A question on the health care bill

(Note: this entry includes an illuminating breakdown, supplied by Duncan Currie at National Review, of who the “46 million uninsured” really are.)

I realize this will sound like a stupid question, but the only way I can answer it is by asking it. The major reason for nationalized health insurance is that 40 or 50 million American don’t have health insurance, and the demand is that everyone must be covered. Now the reason many, perhaps most, of those people don’t have insurance is not that they can’t afford to buy it, but that they choose not to buy it. Many of them are young, healthy adults, and they’d rather spend their money on other things. The health care bill will force those people to buy medical insurance, under threat of fines and imprisonment if they don’t buy it. How is that helping them—the very people we’re nationalizing the whole country in order to help?

- end of initial entry -

Bill in Maryland writes:

You write: “The major reason for nationalized health insurance is that 40 or 50 million American don’t have health insurance, and the demand is that everyone must be covered. “

The usual figure given is 46 million, which BHO used repeatedly in his election campaign to promote health care reform. In his address to Congress in September, however, he dialed it back to 30 million, since, though the 46 million figure is technically correct, about 10 million of those are illegals. But the actual number of Americans who have no insurance and genuinely need it is actually far lower. Duncan Currie writes at National Review:

The American health-care debate is a blizzard of numbers, but few get tossed around as frequently as “46 million.” According to the Census Bureau’s Current Population Survey (CPS), that’s roughly how many people (the more precise figure was 45.7 million) lacked health insurance at a given moment in 2007—nearly one-sixth of the entire U.S. population. The latest CPS data show that 46.3 million were uninsured at a given moment in 2008.

Yet while it carries superficial appeal as a political talking point, the “46 million” statistic tells us nothing about the demographics of America’s uninsured. Economist Keith Hennessey, director of the National Economic Council under Pres. George W. Bush, has examined the 2007 data and sliced the 45.7 million uninsured into several distinct clusters, basing his estimates on an earlier government analysis, conducted in 2005. Hennessey reckons that 6.4 million were enrolled in Medicaid or the State Children’s Health Insurance Program—now known just as the Children’s Health Insurance Program (CHIP)—but misreported their status (a phenomenon known as the “Medicaid undercount”); 4.3 million were eligible for Medicaid or CHIP but not enrolled; 9.3 million were noncitizens; 10.1 million belonged to families earning more than 300 percent of the federal poverty level (FPL); and 5 million were childless adults aged 18 to 34. If we eliminate those individuals from the original 45.7 million, we are left with about 10.6 million.

[end Currie quote]

You write: “Now the reason many, perhaps most, of those people don’t have insurance is not that they can’t afford to buy it, but that they choose not to buy it. Many of them are young, healthy adults, and they’d rather spend their money on other things. The health care bill will force those people to buy medical insurance, under threat of fines and imprisonment if they don’t buy it. How is that helping them—the very people we’re nationalizing the whole country in order to help? “

It doesn’t help them, it helps the insurance companies, who, in another requirement of the bill, will have to cover people with pre-existing conditions. What the companies gain from the requirement that everyone must buy insurance should compensate them for what they lose from the requirement that they must cover people with pre-existing conditions, or so they calculate (and thus they by-and-large support the legislation).

Of course, this is not actually insurance but rather a form of “obligatory charity.” Insurance is the assumption of risk. By signing up someone with, say, cancer, the “insurance” company faces certainty, not risk.

LA replies:

The figures provided by Currie are so helpful I want to lay them out on separate bulleted lines for easier reading:

Of 45.7 million uninsured in 2005:

• Group A: 6.4 million enrolled in Medicaid or State Children’s Health Insurance Program, but misreported their status;

• Group B: 4.3 million eligible for Medicaid or CHIP but not enrolled;

• Group C: 9.3 million noncitizens;

• Group D: 10.1 million belonging to families earning more than 300 percent of the federal poverty level;

• Group E: 5 million childless adults aged 18 to 34.

Subtracting the above groups from 45.7 million leaves 10.6 million.

