How To Frame The Debate. It’s For The Children.

November 3rd, 2007 | by Craig |

Against expansion of S-CHIP? You hate kids.

Global Warming skeptic? You hate kids.

Against illegal immigration? You hate kids.

  1. 40 Responses to “How To Frame The Debate. It’s For The Children.”

  2. By Randy on Nov 3, 2007 | Reply

    Finally, you get it!

  3. By Craig on Nov 3, 2007 | Reply

    I hate ‘em so much, I had four.

  4. By Mark Tokarski on Nov 3, 2007 | Reply

    Oh, we know you don’t hate kids. We just love it when you decide to fall on your philosophical sword. Makes for great viewing. (Hey - pass the popcorn!)

  5. By Craig on Nov 3, 2007 | Reply

    Weren’t you just giving someone else a lecture about non-sequiturs?

  6. By goof houlihan on Nov 3, 2007 | Reply

    Want honest accounting in government?

    You hate tax refunds.

  7. By Mark Tokarski on Nov 4, 2007 | Reply

    I don’t lecture. I instruct.

    And if you can’t see where you guys would have been wise to set your dog-eared and tattered free market philosophy aside and let S-Chip pass, then you really are blinded by Locke, von Mises and Friedman. But then, you’re free to choose to be politically suicidal.

    Hence the expression, falling on one’s philosophical sword. Thus endeth the lesson.

  8. By Craig on Nov 4, 2007 | Reply

    There’s an important word in there that you missed:

    _expansion_

    Personally, I’m not against S-CHIP, just the ridiculous expansion they were trying to push through.

    But, it’s far easier to argue against “you guys” than anything I’ve actually said, isn’t it?

    Here endeth the reading comprehension lesson.

  9. By Mark Tokarski on Nov 4, 2007 | Reply

    Oh, we totally got the expansion thing. We believe that when the market fails to provide for the general welfare, as it must by design with poor and working poor and health insurance, that the public must step in. Expansion, it is called. The exact thing you oppose. For philosophical reasons, you’re not focused on kids or health care. The word “hate” is way too strong, as no one hates kids. “Indifferent” comes to mind. So too does “collateral damage”, as in kids being the unintended victims of a philosophy gone haywire.

  10. By Craig on Nov 4, 2007 | Reply

    Mark, you’re the one arguing philosophy, while I’m pointing out a very specific example. Re-read the grandparent:

    “Personally, I’m not against S-CHIP, just the ridiculous expansion they were trying to push through.”

    Trying to fund an expansion by taxing a behavior that everyone is trying to make go away is ridiculous and short-sighted, to say the very least.

    I’ll say it again, since you seem to be willfully ignoring it:

    “Personally, I’m not against S-CHIP, just the ridiculous expansion they were trying to push through.”

  11. By JP on Nov 4, 2007 | Reply

    I’m no SCHIP expert, but didn’t I hear somewhere that the current program (in Montana) has excess funds annually due to lack of enrollment? If so, wouldn’t that indicate that it didn’t need more funding, just a raising of the ceiling?

    Not positive about it, but fairly sure I heard something to that end.

    Also Mark, how do you define ‘working poor’? Is there a dollar figure attached to that, like a threshold where one becomes just ‘poor’, or graduates to ‘middle class’ or ‘wealthy’?

  12. By Mark Tokarski on Nov 4, 2007 | Reply

    I totally got you, Craig! Totally. I know you supported the old program, so long as it stayed in its place. I know you wanted to fund it, so long as it stayed in its place. There’s something far more basic going on here - you’re afraid that the public model will supplant the private one. That is what has naturally happened in other countries - private systems wither and fade away when public systems come around.

  13. By Mark Tokarski on Nov 4, 2007 | Reply

    JP - I don’t know the status of S-Chip in Montana but even if it does have excess funds, it’s irrelevant. The question is, do we offer more kids insurance who do not have it? You don’t address that question - kids without insurance are not your concern.

    I want to provide health care to people who cannot currently afford it. There are 47 million of them. I oppose the private insurance model as it is wasteful and inefficient, but we’re stuck with it for now. I doubt that people at twice the poverty level can afford health insurance unless they get it through their jobs, which is becoming more rare.

    JP - do you support he $trillion dollar war in Iraq? the $trillion dollar tax cuts? And yet you oppose this program? Is there a clearer example of screwed up priorities than you?

