Oh yes, and let me know if you’d like your blog to be added to the Fat Liberation feed. Cheers!

Perhaps that should be one of my next steps, though unfortunately I have little motivation to do so. I fear that what “we the people” have to say about this issue matters very little, and that the elected officials will do what they want. At that level, it really has very little to do with actually providing care for people, and everything to do with seizing control of a large part of the economy, translating into a very large share of political power. If you don’t believe this, try looking up some of the back room deals that are being made in trade for votes to pass the health care bills – politicians who refused to vote for the bill unless they also got certain deals that benefited their districts.

The politics of this country disgust me more every day. The politicians no longer represent us – they are there to get as much power for themselves as possible. And if anyone thinks that healthcare will be different, they are greatly misled. I work in the federal government (in one of the few areas where the federal government should be involved – defense). There is no way I want the government running my healthcare. I understand intimately how the government works, and what everyone fears about government control will inevitably happen – the cost will be at least 3 – 4 times what it is now (probably more), we will have less services, service will be rationed, bureaucrats will dictate to us what is medically necessary, regulations will not account for individual cases, and yes, I have no doubt that “scapegoats” will be needed – those that can be “blamed” for their own conditions, and therefore penalized in some way by denying services or making necessary services conditional on taking certain proscribed treatments. In the case of those of us who are fat, I am sure we will eventually be targeted for mandatory weight-loss programs, and at the very least strongly “encouraged” to get WLS. And if we don’t lose weight, we will be considered non-compliant, and will be denied anything but the most basic of life-saving services, or will find that we will be penalized monetarily, or other such methods of trying to make us “conform”. After all, we obviously just aren’t trying hard enough.

And believe me, I’m not just worried about those of us who are fat. I’m worried about a whole lot of people if government health care gets enacted in this country. If you care to read it, my blog is http://www.kims-world.net/Blog/

Thanks for commenting, and thanks for following the links. I think your question has a two part answer: one is purely markets, dollars, and cents, and the other is moral.

In dollars and cents, when a market is deregulated that means that players usually have a lot less overhead in order to enter the game. For instance, in Massachusetts insurers are required to offer a particular number of benefits. Not all people use these benefits, but all must purchase them. That drives the cost of the average plan way up. Now, insurance is a risk-rewards game (I mean “game” in the economic sense). If you get enough people in the game who may not utilize all the pay in for, you can afford to take on more people who would utilize more than they pay for. Obviously you would have to have more people paying in than have people who are getting more payouts than payins in order to make the model financially viable or “worth it” for the insurer to get involved.

Now, it’s in the insurer’s best interest to maximize payins and minimize payouts. That’s why people without pre-existing conditions can buy cheaper plans – if you have a pre-existing condition, then (depending on the condition) you’re almost sure to cost more than you’d pay in. In order to balance that out — because insurers do indeed want the money of those with pre-existing conditions — they raise the rates on those plans.

However, a person with a pre-existing condition could, in an unregulated market, pick and choose which benefits they are interested in in order to lower the cost of their more expensive plan. Right now most states require a certain list of benefits to be covered; a person with a pre-existing condition could get a custom plan which allows them to pay in to help defray costs for their condition but not pay for all that other stuff. The plans would probably still be expensive, but less so than now, and could give people with pre-existing conditions a fighting chance to afford their own coverage.

I’m not an insurance expert — I’m mostly interested in complex political/social/economic systems (I research and build computational systems which model these phenomena). So I urge you to get in touch with someone who knows the ins and outs of the system now (and has enough imagination to extrapolate to a deregulated system), and could provide you with more detailed answers.

There are other ways such cases could be covered: foundations to help defray costs through private charitable contributions, an optional tax which would go directly to those who can’t afford healthcare, and so on.

This brings me to the moral question. Should people be forced to pay for the healthcare of others? I don’t think so. I think a system which forces people to subsidize others’ health insurance plans is unsustainable and will lead to the rampant cost overruns and inevitable political scapegoating in order to save money (as detailed above). I also being that kind of compulsion is wrong.

There’s no reason private charity can’t be robust enough to help support the unfortunate health situations of those in the community. Concerned individuals, or those with an interest or stake in the cause, could contribute via optional taxes or, even better, directly. It still might not cover everyone. But that’s the way markets work — there are always a few that slip through the cracks. The idea is to try to set things up so that the fewest slip through the cracks as possible, and creating conditions for health care to be privately offered through many competing entities where people can create custom plans is the best, most stable way to lower costs and hence cover as many people as possible. Charities can be set up to try to take care of the rest.

Sorry if this is somewhat rambly or incoherent, I’m absolutely exhausted after a long day.

Only government can operate in this so-called ‘multi-agency’ capacity, only it has the vast sums needed to build and run immense Orwellian databanks, and the more ‘joined-up’ it gets, the more dangerous for all of us. It’s becoming a nasty horrible world out there; Joe Public wants a scapegoat – someone to blame for why he’s paying more and getting less, and no-one fits the bill right now as well as fat people.

(Did anyone else pick up on the way the child’s broken nose seemed to be framed as ‘losing weight also prevents bullying?’ It’s something I’ve heard stated and implied time and again, even more so since the media picked up the attack on Marsha Coupe a couple of weeks ago. It’s despicable that the threat of emotional and physical violence is increasingly being accepted as a legitimate weight-loss motivator by supposedly educated people and those allegedly concerned with child welfare, without so much as a passing acknowledgment of the dangerous implications of such warped ‘logic’.

I’m hoping you can answer a question for me about healthcare in a free market (I will freely admit to not being an expert on this topic, although I did follow your links to try and sort it out). How would people with “pre-existing conditions” ever have a prayer of getting health care? If you have cancer, how could you prevent your insurance from dumping you when your care becomes “too expensive” for them?
And I read this, but it really isn’t an answer as to how exactly this would save money. “The expansion of “health status insurance” would protect many of those with preexisting conditions.”

Thanks

“Labour’s secret plan to send overweight children to NHS fat camps”

http://www.telegraph.co.uk/health/healthnews/6142249/Labours-secret-plan-to-send-overweight-children-to-NHS-fat-camps.html

Could Blue Cross do this?

I don’t have time to write a lengthy response right now. (Maybe I will later—I’ve a lot to say on this topic.) However, for those who are so fearful of insurance companies (who are not all for-profit institutions, by the way), think about the last time you heard about an insurance company arresting, taxing, imprisoning, siezing property, etc. That’s right. They don’t have the power to do those things. But our governmental institutions do have that right. My healthy fear is of those who have the most power over me.

Poisoning the Well

(oh yes, and the depth of the recent financial meltdown has everything to do with the devaluing of risk — backed by government ratings and promises — and nothing to do with the free market, as it were. Though a free market system will always experiences a cycle of ups and downs with a constant trend up, the market self-corrects both the bottoms and bubbles. It’s when the government intervenes that the market gets distorted, and bubbles get bigger and bottoms get deeper (and wider))