Lion of the Blogosphere

Robert Frank endorses “Medicare for all”

Robert Frank, an economics professor from Cornell whom I respect quite a bit and I have mentioned many times before in my blogs (and he may even be a secret believer in HBD) endorses “Medicare for all” in a New York Times op-ed, and I agree with it.

Written by Lion of the Blogosphere

March 25, 2017 at 10:06 am

33 Responses

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  1. What is the difference between Medicare for all, and Medicaid for all?

    When my income dropped & Obamacare kicked in I got put on Medicaid. I was devastated. That’s for poverty cases with rotten teeth.

    I ended up with the best medical care I ever had. Of course, I recognize that in NYC I am in a way different situation than other states.

    All of my doctors are affiliated with either Columbia U Medical Center or Northwell (formerly North Shore LIJ). They are all top flight. They all take Medicaid.

    gothamette

    March 25, 2017 at 11:35 am

    • A local nurse told me the care at the county public health clinic was excellent and they are always staffed up to see you. And they take insurance. So, one time when I’ll I sat in a waiting room full of clearly poor NAMs, gave my insurance, and had a perfectly decent health care experience. The only real irritant was the place was named after one of our ever increasing # of national black heroes.

      Curle

      March 25, 2017 at 5:35 pm

      • Right, it’s not the Medicaid, it’s the patients.

        Lion – did you know you can get excellent dental care at NYU School of dentistry, and the state optometry college does a better job of checking your eyes than private practitioners.

        “increasing # of black heroes” – see,

        https://www.google.com/search?q=american%20inventors

        gothamette

        March 25, 2017 at 11:15 pm

    • “What is the difference between Medicare for all, and Medicaid for all?”

      Have you ever noticed that you never hear the left clamoring for Medicaid for all? Since Medicaid has no premiums, co pays, or deductibles, it’s truly free healthcare (from the consumer point of view). Meanwhile regular Medicare has a 80/20 cost share. I think they don’t like Medicaid as the basis of a national healthcare plan because unlike Medicare, states have to pitch in for the cost (not counting the expanded Obamacare version). I was on a forum discussing the late, unlamented Ryan plan, and how it weans off Medicaid funds to the states with a different formula over the years. Some left leaning poster complained that means the states would have to raise taxes!

      A fully federal plan is paid for by deficit spending, so no one is really paying for it (yet) but the states have to tax real money to pay for things.

      And that’s how you defang the left. A balanced budget amendment that forces real taxes to be raised to pay for things on the federal level too.

      Mike Street Station

      March 26, 2017 at 7:58 am

      • “Have you ever noticed that you never hear the left clamoring for Medicaid for all? ”
        No, and that’s why I asked. Thanks! I’m in favor of Medicare for all too, now, because something in my gut said that Medicaid for all would bankrupt the country.

        Oh wait, we’re already bankrupt.

        Of course you’ve depressed me because you’ve told me that when I reach Medicare age (if I do), my healthcare costs will go up.

        gothamette

        March 26, 2017 at 1:33 pm

      • “Of course you’ve depressed me because you’ve told me that when I reach Medicare age (if I do), my healthcare costs will go up.”

        Well you have options. You can get a supplemental plan or get a Medicare Advantage plan. Ironically, Bernie Sanders has a Medicare for all bill out and my Facebook timeline is filled with shrieking for it. However I wonder if Trump counter offered with Medicaid for all if they would be all that interested in it.

        Mike Street Station

        March 26, 2017 at 6:12 pm

  2. Not for 1 meter falls

    Definitely for 3 meter and up falls

    What I am talking about is logarithmic escalations of harm – yes cover for all.

    No support for Bandaids.

    Anonymous

    March 25, 2017 at 11:44 am

  3. Here are some concrete issues the mess up the cost of Healthcare:

    -illegals who get care

    -the poor in general who game the system

    -the AMA (the guild-union for doctors) suppressing the number of MDs and med schools for *centuries* and preventing others (like NPs) from practicing

    -malpractice lawyers

    -hugely expensive end of life/ICU treatments for people who aren’t paying for it and will kick the bucket at the same time regardless

    -a country of fat-fuck consumers/labor units instead of lean and mean citizens.

    It’s time people learn that medicine and doctors can rarely cure you. You can get drugs to control your BP/cholesterol and a surgeon can fix your bones, divert your arteries, etc.

    But we’re all going to get sick and die, doctors are just egotistical shlubs getting through the day, and prevention is worth more than “cure.”

    Like most every other problem or issue, the answer isn’t some policy, really. The answer is a better populace. But America is a dysgenic dystopia that subsidizes the stupid over the smart, and the old over the young.

    fakeemail

    March 25, 2017 at 12:09 pm

    • And the role of a 3rd payer (besides the patient and the doctor/hospital), is a cause/symptom of the fucked up system and further inflation of medical prices. An insurance company or the government getting in this process (except in the most minimal way to protect against fraud) just exacerbates the fucked-upness of it all.

      fakeemail

      March 25, 2017 at 12:14 pm

    • Re: the AMA limiting the number of physicians thing.

