ACCUMULATING PERIPHERALS


There goes Sarkozy's post-retirement gig at AEI by mattsteinglass
March 30, 2010, 3:30 am
Filed under: Conservatism, Europe, Health care reform, Uncategorized

The President of France gave a speech yesterday at Columbia University. (Hat tip Kevin Drum.)

“Welcome to the club of states who don’t turn their back on the sick and the poor,” Sarkozy said, referring to the U.S. health care overhaul signed by President Barack Obama last week. From the European perspective, he said, “when we look at the American debate on reforming health care, it’s difficult to believe.”

“The very fact that there should have been such a violent debate simply on the fact that the poorest of Americans should not be left out in the streets without a cent to look after them … is something astonishing to us.”

Then to hearty applause, he added: “If you come to France and something happens to you, you won’t be asked for your credit card before you’re rushed to the hospital.”

But I bet he still loves hot dogs!



Wait, not Waterloo…what was that battle called again? by mattsteinglass
March 22, 2010, 3:50 pm
Filed under: Health care reform, Russia, Uncategorized

Lots of amusement going around over the Waterloo metaphor and whose it turned out to be (Yglesias, Frum, Benen). In the latest twist, the Sunny Idiot is proclaiming that actually health-care reform isn’t Obama’s Waterloo, it’s his Borodino; he won, but with significant casualties, and presumably he will find his victory over health-care to be empty and pointless, like Napoleon’s occupation of the burnt-out Moscow, and soon see his shrunken armies retreating across the landscape, harried by Russian partisans and diphtheria. (Who’s fond of czars now? Eh?)

I’ve had enough of this. It seems to me that in the context of a year-long campaign punctuated by striking victories where the invading forces were in sight of their ultimate goal and confident of gaining a crushing symbolic victory, only to fall just short, be unexpectedly held off, and finally driven back in a disastrous rout, a different battle metaphor may be more apt. I think Godwin’s Law considerations prevent me from getting any deeper into this issue though.

[youtubevid id=”zIcYsUpgbHM”]



Dingell: This machine kills Republicans by mattsteinglass
March 22, 2010, 6:24 am
Filed under: Health care reform, Uncategorized

John Dingell: If I had a hammer...

John Dingell apparently used the same gavel to ring in health-care reform that he used during the vote to create Medicare in 1965. Check it out.



Health care reform and game theory by mattsteinglass
March 9, 2010, 2:16 am
Filed under: Health care reform

I’m generally a fan of both political science and game theory, and of using the insights of same to analyze current events. But some game-theory insights are more counterintuitive, data-based or insightful than others. Excellent poli-sci blogger John Sides references Sandeep Baliga, who thinks House Democrats are currently playing chicken on the health-care reform vote, and comments:

One implication: if the representative wants to extract concessions from the Democratic leadership, it’s thus a good idea to signal uncertainty or even opposition to the bill — as many conservative Democrats have done. This raises the possibility, as one friend noted to me, that the prevalence of these signals in news stories may inflate the perceived chance that health care reform will fail in the House.

To this, I must confess, my initial response is: duh.



If it doesn't vote like a Democrat, it's not a Democrat by mattsteinglass
March 1, 2010, 8:45 am
Filed under: Health care reform

Someone at Ezra Klein’s site wrote something smart in a thread and he turned it into a post:

I was looking today at the list of Democrats who voted “no” on health-care the first time around. What struck me was how many of them were heavily supported by the DCCC in 2008. Shouldn’t that kind of financial backing, a considerable part of which comes from center-left national Democratic party supporters, not go to members who simply do not support the Democrats on any of the big stuff? I mean, if you added up all the money from the DCCC given to some of the folks on that list, it’s definitely in the couple of millions. I don’t think these guys should be getting national Democratic Party funding if they are going to act like free agents all the time.

At some point, if you take the support of the base, you have to be accountable to the base.

Absolutely right. The Democratic Party should provide no financial support whatsoever to anyone who calls themselves a Democrat but votes against this health-care reform bill. I don’t care what the reason is. I don’t care whether you’re Bart Stupak voting against it because you’re a fanatical pro-lifer, or a far-left progressive voting against it because you got left behind on a desert island and nobody told you the war for single-payer was over.

