Sunday assorted links

by on July 2, 2017 at 12:33 pm in Uncategorized | Permalink

1 dearieme July 2, 2017 at 12:43 pm

#7: why don’t the Republicans just let the misbegotten thing die?

2 ¯\_(ツ)_/¯ July 2, 2017 at 2:04 pm

Strangely enough, my girlfriend looked up from her paper this morning to ask “if they can’t get rid of Obamacare, why don’t they just fix it?”

I explained, I think fairly, that there are two kinds of Republicans right now: those that want to keep Obamacare protections, and those who want a high end tax cut. Even leaving aside all Democrats in government, those two groups of Republicans are deadlocked.

3 ¯\_(ツ)_/¯ July 2, 2017 at 4:20 pm

So in a little while no one has disagreed that this is a Republican deadlock, but for some reason the Republicans want to blame the media:

https://twitter.com/realDonaldTrump/status/881604490041995271

Some good commentary on that focus:

https://twitter.com/RadioFreeTom/status/881546248699904000

Very strange days.

4 ¯\_(ツ)_/¯ July 3, 2017 at 11:15 am

Related news this morning. 42% of Republicans think press freedom has gone too far .. but only 26% of Americans are willing to self-identify as Republicans.

As someone used to say here, the Republican strategy seems to be “divide down.”

5 robert July 2, 2017 at 2:22 pm

…because Obamacare is a very active, extremely destructive beast — not some passive entity resting quietly in the law library. That voracious beast must (legally) be fed with huge expenditures, new taxes/fees and a bizarre array of regulations & regulatory additions/modifications. You can’t just ignore a hungry violent Grizzly Bear that breaks into your home.

Ross Douthat adds nothing at all new to the discussion. He does not like the current Republican healthcare bill… and thinks Republican officials are divided and incompetent. Yawn

6 ¯\_(ツ)_/¯ July 2, 2017 at 2:35 pm

Bear? No. Obamacare is shark with a frickin laser beam on its head. Though now, Republicans want us to settle for mutated sea bass.

7 JWatts July 2, 2017 at 2:41 pm

“Obamacare is shark with a frickin laser beam on its head.”

Powered with an extension cord.

8 Anon7 July 2, 2017 at 5:03 pm

Starve the beast is the best thing that can happen to Obamacare.

9 Jan July 2, 2017 at 6:09 pm

Poll after poll have shown that Republicans and Trump own health care now. Lots of markets end up without insurers? Voters blame GOP. Lots of steep increases in premiums due to lack of enforcement of individual mandate or refusal to pay CSRs? Voters blame GOP. Etc, etc. It’s not complicated. So even from a purely political standpoint, if GOP actively inflicts pain by undermining or simply not stewarding the ACA, which most the public now supports, Republicans will pay the price in 2018.

10 Anon7 July 2, 2017 at 7:42 pm

I was talking good policy, so spare us the conventional political (lack of) wisdom. Finding ways to provide bread and circuses is corrupt.

11 Jan July 2, 2017 at 9:35 pm

Spare us the dramatic starve the beast garbage. That’s precisely politics, and what Trump is threatening to do with CSRs — it ain’t policy

12 David H July 2, 2017 at 10:18 pm

I have a feeling that this is what we will end up getting. If I were the Republicans I’d craft some “generous” replacement plan which will get a couple of Democratic votes, but not enough to pass. Then you can say you tried, point to how angry you made poor Ted Cruz, and then just wait until the number of insurers that offer Obamacare plans to falls to zero. Then it dies – just like you’ve always said it would – and you don’t have to kill it.

13 Anon7 July 3, 2017 at 3:59 am

A full repeal is not possible under reconciliation rules, so that’s the next best thing. Neither conservatives nor libertarians should accede to the promiscuous minting of a universal “right” to health insurance, which was animating spirit of Obamacare. STOP!

14 ¯\_(ツ)_/¯ July 3, 2017 at 12:01 pm

Basically Anon7 frames the position of the 17% of Americans who support these bills.

Cue the “democracy is terrible (when it disagrees with me) tirades.”

15 Boonton July 2, 2017 at 4:05 pm

It isn’t a beast, it is reality and it is very simple:

1. You cover people with a gov’t program like Medicare (generous) or Medicaid (skimpy). That means more taxes but more security since your coverage isn’t going to vanish every time you change jobs or have a setback.

2. You give people money to buy their own coverage but you insist they buy coverage which means you define what coverage means and you require insurance companies to provide them coverage rather than price them out via pre-existing conditions and other mechanisms.

