New at Reason
Steve Chapman cheers the creeping free market thinking of Hillary Clinton.
Comments to "New at Reason":
brian | October 11, 2007, 7:10am | #
Good. Let's hope it creeps a bit further.On a related note, I saw a little bit of her speech revealing her plan. She stressed "individual choice" and "competition" as vital aspects to her plan. Maybe Old Boy Bill is whispering in her ear--we can only hope.
I'd say HRC is creeping more toward pragmatism than idealism. Front-runners tend to get more conservative as the prize gets closer and closer.
Isn't it convenient that she leans Libertarian and borrows ideas from conservatives more as elections approach....Why didn't she present such ideas at the YearlyKos convention?
R C Dean | October 11, 2007, 8:47am | #
She stressed "individual choice" and "competition" as vital aspects to her plan.When she says those words, I don't think they mean the same thing as when we say those words.
Just sayin'.
horsewithnonick | October 11, 2007, 8:54am | #
When she says those words, I don't think they mean the same thing as when we say those words.I'm not certain they mean anything at all...
I'm with ed. When Hillary creeps towards free-market thinking, she has a ways to go before she reaches mainstream thought, much less libertarian thought. The difference this time is that she actually has to sell the idea herself and doesn't get to rely on her husband. Bill has just a little bit more charisma than his wife. Plus, he also doesn't induce the urge to stab out your eyes and ears every time he talks, unlike Hillary.
Like Nixon to China, only a Democrat can do any real privatization and de-regulation. If it is a good plan, enough Republicans will do the right thing to outweigh the objecters on the Democratic side. Look at it this way, if Reagan had proposed welfare reform, he would have been destroyed as wanting to throw starving masses into the street. Clinton not so much. Perhaps I am too much of an optimist, but I would like to give Hillary Clinton the benefit of the doubt on this.
libertreee | October 11, 2007, 9:20am | #
So, what the Republicans said at the debate on Tuesday was "Pay no attention to the Democrats and their Communist Health Care plans, come to us with our Fascist Health Care Plan.Hillary is making nice to fascism, but its still socialism.
Randolph Carter | October 11, 2007, 9:22am | #
I don't know John, the snowclone "Only x can go to x" doesn't really work in this situation - Nixon went to China to open trade with a huge nation - it was in his best interest and in the Republican party's best interest. It's not in Hillary's interest AT ALL to do any kind of privatization, rather it's in her interest to use all the presidential power that Bush has claimed and then some.Conservatives spent so many years demonizing "Headband Hillary," the hippie who kept her maiden name and "compared marriage to slavery" and wants the government to raise everyone's children that they are continually suprised to discover that she's a cautious centrist.
Why do I think that the first thing Congress is going to do with HillaCare is strip out the more market oriented provisions.
Rattlesnake Jake | October 11, 2007, 10:05am | #
"Conservatives spent so many years demonizing "Headband Hillary," the hippie who kept her maiden name and "compared marriage to slavery" and wants the government to raise everyone's children that they are continually suprised to discover that she's a cautious centrist."Is this the case or is her health plan a back door to socialized medicine which could be the case if private insurance goes out of business if government run insurance can out compete it with by operating at a loss.
dbust1 | October 11, 2007, 10:07am | #
I would like, once and for all, a break down of this "47 million without healthcare" figure. Who EXACTLY are each of these people? If those who call for universal healthcare want to use this figure in order to saddle me with yet another inefficient government agency (in charge of my healthcare no less) then this figure needs to be broken down. Anyone out there know who/where all these uninsured are?chancelikely | October 11, 2007, 10:20am | #
dbust1: A hell of a lot of the uninsured are chaps like me with youth and decent health who are taking a small risk because it's cheaper.dbust1 | October 11, 2007, 10:32am | #
chancelikely,Exactly. I made the mistake, yes mistake, of paying for healthcare in a previous job. I'm young, like you, and in great health. I was also cash strapped and, like you, should have taken a chance on not needing insurance. So, if some of the "47 million" are just those who CHOOSE not to buy insurance who are the rest? Anyone know? I'd hate to think that the universal healthcare nanny staters have succeeded in feeding America a big lie.
JasonL | October 11, 2007, 10:34am | #
I think Hillary will win, and I think she will ultimately govern as a self interested poll watcher, which means the quality of her term will have a lot to do with how reasonable public opinion is on various issues.Also:
Dave Weigel in a pants suit?