      You beat me to the punch, man. This will HAVE to be addressed if we want to solve our healthcare woes.

      Stealth

      March 25, 2017 at 10:37 pm

  4. You should read The Affluent Society by John Kenneth Galbraith he hit on all the big issues that Frank did in the Darwin Economy but with much better writing, a more coherent overall thesis, and in 1958! It’s a brilliant book.

    Magnavox

    March 25, 2017 at 12:47 pm

  5. Frank is very misleading in saying that single payer leads to lower costs. There are plenty of other countries without single payer that have much lower costs than the US. What they all have is government price controls.

    If Medicare weren’t allowed to set prices (it’s not really negotiation with a complete monopsony) then we wouldn’t expect to get dramatic price reductions. So he’s putting the focus on the wrong thing.

    Magnavox

    March 25, 2017 at 12:54 pm

    • “What they all have is government price controls. “

      Price controls lead to shortages. There’s really no way around that pesky old law of supply and demand.

      destructure

      March 25, 2017 at 6:30 pm

      • We have price controls for water, natural gas, electricity, and steam all without shortages. Other countries also have them for health care, cable television, and internet similarly without shortages.

        Part of the problem is people draw some stupid graph in freshman economics and forget that they didn’t actually learn anything about the real world.

        Magnavox

        March 25, 2017 at 9:34 pm

      • “We have price controls for water, natural gas, electricity, and steam all without shortages.”

        I don’t know anything about steam. But the others have had shortages in the past. And still do from time to time. And that’s with resources that are inexpensive and abundant.

        That’s not the case with health care. Medicare can negotiate price cuts without shortages (up to a point) because the costs are shifted to other customers. But who will they shift the costs to when everyone is on Medicare?

        destructure

        March 26, 2017 at 1:32 am

      • “That’s not the case with health care. Medicare can negotiate price cuts without shortages (up to a point) because the costs are shifted to other customers. But who will they shift the costs to when everyone is on Medicare?”

        That’s why I think all of these imaginary cost savings from single payer are nonsense. There is no one left to cost shift to.

        Mike Street Station

        March 27, 2017 at 6:36 am

  6. I’ve pretty much come around to this too. With the government already paying 60% of the nation’s medical bills, it doesn’t really seem like that big a deal anymore.

    You would have to get a handle on illegal immigration. You know the courts will rule anyone living in the country is entitled to care. I think you’d also have to have some way to address Medicare fraud, which is largely ignored in the whole debate, but is around the same size as the “evil insurance company profits” we hear so much about. Note for example the otherwise good Op-Ed makes no mention of the extent of fraud. I particularly like his opinion that supplemental insurance and premium care should be allowed. This will keep doctors happy and put more money into the system

    I hear murmurs of acceptance on the right. Charles Krauthammer seems to think it’s inevitable. Derb is aboard, as he talks about in his latest Radio Derb. A couple of recent posts at National Review even seem to hint at acceptance. It’s going to happen, Trump should just go for it and get the credit, which in the end will likely be Huge.

    steve@steve.com

    March 25, 2017 at 1:04 pm

  7. Lion – if you could set the dollar amount of UBI per capita, at what amount would you set it?

    anon

    March 25, 2017 at 1:08 pm

  8. Is there nothing Big Government cant do!

    Lion o' the Turambar

    March 25, 2017 at 2:10 pm

  9. Lion I remember mentioning Robert Frank to you sometime ago (under the name “Gurney Halleck.”). I like his work and I think the “libertarian” critique of it has been ineffectual, especially the libertarian critique of “The Darwin Economy.” He makes a really good case for progressive taxation.

    dunefan85

    March 25, 2017 at 2:49 pm

    • So, those Bryan Herbert / Kevin J. Anderson books…. Your thoughts in ten words or less, please.

      Stealth

      March 25, 2017 at 10:39 pm

  10. Socialists used to claim that controlled economies were better than free markets. Yet controlled economies always lag and end up collapsing. So they changed tack and started claiming there was something “different” that prevented free markets from working in certain industries. Just more of the same socialist baloney. It’s a mental disorder.

    https://www.theatlantic.com/business/archive/2012/03/liberals-are-wrong-free-market-health-care-is-possible/254648/

    http://www.heritage.org/health-care-reform/report/compelling-evidence-makes-the-case-market-driven-health-care-system

    destructure

    March 25, 2017 at 3:30 pm

    • You do realize that our economy is completely controlled? There’s nothing free about the US economy.