3. You let people buy or not buy coverage….but you provide various sticks and carrots so that they do and insurance companies provide it (this is Obamacare).

4. You don’t do anything but you provide aid to those who can’t get coverage due to low income or pre-existing conditions (this means taxes at some point or another).

5. You do absolutely nothing and let everyone fend for themselves.

Most people want something like 1 or 2. #3 gets a lot of heat because it’s smack in the middle so plenty will bash it from the left and right but not stick up for it. But if you are not 100% convinced that one ideology or the other has all the answers it’s probably a good place to go.

The problem is the Republicans ran on a platform of #2 (or #2 provided by magic some combination of taking away the mandate and ‘regulations’ would make premiums super cheap and affordable for everyone) but are trying to swap out a #4 or #5 in its place. Rather than even try to make a case for an ideological solution (like Reagan once did when he first came out against Medicare and then later accepted it and Social Security as part of a compromise and coming to terms with modernity), they are trying to impose it while lying about it.

The reason this is not working is not an unfair media or because ObamaCare has some type of mystical power to frustrate Republicans (despite having Congress and the White House). It’s because Republicans refuse to provide a solution.

16 msgkings July 2, 2017 at 11:00 pm

Well summarized

17 Oreg July 5, 2017 at 5:46 am

Indeed.

18 Anon7 July 3, 2017 at 4:05 am

“Rather than even try to make a case for an ideological solution (like Reagan once did when he first came out against Medicare and then later accepted it and Social Security as part of a compromise and coming to terms with modernity), they are trying to impose it while lying about it.”

It would be much better to do the former but I’ll settle for latter (following the precedent of Obamacare).

19 Jan July 2, 2017 at 6:10 pm

He actually has a very good suggestion for the GOP. I don’t happen to agree with it. But not to worry, R’s won’t listen to him because their policy is driven by there big dollar donor masters and hatred for Dems.

20 mulp July 2, 2017 at 3:32 pm

“why don’t the Republicans just let the misbegotten thing die?”

Because it’s working too well, much better than the “Bushcare” it repaired, which worked better than the “Clintoncare” it repaired.

It’s called progress, something that is bipartisan, with only the right-wing opposing, but a right-wing that can’t tell the truth: the right-wing wants death panels to kill off the “burdens” to the economy.

The only places the right can point to to claim Obamacare is failing are the places where there exists no supermarket to buy food, not even a Walmart non-supercenter with limited food, and, horrors of horrors, only one, or maybe no, State regulated insurer listed on the Federal marketplace to provide the subsidies in the form of tax credits to the few people with earned income in excess of $13,000 or more, the minimum income to get insurance subsidies.

Somehow, in health care, competition must exist even where zero competition exists selling food.

And somehow, Obama is responsible for healthcare costs raising much faster than anything else since at least 1980 when US health care costs were near the same share of gdp as the UK, Europe, Canada, Japan, and Obama is totally to blame for employer health benefits costs doubling from 2000 to 2008. Worse, those benefits rose 50% while Obama was president which is worse than increasing 100%.

Note, nothing Republicans have proposed since Obama stole the Republican health reform solution, and implemented by Gov Romney as his ticket to the White House, does a single thing to address any complaint they say out loud about Obamacare.

Not one thing to control medical costs.
Not one thing to increase access to medical care to tens of millions with limited access.
Not one thing to ensure doctors and nurses get paid promptly for providing necessary medical care.
Not one thing to address some of the factors driving increased need for medical care like lack of access to healthy food.

Why aren’t conservatives doing something to ensure the rural working poor can shop at two or three supermarkets with lots of fresh fruits and vegetables with store personnel promoting new foods by giving out samples and giving food prep demonstrations? Like you can find in wealthy liberal elite neighborhoods… Why aren’t conservatives doing something to make sure the rural working poor have many choices of convenient food that is healthy, making extensive use of local farm production to produce tasty meals of fresh fruits and veggies? Or, at least teach how to grow your own food, like back when America was Great, so you can eat well without spending money? Why isn’t the NRA teaching how to stalk game, kill it, dress it, the prepare the meat for storage, the reason most people had guys back when America was Great?

Conservatives offer the solution used by the US Army in WWI to stop it’s pilots from getting shot down by German fighter pilots who had parachutes: US Army fighter pilots were not allowed to have parachutes. If the working poor have no access to medical care, then the working poor will never get sick or disabled. But just like US fighter pilot aces who won in dog fights, and then died when their crippled planes crashed because they could not bailout, the ultimate in “no bailouts” policy, making medical care unavailable to workers, still workers die.

