From: Black Unicorn <unicorn@schloss.li>
Date: Wed, 18 Sep 1996 06:20:17 +0800
To: jbugden@smtplink.alis.ca
Subject: RE: Risk v. Charity (was: RE: Workers Paradise. /Politica...
In-Reply-To: <9608178429.AA842985398@smtplink.alis.ca>
Message-ID: <Pine.SUN.3.94.960917141612.24479A-100000@polaris>
MIME-Version: 1.0
Content-Type: text/plain


On Tue, 17 Sep 1996 jbugden@smtplink.alis.ca wrote:

> Subject: RE: Risk v. Charity (was: RE: Workers Paradise. /Political rant)
> 
> Black Unicorn <unicorn@schloss.li>
> >On Mon, 16 Sep 1996 jbugden@smtplink.alis.ca wrote:
> >> Specifically, that anyone can "save for a rainy day" and still not be
> >> able to provide for events that can always happen: Heart attack,
> >> stroke, car accident, pinched nerve that leaves you in excruciating
> >> pain and unable to work for several years.
> >
> >Understand what it is you are saying.
> >
> >You are saying that everyone on the planet has a right to health
> > insurance and disability insurance whether they can afford it or not.
> > This is folly.  The result is serious moral hazard problems.
> 
> Almost, but not quite. I'm saying that within our two countries at least
> (Canada, U.S.) everyone could have access to medically necessary procedures
> because the *society as a whole* can afford it.

Your statement above is a loaded gun.  The decisions about what is or is
not medically necessary must by design be made by government in a
socialized medicine regime.  If I need to get in to why, it is because
you don't understand socialized medicine as well as you think you do.  As
for society as a whole being able to afford it, that's hogwash unless you 
permit serious restrictions on the definition of "medically necessary."

This evades an important point as well.  Namely, who cares if society can
afford it?  Should it have to?  Why is Joe Cracksmoker's fifteenth CBC
blood test a bill that the taxpayer must pick up?  Since when is every
citizen on the planet entitled to free health insurance?

> I understand moral hazard and risk pool seperation. I also understand that the
> insurance bureacracy required to manage much of the U.S. health care system
> absorbs much of the money going into the system. Managing risk pool seperation
> proves to be expensive, or perhaps just very profitable.

Of course it's profitable.  Health care is not PBS.  There is a price to
be paid for getting someone else to promise to pay your bills if you get
sick.  To have it otherwise is to have a free lunch.  There is no such
thing.

The reality is that socialized medicine, in every example I can think of,
is merely low end health care.  Anyone who can afford it opts out of the
program and seeks the better quality and shorter lines within the private
health care system.  (Often in another country).
 
> > Social safety nets prevent rioting by the lower classes, revolution and
> > general civil disorder because they appease the masses.  Indeed this
> > is a form of health and life insurance for the middle and upper classes.
> 
> Absolutely. And it is a scheme that many of the lower classes pay into. Since it
> is to our mutual benefit (yours and mine), I choose not complain about it.

I'm not going to complain about it so long as you don't put me in a
position where I am asked to pay for every nerotic and friendless patient
who calls the ambulance on a lonely night for company.  (A friend of mine
once worked EMS Boston, by his estimate his ambulance alone ran up about
$7500 a month visiting ten or eleven such individuals.  They'd get a call
for a heart attack or somesuch and then some sweet old lady would invite
them up for coffee).

> > Spreading the risk, by itself, does NOT reduce cost.  
> > You must properly PRICE risk.
> 
> Agreed. But there is a balance between accurately pricing the risk and
> minimizing the cost of the bureacracy that polices this pricing. 

Oh, I see.  Let's give the program to the government then.  Good idea.
That will reduce the cost of the bureacracy.

> There are also many ways to modify behaviour, not all of them direct. We only
> need a correlation here, not causation. For example, high taxes on smoking and
> drinking or spot checks for drunk driving. All of these correlate with a
> reduction in high risk behaviour and a reduction in health costs.

And all of them buy into the notion that people are not to be made
personally responsible for their high risk behavior.  Instead, according
to these solutions, it is the role of government to identify it, and
discourage it.  I prefer market solutions.

> There is much potential for moral hazard when the PRICE for your insurance is
> affected by the accuracy of your disclosure. How will they ever know...
> 
> Fact: Canada spends less than the U.S. per capita on health care, while
> covering more people in percentage terms.

Fact: I would sever my own festering leg before I would check into a
Canadian hospital.

> And he brought the present unto Eglon king of Moab: and Eglon was a 
> very fat man. [Judges 3:17]
> 
> "Of all tyrannies a tyranny sincerely exercised for the good of its victims  
>  may be the most oppressive. It may be better to live under robber barons  
>  than under omnipotent moral busybodies. The robber baron's cruelty may  
>  sometimes sleep, his cupidity may at some point be satiated; but those who  
>  torment us for own good will torment us without end, for they do so with 
>  the approval of their own conscience."   -  C.S. Lewis, _God in the Dock_ 

It seems C.S. Lewis agrees with me on this point too.

--
I hate lightning - finger for public key - Vote Monarchist
unicorn@schloss.li