Sunday, May 04, 2008

Why you'll never have single-payer insurance here

If you think unemployment is bad now, just count up how many people will be out of a job if we eliminate the for-profit health insurance industry and all its remoras.

The BLS doesn't break out insurance employment statistics by type of insurance, so it's a bit of a challenge to guess just how many of the 2.3 million who are employed in the insurance business and related industries are in the [cough] health [cough] sector, but what with:
Well, it's bound to be a whole slew of folks any which way you look at it.


Anonymous said...

They're going to have to change their service offering, and offer more and better services to clients.

If you don't like that idea, how about a guaranteed annual income? It would be cheaper to pay people to stay home than drive to and from work to push papers denying coverage.

Keifus said...

Sigh. I'm growing in my conviction that this notion of (uniquely!) American management skills is one of the Big Lies. Big value added, sure, but no substance.

Anyway, nice summary.

Anonymous said...

...and the horse they rode in on.

I would note that those with a bit of intelligence would be contractors in an enlarged Medicare for All, because the Medicare claims system is "untouched by government employees", and it is done by contract workers for health insurance companies.

hipparchia said...


even if we employ 2 or 3 or 4 times as many people as canada does, that's enough jobs for aomething like 150,000-200,000 people. what do we do with the maybe-a-million or so others?

although i kinda like michael's idea.

hipparchia said...


i'd actually happily pay higher prices for health care, and i'd happily support all those layers of people, because people do like to have jobs, IF THEY ACTUALLY PAID FOR MY HEALTH CARE.

but yeah, the greener idea may be to pay them to stay home and drive and not shuffle dead trees.

hipparchia said...


doesn't seem to have worked too well in this case, does it?

saw it somewhere but lost the link [and am trying to quote from memory] - our uniquely american management system works ok for producing widgets, but not so much for distribution.

actually there's stuff to like about our way of doing things, if there are sufficient checks and balances. maybe if we change the brake pads, turn the drums and rotors, replace a few hoses, we can get this bus back on the road.

Keifus said...

Ha. Tell that to Wal-Mart. I think the American management system is good at keeping non-management costs down and prices up, even if it's just to pay for themselves. A while ago (and I must say that you usually end up with my better comments somehow), I compared it to an eastern European party apparatus. I think there's something to that.

Civilization, and humans, may well be inherently fucked. But I can't help but observe that some versions have been a lot more fucked and more evil than others (or maybe "believe" is the better word--ours sure has a nasty awful imperial history), so maybe there's hope we can keep the expression of our foul natures to a minimum. Frankly, I think shame has a better chance of getting somewhere than electoral politics do (even though I basically write because I can't shut up).


[Off topic: I've got a little girl that's going through an animal-love phase. I may ask you for some advice if it ends up taking more strongly than her other phases have.]

hipparchia said...

[sure! any time. ask away. some of us never grow out of that phase.]

heh. no need to shut up. i've always liked ioz' throwing orange peelings references myself.

i'm not a fan of shaming, though it's certainly been employed by a lot of groups, including our own. hester prynne, anyone? which should give you an idea of its utility, perhaps.

dude, nobody makes it off this planet without leaving footprints, be they human, critter, or otherwise. and frankly, i'm on the side of the critters more often than not. in my darker moments i'm pretty sure we humans all deserve each other. you could probably argue that nobody in history has quite matched us for nagasaki and hiroshima, but here, this should make you feel better about us. or not.

i've often wondered just how much this human tendency to rape, murder, pillage, and plunder has contributed to our developing the ideas we have about good and bad karma.

i think that management quote i found was on a blog about halthcare, so perhaps there was something specific aboput healthcare delivery. can't remember for sure, too lazy to look for it.

as i've said before, i don't mind paying extra, *lots extra, and i don't even have a preference for how we pay it [govt or free enterprise] because i believe everyone ought to be able to work if they want to, but by golly, i'd better be getting what i paid for.

* what difference does it make if i pay a premium for health care and employ lots of paper pushers in the healthcare system or if i pay higher taxes for welfare for the unemployed? ideally, we'll have a flexible mix of both: lots of people want to work, and lots of others can't work. a society that doesn't make a pact to provide all these people isn't a society. it's not even a wolfpack.

Keifus said...

By shame, I was thinking more like appeal to dignity (or against dignity) than the Scarlet Letter. (How naive of me.)