21 GoneWithTheWind July 2, 2017 at 9:22 pm

The ACA was a poison pill with the name of a health care bill. It cannot be fixed but it promised “free stuff” so it is popular with the rentseekers so if the politicians repeal it the low information voters who want more free stuff will be angry. If they try to “fix or replace” it they will simply create another version of a doomed socialist health care system which will unravel and need to be repealed or fixed or replaced. Politicians are unable to fix this because they are always looking towards reelection and what gets you reelected is giving away more free stuff. Soon the federal government will effectively go bankrupt because of the need to give free stuff to the voters. But in the meantime they will screw up health care even more than it already is.

22 RealDonald July 2, 2017 at 11:17 pm

Failing, low IQ Ross Douthat wanted to come to Trump Tower to talk about his healthcare plan. He was bleeding heavily from a stigmata. I said NO!

23 Moo cow July 2, 2017 at 12:53 pm

#6. Right. Blink…blink…

If I wanted to drive somebody crazy I would just keep buying their shit and setting it on fire. This is not a good idea lol.

#7. Obamacare Light? This is the Great Republican Idea???

24 swedenborg July 2, 2017 at 2:46 pm

Every time you buy my stuff, I have more money than I thought the stuff was worth, and you have less money. That would make me happy, not drive me crazy.

25 mulp July 2, 2017 at 4:07 pm

If you can’t sell stuff for more than you think it is worth, but only what it costs you to sell stuff, will you stop working and sell nothing?

26 Moo cow July 2, 2017 at 4:46 pm

Well, you’re supposed to put everything up for sale. I keep buying your spatula and toilet paper holder. It’s insane!

27 Jan July 2, 2017 at 6:12 pm

7) I think the lack of ideas is mostly to do with the fact that R’s just don’t care about health care. It’s like #8 on their list of priorities. Their only interest in it is related to politics and cutting taxes, not policy principles about how health care should work.

28 Chip July 2, 2017 at 10:24 pm

“Their only interest in it is related to politics and cutting taxes, not policy principles about how health care should work.” – Jan

“It’s going to be very, very exciting. But we have to pass the bill so that you can find out what is in it.” – Nancy Pelosi

Bonus quote: “everybody will have lower rates, better quality care, and better access.” – Nancy Pelosi

Jan, your ability to spew mindless, partisan hackery is truly amazing. Bravo.

FWIW, there are 15 doctors serving in Congress and 13 are Republican.

29 Moo cow July 2, 2017 at 10:30 pm

If that’s the case why can’t they come up with something better than Obamacare Light?

30 Daniel Weber July 5, 2017 at 2:45 pm

Because getting a good health care system requires hard but painful choices, and politicians have no stomach for hard but painful choices.

The lynchpin of Obamacare was the mandate, which kept on being relaxed and reduced and delayed. It’s hated but it’s what makes guaranteed issue and community rating work.

European systems involve price controls and implicit or explicit denials of care when “not worth it.” I would generally be fine with such a system for my personal care, but it’s very easy to see how anyone who proposes this would be attacked by the opposing party.

If Obama had gone full bore with a real but painful mandate, we might have a working and stable health care system.

31 Ricardo July 3, 2017 at 4:13 am

Dr. Rand Paul was one of the Republicans complaining about how the AHCA was being drafted in secret with little opportunity for open debate. That proves Jan’s point. The Republican Party leadership has had seven years to formulate a concrete alternative to PPACA and build a critical mass of support for it. They haven’t because it is simply not a priority.

32 Art Deco July 3, 2017 at 3:14 pm

Arguably.

There’s probably something on the shelf at Heritage or AEI as we speak. Either Congress has lousy research assistants or they don’t want what an economist or policy specialist would come up with. Wagers that’s because what a wonk would come up with would incorporate an end to 1st dollar coverage,and they don’t want to try to sell that, so more diversions, more smoke and vapour, and, oh, let’s have a tax cut.

And, of course, even if they were operating in good faith, they’ve got a two-seat margin and just enough Republicans addled by silly shticks or general perversity to blow any reform out of the water. (Susan Collins thinks the federal government should be tossing swag at Planned Parenthood; Collins is congenial, though, so she’s not going to upend the table over that; others aren’t so sweet. Remember the Cornhusker Kickback?)

33 Albert July 2, 2017 at 1:07 pm

The idea of replacing the “hated” insurance mandate with a six-month waiting period is atrocious. If you think the mandate is unpopular, wait until people see the six month waiting period. Apparently, it’s not even a waiting period to get subsidies?! That would have been bad enough, but it’s outright illegal to buy health insurance for six months!

