I became insane with long intervals of horrible sanity.
Edgar Allen Poe

The trouble with fighting for human freedom is that one spends most of one's time defending scoundrels. For it is against scoundrels that oppressive laws are first aimed, and oppression must be stopped at the beginning if it is to be stopped at all.
- H. L. Mencken

Many people would sooner die than think; In fact, they do so
-Bertrand Russell

What I have been telling you, from alpha to omega, what is the one great thing the sigil taught me — that everything in life is miraculous. For the sigil taught me that it rests within the power of each of us to awaken at will from a dragging nightmare of life made up of unimportant tasks and tedious useless little habits, to see life as it really is, and to rejoice in its exquisite wonderfulness. If the sigil were proved to be the top of a tomato-can, it would not alter that big fact, nor my fixed faith. No Harrowby, the common names we call things by do not matter — except to show how very dull we are ...
-James Branch Cabell

June 30, 2012 - 8:51 a.m.

Health Care Part 1

I woke up ridiculously early this morning so I have time to write before I got to the American Roots Festival at Caramoor.

I spent yesterday hiding from the heat. I only have AC in my bedroom. There is nothing in my bedroom but my bed, a dresser, and a laptop. So guess what amused me; Well first it was the bed. After breakfast and my morning internet fix and writing Wise Madness I gave up on lasting out the heat, went to my bedroom and took a nap. Then I messaged Carey and spent the afternoon playing on Turntable.fm. I ended up going out for dinner because it was too hot to cook the soup I had planned.

But that's not what I'm here to talk about. I wanted to talk about the draft. Make that the Affordable Care Act. Make that health care.

The debate on the ACA is a failure of democracy. Ironically the breakdown is at least partially due to the very things create the market failure of health care and the need for the individual mandate, ignorance and asymmetric knowledge.

The polls show that the majority of Americans are against the ACA. The thing is that most Americans don't know or understand what the ACA is. When asked about the individual parts of it they are for them except for the mandate. So why not get rid of the mandate? Because it is absolutely necessary to make the whole thing work. I'll let Mark Thoma explain why; The economics of the SCOTUS health care decision and More on the Economics of the Mandate.

Those are mathematical and technical arguments so you lose people right away. A huge part of the population will never start to reason for themselves on its wisdom.

It gets worse though. A huge part of the electorate is simply ignorant. A quarter of the people think the act had already invalidated by the Supreme Court. They don't know the provisions. All they actually know is that they are against it. I read on FB people saying how they can't afford it when it fact they have no idea if they can. They don't know how large the subsidy will be. Many don't know that the government will subsidize their insurance. Did you know that? And it isn't just the poor; it's the middle class too. People are against something that doesn't exist, a unsubsidized mandate. And of course if you already have insurance it doesn't affect you at all. You just keep your insurance. There's no penalty for that. It's how it is supposed to work. And here's the thing. Essentially the same plan is in effect in Massachusetts and it is working. The majority of the people who live with it are in favor of it. None of the dire consequences the radical right warned against happened.

The Supreme Court is not free of the irrationality. The conservative wing is caught up in semantics. The entire broccoli argument is specious. The fact is that the government has always been able to force us to buy broccoli and they do the logical equivalent every day. Here's some simple questions for you. Does the government have the power to tax everyone $1? Of course the answer is yes. Does the government have the power to give every American a $1 head of broccoli? Of course. How is that logically different that saying every American has to buy broccoli? The fact that you are now given more choice and can pay less? Giving you a choice of where to buy your broccoli somehow makes you LESS free? That's absurd but that's the entire core of the argument that the ACA is unconstitutional. We are forced to pay for all sorts of things many of which we are personally against. You can't run a government without that.

If people knew the facts and were willing to spend the time thinking things through the polls results would be different. So what do we need to do? Educate the people. That's everyone's job but especially the President's.

How is this like the need for the act? Insurance consumers are rarely fully informed. In fact they can't be as much of what people need to know is not public knowledge. The insurance companies know far more about the plans than the consumer. It's economics 101 that markets fail when there is asymmetric knowledge between buyer and seller. And that's why we need the mandate. Here the consumer has the knowledge advantage. The healthiest can opt out which drives up the cost for everyone else which causes more people to drop out. Read Thoma's first piece for the details.

I planned on writing a lot more but now I have to go. This has taken longer than I thought. I'll pick up on it again on Monday.

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Horvendile June 30, 2012
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