Strangling Ourselves With Selfishness

The headline on Shailagh Murray’s WaPo piece is “Young Adults Likely to Pay Big Share of Reform’s Cost,” and of course righties who have seen the headline are quivering with outrage on the burden that’s about to be put on the young folks.

This is what Murray writes,

A 2008 study by the Urban Institute found that more than 10 million young adults ages 19 to 26 lack health insurance coverage. For many of those people, health-care reform would offer the promise of relatively inexpensive individual policies, which do not exist in many states today.

The trade-off is that young people would no longer be permitted to bet on their good health: All the reform legislation before Congress would require individuals to buy at least minimal coverage.

This is the part that has the libertarians so upset:

Drafting young adults into any health-care reform package is crucial to paying for it. As low-cost additions to insurance pools, young adults would help dilute the expense of covering older, sicker people. Depending on how Congress requires insurers to price their policies, this group could even wind up paying disproportionately hefty premiums — effectively subsidizing coverage for their parents.

One of the relatively milder reactions, from one of the unfree thinkers at Reason:

Despite rhetoric to the contrary, government policies tend to take from the relatively poor and give to the relatively wealthy (see the Medicare prescription drug plan for an example). And so it is with health insurance reform, where it’ll be the kids who pay for the rest of us.

The more I wade around in rightie ideas about health care and insurance, the more I think they just plain don’t understand risk pooling.

I share the concern that young people will be required to buy insurance that is too expensive for their entry-level budgets. That’s one of the reasons a public option is so important. On the other hand, at least some of those young, healthy folks will have catastrophic accidents or unexpected illnesses, and their medical care will be paid for by the premiums of other healthy people. And the rest of the young, healthy folks will eventually grow into older and less healthy folks.

But here’s another piece of the puzzle the righties don’t get — the uninsured drive up health care costs. In fact, the uninsured may be one of the biggest drivers of rising health care costs.

Last week the Los Angeles Times published a letter from Dr. Robert W. Robertson Jr., former director of emergency services at Western Baptist Hospital in Paducah, Kentucky. Dr. Robertson wrote,

In 2005, there were 44.8 million who had no medical insurance. In 2006, that number had grown to 47 million. Presently, it is estimated that there are 50 million who have no coverage, and that number will rise to over 52 million at the end of 2010. …

  1. The uninsured numbers are constantly increasing.
  2. The unreimbursed expenses incurred by hospitals in treating those ever-increasing numbers of the uninsured are constantly increasing.
  3. Hospitals must increase their charges in order to cover the ever-increasing costs of treating the uninsured.
  4. Medical insurance companies must increase the premiums of those they insure in order to pay for the increased hospital charges when their insureds seek treatment.
  5. Each time insurance premiums increase, another portion of the population opts out of carrying insurance. Individuals or companies reach a point, finally, when they can no longer afford insurance, and individual policyholders or employees of companies which drop their benefits enter into the pool of the uninsured.
  6. More uninsured people = increased, unreimbursed hospital costs = increased hospital charges = increased insurance premiums = more uninsured people…. The upward spiral is incessant.

The pressure created by the ever-increasing number of the uninsured is the driving force behind the ever-increasing cost of medical care in the United States. That force is unrelenting. It can only accelerate. It has created a system which is unsustainable.

If you want to fully appreciate how unsustainable it is, take a look at these numbers from the Kaiser Family Foundation. The average cost of a family health insurance policy in 2009 is $13,375. If insurance costs continue to rise at the same rate they’ve risen in recent years, by 2019 the average cost of a family health insurance policy will be $30,803.

It follows that to put an end to the spiral, we must choose one of these three options:

  1. Get everyone insured.
  2. Allow hospitals to turn away people who don’t have insurance. Of course, that could be any one of us if we lose our wallets in an accident and show up at an emergency room with no identification. Instead of death panels, we’ll have a death lottery.
  3. Scrap insurance altogether and go with single payer.