  14. By Craig on Nov 4, 2007 | Reply

    Yes, I am afraid of the “public” system taking over. When that happens, we will have a one-size-fits-all system dictated from Washington D.C. that more or less fails to meet anyone’s actual needs.

  15. By JP on Nov 4, 2007 | Reply

    Let me re-read my question. Yep, just like I thought. I didn’t say in there anywhere that I didn’t support SCHIP, or the expansion.

    I’m personally disgusted with the entire health care insurance system. That said, I don’t know what the solution is - but throwing more money at insurance companies probably isn’t it. Getting quality health care for folks is one of many gordian knots we face in this country and I think it’s going to take a significant amount of work, and sacrifice, to make it better for our kids. I also don’t hold out the optimism that we have it in us to make it happen. So that leaves throwing more money at it.

  16. By Mark Tokarski on Nov 5, 2007 | Reply

    At last, the argument has crystallized. No country (except Iraq, at the point of a gun) has ever gone back to private health care once public became available. These are free and democratic countries with electorates as informed as ours, probably more so. And that’s your problem - you know that the public prefers a government solution to the health care crisis. On some level, you know the private sector is unable to fix the problem. You’re in a quandary. All you can do is lash out at S-Chip in philosophical panic. Kids be damned. Collateral damage.

  17. By Mark Tokarski on Nov 5, 2007 | Reply

    If you are for S-Chip expansion, why are you in this thread, other than to support me? As to what to do, it’s cognitive dissonance for a conservative, to see public systems work so well in other countries and yet know on a base level that public systems don’t work. I leave you to your discomfort.

  18. By JP on Nov 5, 2007 | Reply

    I was unaware that health insurance was a didactic issue, Mark. To be in this thread I have to either support you, or I’m against you?

    Sounds a bit like some others I’ve heard. Remember, only a Sith deals in absolutes.

    Heh.

  19. By Mark Tokarski on Nov 5, 2007 | Reply

    S-Chip, not health insurance in general - that’s what we are debating. Craig opposes its expansion, you and I support it. We don’t disagree.

    Anyway, check out Piece of Mind - you are quoted at length, and with respect.

  20. By Gman on Nov 5, 2007 | Reply

    Wow! I don’t know what’s more painful reading this discussion — Mark T’s incredible assumptions about the success of public health care and the failure of the private sector; or Craig and JP’s insistence that they support S-CHIP and their reluctance to defend the free market (which may not have been their purpose, but…).

    The reason we’re in the mess that we’re in is simple — the gov’t runs a vast majority of our health care system while intervening deeply in what it doesn’t run.

    Mark T, on what moral basis do you defend the idea that I should be forced to pay for someone else’s health care? What if I’m generally healthy and don’t need health care? What if I’m willing to take responsibility for my own health care?

    What needs to happen, to put it rather simply, is to get gov’t and the middle-man out of health care — i.e. employers, HMOs, etc. We need to create a system where we’re not shielding consumers from the real cost of their care. If we do that, consumers will push down the cost of health care goods and services. The current system operates on creating deep pockets and spreading risk.

    Of course, the other alternative is to clearly state in the U.S. Constitution that everyone has a right to good health… Yikes…

  21. By Mark Tokarski on Nov 6, 2007 | Reply

    If I read you correctly, you’re against the concept of insurance, or shared risk. You believe that what calamities befall us ought to be managed alone. I assume you apply this in your own life, that you don’t carry health insurance, or auto or liability for that matter.

    Your position is comprehensible and understandable, but quite extreme.

  22. By Gman on Nov 6, 2007 | Reply

    Mark T, private sector health insurance offers quite a conundrum to anyone who has thought a little bit about health care policy. It’s not problematic insofar as consumers are not forced to purchase insurance (unless you live in Massachusetts). Insurance is inherently problematic insofar as it insulates consumers from the true cost the health care goods and services they consume. This is, of course, could be a more acceptable alternative to a catastrophic event that breaks the bankd, so to speak. Yet, one cannot ignore the fact that when a consumer is shielded from the actual cost of a good or service, he or she will consume more of it. So, the health insurance market is beset by massive costs that require considerable premium increases and cost-sharing. Moreover, it pushes health benefits managers (HMOs) to restrict access to certain benefits or even to ration care. Hence, as someone who is insured, I carry the burden of general over-utilization. And, when HMOs start restricting access to benefits, what happens? The gov’t mandates that providers provide such benefits. That invites gov’t intervention in the health care market, which only expands as more and more people cannot afford insurance. So, the nature of insurance and gov’t intervention in the market create supply/demand disequilibrium that results on more insurance provider and gov’t intervention in the doctor-patient relationship. As we know, gov’t health care is not immune to the same forces.

