Adverse Selection

I will put on my healthcare wonk hat for a second and quibble with Ezra’s reaction to John Edwards’s just-released health plan.

[I]t puts the onus of the responsibility for funding health coverage on employers, a decision I don’t quite understand. The employers can satisfy that responsibility by either providing comprehensive care, or helping employees purchase from a menu of insurance options provided by newly formed, state-run “Health Markets.”

As of now, the plan doesn’t explain how much employers must provide towards health market coverage, but it’s a safe bet to assume that it’s somewhat less than the total cost of health care, and so the incentive will be for employers to encourage their employees to purchase from the HMs. And that’s where things get interesting. The HMs will offer a menu of private options that are totally community rated. The plan “will require insurers to keep plans open to everyone and charge fair premiums, regardless of preexisting conditions, medical history, age, job, and other characteristics.” These days, though, community rating is a common enough.

Where the Edwards’ plan takes a big step forward is in mandating, along with the private options, that HMs offer “at least one plan [that] would be a public program based upon Medicare.” And the intent is explicit: “Health Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan.”

In other words, the public sector will finally be allowed to compete with the private sector, and consumers will be able to decide which style they prefer.

Like most public-private mashups Edwards’s plan has a flaw that can’t be solved by tinkering with the implementation. The employee choice model suggests that employees will sign on to things that look much more like modern individual plans than the group coverage that we have today. Private insurers who enter these “Health Markets” will have every incentive to skim off the healthier clients, who cost less to insure, with plans tailored to screen out the applicants who might cost them money. The government’s Medicare-like plan, by definition, can’t do that, and the existence of a guaranteed safety net will give the private insurers a decent argument in favor of skimming.

Private insurers will spend less on covering their skimmed clients, while the government plan will have to account for a less-desirable client pool. Private insurers’ ginormous administrative costs (it takes a lot of work to find legal ways to avoid paying a claim) could cut their advantage but I doubt that it would be enough to account for the adverse selection effect. I suppose that government could ban applicant selection by the private insurers, and Edwards’s plan may even include that, but if that were the case the idea of insurers getting on board with the plan is ludicrous. No matter how the playing field lays out I have a hard time seeing the insurance biz signing on to a forcible restructuring that ends with them competing with the government.

I think that it’s time for Democratic candidates to recognize that insurers simply won’t be your friend on this issue. There is no solution that will both improve coverage for Americans and make them happy, so any top Dem should plan to be sailing into the same winds that sank Hillarycare.

Given that private insurers will fight half-measures just as fiercely as they would a total single-payer realignment I have a hard time seeing any tactical benefit in going halfway. Worse, the basic flaws in these halfway plans could prove counterproductive if years later people look back and think well, the Democrats tried reform and it didn’t work. Now let’s see what Republicans can do. Starting with halfway measures could backfire both tactically and strategically.

In my view the problem necessitates allies who can counterbalance insurers and their titanic K Street operation. That’s a tall order, but as I laid out in two recent posts it’s clearly within our reach.






58 replies
  1. 1
    Zifnab says:

    The American People like capitalism. Taking the heavy-handed “we’re going to eliminate insurance companies” approach makes you look like a thug while taking the “we’re going to allow the government to compete in the insurance marketplace” makes you sound like an entrapenuer. So, in many ways, this is just a matter of packaging.

    Private insurers’ ginormous administrative costs (it takes a lot of work to find legal ways to avoid paying a claim) could cut their advantage but I doubt that it would be enough to account for the adverse selection effect.

    I think this actually works in Government Insurance’s interests. How many times has it been said that a little preventative treatment today will save you a fortune tomorrow? Edwards is gambling on the idea that insuring a million sick people is actually cheaper than insuring ten-thousand healthy people. What’s more, who wants to get remmed by a private insurance company when you can buy from a government program that garantees your benefits? Insurance becomes the new Social Security. Sure, its not great, but its a hell of alot better than gambling on the private sector and fighting court battles for your chemo treatments. We’ve all heard the HMO horror story. Just hearing about insurance that doesn’t stonewall you at a glance sounds immediately attractive.

    Of course, even on the off chance that this plan sees the light of day, my real fear is in it getting FEMA’d. Edwards sets up the program, but loses the ’12 election. Then his Republican replacement underfunds, overregulates, and generally pisses over the whole thing. Then tosses it when he declares that government insurance doesn’t work. If the plan is deliberately sabatoged every step of the way, then I agree, its dead in the water. But under that logic, we should just toss up our hands, bend over, and take it from the entire Insurance Industry. Cause they’re going to fuck with ANYTHING we put out that doesn’t go primarily to pumping taxpayer dollars down their gullets.

  2. 2
    Andrew says:

    The other option would be for us to imprison all of the CEOs of healthcare companies for murder, any time they deny coverage. It’s a crime with a clear financial motive, to make money, and a clear link from intent to outcome.

  3. 3
    Russell L. Carter says:

    It sure would be interesting to hear your take, Tim, on Tyler Cowen’s (and Alex Tabarrok’s) parsing of ‘adverse selection’:

    http://www.marginalrevolution......verse.html

  4. 4
    Tsulagi says:

    Now is likely a better time to push for comprehensive healthcare reform than it was when Hillarycare was debated. Dems could likely find some big corporate allies. Companies like GM have been screaming about the cost of health benefits and care causing them to be much less competitive in the global marketplace. Other companies with big, maturing workforces like Boeing would probably join in. Even newbies like Microsoft.

    Dems could also pitch it as a way to hopefully slow down the outsourcing of jobs to foreign companies. Part of the reason foreign labor is priced attractively is those companies don’t have to pay or deal with health care. Let Republicans cry their crocodile tears for their pharmaceutical and insurance company campaign contributors as if the prescription drug bill wasn’t enough of a payoff to them.

  5. 5
    TenguPhule says:

    First, shoot all of the insurance executives…

  6. 6
    ThymeZone says:

    Excellent post. The line about insurers not being our friends is critical, and exactly right.

    Edwards’ plan is based on the availability of ponies.

    Reality tells us to start with single payer and work down from there. One doesn’t have to work the problem very far down from there to find out that most of the “alternatives” are dismal and half-assed.

  7. 7
    Tim F. says:

    Dems could likely find some big corporate allies. Companies like GM have been screaming about the cost of health benefits and care causing them to be much less competitive in the global marketplace. Other companies with big, maturing workforces like Boeing would probably join in. Even newbies like Microsoft.

    Yes, that was precisely the point of the two posts that linked in my last sentence.

    Russell,

    I will give it more thought when I have more time. Thanks for the link.

  8. 8
    Andrew says:

    The best plan, politically and logistically speaking, is to just incrementally expand Medicare.

    Lower the age limit, slowly.

    Add kiddie coverage at some point in the future.

    Roll Medicaid into Medicare.

    Expand Medicaid (newly Medicare) income restrictions.

    Soon enough, you’ll have upper middle class and rich 35-50 year olds as the last people with private insurance.

  9. 9

    The best plan, politically and logistically speaking, is to just incrementally expand Medicare.

    I believe that is Edwards’ idea.

    Personally, I prefer the reverse proposal: everyone gets Medicare *now*, and employers can compete by covering the copays if they choose to do so.

  10. 10

    Insurers are like spoiled gamblers, as long as they’re winning they’re your pals, but lose a hand and all hell breaks loose. The idea some people have that insurers are their friends may be bolstered by ads, but reality quickly hits during a claim.

    Going half way only encourages the insurers and leaves the onus on employers. Some of us are slowly sinking under insurance costs now, my construction liability ins has gone up 1,000% in 5 years with no claims, I pay 27% of wage for Workman’s Comp (standard), I’d as well shoot myself as offer Health Care Ins.

  11. 11
    Tsulagi says:

    Yes, that was precisely the point of the two posts that linked in my last sentence.

    Oops, guess I should have done a little more than just skimmed your post without following links.

    Anyway, I think everyone knows it’s time for healthcare reform. Just a matter of what form it takes. Far more than Social Security it’s broken.