My guess is that libertarians will go with Option 2, figuring they can have their insurance information tattooed on their butts. Or, we can have microchips inserted under our skins so the hospital can scan us and determined we’re covered by Blue Cross, or whomever. Because, you know, everybody could buy insurance if they really wanted it. That’s how Reason sees it, anyway:

To me, Reason‘s video presents a great argument for mandates. I have no way to know what percentage of young people are willfully choosing not to get insurance and what percentage cannot afford insurance, but let’s remember how some of them are coping with not having insurance —

They borrow leftover prescription drugs from friends, attempt to self-diagnose ailments online, stretch their diabetes and asthma medicines for as long as possible and set their own broken bones. When emergencies strike, they rarely can afford the bills that follow.

Enough, I say. We’re strangling ourselves with our own selfishness.

19 thoughts on “Strangling Ourselves With Selfishness

  1. You’re right, but even though I will gladly pay, I still feel resentment at the baby boomers anyhow. Truckloads of it.

    • MNPundit: Hey, watch your mouth, young’un. Some of us here are boomers. Anyway, don’t forget — sickness, old age, death. We all get our turn.

  2. I paid premiums on employer-provided group health coverage from the age of 23 on. Nearly 30 years of premiums by now. I never whined about it, or was fussed that my money might help to treat an elderly person. I was raised by elderly people, so the value of their lives was obvious to me.

    Ten years ago I had a young friend in her late 20s who’d already been diagnosed with 2 different forms of cancer. Really, going without health insurance at any age is dangerous. We all still pay for it when an uninsured person, of any age, gets sick.

  3. Here’s the way risk loading works when you’re talking about many life insurance policies:
    When you are younger you pay less in the beginning (you can afford only catastophic term/death insurance), the most in the middle (your prime earning years – this is when you switch from term insurance to whole life (with money for investment), and little at you get older (because your prime earning years are done, providing you’ve had the same policy for years. Good luck trying to find a new one at any age past 55).
    Here’s how our current health insurance works:
    You pay little in your younger years because you aren’t likely to have anything major. You pay more in you middle years because you are more likely to have something major. You pay the most as you get older because, well, we all gotta die sometime, and as you get older, the dice roll against you.
    If you risk pool in health care, you can equalize costs. If we had single-payer, this would be most cost efficient – all illnesses are spread out across the ages. If we have a public option for people, this would force insurance companies to keep costs down to prevent people from going to a government sponsored program.
    The one that the insurance companies salivate at, is the one where we force everyone to buy private insurance with no public option to inhibit huge cost increases. I would call this Vegas Rules Health Care, because the system will be gamed against you. You will no longer have a chance to NOT go to Vegas. You will NOT have a choice to get a cheaper motel, let alone a hotel. You will be FORCED to go to Vegas, stay at their hotels, and pay whatever they want for food. And as for your health care coverage, well, it’ll still be a crap-shoot whether they decide to cover something or not.
    Kidney disease coverage – COME ON SEVEN’S… PAPA NEEDS A NEW DIALYSIS MACHINE!!!

  4. “But here’s another piece of the puzzle the righties don’t get — the uninsured drive up health care costs. In fact, the uninsured may be one of the biggest drivers of rising health care costs. ”

    Neither do the libertarians who I recall blathering on about their right not to wear a motorcycle helmet or to be compelled by the state or anyone else to do that or anything else they might not care to do.

    Somehow they rarely make the connection between the the total freedom they imagine themselves having and the dystopian result which would be leaving the uninsured to die and sweeping their remains off the street. We hardly need to lose our humanity on account of someone else’s stupidity.

    They’ll either have to get on board willingly or dragged along kicking and screaming. It’s their choice and what they choose hardly matters to me. I can tune them out.

  5. “You will be FORCED to go to Vegas, stay at their hotels, and pay whatever they want for food.”

    From what little details I’ve heard this sounds like what came out of the senate finance commitee. Fine job Max!

  6. In the days when I frequented the hip replacement self-help sites, I was sometimes on the verge of tears reading the callous comments on health care. I really despair at the selfishness of the American people as a whole. I have no doubt that there are millions of caring, kind-hearted people in your country, just as there are millions of selfish ones in mine, but for reasons that would take too long to explain here, as a nation, Canada chose to provide basic protection against illness to all its citizens (as has virtually the rest of the first world) while in the States, libertarianism has become increasingly entrenched in the collective psyche.

    Honestly, I don’t know if Obama can win on this issue.

