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No one should ...

2009-09-05 22:30:31.264734+00 by Dan Lyke 17 comments

So you've probably seen this meme floating around the social networks:

No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.

I love y'all, but, honestly, this turns the health care discussion downright silly. We are going to have people die because we, collectively, can't afford to keep them on respirators, and people are going to go broke because they're incapacitated. And the whole discussion is far more complex than this. With that in mind, my favorite parodies:

No one should die. (sorry not much of a team player this evening). --- Jessamyn West

No one should die because of zombies if they cannot afford a shotgun, or even just a machete, and no one should be turned into a vampire if they get bitten by one--or a werewolf for that matter(unless they want to be a vampire or werewolf). If you agree, post this as your status for the rest of the day. --- Ted Howard

No one should care about their health. If you agree please post this as your status for the rest of the day. --- Clay Didier

No one should die for any reason ever, and every human being should have a million dollars at all times. I want a pony. If you agree, please post this as your status for the rest of the day. (via mk, via rcm) --- Dave Polaschek

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comments in ascending chronological order (reverse):

#Comment Re: made: 2009-09-06 01:41:25.037934+00 by: Medley

this turns the health care discussion downright silly.

THIS? THIS is what turns the health care discussion silly?? May I introduce you to the "Obama wants to kill Grandma" meme? Or the "Keep the government away from Medicare" meme?

Obviously the "no one should" exhortation is overly-simplified. But it's also abundantly clear that nuanced policy explanations FAIL.

They fail utterly.

As a statement of goals and as a way to provide a contrast to the status quo (where, yes, children die because don't have access to basic dental care), I think this meme is fine (albeit, yes, overly-simplified). And even as stated, I don't interpret the first statement as suggesting that all available measures must always be taken.

It always amuses me, in a bitter sort of way, that certain portions of the political spectrum are allowed to brandish all sorts of not only overly-simplified but downright misleading propaganda, but when other portions of the spectrum (who are usually criticized for being too wonky with too many bullet points and way too many subclauses) attempt even a bit of simplification for clarity, that it's this second group who are accused of not being sophisticated about their ideas.

#Comment Re: made: 2009-09-06 02:17:04.11712+00 by: ziffle [edit history]

From Mr. Sunstein Obamas Regulatory Czar:

In protecting safety, health, and the environment, government has increasingly relied on cost-benefit analysis. In undertaking cost-benefit analysis, the government has monetized risks of death through the idea of "value of a statistical life" (VSL), currently assessed at about $6.1 million. Many analysts, however, have suggested that the government should rely instead on the "value of a statistical life year" (VSLY), in a way that would likely result in significantly lower benefits calculations for elderly people, and significantly higher benefits calculations for children. I urge that the government should indeed focus on life-years rather than lives. A program that saves young people produces more welfare than one that saves old people. The hard question involves not whether to undertake this shift, but how to monetize life-years, and here willingness to pay (WTP) is generally the place to begin. Nor does a focus on life-years run afoul of ethical limits on cost-benefit analysis. It is relevant in this connection that every old person was once young, and that if all goes well, young people will eventually be old. In fact, a focus on statistical lives is more plausibly a form of illicit discrimination than a focus on life-years, because the idea of statistical lives treats the years of older people as worth far more than the years of younger people. Discussion is also devoted to the uses and limits of the willingness to pay criterion in regulatory policy, with reference to the underlying welfare goal and to the nature of moral and distributional constraints on cost-benefit balancing.

Now as an older person, I think my life is worth quite a bit thankyou and I am willing to pay for it. Under Obama Plan we get Sunstein - feels like "March them into the gas ovens". In other words Death Panels.

So I say to all: FUCK OBAMA. The sooner that sanctimonious piss ant is gone the better. The next election in 2010 will mind blowing. All those who support O will be voted out forthwith. Old people vote and they will appear in droves. It will be a beautiful thing. And once they are gone, they will reverse all the damage O has done and beginthe long process of paying off the Trillions of dollars he pissed away. He will be remembered like a bad dream - a dictator who everyone would like to forget and will wonder how he ever got into office.

#Comment Re: made: 2009-09-06 02:46:03.985806+00 by: Larry Burton

It turns the discussion downright silly because it isn't an oversimplification it's statements based on the false premises that people dying because they can't afford health care and people going broke because they get sick can be avoided. As misleading as some might think the "Obama is going to kill Grandma" meme might be it is still a point of discussion of what is in the health care bills being passed through congress and it can be refuted. How can you refute something that has no basis in reality to begin with?