That’s insane, and the only reason to be opposed to the mandate (at least the only reason given in Douthat’s article) is that it’s unpopular, but there’s no way the waiting period will be more popular. It just hasn’t become “hated” yet because it hasn’t happened yet.

34 Moo cow July 2, 2017 at 1:16 pm

It works for the hip replacement. My understanding is you complete the application etc. Then your waiting period begins so you can hobble around for 6 months np.

Doesn’t work so well for the ruptured appendix.

35 AndrewL July 2, 2017 at 1:25 pm

What makes you say that? if you got a ruptured appendix, you go to the ER and you’ll get immediate treatment, insurance or not. That’s the way it’s always worked. A portion of everyone’s insurance premium went to this “uninsured” pool to cover these kinds of cases in the pre-obamacare era.

36 Moo cow July 2, 2017 at 1:33 pm

They still bill you. If you have the money you’re supposed to pay. It wasn’t just free for those without insurance.

37 AndrewL July 2, 2017 at 7:54 pm

“if you have the money you’re supposed to pay”

what a novel concept, having to pay for goods and services rendered.

Maybe an underreported fact is that medical service providers will go to great lengths to get you, the patient, to pay something, anything, and even reduce the cost of services to something you can afford. The fact the the service providers are willing to discount so heavily leads me to believe that 99% of medical accounting is completely fabricated, and must only exist as some kind of tax dodge.

38 ¯\_(ツ)_/¯ July 2, 2017 at 2:07 pm

My college age nephew just got pneumonia and blew through a $7500 deductible in 3 weeks. So you know, so much for the “young and healthy prudently not having insurance.”

39 AndrewL July 2, 2017 at 7:59 pm

You are confusing statistical average with a single anecdote. On average, you are unlikely to use major medical services when you are young and healthy, therefore expensive plans are not expected to pay off.It doesn’t mean NO young person may incur a costly medical condition. Thats why it makes sense to have a low cost plan that would cover catastrophic conditions, or something similar. Easier for young persons to afford, at the same time having something to cover major illness.

40 ¯\_(ツ)_/¯ July 2, 2017 at 8:27 pm

My story shows why the fantasy “free market insurance would be cheap and affordable” does not fly. All medicine is expensive now. Another example:

“Typical costs: Without health insurance, diagnosis and non-surgical treatment for a broken arm typically costs up to $2,500 or more. For example, a forearm X-ray costs an average of $190, according to NewChoiceHealth.com , but some radiology centers charge $1,000 or more.”

“Without health insurance, surgical treatment of a broken arm typically costs $16,000 or more. For example, surgical treatment of a fracture of the humerus (upper arm bone) costs about $14,911, not including the surgeon fee, at Baptist Memorial Health Care in Memphis, Tennessee. A typical surgeon fee for surgical treatment of a fracture could reach $2,000 or more, according to Carolina Orthopaedic Surgery Associates.”

http://health.costhelper.com/broken-arm.html

Sure a “low cost plan that would cover catastrophic conditions, or something similar” would be great. So would a fish that grants three wishes.

41 ¯\_(ツ)_/¯ July 2, 2017 at 8:34 pm

Ok I see above “99% of medical accounting is completely fabricated.”

Sorry, no. American healthcare may be over provided in some situations, but it is overproviding real and often cutting edge technologies.

They don’t slap a cast and say “so your arm will be a little crooked.”

42 AndrewL July 2, 2017 at 9:07 pm

Well you attempted to use a anecdote to disprove my argument, so I will do the same.

My wife and I took a genetic test, and we received a bill for 3000$ for the test. It appeared they did not include our insurance information on it, so we sent the bill back with the insurance information. They sent us the bill back and indicated that the insurance will not cover the test, so they reduced the cost of the test from 3000$ to 305$. I shrugged my shoulders and paid it, but not 1 week later, they sent us another bill for 305$. So we called them up and they offered to reduce it to 200$, apparently not aware we paid the 305 already? Finally, the last bill they sent was for a balance of 0$ with no record we actually paid the 305$.

So your whole typical cost example is bunk. On paper thats what they say it will cost, but when it comes down to actually paying money, they are far more flexible.

why do you think a low cost, catastrophic plan is impossible? Currently I have a low premium high deductible plan with Health Savings Account, which I think is great except that there still is very little cost transparency in the industry.

43 ¯\_(ツ)_/¯ July 2, 2017 at 9:26 pm

I did link to typical costs for a routine injury. They are congruent with my nephew’s pneumonia experience.

