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Monday, January 23, 2017

National Health Care and an interesting opinion

Posted Friday, April 6, 2012, at 6:38 PM

I tend to read Ed Lotterman's columns because they tend to be in plain English when dealing with the subject of Economics. I agree with some of his columns and disagree with others. Opinions are like armpits. Everyone has them, and there are times they smell bad. I'm doing a copy and paste since some of you don't like links. The first part is his most recent column and the second part is his bio from his web site. He makes some very interesting points, including one I wasn't aware of.


Economists aren't lawyers and should not speculate about any Supreme Court ruling on the constitutionality of imposing penalties on people who don't buy health insurance. But economists do have insights for considering the issue more broadly.

Start by recognizing that the extent to which individuals should be coerced to contribute resources for the well-being of a larger group is an economic question dating to pre-history. Prosperous societies have always implemented some element of such compulsion. All societies recognize the right of government to tax and, in many, to compel individuals to military service.

Libertarians may long for government that impinges only minimally on individual autonomy, but history and anthropology show that compelling individuals to help defend the group and to perform tasks like producing food for common consumption has been ubiquitous.

Individualists argue that there is a vast gulf between the social pressures within traditional tribes or villages and modern government mandates per se, but for those who study such societies, the distinction is not so clear.

In U.S. history, George Washington's administration secured legislation requiring all adult males to own guns. How much such laws were enforced is unclear, but the constitutionality of the requirement, with a clear public purpose of defense, was never challenged.

Nor was there ever any successful challenge to the Civil War laws that compelled military service but allowed those chosen the option of hiring a replacement.

Second, economic theory and psychological research show that in the absence of compulsion, some individuals always will opt to try to get a free ride on others' efforts. The first English colony in Virginia instituted a rule of "he who does not work may not eat" to combat just such behavior. In the case of health care, if one allows enrollment in health insurance at any time and at "community rates," regardless of health condition, many people will choose to not buy insurance until they need it.

Third, society already expends enormous resources on medical care for the uninsured. The annual cost of unpaid care is estimated to exceed $100 billion per year. This largely gets picked up by local governments or passed along to paying patients in the form of higher hospital bills. So there already is considerable free-riding. The issue is one of how the burden is spread across society.

Such free-riding will increase if the mandate provision is struck down, but the ban on denying coverage to those with pre-existing conditions is allowed to stand. Some commentators now argue that there are alternative ways to motivate the existing uninsured to buy coverage. But this ignores the fact that the number of uninsured will burgeon if open access is guaranteed without any compulsion to pay before care is needed.

Fourth, it is clear that government already has the constitutional right to operate mandatory insurance programs itself under its taxing powers. We don't allow workers (in Idaho, employers) to avoid unemployment taxes paid on their wages even when unemployment benefits are of little value to them. Nor, with limited exceptions, do we allow people to opt out of Old Age, Survivors and Disability Insurance, commonly known as Social Security.

Opponents need to recognize that a government mandate to buy health insurance long was the preferred conservative alternative to a government-run "single-payer" system. It was championed by Senate Republicans as a better option than "Hillary-care" in 1993, and the conservative Heritage Foundation pumped it as an alternative to government-run medical insurance.

The inclusion of a mandate in "Obamacare" was intended as a compromise to gain GOP support by forgoing the single-payer system most Democrats preferred. Throw out the mandate and many will see a government-run "Medicare for everyone" as the only alternative left.


For more than 30 years, Ed Lotterman has been combining history and economics to illuminate the "dismal science" and give ordinary people a "real world" explanation of what's happening in the economies of countries, governments, businesses and even our own households.

On the Farm -- Born in Michigan, Ed was raised on a southwest Minnesota farm that is adjacent to the one owned by his Dutch immigrant grandparents, Cornelius and Marie Antoinette Rylaarsdam. More than 100 years later, both farms are in the hands of second- and third-generation Rylaarsdams.

On his own farm, Ed rents crop land and pasture to local farmers, has land in CRP, is finishing up a pasture improvement project through the Soil Conservation Service and is part owner of a local wind project.

