Saturday, April 4, 2009

Government Control

With the liberals so strongly in ascendance right now, the push to implement many long cherished plans to improve the welfare of the public. It's what liberals do, and that is as it should be, at least in my eyes.

Attendant to this is the resistance of conservatives, who are concerned with what the consequences of these programs will be, both in what they intend to accomplish, and in the unintended side effects. It's what conservatives do, and that is as it should be, at least in my eyes.

The usual game of straw arguments is being played out right before all of our eyes, with liberals pointing out the great successes of some programs while ignoring the failures, and conservatives pointing out the failures, while ignoring the successes. Preach to the choir, pat each other on the back and go flame the other side. We all think the other side is stupid, greedy, lazy.

Enough.

I will attempt here to take an honest view of the great concern of the conservatives when we talk about government programs, and that of course is government control.

I wanted to keep this abstract, not touching on any actual current issue to avoid entrenched positions, but I find that it will not coalesce without a real world example. So (deep breath) I will go with a single-point example from health care.

One common criticism of our current system of health care is the relatively low life expectancy, especially compared to how much we spend. Nobody really has a good explanation for this, I suspect because the obvious is too uncomfortable to talk about. Obesity. Obesity in the US has reached levels unprecedented in history. And it has health implications, serious ones. If we go to a government controlled health care system, the pressure will be immense to show gains in health and life expectancy. That cannot be done without reducing obesity.

But how? Forcing excercise? Banning high-fat foods? Taxing the overweight? Or doing a sneaky tax - this is a 'credit' for being a healthy weight, which has the exact same effect as taxing being overweight, while calling it a tax cut (the last is not an abstract example, the UK is considering it last I checked).

Are we willing to accept this sort of control over our lives? Let someone tell us that we have to excercise. What we can and cannot eat? Obesity is over represented among the poor. Are we going to tax them for it?

And can it work? Solutions applied to literally millions of people are either going to be one-size-fits-all or else riddled with rules and loopholes. Will that be outweighed by the benefits?

10 comments:

James Wolfer April 4, 2009 at 11:38 AM  

We already do accept it.

Private insurance does it all the time.

Take car insurance, for example.
Discount for being female. Discount for being over the age of 25. Discount for being under the age of 65.

Health insurance:
Discount for being a healthy weight. Discount for not smoking. Discount for blah blah blah.

As you said, they aren't really discounts. They are fines for being unhealthy and wanting to be taken care of.

So maybe the answer is yes: If you want to be taken care of by the government, you can't not take care of yourself.

Maybe we should have an opt-out program? If they dont' like it, they can opt out of the program and get private insurance, or no insurance. But if they opt out, then hospitals won't treat you (unless you're a child, of course, but child obesity isn't near as bad as adult obesity).

OpenMindedRepublican April 4, 2009 at 11:49 AM  

The one thing you can be certain of is that they will never allow an opt-out system.

Canada, for example, even banned supplemental insurance used by those who did not want to wait months to see a doctor, this just recently got struck down by their supreme(?) court.

A two path system that allows opt-out or participation will collect all of those who do not pay for themselves into the state group, and a sizeable portion of those who do pay for themselves in the private group.

The state system would crash almost immediately.

James Wolfer April 4, 2009 at 12:10 PM  

Or maybe they could do what they do with private vs. public school.

Public school (mostly) works just fine.

People still want to put their children into private schools.

They are paying for both.

I don't have children.

I'm paying for public school. It was available when I needed it. It will be there if my children need it. I'm okay with that part.

Maybe we could look at those "taxes" for obese people this way, by continuing the public school analogy.

We all pay our taxes that go to public schools. But some kids go through their paper and pencils quicker than others, because they are consuming them (coloring, doodling, etc) and as such, they have to buy new pencils and papers again.

Much like an obese person who has to go to doctor time and time again for something that could have been avoidable if they got off their couch and dropped the potato chips.

I know this is an oversimplification, but I think its a start.

TAO April 4, 2009 at 4:26 PM  

I would like to start the reform of our healthcare system by looking at our agriculture budget.

I also would like to see stats on things like cancer, diabetes, strokes, and heart attacks in the United States versus other developed nations.

To remain competitive in the world we have to find a short term fix to our healthcare costs but long term I think our issues lie in other areas.

TRUTH 101 April 4, 2009 at 8:35 PM  

Alcohol and cigarettes are taxed through the roof. I would suspect lard and sugar would be the next items that are subject to big taxes. I don't have a problem with those that cost the system more through their behavior paying more.

(O)CT(O)PUS April 5, 2009 at 4:06 PM  

Some quick thoughts:

The reason why opt-outs would be disallowed: One could not deliver the lowest cost insurance unless actuarial tables were based on the entire population, i.e. spread the risk factor evenly and equally.

Supplemental insurance: I lived in the UK in the 1980s and France in the 1990s where supplemental insurance was available to augment public plans. In the UK, this plan was called BUPA, and it was actually quite cheap.

I enjoyed reading your opening paragraphs and your masterful use of chiasmus, but found this a bit more problematic:

... low life expectancy, especially compared to how much we spend. Nobody really has a good explanation for this, I suspect because the obvious is too uncomfortable to talk about. Obesity.

Maybe it was your transition to "the obvious" that troubled me. Perhaps the "obvious" is poverty, not obesity. Perhaps data mining would reveal other factors such as poor diet, the lack of preventive care and regular checkups (pls. note: highest healthcare expense are among the undiagnosed), child mortality, and other factors less "obvious" but all attributable to poverty.

How about another methodology ... say ... an examination of mortality data by quintile and age group. Sometimes data mining reveals all sorts of hidden surprises, and then we apply the usual tests of statistical significance to confirm our findings.

I'm sure there is stuff on the Internet. Maybe a little more digging?

OpenMindedRepublican April 5, 2009 at 5:14 PM  

Tao - "I would like to start the reform of our healthcare system by looking at our agriculture budget."

OK, you cannot drop a notion that intriguing and not expand on it. That's just mean.

Octo - "masterful use of chiasmus"

I don't even know what that is, but thanks. I looked it up on the ol' wiki and guess it is an effect of my tryng to be as balance as possible where I step outside my own beliefs.

I present obesity as an 'obvious' cause because the unprecedent level in America must have a statistical health consequence, and because it fit the larger discussion.

Besides, obvious is not a synonym for correct, right? :)

(O)CT(O)PUS April 5, 2009 at 6:04 PM  

Correct. Please accept my apologies if this comment came across as pedantic and tedious. It is a fault of mine.

OpenMindedRepublican April 5, 2009 at 6:16 PM  

Octo - Your comments are always welcome here.

I probably won't agree with them...

(O)CT(O)PUS April 5, 2009 at 7:44 PM  

BTW, although I know you didn't agree with The Gray Headed Brother, you were nevertheless respectful and kind in your comments, and I want to express my thanks and respect for you. You are always welcome at the Zone too.

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