I think that more likely than “all costs collapse to $200.”

44 Boonton July 2, 2017 at 2:17 pm

How would that work for a 40 year old single mother ‘between jobs’ who let her insurance lapse because she had to make the rent payment who one day finds a lump in her breast?

Go to the ER? Nope, they would just suggest she get a biopsy and consult with an oncologist. Wait 6 months for it to grow then?

45 Anonymous July 2, 2017 at 2:22 pm

stop sponsoring single motherhood

46 Boonton July 2, 2017 at 2:35 pm

And that solves her breast lump?

47 Anon7 July 2, 2017 at 5:13 pm

If she had a husband she would be much more likely to be able to afford insurance (because single mothers are much more likely to be poor), which is one of the many reasons why normalizing single motherhood is obnoxious.

48 Boonton July 2, 2017 at 5:27 pm

OK so she has a husband but because they let their insurance lapse two months or so they can’t get coverage for 6 months, a year or whatever the GOP plan is. How does the ER solve her problem?

49 Boonton July 2, 2017 at 5:29 pm

Even better, you can have your Republican plan once you figure out single motherhood and how to solve it.

50 Hazel Meade July 3, 2017 at 10:11 am

She should have bought one of those $50 a month plans than covers catestrophic, but not stupid shit like birth control pills. Oops, ObamaCare made that illegal.

51 ¯\_(ツ)_/¯ July 3, 2017 at 4:48 pm

Come on, it is numerically impossible for a $50/month plan to “cover” catastrophic charges. One young person with cancer and boom, a $2,000,000 charge. That is where costs come from, not a $40 office visit.

52 Boonton July 3, 2017 at 6:00 pm

The Republican plan for someone who is about 40 who makes around $26K a year would cover 65% of costs on average. Current Obamacare plans would cover about 87%.

Comparing copays, deductibles, co-insurance is a bit tricky since two plans could be roughly equal but one hit you on higher copays while the other gives you lower copays but higher deductibles etc. One figure I found would be at least $4100 as a deductible and practically 65% is not that far from about 50%, which is what many dental plans offer. And if you have had serious dental work you know most of them demand a good chunk of payment up front.

A ‘$50/mo catastrophic plan’ would probably mean the woman gets no real care at all. With something like cancer there is no ‘$2,000,000 charge’ unless you’re talking about major surgery (which is how a minority of cancers are treated these days). You are talking about many visits, treatments, scripts and scans which can easily add up to hundreds of thousands of dollars but individually be small enough not to constitute an emergency or single-handedly let you hit your OOP max.

53 Hazel Meade July 4, 2017 at 11:15 am

Come on, it is numerically impossible for a $50/month plan to “cover” catastrophic charges.

Bullshit.
It depends how high you set the deductible. Maybe it’s a $30,000 deductible, but if you can afford to pay off $30,000 out of pocket, that $50 a month still protects you from bankruptcy.

54 Hazel Meade July 4, 2017 at 11:18 am

65% of costs on average.

See THAT’s where the ACA screwed up. It’s better to have a huge deductible and then 100%coverage after that, than to have 65% of costs , or even 80% of costs covered. If you have a $2,000,000 bill, you’re still going to end up bankrupt if only 80% of your costs are covered. Whereas most people, except maybe the indigent who should be on medicaid, can pay off $30,000 in debt over a few years.

55 ¯\_(ツ)_/¯ July 2, 2017 at 2:14 pm

I agree that the block on buying insurance is a worse and weirder market intervention than the mandate. “They made you buy insurance, instead we won’t let you!”

It is an idea from the madhouse.

56 Hazel Meade July 3, 2017 at 10:07 am

I agree, the six month waiting period would be even less popular than the free market solution – you can buy coverage, but it’s not going to cover pre-existing conditions.

57 Boonton July 2, 2017 at 1:55 pm

#7 And what problem is solved?

The mandate is not ‘hated’. Sorry it doesn’t impact most people and those that it does it isn’t really that big a deal. What most people hate is not the mandate but the fact that they see the premiums as very high AND when you pay those premiums you are stuck with high deductibles and copays.

Ross’s solution makes this problem worse, not as worse as the House and Senate bills but worse nonetheless. Doing spending cuts means fewer people could be on Medicaid and fewer subsidies for those who buy on the exchanges. So more people will be confronted with higher premiums for plans that cover less….and then you tell them if they have the nerve to let their coverage slip for 2 months or more they get excluded from buying it as ‘punishment’. Cue now to that moronic Congressmen lecturing people about buying iPhones rather than insurance.

