Wednesday, November 06, 2013

Men and women paying the same premiums: but It's GUY-necology, not GAL-necology!

Under Obamacare, men and women will pay the same premiums. Fox News has decided that this is unfair on teh mens, as they don't have babies and therefore go to the doctor less.

Let's get over the libertarian hurdle first. There may be libertarians who believe that the babies are for the woman, rather than for society as a whole, and therefore the woman should pay. I would ask all three of you who believe this to consider an even more libertarian view, which is that the baby isn't a project for the individual woman, but for itself. Babies should pay for themselves. And since 51% of them are boys, that's a lot of OB-GYN costs per boy they need to make up when they start earning the dough.

Stephen Colbert supports Fox in this issue, of course. If women go to the doctor more, then they should pay more. He showcases some choice Fox talking points. I have had to remove the video from this blog as it autoruns in an annoying loud fashion, but you could check it out at his website http://www.colbertnation.com/the-colbert-report-videos/430200/november-04-2013/obamacare-s-gender-blind-premiums

Partial Transcript:
8/27/2013:
DR. DAVID SAMADI: That's not a really fair system.  She sees her doctor all the time.  When was the last time you went to see your doctor?
BRIAN KILMEADE: Two years ago.
DR. DAVID SAMADI: Exactly.  And you?  Last week.
GRETCHEN CARLSON: I've had Lyme disease for the last 10 days, so....
DR. DAVID SAMADI: That's what happens.  So you're basically paying for her.
Yeah, that's what happens.  Women get bitten by an insect, they get Lyme disease.  A man gets bitten by an insect, he becomes a superhero. [Shows picture of Spiderman.]
Jokes aside, I love the breathtaking insouciance with which the talking head dismisses Lyme Disease as a woman's issue. I don't know if he didn't hear her, or whether he just assumed that she would say "OB-GYN checkup" and marched on, or whether he just didn't care as long as he could talk over her to make his stupid point.

I also loved the earlier remark that free birth control only benefited women - it had no utility for young men. If this is true, young men have changed since I was a young woman.

One major problem is, of course, that it isn't "health insurance". Insurance is like earthquake insurance. 10,000 people buy it for $100 each, a quake happens and two houses fall down. The insurance company gives them $250,000 each and pockets the rest.  Healthcare doesn't work like that - it isn't, and can't ever be, a Free Market, as you can't vow to just do without it, unlike a Lamborghini or a second home in the Catskills. You also can't shop for best prices, particularly in the back of an ambulance after a car goes straight through a crossing and breaks your legs without deigning to stop. Healthcare costs will eventually eat all the money going into it, which is why a single-payer system works best.  Somebody is going to pay, and it's better to endow that body with sufficient clout to negotiate for standard prices and monitor for better outcomes - like a government.  Calling it "insurance" and forcing everyone to buy it on their own behalf is a silly, mixed system.

But it's oh-so-much better than the previous system where some people got "insured" and some people didn't. And the ones who didn't quite often ended up bankrupt - and their remaining bills were paid by us, in the guise of increased premiums. This is quite literally the worst of all worlds.  Untreated sick people, bankrupt people AND other people have to pay for it. The mind boggles as to how this ever came about. Obamacare is such a win compared with the baseline.

Some people are going to say, "Of course you think that way - you're old, and you want me to pay for you. I don't need insurance." Well, first, Mr. Chivalry, thanks for the assessment. Second, I would be happy for my "insurance" to coexist with your literal pay-as-you-go service - which I believe the US had a hundred years ago. I have a modest proposal. If you go to the doctor, you pay him or her. If you don't go, you don't pay. But to avoid the I-don't-need-no-insurance brigade from becoming scroungers dependent on my money, this system would have to include hospitals. If you turn up at the emergency room either because you didn't take preventive care, or because you developed an acute condition, or because of an accident, the hospital should first x-ray your pockets. If you have either an insurance card or a credit card, they admit you. If you don't they push your gurney into the parking lot and phone your next of kin. Next of kin arrives with a bag of cash, and you're admitted, assuming you're still alive. Treatment continues until bags of cash/and or credit card runs out and then you're discharged - into the parking lot, sans gurney.

I think after a few evening news items featuring dead telegenic young mothers, handsome young motorcyclists with soon-to-be-fatal brain bleeds and little children with skunk bites banging on the hospital doors to no avail, and a single payer system will be well on its way.

Edit: For a description of an even better way to ensure no-one has to pay for other people's healthcare, here's an update.


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