Healthcare is passed.

I remain puzzled by anyone who thinks this bill being passed is a bad thing.  Consider this story of what happens in the US – the downward spiral without insurance.  Or this one (at the bottom of a Brad DeLong post):

Suburban Guerrilla: Late this afternoon I was gobsmacked by a Facebook announcement that a high school friend had died. I tracked down the story, and it is an absolute textbook example of everything that’s wrong with our health care system – so knowing that we share a passion for this topic, I’ll share it with you.

She was 49 years old and in good health, other than a propensity to develop bronchitis. A couple of weeks ago, after a trip to Disneyland, she came down with a terrible flu. After running a high fever for four days she knew she should see a doctor, but she didn’t – no insurance. Her husband, who owns his own business, had cancer a year and a half ago and is not insurable on his own. She originally had insurance through her job, but had been placed on disability after developing carpal tunnel syndrome (she was a transcriber). Eventually she was no longer eligible for insurance through her employer, other than COBRA, which she could in no way afford – her husband’s business had been hard hit in the recession.

So. She waits six days before finally dragging herself to an urgent care clinic, but the wait is so long and she feels like shit on a stick so she goes back home. Eventually ends up in ICU with pneumonia, and, as it ends up, tested positive for H1N1. By then the infection had gone too far, her organs started failing, and after a week in the hospital she died this morning, leaving a teenage daughter and a husband who don’t know what hit them. As though grieving isn’t enough of a burden, imagine the hospital bills they’re going to face.

In what system of values does maintaining such a cruel, arbitrary system a good idea? Only one that placed an extraordinarily low value of the outcomes of the unlucky


14 thoughts on “Good things happen

  1. Giles: If it’s the wrong package of reforms, it’s a bad bill. I’m slightly surprised that you’re taking the view that any action is better than inaction. You may disagree with opponents of this package of reforms, but surely it’s not a puzzling position to take, to say that they’re worse than doing nothing?

    Still, you’re in good company. The bill is a thousand pages long, and Nancy Pelosi is on the record as saying ‘We have to pass the bill so that you can find out what is in it.’ (src) Not the most inspiring of reasons to pass a bill: who cares what it’ll do, it’s better than nothing!

    It’s not like the legal position of healthcare is lacking for potential reforms: opening up interstate commerce in insurance, and removing incentives for workplace-based insurance are two examples. Reform is necessary. But is this reform what is necessary?

    1. But wasn’t the alternative to these reforms no reform ever, for another twenty presidents? Would you prefer that?

      Paul, that is an extraordinary video – thanks

      everyone – my office net is down. Lack of comments is not a sign of either cowardice or discourtesy, for once

      1. But wasn’t the alternative to these reforms no reform ever, for another twenty presidents?

        Do you seriously think that that was the choice? Given that the employer-based insurance model is a post-War phenomenon, I find it hard to think that no reform has taken place for a hundred years. We don’t know what’s in the future, so the choice can’t have been between some hypothetical future and a very real present: the choice before the House was between ‘these proposals now’ and ‘not these proposals now’.

      2. But realistically, how long? Not this presidency. In the meantime, his political capital shot, and many person-years uninsured. Are you sure you think it’s that bad?

  2. IIRC this bill is essentially identical to the Senate bill, which was generally more sensible than the original House version. I think the reform is a disappointment – especially because there is not enough real action to reduce costs, such as by increasing competition, and because tort law has been left alone. But extending coverage should reduce the burden of providing emergency care to uninsured people who could have been treated more cheaply and with less suffering had they gone to the doctor immediately, as in the example Giles gives. The existing system is unreasonable and poorly thought out (though alas the core problem of employers paying for most insurance is still there).

    Moreover, almost all of the Obama administration’s American critics on this issue failed to make positive proposals for what they would do instead, beyond simply increasing competition in health insurance, which would be useful but is hardly a silver bullet. This bill was clearly the least bad option, and better than doing essentially damn all as the Republicans seemed to be advocating.

    The next challenge is to get the Democrats to revisit the reform and improve on it, ideally with bipartisan input. But first the Republicans need to start behaving like a constructive opposition.

  3. America’s real healthcare problem is the ambulance chasing lawyers who multiply the costs of care. This bureaucracy isn’t in any way going to reduce those costs it will merely add a new bureaucracy with much added pork barreling.

  4. The height of irony about the whole situation is that whilst the RepCons were screaing “socialism” probably the only person on that godforsaken hill who had any real commitment to doing the *right* thing was the one man who dares to call himself a “socialist”.

    I have been against this from the start, but as it has drifted on and it has been clear that those who could have made a difference who were against it had no interest in challenging the real reasons why people cannot afford proper health care in the Land of the Free-ish.

    So, I believe this is the best outcome. Because it is the most expensive outcome. And there is a reasonable chance that it will now, or very soon, with a couple of years of operating anyway be brought home to people just who is gaining out of this privileged protection racket and perhaps, either in 2012 or 2016 someone will stand for 1600 Pennsylvania Avenue on a ticket to stand up to the corporate troughers and their lawyers, and the protected medical establishment and their economic rent once and for all.

  5. Jock, the most expensive outcome would’ve been to do nothing. One of the primary aims of this bill was to get health care inflations down to more European levels.

    Phillip, your proposal wouldn’t work:

    This shouldn’t all detract from the bill’s flaws. As Krugman has been pointing out, it is the bare minimum necessary to have universal health care. There is no “public option” (an interesting idea, which I wonder whether it could be thought about in other areas of the economy). Single payer wasn’t even on the table.

    Anyway, I agree with the sentiment of the twitterer who said:

    “Hello America! Germany says, Welcome to 1883! The UK says, Welcome to 1911! France says, Welcome to 1930!”

    1. It’s nothing like the “bare minimum” required. It makes virtually no tangible attempt to break the state created protection rackets that keep healthcare, not just in the US but as a result everywhere else in the world out of the reach of the ordinary person’s pocket without inflicting further robbery on everyone else to help pay for it.

      Of course Krugman is part of this bourgeois conspiracy – now I see he wants to go to war with China to protect similar bourgeois US interests, whilst real people in the US have to pay for these rackets.

      I’d have some sympathy with a system that subsidised the real poor if it first removed all the economic rent, of practitioners, suppliers and so on so that what it was subsidising was at natural non-state inflated price levels. But such is the extent of that existing state protection for the health-care cartels that in reality I suspect it would not even need to subsidise it for the poorest even if it made a really determined attempt to butt out.

    2. I think the twitterer is being a bit harsh – I don’t know about France or Germany, but the health element of National Insurance in the UK was mainly about providing sick pay. There was a sanatorium benefit (for TB) and a sort of prototype of the GP system with “panel doctors” being created, but beyond that there was no promise of actual medical treatment. For that you would have had to pay from your own pocket, through one of the many mutual schemes that had sprung up to provide cheap healthcare to workers in the nineteenth century, or at last resort go to a Poor Law infirmary. As I understand it healthcare “free at the point of use” was only brought in with the NHS in 1946.

      I do wonder why the American lawmakers didn’t adopt a system based on the Dutch or Singaporean examples, if they didn’t like the idea of a “public option”.

      1. I think all they were getting at was that the US had by this one bill only got as far towards a welfare state as we did in 1911 etc…

        …a step too far nonetheless…:)

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