Single Payer Health Care is a Conservative Policy

Health care costs are the elephant in the room (Photo by Lauren Nelson on Flickr)

Medicare for all, or other incarnations of the idea of federalized universal healthcare funded by tax dollars, is seen as a far-left liberal policy. Yet from a strictly financial point of view, it should be the policy true fiscal conservatives are advocating for.

Looked at economy wide, the biggest problem facing America is the cost of health care.  At present it is 17% of our total economy.  It also represents over 20% of our federal budget, amounting to some $800 billion a year.  Further, these costs are borne system wide.  Companies pay for it in their employee benefits costs, States pay for it in Medicaid, and individuals without insurance or who have moved to high-deductible plans feel the pain as well.  To add insult to injury, costs are rising at a rate of about 6.3% a year, which is a rate far exceeding inflation or GDP growth.

If these costs could be dramatically reduced it would mean a significant reduction in federal deficits and relief to cash strapped states.  It would mean more corporate profits available for growth and investment or worker wages.  And it would mean more money in everyone’s pockets as well.  No one whose priority was fiscal responsibility and economic growth could possibly stand against such an opportunity.  Yet that is where we find ourselves.

Heath Care Costs per Capita

Health care costs per capita in the US are currently about double what the rest of the industrialized world pays.  While some might argue this is because we have access to superior care, the evidence doesn’t bear that out in aggregate.  Our life expectancy, infant mortality rate, and other indicators place us as a below average country for quality of care.  Even allowing for a bit of American exceptionalism here, our “superior” care doesn’t warrant double the investment.

So why do we pay so much for care? We are the only country not providing centrally managed care, and one of only two who do not provide for universal coverage (Mexico and Turkey are the others).   No one insurance company is currently responsible for you from cradle to grave, and hence there is little incentive to prevent future medical conditions or mange chronic conditions.  The incentive is to spend as little as possible until you can pass the patient on to the next carrier.  Patch ’em up and move ’em out.  And in addition, everyone in the current system needs to make a profit.

Medicare currently controls costs better than private insurance in this country.  And recall that Medicare was created entirely because it became impossible for seniors to afford private coverage.  There is no evidence that further privatizing medical insurance will result in better, cheaper, or more universal coverage.  There is no model anywhere else in the world, or even in our own history where that has worked.  On the other hand, federally managed universal care is proven to work in dozens of countries around the world—at half the price.

Conservatives are by nature risk averse.  Choosing between a solution proven to work and an alternative unproven solution at double the cost should not even be a debate in those circles.  Yet anything that even smells like single-payer is a non-starter. It is not even open for discussion.

I don’t favor a single payer system because I have some lefty liberal bias that assumes everyone has an entitlement to be be healthy and well cared for.  I favor it because I’m cheap.  I favor it because I’m pretty sure (but not quite certain) we won’t entertain walling off the Dakotas and tossing in all the indigent old and sick and leaving them to die in their own filth.  I’m pretty sure we wind up providing them some level of care at some point.  And given we’re stuck with that societal obligation, let’s do it as cost effectively as possible.

I understand the social justice or social Darwinist side of this issue.  People who didn’t earn their way and can’t provide for themselves don’t deserve to sponge off people who worked, saved, and did prepare.  But people with such views fail to look at the larger picture.  Unless we’re really okay with the Dakota Internment Camp, those people wind up being a “burden” somewhere on someone.  You may think you’re ducking being saddled with that burden, but issues as pervasive and large as health care are an economic drain on us all.  If you live, work, and pay taxes here, you’re saddled.

So here’s a plan with a proven track record to take half the load off us all.  That’s $400 billion a year off the federal budget alone.  Are you in?

It’s the Revenue, Stupid

As we rapidly approach another potential government shutdown due to the Congressional budget impasse, it’s a good time to examine to root of the fiscal situation in which we find ourselves.  Republicans did well at the polls in 2010 by framing the problem as one of out of control government spending.  Democrats have basically conceded that point, and the current debate rages over exactly how many billions of dollars should be cut and from where.

Looking for ways to contain spending is always smart, whether you’re a government, a corporation, a small business, or just a household.  Left unscrutinized, expenses tend to accumulate over time, and the larger the organization, the larger the accumulation of programs and services that no longer provide a valuable service, or do so inefficiently.