    Probably why dipshit brought it up in his last SOTU address. And maybe it was just me because I don’t trust the fucker farther than I could throw the planet, but it seemed to me he was suggesting people get moved off employer paid group plans to individual ones giving them a tax benefit as compensation. Maybe I heard wrong. Doesn’t matter, other than his operational control of the military his big deciding days are gone.

  12. 12
    TenguPhule says:

    but it seemed to me he was suggesting people get moved off employer paid group plans to individual ones giving them a tax benefit as compensation.

    It bears repeating: “He wants them to pay with money they don’t have and get it back with a tax break they can’t use.”

  13. 13
    uptown says:

    What about when your insurer is your provider? I have a non-profit insurer/provider which does a much better job than the government. The doctors are directly employed by them; they have their own pharmacy, hospitals, etc…They can control costs and fund preventative care.

  14. 14
    Andrew says:

    I believe that is Edwards’ idea.

    And how, exactly, would I have known that? Read?

    Hahahahahahaha.

    Newb.

  15. 15

    Newb.

    That’s spelled, n00b, B1ff.

  16. 16
    sab says:

    The fundamental problem with employer-based health insurance is that not everyone is employed continuously all of the time. If you have a medical event while you (or your spouse who had the coverage) are unemployed you are screwed. Or if you work for a small employer, your medical event could make your employer’s entire health plan prohibitively expensive. So your employer switches to lousy coverage, or figures out how to terminate your employment to save his coverage, or his company. I had one friend fired during her cancer chemo because she wasn’t pulling her weight in the company, and her husband was almost fired because he was spending too much time with her. Employer based health insurance doesn’t work because if you are really sick you aren’t employed.

  17. 17

    Tim F. Says:

    Worse, the basic flaws in these halfway plans could prove counterproductive if years later people look back and think well, the Democrats tried reform and it didn’t work. Now let’s see what Republicans can do. Starting with halfway measures could backfire both tactically and strategically.

    This is a serious problem with lots of policy initiatives dealing with opening previously state-run sectors up. The more important and far-reaching they are, the more likely there’s going to be some half-assing gussied up as “compromise”. The ultimate example of what can happen when you water down in all the wrong places was the California energy deregulation, where they set artifical prices to entice the private sector to play ball, and then left all kinds of loopholes for dicksmiths like Enron to exploit. Normal, non-evil energy providers were on the hook when energy prices went above the state-mandated price cap (and of course, capping the price encouraged poor conservation and all kinds of silly consumption, like only Californians can do), blowing the whole system apart so a bunch of Berkeley Marxists could go “See! See! Deregulation is EVIL!”.

    Reforms like this are like pregnancy or murder- there’s no half way measures. You either do it, or don’t bother.

  18. 18
    Pb says:

    Reforms like this are like pregnancy or murder

    Or both! I’ll cover it all in my new book, “Socialized Medicine Kills: The Mass-Murderering Liberal Abortionist Agenda”, by Regnery.

  19. 19
    scs says:

    I’m not really clear on why healthcare is hurting employers. Don’t employers just pay the premuiums for their employees and the company they use as an insurer actually pays for the healthcare? What difference then does it make if the employees are sick or healthy as the company just pays the premiums the same? I don’t really get how that works.

    And if we get government funded healthcare then probably it will be roughly the same costs to employers through fees and extra taxes. So I doubt that will help our competitiveness for say car makers- I think it’s more their car designs aren’t much good – not the healthcare costs.

    And last, but most importantly, does anyone but me think John Edwards has gotta be secretly gay? I predict a NJ governor (what was his name?) style gay scandal from him sometime in the future.

  20. 20
    TenguPhule says:

    What difference then does it make if the employees are sick or healthy as the company just pays the premiums the same? I don’t really get how that works.

    Shorter Scs: I’m just a dumb Cheney sucker too stupid to spend 15 minutes learning about something before trying to talk about it.

    And if we get government funded healthcare then probably it will be roughly the same costs to employers through fees and extra taxes.

    Shorter Scs II: The more I say, the less I know.

    And last, but most importantly, does anyone but me think John Edwards has gotta be secretly gay?

    Shorter Scs III: **Spurt**, Thank you Mr. Cheney, may I have another?