    BTW, our prime minister, Stephen Harper (a closet Bushie if there ever was one), had a one-hour chat with Obama today and will be giving a speech on the economy in New York tomorrow. I mention this because on the news here in Canada, they’re explaining how, even if Harper convinces Obama that the pure “buy American” policy is harmful not just for Canadians but for Americans, Obama has his hands tied and can’t do much to sway Congress. US presidents are toothless when it comes to domestic policy. I’m not in favour of an autocratic ruler who imposes his way, but this toothlessness goes a long way towards explaining why a duly elected, (somewhat) progressive president seems totally hog-tied when it comes to introducing much-needed programmes like health care.

    P.S. c u n d gulag: I’m seeing great progress in your struggle with apostrophes! Keep up the good work.

  7. It really seems to me that we’re getting nothing from the Baucus bill other than the potential to remove some cherrypicking from the concept of insurance. I just can’t support what I have seen. It lacks inclusiveness and cost control. But the millions Baucus has been paid by the insurance companies have certainly gotten them something. I heard his response to this criticism today. He was assuring us all that he was not influenced by anything but consideration for the best interests of his constituents. Yeah, I believe that.

  8. Well, you’ve got to admit the insurance con jobs got a real bargain when they bought Baucus.

    How much time did it take the insurance con jobs to write this and slip it to Baucus?

    A new word to learn: Baucus – definition: cheap crook.

    Let’s string this out. How much did that jackass from South Carolina get for saying his “you lie?” “campaign contributions” of what $1 million? Cheap for distracting attention from what the President said and extremely profitable for the hog caller. Don’t even pretend that when someone behind you yells, you don’t turn around unless you know that it is coming. Fine discipline in the Republicans.

    Debate health care? Hell, yes, it keeps people from seeing the fat swollen “defense” and “intelligence” industries getting their huge profits. Let’s distract the suckers from where the real damn money goes. See any of the banksters going to prison? Nope, why not? Follow the money right into Bush III’s campaign coffers.

    Shut down the 2 unwinnable wars. Stop the meddling in other peoples countries for fun and profit of the evil merchants of death.

    Then you have some real money to fund healthcare.

    PS, do YOU own stock in evil insurance, evil banks, evil contractors?
    Who does? Huh? Oh, those poor rich people who like a real healthy return on their “investments.” The ones best able to pay for their health care from the petty cash drawer in their homes.

    This is not a democracy, it is an oligarchy, run strictly by and for the plutocrats. They got a real bargain in Bush III. So far stem cell research is the only thing that I have seen Obama do, that he “implied” he would do on the campaign trail. Other than that, I would not stand behind him on anything.

  9. “…as a nation, Canada chose to provide basic protection against illness to all its citizens (as has virtually the rest of the first world) while in the States, libertarianism has become increasingly entrenched in the collective psyche.”

    Sad, but true. Many of the “political” problems the US is facing actually have “cultural” roots. Even though many Americans may not have read Ayn Rand or even heard of her, it is a cultural norm here that selfishness is a “virtue.” As long as the problem is addressed only as a political problem, it will never be solved.

  10. Even though many Americans may not have read Ayn Rand or even heard of her, it is a cultural norm here that selfishness is a “virtue.”

    I’m not so sure we are that sophisticated as to have coupled greed with an ideology. Some of the elite might do this but most come by their virtue cheaply by just declaring it so and by believing myths and lies such as helping instill freedom and democracy while we are really just helping ourselves. Most Americans think we have deep pockets when it comes to charity when we rank far down from the top. Many think our schools and our healthcare are the envy of the world when they’re not.

    Our problem is not some ideology of virtue, it’s that we believe our own bullshit. We feel really warm when we curl up in it and get damned ornery when it is pointed out to us. To some pride and ignorance trump realism and tackling challenges every time.

  11. My daughter was just a few days past her 18th birthday when the accident happened. She got on the trunk of a car driven by her ‘best friend’ who was unlicensed, driving her mom’s uninsured car. With my daughter riding, the car took off at high speed – jumped a curb and threw Stephanie on her head. She almost died in the operating room, and ICU had a ‘death watch’. The following day more surgery was nescessary to ease the pressure from swelling. After that, physical therapy to learn to walk and talk and feed herself. She suvived – I will be a grandpa in December.

    But don’t tell me that the young don’t need insurance.

  12. As an 85 year old American pal of mine put it, “there are those Americans who are too stupid to come in out of the rain”.

