize a person to visit the doctor when he/she first sees symptoms of a disease.
  • Incentivize a person to visit the doctor for regular check-ups.
  • Incentivize the doctor to do tests and treatments on patients that need them (based on a reasonable analysis of symptoms and medical history) and not to do tests or treatments on patients that likely don’t need them.

Or more simply put, there should be an easier, more open, relationship between patients and doctors. Frankly, after the $53 bill, I’m hesitant to go there again unless something is clearly wrong, and my definition of “wrong” covers cases that would probably cost the system a lot less if they were treated earlier

I’m willing to pay more, but I want the assurance and clarity that the current 100 pages of legalspeak in my insurance plan does not provide.