Category Archives: Healthcare

Health Care @ Coyote Blog

Over at Coyote Blog, Warren takes WaPo columnist Steven Pearlman to task for an article on health care. It’s far too extensive to summarize, but I highly recommend taking a look. An excerpt:

But let’s get into all that money-grubbing. Mr. Pearlstein reads the study as saying the problem is all that profit. Because we have layers of profit in the distribution channel, our health care costs more than it does in Europe, where you have the efficiency [sic!] of government management. Before we get into detail, I would observe that this fails a pretty basic smell test right off: Nearly every single product and service we Americans buy, all of which are rife with layers of nasty profits in the supply chain, are cheaper than their counterpart services and products in Europe. If this layering of profit without government management is a problem, why is it only a problem in health care but not a problem in thousands of other industries.

Go check out the rest.

Edwards Has Big Ideas; Need Bigs Taxes

Edwards appears to be leading the charge of Democrats on this issue. He’s likely to drag the entire left side of the field over to promising some form of universal coverage. This may be either the rallying cry for our populace to raid each others wallets, or the death knell of Democrat ’08 electoral chances. Either way, he’s at least honest about what it’s going to cost.

Edwards’ health care plan includes taxes

Health care coverage would no longer be optional in the United States under a plan announced Monday by presidential candidate
John Edwards that would require all businesses to provide insurance and all Americans to have it.

The 2004 vice presidential nominee said he would raise taxes to pay for the plan’s cost of up to $120 billion a year.

Edwards said he would free up money for health care coverage by abolishing
President Bush’s tax cuts for people who make more than $200,000 a year and by having the government collect more back taxes.

“Yes, we’ll have to raise taxes,” Edwards said on NBC. “The only way you can pay for a health care plan that costs anywhere from $90 (billion) to $120 billion is there has to be a revenue source.”

I don’t, for a second, believe that this and all the other spending programs we need to pay for will be financed by increasing taxes on those making over $200K. They can claim that, but I guarantee every one of us will feel the sting. The Democrats are making noise about how wonderfully “fiscally responsible” they are, and $240B per year* is a LOT of new spending.

The question is whether the government has screwed up our health care system enough that the people will be duped into letting them take the whole thing over.
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US Lags In Family Laws; Leads In Freedom

The AP is reporting that the US is far behind other nations when it comes to family-leave legislation.

The United States lags far behind virtually all wealthy countries with regard to family-oriented workplace policies such as maternity leave, paid sick days and support for breast-feeding, a new study by Harvard and McGill University researchers says.

The new data comes as politicians and lobbyists wrangle over whether to scale back the existing federal law providing unpaid family leaves or to push new legislation allowing paid leaves.

The study, officially being issued Thursday, says workplace policies for families in the United States are weaker than those of all high-income countries and many middle- and low-income countries. Notably, it says the U.S. is one of only five countries out of 173 in the survey that does not guarantee some form of paid maternity leave; the others are Lesotho, Liberia, Swaziland and Papua New Guinea.

“More countries are providing the workplace protections that millions of Americans can only dream of,” said the study’s lead author, Jody Heymann, founder of the Harvard-based Project on Global Working Families and director of McGill’s Institute for Health and Social Policy.

I hate to bring up the “love it or leave it” idea, but there are 168 of 173 countries in this world that offer these “protections” that so many Americans are dreaming of, and yet it is America that has high economic growth (for a developed nation) and people who just dream of leaving their own shores and immigrating here. France’s bloated welfare state is in dire need of workers, so I’m sure those people who dream of workplace “protections” could take up residence there.

I’d like to say that American has chosen a completely different path, one of liberty and freedom of contract. One where we choose to allow workers and employers to decide what benefits are and are not necessary. But then I woke up. American laws haven’t always been completely pro-liberty. But we do have one feature here, which I would consider an advantage, but which makes it very easy to attack us on these grounds. We’re a federal system, where these decisions are left to individual states rather than mandated from above.

Fathers are granted paid paternity leave or paid parental leave in 65 countries, including 31 offering at least 14 weeks of paid leave. The U.S. guarantees fathers no such paid leaves.