Spending as a % of GDPHowever, the current debate overlooks the larger, and frankly glaring, reality that we are not in the midst of a period of out of control spending.  We are in a period of unprecedented loss of income.

The chart at the right shows spending relative to GDP. Looking at these numbers relative to GDP is the only sensible approach as it takes into account the dollars relative to the size and strength of the country’s economy.  What’s clear from the chart is that we are on the line that extends back for a century.  The two big blips are the World Wars, but otherwise, spending growth is relatively constant.  It’s also interesting to note that one of the only extended declines in spending was during the Clinton administration in the 1990s.  We’ve since squandered that, which does lend credence to the claim that spending has increased dramatically in recent years.  But it would still be difficult to characterize this as run away spending.  Especially considering we are already seeing a downturn in spending because of the expiration of most of the stimulus programs.

Still, it’s also important to recognize the slope of this spending line is ultimately unsustainable.  Eventually, this line will cross 100% and keep on going.  And realistically, we need to flatten it out long before then.  So yes, make some tough priority choices, strive for efficiency, and reduce waste because ultimately we do need to flatten this line out.

Revenue as a % of GDPOn the other side of the equation though, look at the revenue graph.  There has been a precipitous drop in revenue over the last decade.  As a percent of GDP, revenues have not been this low in 50 years.

In part, this loss of income is attributable to the economic downturn, but it is attributable in larger part to the many tax cuts passed.  So while we may argue that some of our deficits are caused by economic realities, a non-trivial chunk are caused by our choices.  We are choosing to be broke, or at least choosing to be as broke as we are.

Think of this in the framework of a typical 2-income household.  As a couple, you decide you need to get your spending under control as its year-on-year growth is not sustainable, but you just can’t bring yourselves to contain your spendthrift habits.  So you decide to have your spouse quit their job.   For a while you continue to spend at your old rate anyway because your credit cards have not maxed out.  And it is only when they do that you force yourselves to cut back.  Yet now you have to cut back to one-income levels, and you are also saddled with interest payments on all the debt your racked up.

Mission accomplished?  In what reality?  We need to get spending under control.  We have a revenue problem.

Would Jesus be a Conservative?

WWJDI’ve been having a protracted email discussion with someone who’s a very fervent Christian and also a staunch conservative.  Anyone paying any attention to American politics will be quick to observe this is not exactly a rare breed—a point which I have trouble reconciling in my feeble brain.  It seems to me that Christian Conservative should be an oxymoron, at least within the context of what the conservative agenda has revealed itself to be in this country.

To that end, I posed the following question to my pen-pal this morning, and I’m posing it here as well in the hopes of generating some conversation and insight.

Presumably a Christian’s worldly politics are aligned with what they feel Jesus would advocate for if he were here today.  In essence, WWJD?  Yet most of the fundamentalist Christians seem strongly aligned politically with the conservatives.  I would go so far as to say there is a pretty strong correlation between those who profess to model their lives on Jesus and those who vote conservative.

It strikes me that in his day, Jesus was a flaming liberal.  He advocated for the poor, the downtrodden, and the sick.  He accepted everyone. He turned the other cheek. He taught to give away your worldly possessions, help your neighbors, and love everybody. He was persecuted precisely because he stood as an organizer of the people and was seen as a threat to the power structure of the day.

While I can understand Jesus might be strongly pro-life on abortion, most of the remaining conservative agenda seems to me to be against what Jesus would do.

  • Reduce or eliminate social security (meaning many elderly will live in poverty)
  • Reduce or eliminate Medicare/Medicaid (meaning most poor and elderly will not receive adequate medical care)
  • Place the tax burden disproportionately on the backs of the non-rich
  • Eliminate unions (removing the voice of the people)
  • Eliminate environmental regulations (leading to pollution, extinctions, ecosystem damage)
  • Reduce spending on education
  • Reduce spending on assistance for the poor
  • Increase militarism, don’t negotiate with our enemies

Note that all the bullets above are references to policy positions, proposals, or legislation backed by conservative politicians within the last year.  This is not about what they are saying, but about what they are actually doing.  (It seems Jesus would be big on the whole doing part as opposed to just giving lip service to high ideals.)  I can’t fathom Jesus entreating his followers to get behind any of this.

In that light, if good Christians are truly trying to create a world Jesus would be proud of, why are they primarily standing behind people and policies it seems Jesus would have reviled?  I don’t get it.

