Per Capita

 SO many people just repeat the line about the US having the "most deaths from COVID," as evidence that Trump (but NOT the CDC, FDA, and other bureau-nebishes) "botched" the American "management" of  the pandemic. For example,  NPR's constant "America is the world leader in Coronavirus fatalities..."

I have some sympathy for that (except the absolving of the CDC, which was borderline criminally negligent; to be fair, NPR hammered the CDC) view. But it really does matter that the US is a very large country, with a large population. The more relevant consideration is deaths per 100,000, and by THAT measure the US is not even in the top 10 "most deaths." 

Took the data from the Johns Hopkins database, and then deleted all the tiny countries with fewer than 10,000 total deaths (there were MANY countries that had very high death rates per capita, but only a few hundred deaths total, which seems to put TOO MUCH emphasis on the per capita thing...)

The resulting table, deaths per capita as of June 1, 2021, for countries with at least 10,000 total deaths, is reproduced below.  And the results are interesting.

1. The US is not in the TOP TEN.

2. Countries with national health services, including the UK, Italy, and Belgium, have MORE deaths per capita than the US.

3. Sweden, which of course did the "no lockdowns" thing, has FAR fewer deaths per capita than the US. You can say Sweden had more deaths than Sweden WOULD have had, if they had locked down, but clearly locking down everything by force was not a panacea. 

Anyway, if you want to say that the US health authorities got a lot of things wrong, and never acknowledged that they made this much worse than it should have been, I'm with you. But the US is not even close to the "most deaths" if you use a reasonable measure that controls for total population size. 

 

 

 

 

Can you advocate for both a universal basic income AND increased immigration?

SG, a loyal KPC reader writes to me, "How is it possible to provide a basic income and universal healthcare and at the same time increase immigration? To me it appears unsustainable. Too many people would want to immigrate to the US under those conditions. Furthermore single-payer universal healthcare would appear to me to increase government interference in our lives, not lessen it. I'd appreciate your thoughts on this"


I actually think single-payer would result in less overall interference as it would just be one layer instead of the system we have now where the Government is regulating/paying off insurance companies, doctors, hospitals, medical device manufacturers and us.

I would prefer to bust up the AMA cartel, somewhat deregulate the practice of health care, increase the supply of doctors (through immigration), and have a free market in health care, but I still prefer single payer over the ACA.

Turning to immigration, we can always place some limits on entry if mooching is thought to be / turns out to be a big problem. There is a very large area in between where we are now and an open border "free for all".

For example, if we gave green cards to all foreigners who earned graduate degrees here in the US, they would probably not increase use of the welfare state. Or we could limit UBI to citizens if there were strains on the system.

We are just shooting ourselves in the foot by turning away hundreds of thousands of talented people each year.

Remy on VA: Perhaps the best Remy yet...

This is pretty savage.  Not unfair, but savage.  (I like the "one way" that we can be made to care about a soldier:  desert your unit under fire...)

There is an actual problem with government provided health care.  It doesn't really work, anywhere.  England and Canada have systems that allow "important" people to jump the endless queues.  And the U.S. just lets people die as a means of making the queue shorter.




My own view is that single-payer INSURANCE, or government FINANCING combined with private provision, may be the best we can hope for.  So, people who are using the VA crisis to indict tax-funded insurance are mistaken.  But the VA crisis is a perfectly legitimate indictment of those who want an English-style system.  It sucks.

UPDATE:  Some useful background:  VA system is NOT a test of ACA.  But if we aren't careful, we could move toward VA-type system.  Republicans need to make some actual proposals, instead of just being hopeless hypocrites.

The snake eating its own tail?

The symbol of the snake eating its own tail is ancient.  The idea of this kind of circle is appealing, because it is so paradoxical.

So...Obamacare imposed a new tax.  But then panicked, because the tax would have to be paid, and if someone has to pay something they can't claim that their chosen role as Santa is viable.  Santa claims he doesn't like naughty kids, but in fact even the naughty kids want to keep stackin' that paper.

So, the plan is to pay the tax that is being charged to finance Obamacare.  But then who will pay the tax that will be used to finance the subsidies that go to pay the tax that was supposed to finance Obamacare?  Ummmmm.......tail.