58 Oreg July 5, 2017 at 6:53 am

That. The one thing all functioning health-care systems on the planet have in common is the individual mandate. Trying without is folly. And a spending cap makes health insurance entirely pointless. The idea is to prevent illness from bankrupting patients, not to spare them temporary financial inconvenience. You want to be insured against catastrophes more than anything.
As both Republicans and Douthat don’t care for these fundamental points it is a mystery what problem they are trying to solve. Their proposals have no obvious advantage over no health-insurance regulation at all.

59 Captain Obvios July 2, 2017 at 1:57 pm

#4 Talk about feeding the bubble! I am not sure whether even Keynes would agree…

60 rayward July 2, 2017 at 3:20 pm

7. Of course, what’s dreaded by real people with real health care problems is high deductibles and co-pays. The Republican alternative would partially solve that problem by allowing insurers to sell what are skimpy insurance policies with exclusions and caps; sure, the deductibles and co-pays might be less, but the insurance policy won’t cover much. Have a nice day. Douthat’s alternative doesn’t address high deductibles and co-pays; instead, it cuts some taxes (not clear if it cuts the tax on investment income of high investment income earners), cuts Medicaid, and cuts the mandate. With health care, everybody’s an expert. Obamacare might not appeal to readers and writers of this blog, but at least it was put together by people who had studied health care for a long time and who considered the whole rather than just a few parts. One example: the age band for premiums. The Democrats considered many age bands and settle on 3:1, not because it’s some magical figure but because it helped make the reform deficit neutral. Should someone age 64 in good health pay three times the premium as someone 25 with a chronic illness? Cowen’s buddy Avik Roy would eliminate the age band limit entirely because, according to Roy, it doesn’t in practice limit the premiums charged to someone age 64 but only increases the premiums paid by someone age 25. Get it? Good, because my head hasn’t stopped spinning since trying to figure out Roy’s logic. As for the mandate, candidate Obama actually opposed the mandate (while candidate Clinton supported it), only after he took office did Obama come around and support the mandate. I actually aligned with candidate Obama on this point. My view is let the insurers figure out how to get young and healthy people to buy insurance, such as fixed premium policies (i.e., policies with premiums that remain the same until age 65 as long as coverage is maintained, similar to some life insurance policies). That view may be wrong, but at least it’s a view. Douthat and every other self-appointed expert just wants to throw a few proposals out there and see if they stick. I’d call it spaghetti policy.

61 mulp July 2, 2017 at 4:24 pm

Republicans and conservatives argue that no one has the universal preX as long as they can buy a gun and kill themselves before they get old.

Accepting the fact that every year you get a year older is a choice.

You can always kill your self, ideally by updating your organ donor card and showing up at a large hospital ER and blow your brains out without harming your brain stem, at age 21, 26, or 30. A less traumatic way is to overdose on heroin laced with Carfentanil. Blood flow and respiration are restored quickly enough to preserve most organ but not soon enough to prevent major brain damage.

If charging those older five times the young does not increase the supply of organs for transplants, then jack up premiums on the old to ten times the young.

62 Hazel Meade July 3, 2017 at 10:04 am

Should someone age 64 in good health pay three times the premium as someone 25 with a chronic illness?

Say, why don’t we let insurers decide how much to charge these two people? I know it’s a radical thought, but they might just decide to charge the 25 year old more than the 65 year old in good health.

63 Oreg July 5, 2017 at 6:59 am

Because the whole idea of insurance is to hedge the risk. Charging the insured more as soon as they need the insurance (i.e., they get sick) removes the hedge and with it any advantage over “self-insuring”.

64 Hazel Meade July 5, 2017 at 9:58 am

This is a non-sequitor. It was posited that it was unfair for the healthy 65 year old to pay more than a chronically ill 25 year old. Presumably a “chronically” ill 25 year old has been sick for some years, or that he’s just now signing up for insurance, having a chronic pre-existing condition. We’re not talking about someone who has been paying premiums for years and just recently got a chronic condition. Plus insurers can always offer policies with terms longer than 1 year or with guarentees that limit premium increases as long as you stay covered.

65 Oreg Meyer July 5, 2017 at 10:18 am

Indeed, rayward appears to suggest that the insurance risk models used to set premiums don’t reflect every individual’s actual situation. Well, of course not. That, again, is the whole point of insurance: to normalize everyone’s exposure to the mean.
Increasing premiums with age makes sense not only because of the higher risk but also because people tend to grow richer over time.

