Mitchell’s laws: The more budgets are cut and taxes inceased, the weaker an economy becomes. To survive long term, a monetarily non-sovereign government must have a positive balance of payments. Austerity = poverty and leads to civil disorder. Those, who do not understand the differences between Monetary Sovereignty and monetary non-sovereignty, do not understand economics.
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I thought the Supreme Court’s worry about mandatory broccoli had reached the apex of foolishness, but I was wrong. Dennis Byrne, a columnist printed in the Chicago Tribune has exceeded that mark. I publish excerpts from his article only because (alas) he echoes some commonly held sentiments.
Chicago Tribune
The imagination goes wild: Paying for the health care of the irresponsible
Dennis Byrne, April 3, 2012One thing last week’s historic U.S. Supreme Court oral arguments about Obamacare clarified: You healthy people will be paying more for juicers, addicts, gangbangers, smokers, fatsos, drunken drivers and other assorted careless, thoughtless creatures.
There are more than 30 million people who can’t afford insurance and many millions more who have pre-existing conditions that all but prevent them from obtaining affordable insurance. The primary purpose of “Obamacare” is to cover these uninsured people and their children.
To Dennis Byrne, poor people, who can’t afford insurance, are “juicers, addicts, gangbangers, smokers, fatsos, drunken drivers and careless, thoughtless creatures.” Where he gets his data is not important; being a columnist, therefore needs no data.
Dennis wants all 30+ million to be punished for their misdeeds by early death, or to go to emergency rooms, where they will cost the paying public even more than Obamacare.
Tellingly, Obamacare does not affect those rich, who may be juicers, addicts, etc. They already can afford insurance. It just helps the poor and middle classes.
The central idea of the Patient Protection and Affordable Care Act — the formal name of the Obamacare law — emphasized in the hearings is to spread the cost of health care to ever-larger pools of Americans. In particular, to those who pay low health insurance premiums, the young who choose to have no insurance and the healthy.
As Justice Samuel Alito pointed out, a typical healthy young adult annually may pay $854 for health care, but under the Obamacare mandate to buy insurance, he could end up paying $5,800 in premiums.
Pul-eeze! Does Justice Alito really believe Obamacare will give license to insurance companies to raise rates 680%? No, he doesn’t. He’s just being a typical extremist, tossing out all kinds of nonsense (remember “death panels”?) for political, not truthful, reasons.
Much of that money, of course, will fund such expensive services as end-of-life care. But will uncounted billions — trillions over a decade — be funneled into hospital emergency rooms to, for example, patch up Maniac Latin Disciples? To care for the increasingly large host of obese people?
Or for drivers who were ejected through a windshield because they refused to buckle up? For injured kids whose parents couldn’t be bothered with child-restraint seats? For helmet-less motorcycle riders whose brains were scrambled when their bike hit loose gravel at 70 mph? For those with repeated traffic violations?
For those whose reward for engaging in unsafe sex is a sexually transmitted disease? For alcoholics and the drug addicted? For smokers who won’t kick the habit?
Dennis, first allow me to deplore the obvious and contemptible, racial profiling bigotry of “Maniac Latin Disciples.”
Back to cases, I hate to break this to you, but Obamacare would decrease the use of those costly, hospital emergency rooms, which now are used by uninsured, poor people who know they cannot be refused service there. But never let the facts get in the way of a good story.
How will the secretary of the Department of Health and Human Services and her bureaucrats allocate those costs? How will the Independent Payment Advisory Board, created under Obamacare, resolve that problem when slicing $500 billion out of Medicare? What about Medicaid?
People who show up at a hospital emergency room without insurance go on other patients’ tabs. Obamacare advocates would assign the allocation job to omnipotent panels of unelected experts, unresponsive to marketplace realities and unaccountable to the public.
Dennis, you and others of your ilk, can’t have it both ways. You want to eliminate the cost of insuring “irresponsible” behaviour, but you decry “omnipotent panels” (aka the aforementioned “death panels”), who will judge what constitutes “irresponsible” behavior. Make up your mind, boy.
Consider what a cut in benefits might mean for irresponsible Americans who refuse to use certain preventive services. How would they handle intravenous drug users who continue to irresponsibly share needles? Send them to economy-class wards in the hospital?
Would the mandarins resort to trying to “incentivize” behavior change (further increasing everyone’s costs) or employ behavior modification methods that I’ll leave to your imagination? Would the mandarins begin asking people whether they used condoms when they are tested (also required) for HIV? Would single, pregnant women be asked if they used contraceptives? If not, will they have to pay their OB-GYN a higher deductible?
The imagination reels at the possibilities.
Dennis, you call that imagination? Hah! It pales in comparison to the crazy inventions of the Supreme Court extremeists who imagine mandatory broccoli as an outcome of an Obamacare decision.
Sure, you can say I’m scare mongering; no government would resort to such extremes.
Right, Dennis. You’re scare mongering. Proud of it?