Rattlesnake Jake | October 11, 2007, 10:40am | #
"Anyone out there know who/where all these uninsured are?"A study in 2004 by the Actuarial Research Corporation found that 14 million of the uninsured were eligible to be enrolled in public insurance programs such as Medicaid or SCHIP. 9.3 million uninsured individuals earned $50,000 or more. More than 45% of the uninsured are people under 35 years old. Almost 33 percent of the uninsured are Hispanics, many of whom are illegal immigrants who would qualify for Medicaid but are araid to sign up for fear of being deported. It was estimated that only 8.2 million were chronically uninsured and low income. So, you can see that this 47 million figure is highly exaggerated to try to justify putting us all under a socialized medicine system.
dbust1 | October 11, 2007, 10:56am | #
Rattlesnake Jake,Thank you, thank you, thank you. Now if only the media and pols would read anything besides tele-prompters or spoon fed "research" then this big lie would die the ignominious death it deserves.
VM | October 11, 2007, 11:01am | #
dbust: an excellent question!for starters:
hier PDF!PDF!PDF!
some are young - like chance. some actually are wealthy. For some, it's too expensive - they pay more for coverage than they'll need.
Estimates of the uninsured are generally taken from surveys - samples of interviewed rather than from the census.
The NHIS (National Health Interview Survey) is the go-to source. The Current Population Survey, the Survey of Income and Program Participation, and the Medicare Expenditure Survey are also sources used in finding this number.
The NHIS defines individuals as "uninsured" if they lacked coverage in the month prior to the survey. The CPS defines individuals as uninsured if they have lacked coverage for the entire previous calendar year (*the CPS has been questioned: many suspect that the respondents provide incorrect info).
THe MEPS data come up with "insured" to mean "those without insurance coverage for the entire interview round (3-5 months)".
The SIPP counts individuals who are uninsured for each month of the four month reference period.
Since these are surveys with different methodologies, there are varying "answers" to the uninsured.
The NHIS had around 40.5 million; MEPS got 46.
In 2004, MEPS counted about 48 million.
The HHS has this info, hier
The "economic reason" for the uninsured is that consumers face the "wrong price" (defined as the actuarially fair insurance, where price = risk)
The consumer selects level of coverage based on expected utility of being sick, well, and the financial loss from illness or from expenditures on medical services.
To be fully insured, you'd set the level of coverage to equal your expected loss of income from illness or from medical expenditures.
Since there is uncertainty, that's why you need insurance.
Cutler and Zeckhauser's 2000 paper, the Anatomy of Health Insurance (abstract)
Market failure is famously attributed to moral hazard and adverse selection. Ehrlich and Becker (1972) have a paper on this, abstract)
That can help explain why there are uninsured.
One problem with health care is that there is an overuse, misuse, and underuse of resources. Preventative measures.
The RAND Health Insurance Experiment
(http://www.rand.org/health/projects/hie/) has more on this - there are some problems with the study (including participation incentives).
Newhouse (1997) summarizes the RAND experiment in "Free For All"
hier
This is a complex issue, and it cuts across many contentious political issues...
ed | October 11, 2007, 11:02am | #
Not to mention the moving target of the temporarily unemployed who are temporarily uninsured. The "47 million" figure also dishonestly presumes that every one of those individuals wants to be insured but cannot afford it, which is untrue but useful in a political context where "the wide stance" has trumped the old-fashioned concept of "truth".**Something that is actually true, not just expedient
jmklein | October 11, 2007, 11:14am | #
"Their being uninsured is regrettable because it prevents them from getting adequate care and forces the rest of us to shoulder the cost when they get sick."First off there is a law already in America that everyone must receive the health care ordered by a doctor. This is in contrast to the "rationing" system in public insurance where you receive your health care at the mercy of a commissioner.
Secondly in a public insurance scheme we will always have to shoulder the burden of people getting sick as opposed to the current arrangement where only a small fraction of bills must be paid out of the public expense.
Remember, health insurance does not mean health care and making something a public responsibility is a poor tactic to reduce a public burden.
VM | October 11, 2007, 11:25am | #
"health insurance does not mean health care"QFT
and health care does not mean health. It is one of many inputs in the "production" of health.
LarryA | October 11, 2007, 12:10pm | #
To be fully insured, you'd set the level of coverage to equal your expected loss of income from illness or from medical expenditures.Well, no. Insurance should cover unexpected losses. There’s no reason to pay the insurance company $120 so they’ll cover the cost of a $100 annual checkup and the paperwork to file the claim. Unfortunately many folks think they should, and too many politicians pander to them.
