Friday, November 22, 2013

Three Ways to Universal Health Care

The disastrous roll-out of healthcare.gov has been much in the news these last few weeks. Unsurprisingly, the Affordable Care Act is polling at an all-time low. I can certainly understand why. However, as much bad press as the IT disaster has received, I think there is a more fundamental reason why the law is unpopular. Universal health care, whatever the details of its implementation, forces healthy people to pay for sick people's care. No matter how smoothly healthcare.gov operates, the redistributive principle that underpins it will rankle many Americans.
One logical solution to this problem is to reject the idea of universal health care entirely, because of the coercion under-girding it. (This might be considered the Randian position.) The drawback of this approach is the heightened risk of bankruptcy or death among the population that can't pay for care. Many Americans find this unappealing: polls are generally in favor of some form of guaranteed health insurance.
If we are agreed on some sort of guaranteed health care as a goal, we have three broad strategies to achieve it:
  1. Provide health insurance through the private sector, and introduce taxes, subsides, and regulations that allow everyone to buy on the private market. (Examples: Obamacare, the Netherlands, Switzerland)
  2. Levy a tax on all citizens to fund a government-run health insurance program. (Examples: Medicare, U.S.; Medicare, Canada)
  3. Levy a tax on all citizens to fund a government-run network of hospitals and clinics. (Examples: the Veterans Administration, the UK's National Health Service.)
The last two options are quite common in the OECD, but they are political non-starters in the U.S. Despite the support in the abstract for guaranteed health care, Americans are less enthusiastic about measures such as federal intervention or higher taxes that might provide it. Having eliminated these more statist options, let us consider what sort of taxes, subsidies, and regulations might be able to provide universal health care through the private sector.
An important concept here is the "three-legged stool of healthcare reform." The first two legs of the stool should be uncontroversial: no one should be barred from purchasing health insurance, and everyone should be able to afford it. Any healthcare reform without these criteria is not worth the bother, because it exposes anyone who can't purchase care to bankruptcy and death.
The problem is that the first two legs work against each other. Sick people are more expensive to insure than healthy people. In the pre-Obamacare individual market, healthy people could buy cheap insurance precisely because sick people were denied coverage. Banning this kind of discrimination just makes insurance more expensive. In 1993, the state of New York "required insurers to accept all customers [and] also mandated that insurers charge everyone the exact same price." [1] These requirements led to the highest insurance rates in the nation. "[In] 2009, it cost an average of $6,630 to purchase health insurance on New York individual market. That's more than $1,000 higher than any other state in the country." [1] Unsurprisingly, the price tag discouraged more and more people from purchasing insurance:
Back when the state instituted the reforms about 752,000 residents were buying health insurance directly from insurance companies in the individual market. But premiums immediately started to soar, and as residents realized they could purchase insurance at any time, even after they got sick, New York's individual health insurance market disappeared, shrinking by 95 percent all the way down to a mere 34,000 individuals. Meanwhile, the ranks of the uninsured spiked to 20 percent by 1997. [2]
There are many ways to get around this problem and keep insurance affordable (the third leg of the stool). The government could levy a tax in order to give a subsidy to insurance companies in exchange for offering lower prices. The government could levy a tax in order to give individuals a subsidy or a voucher to help purchase insurance. Or the government could mandate that everyone purchase insurance, so that the expense per insured is kept down. (It is cheaper to insure many healthy people and some sick people than to insure a ton of sick people.) Obamacare's individual mandate halved insurance premiums in New York. [1]
Without exception, every scheme outlined in this post, from the NHS and Medicare to the alternatives to Obamacare's unpopular individual mandate, operates by forcing healthy people to give money to sick people. In Obamacare, the individual mandate is the mechanism that accomplishes this, which is why it is the least popular part of the law. Nevertheless, without the least popular provisions of Obamacare, its most popular provisions will not work.