  13. this just in: young workers have always supported older, retired workers’ benefits. And those presently young workers, should they be fortunate, will receive the same benefits when they’re old. Behold: that system works, whether or not libertarians support it.

  14. I don’t think the cost of covering the uninsured actually add a lot to the price of insurance or healthcare. Yeah, it adds a bit, but like tort costs, the problem is a lot smaller than everyone makes out. Certainly, not 30% like the cost of insurance company profits and paperwork.

    The category of young & uninsured is much less costly than the elderly who have more serious, regular illnesses.

  15. The Congress is back in session and doing the dirty work for the Medical Industrial Complex.mcconnell $3.3M, hatch $2.9M, baucus $2.8M, grassley $2.7M,lieberman $2.6M, burr $2.4M, ensign $2.4M, cornyn $2.2M, kyl $2.1M,conrad $2.1M, cantor $1.8M boehner $1.7M, coburn $1.2M, j wilson 800K were paid by the Medical Industrial Complex to kill Health Care Reform.(Source: Million Americans were denied health care coverage by the Medical Industrial Complex because they had a pre-existing medical condition. 12K Americans are denied insurance coverage everyday by a for-profit Insurance bureaucrat. (Source: WaPo Article 05′ by Harvard Prof. E. Warren) More than 22K Americans between the ages 24-64 die each year because they don’t have adequate health insurance coverage. (Source: Chu, M.C. & J. Rhoades, The Uninsured in America, 96′-07′)Medical malpractice lawsuits are a hot topic but, are they? Tort Reform is such a “red herring” and is easily disproved. I know repubs love to quote the CBO well here’s a quote, ” A 2004 report by the Congressional Budget Office said medical malpractice makes up only 2 percent of U.S. health spending. Even “significant reductions” would do little to curb health-care expenses, it concluded.”Citizens for Tax Justice pointed this out. The tax legislation enacted under President George W. Bush from 2001 through 2006 will cost $2.48 trillion over the 2001-2010 period. This includes the revenue loss of $2.11 trillion that results directly from the cheney/bush tax cuts as well as the $379 billion in additional interest payments on the national debt that we must make since the tax cuts were deficit-financed. Over the upcoming decade (2010-2019), the costs of the health care proposals approved by three committees in the U.S. House of Representatives are projected to be around $1 trillion and deficit neutral(that means they’re paid for). In 2010, when all the cheney/bush tax cuts are finally phased in, a staggering 52.5 percent of the benefits will go to the richest 5 percent of taxpayers. The cheney/bush tax cuts were deficit-financed, which increased the national debt and resulted in greater interest payments on that debt. cheney/bush administration never even tried to pay for their tax-cuts. So, for the price of cheney/bush’s tax-cuts for the wealthiest 5%, we could have had Health Care for every American. Instead Americans got bupkus and cheney/bush’s republican campaign contributors/golf buddies got filthy rich off of the Blood Money from No-Bid, Cost-Plus Federal Contracts.Follow the Money: LinkCall Congress and demand, Single-Payer Health Care for All!(Toll Free # House and Senate)1-866-338-1015_______________1-866-220-00441-800-473-6711_______________1-866-311-3405Sign Single-Payer Petition: LinkDon’t let the Medical Industrial Complex steal your Health Care from you and your family by donating huge sums of money to Crooked Politicians in order to maintain the Status Quo. Keep up the good fight.SEMPER FI!

  16. Baucus $2.8M

    Surprise, surprise, surprise, right?

    Americans got bupkus and cheney/bush’s republican campaign contributors/golf buddies got filthy rich off of the Blood Money from No-Bid, Cost-Plus Federal Contracts. Follow the Money….

    You’re preaching to the choir, my friend. These are the truths the teabaggers deny, because they too are puppets for the Medical-Industrial Complex. Thanks for the links and phone numbers… action (us) is better than bitchin’ (them).

  17. Baucus earned every bit of that 2.8 mil by formualting such a superior health care plan.. I’m gonna save up my pesos and try to purchase one of those bronze plans..It would be nice if he’d designed an aluminum or lead plan for us Americans who are really, really hard pressed to afford health care.

  18. Oh not for being old. But for choosing the selfish option almost every single time when it came to policy, not giving a damn about the long term as a group.

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