Ebola and insuring everyone

If Ebola doesn't convince you that we need everyone in the country to have no-cost health care coverage, I don't know what will.  Even if you're extremely libertarian.

Imagine you come down with some symptoms of Ebola. Here's a handy infographic describing them:

So let's say you have the day 7-9 symptoms of "headache, fatigue, fever, muscle soreness". No big deal, right? Probably just the flu. You would go to the doctor, but you're uninsured, so it would cost maybe a hundred bucks. So you don't go. And you continue going to work because you'll lose your job if you miss work and you don't have a doctor's note.

You infect everyone at your job. With Ebola. If you had gone to the doctor and he had recognized the symptoms, you would have been put in isolation, and no one else would have been infected.

This isn't just a hypothetical situation. There are plenty of people in America who get very sick and don't go to the hospital because it will ruin them financially. And this happens to the detriment of everyone in society.

It's a net positive for everyone for people to feel free to get medical aid. If we could spend a billion dollars of taxpayer money to prevent a virus from killing millions and disrupting global commerce, it would be a no-brainer. So even if you're looking at it from a self-centered, "I want only what's best for me" standpoint, insuring everyone makes sense.

A 1993 study said it would only cost an additional $856 per person in taxes to give everyone health insurance. Isn't it obvious that this is the way we should go?

Why the future is scary

I just turned on my TV.  "We Bought A Zoo" is on.  I'm thinking, this is probably a decent movie.  I seem to remember that it got good reviews, and it's got Matt Damon, who is usually in good movies.

It's certainly not the best movie that I could be watching right now.  I have a list of movies that I absolutely need to watch, and it's not on that list.  So if I were operating like a computer might operate, I would find the most important movie to watch and watch it right now.  And then, next time I had enough free time to watch a movie, I'd watch the next most important movie on that list.  And so on.

But here's the paradox: if I did that, I absolutely would not be able to appreciate the movies that I watched.  My great-movie receptors would be too saturated and I wouldn't even care any more.

To appreciate things, you've got to cleanse the palate and get back to a neutral state.  You need to have non-peak experiences in order to have peak experiences.  But I don't think most people appreciate this.

People claim that they want "the best of everything".  You would get NO satisfaction from that.  You need to experience average for a long time to reset your good-receptors, so you can appreciate great.

What worries me is that we're going to have access to so much instant-satisfaction stimulation in the future, and we won't know how to deal with it.  We'll think that constantly bombarding ourselves with the best movies, TV shows, food, youtube videos, etc. will make us happy.  And when it doesn't we'll think there's something wrong with us.

American free-market health insurance is a disaster

Health insurance companies have become useless bureaucracies set up to complicate a transaction. They are not competing with each other on price or service. They don't have to. They have the country carved up into regions, and there's usually only one or two options available per region.

Doctor's offices have to hire people to interface with the insurance agencies. Their entire job is to persistently hound the insurance companies to get them to pay off claims. An inefficiency (overly restrictive acceptance criteria for claims) gets turned into a job.

And on the other side, there are people who work for insurance agencies whose jobs it is to find ways to avoid paying for claims.

And then health care providers negotiate privately with these agencies to charge absurd fees for things. Seen an ER visit bill lately?

So the prices we pay for insurance go up, but there's nowhere else for us to go; it's expensive-ass insurance or be uninsured.

Conservatives think that the free market will fix the health care cost-benefits problem. And it might, in a way that I can't currently imagine. But the current system, with medical prices rising every year because of the lack of competition, is simply a drain on our economy.

Insurance is an easy thing to provide when you're providing it for lots and lots of people. You simply observe the average amount of money people pay for health care in a free market, and charge slightly above that. You're guaranteed (to a 99.99% level) to make nearly the exact profit you set out to make. Law of large numbers, right?

But you can be undercut by someone else who's willing to make less of a profit. So you differentiate yourself. You think, why not just own a bunch of good doctors? Then we could have our patients go to doctors we choose who set rates we decide. Those rates will be lower, so we can charge less.

Now the insurance companies own the doctors and people have to effectively choose which company's doctors they want to use. But they don't really get to choose, because in the meantime congress made it so companies can give health insurance as a non-taxed benefit, so people get whatever insurance the company they work for has. So now you've got a market where the consumer has absolutely no say in where the product he has comes from.

There is no consumer benefit to the health insurance company system. There are massive drawbacks. There is no meaningful competition. Most regions are monopolies.

But insurance is necessary for health care. It is unreasonable to ask people to save enough money to cover an expensive medical procedure. And it is unreasonable to ask people to not require expensive medical procedures. Insurance is a good thing when properly used. It is a tool to allow people to pool risk, so the occasional devastating disaster can be averted. This benefits everyone; can you really say that it's a good thing that someone goes bankrupt because they had a treatable medical condition?

So we need some form of insurance. The only thing is, I don't see how the free market can provide this insurance without denying agency to the true free-market participants in healthcare: the patients and the doctors. The free market simply doesn't work for necessary insurance for an inelastic good.

With that in mind, I've reluctantly concluded that the best solution is single-payer healthcare. I don't trust the government to do it well. I think it may lead to less innovation. But honestly I don't see how they could make the on-the-ground medical situation for most of the US population worse than it is now: fearful that you'll get some injury or disease because it will bankrupt you.