Can't Even Lie Straight

The only way that Obamacare could work is if he doubled down on the lie that "if you like your current health care plan, you can keep it." That was never true.  The only hope was to charge much higher prices to healthy people so that the government can force insurance companies to offer "insurance" to folks with pre-existing conditions or who were too poor to pay the actuarially fair rate for that policy.  There  is no way to offer insurance far below cost to some people without raising the costs to other people.

It was ALWAYS a lie.  It had to be.  But at least it would have "worked," in the sense that he could have had most people forced--yes, at gunpoint, forced, but at least they would be included--into the system.  But now the Dems are too chicken-sh*t even to play out their own fraudulent bluff.  They are "extending" and "exempting" like there is no tomorrow.

This is an actual disaster.  Because it means that people who have cheap policies can keep them, but people who must be given cheap policies, people whose expected care far exceed premiums, must be written new policies.  It's Christmas!  The problem with Christmas is that our President is trying to be Santa Claus.  Even a Peronista would look at this and laugh.  "No, you can't back down now!  Grit your teeth and carry out the lie."

To paraphrase Glenn Close, "If you just told us to f**k off, we'd have more respect for you."

UPDATE:  Just when it couldn't get worse....it got worse.  They can't keep doing this.  They have to force people to sign up.  It's the logic of the system.  It's based on force, and cross-subsidy.

The Importance of Basic Economic Education

The reporters of the New York Times illustrate yet again the importance of a basic knowledge of economics.  By, yet again, showing what happens when "reporters" lack such basic knowledge.

A truly remarkable article.  Even by the appalling standards of the Times, this is terrible.

Pelsmin provides this commentary, via email.  I have underlined some points that made me giggle:

I've been following the NYTimes' coverage of drug shortages. I'm sure you've seen the stories about how critical drugs are running out, even generics. The lack of understanding of the most basic economic principles is funny, or maybe sad or pathetic. To me, there was only one POSSIBLE reason why widely manufactured on-patent and generic drugs could be running out; government interference. 

Sure enough, the reasons I've seen include factory shutdowns imposed due to failure to meet gov't quality standards and restrictions and hurdles placed on "over-prescribed" drugs like Adderal and certain pain killers. There is now a shortage of saline solution (!) and critical cancer drugs. 

The Times' coverage not only misses this but presents the government regulators as acting heroically to fix this. For example, the FDA proposed that a company with physical contaminants in a product FILTER the product and then sell it, instead of shutting down the factory, as if the company wouldn't have proposed this themselves. Now, not imposing a draconian restriction or condition on a company is considered innovative problem-solving by the government. 

Better is their feeble stab at the evil thinking by the drug companies. First, they blame "narrow profit margins" as one reason companies won't make vital drugs that are in short supply. I'm trying to picture the curve that explains this (currently reviewing some Escher drawings for inspiration...) The writer also states that "in a peculiarity of the generic drug industry, a drug is often made by only a few producers, making it difficult to mitigate the effects of a shortage". 

Think about that one; generic drugs are only made by a few producers, whereas on-patent drugs are -- what, made by hundreds? No, made by one company, typically, except for license deals. Other reasons indicate that either the writer understands factory production line optimization better than the companies, or maybe doesn't have a clue what she is talking about. Of course, the only way the wackier ideas of high-demand/low-supply/low price are possible is if the FDA has caused this (e.g. Medicare sets and enforces prices that have no bearing on costs or utility.) Yet the article cites praise for the government and "acknowledged that [the FDA] could not ultimately force drug companies to produce." Not yet, until the new five-year quotas are issued under executive order through the medical commisar.

Ironies, or Fibs?

Fast food restaurants have to be "transparent," and post calories. Even though there is no evidence that this helps.  It's just expensive.  But members of Congress don't have to allow anyone to read legislation before it's passed.  Let's pass this thing, so we can find out what's in it!

And there are no pre-existing conditions or upcharges in ACA.  No one can be denied.  Except that there are, and you can.  And anyone who is upcharged will just not finish the application.  So we are manufacturing a giant adverse selection problem.

I don't think "the state" has a real collective consciousness capable of appreciating irony.  These are just fibs that serve to protect the corrupt individuals who are yelling "Pay no attention to the politicians behind the curtain!"  Nancy Pelosi is NOT a very bad woman.  She's just a very bad leader in a democracy that values transparency.

