Tuesday, April 19, 2005

This Poll result noted by Kevin Drum is fascinating

via Brad DeLong

"here are the percentages of Americans who say they are "fairly or very satisfied" with their own health system:

Poor: 45%

Elderly: 61%

Everyone else: 34%"

Drum interprets this as showing that private health insurance implies so much worry and hassle that even the poor are less displeased than Americans who don't get public health insurance.

I guess that is part of the story. Mainly, I think, it shows that poor Americans just don't complain, because they don't feel entitled.

Now a question arises, oh I'm linked to Kevin Drum so I should say
This begs the question of why Clinton's health care reform drive failed, since not only does single payer work better, but Americans recognise this when they experience it.

I don't want to go back there (for long). I blame Ira Magaziner and the Clintons for listening to him (of course Bill was the Clinton who really called the shots on health care reform). A huge ad campaign can convince people to ignore their personal experience when forecasting the future. Most of all, the Clinton Clinton and Magaziner plan tried to make coverage universal and impose cost controls at the same time. The evidence suggests that single payer health care alone would reduce costs both because of lower administrative costs and because the single payer could internalise the cost reduction due to preventive medicine (google this site for Glastris and Cutler yourself).

The point is that the American people weren't offered medicare or medicaid. They were offered some system that was supposed to cost less. The people who sank the plan were people who didn't want anyone to touch their medicare. Then the Republicans tried to cut costs and Clinton was re-elected.

I'd say the way to go is for the government to pay for universal catastrophic with a tax on credit cards (since that would reduce bankruptcies) and to pay for universal screening for high blod pressure, diabetes, high cholesterol and obesity and to pay for universal treatment with payment higher (non zero) only if the problem is controlled. This would more than pay for itself in reduced/delayed medicare spending. (google this site for Glastris and Cutler or you are a lazy as I am).

Then, if that is accepted sneak socialised medicine in by gradual reform. Then sneak it socialism, gay marriage, gun control and mandatory public readings of "The Origen of Species" in evangelical churches.

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