Two More Thoughts On Health Care: It's All Your Fault! It's All Up to You!

The U.S. healthcare system is moving from a "social insurance" model, where healthy people pay the same amount for insurance as those who are sick, to an "actuarial" model, in which sick people pay more than healthy people. By way of background, the social insurance model has been the traditional way of thinking in the U.S. in the past (and still is in most Western nations). Health insuance economics in the U.S. has been infected (sorry) with the concept of "moral hazard"--the notion that people with insurance will use the system more. (An example of this would be if you were provided free sodas at work: you'd probably drink more than if you had to pay for them). As this recent article explains, however, moral hazard, when applied to people's use of health care, is fundamentally flawed: people go to the doctor when they have to, not for frivolous reasons. Do the "well insured go to the doctor because it's free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?"asks Uwe Reinhardt, Princeton health care economist. Health savings accounts are the ultimate expression of those who believe that people have too much health insurance, and need less. Check out 2004 Economic Report of the President's outrageous intentional misinterpretation of why poor working people don't have insurance: they had the opportunity (from an employer) but "declined the coverage." Wonder why that would be? Surely not because they couldn't afford it, right? Reading this makes Chaos wonder if Reinhardt is wrong: blaming the devil for the state of healthcare lets the sleazy Republicans who produced this off the hook.

On a cheerier note, one 86 year old man has the cure for healthcare, and it's a booming endorsement of prevention. Exercise and diet (and, possibly, a wife 29 years his junior) keeps this fellow in top form: his doctor, frustrated with his nonparticipation in the healthcare system, tries vainly to attribute his success to nonprescription drugs. Chaos observes that the novelty of the author's habits are the reason for publication, and wonders how many sedentary citizens of the Republic can or will avail themselves of the methods detailed. Given the current rates of obesity, skepticism seems the best course.