Monday, June 28, 2004

The number of uninsured

RE: (rising healthcare costs)

You contend that while nonpartisan sources (such as the Congressional Budget Office) claim that there were between 21 and 31 million citizens who were uninsured for the entirety of 2003 (not including the temporarily uninsured!), there are actually far fewer people who are legitimately uninsured, perhaps 15 million [citing the partisan National Review as a source].

I would say, first, that it is relatively unimportant exactly how many people are uninsured, because the fact is that there are millions of working people supporting families that cannot afford health insurance. This is inescapable no matter whose data you use. And because the numbers do not change over the years [except that they have been increasing since the late 1990s], there are at any given time, 35 million or so uninsured citizens who may need preventive medicine but cannot get it. And 57-59 million people [using, in fact, the sources cited by the National Review article] do not have insurance at some point during a given year, or 24-25% of our nonelderly population.

The major concern I have with the millions of uninsured, whatever their number, is not necessarily out of my being "humanitarian" but my concern for their social burden. People who are uninsured frequently ignore the early symptoms of serious complications -- not because they choose to ignore them, but because they cannot afford to see a doctor. Then later when these symptoms have blossomed into full-blown medical conditions, they end up in the Emergency room of a hospital, burdening our healthcare system with the high costs of illnesses that were treatable and preventable months ago. This creates ridiculous lines at ER rooms [undersupply of a key medical service], and raises the cost of emergency care do to overuse [excessive demand] and thereby raises the cost structure of the whole health system. Economically, it is bad policy and it impedes the ability of the rest of us to get adequate and responsive care.

So let me state that this is a problem. And dealing with it appropriately, by expanding coverage for working American families will lower costs for all of us, do to much greater use of preventive care -- especially if we emphasize that this is our goal. We also will save money in the long-run by expanding coverage (either through the state or otherwise) for people who are chronically out of work, for much the same reasons. (Prescription drug costs are another matter entirely, and we can talk about that later -- part of that problem is simply that Doctors have shifted to a model where they prescribe drugs for everything, and where consumers/patients demand drugs for everything, leading to soaring demand -- and hence, soaring prices -- for prescription drugs.)

Wednesday, June 23, 2004

Rising Cost of Healthcare for the Middle Class

RE: Rising Healthcare Costs

(Note: The above shall be the format of all formal posts on this board, where a RE: tag will be followed by the current topic at hand.)

I think it is universally agreed that the cost of healthcare has increased more than ever before in the last decade, and that there is a strong opinion among the public that something must be done about it. I want to focus on the cost of health insurance -- both for individuals and for businesses -- and on the middle class. It is not really important to lower the cost of healthcare for the wealthy, high-income upper 5% of the country, who are 100% covered and 100% capable of paying for any kind of treatment -- voluntary or necessary -- that they want.

So what are the best ways to address this problem? What are the solutions offered by the two political parties? What are the faults with those approachs, if there be any?

Tuesday, June 22, 2004

Inaugural Message

It is hoped that this weblog will be not a source of contention, nor a pouring out of grievances or old partisan quips, but a meeting point for common discussion of some chiefly American problems. These are problems that are primarily the domain of what we call "politics" in this country, and while not everyone would agree that politics or deliberative democracy can solve them, indeed that is the subject of posting for this blog.

Policy discussions and questions on the role of government are welcome here, and new posters on this blog will be added as they prove interesting in their commentary on what is being discussed. This is exactly why anonymous and open comments will be allowed -- to move the discussion to new places, and bring other perspectives to bear on issues.

That said, outright inflammatory comments -- and posts -- will be summarily deleted. Nothing short of inclusive debate should be encouraged here, and it would be foolhardy to allow an unregulated anarchy of jibes and ad hominem attacks to replace genuine consideration for well-written viewpoints.

The format we will use, I think, will be one where a specific issue is identified by mutual agreement for discussion for an indefinite period of time. After which conclusions may be drawn (or attempted) and a new topic proposed. It is of utmost importance that postings and comments be confined to the subject at hand, and not stray too far in its references to other subjects.

For example, if the topic matter is the U.S. invasion of Iraq and its efficacy in combatting world terrorism (ostensibly the intent of the invasion), then references to the politics of U.S. gun laws would be misdirective, and thus, dismissed out of hand.

There is a time and a place for far flung discussions of everything political, but this is not the place. And I think our time would be better used if focused upon narrow, specific issues -- as much as this is possible. Narrowness in focus must not replace good sense, and it is perfectly acceptable to point out, for example, that the plight of the poor in this country is a broad issue involving everything from government programs to criminality to race relations.

This first message has grown too long and too arduous -- already I have bored my reader. So, let us commence with something interesting, and it is hoped that we will be successful.