  21. 21

    Uh, private insurers have significantly higher administrative costs than public ones, because of all the paperwork and all the fighting over whether something is covered or not.

    Thing is, universal healthcare is one of those things people scream bloody murder about at the time, but it rapidly becomes extremely popular. Not a single First World country has rescinded universal healthcare after having implemented it, and developing countries have only cut back on whatever free services they offer after heavy pressure from the IMF.

    When Tommy Douglas brought in universal healthcare in the province of Saskatchewan, a whole hell of a lot of people predicted doom. Doctors threatened to leave the province en masse. Instead, it rapidly became something Canadians in other provinces wanted as well, because the benefits were obvious. Our system is very far from perfect, but it’s a hell of a lot better than nothing. And pissing off the insurance industry is inevitable. May as well do the thing properly, since you’ll have them screaming for your blood anyway.

  22. 22
    rachel says:

    And if we get government funded healthcare then probably it will be roughly the same costs to employers through fees and extra taxes. So I doubt that will help our competitiveness for say car makers- I think it’s more their car designs aren’t much good – not the healthcare costs.

    The American healthcare system harmed our competitiveness in this case:

    […]There has been fierce competition among states hoping to attract a new Toyota assembly plant. Several Southern states reportedly offered financial incentives worth hundreds of millions of dollars.

    But last month Toyota decided to put the new plant, which will produce RAV4 mini-S.U.V.’s, in Ontario. Explaining why it passed up financial incentives to choose a U.S. location, the company cited the quality of Ontario’s work force.

    […]

    But education is only one reason Toyota chose Ontario. Canada’s other big selling point is its national health insurance system, which saves auto manufacturers large sums in benefit payments compared with their costs in the United States.

    You might be tempted to say that Canadian taxpayers are, in effect, subsidizing Toyota’s move by paying for health coverage. But that’s not right, even aside from the fact that Canada’s health care system has far lower costs per person than the American system, with its huge administrative expenses. In fact, U.S. taxpayers, not Canadians, will be hurt by the northward movement of auto jobs

  23. 23

    And last, but most importantly, does anyone but me think John Edwards has gotta be secretly gay? I predict a NJ governor (what was his name?) style gay scandal from him sometime in the future.

    Whitman is gay?

  24. 24
    Tulkinghorn says:

    problem necessitates allies who can counterbalance insurers and their titanic K Street operation

    Where is the AMA on this? One would think their constituents would be unhappy with all those years in school, all that debt accrued, just to watch half their profits going out the door to a pack of corporate cretins.
    Then again, like the executives at Ford and GM, they may prefer losing money to disturbing their class-consciousness and social solidarity with their fellows in the elite.

  25. 25
    scs says:

    the company cited the quality of Ontario’s work force.

    By the way, that’s basically the code-word for “less black people”. I heard rumors that Japanese companies were very racist and purposefully looked for sites in the south with the least amount of black people – such as more rural sites in KY and TN. The health ins. bit is probably a way to cover their motives.

  26. 26
    scs says:

    I think the use for universal health care is to get the self or unemployed people covered – not to save money for employers. Again, most companies pay just the premiums – where’s the savings here? We are just spreading the cost from about 80% of the employers to 90% of the taxpayers (guessing 10% in poverty)- so the employers might end up paying 10% less. I suppose the only way to actually save from this is getting some magical savings in administrative costs -which I’m not convinced yet would happen. People are dreaming a little here.

  27. 27
    Krista says:

    the company cited the quality of Ontario’s work force.

    By the way, that’s basically the code-word for “less black people”. I heard rumors that Japanese companies were very racist and purposefully looked for sites in the south with the least amount of black people – such as more rural sites in KY and TN. The health ins. bit is probably a way to cover their motives.

    That’s right, scs. The only thing that the Ontario workforce has going for it is that it’s lily-white (which it actually isn’t, but you go on thinking whatever you like). The fact that they’re very well-educated, skilled, and often know multiple languages has nothing to do with it.

  28. 28
    Andrew says:

    By the way, that’s basically the code-word for “less black people”. I heard rumors that Japanese companies were very racist and purposefully looked for sites in the south with the least amount of black people – such as more rural sites in KY and TN. The health ins. bit is probably a way to cover their motives.

