10/30/2008
 Independence Day II
By John Tillman, CEO
This Election Day each candidate has flaws, but they each represent a different view on whether the Founders’ vision and values should be affirmed or rejected. If rejected, what will be the new vision and values for America?
One
choice will affirm the Founders and the seeds that were planted by the
generations that preceded them. The seeds of Independence were sewn
year after year from Jamestown to Plymouth and every place that
followed. Those seeds--liberty, autonomy, free will, independence,
optimism, self-reliance--were planted each time a ship sailed into a
New World harbor and a man, woman or child set foot on dry land.
The
settlers lived, died and progressed. They adapted. By 1776 they had
grown used to their liberty, their autonomy, their self-reliance. They
enjoyed their independence. And they prospered as did the American
born generations and new immigrants that followed.
New seeds
were planted in the 20th century, especially during the 1930s, 60s and
70s. These seeds represent different values. Dependence.
Victimization. Envy. Resentment. Retribution. Coercion. These seeds
always existed, but some people began to see the government as the
instrument to fix our social ills, which starkly countered the
Founders’ notion of government’s role.
On Tuesday we
will choose. Will we affirm the Founders’ vision of independence,
self-reliance and voluntary cooperation? Or will we affirm a vision of
dependence, collectivism and the primacy of the common good, even if it
requires the coercive use of power?
For more on the theme of the upcoming historic vote, take a look at the commentary by Daniel Henninger in today's Wall Street Journal.
Questions? Comments? Like to get involved? E-mail John Tillman at jtillman@illinoispolicyinstitute.org.
 Beware of Simple Solutions
By Greg Blankenship, President
In a recent Health Affairs commentary, two Harvard Professors, Katherine Baicker and Amitabh Chandra, address some "Myths and Misconceptions About U.S. Health Insurance."
They discuss five myths surrounding the simple fixes for health care
often proffered by politicians and the chattering classes (that would
be me). The article is a must read for anyone trying to wrap their
head around the issue of health care reform--especially if that is the
vote-moving issue bringing you to the polls next week.
For those who don't have time, let me try and give you a "Readers Digest Version:"
"Myth 1: The Problem With The Health Insurance System Is That Sick People Without Insurance Can't Find Affordable Policies."
Leave
it to economists to point out that when you get sick you no longer need
health insurance, you need to see a doctor. This is a problem if you
are poor and have no insurance. This is what social insurance (Medicare & Medicaid)
is supposed to address. Yet associated costs cause problems with this
route, including costs, loss of innovation, redistributive issues (more
of a normative issue), and inefficiency. The challenge for citizens is
figuring out how much of the costs we are willing to accept and how
many benefits we will distribute.
"Myth 2: Covering The Uninsured Pays For Itself By Reducing Expensive And Inefficient Emergency Room Care."
Actually, people with health insurance spend more than those without health insurance--despite emergency room care. The RAND Health Insurance Experiment
-- the largest ever in social science -- found that people with more
generous health insurance coverage (low deductible, comprehensive care)
spent 30% more than those without insurance.
"Myth 3: Lack Of Insurance Is The Principal Barrier To Getting High-Quality Care."
Not
even close. Even among Medicare beneficiaries, geography is the
biggest determinant of quality care. There is no association between
higher health spending and mortality, either. Just like our Collin
Hitt will tell you with education spending, there is just no
relationship between spending and outcomes.
"Myth 4: Employers Can Shoulder More Of The Burden Of Paying For Health Care."
Nope.
Your employer-provided insurance is part of your compensation. When a
business hires it does so based on the total costs of an employee, not
just wages. One of the reasons for the apparent wage stagnation among
the middle class is that gains in wages have been eaten up by higher
health costs.
"Myth 5: High-Deductible Health Plans And Competition, Not Government Action, Are The Keys Lower Costs.”
It
helps the symptoms, but isn't necessarily the cure. The
high-deductible plan isn't the right model for everyone. Different
people are going to have different needs, and developing more
sophisticated products that can distinguish from these differences will
make the difference.
In the end, say the authors, meaningful
health reform means getting those who need insurance access to it and
improving the quality of care for those who have it already. It's not
a simple task. |
