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Good: A large, faceless, bureaucratic institution that has no competition called an "insurance company."

Bad: A large, faceless, bureaucratic institution that has no competition called a "government."

Good: Paying an annual sum of $6,000 a year per person in a transfer called an "insurance premium."

Bad: Paying an annual sum of $6,000 a year per person (or, whisper it softly, less) in a transfer called a "tax."

Good: Aggregating the total cost to the nation and employers if paid in "taxes."

Bad: Aggregating the total cost to the nation and employers if paid as "insurance premiums."

Good: Rationing health care using dollars.

Bad: Rationing health care using medical advice.

Good: Not being able to "choose your own doctor" through price constraints and insurance company policies.

Bad: Not being able to "choose your own doctor" through resource constraints and government policies.

*^*^*

Good: Having a substantial percentage of the population uninsured.

Bad: Having the overwhelming majority of the population insured.

Good: Having high absenteeism and lost productivity due to poor employee health.

Bad: Having low absenteeism and optimal productivity due to good employee health.

Good: Having only private companies who have themselves grown to be large, faceless, bureaucratic institutions that have no competition be able to afford insurance premiums for their employees.

Bad: Having private companies who have themselves grown to be large, faceless, bureaucratic institutions receive competition from smaller, more nimble, more agile companies who are now able to afford health care for their employees.

Good: Having US employers at a competitive disadvantage to employers in countries that insure their citizens.

Bad: Giving US employers a level playing field in the global marketplace.

Good: Having citizens, employees, and small business owners who are lucky enough to be covered in the first place, live in constant fear of losing that coverage, either for themselves or their employees.

Bad: Having citizens, employees, and small business owners covered, and unafraid of losing that coverage, either for themselves or their employees.

Good: Having retirees fear losing their health care if their former employer goes bankrupt in a way that reneges on their fiduciary commitments.

Bad: Having retirees assured they'll never lose their health care.

*^*^*

Or, in sum:

Good: Fear.

Bad: Confidence.

Comments

( 10 comments — Leave a comment )
daveon
Jul. 28th, 2009 04:52 pm (UTC)
While I've said before that I refuse to believe that American's are less able to run a faceless bureaucratic organisation compared to, say, the French... I do keep coming across instances where it's quite obvious that, on occasions, the ability of an American bureaucrat to follow rules to breaking point would put an EU official to shame.
hal_obrien
Jul. 28th, 2009 04:59 pm (UTC)
And, at that, we are as nothing compared to the Swedes.

There was a Frenchman quoted in Harper's an issue or two back, who said something along the lines of: "Americans will fight all day about whether they have the right to argue about something, rather than arguing about the thing itself." That's not exactly it, but close.
tylik
Jul. 28th, 2009 05:00 pm (UTC)
Have you read this?

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

One of the saner looks at health care costs I've seen. Useful for reframing the question, anyway.
hal_obrien
Jul. 28th, 2009 05:18 pm (UTC)
I have a subscription to the New Yorker, and browsed it when it went by. I've long admired Dr. Gawande's writing (this early post of mine is an example).

Thanks.
supergee
Jul. 28th, 2009 05:10 pm (UTC)
Blogging this. Thanks.
hal_obrien
Jul. 28th, 2009 05:23 pm (UTC)
You're welcome.

As usual, I got somewhat weary of the distinctions without a difference being made so consistently.
men_in_full
Jul. 28th, 2009 09:16 pm (UTC)
Here from supergee's LJ.

Excellent list. I voted for Obama but am quite unhappy with the turn the health care bill has been taking; I would much rather see a Canada or UK-style single payer system.
noveldevice
Jul. 28th, 2009 06:37 pm (UTC)
Excellent; linked.
bientot
Jul. 28th, 2009 10:41 pm (UTC)
I think you forgot a couple...
Good: Having coverage through work so that, if you're injured or sick enough to be unable to work, you lose your coverage.

Bad: Having coverage independent of work, so that, if you're unable to work, you can still get medical care.

Good: A system which provides insurance companies enough profit to keep an army of lobbyists in DC to ensure the status quo.

Bad: A system putting that profit back into the system to provide better health care.

Thanks to supergee for posting a link on Dreamwidth!
holyoutlaw
Jul. 29th, 2009 03:53 pm (UTC)
This was also linked to by andrewducker.
( 10 comments — Leave a comment )