    Ah, here’s the scs we know and love.

    And did you hear about how the Camry has a skin color detection system, and breaks down more frequently when driven by a person of color?

  29. 29
    ThymeZone says:

    I’m not really clear

    I think

    Yeah, here’s the thing. If this were a blog designed to be a place where stupid, ignorant people just think out loud and make up ridiculous shit, your posts would be gold.
    Gold, I tell you.

    However, in reality, it’s a little seeing a cat watch television. Amusing for a short time, but eventually it’s the cat that gets the most out of it.

    Maybe a blog for cats would suit you better?

  30. 30
    scs says:

    Come on. This has been rumored knowledge for years – and well known that Japanese chose sites in rural areas because of the “better educated” people. And what does that mean, “well educated”, Krista? You think there are a bunch of PHd’s running around in rural Kentucky? Everyone knows what it meant.

  31. 31

    Anything would be an improvement over the current system.

  32. 32
    scs says:

    And by the way Krista, I looked at your site on Canadian stats to check your statement that Ontario is racially diverse- and I tried a search on “race” and no results – no stats on race at all. In contrast for “education” they had a whole page of stat types. That’s sooooo PC of Canada – that they don’t even track race or recognize it as a concept..

  33. 33
    scs says:

    Maybe a blog for cats would suit you better?

    I thought this was. Remember Tunch?

  34. 34

    This has been rumored knowledge for years – and well known that Japanese chose sites in rural areas because of the “better educated” people. And what does that mean, “well educated”, Krista? You think there are a bunch of PHd’s running around in rural Kentucky? Everyone knows what it meant.

    I had an interesting discussion about exactly that with a statistician friend of mine just last week. It turns out the “outcomes” of urban school systems are essentially equivalent to those of suburban school systems when you control for parental SES, and that both of them are inferior to rural school systems. So, yes, in fact, it’s quite likely that people in rural Kentucky are better educated than people in New York.

  35. 35
    scs says:

    What do you mean by outcomes – and what is SES. This has got to stop with all the unneccesary abbreviations nowadays – when will it end?

  36. 36
    Zifnab says:

    By the way, that’s basically the code-word for “less black people”. I heard rumors that Japanese companies were very racist and purposefully looked for sites in the south with the least amount of black people – such as more rural sites in KY and TN. The health ins. bit is probably a way to cover their motives.

    Actually, the Japanese are far more racist against the Chinese and the Koreans. They were probably moving to America to get the hell away from all those Chinks and Gooks and Kore-be-je-bezes. Fucking Koreans and their god damn Zerg Rush. One of these days, someone’s going to hit’m with a wing of Protoss Carrier ships and that’ll shut’m the fuck up. I can’t fucking stand Koreans.

  37. 37
    Andrew says:

    So, yes, in fact, it’s quite likely that people in rural Kentucky are better educated than people in New York.

    No, it isn’t.

    Southern rural school systems are despicable. Of course, Southern urban school systems are also often horrible.

    The national performance numbers are significantly skewed by the upper midwest, where the rural school systems are by far the best systems, in any category, in the entire country. Rural Iowa, Minnesota, Wisconsin, etc. are rather incredible. Also, the rural school systems in New York and the Northeast are also quite good.

  38. 38
    ThymeZone says:

    when will it end?

    A question we all ask, every time you post.

  39. 39
    rachel says:

    Fucking Koreans and their god damn Zerg Rush. One of these days, someone’s going to hit’m with a wing of Protoss Carrier ships and that’ll shut’m the fuck up. I can’t fucking stand Koreans.

    Is somebody having a leeetle trouble with his Starcraft sk1llz?

  40. 40

    The national performance numbers are significantly skewed by the upper midwest, where the rural school systems are by far the best systems, in any category, in the entire country. Rural Iowa, Minnesota, Wisconsin, etc. are rather incredible. Also, the rural school systems in New York and the Northeast are also quite good.

    That’s because us Minnesotans and Iowan value a gud edumikation. :-)

    This is generally been the problem with NCLB up here. It’s not designed to make bad schools good, but rather to dumb down the good schools so the bad schools don’t look so bad.