Saturday, November 16, 2013

If You Smoke Pot, You Deserve to Die

Last year, Michael Saffioti died of a dairy allergy while in the custody of the Snohomish County Jail, the eighth death there in the last three years. The guards told him that his oatmeal did not contain dairy, then denied him medical treatment when he went into shock. Snohomish County subsequently tried to cover it up. No criminal charges have been filed.
Most commenters on the story are rightly aghast, but some think that Saffioti got what was coming. Imagine how much less they would care if he were a blah person.

Comments on Salon

If you're aware of a deathly allergy then why would you eat the food..?
It's sad, but, no one forced him to do something illegal and get arrested, and no one forced him to eat food he was allergic to.  The guards should still get charged for not following protocol, but it was pretty much this kid's fault that he put himself in the situation.
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OK, I know a few prison guards.  And these slime balls under their supervision are always trying to pull some stunt.  They see so much BS that when something real happens it is hard to tell.  It is the boy who cried wolf syndrome.

Comments on Huffington Post

...also he could have just made his appointed court date for possession of marijuana instead of blowing it off, but he didn't. He could have refused to eat whatever it was they gave him to eat for breakfast, since he seemed to be unsure of it. Someone with allergies as severe as he seemed to have could certainly be better served by skipping a meal than eating a questionable one. And of course the jailers could have taken his concerns more seriously and responded appropriately before it was too late. I doubt the court will hear much about Saffioti's personal responsibility though.
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Ignorance of the law is not an excuse. And using marijuana to relieve stress is a cop out. How did individuals deal with stress 30, 50 100 years ago without having to use an illegal drug? There is also something that is legal that would do the same job and that's meditation and or yoga. Any reason why they can't do that today or are people really addicted to marijuana? And how come people in countries where marijuana is non-existent can live day to day without resorting to drugs?
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Absolutely horrible. The saddest part is, it all could have been avoided if he had just obeyed the LAW!
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Prisons are suppose to dark and deary, so people want to avoid it. It is not suppose to be 5 star hotel, when a law abiding citizen can't even afford healthcare.
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It's not the system that's to blame. It is the 99.999% of other inmates that abuse such services, and constantly lie to guards. No wonder they didn't believe him, they don't even know what a food allergy looks like.
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The people are without blame either. There is a reason the guards thought he was faking it. Because people fake it. Even life threatning symptoms. This is why we can't have nice things.
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Can we all agree had he not committed a misdemeanor he'd still be alive today?
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You can't be framed if you're not in the picture. No one with allergies so severe that "the smallest break in vigilance could result in his death" should commit crimes, lest he be away from his support system. It seemms he broke the law, failed to show up for court, then surrendered himself, then ate food containing stuff he was allergic to? Reminds me of another saying: "There's a reason they call it 'dope."
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If he hadn't been smoking pot none of this happens.
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Not saying he should have died, but why didn't he just do the right thing in the first place and show up in court?
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Here's a novel idea... don't break the law and get locked up. Simple.
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What happened was wrong, but guess what, he wouldnt have been there if he hadnt broken the law..TWICE

If you break the law, you deal with what happens. He didnt get the death penalty, stop being melodramatic. Bottom line is, dont break the law...he did it twice. Its like the minorities who sell crack cocaine saying the penalty for it is too harsh. Guess what, dont break the law
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Don't break the law. Don't risk jail.

He broke the law. How is he a victim now? I don't break the law and I don't risk jail.
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hmmm.....he failed to make his original court date....in other words he decided to show up to court when he felt like it.....thus every action has consequences......
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Maybe this guy should have showed up to face the judge instead of getting high!!