66 Hazel Meade July 5, 2017 at 2:18 pm

Increasing premiums with age makes sense not only because of the higher risk but also because people tend to grow richer over time.

Yes and no. Premiums should not be set higher just because someone has more money. We don’t charge richer people more for movie tickets or cars or houses, so how is it fair to charge them more for health insurance?
Nevermind that not all older people are richer, and not all younger people are healthier.
In a free market insurers adjust premiums according to risk, and nothing else. higher risk people pay more than low risk people. A 25 year old with a chronic condition MIGHT pay more than a healthy 65 year old. It’s unlikely, but it’s possible.

67 Daniel Weber July 5, 2017 at 2:52 pm

Plus insurers can always offer policies with terms longer than 1 year

But did they?

My life insurance won’t be jacked up if I get AIDS this year.

Making the health insurance industry function like the life insurance industry would be a step in the right direction.

68 Oreg July 5, 2017 at 3:58 pm

@Hazel: Now you’re arguing against a bunch of straw men. Neither did I imply that all rich should be charged more, nor did I suggest that every old person is richer than every young one. But I prefer to be charged less when I’m young and money is tight in return for being charged more as I grow older and probably wealthier. That happens to nicely match the risk profile over time.

69 Daniel Weber July 5, 2017 at 5:29 pm

But I prefer to be charged less when I’m young and money is tight in return for being charged more as I grow older and probably wealthier.

Unfortunately, PPACA has the young paying much more than their costs are, in a transfer to the baby boomers.

70 Meets July 2, 2017 at 3:34 pm

#7 seems completely reasonable and makes good sense

Reform Medicaid and improve the exchanges.

71 Colin July 2, 2017 at 3:59 pm

2. Death of NYC diners was also covered by the NYT last year: https://www.nytimes.com/2016/11/23/nyregion/diners-new-york-city.html

72 rayward July 2, 2017 at 4:17 pm

4. From the linked article: “Li Xiaojin, another industry analyst, warned of a possible glut in airport capacity given the country’s rapidly growing market for drones, the unmanned aircraft that don’t need airports to operate, according to the report.” While China looks to the past, America is preparing for the future, a future without airports, and without roads. While some may believe America is ignoring its infrastructure, don’t let deteriorating infrastructure mislead you: in the future, we won’t need infrastructure.

73 Mark Thorson July 2, 2017 at 6:30 pm

It’s my understanding there are no recreational aircraft in China (except ultralights). Has that changed? Without that, you’ve got a lot less aircraft in the sky because they’re all commercial or government. This is not peculiar to China — South Korea is the same way.

Lack of recreational aircraft is a major reason for the poor competence of pilots in many countries.

74 chuck martel July 2, 2017 at 10:54 pm

What are “recreational aircraft”? You probably mean “privately-owned light aircraft”, which are the majority of general aviation. The people that own them don’t regard them as recreational, they look at them as a more effective means of private transportation, somewhat akin to automobiles that aren’t tied to the highway system. Not everyone can afford their own plane but those that can use them to get from point A to point B efficiently, often for business purposes. Sales, contracting and others make extensive use of aircraft. The big question for Chinese airport construction isn’t remoteness from cities, which actually encourages general aviation, but the number of privately-owned aircraft. Of course lack of airports would inhibit the growth of general aviation.

75 Mark Thorson July 2, 2017 at 11:41 pm

I meant “privately-owned” if that only includes people and not businesses. I meant “commercial” in the sense of business-owned or licensed for a business purpose.

76 Donald Pretari July 2, 2017 at 7:06 pm

#5…It wasn’t that long ago that some commenters on this blog were downplaying ISIS and drones.

77 byomtov July 2, 2017 at 7:15 pm

Among his other stupidities, Douthat vastly overstates the importance of Obamacare in the 2010 MA Senate election.

By no means was it, “the cause of a shocking special-election defeat in Massachusetts,” despite lots of claims to that effect by its opponents.

78 Rich Berger July 2, 2017 at 7:34 pm

Flooding the zone with stupidity.

79 JMCSF July 2, 2017 at 8:46 pm

With brunch as big of a business on the weekends. I have always wondered why NYC diners (manhattan especially) have not stepped up there game.

I live in the Financial District and very few restaurants are open prior to 10 or 11 on weekends. There is only one diner left that I am aware of but it doesn’t look to appealing (another on Nassau street appears to have been shut down for health code violations).

I don’t excpect diners to start serving instagram-worthy avocado toast, but I think if they want to survive (in gentrified neighborhoods) they need to up their game.

