Healh Insurance Might not be Good for Everyone

Steve Randy Waldman‏ of interfluidity called this thread: Thread, counterintuitive and disheartening.

It could for a number of reasons be that the current western healthcare (beyond the basics that you do not need insurance to get) is not good for those at the low end of diligence, IQ, conscientiousness scales.

Here are some possible reasons why:

• MD’s often do not explain enough and nobody follows up.
• Protocols are sometimes too complicated and require too much attention. 
• Opiates are too tempting.
• etc. 

If true it could explain:

• Why the more educated (a good measure of the above traits) are getting healthier faster than the less educated. 
• Why the health/income gradient is greater in Canada than the US. Everyone gets access to healthcare in canada.
• Why Medicaid does not seem to improve health.
• Why the PPACA (Obamacare) looks like it did not save lives. 
• Why some groups with less access to healthcare have greater life expectancy.
• The states leading the pack in overdoses all expanded the program.
  
  Read more at: http://www.nationalreview.com/article/449171/medicaid-opioid-problem-has-it-made-epidemic-worse
   

U.S. Age-Adjusted Mortality Rates per 100,000 (Annual, 2002–2015)

And BTW  on the opioid epidemic being deaths of despair:

New Hampshire has the second highest opiate death rate in the US.  Very good economy in NH. These epidemics come and go look more like viruses than anything caused by despair. 
So why would West Virginia be the leader in overdose deaths, because it has been loosing its best and brightest for a long time leaving a higher percent on the lower end of diligence, IQ, conscientiousness scales, the most susceptible.

Related links:

The Amish and the marginal value of health care

The Amish and the marginal value of health care

The Amish and themarginal value of health care

Ironic Health Links 
Hanson on Health
Wealth and retirement might not be good for everyone!
 

Why I am Against the Minimum Wage

2 recent minimum wage studies here and here.

So here is why I'm against the minimum wage:

1. Idle hand are the devils workshop. Young men not working get into more trouble than those with jobs. I would rather not take the chance of even putting a very small number of people out of work.
2. Anyone working full time in the developed world is really not living in poverty. See: How I Live on $7,000 per year.
3. Unemployment is depressing. The Grave Evil of Unemployment
4. People often learn skills on the job and BTW you would have to make internships pay minimum wage to be fair.
5. Jobs integrate younger and older people and older people's life styles are generally better.
6. If you consider the difference in pay between the market rate and the minimum wage rate a tax, fair in my mind, the tax falls on employers of low wage labor in the short run and consumers of products produced by low wage labor in the longer run, why tax them more than others? BTW Dear Republicans even if you do not call it a tax it's still a tax, so  you might want to support a higher taxes to fund an hourly wage subsidy or a UBI.
7. Many people are already working for less than minimum wage.  WHy Drug Dealers Live with there Mom's
8. Black youth unemployment is already much to high. 
9. An hourly wage subsidy would be so much better. 

And yes, I would get rid of it all together and leave it to individuals, unions to work out wages.

BTW statistics and be tricky and when you read economic studies, you need to think about what could have gone wrong on the study and how they could be biased, but statistics are much better than stories (anecdotes). Statistics and theory are the best we have. The old saw "There are three kinds of lies: lies, damned lies, and statistics." has truth to it but again statistics are better than the alternatives.

My Playing off Arnold Kling's Clarifying his Null Hypotheses on Schooling

Here is Arnold answering: The null hypothesis: do I really believe it?

My null hypothesis says that spending more inflation adjusted on schooling than was spent in 1960 has no positive effect on education. (that's about 1/3 of what is spent today.)

Also that only a tiny fraction (perhaps .1%) of schools are good or bad schools. The rest are judged good or bad have good and bad students. And so parents should relax should only try to avoid the worst .1% of schools and not pay more for a home in a “good” school district.

Also my mother has told me that her parents went to school for just 1 year, yet they where educated. They were not superstitious as many where in their era. They could read and write and do arithmetic. They read books. They owned and ran a barber shop. they speculated in real-estate (but lost most but not all of it in the great depression) and sent their son to Brown University.

School is not only place people learn.

Perhaps 3 years of formal schooling would be enough for most people. Never the less in the modern world we would need something for them to do so maybe keeping most in school to 16 is a good idea, not so much for education but to keep them out of trouble.

The Amish drop out early and do OK.

For a modern example, the guy who invented this car claims to have dropped out of school at 14 years old.

Also, if we cannot teach children more and it looks like we cannot, we should focus on teaching the most valuable stuff.

What are the Best Things We Could Do for the Poor Through Government

• End the War on Drugs, and amnesty for non-violent drug prisoners, and criminal justice reform with the aim of reducing incarceration rates. What has done more economic harm to the poor than having their working-age men locked away
•  Wipe out the mosquito see: http://www.npr.org/sections/health-shots/2016/12/14/504732533/to-fight-malaria-scientists-try-genetic-engineering-to-wipe-out-mosquitoes
• And more and better police. http://marginalrevolution.com/marginalrevolution/2013/01/more-police-fewer-prisons-less-crime.html Poor people are too often victims of crime and fraud. It is better to live on a corner of the roof than share a house/neighborhood with crime, violence or biting insects.
• Allow any subdividing and residential building that increased overall density and some that does not.

Plan from the Niskanen Center: Universal Catastrophic Coverage

This plan from the Niskanen center: Universal Catastrophic Coverage — Or How the Senate Can Fix the AHCA

Is similar to my compromise proposal.

 

A Healthcare Compromise

I think that they are a little to people with above average income but I like it otherwise. They say it would be cheaper than the ACA. So why are we stuck with the ACA and AHCA?

USA Healthcare Facts

In 2003, of the roughly 3,900 nonfederal, short-term, acute care general hospitals in the United States, the majority—about 62 percent—were nonprofit. The rest included government hospitals (20 percent) and for-profit hospitals (18 percent). In exchange for tax-exemptions, estimated to total $12.6 billion in 2002, nonprofit hospitals are expected to provide community benefits.

Percent of national health expenditures for prescription drugs: 9.8% (2014)

Many health insurance companies are nonprofits including some of the state Blue Cross organizations. see: Google search for percent non profit health insurance.

It's Surprising How Few Countries Have National, Single Payer, Health Care Systems


It is surprising how little, expensive healthcare contributes to health. See here. (buy expensive I mean beyond vaccinations and antibiotics).

Trust and Cost Disease

I have been wondering if loss of trust is a significant driver of our rapidly increasing spend for schooling and medical care. Spending is increasing rapidly and yet the teachers and MD's are less happy with their jobs and the patients are not happier with the service. See here.

We do not trust the teachers as much as we used to and so we test more and regiment them more. We don't trust MD's and so we build rules and bureaucracy to regiment them. Part of that is inevitable in a 3rd party payer system but it might be increased by this international competition. All the stories that tell us how poorly the USA does on PISA and life expectancy as compared to the other developed countries when there are many non schooling non health care things that effect PISA scores and life expectancy.

BTW As far as schooling goes, does PISA really test anything important? On PPP GDP per capita USA Ranked 6th, 44% more than Finland, maybe the Finns should change their schools to look more like ours? Maybe the PISA tests are too close to an IQ test tell us much about the quality of our schools.