Posts Tagged health insurance

Stephanopoulos Doesn’t Need a Dictionary

From Bonnie Kristian at Young Americans for Liberty:

There is one point on which the president may not be criticized: he is a skilled verbal gymnast and there is no denying it.  Most recently, he has denied that the government taking more of our money as a penalty for not living up to our supposed “responsibility to get health insurance” would be a tax increase, despite the dictionary’s assertion to the contrary:

“I don’t think I’m making it up,” Mr. Stephanopoulos said. He then had the temerity to challenge the Philologist in Chief, with an assist from Merriam-Webster. He cited that dictionary’s definition of “tax”—”a charge, usually of money, imposed by authority on persons or property for public purposes.”

Mr. Obama: “George, the fact that you looked up Merriam’s Dictionary, the definition of tax increase, indicates to me that you’re stretching a little bit right now. . . .”

Riiight…because checking with the dictionary is always indicative of stretching the truth.

Very nice post, Bonnie. I wanna talk a little bit more about the individual mandate and taxes. Let’s take a look back at what Obama said during his campaign about tax increases at 1:20:

Now, let’s take a look at two different bills. The first one is the House bill, H.R. 3200. This is what the bill says about individuals who chose not to, or couldn’t afford to purchase health insurance:

Subpart A–Tax on Individuals Without Acceptable Health Care Coverage

    • `Sec. 59B. Tax on individuals without acceptable health care coverage.

`SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.

    `(a) Tax Imposed- In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of–
    • `(1) the taxpayer’s modified adjusted gross income for the taxable year, over
    • `(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.

I’m not lying to you, I’m quoting the actual text of the bill. This part of the bill is found in a section that modifies the Internal Revenue Code. Stephanopoulos doesn’t even have to go to the dictionary to check whether or not this plan involves a tax, the word tax is literally written all over it. The tax is charged to any individual who does not purchase health insurance — regardless of his or her income.

Now, let’s look at the Baucus Bill. The text of the Baucus Bill is here (go to Page 32) and here (scroll down). What do you see?

Excise Tax. The consequence for not maintaining insurance would be an excise tax.

Not only is it written there, it’s italicized and bolded in the PDF.

Clearly the individual mandate is a tax. And what does our President say…?

STEPHANOPOULOS: But you reject that it’s a tax increase?

OBAMA: I absolutely reject that notion.

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Back From Vacation: 10 Things I Read

I’ve been on vacation these past few weeks (San Francisco, Yosemite, Napa Valley, New York, and Virginia Beach), but just because I’ve been away doesn’t mean I haven’t been following the news (and blogosphere!).

I have a couple things to take care of now that I’m (finally) in college, but I’d like to share a few interesting things I read.

The Top Ten Things I Read on Vacation

10. The math of a zombie attack

Freakonomics readers, however, point out that the model was flawed.

9. John Goodman notes a Joint Economic Committee report with this table

Or as I like to call it, we’re screwed!

8. How to publish a scientific comment in 123 easy steps

7. Jon Stewart shows why Fox News is stupid

6. Don Boudreaux explains why insurance should only cover catastrophic events

and why Medicare isn’t necessary

What’s funny (well not funny, really) is that we’ve totally forgotten the point of insurance and why it’s economically sensible. Insurance is designed for the unpredicatable. There’s nothing unpredictable about bad health when you get old.

5. WSJ: The CBO says the debt will increase $9 trillion over the next decade, but it’s really more than that

Many of the current budget assumptions are laughably implausible. Both the White House and CBO predict that Congress will hold federal spending at the rate of inflation over the next decade. This is the same Democratic Congress that awarded a 47% increase in domestic discretionary spending in 2009 when counting stimulus funds. And the appropriations bills now speeding through Congress for 2010 serve up an 8% increase in domestic spending after inflation.

4. Political Math does an epic beatdown on Paul Krugman

My problem with Mr. Krugman’s “How big is $9 trillion?” is that he is aware of all the problems I pointed out. He didn’t explain how much $9 trillion is; he obfuscated it. By comparing the debt load in the heart of a world-shaking war to a debt load that was accumulated in (relative) peacetime, he has misled his readers to the real significance of the data.