    I’m not suggesting that we do away with insurance. What needs to happen is to place more power in the hands of consumers. Concomitantly, consumers simply have to take more responsibility for their health care needs. Doing so will drive down the cost of health care and help all consumers in the end.

    The fact of the matter is that the single biggest barrier to access to health care is the gov’t. The gov’t distorts the market and drives up cost. You simply have to consider that gov’t tax policy actually encourages and bolsters private sector insurance.

    Also, Mark T, the reason no country goestt back to private health care because the people are manipulated by gov’t policies that make it almost impossible to go back. In many cases, the people have no choice but to participate in a socialized system. To base the virtue of public health care on this premise is pretty weak…

  23. By Randy on Nov 6, 2007 | Reply

    Who would have thought hating kids would create such an uproar. ;-)

  24. By Dave Budge on Nov 6, 2007 | Reply

    Gman, smart guy…

  25. By Mark Tokarski on Nov 6, 2007 | Reply

    Actually, GMan, I have thought a little bit about health care. Your offerings regarding over-consumption are interesting, but not true. Over-consumption is not the reason for rising health care costs, or is but a small one. It is a few of us, selected at random (it could be you)requiring huge expenditures, coupled with advancing technology. So your essay on market and supply and demand are simply off the mark. Don’t apply.

    The only way private insurance will work in health care is if we have a mandate that everyone carry insurance. Otherwise, adverse selection takes over. It is much simpler to eliminate the whole problem and have “us” take over our own care, define “us” as the benefit pool, and ration care according to need. We’re rationing right now, but it’s based on who has money, who has insurance.

    No country goes back to private health care becuase public systems have been shown to work. The Canadian system is very popular - they don’t want our system back. These are democracies, probably with better informed populations than we weird Americans. If they wanted a private system, they would have it.

    You surprise me, Dave. You’re not the cheerleader type.

  26. By Dave Budge on Nov 6, 2007 | Reply

    Mark, I’ve made the same points that Gman made above several times. But was surprises me about you is that you misread Gman about and insurance while denying the market at the same time.

    There’s really no reason for us to even debate the issue any more inasmuch as you’re a trick pony. I’ve tried to engage you on the issue of cost reduction and the only thing you point to is administrative overhead. There’s much more to it than that.

  27. By Mark Tokarski on Nov 7, 2007 | Reply

    GMan made points that are either overstated or unsubstantiated. The idea that insurance promotes over utilization is your gold standard, but there’s very little data to support it. But you seem to offer that up as your sole curtsy to the problem - that you’ll fix the over utilization problem with high deductibles and and HSA’s. But very little of use will come of that.

    I don’t think I misread him at all. I think he misreads to nature of insurance. The very idea that he can’t see it as ineffective unless mandatory to avoid adverse selection speaks volumes. MA mandates that everyone own insurance, which is likely and insurance industry-proffered solution. Much easier just to bypass health insurance as a quaint idea that doesn’t work very well.

    So there’s adverse selection and gross inefficiency in the insurance solution. You seem to want to ignore administrative overhead, to minimize its impact, as you can’t do anything about it if we are going to have a private insurance system. I don’t minimize it - I see it as extremely important - in fact, of overriding importance.

    But I agree we’ve little to discuss.

  28. By Gman on Nov 8, 2007 | Reply

    Mark T, what’s amazing about your comments is this naive devotion to public health care as if it is some sort of panacea with absolutely no shortcomings. It’s utter hubris.

    Moreover, I’m not saying the free market is perfect. It never has been and never will be. However, it is the most just. When I speak of the free market impliedly I speak of free individuals and social cooperation. Let the market dictate supply and demand of health care goods and services. If some are left out of the system, which some will be, private charity will help them. It has in the past. Of course, the capacity of private charity and private individuals to help the poor is hobbled by the massive tax burden foisted on us. Ironically, private charity can help the poor vastly more efficiently and effectively that the gov’t could ever dream of.