Personally, I think we need to get employers out of the loop. If we could get policies individually, or in voluntary groups, it would end the huge problem of loosing coverage every time you change jobs.
What if (for instance) I could get the same tax benefits by applying for insurance through the National Rifle Association, the United Methodist Church, or Wells Fargo Bank? The insurance companies get large groups to deal with, and they stand a much better chance of keeping customers long enough for preventive services to pay off in long-term health care.
prolefeed | October 11, 2007, 12:27pm | #
How long before she becomes a libertarian?Ummm -- never, yeah?
Uncertain losses. You know how much you're gonna lose from lost work, for example. It is muddied by not knowing price schedules for treatment, but it's uncertainty that you're insuring against, and you select your level of insurance coverage by what you'd expect.
VM | October 11, 2007, 12:36pm | #
whoops. (sorry for double)and what you're writing is exactly what I'm saying.
it is uncertain whether you're going to be sick. if you are and miss work, you know how much you would expect to lose.
you have insurance
risk aversion
willingness to pay to reduce risk
risk premium - willingness to pay to insure against the risk of loss. to be able to do this, you have to have an expectation of loss.
the greater the potential loss, the greater demand for insurance. the greater the uncertainty, the greater demand for insurance.
risk averse will have more insurance than those who are less averse.
the occurrence is unexpected. but the losses are not.
prolefeed | October 11, 2007, 12:36pm | #
But more government meddling isClarity should not be sacrificed to brevity, Steve Chapman.
dbust1 | October 11, 2007, 12:41pm | #
I got so caught up in the healthcare portion of the article that I ignored the political spectrum. Calling Hillary a "centrist" is a misrepresentation. "Center left" may be more accurate. Looking at just the left end of the spectrum she may be ‘center’ but she sits well to the left on the whole spectrum.And as far as front runners becoming more conservative as they get closer to the "prize," I really can't say; but I don't think that is the case with Hillary. With her I think she lets the winds of opinion steer her rudder more so than any personal political convictions. Furthermore I really do question her integrity and any statements she makes now are just that, statements. NOT commitments.
Also, John, please explain how "only a Democrat can do any real privatization and de-regulation."
Mathew Andresen | October 11, 2007, 1:21pm | #
I think the following facts are ingnored by both conservatives, liberals, and yes libertarians.1. We are already paying for everyone's healthcare. Just right now we often wait till it reaches the point of being emergency care, and so it costs more. So people who complain about not wanting to subsidize other people need to wake up because we already do. The only way that would change is if we stop providing emergency care to people, but that's just not going to happen.
2. If we accept point 1, then are mission is to try and provide healthcare in the most efficient and cost effective method provided. I think most of us would agree that will require people paying for their own healthcare costs as much as possible. For example, right now the connection between healthy lifestyle choices, and healthcare costs is broken. If you restore it and make people pay for their own choices (shocking) then people will start to make better choices, and total costs will come down. Ideally this would mean that people's premiums would be tied to their health and lifestyle choices.
3. Now accepting points 1 and 2, we ask what about poor people. Since they normally don't pay for their own healthcare anyway, how could you tie their premiums into their healthcare. Obivously with some type of refundable credit. Broken down this means you are paying some people to remain healthy. Not nessecarily a plesant thought, but IMO an inescapable one.
In general it costs $2400 a year ($200 a month) or so to insure a healthy person, but the costs quickly clime to $6000 a year or more to treat someone with any number of chornic ailments that are prinipally caused by poor lifestyle choices. We need to restore the direct link between healthy living, and medical costs. Once we do that we can begin to lower overall medical costs that are in danger of bankrupting our country.
For those that are interested you can see more about heathcare http://kronesblog.blogspot.com on August 13. It's directly related to CA current proposals.
Rattlesnake Jake | October 11, 2007, 3:11pm | #
Good points, Mathew.dbust1, you're exactly right about Hillary on your 12:41 post.
What John meant by only Democrats doing any real privatization or deregulation is that anytime a Republican tries to get privatization or deregulation passed, they get howled at for being heartless. Democrats don't get that same kind of criticism. Would a Republican president have been able to have passed welfare reform?
Frank Booth | October 11, 2007, 3:43pm | #
Great points, Mathew Andresen.For all those that are looking, I'm the person that is often spoken about when people speak of the uninsured. I'm 32, unenmployed, and while I'm generally healthy, I have occasional healthcare needs.