3. “Radio Nowhere” by Bruce Springsteen

I flew Virgin America, which gives you loads of music to listen to. Luckily, they had 15 of The Boss’s best tracks. I hadn’t listened to Magic before, but that’s definitely the next album I’m buying. Unfortunately, I can’t embed the video.

2. TSA assaults pregnant woman, and arrests husband

There is now a division between the citizenry and the state. When that state is used as a tool against me, there is no longer any reason why I should owe any allegiance to that state.

What troubles me is when liberals decry the tyranny of the state when it comes to the police — but they’re perfectly willing to put the same folks in charge of health care, auto companies, and finance.

1. The best article I’ve ever read on health care reform

The most important single step we can take toward truly reforming our system is to move away from comprehensive health insurance as the single model for financing care. And a guiding principle of any reform should be to put the consumer, not the insurer or the government, at the center of the system.

The article is written by a Democratic businessman whose father died in a hospital. Although it’s 6 pages long, the author offers the best diagnosis of why health care is so bad in America. He ends with his idea of how government should support the sick and poor — if I were to design a health-welfare system, that’s how I would do it.

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My Glasses Broke

I’ve been using an old pair of glasses, but they’re not all that comfortable and the prescription isn’t perfect. They work, but not as well as I’d want them to. So I went to the glasses store to get my nosepad replaced, and they told me the thing holding the screw in was broken. I’d have to get a new pair of glasses.

Now, my insurance — yeah, you knew I’d get to economics — doesn’t cover a new pair of glasses for me, at least not all of the cost. The new frame would cost me hundreds of dollars, and I’m just not willing to pay that right now. Even if it cost me $50, I wouldn’t buy them.

That’s not a bad thing.

You see, as much as I’d like to have that new pair of glasses, I didn’t need it. So, as an individual consumer facing both the benefit and the cost of my consumption, I made the tradeoff between the resources needed for glasses and the benefit of new glasses. the benefit was simply so low that it wasn’t worth the cost.

But you see, if I was insured in the normal way health insurance works, someone else would bear that cost for me. I’d get the glasses no matter how much they cost or how many resources they used, as long as someone else was paying for it. And I’d get all the bells and whistles for it, too, no matter whether I really had a need for them or not.

That’s the way most health insurance works in the U.S. today, and it’s part of why health care is so damn expensive. Health insurance today involves a third party — the government or an HMO — paying for all your medical treatment, even routine checkups. As a result, no one pays attention to what the doctor is charging, or whether they really need the treatments they’re getting.

We overconsume, prices go up, people without health insurance (rightfully) complain, and here we are today.

Anyways, I’ve been talking a lot about health care lately (well, it’s in the news…) and in the next few days I’m going to lay out my plan for health insurance.

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Why Waitlists Matter (and another story of a girl)

Because I’m a nerd…

I was talking with a classmate the other day about health care.

She was upset that many people couldn’t afford health insurance and favored a government-run program. I pointed out that in Canada and other socialized systems, people have to wait 10 weeks for an MRI and 17 weeks to see a specialist. While in the United States, access to health care is much faster. You ever watch House? Imagine House in Canada.

Get an MRI to confirm. Wait, we have to wait how long for an MRI?

The fact is that Canadians and Britons don’t have access to health care. They have access to health care waiting lines. But of course, as usual with most proponents of government-run health care, this did not deter my friend, who said:

Well, waiting 6 months for care is better than waiting forever to get care because you don’t have health insurance!

Ignoring the numbers

ON its face, that makes sense. It’s better to schedule chemotherapy later than never. But she seemed to forget that only a few Americans lack this access to health care. There are 47 million uninsured Americans; most of these are illegal immigrants that probably wouldn’t have health care anyways if we had a national program.

Of the remaining uninsured citizens, a good portion of these people are simply young, healthy people who, on average, would pay more into the system through premiums than they would receive through health care, so they just pay their health care costs themselves.

So when all is said and done — I’m fuzzy on the numbers, so excuse me if I’m not completely accurate — probably less than 10 million Americans lack health care simply because they cannot afford it. That’s a significant minority, but a small minority nonetheless considering there are 300 million people in this America.

For the great majority of Americans, health care is quick and accessible. But in Canada, everyone has to wait 6 months for their chemotherapy and other medical treatments — unless they dip into the illegal private health care system or fly to America to have their treatment.

