Blog Credo

The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

H.L. Mencken

Thursday, January 19, 2017

What Would Ayn Rand Do?

Take a read about Tom Price's plan to take away your employer-based health insurance.

This is - to put it mildly - a terrible idea. Perhaps in the long run, it would be a good idea, because it would necessitate a move to single payer.  Single payer - as every other unfucked country in the world knows - works better than the odd patchwork of federal insurance (Medicare, Medicaid, CHIP), private plans provided by employers and individual plans covered under ACA.  Single payer produces better results at a lower price.  Yay for single payer.  Following Price's plan would presumably hasten the day when we get there.

But in the real world, that will likely be hard to realize, as long as people are willing to vote the Scary Brown People Are Taking Our Jobs ticket.  In the meantime, we would see a profound economic dislocation that would crush middle and working class people.

At the root of Price's "plan" is the idea that to every problem the solution is more market.  Education not making everyone a theoretical physicist or hedge fund manager?  More market.  Health care not perfect?  More market.  Pensions no longer viable?  More market.

Of course, the broad purpose of social insurance and social programs is to distribute precisely the sort of public goods that can't be accurately priced or delivered via the market.  The market is great for determining which toilet paper to buy at what cost and in what quantities.  The market categorically does not work when one party enjoys a monopoly.  Health care is a monopoly, in the sense that when you get sick, you need the care.  You can't negotiate with the provider, because you are fucking sick.

The GOP position is that people use TOO MUCH HEALTH CARE.  Seriously, that's the position.  People just go to the doctor because they don't feel well.  I mean....the NERVE of some people.  But if we made each visit to the doctor financially painful, we would reduce the demand on medical care, which would control costs.

Seriously, that's their argument. Forget for a minute that the point of health care is to maintain people's, you know, health, what are they saying to the people who are older and sicker and about to get a fiscal prostate exam that they DID NOT ASK FOR?

I'm 50.  I have some nerve issues in my neck that are causing pins and needles in my shoulder when my neck is at certain angles.  I have to go through my school doctor to get an MRI scrip, because I can't find a primary care doctor who won't retire on me.  Once I get the MRI, I can see a neurological orthopedic surgeon to see what the hell is going on.  Maybe it's just a pinched nerve.  Maybe it's spinal stenosis.

But it sure as shit is a pre-existing condition.  And at 50, my insurance will cost a ton of money.  People over 50 are the Republican base.

Are they really that stupid?  Or more accurately, are they really that blinded by the ideological restraints of Randian socio-economic theory that they simply can't accept there might be something as a "public good"?

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