Unless the government is in the hands of those hated right-wingers who would “impose their morals on America.” Who, in the interests of the greater good, would drag single women to “abstinence only” classes to be eligible for maternal benefits?
Who, indeed? Congratulations Dennis, on creating the most ridiculous straw men in the history of irrational debate. Maybe your imagination really is as good as that of Roberts, Scalia, Thomas, Kennedy and Alito.
Should the government force responsible people to pay more for health insurance so that irresponsible people can pay less?
That phony issue is no issue at all. Define “irresponsible.” Who will make that judgement? Out of the total number of uninsured people in America, how many are “irresponsible”?
Here, for your convenience, I have created a sample, Dennis Byrne, “irresponsible” definition test, for readers to answer:
1. Have you, or anyone in your family, ever smoked?
2. Has there ever been a time when you did not have a working fire alarm and burglar alarm in your house? (Same question for radon and CO detectors.)
3. Have you, or anyone in your family, ever not worn a seat belt while in a moving car, truck, bus or airplane?
4. Have you, or anyone in your family, ever ridden on a motorcycle while not wearing a helmet and/or leather clothing?
5. Have you, or anyone in your family, ever taken any recreational drug or taken too much of any drug, legal or otherwise?
6. Are you, or anyone in your family, overweight or underweight?
7. Have you, or anyone in your family, ever been diagnosed with any disease or disability, that continues today?
8. Have you, or anyone in your family, ever become inebriated?
9. Have you, or anyone in your family ever climbed a mountain, flown an airplane, bungee jumped, zip lined, had a fight or committed any traffic violation like speeding, illegal turn, burned out light bulb, etc.?
10. Have you, or anyone in your family, ever done anything that anyone might consider irresponsible, like having sex without a condom, eating fatty foods, not washing your hands before dinner, failure to have a flu vaccination, failure to have a shingles vaccination, living in a high-crime neighborhood – that kind of stuff?
11. Can you afford health insurance?
If you answered “yes” to any question, 1-10, you are guilty of “irresponsible” behavior, and deserve no insurance. You and your kids can die early, for all I care. However, if you answered “yes” to question 11, don’t worry about 1-10. You’re our kind of people.
Sincerely, Dennis Byrne
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Rodger Malcolm Mitchell
http://www.rodgermitchell.com
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No nation can tax itself into prosperity, nor grow without money growth. Monetary Sovereignty: Cutting federal deficits to grow the economy is like applying leeches to cure anemia. Two key equations in economics:
Federal Deficits – Net Imports = Net Private Savings
Gross Domestic Product = Federal Spending + Private Investment and Consumption + Net exports
#MONETARY SOVEREIGNTY
#Monetary Sovereignty - Mitchell 
Rodger,
Your ideal plan would be to extend the whole medicare alphabet soup to everyone. This seems like a good and simple plan to me. Now unless I’m misinformed (highly possible) Obamacare does not resemble this in any way. Why the passionate defense? Is it just that doing something, anything, is better than nothing?
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Kris,
You are right. Obamacare is far better than what we have — far more inclusive. The biggest problem is the false belief that people should pay for it.
The government should pay, but until we are able to educate the public and the politicians about Monetary Sovereignty, we have to settle for the improvements offered by Obamacare.
Rodger Malcolm Mitchell
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Roger,
I’ve had a lot of fun discussing this with you today, but I’ve got a feeling I need to spend a lot more time on your blog to grasp the mental gymnastics going on in your comment.
Where do you think the government gets its money?
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As ever, being an outsider who lives in a country which has ‘socialised medicine’, I shake my head in despair at the straw man factory of arguments used against it’s introduction in the USA. These guys are either so bigoted, or in the pockets of the drug and private insurance companies, the fact that socialised medicine would be much cheaper overall doesn’t get a look in…
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it is orwellian, alot of people have been brain washed into thinking that it is best to vote for “the job creators” instead of their own self interest. in doing this they fuck the rest of us who havent bought into the “trickle down” horseshit. it is very sad and needs to come to an end, quickly. hopefully the right wing will fade away, the democratic party will replace the republicans and the green party will be the new “people” party. one can dream
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Roger,
You’re mixing up health care costs with insurance premiums, or the price people pay to obtain insurance coverage. Justice Alito’s $854 figure is health care consumption (I think this is called “utilization” in the insurance world, or the total payments to doctors, pharmacists, massage therapists, et. al.) not premiums.
I’m 26 years old and my wife is 27. In 2011 our utilization was less than $700 between the two of us, but we paid $720 in premiums and my employer picked up over $3000 in premiums. These premiums should represent the total cost of our actuarial risk for all of the medical services that the plan covers plus our share of the administrative and other costs incurred by the insurer to administer the plan (they likely also include a portion of the actuarial risk of other members of the insurance group).
Justice Alito is not saying that the law will allow insurers to raise their premiums, but that it will force young and healthy people to pay for expensive health insurance premiums instead of allowing us to simply cover our utilization. This becomes a bigger burden when the law stipulates which risks we must insure against, and the requirements include everything from acupuncture to drug rehabilitation.