Next Time, Pick Up a Newspaper

Wow.  Once you have lost the late night comics, you've lost.  This is hilarious, until you realized it's very sad.  People seemed to think that since Obama was a good man and said he cared about them the policies must be good. 

Kimmel gives as a good a public choice explanation of the problem as I've ever seen.
1.  Rational ignorance
2.  Interest groups
3.  Concentrated benefits, diffuse costs.

C'mon honey, let's go check out that Levitra!



Nod to WH

The real problem with Obamacare

Tyler linked to this piece yesterday, but he left out the money quote:


The problem with Obamacare is it’s product driven and not market driven. They didn’t ask the customer what they wanted. And I think that’s the fundamental problem with Obamacare. It meets the needs of very poor people because you’re giving them health insurance for free. But it doesn’t really meet the needs of healthy people and middle-class people.

And of course, without enough healthy, middle class people in the system, eventually the system won't work.

Cheap Networks are Large

Cheap insurance networks are large.

Unless making them large lets sick and expensive people select in.

In that case, it's better to go small.  But THIS small?  That's small.

The solution?  Let vet hospitals treat humans, for cuts and scrapes and broken bones.  You can get a two-fer-one deal, where Paco the pup and Angus the guy both get treated.  No waiting, adjacent exam rooms!

Nod to WH.

Oklahoma Doctors Against Obamacare

With thanks to WH.  To be fair, these Okies may be upset because their vending machines are under attack... I hope they learn a lesson 'bout messin' with a vending machine's jealous man.

Seriously?

The "Get Enrolled!" "ad" for Obamacare.

Questions:
1.  Did they actually think this was a good ad?  Is it a spoof?

2.  Is there any gay stereotype left out here?  Is this as offensive as it seems, to an outsider?  (That's not "out", but "outside"?)

3.  This seems to me to be a reasonable reaction.  But then I have never understood the ability of the left to suppress outrage at outrageous things done by "friends" of the left.

4.  Consider a heterosexual version of this ad, just as revealing and just as objectifying.  Would THAT be okay?  (No, it would not).  So why is it okay to treat gay people this way?

5.  Whatever else is true, these are some mighty attractive young folks.  Tommy TTB, what say you?

ObamaCare Stinks for Young People

With a nod to WH:

Seeking Arrnngement Dot Com: Obamacare Edition

Not exactly safe for work.  But pretty funny.

For Profit Medicine: Blood Work

The other day I had to drive 20 miles to my doctor's office, just to get blood work done.  It took about 3 minutes to draw the blood, but it took me 45 minutes in morning traffic to drive to the facility, then 20 minutes wait, then 45 minutes back. 

Why not just have generic facilities (drawing blood is no more complicated than an oil change) at grocery stores?  Wait....Schnucks!

QOTD: Paradise Lost?

Tyler drops a truthbomb in the NYT:

Republicans will need to recognize that repeal of Obamacare should not be their obsession, because they would then be leaving the nation with a dysfunctional yet still highly government-oriented health care system, not some lost conservative paradise.

Amen. The pre-ACA status quo was a mess, there is no coherent Republican plan out there, and simultaneous control of the House, Senate and Presidency does not appear to be in the near-term cards for the GOP (nor even a veto-proof majority in both houses of congress).

The whole piece is well worth reading.

I am not sure of the procedure for Federalizing Medicaid, but the idea is a good one. Let the rich liberals pay for the poor in the red states!

And I'm already on record as supporting a less comprehensive but still mandatory insurance package.

While we are at it, let's throw in breaking the AMA stranglehold on the practice of medicine. More immigration, less strict rules about who can do what, even more entry into medical schools are all good ideas.

Unicorns, Rainbows, and the ACA

People, the rubber biscuits are out on the table. The Chicago Tribune is incensed that ACA plans with the lowest monthly premiums have the highest deductibles.

Really, they seem amazed that the world isn't made out of unicorns and rainbows, and they go looking for a scalp to put on the wall,

Plans with the least expensive monthly premiums — highlighted by state and federal officials as proof the new law will keep costs low for consumers — have deductibles as high as $6,350 for individuals and $12,700 for families, the highest levels allowed under the law. 

 Insurers say the price and cost hikes result from new benefit mandates, additional taxes levied as part of the law and a requirement that they can no longer deny coverage to people with pre-existing medical conditions. 

 The vast majority of insurance plans for 2014 must include a list of 10 essential health benefits, some of which, like maternity care, weren't necessarily included in all health plans a year ago. The law also includes mandatory coverage of mental health and substance-abuse treatment, prescription drugs and rehabilitative care. All preventive care, including annual physicals and routine immunizations like flu shots, must be covered at no cost. 

 Further, insurers are required to take all applicants, regardless of whether they have pre-existing medical issues that may have locked them out of coverage in the past. And they're prohibited from charging their oldest, sickest members any more than three times as much as their youngest, healthiest members, causing premium prices to rise for many younger people. Costs associated with those mandates are passed along to all members of a health plan. 

Considering those factors, "the rates are actually quite reasonable," said Kelly Sullivan, a spokeswoman for the Illinois health insurance marketplace.

People, not even President Obama can defeat common sense and basic economics. If you increase demand (the mandate and subsidies) and expand the scope of the product (more required benefits), and disallow discrimination, then prices will rise. And if you squeeze the monthly payment down to make it look good, the deductible must rise.

I'm not saying any of the above actions are bad, I'm just saying it's nuts to think they'd be accompanied by lower prices.

I favor mandatory, high-deductible, insurance for everyone. Say a $10,000 deductible plan that covers major injury, illness, etc., just like we have for car insurance. I am less sure, but I think I'd even favor letting each state set the standard of what this bare bones coverage looks like inside its borders, just like we do for car insurance. You'd have to show proof of insurance to get a license, receive benefits, etc.

But instead of subsidizing the policies, I'd prefer to use the EITC or a basic income grant to deal with affordability issues.

ACA: A Jobs Bill for Wealthy Democrats

So, this should surprise exactly no one. The point of ACA was never to take care of sick people, or poor people.  It was to line the pockets of rich campaign contributors to the Democrat Party.  And it's working out very well, for them.

The amazing thing is that our President seems genuinely to be confused between insurance, and health care.  I found this remarkable.  Is he proposing a new program, actual provision of health care?  Surely he recognizes that ACA is an insurance program, right?  As more and more units drop out of the system, health care is going to be sharply rationed.  Maybe that's a good thing.  But you can't possibly believe that ACA is going to increase health CARE options.  It will provide a way to pay for now sharply rationed* health care after all the private options disappear.  Will that be good for poor people? 

Why would it be? As usual, Frederic Bastiat had the model we need to understand what is going on.  From Angry Alex:

"When under the pretext of fraternity, the legal code imposes mutual sacrifices on the citizens, human nature is not thereby abrogated. Everyone will then direct his efforts toward contributing little to, and taking much from, the common fund of sacrifices. Now, is it the most unfortunate who gains from this struggle? Certainly not, but rather the most influential and calculating." (Source)

*Yes, health care is rationed now, and has to be.  But now it is rationed by price.  Soon it will be rationed by queueing.  If that were intentional, and had been explained, okay.  It isn't, and it wasn't.

If A Clearly Causes B, and You don't like B, Don't pick A

If you say you want to solve the problem of B, you should, at a minimum, not do things that make B much worse.  And if it is known that A makes B worse, why choose A?  Here's the problem, as Freddy Bastiat put it:


"When under the pretext of fraternity, the legal code imposes mutual sacrifices on the citizens, human nature is not thereby abrogated. Everyone will then direct his efforts toward contributing little to, and taking much from, the common fund of sacrifices. Now, is it the most unfortunate who gains from this struggle? Certainly not, but rather the most influential and calculating." (I talk about it here, #13)

ACA is a huge festering pile of opportunities to rip off the poor, the old, and the confused.  It hurts the people it was supposed to help.  Why did we do it?

So smart, rich liberals could feel good about themselves.  It has nothing to do with the actual effects.  All that matters is the intent.  Then, when it doesn't work out (as it clearly won't), they will blame greed, capitalism, phases of the moon, everything except the real cause:  an overly complex, impossibly over-directed, attempt at social planning.

It's enough to make you want to break your arm

You might want to break your arm, just to get aholt of some of these drugs.  Apparently.


Now we know what Angry Alex does on weekends...