In the World -- Ed landed in Brazil with the US Army in 1968--he was 18 years old. Two years there, a year in Vietnam, two years in Peru working on a USAID project and multiple consulting trips to Bulgaria, the Czech Republic and Barbados have given Ed a broad view of the world, its governments, its people and its cultures. He is fluent in Spanish and Portuguese.

In the Classroom -- Since 2005, Ed has been a professor of economics at Augsburg College in Minneapolis, MN, but has taught at many of the higher ed institutions in and around the Twin Cities. In his 30 years as a teacher, he's had the priviledge of educating thousands of students.

Before he stood at the head of the classroom, he spent time at the University of Minnesota where he got a bachelor's degree in Latin American studies and a master's degree in agricultural economics.

At the Podium -- Ed has spoken to groups large and small about a wide range of issues. In 2007 and 2008, he presented a popular series of lectures as a run-up to the presidential election. Find out more about how to hire Ed as a speaker.

On the Job -- For most of the 1990s, Ed was the regional economist at the Federal Reserve Bank of Minneapolis, where his chief responsibility was to write that Bank's portion of the infamous "beige book." In 1998 he left the Fed to begin writing Real World Economics.

At Home -- A do-it-yourselfer and acknowledged dumpster diver, Ed hopes to spend more time welding in the near future. He lives with his wife, Victoria Tirrel, in the Saint Anthony Park neighborhood of Saint Paul.

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I think a government run medical program is the way to go and it should be paid for out of our taxes for all citizens of the U.S. No citizen should be afraid to go the doctor because of the cost of care. All green card holders would still have to pay the tax but would not get the benefit. Maybe that would motivate them to become citizens. Citizens could allways buy supplemental coverage and Gcard holders could buy basic and supplemental. Illegals should be shipped home after being stabilized with a bill for services.

This would not be a mandate to buy insurance but a service paid for by an increase in tax of 1 or 2 percent.

-- Posted by gmoney on Fri, Apr 6, 2012, at 8:36 PM

A snapshot of Idaho.

Survey: Fewer Idaho Employers Offered Health Coverage in 2009

Idaho employers continued reining in access to health care coverage between 2007 and 2009 as the state's economy moved from creating more jobs than any other state to shedding more than 8 percent of its jobs.

The 2009 Idaho Fringe Benefit Survey found the number of employers offering full-time employees medical coverage had fallen to 56 percent last year - down sharply over the last seven years. Idaho's smallest employers -- those with fewer than 10 workers -- pulled back the most. The percentage of businesses with more than 10 employees offering health insurance was essentially unchanged from 2007.

In 2002, 82 percent of Idaho's employers offered health insurance to full-time workers. In 2005 the percentage had fallen to 74 percent, and by 2007 it was down to 63 percent before hitting 56 percent in 2009.

On average employers offering insurance paid 83 percent of the monthly premium for single coverage, but only 56 percent of those workers with access to that coverage took advantage of the option.

The decline in employers offering health care coverage was not as precipitous in the case of family coverage. The 2009 survey found 53 percent of employers offered family coverage to full-time workers, down from 62 percent in the 2002 survey. Only a third of employees with access to family plans participated in 2009, but employers, on average, covered just 38 percent of the monthly premium.

By size of firm, all of the state's largest employers offered health insurance as did over 90 percent of those with 100 to 250 workers. Seventy percent of businesses with 10 to 50 workers provided insurance, but only 40 percent of those with fewer than 10 employees provided coverage. Businesses with fewer than 50 workers employ half of Idaho's labor force.

Access to health insurance through the workplace during 2009 was substantially lower for part-time workers and their families with 11 percent of employers offering both.

This is from the Idaho Dept. of Labor

-- Posted by royincaldwell on Sat, Apr 7, 2012, at 7:40 AM

You want healthcare? Great! Get out and get it the way millions of Americans are already doing it - WORKING FOR IT! -- Posted by Buckshot61 on Thu, Mar 29, 2012, at 6:57 PM (http://www.mountainhomenews.com/blogs/1582/entry/47011/)

-- Posted by bondyweb on Sat, Apr 7, 2012, at 10:28 AM

Uh, right!

-- Posted by royincaldwell on Sat, Apr 7, 2012, at 10:41 AM

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Thoughts from an old progressive
Roy Pratt
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Almost 65 and retired. Raised by an East Coast liberal. I am also a child of the sixties.