Or maybe if you are a person with food allergies like some of my 8 year old sons friends you offer that information to the people at the jail as the 8 year olds do when they visit our home...and if you don't get the answer you need you don't eat what is given to you...but were dealing with a pot head here who probably smoke a fat one before turning himself in and had the munchies!!! One less pot head for the rest of us to support!
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well maybe he should have not smoked pot in the first place or show up for his court date. Pot a harmless drug, I don't think so
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A prison is not a hospital - it's a place for criminals and a place in which every sane person should do their utmost to avoid. This man broke the law by taking drugs - he was a repeat offender and well known to the other convicts. Saffioti was known by fellow inmates at Snohomish County Jail as “Bubble Boy” because of his severe allergies and the accommodations made during previous stays at the jail, always in the medical unit." So the prison messed up but had accommodated this repeat offender multiple times in the past at tax payers expense. Drug users: stop breaking the law.
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This article omits information that is sympathetic to the jail.  If you have severe food allergies, carry an epi pen
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If you have severe food allergies, such that you can die this easily -  don't risk going to jail!
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No excuses for him either for not showing up for his court date ------PLAY WITH FIRE AND YOU ARE GOING TO GET BURNT
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He should have made his court date and none of this would have happened.
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its the kids fault he was in jail, he decided not to go to court ,, no one locked the door to keep him form showing up,, had he done the responsible thing he would probably be alive today

failure to appear in court is a more serious crime then the one he was facing,, the putz
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And you missed the point that had he taken just a little personal responsibility by not missing the court date, he would still be alive today, or at least he would not have died due to being held in a jail.
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Life is unfair, I do not expect guards to jump for inmates. They would never touch the ground if they did.
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Oh please what a tired excuse! Was he having difficulty? Yes. Was he ignored? Yes. Did he come by his money for his pot honestly? Who knows and it seems no one cared, but that's besides the point. Did he die? Yes. But NOT because he was in there because of the offense. He was allergic because he was. Why he was in jail had nothing to do with it. Tough that people have a problem with putting in jail someone on a drug charge. But what happened to him was NOT because OF that drug charge. Pot is against the law. That's the only thing to me that matters. Should he have been paid attention to? Well he should've also paid attention to the fact that Pot for now is illegal!
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Sadly, you would have every prisoner in the jail calling out for an ER visit. I have a family member that works in a prison and it's very common for prisoners to fake an injury or illness to get out of jail. It's a bit of freedom.
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Learning consequences is missing in our society. If you cannot do the time, don't do the crime.
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This is why you don't miss court dates.

Comments on Fox 13

Too bad he didn't try harder to stay out of jail. This was very predictable.
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This guy is an idiot! How about don't go to jail!

Comments on Everett Herald

Gee, maybe if he wasn't a criminal, he would still be alive.
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A lottery ticket for the mother.
I love all the haters here, I have never,or will never go through this experience myself, my parents raised me to make good decisions and my wife and I are raising our children to do the same. It's just odd to me that I have never had a negative experience with law enforcement,maybe it's cause I'm a winner!

Tuesday, November 12, 2013

Rhetorical Bestiary: Hyperbole

Hyperbole is not a blank check to say stupid shit.

Sunday, November 10, 2013

Invisible Bike Helmet

A pair of Swedes has developed a clever "invisible bike helmet" (hat tip: Zach Yeager). I won't spoil how they did it, so please watch the video. I hope their new design prompts more people to wear helmets.
That being said, there is a lot more to being safe than merely wearing a helmet. Some observations:
  • Helmets certainly can't prevent broken limbs; it also seems unlikely that they would reduce neck and spinal injuries.
  • Rotational acceleration is a major contributor to brain injury. Ongoing research on football concussions suggest that helmets do little to reduce rotational acceleration.
  • Styrofoam helmets may not even be that good at reducing linear acceleration, either. They are supposed to reduce acceleration through compression, but it is fairly common for them to fracture instead. Fracturing reduces acceleration less than compression does. (I expect the invisible Swedish helmet to be far superior on this front. Watch the video!)
If you don't like styrofoam helmets, please buy and wear the invisible bike helmet. Despite the limitations above, helmets surely reduce the severity of injuries in the event of a crash. 
Please remember, however, that injury risk is the product of the probability of a collision with the severity of injuries. As important as helmets are, I believe it is even more effective to reduce collision probability. Use safe cycling practices: be observant of traffic and potential road hazards, communicate with other road users, use lights and bright colors, and campaign for safe cycling facilities. Helmet use might not be enough to keep you safe.