Let’s look at it this way. Of the 45.7 million uninsured, Group A, B, and C, totalling 20.0 million, should not be counted at all, since they are already covered or are illegal aliens. That leaves 25.7 million uninsured. Of that 25.7 million, Groups D and E, totaling 15.1 million, consist of people who basically are choosing not to buy insurance because they don’t need it. That leaves 10.6 million insured who need insurance but aren’t carrying it. (Actually the figure is probably substantially less than that, as there are probably many childless adults in their 30s and 40s who choose not to buy insurance; but to keep things simple we’ll say the figure is 10.6 million.)

The upshot is just as I guessed in the initial entry: the majority of genuinely uninsured people (15.1 million out of 25.7 million) are people who don’t need insurance and choose not to spend their money on it.

Therefore my question stands. A majority of the people for whose benefit this nation-changing take-over of health care is being proposed not only do not need health insurance, but as a result of this new law will come under the power of the government and be forced against their will to buy insurance. So the entire country is being enslaved for the sake of people who do not need help, and who also will be enslaved by this same “help.”

How does this make sense in anyone’s mind? Even on its own terms, the bill makes no sense.

Robert Bove (here is his website) writes:

Short answer to your query:

Nationalized medicine is just that: medicine dispensed by the state and the state alone. It’s not about and never has been about “insuring health.” There is no such thing as insuring health. We all get sick, we all die. Insurance is to prevent bankruptcy. It always has been.

“Nationalized health care” is about power over human beings from womb to grave. Nationalized “health care” is a tool for statists—those who believe first, last, and exclusively in the state above all—to seal man’s fate.

They itch, they scratch, the statists, the “God is dead” crowd. They scratch that itch on cable, 24/7. They scratch in New York Times HQ. They scratch in front of kindergarten classes, in front of grammar school classes, in front of high school classes, in front of college classes. They scratch their itch when they are awake. They scratch when they are asleep.

The question is how to put them out of their misery.

Stuart T. writes:

In response to your rhetorical question: These people will be “helped” because the government will confiscate my money and use it to subsidize the “help” provided to the uninsured. Thus, their dilemma is not “pay or else,” but rather “receive or else.” I think I know which they will choose.

I very much enjoy reading your work. All the best.

Ray G. writes:

I think the bottom line is that liberals/leftists/progressives are motivated by the idea that no one is better, or has more, or is more successful than another. They are obsessed with equality—sameness really. They love the concept of “universal” everything (universal healthcare, universal education, etc.).

But as far as the details, of the 30-45 million uninsured, it breaks down roughly as about ten million being illegal aliens, another ten million earn more than $70,000 per year and choose not to have health insurance. Another several million are people who have quit one job and started another but the insurance on the new job hadn’t kicked in yet when the survey was taken. Approximately one-third of the uninsured are immigrants—legal and illegal. Plus, the vast majority of the uninsured are young people. How much healthcare do you really need when you’re 23? Obamacare basically is a transfer of wealth from the elderly, who need it most, to the young (and often immigrant).

Yet no commentator ever brings up the impact that continued mass immigration has on rising healthcare costs. Doesn’t it stand to reason that by admitting so many millions of poor and grade school educated immigrants (who rarely earn enough to pay income taxes or who simply work “under the table” and again don’t pay taxes) we are escalating healthcare costs? Can’t someone propose simply a reduction in immigration for just five years or so to give the system a breather?

James N. writes:

You write:

“How is that helping them—the very people we’re nationalizing the whole country in order to help? ”

Simple. By smashing the class enemy, destroying the kulaks, and enabling coalitions of power to bring about redistributive change. The working class (none of whom actually have jobs) will be empowered as never before. The bosses and the capitalist roaders will be ground under the heel of the workers and students soviets.

A bright People’s Future is dawning. You can’t make an omelette without breaking eggs. The system is tottering. We must deal it the death blow at any cost. To delay action is the same as death. Sometimes history needs a push. Sailing the sea depends on the helmsman.

