Friday, February 08, 2008



BUT ENJOY THIS if you like watching pointless confrontation become meaningful conversation.

That is all we need right now



R.A. Porter said...

Measured, reasonable discussion. That's nice. My question:

We have so much...secondary health care; we don't really have preventative care. We would make tons of money if we actually invest in keeping people healthy in the first place.

I can't disagree with that statement at all. But how do we really save that money with a voluntary program? Many of the young and healthy will opt out of coverage because they don't need it, so they won't get the advantage of that preventative care. Especially as they'll be able to opt in later, when they do need it.

This is one of the major problems I have with the Obama plan. It looks good on paper, but in action will end up being more expensive, as those who cost more to take care of will be the majority of members of the pool.

With mandatory coverage, the healthy (who are the vast majority) get to subsidize expensive medical care, since they would only be costing the program for routine and preventative care.

nickz said...

Question for r.a. porter: unless the plan is strictly socialized medicine, what should the penalty be for not having the mandatory insurance? I would imagine that, if you wanted people to actually have the mandatory coverage, it would have to be a substantial monetary penalty, no? What would happen if I could not afford the penalty?

R.A. Porter said...

Me personally, I favor single payer, so it would effectively be socialized medicine. Barring that, with a public-private partnership and mandatory participation, I imagine the financial penalty would be the price of insurance + a small surcharge. The surcharge would pay for the administration of...using the rest of the penalty to buy that person coverage.

For those who could not afford the penalty - effectively those who could not have afforded buying their own insurance to begin with - they would be covered with public funds.

The surcharge would be the actual penalty, and I doubt very many people would voluntarily pay that extra amount for the coverage just to spite the system.

nickz said...

Sounds reasonable. However, I work in the criminal justice field and see countless people that do not pay very minimal fines, even though they can afford to pay (and are not "criminals," but average people). In this case, the "stick" to pay is a criminal warrant that lands them in jail (usually just for a few hours, but jail, nonetheless). And they still do not pay. What would happen if the surcharge is not paid?

Andrew said...

I don't care what the policy details are, we just had 9 reported cases of leprosy in Arkansas.


I expect the locusts any day now.

R.A. Porter said...

There will always be ways to fly under the radar, but short of not working or being paid under the table, it's pretty easy to garnish wages.

A simple change* to the tax code would get pretty much everyone. Perhaps take the money off the top like FICA, but refund it with proof of insurance. Conversely, trust people to be honest, and if they don't submit proof of health insurance when filing their taxes it impacts them then.

Realistically, we can only hope to truly require coverage of those people who appear on the grid. That's a lot closer to universal, however,

*Obviously nothing involving the US Tax Code is ever simple.

nickz said...

I agree - the only way to ensure universal coverage is through single payer - which I support. Yes, we can garnish wages, but do we really want to be garnishing wages for people that didn't have health care? Do you know how much in administrative costs it takes to go through garnishment proceedings? (substantial, if you don't know). The tax code idea might work, but, not everyone files and the administrative costs would take a bite out of the proposed savings of the plan.

My point is that, what is trumped up to be a "major" policy difference over health care is actually quite minor. That is, of course, unless you want to make really onerous penalties for not having insurance - which I do not think reasonable people would want due to equity issues.

JackalFive said...

That's so bad. You can tell the interviewer was just trying to make Derrick look like an idiot, and then Derrick turns out to have an answer to every question asked.

I would suggest the American health system take a cue from us up here in Canada, but we really should be taking a cue from France, who probably could take a cue from Cuba.

Just thank your lucky stars we don't live in Paraguay!


Oh, and everything I know about Massachusetts I learned from your book. You should be very proud.

kristen said...

that interviewer is a weenie. Good answers from the respondant at every turn though! He's a lot more patient than i would have been... my question would have been "Do you want me to answer, or do you just want to interrupt me? WTF - are you an O'Reilly wannabe, or what?"

Emily Blake said...

That jackass saw some black guy supporting Obama and assumed he was only doing it because he was black.

He got schooled.