      Don’t argue with me, argue with Dwayne Andreas, one of the legendary CEOs a/k/a, influence peddlers.

      http://www.motherjones.com/politics/1995/07/dwaynes-world

      “Sitting behind a lunch of soy burgers, soy taco meat, and soy cheese dessert, Andreas announces that global capitalism is a delusion. “There isn’t one grain of anything in the world that is sold in a free market. Not one! The only place you see a free market is in the speeches of politicians. People who are not in the Midwest do not understand that this is a socialist country.”

      I really liked old Dwayne. He was an honest guy.

      gothamette

      March 26, 2017 at 1:38 pm

  11. This is so much a no-brainer for Trump it’s driving me crazy that I don’t have a seat among his circle of advisors. He needs to back “Medicare for all.” If it doesn’t pass under his administration, it most certainly will under a subsequent Democrat administration. But if he gets ahead of it, he can wear it as an achievement, and might even buy him a second term. Rank and file Republicans are not as opposed to this as one might believe. Most business owners, small to large, and the self-employed, and these are mostly Republicans, are going to be pro-single payor Get a room full of Republicans to discuss this, and at least half are going to be very open to it.

    Kosher Kowboy

    March 25, 2017 at 6:49 pm

    • He needs to back “Medicare for all.” If it doesn’t pass under his administration, it most certainly will under a subsequent Democrat administration. But if he gets ahead of it, he can wear it as an achievement, and might even buy him a second term.

      Yes, absolutely! If “Medicare for All” can get implemented on Trump’s watch he will go down in history as one of the great U.S. Presidents (and I’ll be able to retire early!) But he’s only got 45 months to do it because Trump will not seek a second term.

      E. Rekshun

      March 25, 2017 at 7:54 pm

  12. Medicare for all may be inevitable, but don’t kid yourself as to its weaknesses.

    Medicine or health care is subject to three absolutes.

    1) We are not going to let people die due to lack of health care (note: this is absolutely true-for emergencies. It is illegal for any healthcare facility to provide emergency care. This is why emergency rooms have become de facto primary care clinics for the poor-they can’t refuse to treat).
    2) If you let people choose their health care, some will choose poorly (i.e. either poor plans, which don’t protect their money, or no plans at all. Both choices make everyone else pay for their health care).
    3) If you provide universal health care, under any guise, it is in effect government-provided care. And government provided anything sucks. This is because if nobody has skin in the game (if nobody ‘owns’ anything in the game, they don’t care about it). So their performance suffers. This was recognized by Aristotle, and is an immutable truth.

    You can prove this with your experience with the US post office. The US post office was a government provided monopoly for a long long time. Nevertheless, UPS and FEDEX arose. Why, if government services are so good? Because they weren’t so good.
    If government service isn’t good enough for you to ship your Christmas presents to your mom, why do you think it will be good enough to provide you with heart surgery?
    Similar with public schools. If government provided education is only good enough for the lower and middle classes (but anyone with enough money sends their kids to private schools), why do you think government provided eye surgery will be the best?

    Back to the point: we won’t let people die if health care would save their lives, we can’t let people choose their health plans because many won’t choose wisely, and thus we have to dictate people’s choices, which will result in systemically poor care. That’s just the way it is.

    anon

    anonymousse

    March 26, 2017 at 9:21 pm

    • “You can prove this with your experience with the US post office. The US post office was a government provided monopoly for a long long time. Nevertheless, UPS and FEDEX arose. Why, if government services are so good? Because they weren’t so good.”

      The purpose of the post office is to bring mail to everyone for an affordable price. Even to out of the way places like rural Alaska. Try to mail something Fedex or UPS for only 49 cents.

      Lion of the Blogosphere

      March 26, 2017 at 10:06 pm

      • Thanks for this blog post, Lion.

        Among the comments at the NYTimes article you linked, someone stated the obvious, that Republicans had eight years to come up with a reasonable plan to repeal/replace ACA, but now are flummoxed rather than prepared.

        It then occurred to me that the Republicans could have been working with Democrats to bit by bit add ever more classes of people to Medicaid which would render the ACA rather redundant and ripe for even more expansion at the same time the Republicans could with great fanfare now completely repeal the ACA with little consequence to the people affected. Surely allowing people to access Medicaid has to be cheaper than paying their expensive private insurance premiums for them. Sadly, the Reps had to be the stupid party.

        no too late

        March 26, 2017 at 10:29 pm

      • The purpose of the post office is to bring mail to everyone for an affordable price.

        Yes. And similarly, the purpose of universal health care is to bring health care to everyone for an affordable price. Try to get a hernia operation on a strawberry picker’s salary.

        The purpose of the public school system is to bring education to everyone for an affordable price (in this case, free). Try to get a high school education on a nurse’s aide’s salary.

        How does this address or affect my argument?

        anon

        anonymousse

        March 27, 2017 at 4:35 am

      • The Post Office runs at an operating profit.

        Your argument seems to be that anything government does is a waste of money, Post Office examples shows you are wrong.

        Lion of the Blogosphere

        March 27, 2017 at 9:44 am


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