80 JMCSF July 2, 2017 at 8:47 pm

*stepped up THEIR game.

81 Mark Thorson July 2, 2017 at 8:57 pm

Too late. You’ve already been outed as a non-native speaker of English.

82 JMCSF July 2, 2017 at 8:48 pm

Or as Tyler would say, average is over.

83 dux.ie July 2, 2017 at 11:58 pm

#1 https://motherboard.vice.com/en_us/article/evdd84/10-rich-families-are-paying-their-dollar30000-preschool-tuition-in-bitcoin

“””Earlier this week, Coindesk reported that the luxury preschool started
accepting cryptocurrencies as payment for tuition. In a follow-up
interview with Motherboard, Ciocca told us 10 families have paid or are
planning to pay in cryptocurrency, and said the school began accepting
payments in bitcoin, litecoin, and ether on June 1 as a response to the
“numerous requests from parents to pay with digital currencies.” “””

84 Tom Whitwell July 3, 2017 at 4:45 am

#5 reminded me of this post from 10 years ago:
“Part of me says “Bravo Amir! Excellent work on the airframe, and thanks for posting.” And part of me says “Yikes. We’re helping Iranians make UAVs draped in nationalistic colors. This isn’t going to help us in our efforts to destigmitize drones.””
http://www.longtail.com/the_long_tail/2007/08/can-open-source.html

85 Art Deco July 3, 2017 at 8:56 am

#7: More chewing gum and twine. Thanks for nothing, Ross.

86 Hazel Meade July 3, 2017 at 10:02 am

#7. “a waiting period to purchase health insurance”.

Please. Why don’t we just go back to the free market solution – if you drop your coverage, your pre-existing conditions are not covered or you will pay more for them.
Frankly, barring people from even purchasing ANY coverage if they drop coverage seems a heck of a lot more brutal than just saying “if you don’t buy coverage, and you get cancer during that time, we’re not going to pay for your cancer”.

87 RD July 3, 2017 at 11:56 am

There is no such thing as a free market.

88 Art Deco July 3, 2017 at 3:04 pm

Thanks for the ex cathedra pronouncement. It’s been an education.

89 A clockwork orange July 3, 2017 at 10:22 pm

Just because you wag your tail, frocked in your Guayabera whilst nibbling dragonfruit, at every toothsome fraulein wearing a diadem or carrying bibelots doesn’t mean anyone owes you a hosanna.

You’ve not read a single poem of Soumorokoff, Lomenosoff, Karamzin, or Pouchkin nor do you know anything about Sebastopol, and I bet your pension fund and life insurance company are starved for capital. You were never a Malodetz and so you are referred to by those who know you as the Queen of the Antilles.

For I am Othman Danfodio, a harlequin sicario.

90 RD July 3, 2017 at 12:02 pm

Anecdote:
Wife went in for 3d Mammogram, ordered by Doc.
Submitted claim.
Denied.
Reason: Billing code changed by UHC between procedure and claim submission.
Called UHC to complain.
UHC,” Suck eggs!”
Called provider to explain and ask for payment plan.
Provider,”That stinks! OK. No charge.”

91 Art Deco July 3, 2017 at 3:06 pm

Your point is what? That your insurer won’t bay for mammograms ad infinitum ergo ‘that stinks’?

92 RD July 3, 2017 at 3:42 pm

You are an asshole.

93 Daniel Weber July 5, 2017 at 2:54 pm

Because the provider screwed up and it was simpler to say “no charge” than to fix their mistake.

94 mkt42 July 4, 2017 at 11:26 am

2: meh, free markets. If you grew up liking say Farrell’s Ice Cream Parlors, you were out of luck when they went out of business.

Does the loss of NYC diners represent a market failure? The author has the beginning of an argument, but a weak one: the externality created by a certain type of diner attracting a range of types of customers, so that he can encounter Mizrahi over his eggs and coffee.

This argument can have merit when applied to schools and the ways in which Americans are segregating themselves (and vouchers exacerbate this problem). But I don’t see it as a major issue with eating places.

95 mkt42 July 4, 2017 at 11:31 am

3: interesting idea by someone who’s seen a lot of soccer/football images. But I was completely off-put by the non-sequitur image in the “ball bulging an onion bag” images in #8. Three images were on point, but amidst them he has a photo of a guy in a chair watching multiple TV screens. Yes the article overall is about generic soccer images, but WTH is that photo doing in the middle of a stream of ball-in-the-net images?

Comments on this entry are closed.

Previous post:

Next post: