Wednesday, September 22, 2010

For the Health of Our Children

Let the little children come to me; do not stop them; for it is to such as these that the kingdom of God belongs.
Mark 10:14b

Tomorrow, September 23, 2010, marks the official kick-off of The Patient Protection and Affordable Care Act, passed by Congress and the President this Spring to reform America's vastly inefficient and ineffective health care system. This reform, of course, has been lambasted by the GOP, the Tea Party and even conservative Democrats as "Obamacare," "socialist" and, yes, even "fascist." We've noted before and we'll reiterate the tremendous need to provide affordable coverage for the 50 million Americans without insurance and to provide a mechanism to bring down out-of-control costs. In addition, we've noted the meager attempt of GOP leaders to provide any sort of vision (beyond "NO!") for this vital issue in our society. And, lastly, we've predicted that the "reform" that eventually was (narrowly) voted for by Congress and signed by the President is inadequate for how gigantic this issue really is. We advocated for a Medicare-For-All program that would truly reduce costs AND cover everyone. However, (as we've noted before) it will, at the very least, provide coverage for some of our most vulnerable members of society. That matters.

Here's what kicks in TODAY and forever (unless GOP leaders succeed in getting "Obamacare" overturned):

--> Insurance companies can no longer deny coverage to a child without health insurance because he or she has a pre-existing health condition.

--> Young adults can begin signing up to stay on their parent's insurance until age 26

--> Insurance companies will be required to cover preventive care, including immunizations, at no cost to the family

--> Insurance companies won't be able to drop children when they are sick, or limit the lifetime value of coverage.

--> Families will be able to use a Web site ( or or call a toll-free number (1-877-KIDS-NOW) to learn about health coverage options available to them-whether it is a publicly subsidized program like the Children's Health Insurance Program (Healthy Families in California), Medicaid, employer coverage, a state's High Risk Pool, or, after January 1, 2014, the state's health insurance "marketplace" called the Exchange.

Health care (or lack thereof) is an important "family value." Free market fundamentalists who claim that "government has never done anything efficiently" are overlooking the vastly lowered costs and the universalized coverage in places like Canada, the UK and Scandanavia. Sure, those systems are not perfect but they are rated much higher than the US in health care studies and surveys (not very good for the only superpower on the planet for the past two decades).

It is important for us to get the word out and let families know that their medical care may greatly benefit as a result of this recent legislation and it is vital that we hold our political leaders accountable for keeping these benefits in place and building upon them. If they are working to overturn this legislation, we need to ask what, in fact, they will replace it with to insure more Americans and cut costs. When it comes to health care, the status quo is not acceptable.

--Theological Autopilot


  1. Rumor has it you teach economics in a high school. Here is a question you can ask your students on an exam:
    If a government passes legislation aimed at preventing health insurance companies from discriminating against children with preexisting conditions, how will insurance companies respond?
    A) Comply with the law without increasing premiums.
    B) Increase premiums to cover higher projected costs.
    C) Stop offering plans that cover children altogether.
    D) B and C

    As a bonus question you can ask:
    To the extent that some families with children cannot afford health insurance because they cannot afford it or because their children have preexisting conditions, what predictions can you make about the social welfare effects of the Patient Protection and Affordable Care Act of 2010?

    A super bonus question:
    Are the effects you predicted either Pareto efficient or Kaldor-Hicks efficient?

  2. Fred B...all the rumors are true. I do teach high school economics. The CA State Standards do not, however, cover the Pareto efficient or Kaldor-Hicks efficient so I am not aware of what you are referring to. As far as your others points (which you creatively framed in questions for my students), I'm not sure that I would disagree with anything you wrote (although my hunch is that we are coming from quite different theological and socio-economic perspectives). My simple point in this post was that some (italized) vulnerable patients will (italized) benefit from this far-from-perfect law and that we should communicate this message so that these vulnerable patients can know about it. EY had advocated and hoped (and prayed) for a single-payer plan (or at least a public option) that would/could function as it does in other economies (lower costs and universalize coverage). Truly, insurance companies, by their very nature, exist to make as much profit as possible without regard to the real "health" of their clients. What would you envision is our solution to the current US health care quagmire: 50 million uninsured and rising medical costs?

  3. I see the point you are making in your post (inform the “winners” that they can collect on their benefits). Yes, we should tell families in need how they can best take advantage of the new law to their benefit.

    As for your hunch about my theological and socio-economic perspective, I’m not sure how that matters because my questions are fairly agnostic and use only elementary tools of economic analysis (incentives, opportunity costs, and efficiency). If there is any agenda to my questions, though, it would be that there will probably be “losers” from the new law as well. A cost-benefit analysis that only considers positive welfare benefits for the winners without regard for the potentially devastating welfare shocks to the losers is no cost-benefit analysis at all. It is just a benefit analysis.

    We both agree this law is far from perfect, but is it worth having at all? What if this new legislation allows 10 families that have children with preexisting conditions to now buy coverage but at the same time prices 11 families who previously had coverage out of the market due to higher premiums? Would you still say “…it is vital that we hold our political leaders accountable for keeping these benefits in place and building upon them?”

    As for my answer to this quagmire I think that is another post altogether. I do not claim to have an answer, but I do know from personal experience that single-payer has its share of problems as well. I moved to America for many reasons, and health care options for my family was one of them.

    On a final note, you should at least read the Wikipedia entries for Pareto and Kaldor-Hicks efficiency. They are the most basic standards for comparing legislative policies and Pareto would be taught in the first semester of any college-level introductory economics course.

  4. Fred B, the US physcologically cannot tolerate a pareto efficient outcome when it comes to health.

    Easy Yolk, you unfairly characterize the GOP position as wanting to overturn everything Obamacare does. Generally everyone agrees that some general safety net like covering individuals with pre-existing conditions is important . In fact, even if the GOP was able to repeal this bill they would keep that important provision. (I sure you read the GOP "pledge" first thing this morning).

    So given 25% of children already have entirely free health care through medicaid, we now agree that the non-poor with pre-existing conditions should not be denied coverage. It is not clear to me who the remaining "vulnerable patients" are? It is hard to justify the major cost increases that will result from this bill if it does not truely help vulnerable patients.

  5. Jon, you are right that the US can not psychologically tolerate a Pareto efficient outcome w.r.t. health insurance. Since Pareto assumes the prior distribution and utility functions as given, it's hard to imagine any health care change in the US (no matter what it is) being anything close to Pareto efficient!

    But I was not implying the US should seek a Pareto efficient outcome. Perhaps Kaldor-Hicks (despite its shortfalls) would be more "reasonable"? We could use Kaldor-Hicks to address your question about cost increases while not simultaneously helping vulnerable patients.

    I merely suggested the Pareto question for Easy Yolk's students -- a fairly "standard" question for economics, no? At least it gives us some common ground to have a conversation, and for the future I would like to be able to have a conversation with an economics teacher using, well, economics.