I would rather have an open market for health care, and no state involvement...BUT, we don't have that. Right now we have outrageous prices for health care because we haven't let the free market work. I can't get a prescription drug without going to a doctor, paying for advice I'm quite capable of finding on my own, and then paying ridiculous prices for prescription drugs all because there's a monopoly on health care and pharmacueticals in this country. There are no price lists when you go to a doctor. It's extremely difficult to shop for a cheaper doctor. Usually, you are shunted into whoever your insurance provider wants, or you go to the emergency room if you're uninsured.
The vast majority of my health care needs could be taken care of by myself, through ordering prescription drugs from the internet, where I can compare prices easily. If I need advice, I should be able to choose from a wide variety of doctors with different pricing schedules to remain competitive. If I need a procedure done, I should be able to pick from a list of doctors willing to do this procedure, along with their prices.
Since I am unemployed, and have a hard time getting employment due to a drug related felony (completely victimless crime), I'm forced to go to the emergency room when I have an acute illness, such as last year when I had kidney stones. They charged me several thousand dollars for this.
If I cannot get a job in order to get insurance due to government interference, and cannot get health care at reasonable prices due to government interference, then I don't feel bad taking government assistance with health insurance so that I can manage to keep myself alive long enough to find some sort of work that pays well enough to pay rent, and if I'm very lucky maybe has some sort of health plan. In short, the government has made it impossible to take care of my own health care. Now they should be required to step in, in at least a minimal capacity, so I can afford things like penicillen, and asthma medication.
Ben Rushing | October 11, 2007, 4:04pm | #
Next thing you know the Liberal-Statist-Centrist Democrats will want to take over home and Auto insurance too.Au standard | October 11, 2007, 5:26pm | #
yet another light, airy, always moderately positive toward any democrat in this country piece from mr. chapman....just shocking....hmmm... Bush for once gets something right and vetos the schip thing...i mean i can't even remember when any welfare state measure has been actually vetoed by a president...think that might be a story, but chapman writes this this about hillary...whewNeu Mejican | October 11, 2007, 7:24pm | #
I got so caught up in the healthcare portion of the article that I ignored the political spectrum. Calling Hillary a "centrist" is a misrepresentation. "Center left" may be more accurate. Looking at just the left end of the spectrum she may be ‘center’ but she sits well to the left on the whole spectrum.Well...depends on how you measure the spectrum.
Since America, in general, skews right of center when compared to the rest of the world, being "center left" in America might even put you "center right" if the distribution of the world across the spectrum is considered.
I would guess someone has tried to quantify this more rigorously.
Ebenezer Scrooge | October 12, 2007, 5:41am | #
First off there is a law already in America that everyone must receive the health care ordered by a doctor. This is in contrast to the "rationing" system in public insurance where you receive your health care at the mercy of a commissioner.Except, that's not really true either. Many (most?) doctors get a lot of their pay check from insurance companies that slap them, if they recommend people for further treatment "too much" or "too often".
My wife had to overtly threaten a lawsuit, when she thought she had a serious problem, because our primary care physician was refusing to acknowledge it, or to recommend the the testing that needed to be done.
Turns out, when she was tested the problem was real.
If you think we aren't rationed already, you haven't looked at the system close enough. It's just a question of whether the rationer is a buearacrat of Big Government, or of Big Business.
Unaccountable, non-free market Big Business, I mean. Because the entire medical industry does not have to play by the same rules of business practice that everybody else does.
Put the freaking medical system into the free market, and you'll be amazed at how affordable health care becomes for the teaming masses.
Ebenezer Scrooge | October 12, 2007, 5:54am | #
I want everyone to know that HRC figures big in my own health care plans. I plan to vote against her.I also plan to hope like hell that the alternative is actually better.
dbust1 | October 12, 2007, 8:49am | #
Trea,I hereby declare that "triangulatable" is now a word.
Triangulatable- possessing characteristics endowing one with the capacity for being measured utilizing trigonometric relationships.
Let's not forget that Roosevelt before his first term said a lot of things that didn't exactly pan out over his reign.
Jonathan Bostwick | October 12, 2007, 10:42pm | #
How about we get rid the regulations on medicine instead of using the tax code to give government more control over medicine and people?The Libertarian Guy | October 16, 2007, 2:32am | #
This is the same Hillary who very recently said - supposedly just about Social Security - this nugget:"When I'm president, privatization is off the table because it's not the answer to anything."
Take that statement, and you have her solution to "anything"... she does NOT like the private sector. In her world, if government does not provide it... it's not worth providing.
Yikes. Why would ANYONE write anything favorable about this foul creature?