The Haves and Don’t Have Tos of Healthcare
Mark Patinkin begins a brief examination of “why there’s all this fuss about revamping the [healthcare] system” with a faulty premise:
I’m guessing there have been two distinct audiences for the health-care debate.
Those who have an affordable plan and those who don’t.
If you don’t, you doubtless paid a lot more attention.
Patinkin’s essay stands as evidence that there are at least three audiences, and since the third implies an antipode, there must be four:
- Those who have an affordable plan and believe something like the Democrats’ plan will not affect them.
- Those who have an affordable plan and believe something like the Democrats’ plan will threaten them.
- Those who don’t have an affordable plan and believe something like the Democrats’ plan will ensure one.
- Those who don’t have an affordable plan and don’t believe something like the Democrats’ plan will ensure one.
So dramatically different is my understanding of the landscape than Patinkin’s that he assumes the “don’t haves” to be the most interested in the debate, while I’ve perceived the debate mainly to be between the factions of the “haves.” Note that the Tea Party phenomenon was heavily populated by working and middle class folks, and that much of the advocacy for the Democrats’ policies has come from Patinkin’s peers in the media, academia, and government, all likely having excellent benefits.
A telling bit of the perspective difference between the “have” groups comes when Patinkin investigates the options that “have nots” can pursue. Just after explaining to his readers how a deductible and copay would work on a $2,000 MRI, he writes:
I was told you might be able to get that $660 monthly fee down to $487 if you proved you were very healthy. But you’d still have the deductible, leaving folks to debate every procedure.
Here’s my question in response, as somebody who has decent (although too expensive) coverage and fears that the Democrats are on track to price me out of it: What is wrong with folks debating every $2,000+ procedure? Simply put, there will never, ever be an effective mechanism for controlling healthcare costs unless every potential patient weighs the value of every test, drug, and procedure. Pretending otherwise is going to cause a whole lot of suffering among a whole lot of people.