Your Take 

Your Take: On the Healthcare Law

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Earlier this week, the Supreme Court heard oral arguments over the healthcare law over the course of three days. It’s been the subject of debate all over the news and it’s something that even my lovely wife has asked me about. This Your Take is going to be exceptionally long, I hope you read most of it and I really hope you share your thoughts. Unlike the vast majority of the comments on the Internet, I know that when it comes to thoughtful insight, you guys have enlightening me more than the other way around.

Before I get into what I think, I want to introduce the idea of the tragedy of the commons, because it plays an integral role in how I think of health care. If you have several herders sharing a common piece of land, where each herder is allowed to let their cows graze there, and each herder has an incentive to keep the pasture in good condition. If everyone starts with five cows and they agree to share the land, the grass can grow back and the pasture is kept in good condition. Then someone gets a new cow, lets it graze in the fields, then someone else gets a new cow, and it too grazes. They know they originally agreed to share the land but now two of the owners are getting a little bit more than the rest and the pasture suffers from overgrazing.

How does health care look like the tragedy of the commons? Healthcare is the pasture and everyone is a herder with one cow. Except some of the herders say they don’t want their cow to graze in the pasture, they have other pastures to graze on so they don’t pay to maintain the field. Then disaster strikes, a flood destroys their other pastures and they now need to use the common one. The problem here is that the other herders can’t stop the new herders from using the land and they pay for the addition upkeep because the pasture’s maintenance staff increases prices to help pay for the added demand for grass.

I think the individual mandate forces those herders who don’t want to pay for the upkeep of the communal pasture to pay. They may not need it today, but they will need it one day.

Let’s depart from the analogy and talk about health care specifically – I believe that health care is something all Americans should be able to access. I also believe that healthcare is expensive because our the economic incentives are built in such a way that you want to maximize procedures to maximize profits. Preventative care is cheaper than prescriptive care, so medical companies want more prescriptive care because it’s makes more money. What’s more profitable, a cholesterol drug (best selling drug ever is Lipitor) that someone has to take for the rest of their life or preventative care through healthy eating, exercise, and other mechanisms? So I like that the healthcare law did something to address preventative care, though it’s still limited.

As for the mandate and the argument that it’s the government overstepping its authority by forcing people to buy something – I agree. I also think this is an exception. When we pay for Medicare and Social Security, aren’t we being forced to buy something? I don’t know the legal arguments but I know that those payroll deductions are non-elective and mandated by the government. Health care should be the same.

Finally, on this point of healthcare overall… the problem with health care isn’t that people are uninsured, it’s that you can’t, morally or legally, stop someone from receiving treatment if they need it. If the herders didn’t have to pay for fields they didn’t need and were willing to let their cows die, then we shouldn’t require them to pay. But they won’t let their cows die, nor should we be a nation in which we let them even make that decision, so the individual mandate to pay for the pasture is necessary.

What do you think?

{ 79 comments, please add your thoughts now! }

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79 Responses to “Your Take: On the Healthcare Law”

  1. real conservative says:

    Now you want irrefutable proof that Republicans, and the right-wing Media/Cabal behind them, are the TRUE ENEMY of the American People.

    You can have this proof by asking them a few questions, that is ask Romney, Scrotum, Fox news, Wall Street Journal, etc.:

    1- What do you think of Government run Universal Nationalized Health Care (aka NHS)?
    They would answer that NHS is “Socialism”. Or NHS will lead to ruin of our economy, etc.

    2- Then ask them what do you think of Israel?
    They would answer “Israel is an example of a successful economy”, “Israel is a shining beacon of Democracy”, etc.

    Then ask them, do you know that Israel has totally Government run Universal Socialized health care? Where all Israeli’s have access to the same health care from cradle to grave for FREE, of course free for Taxes they pay. Here:

    So how can you explain your total opposition to NHS for American people while your beloved Israel has totally FREE Socialized health care? HOW?


  2. matt says:

    The Conservative parties in entire developed World are 100% for their NHS

    Consider the FACT that the Conservative parties in entire developed World are 100% for their NHS, which would then make it instantly deducible that Republicans in US are lunatics to call NHS to be “Socialism”, because that would mean then that they are then effectively calling the Conservative parties in Europe, Canada, etc. to be “Socialist”, and how right-wing Obama Admin is that it did not even propose, set aside pass NHS.

    So, here is Margaret Thatchers Conservative party in UK, stating that they are 100% for their Universal nationalized single payer health care system:

    And quoting from it:
    “Over three years ago David Cameron spelled out his priorities in three letters – NHS. As the party of the NHS, we will never change the idea at the heart of our NHS – that healthcare in this country is free at the point of use and available to everyone based on need, not ability to pay.”

    or here is the Conservative party of Stephen Harper of Canada:

    and quoting from it:
    “The Conservative Party of Canada has released its platform, which is committed to ensuring that all Canadians have access to timely, quality health care services regardless of their ability to pay.”