  41. 41

    Is somebody having a leeetle trouble with his Starcraft sk1llz?

    We got Zealots!

    I say “Bring it on!”

  42. 42
    Krista says:

    And by the way Krista, I looked at your site on Canadian stats to check your statement that Ontario is racially diverse- and I tried a search on “race” and no results – no stats on race at all. In contrast for “education” they had a whole page of stat types. That’s sooooo PC of Canada – that they don’t even track race or recognize it as a concept..

    Fuck me, but you’re retarded.

    Did it even occur to you to try a different search term before making such a boneheaded assumption?

    Here, sweetie. As the big, bad, internet, and big, bad synonyms confuse you, I’ll provide you with the link to the exact table for which you’re looking.

  43. 43
    TenguPhule says:

    By the way, that’s basically the code-word for “less black people”. I heard rumors that Japanese companies were very racist and purposefully looked for sites in the south with the least amount of black people – such as more rural sites in KY and TN. The health ins. bit is probably a way to cover their motives.

    Shorter Scs: I only spread my legs for dumpy old white men with lots of money.

  44. 44
    ThymeZone says:

    Shorter Scs: I only spread my legs for dumpy old white men with lots of money.

    Not that there’s anything wrong with that.

    Heh.

  45. 45
    scs says:

    Shorter Scs: I only spread my legs for dumpy old white men with lots of money.

    Okay Doug, your sexual persona Tengu is getting REAL old. Honestly you should be in a mental hospital. And even though we know this is a spoof, and you’ll just pop up with another name, Tim and John should try to control your spoofing personalities viruses as best they can. That comes with their responsibilities with running a public forum.

  46. 46
    scs says:

    Did it even occur to you to try a different search term before making such a boneheaded assumption?

    Yes intellectual scholar Krista. I tried ethnicity too. I thought that pretty much covered it. It would in this country where we don’t spend all day trying to convince ourselves how PC we are.

    But boy I am sure retared for not trying this term: “Visible minority population”.

    Duhhhh. Everyone knows it’s not race – it’s “Visible Minority Population”! Boy how retarded was I???

  47. 47
    scs says:

    And Krista, yeah using your stats I see there’s sure a lot of black people in Ontario – about 3%. Whew!! That compares real well to about 30% in some southern states. And if you add up the non-Asian minorities in Ontario you only get about 6%. So you don’t think that the Japanese car companies moved over the border from Detroit with to Ontario because of anything to do with race right? Oh nooo. It was “education”.

  48. 48
    Krista says:

    So you don’t think that the Japanese car companies moved over the border from Detroit with to Ontario because of anything to do with race right? Oh nooo. It was “education”.

    I was taking issue with your implication that the ONLY reason that they would select Ontario was due to ethnic diversity, or lack thereof.

    In other words, I found this following bit pretty offensive:

    the company cited the quality of Ontario’s work force.

    By the way, that’s basically the code-word for “less black people”.

    And I found that table in about 10 seconds, and no, I didn’t have to enter the term “visible minority population.” I just went to left-hand menu, selected “Find statistics by subject”, and then, clicked on “Ethnic diversity and immigration.” It really was ridiculously simple to find. But because you couldn’t find it right away, you assumed that it wasn’t there, and that they had…

    no stats on race at all. In contrast for “education” they had a whole page of stat types. That’s sooooo PC of Canada – that they don’t even track race or recognize it as a concept..

    So because you couldn’t find it right away, you leapt to the conclusion that the Canadian government keeps absolutely no statistics on its own ethnic demographics, because (in your words) we’re sooooooo PC. Oh, and not only do we not keep any statistics on it, we don’t even recognize race as a concept!

    If you don’t want me calling it “retarded”, then that’s fine. But, for a self-professed expert of logic, you certainly weren’t showing too much logical thought on that one, were you?

  49. 49
    ThymeZone says:

    Tim and John should try to control your spoofing personalities viruses as best they can

    Many people think that they write them. Some think they write your character.

    Please prove otherwise. I can prove my identity. Can you?