A revolution is not a dinner party. U.S. imperialism has not yet been overthrown and it has the atomic bomb. It will also be overthrown. It, too is a paper tiger. Sailing the sea depends on the helmsman.

You are not thinking about the health bill in the right way. You are analyzing it using Old Thinking. The health bill will help the uninsured by razing the rotten edifice of capitalism to its foundations, ushering in the bright socialist future.

Stop worrying about the “health system.” When New American Man is created, no one will ever get sick. If they pretend to be sick—they are joining the class enemy, and will be assigned to retraining.

Robert R. writes:

This isn’t about helping young people, it’s about helping illegal aliens and low income types. Just wait, they won’t have to pay anything, or very little, to receive the same level of care as us.

LA writes:

The replies so far are along the lines that the left simply wants to gain control and crush the white middle class, crush what remains of the old America—or, should I say, crush what remains of America. Of course I agree. But I’m not dealing here with the issue of the cosmic intentions of the left. I’m just trying to understand how the bill makes sense and can be defended on its own terms, as a measure to help the uninsured, when the very people being helped don’t need the help but instead will be very substantially harmed? And why hasn’t our side made this point more forcefully, that the main argument on behalf of the bill is a ridiculous lie and the very opposite of the truth?

Jacob M. writes:

You wrote:

“How is that helping them—the very people we’re nationalizing the whole country in order to help?”

Having been immersed in the world of academic medicine for over two years now, I can tell you how the liberals who occupy that world would reply:

“No one doesn’t need health insurance. First, almost everyone will have the need to seek some kind of medical treatment at some point and especially if catastrophe strikes, it is better that they be insured. That perfectly healthy twenty-five year old electing not to buy insurance, whom you naively claim doesn’t ‘need’ it, could be diagnosed with a brain tumor tomorrow and need surgery. Second, an enormous amount of the money spent on health care in this country is spent treating advanced diseases like heart failure or kidney failure which develop as consequences from much simpler, easily prevented conditions like high blood pressure and type II diabetes. This costs all of us, whether in the form of higher insurance premiums or higher taxes to cover the expense of Medicare. If everyone were covered, all those 18-to-34 year olds would get the preventive care they need, nipping their high blood pressure and obesity in the bud, preventing them from ever developing those advanced diseases, and saving us all billions of dollars. There are all kinds of other benefits even to those currently covered which you might not think of, like less chance of being exposed to infectious disease (because everyone who becomes infected can be treated early, thus lessening the spread of the disease,) and the economic benefits to employers of having fewer missed work days due to illness. The list goes on.”

Of course I’m not advocating this view, just pointing out that in the liberal’s mind, universal health coverage not only benefits each individual but also saves society at large an enormous sum of money and improves our quality of life in all kinds of yet-to-be imagined ways.

Terry Morris writes:

You wrote:

I’m just trying to understand how the bill makes sense and can be defended on its own terms, as a measure to help the uninsured, when the very people being helped don’t need the help but instead will be very substantially harmed?

Well, in defense of your respondents I would say that it is hard to make a distinction between the two—the cosmic intentions of the left and the fact that this bill makes no sense and cannot be defended on its own terms. Add to that that it is blatantly unconstitutional, and what are you left with but the cosmic intentions of its wild-eyed advocates?

You wrote:

And why hasn’t our side made this point more forcefully, that the main argument on behalf of the bill is a ridiculous lie and the very opposite of the truth?

Good question and good point. It reminds me of the oft repeated falsehood we’ve all had pounded into our heads so many times that many of us have either accepted or are beginning to believe, which is that “We can’t or shouldn’t legislate morality.” If we hadn’t already had the sense beat out of us on this question of morality-based legislation, whenever someone said something like that we’d be able to respond by pointing out that all legislation is morality based, and by showing how the “we can’t legislate morality” hypocrites are in actuality, while in the very process of stating this claim, legislating, well, morality. Their morality.

Posted by Lawrence Auster at November 23, 2009 03:56 PM | Send