You know how Bart Stupak appears outraged at the idea that some dollars that once passed through the bank account of a Catholic person might eventually go towards paying for an abortion? I’m outraged at the idea that some of the dollars I donate to the Democratic Party might go towards paying to re-elect Bart Stupak. And if health care doesn’t pass, in part because of people like him, then I’ll donate no money this year to the Democratic Party. I’ll donate to my representatives or to others who share my views. Not to the party.



A brief post on the 'lack of insurance kills people' theme by mattsteinglass

A few days ago apparently Megan McArdle posted (which seems to be supplanting the verb “wrote” in modern usage) an argument along the lines of “we don’t really know how big an effect universal health insurance has on saving people’s lives.” This occasioned furious blogospheric responses from Matthew Yglesias, Austin Frakt and others. That in turn prompted Megan to explain that she wasn’t saying that lack of insurance doesn’t kill people, but that she doesn’t think we really know how big the effect is, and that the size of the effect makes a difference to arguments that ground the need for universal insurance in that effect. She sums up:

The mortality question is really important, but it doesn’t touch non-mortality outcomes, which are even harder to measure comprehensively.  It doesn’t touch on the financial questions raised by medical bankruptcies–I think they’re overstated by the Himmelstein/Woolhandler crowd, but that doesn’t mean I think they don’t exist.  It doesn’t address the social justice questions.  It just says, this is probably not the best grounds upon which to make the case for national health care, because we don’t have a good handle on the number.

As I understand it, the estimate is that lack of health insurance leads to up to 45,000 premature deaths per year.* [Addendum: Megan points out that the studies she cites find no increase in mortality at all. True; see below for more.] I have no reason to believe this figure is wrong and no time to investigate it, but putting that aside for the moment, the reason why people who argue for universal health insurance have often come to use the increased-deaths argument is that opponents of universal health insurance so often refuse to accept any other arguments. All of the things Megan notes above — the medical bankruptcies issue, the social justice issues, as well as others like the economic inefficiencies issues due to reduced labor mobility, the quality-of-life issues, the population health issues, the question of whether cost reduction is possible without universal coverage, etc. — these are all routinely dismissed by many conservative commentators. When I post on the impossibility of continuing as we are with our ridiculously broken health insurance system, I routinely get responses like: “Will people be dying in the streets? I think not.” For such people, one must demonstrate that people will in fact be dying in the streets, and are in fact dying in the streets, before any reforms will be countenanced.

It is, to me, obvious that the US’s health insurance system is a travesty. Health care in the US costs 150% or more what it costs abroad, and is no better; insurance costs three times as much in premiums (abroad, the rest of the cost is covered by taxes, which spreads the burden equably so that the poor get care when they need it); there is a serious risk in the US that you will lose your insurance because you get sick, which ought to be demonstration enough that the object you are buying does not work to do that thing it is supposed to do. But conservatives have spent the past 18 months working out ever-more-sophisticated arguments to convince themselves that the sun don’t rise in the morning, and by now they’ve just about got the job done. In the face of this, people who support universal health insurance have found themselves resorting to the quickest shorthand justification of its necessity: lack of universal health insurance kills poor people. It’s a solid argument because 1. you would expect it to be true, all else being equal, and 2. studies find that it is in fact true. But if conservatives want liberals to stop talking about it for whatever reason, they should do what Megan begins to do in that paragraph: they should start taking a serious look at all the other reasons to have universal health care (medical bankruptcy, social justice, labor mobility, increased ability to cut medical spending when benefits are distributed more equally, etc.) and evincing some willingness to achieve those goals and some serious approach for doing so. As I recall, Megan’s plan for doing this was universal government-paid catastrophic health insurance, which seems like an OK idea to me; I’d like to hear more about it.

I was wrong to write that I have “no reason to believe” the 45,000 figure is wrong: I have the reason that Megan cited studies saying it’s wrong. But the next part, about not having time to investigate it, is true. I have just enough time to point you to the posts by Ezra Klein and Austin Frakt supporting findings that lack of insurance leads to many premature deaths every year and has powerful negative effects on the health of the uninsured.



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