In the interests of the fairness for which I am so justly famous, I will admit that if you make a lot of money and have stable employment and will continue to have stable employment until you die, then this is Not Your Problem. Congratulations to you.

Just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report.

We just might have to do something about healthcare sometime soon.  And the choice will probably come down to whether we want everyone covered or less people covered.

Hat tip to Nagasaki.

If Reuther’s advice had been followed, and healthcare and company pensions had, for example, been effectively nationalized, fluctuations in the fortunes of any single company would not affect a worker’s access to benefits. Even better, companies would be better able to compete in a global marketplace.

So, how do we ensure that workers and retirees don’t get crushed by the implosion of the Big Three? Simple. Any bailout, restructuring or government-overseen bankruptcy should be accompanied by comprehensive healthcare reform for all workers, along with substantial improvements in the safety net such as wage insurance, extended unemployment benefits, training and education subsidies.

That’s from a Salon article called How Healthcare Could Have Saved Detroit. I wish there was more talk about this connection, not just wrt Detroit, but for all businesses, who are put in the untenable position of having interests opposed to their workers’ interests. I was going to rant about it for a while, but I’ll spare you any more.

Anyway, the conversation moved to insurance. I’ve been dealing with getting me and Monica health insurance, and guess what: it fucking sucks. For $160 a month I can get a policy with Blue Cross with a 10k deductible. Which means, in effect, that if either of us gets sick we still can’t go to the doctor unless we pay out of pocket. The $160 a month is to prevent my parents from having to sell their house if one of us gets cancer. Or, alternately, to keep you guys from having to pay for my treatment in your property taxes.

That seems pretty bad for me, since I have no income and $160 a month is a lot. But Jenny’s situation is even worse: she has a few kids, so it’s costing her family $500-something for the same insurance with the same 10k deductible. In other words, $500 a month to receive no services except in the case of total catastrophe.

This is what economists call a “moral hazard.” Why the fuck are Jenny and I paying for this insurance? In my case I’m doing it to protect my family. Maybe Jenny’s doing the same. Maybe we’re doing it because it seems like The Right Thing To Do, but my belief in The Right Thing is getting increasingly tenuous. The insurance I can afford is prohibitively expensive and gives me nothing in my day to day life. Since the cost of defaulting is so low (hospital won’t turn me away if something really disastrous happens) there’s precious little reason to have insurance. If I didn’t have to protect my folks, I probably wouldn’t bother.

And a lot of people _don’t_ bother. Can you really blame them? It’s like buying snacks for a party you can’t afford to attend. As more and more people stop buying the snacks, the parties get worse and worse. This is retarded. And it’s retarded that so many people are so poorly served, and yet making any change is a non-starter. Engh.

The big takeaway from the McCain proposal:

McCain’s health care plan would increase taxes on employer based health insurance and price 20 million plus Americans out of the coverage they currently rely on. In return, he’d give them a tax credit that is not indexed to health costs, and will become worthless as the years pass. He’d push them into the individual market, where higher administrative costs and underwriting practices mean that if individuals try to purchase the exact policy offered by their employers, they will pay $2,000 more per year. In addition, the sick can be turned away, and the state regulations that ensure some minimum level of benefits will be dismantled.

And on Obama’s plan:

And so the Obama campaign, for all the gestures to the contrary, does not seriously control costs. It does integrate the system further, and do more to offer health security. And it implements a structure which, like Medicare, could prove incredibly effective at restraining spending growth. But it does not flip the switch.

My take is that it really comes down to the question – Do you think too many people have healthcare or not enough?  

McCain’s plan provides disincentives for employers to offer health insurance so that individuals go out into the market to negotiate with United Health Group on their own without the negotiating power of all their fellow employees behind them.

Obama’s plan helps everyone who wants health insurance to afford their premiums but doesn’t do much to control the costs of the actual healthcare.  That is clearly not a long term solution.