What my friend ignored was the fact that waiting forever because of a lack of insurance only happens to a few people in America. Of course, unless she thinks that forcing everyone to wait 6 months for their treatment is better than a majority of them not having to wait.

And why is waiting so bad? I have a story for you.

Once upon a time

I knew a girl who once had cancer. She was young, beautiful, and had a brilliant mind. But one day, she started to feel nauseous and threw up a lot — eventually they discovered that she had a tumor in her liver.

The exact details of her medical journey are not so relevant. What is relevant is that despite the fact that we were all extremely devastated by this, there was one hopeful gem: She was able to catch her cancer early and start her chemotherapy soon enough to fight her cancer. Because of the timely treatment she received, she is still with us, and she was able to go back to school like any other girl.

Sometimes I can’t help but think that if we lived somewhere where people had to wait 6 months between seeing their physician and receiving treatment for cancer, she might not be with us now. Maybe, maybe not, but those few months are crucial in cancer treatments. Certainly she would be less healthy if she had to wait. If we lived in Canada or Britain, she would have had to wait 6 months while cancer attacked her still-young body.

I also had a violin teacher who had cancer in her brain, liver, and lungs. She was told she had 6 months — at maximum — to live, but beacuse she was able to start treatment soon, she was able to live for almost a year longer than her doctors first thought. If she lived in Canada, she would have never gotten that extra year, and I would have never learned the Mendelssohn Concerto.

You see, waiting lists for health care are worse than you might think. People die on waiting lists. People resort to the illegal and underground medical communities to receive treatment. People from socialized systems come to the US — where we still have some private health care — to escape that. Sometimes as a last resort, people resort to trying to treat themselves.

Health Care is not the Same Thing as Health Coverage

JUST because you don’t have health insurance doesn’t mean you lack health care. The two are different things. Health insurance means you pay into a pool that pays for your medical costs — you share your risk with other people. Health care is the actual visit to the doctor. Health insurance is a way of paying for health care, but it’s not the only way.

Think of it this way: Do you eat food? Yes. Do you have food insurance? No.

Therefore: Does a person who lacks health insurance necessarily lack health care? No.

My friend said that people “have to wait forever if they don’t have health insurance.” But not having health care coverage does not mean you have no health care. Even without health insurance, there are other ways to get health care. The most obvious way is paying out of pocket for your expenses.

In fact, some doctors have embraced this form of paying for medicine, offering cheap, low rates and quality care to those who are poor, uninsured, but not poor enough for welfare.

Of course, government seems to hate everything that makes things better. Oops.

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High School Government and SCHIP

Bill Killer

APPARENTLY I’ve earned a new name for myself in my high school government class: “Bill Killer.” We were debating bills in a Legislative Simulation (LegSim), and the first bill to come up was a bill to expand SCHIP, the government program providing health insurance to children.

The bill proposed:

-Expanding health insurance to all children living in families below twice the poverty level.

-Funding for the bill would come from increasing the cigarette tax to $1.00 per pack (the bill was written before the real SCHIP bill was passed).

And I’m going to address these two key proposals today, as well as the moral issue.

#1. Expanding health insurance to below twice the national poverty level.

Eligibility for SCHIP will be kept uniform among states and will be frozen at 200% or below the federal poverty level. If states are to exceed the maximum eligibility requirement of 200%, they will risk losing significant portions of their SCHIP funds determined at the discretion of the CMS.

WHILE using the national poverty level sounds like a good idea, we have to realize that income levels and price levels differ greatly across the country. A $50,000 income goes a lot further in Mississippi than it does in New York (I had a campaign manager from Mississippi who once said that living in Mississippi with a Washington, D.C. income was the best deal in life). This also means that poverty levels are extremely different in different areas.

Let’s say, for example, that a person making $30,000 in Mississippi is as rich (or poor) as a person making $50,000 in New York. (Why the disparity? Because in Mississippi, everything is cheap; in New York, everything is expensive). Let’s also say the national poverty level is set at the income of $20,000 a year.

Under the bill, children in families with an income of $40,000 would be eligible for health care. But that would include children from overqualified families. The families making between $30,000 to $40,000 in Mississippi would be getting health care, but the families making between $40,000 and $50,000 in New York would be excluded from SCHIP. But, when you adjust for price levels, the Mississippians getting health care are actually richer than those in New York. So poor people in New York get shafted because they don’t appear to be rich. Meanwhile, families in low price-level states such as Mississippi will benefit at the expense of New Yorkers.