  50. 50
    Andrew says:

    scs, Krista’s moose talk was far too polite to even begin to describe the depths to which your intellect plumbs.

    Toyota: San Antonio, TX, Baja, Mexico, Huntsville, AL, Fremont, CA, St. Louis, MO, Long Beach, CA
    Honda: Alpharetta, GA, Lincoln, AL, Swepsonville, NC, Greensboro, NC,

    Surely there are no minorities in these places!

  51. 51
    TenguPhule says:

    And even though we know this is a spoof, and you’ll just pop up with another name, Tim and John should try to control your spoofing personalities viruses as best they can.

    Shorter Scs: You are all DougJ! Even when you’re not!

    Silly little stupid cheney sucker.

  52. 52
    TenguPhule says:

    Oh nooo. It was “education”.

    Shorter Scs: I like Pies. Especially Cream.

  53. 53

    “Soak the rich” is not shared responsibility.

    I haven’t had time to work my way through John Edwards’ proposed health plan (pdf), but I’ve read enough to know that it’s a preposterous joke that would end in fully socialized health care. No thanks. But instead of summarizing…

  54. 54
    scs says:

    Toyota: San Antonio, TX, Baja, Mexico, Huntsville, AL, Fremont, CA, St. Louis, MO, Long Beach, CA
    Honda: Alpharetta, GA, Lincoln, AL, Swepsonville, NC, Greensboro, NC,

    We are talking about Japanese being perceived to be unwilling to hire black people. I don’t know about the California and Texas ones but I assume the minorities there are mostly Hispanic. And as a matter of fact, I know that Huntsville AL, Alpharetta, Greensboro NC are all less populated with black people than the rest of the states. They are in the mountainous parts of the states. Alpharetta, an Atlanta suburb, is one of the wealthiest areas in the south if not the country. Swepsonville is in the Research Triangle. I think I’ve been past the Lincolnville plant on the way to New Orleans once. It is out in the middle of nowhere. The whole of Alabama except for right around the cities, and Missiisspi somewhat, is pretty much an abandoned state. So I’ve been in the area of all those places, and believe me, they picked some of the areas least populated by black people in the south- combined with a low cost of living. That’s probably their formula right there actually.

  55. 55
    TenguPhule says:

    We are talking about Japanese being perceived to be unwilling to hire black people.

    Shorter Scs: Suckee Suckee! Five dollah Five Dollah!

  56. 56

    […] There’s quite a bit of discussion of the Edwards healthcare proposal. Ezra Klein’s first blush reaction to the plan is that he likes it; Steve Verdon isn’t completely negative on the plan although he does provide some useful criticism; Balloon Juice and Newshog are both critical of the plan because it doesn’t remove insurers from the picture. […]

  57. 57

    […] Adverse Selection […]

  58. 58

    […] Yup, like I observed back in February. Politicians try to propose these public-private mashup plans because (1) incremental change feels like less of a risk, and (2) some genius advisor always tries to convince them that they can gimmick the incentive structure to avoid outraging every major interest group. It. Can’t. Happen. Adding another layer of bureaucracy without fixing the underlying mess will just increase the opportunities for sick people to die broke. […]

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  1. […] Yup, like I observed back in February. Politicians try to propose these public-private mashup plans because (1) incremental change feels like less of a risk, and (2) some genius advisor always tries to convince them that they can gimmick the incentive structure to avoid outraging every major interest group. It. Can’t. Happen. Adding another layer of bureaucracy without fixing the underlying mess will just increase the opportunities for sick people to die broke. […]

  2. […] Adverse Selection […]

  3. […] There’s quite a bit of discussion of the Edwards healthcare proposal. Ezra Klein’s first blush reaction to the plan is that he likes it; Steve Verdon isn’t completely negative on the plan although he does provide some useful criticism; Balloon Juice and Newshog are both critical of the plan because it doesn’t remove insurers from the picture. […]

  4. “Soak the rich” is not shared responsibility.

    I haven’t had time to work my way through John Edwards’ proposed health plan (pdf), but I’ve read enough to know that it’s a preposterous joke that would end in fully socialized health care. No thanks. But instead of summarizing…

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