Tuesday, May 10, 2011

Dear John Letter #4. health care part 2.

I am not blaming Obama.  he is just taking a broken system and making it worse.

The bad policy that underpins the current health care crisis is a result of the accumulated BIPARTISAN public policy mistakes beginning in WWII when the Federal government put price controls on labor (as war time labor shortage and war spending put upward pressure on prices) and companies started to give “free” healthcare benefits to attract workers.  The federal government -- including many members of both major parties -- loved the idea of companies providing health insurance, so they incentivized this practice further by offering tax breaks to corporate provided health insurance. 

Why should companies offer health insurance???  It is a totally crazy system which worked when labor patterns were  much more stable in the 1950s and 1960s and 1970s. 

THE LAW OF UNINTENDED CONSEQUENCES STRIKES AGAIN
Price controls in WWII and the resulting (unintended) corporate response to offering free health insurance is the  policy screw up that is at bottom of current health care crisis because it has incentivized systematic over consumption of health care especially by the wealthy over 50 years.

over-consuption driven by subsidized corporate health insurance has meant a price inflation crisis in health care as demand outstrips supply. 

it really is that simple.  this isn't a market failure; it is government failure.

(corporations offer too much health insurance because  it is subsidized by the state: the result is a low deductible health insurance system that encourages over consumption of health services, which drives prices inexorably higher.  health insurance subsidies for top earners doesn't make sense, but it is politically difficult to eliminate them; remember obama tried to get rid of cadillac insurance but the unions blocked this!!)

WWII price controls are a great example of well intended public policy setting in train a series of negative unintended consequences that ends in total and utter disaster for society as a whole.  The current health care crisis can be traced to wage / price controls during WWII.

it is disingenuous to blame the private market for the healthcare crisis we face in this country.

What about Greed?
Is greed to blame for health care crisis?  In particular is the problem greedy insurance execs who don't care about patient health and only care about 'profits'?

humans are greedy.  that is a fact. 

businessmen are greedy and so are bureaucrats.   those are facts.   the system has to function well despite the underlying greed of human beings.  the only system that channels greed into productive ends is the market system because only the market faces competitive pressures.  if the government undermines competitive pressure or distorts the pressures -- as is the case with health care system -- then the market will never work. 

what makes you think bureaucrats won’t be just as greedy as insurance execs?  How do you hope to have a workable system that is turned over to greedy bureaucrats in BOTH PARTIES -- who have gamed the political system to avoid public accountability via redistricting???

I think only something like 5% of congressional seats are competitive in any election cycle.  THAT IS THE PROBLEM WE HAVE.

Greedy businessmen and evil free markets are easy whipping boys.  

John, what your world view entails is really a very simple trade off.  you want to trade a little bit of individual liberty for collective security provided by government.  as ben franklin says, anyone who makes that trade deserves neither liberty or security because to believe it is possible to have such a cake and eat it too outcome is utopian, wishful thinking.

Life isn’t fair and the government can't provide free lunches for society despite our most passionate and well intended hopes and utopian dreams. 




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