The point here is that any governmental form of welfare should be as local as possible. Local and state governments know their areas better than bureaucrats in Washington, D.C. They know what levels of welfare are appropriate and they know better how to do it.

EDIT 6/4/09: Apparently, in New Jersey, SCHIP is currently extended to families that are at 3.5 times the poverty level. The bill would essentially prevent New Jersey from funding  many of the families who are using SCHIP right now… so this “expansion” of children’s health care will actually cause some children to lose it!

#2. The cigarette tax


EXCISE taxes are dangerous for a few reasons.

One is the arbitrary nature of a specific tax on a specific product. Why cigarettes, and why so much? Why not alcohol or puppies or sports drinks? to be sure, there is second-hand smoke. Like other pollutants, it makes sense to tax cigarettes for second-hand smoke because of externalities.

But, if anything, this should be done locally. After all, second-hand smoke generally doesn’t cross state (or even city) lines. Again, policy is better when it is localized. Why should the national government do it when the state and city governments can do so much better?

The second reason is that excise taxes have vastly different impacts on different areas of the country. Different states have different rates of smoking. For example, according to Indiana Tobacco Prevention and Cessation (pdf), the rate of smoking in Utah is just below 10%; in Kentucky, it is nearly 30%. Increasing a tax on cigarettes would make Kentucky pay disproportionally more for the health care program than Utah.

The third reason is simply supply and demand. If you arbitrarily increase the cost of cigarettes, people will buy less of them. The amount of tax dollars you get from a cigarette tax is (quantity sold) x (tax). But increasing the tax decreases the quantity sold, so you get less tax revenue than you were hoping for. But I won’t dwell on this, because it’s not a major issue (demand for cigarettes is inelastic — comment if you want me to go into that).

The fourth reason is that some taxes are regressive; they hit poor people hardest. Cigarettes and alcohol are examples of these, because a greater percentage of a poor person’s income is spent on cigarette taxes than a rich person’s. Basically, the tax unfairly targets poor people.

EDIT 6/4/09: It’s also harder for poor people to quit cigarettes — the poor have less access to programs and technologies that help them quit smoking.

#3 The moral issue

I think it’s pretty apparent that my first career choice is going to be an economist. My second career choice is actually to one day run a hospital or a school for poor kids — I believe very strongly that every kid should get a fair shot at life, regardless of their family backgrounds.

What I don’t believe, however, is forcing this moral onto other people. I’m not saying that there are many people out there who don’t believe that kids should have access to health care, but maybe they have other charitable priorities. Perhaps they care more about the environment, or helping refugees, or providing education to poor kids.

The wonderful thing about a free society is that you, as an individual, will have the ability to choose how to use your money, whether it be on yourself or any one of a large number of charitable causes — and no one can force you to choose one charitable cause over the other. You have that choice.

Many political liberals believe strongly in taxing the people to spend on government charity — basically forced charity. Force charity is forced morality. But for some reason, many liberals also oppose the use of government to tell people how to behave in regards to religion and sex, but those are also forms of forced morality.

The fact that the bill proposed in our mock government class involves an excise tax makes it even less moral. I think a lot of people supporting this bill would never, ever smoke — this bill would be forcing someone else to pay for their own personal motivations.

Charity involves self-sacrifice for the benefit of someone else. Forcing someone else to pay for your charity isn’t moral, it’s selfish. It’s saying that yes, I’d like this to happen, but I don’t actually want to have to sacrifice for it myself. That’s someone else’s job.

When government gets involved in welfare, it takes the moral burden off of the individual. But morals are and should be an individual thing. Before the government got involved in health care, doctors often offered cut-rate services or free services to those living in poverty.

But now that government has stuck its nose in, we’re starting to accept that someone else will take care of it, that we can always force someone else to be charitable in our place, that government will take care of us from cradle to grave — and then we become dependent on government. We begin to draw our power from government, not the other way around… and then we really have lost what was great in America.

A government that is big enough to give you all you want is big enough to take it all away. — Barry Goldwater

– Bill Killer

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