    It has to be clarified that people like Dave Budge (let me know if I’m putting words in your mouth, Dave) and me do not think that anti-competitive corporate influence of public policy is good for a free society. In a competitive marketplace, private insurance companies should be competing in an open market, not creating artifical markets via gov’t edict and largesse. It’s quite reprehensible that a private insurance company would support legislation that forces individuals to purchase health insurance. This is corporatism and is antithetical to the free society and free markets.

    Finally, to state that overutilization is unproven is preposterous. It is a bloody economic fact. It doesn’t have to be documented. And, then, you go on to say that market supply and demand to not apply. Man alive!

  29. By Mark Tokarski on Nov 8, 2007 | Reply

    To clarify, supply and demand apply, and create gross inefficiencies that can only be rectified by a public system. Currently, there are 47 million who do not have insurance due to either low income or pre-existing conditions. That’s the market at work. Can you not see that?

    Insurance has mostly been applied in this country through the workplace. There’s a reason for that - people working for a company are not drawn there by the availability of insurance. Therefore, you get a good mix of health and unhealthy people, and costs can be managed. That is the situation where insurance actually works.

    But in the private market for insurance, healthy people tend to avoid insurance, while unhealthy people are drawn to it. Adverse selection. The only way to remedy this is to mandate coverage. In a free market, this cannot be done, therefore, health insurance in the free market does not work. The natural outcome is 47 million uninsured people.

    Yes, you do have to document. Health care, like most human activities, falls under an 80/20 rule - 80% of the costs are consumed by 20% of the patients. In 2003, 1% of the patients accounted for 22% of health care expenditures. That is the driving engine - not over-utilization.

    Say you get your fix - say that government gets out of health care. Say taht we leave uninsured people to private charity? What will happen? First, senior citizens will be without coverage. They are the most likely to get sick. Poor people will have no coverage, and charity will not extend enough to help them. So government will have to step in to help - let’s say that they devise two programs … we could call them “Medicare” and “Medicaid” … do you see how we got where we are? The marked failed to provide.

    Anyway, who’s being naive?

  30. By Gman on Nov 9, 2007 | Reply

    Mark T, there are so many economic fallacies in your last post that I’m not even going to waste my time on a substantive response. You blame the free market for uninsurance rates when the gov’t controls more than 50% of the market. Amazing.

  31. By Mark Tokarski on Nov 9, 2007 | Reply

    I accept your surrender. Leave your sword on the table.

  32. By Randy on Nov 9, 2007 | Reply

    I must be in Hell!
    When will this infinite thread of futility ever end?

  33. By Gman on Nov 9, 2007 | Reply

    I’m sorry, Randy. It’s sort of like the drunk that you keep trying to help but keeps returning to the bottle. You feel compelled to help…

  34. By Mark T on Nov 9, 2007 | Reply

    Gman - in all honesty you made points that seemed perfectly reasonable to you, but you didn’t put up very good arguments. Then you gave up.

  35. By Randy on Nov 9, 2007 | Reply

    Did too! Did not! Did too! Did not!
    Enough already.

  36. By Mark Tokarski on Nov 10, 2007 | Reply

    And what, pray tell, have you actually added to this debate? Clam up, please.

  37. By Randy on Nov 10, 2007 | Reply

    “And what, pray tell, have you actually added to this debate?”

    About as much as you have I see.

  38. By Mark Tokarski on Nov 11, 2007 | Reply

    Thanks for stopping by the gun fight. Next time bring ammo.

  39. By Gman on Nov 12, 2007 | Reply

    Mark T, it’s kind of funny to see you get cocky and talk trash in cyberspace. It’s entertaining, and quite sophomoric and pretentious. “Thanks for stopping by the gun fight. Next time bring ammo.” Hee, hee… How cute. How clever you are.

  40. By Mark T on Nov 12, 2007 | Reply

    Gman - 1) you failed to put up credible arguments; 2) your heavily criticized my arguments (”full of economic fallacies” but didn’t offer specific examples, and now are reduced to sniping. Why would I think you are anything but a lightweight? You run with the pups. Please - move along now.

  41. By Gman on Nov 14, 2007 | Reply

    Mark T, I realize I’m beating a dead horse here, but take some time to listen to this:

    http://www.fee.org/events/detail.asp?id=6259&page=1&t=0

    It’s a well-rounded critique of our current health care situation. It’s from the free market perspective, which will feature critical analysis of both the gov’t and the insurance industry.

Post a Comment