Friday, March 24, 2017

Reflections on today's vote on the Trump-Ryan plan

There is no shortage of arcane details in which one could get bogged down.

But that actually makes my point: Modern delivery of health care is complex enough without government involvement.

James C. Capretta, an American Enterprise Institute scholar who is considered a right-of-center wonk on health care, says, quite rightly, that it would be best if everyone cast off the self-imposed pressure and craft a better bill. And he offers a list of concrete measures he'd like to see.

Here's the problem with his list: It's still predicated on government requiring things of private organizations, and, more fundamentally, the notion that has insidiously established itself as a national assumption over the last century: that government ought to be in the business of providing services.

The two most egregious manifestations of his premise - his surrender to the statist mindset - are the idea of automatic enrollment, which would be based on requiring (there's that word again) insurance companies "to offer plans with premiums exactly equal to the standard credit," and ratcheting up the penalty for breaks in coverage.



He lays bare the extent to which he has succumbed to a view of the inviduals comprising the American populace as cattle-masses:

Moreover, states could identify individuals who fail to use their credits using federal tax data and state data sources, and automatically enroll then into such plans. Under this approach, the affected individuals would be notified of their coverage but could choose a different plan or withdraw their enrollment at any time. Most people are likely to remain with their assigned plan, especially since there would be no financial obligation on their part. They would get a high-deductible insurance plan at no cost to themselves, which is far better than no coverage at all.

And think about the substantial-increase-in-penalty provision: Mr. Capretta, how is it any of government's damn business whether a given citizen chooses to interrupt his insurance coverage?

As push comes to shove and guys like Capretta buy into the supposed need for government to swoop in and mop up even the slightest hint of upheaval, I get a clearer notion of who deserves my respect and who doesn't.

And then there's the Wall Street Journal editorial this morning that, dismayingly but not surprisingly, disparages the House Freedom Caucus as the House Freedom-From-Reality Caucus. The good old accusation of insistence on perfection standing in the way of the good getting enacted.

No, it's not an insistence on perfection. It's insistence on this whole effort being driven by the primacy of freedom.

And now Squirrel-Hair is strongly intimating that, if the frantically-tweaked Ryan bill doesn't pass today, he'll move on to other matters and let the "A"CA continue to wreak its ruin.

This whole thing makes clear just what a huge percentage of our political and governmental class, our policy-wonk class, and our pundit class, have lost sight of the proper relationship between the state and the individual.

Health insurance is just a service. If produced and consumed in a manner that reflects an understanding of that - namely, that it should exist to cover catastrophic occurrences, but not routine health care - there's not much role for government.

But then the question arises, who finds that an undesirable scenario?



13 comments:

  1. Bloggie's wave of the hand again at his pure free market which cures all ills, Well, good luck with that bloggie, insurance is the most regulated industry out there. And has been for centuries in America. The main issue, as with everything else in America, is still states' rights to regulate vs. federal rights. I know you let the door swing both ways there, depending on whether you are defending defrauders or tokers.

    Why is insurance regulated?

    A little primer from Wiki here:

    Insurance is characterized as a business vested or affected with the public interest.[2] Thus, the business of insurance, although primarily a matter of private contract, is nevertheless of such concern to the public as a whole that it is subject to governmental regulation to protect the public’s interests.

    Therefore, the fundamental purpose of insurance regulatory law is to protect the public as insurance consumers and policyholders. Functionally, this involves:
    Licensing and regulating insurance companies and others involved in the insurance industry;
    Monitoring and preserving the financial solvency of insurance companies;
    Regulating and standardizing insurance policies and products;
    Controlling market conduct and preventing unfair trade pracices

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  2. Well, clearly policing against fraud is necessary but it doesn't require the Byzantine web of bureaucracy we have seen geow

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  3. I'm certain more AI will be the answer on the way to total elimination of that nastiness known as human capital.

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  4. As for what you call arcane details, well yeah, such are contracts and such is legislation in our government of lawyers, not men..

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  5. Not a single Dem vote. Just like the scenario 7 years ago. And Hillie who was for universal won the popular vote in America by 3 million votes. Tat's where I see us heading as I watch your bombastic ilk fail and fail again.

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  6. So by now we know the bill's blown. When Bill's bill blew it would be another 14 years of status quo before the issue was back on the table. Not a single Democratic vote. Do you blame them? Oh well, maybe after the mid-terms where we see where we're at then with the balance of power in Congress. There sure should be record turn-out then. We'll see how it's all going then. Nice try again at no though.

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  7. Apology of the week: https://www.yahoo.com/news/gop-sen-roberts-i-deeply-regret-quip-about-insurance-coverage-for-mammograms-191116178.html

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  8. 7 years of pissing and moaning and you ain't got jack.

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  9. I can't help it if the cattle-masses - and the dweebs they send to Congress - have lost sight of how valuable their freedom is.

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  10. Just bring us something that works, OK? What's wrong with the greatest, most exceptional plan the planet has ever known. We expect no less from you geniuses. Get 'er done! 7 years is a long prep time.

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  11. “Years of hatred and distrust,” he said. “Long before me.”

    Was Trump saying, perhaps, that the inability of Ryan and his team to work well with that caucus was part of why talks stalled?

    “Well, look, you can say what you want,” Trump said. “But there are years of problems, great hatred and distrust, and, you know, I came into the middle of it.”

    “I think they made a mistake, but that’s okay,” Trump said of the Freedom Caucus.

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  12. This comment has been removed by the author.

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  13. "And government health care programs turn out to be very popular, among both Democratic and Republican voters. Medicare is a huge success. Medicaid also works well, and some Republicans have defended it in recent weeks. So if voters like government-provided health care and Republicans are going to undermine private markets, what should Democrats do? When they are next in charge, they should expand government health care. They should expand Medicaid further into the working class. They should open Medicare to people in their early 60s. They should add a so-called public option to the private markets. They should push the United States closer to single-payer health insurance. It will take time and involve setbacks, but they are likely to succeed in the long run."


    https://www.nytimes.com/2017/03/28/opinion/republicans-for-single-payer-health-care.html?ribbon-ad-idx=4&rref=opinion&module=Ribbon&version=origin&region=Header&action=click&contentCollection=Opinion&pgtype=article

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