Comment by tmorton | Hacker News Reader

Comment by tmorton | Hacker News Reader

Parent Full thread

Nothing, including capping Medicare, will "work" if you mean "provide all possible health care to seniors."

Medical science is wonderful, but it's moving faster than the overall economy - the things we can do are advancing faster than our ability to pay. There will simply be too many old people, with too many health problems, to provide top-flight treatment to everyone. Someone will have to tell them "sorry, you don't get that procedure." The only remaining question is: will that decision maker be a health insurance company, a government official, or the health provider refusing to work without payment.

Seniors, and their children, will loudly demand that the government pay their health bills, no matter what the economic wreckage. That's why we need to lay the political groundwork now. Pundits, economists, and anyone else who can understand the situation should be repeating loudly and repeatedly: Health care is not a right, because it can't be. All of us will die, eventually. Most of us will die even though a treatment exists that could have extended our lives a bit. We need to get used to that fact.

> Health care is not a right, because it can't be.

If that's meant to be justified by what went before it, then I think you've overstated it. As long as many effective treatments are very expensive, health care that includes every treatment a person might reasonably want can't be a right.

It's perfectly possible for some health care to be a right. And if by some miracle (and it would have to be a miracle, or something very like one) all the costs came way down, it would be possible for all the health care one could reasonably want to be a right.

The second of these points is, at least for the foreseeable future, merely a quibble. The first is not. It is entirely possible to make some health care -- quite a lot of health care, in fact -- into a right. That's how things are in the UK, for instance, and despite the attempts of some in the US to portray our health system as a disaster, I don't think I know anyone in the UK who doesn't strongly prefer the UK system to the US one.

(I'm taking "right" to mean "thing guaranteed by law" rather than "thing to which one is morally entitled". I take it that was your meaning too.)

Health care is just another example of the "The government owes me something" mentality. We do not need another government program that will only increase in cost that will never go away once it is started.

"I am for doing good to the poor, but I differ in opinion of the means. I think the best way of doing good to the poor, is not making them easy in poverty, but leading or driving them out of it." - Ben Franklin, 1766

I agree with you, health care is not a right, and did not mean to imply that somehow Medicare could be made to work if proper econ principles were addressed. I was just pointing out the theories and implications behind the example of a seemingly simple choice as "cap Medicare".

Also there are important historical questions like how did we get to this point -- something traditional MSM like the NYT has been horrible at explaining. These political issues are raised mid-stream (e.g. how do we cut spending or raise taxes to balance the budget) without any context or question of causes. For example, the other issue I mentioned, income tax exemption for employer-provided health insurance, arose from a prior policy of wage and price controls during WWII. Employers were banned from offering higher wages so they offered non-taxable benefits as a substitute as a means to circumvent the controls and effectively raise wages. The point here being that capping Medicare will be a failure like capping prices and wages during WWII and lead to all kinds of unwanted effects, including further increasing the complexity of the tax code and the government intrusion into our lives.

I also agree that irrational and impossible demands on the government will continue until "economic wreckage" puts an end to it. If we somehow "solve" the budget crisis through some combination of tax increases and spending decreases, but people continue to believe that the government is Santa Claus, then any such solution will be temporary at best. Given these socio-political realities, the end point, in my judgment, is hyperinflation and the destruction of the dollar. I sincerely hope that I am wrong.

Edit: Spelling

Reply on news.ycombinator.com