Lady Gaga makes a splash as a Tech Consultant; Humanity is doomed

Last week, Gaga and UbuntuGrammy award-winning singer Lady Gaga confessed that she is an avid fan of Ubuntu, the Linux-based operating system. Reports are that Ubuntu’s desktop market share has shot up from 1 percent to 7 percent in just two days. Furthermore, due to a huge rise in traffic, Ubuntu’s website suffered a downtime of about 8 hours on Tuesday.

While Ubuntu is a really slick OS, made slicker by its price tag (free), it’s hardly a new kid on the block.  The Linux distro has been around for years, struggling to make inroads against Microsoft and Apple.  It’s got a fair following among the geek crowd, but has yet to make big inroads into the mass consumer market… until now.

Many Ubuntu enthusiasts as well as developers and investors are overjoyed, and understandably so.  But what does this say about the sanity of the average person?  Lady Gaga’s advice might be worth following if she opined on music, popular culture, or fashion. But if we’ve intellectually regressed to a point where we will change our computer operating system based on an offhand remark from a celebrity, what else will we buy?

It’s hard enough to figure out which experts to trust in a sea of competing voices on a topic, but there has to be some ability to discern who should warrant consideration as a person to whom we should listen.  Or have we really reached the point where we are unable to discern that Lady Gaga shouldn’t even get a voice as a tech expert?  Alternatively, are we just so awestruck by celebrity that we’ll do anything a celebrity says?

Even sheep are smarter than that.

FDA study results in concerns about government food Nazis

Calvin thumb on nose
You realize it is April 1st, right?

An FDA advisory committee is evaluating the strength of the evidence surrounding a link between food dyes and behavior changes in children.  Scientists and academics are accusing the dyes of exacerbating hyperactivity in children and are advocating for a ban on the eight dyes they claim are dangerous.

Sarah Palin was quick to dismiss the finding saying:

Those ivory tower elites just think they know everything.  How dare they accuse our Froot Loops of exacerbating? There’s no call for that sort of language. I think maybe, you know, they’re the ones doing that, and if they don’t cut it out they’ll go blind.

Glenn Beck was also on the defensive as he accused the FDA of kowtowing to First Lady Michele Obama’s food Nazi agenda. He asserted that Skittles were the last line of defense against the rising tide of socialist Muslim oppressors intent on taking our freedoms away.  Beck then waxed poetical, paraphrasing Pastor Martin Niemoller.

First they came for the saccharine,
and I didn’t speak out because I wasn’t a coffee drinker.

Then they came for the trans-fats,
and I didn’t speak out because I wasn’t a McDonald’s customer.

Then they came for the red dye 40,
and I didn’t speak out because I wasn’t a Pop-Tart eater.

Then they came for my high fructose corn syrup
and there was nothing left to eat.

Beck then went on to note that this country was founded on corn.  Our founding fathers recognized corn was God’s gift to them.  It was fuel, food, oil, sugar, and vegetable.  John Addams called corn “American manna.”  Beck reminded that the Indians didn’t want us to have corn and tried to confuse our ancestors by calling it maize.  He said, this is why we make corn mazes every fall, to honor the confusion and disorientation the pioneers suffered at the hands of the cruel Indians.  Beck concluded, “And you know who else hated corn?  Hitler!”

Politicians were also quick to rise up against the outrageous actions of the FDA.  Rep. Mike Pence (R-IN) introduced yet another rider to the 2011 budget prohibiting the FDA from using federal funds to restrict food additives whose primary purpose was aesthetic.  Pence claimed America has the single greatest looking snack foods God ever gave man on this Earth, and he would not sit idly by and let our Twinkies take a back shelf to Chinese knock-offs.

House Majority Leader Eric Cantor’s office also released a statement that he was backing a no-bid contract with Haliburton to lease America’s Ritalin riddled children as part of the GOP’s green energy plan.  The press release said this is not the time to be thinking about reducing the hyperactivity of our youth. We cannot possibly cut our addiction to Middle Eastern oil on hamster power alone.  Experiments at powering wheels with seniors in exchange for Medicare coverage didn’t pan out.  It turns out, arthritic men with heart conditions simply can’t sustain the velocity needed for reliable electricity production.  Cantor emphasized, “Children are our future.”

Christine O’Donnell added, “It’s just food coloring people, not witchcraft.”