    If you still do not get it as to why Conservative parties in entire developed World are 100% for their NHS, here it is in number format: that is countries that have not-for-profit Government run NHS, health care is taking on average about 9% of the GDP while in US with Wall Street run for profit health care, 50Mill+ have NO health care, 2Mill+ go bankrupt each year due to health care costs, AND health care is taking a DEFICIT busting 18% of the GDP.

    So based on the above FACTS, one has to face the FACT of what enemy of the Nation Republicans, Republic-rats and the right-wing Media cabal that controls both are to have used their near total control of US Media, to hide from American people the facts about NHS, which facts lead the Conservative parties in entire developed World to be 100% for their NHS.

  3. Vik says:

    Coming from Taiwan originally, I live here in US for the past 8 years. Health care system in Taiwan is one of the things I miss from home. 2 years ago, I went back for vacation. The doctor there diagnosed me for having benign tumor. It was surgically removed. Total out of pocket cost is 15 US dollars. 3 year ago, my sister gave birth to twins. Because of complication, she needs to stay in hospital for 2 weeks. The baby (one didn’t make it) needs to stay for 30 days. Total out of pocket cost is 0. My neighborhood doctor knows all my family members there. Even after I move to US for 8 years, he still remembered me when I came back to visit him. I love life here in US. It’s one of the greatest country on earth. But health care system here is a mind-boggling display of inefficiency with outrageous cost. I don’t see how the system can be sustainable without individual mandate. Here’s CNN Zakaria talking about Taiwanese system:

  4. Sarah says:

    The flaw in healthcare mandate is in the name. Mandate. When states started requiring individuals to carry auto insurance, I was one of those people asking why the state can force me to carry insurance. I did have insurance, but after the law passed my insurance went up for no apparent reason other than the insurance companies could, because we had to have.
    The government has sticky fingers, once they are allowed to dip into someone elses honey pot they don’t stop their. Encroachment on freedom is illegal, but nobody seems to notice when it’s happening to them.
    The healthcare mandate is illegal but it won’t be stopped for the same reason my auto insurance rates went up 15 years ago. Because they can.
    Just as a footnote, my healthcare premium has already gone up 30%. Thanks America for paying attention.

  5. den says:

    Clearly we all agree that Health Care reform is needed. But How is the issue. Personally, I would support this new Health Care approach but I can’t afford it and it is not implemented. I am married age late 50s and fall into the black hole of medical coverage. My wife was employee in a school system until that industry suffered huge layoffs and she was one of the unfortunate. I am self employed in a very small company. Add to that the “uninsurable” clause due to existing conditions from birth but without symptoms. Our only choice was cobra after my wife’s layout. Cobra has now expired and we had to convert to guarantee issued health coverage. Yet there is such a thing but. It only costs 1700+ per month for a family of 2. We could only afford for my wife to be covered which reduced the cost to 800 per month. It has been two months and we received a notice that the premium was increased by 25% to now 1000 per month. That is for 1 person. So I ask where is the cost control? if pre-existing condition are to be covered what is that cost?
    I might add the acutal coverage is not that great. Most Dr visits and meds are out of pocket. For major treatment we pay 30% and there is no annual or lifetime limit on our cost. This is a real and actual situation. If you have a job and are covered be thankful. If you don’t be prepared to go bankrupt. I am now considering that since it will be 6 years before medicare that means at the current premium and cost increased for the premium I estimate that I could put aside between 100K and 150K over the next 6 years and just self insure the both of us. Plus if we have treatment we actually will pay the bill in a more timely fashion rather than Drs not getting paid by insurance companies for 6 to 12 months and if on medicare that timeframe could be in excess of 2 years before payment. I know that because of helping with my Mother inlaw who died in March 2011 and as of this month April 2012 we are still getting claims beneift statements in the mail showing payment for treatment in mid 2010. Again is is real.

    Ther has to be a better way and I dont see our current approach or the health law being reviewed by the courts as working.

    Lets go back to tort reform, inter-state competition and get the lawyers out of the middle.

  6. David R says:

    We need to do reform on health care system but certainly not obamacare.

    Two things can be done easily to start with: tort reform and allowing out of state healthcare company to compete.

  7. emmy says:

    Let us be realistic on this health care Insurance . Car insurance ……… And health insurance suppose to go along together but if you don’t have it you are on your own when police get you. But it is true that they can not impose on any body .

  8. Lori says:

    One big problem is that we have no option but to use the established medical and insurance systems to get prescriptions. Most common things can be found with just following some WebMD guidelines. The problem is we can’t get a prescription filled without going to a doctor. If we cannot get affordable health care (because of greed) than we should at least be allowed to be our own doctors! It’s better than choosing between food and perscriptions.

  9. adam carolla fan says:

    hopefully i won’t be eating my words for this, but i’m all for the individual mandate – whether it’s car insurance or health insurance, etc.

    i DONT need the government telling me i need health insurance or car in surance because i’m (supposedly) intelligent enough to know that i’m putting myself in jeopardy if i don’t have those insurances.

    i think there’re gonna be a lot of young people, ages 18- say 35, that won’t have/buy health insurance because they think they’re invincible. they’re gonna gum up the system a bit, but there’re steep fines ($695 in 2016!) for not having insurance.

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