Congress could accomplish its stated ends by providing subsidies to pay directly for emergency room care and possibly basic universal catastrophic coverage, but they would have to convince the voting public to accept the increased costs that these subsidies would place on the federal budget. The major policy problems that I see with the law we got instead are that 1) it transfers these costs from the treasury to the individual and 2) it accomplishes the unstated end of transferring costs from the young and healthy to the old and sick by forcing us to pay for Cadillac plans when all we need is basic catastrophic coverage.
In many ways I agree with Hamish that a fully socialized medicine program would be cheaper, but I question whether this solution is desired by a majority of Americans, especially considering our heritage of individual liberty and personal responsibility. That’s probably why Congress gave us the strange, constitutionally-questionable law that they did. But that is a discussion for another day…
(If anyone knows how Justice Alito arrived at the $854 figure, I would love to see the study. I’ve been searching but no luck so far.)
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. . . ” it will force young and healthy people to pay for expensive health insurance premiums instead of allowing us to simply cover our utilization.”
Patrick, do you have life insurance? Why would you, if you have not yet died?
Insurance is what you pay for when you’re young, so that you’re protected when you’re older. When you have health problems that cost you $50K, $100K or more a year, will you be able to “cover your utilization”?
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The rules vary from state to state, but in my state, the agreement I make with my insurance is valid for only one year. My insurance premiums are not going into an escrow to pay for expenses 50 years from now. My premiums only cover the actuarial risk that I’m exposed to this year. This is why premiums for the old and sick are higher than for the young and healthy (and one reason why my premiums will be increase as I age).
Of course there is a chance that this year I will consume $50k or $100k or even much more in medical expenses. But my risk of incurring this type of expense during the year is much lower now than it will be when I’m 50.
You bring up an interesting phenomena: The law in essence forces everyone to buy a lifetime policy, and turns insurance into, “something you pay for when you’re young, so that you’re protected when you’re older.”
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I’ll stop preaching about the wisdom of buying insurance when you’re young to assure being able to obtain insurance when you’re older. More to the point, the federal government has no need to charge you anything for health insurance.
The title of this blog is “Monetary Sovereignty.” The federal government can and should provide Medicare free to every man, woman and child in America. Then, we wouldn’t need to have this discussion.
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One man’s opinion. Good luck getting a majority to agree with you. Read a little Tocqueville and remember this is a Democracy.
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Furthermore, if an insurer did for some reason offer me a lifetime policy, I probably wouldn’t accept it for the following reasons:
-It would probably cost a lot more than a policy that covers only the next 12 months
-I anticipate that as I gain experience in my career, I will be able to afford more coverage as I get older to cover my increased medical risk
-I need the money now
These are the same reasons young people decline insurance, and probably the same reasons why insurers wouldn’t offer lifetime policies unless they were forced to by law.
Even if it were a good idea, I would like to have the option to buy a policy priced for 1 year only, but under this law, insurers really can’t offer you that kind of policy.
And if I ever elected to buy a lifetime policy, I would not choose one that covered acupuncture, addiction treatment, elective surgeries, or any of the other extras included in the mandate. I would choose a simple catastrophic plan augmented with coverage in the areas where I’m exposed to increased risk (like maybe supplemental coverage for headaches brought on by reading political blogs:-P).
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Based on your comments, you have no health insurance policy, or your parents are paying for you. When you do find that ideal, 1-year policy you mentioned, price it out, and let me know the cost.
Meanwhile, if heaven forbid, tomorrow you suffer a serious and permanent injury — one that leaves you disabled for life and costs you $100,000 the first year alone — exactly how do you plan to pay your bills?
But, young people never think about that, since they expect to be healthy forever. By the time you’re ready to buy insurance, it will cost you far more than you expect — if you can get it at all.
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This is all one guy here. See the OP. I’m covered through my employer with premiums around $4000/yr that my employer and I share. Again, that’s more than enough to cover my utilization and my risk for catastrophe, plus my premiums are covering some of the risk for older, sicker people in the group.
I don’t expect to be healthy forever, and in fact I expect to pay more when I get older and my risk increases (I’ve mentioned this a few times in during this conversation). The law equalizes everything out, making the young pay more and letting the old pay less.
True, some young people (but not me) expect to never pay anything for health care. But it looks like Old people forget that they got a good deal when they were young and healthy, but now that they’re old and risky, they want us young people to help foot the bill for their care.
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Patrick, if the majority understood Monetary Sovereignty, I wouldn’t have to write this blog.
As far as the old people, they are such a drag, aren’t they. Don’t you wish you’ll never be like them? I hope you don’t get sick before you get fired. Think about it. And why make the healthy pay a little more while the sick pay a little less. Doesn’t seem fair, does it? Oh yes, that’s called “insurance.” 🙂
First, learn Monetary Sovereignty; then we’ll talk.
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