#Comment Re: made: 2009-09-06 03:12:05.894702+00 by: Medley

he false premises that people dying because they can't afford health care and people going broke because they get sick can be avoided

Ever? Really? Come on. Of course there are ways to decrease the number of deaths due to lack of or poor quality health care. One can discuss which ways are appropriate to implement and who pays for them, but health care outcomes in the aggregate can be changed. These are hard problems, not intractable ones.

#Comment Re: made: 2009-09-06 08:58:21.912547+00 by: radix

The old form of this meme was "a chicken in every pot" but people have been desensitized so much to the 'dependent on government' meme that I'd hesitate to say that. Rather than be recognized as a satirical overstatement, it's likely some fool would write it up as a bill and it would get votes.

Have a look at Karl Denninger (http://market-ticker.denninger...t-To-Ponder-Macro-Economics.html). He has some graphs up of debt to GDP ratios. The nation has been on an unsustainable debt tear since 1993. It is unsupportable and it must end. Bad pain now or insane pain later. It's long past time for the stupid to end. Uncle Sugar never could be nor should be the answer to all our problems.

#Comment Re: made: 2009-09-06 10:06:46.957254+00 by: DaveP

I can't claim that my response was original, but the part about "I want a pony" said it best for me.

I've tried to bring up "the law of unintended consequences" more than once during in-person discussions, but it seems that the polarization right now is pretty serious. If you're not for Obama-care, you're obviously a tea-bagger, or believe in death-panels.

Sigh. I keep thinking about a quote: "Drink heavily, and buy more guns." - Jim Bovard, at Freedom Summit 2005, responding to a question about what we should do now about government abuses of rights.

Off to the range today, I think. Unless I go to Duluth to buy a Gatling Gun instead.

#Comment Re: made: 2009-09-06 14:22:31.317758+00 by: Dan Lyke

At this point, with the way that the insurance companies and AMA and drug companies have tied the healthcare system in knots, I'd be completely okay with a Canadian or UK style system, let alone something relatively benign like the current proposals support. So don't yet put me in either polar camp, but...

I think Larry summed up my concerns. There are always going to be people dying because of limited resources. Right now the one I'm seeing up-close is lack of transplant organs. Using words like "should" in this phrase completely ignores the reality: shit happens, especially in healthcare, people will die because of a lack of resources, and either that's going to be their money or something else, eventually it'll be a lack of everybody's money.

No one should go broke because they get sick? I'm not sure how to address this one without a "no one should go broke" solution. No one should go broke leads to no one should get rich, which leads right shortly to everyone will go broke. The person I see who's going broke because of medical bills right now isn't doing so because of the bills (although managing the bills has become something of a problem), it's because of all the ancillary crap that's kept her from working before the real medical problems kicked in, the stuff that made her fuzzy and think slow and all of that. How do you insure against that? How do you distinguish that from lack of motivation?

So the statement's silly because it simply cannot happen. Unlike "death panels" (which we already have, decisions are being made by committee about how to allocate limited resources, and which we're going to need), it's completely absurd to propose that any solution is going to successfully solve those two issues.

Here's my alternative: "I want a taxpayer funded minimum level of basic medical care in order to replace inappropriate use of emergency services with basic preventative care." There's some other stuff: "I want to remove the employer deduction so that healthcare becomes portable", "I want to remove mandated coverages so that I can drop the snake oil (ie: most psychological and psychiatry coverages)".

And, finally, I want people more tuned in to the actual costs of care in this country so that we can start talking about dying with dignity.

#Comment Re: made: 2009-09-06 15:12:35.815232+00 by: ebradway

Ziffle: I really don't understand where you are coming from. Seriously - the public option won't be the only option. It's simply an attempt to create something to support those who can't afford private health care. No one is making you go on the public option - just like Medicare. Turning 65 doesn't mean you can't get private health insurance - it just means you are eligible for that "public option". Unfortunately (for your argument), Medicare is good enough that the pool of people over 65 opting for entirely private insurance is so small that the rates are phenomenal. But the point is there will always be private options - just like in Canada and the UK.

And as far as the VSL vs. YVSL, the reason private insurers don't bother with these statistics is that they calculate the threshold at which point you are no longer their problem. That is, the point at which you were sick enough to rack up enough bills that they just drop you. Remember, it's called Maximum Lifetime Benefit. In all practical terms, it is the same as VSL/YVSL except for one difference: once you've hit your Maximum Lifetime Benefit you have to live with the fact that you are gravely ill, uninsured and most likely broke.