At least 107 countries protect working women’s right to breast-feed; the breaks are paid in at least 73 of them. The U.S. does not have federal legislation guaranteeing the right to breast-feed at work.

At least 145 countries provide paid sick days, with 127 providing a week or more annually. The U.S. provides unpaid leave through the Family and Medical Leave Act, which does not cover all workers; there is no federal law providing for paid sick days.

At least 134 countries have laws setting the maximum length of the work week. The U.S. does not have a maximum work week length or a limit on mandatory overtime per week.

It’s easy to say that the US government doesn’t guarantee these things, and leave the impression in your readers’ minds that these things do not occur in the US. And in some states, that would be the case. In some states, there is very little legislation guaranteeing these sorts of “rights”. In others, though, a state will rank right up there with the “enlightened”.

That doesn’t change the fact that these laws are an infringement on freedom. But it’s easy to paint with a broad brush when you’re trying to compare a system which isn’t designed to be centrally planned, a system where we attempt to let competition between the various states show what system is better.

If the United States were operating anything like its federal, Constitutional design, these sorts of criticisms would hold no weight. People would see the true decisions being made at the state level, with the central government as merely a facilitator of cooperation and an arbitrater of disputes. Such a simple article, trying to talk about the United States as if we should be handling such decisions at the federal level, would be laughable.

But unfortunately, it’s not. The United States has long abandoned federalism, and our state governments have become the laughable, ignored entities. Now, when citizens want to enforce rules which infringe on other people’s rights, they head straight to the top, and expect the federal government to do it for them. Family-leave legislation is an infringement on the rights of workers and employers to set their own terms of contract. Because we haven’t completely allowed our federal government to infringe everyone’s freedom, we still have at least a few moderately free states left. It’s too bad that those states are dwindling, and even worse that the AP is actively lobbying for their demise.

The Quest for Security of Privilege

I’m rereading F.A Hayek’s “The Road To Serfdom“. In Chapter 9, where I currently find myself, Hayek is discussing security and freedom. This seems timely, considering the conversation occuring on Doug’s post The Right Direction on Health Insurance Reform.

In this chapter of Hayek’s classic work, he discusses the quest for security and how it impacts the freedom of the individual. Beyond that, he shows that as we increase security for one segment of the population, the insecurity of the other segments necessarily increases. This applies whether we are discussing securing certain levels of income, specific jobs, or social benefits like healthcare. The basis of this is very simple. As one group has their jobs, for example, secured by society, then other groups are left to compete in a smaller market for jobs. Further, those people are going to be more significantly impacted during economic cycles than they would be if a larger pool of jobs and employees were in the free market. The more security you provide, the larger the group that has that security, the more insecure will the unprivileged groups become.

You can read the chapter yourself (here’s an online version of the book) if you like. The bottom line is that the only way to avoid this problem AND provide security of position or income or privilege is to provide perfect security to everyone. To do this requires taking away all liberty. I leave it to the reader to follow the logic on this. So, your option, if you wish to provide security, is to remove liberty.

Hayek has this very insightful thing to say about the quest for economic security (as well, it applies to security of position and privilege) on page 143 (of the 50th anniversary edition):

Thus, the more we try to provide full security by interfering with the market system, the greater the insecurity becomes; and what is worse, the greater becomes the contrast between the security of those to whom it is granted as a privilege and the ever increasing insecurity of the underprivileged.

This is precisely what has happened with healthcare in this country. As I pointed out in my post Specific Healthcare Changes, our supposedly free market healthcare system is massively regulated and subsidized. The effect of the tax subsidies, regulations requiring specific health insurance minimum standards, healthcare welfare and so forth is to create security and privilege for a subset of the population. This has, necessarily, increased the insecurity of those that do not have that security through the action of the government. If you wish to provide the most security to the most people, you have to stop providing privileged security to a subset of the whole. Or become a serf.

When the government controls all of your decisions about, and ability to get, healthcare, you have lost your freedom. You may retain the illusion of freedom by being allowed to vote in elections, or choose which doctor you will see, but you have no true freedom. Are you truly willing to sell your freedom for the illusion of security? Because even that security is an illusion. It is only secure so long as someone other than you decides it should be.

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