#Comment Re: made: 2009-09-06 16:49:05.214794+00 by: ziffle

Presently Medicare’s bureaucracy prevents seniors from paying their own doctor out of pocket, mandates that seniors enroll in Medicare or forfeit their Social Security benefits, (even the wealthy ones who do not wish to participate in Medicare), and prevents seniors from contributing to their tax-free health savings account (HSA) once they hit 65.

So after paying Social Security for a life time the bastards in Washington say too bad - no can get back if you do not sign up for Death Panels?


Go Ron Paul! Go Rand Paul! Go Peter Schiff!

#Comment Re: made: 2009-09-06 18:41:17.689829+00 by: TheSHAD0W

ebradway: No one is making you go on the public option

The way the original regulation was written, you could keep your old health insurance if you wanted - but you couldn't switch to another policy, nor could you switch to private insurance once you were in the government system. This would eventually have caused private insurers to wither away, leaving Obamacare as the only healthcare supplier.

#Comment Re: made: 2009-09-06 19:34:05.907638+00 by: Dan Lyke

Shadow, I'd love a cite on that. Of course the plan has been changing and morphing dramatically, but I haven't seen a summary which suggested that.

Ziffle, I haven't met a doctor yet who won't take cash for services, so I have trouble believing that you can't pay for your own doctor out of pocket. Yeah, there are limitations on HSAs and such, the right thing there is to either eliminate all deductions for healthcare, or allow them all across the board. HSAs are the worst sort of give-away to financial services companies, and they're a prime example of the corruption that's infected the health care process.

Eric, out here in California the insurers set absurdly low yearly maximums, I think they're usually a million bucks, so if you get sick or have an accident that requires an extended hospital stay you end up on Medi-Cal. The public option is is what happens. But they're yearly maximums, so while you're in the hospital you're still struggling to make sure those premiums get paid for when that year rolls over...

#Comment Re: made: 2009-09-07 00:03:07.915765+00 by: Dan Lyke

Oh, I'd also note: Various people have mentioned that Canadians come down to United States hospitals to get tests that they'd otherwise have to wait for, in some cases even for treatment.

United States citizens seem to be traveling to Mexico, India or Malasia (or, if you're really rich, Tennessee or other second world countries) for the same.

#Comment Re: made: 2009-09-07 02:26:50.192927+00 by: TheSHAD0W

Dan: http://www.ibdeditorials.com/IBDArticles.aspx?id=332548165656854

#Comment Re: made: 2009-09-07 04:12:13.351707+00 by: Dan Lyke

Thanks, Shadow.

#Comment Re: made: 2009-09-07 13:40:17.114734+00 by: andylyke

Ziffle, before you go too far out on the Ron Paul limb, try reading some of his stuff. It's generally simplistic and sophomoric.

#Comment Re: made: 2009-09-07 15:03:47.683777+00 by: ebradway

Ziffle - I have to agree that the current legislation tying Medicare participation to Social Security is pretty moronic. I appreciate your enlightening me on that point. But I do wish the Hon. Sam Johnson had prefaced "citizens" with "rich" when talking about medical choice. I have limited choice in providers (unless, like Pickens or Jobs, I am self-insured). Ironically, I have the "same insurance as Congress and the President". As a Federal employee, I participate in FEHB.

Dan - it would be very interesting to look at state mandates for maximum benefits and how if there's a correlation between the mandate and state-wide costs for unpaid medical bills and enrollment in MediX.

Colorado has very few state mandates. My first year out here, the student health plan required by the University if you didn't have other coverage had a $50K yearly maximum benefit. And I've wondered about roll over to state run programs. I know that Colorado has traded reduced corporate taxes with some insurers in exchange for a guaranteed enrollment plan that's independent of Medicaid. But you really, really have to look hard to find it. The director of the health clinic at the University, who also managed the student health insurance didn't know it existed.

#Comment Re: made: 2009-09-07 15:34:41.705611+00 by: TC

No one should have bad things happen to them because that would make me sad, and no one should be sad because we all deserve to be happy. If you agree, please post this as your status for the rest of the day.

Again we are facing finite resources with an expanding population. One pie with 100 slices and 321 people all feel they deserve their slice. There will be lots of clever(and even more not so clever) shuffling of resources to attempt to serve all(or most) but I don’t think a true fix is possible without a balance.