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June 1, 2002

Cui bono Matthew Yglesias supports universal health care, but wonders what’s so great about prescription coverage for the elderly as a supposed step toward that:
Morally speaking, if anyone’s entitled to basic health coverage at public expense, the case seems clearest when you’re talking about children, not old people—it’s hardly a sick six year old’s fault if his folks haven’t managed to make enough money to get him decent health care. From a pure bang for your buck standpoint children seem like the right place to focus too. They’ve got a lot more to gain in terms of years of healthy living from getting things treated properly, and giving health care to children can (in some sense) be seen as a public investment in a future worker, taxpayer, and generally productive member of society in a way that giving care to the elderly can’t.
Fellow Harvard blogger Glenn Kinen points out, in Yglesias’s comment section, that old people vote; children don’t. He’s probably right, but all the more reason to remark on the hypocrisy implicit in this tactical political choice. [03:09 PM]
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Comments on Cui bono:

Rivka ::: (view all by) ::: June 01, 2002, 07:16 PM:

Uninsured children are eligible for CHIP, a health insurance program administered by the states, even if their families don't qualify for Medicaid. Medicaid also covers health care for a great many children.

Now, it's true that most states don't go out of their way to let people eligible for CHIP know about it, so many children lack coverage even though they could receive benefits. But that's true for most aid programs.

Avram ::: (view all by) ::: June 01, 2002, 11:01 PM:

Not only do old people vote, but they congregate in presidential swing states like Florida.

Lydia Nickerson ::: (view all by) ::: June 03, 2002, 12:27 PM:

The problems of children's health care and health care for seniors are significantly different, though. Kids need regular checkups, vaccines, occasional trauma care, and that's about it -- unless they have a chronic disease. Seniors have a chronic disease: old age. When your life is dependent upon drugs that cost hundreds or thousands of dollars a month, every month, that's a very different situation.

Not that there isn't ample hypocrisy in the whole debate. The drugs cost a lot of money in part because of legislation that the drug company lobbyists have successfully lobbied for. Coverage for expensive drugs is _great_ for the large drug companies, who would like to continue to charge very high prices, higher than most people can pay, with the government footing the bill... One of the reasons most of the "medical industry" hates the idea of universal health care is that it gives the single payer leverage against high prices.

HMOs talk about volume discounts and the like, but they don't seem to deliver. Moreover, they pick and choose who they cover and how they cover. I have a chronic problem myself (manic-depression) and my drugs are terribly expensive -- over $1000 month retail. If it weren't for the fact that I'm working and therefore have access to a group health plan, I wouldn't have coverage at all. As it is, the insurance company has a "formulary" which means that I still have to fight them to get the drugs I really need. Nevermind that the psychiatrist has prescribed them, or that I've been stable on this mix for several years. No, they don't want to let me have this or that, or not so many per month... My pharmacist and I joke every time I go in about what the insurance company has done to me, this time. One time in 5 I actually get everything I need without anything being disputed or screwed up. You know, I can't see that universal coverage can be a lot worse than what I have now.

Simon Shoedecker ::: (view all by) ::: June 10, 2002, 03:45 AM:

Matthew Iglesias writes, "it's hardly a sick six year old's fault if his folks haven't managed to make enough money to get him decent health care."

In contrast to old people. But is it the old people's fault that they themselves haven't managed to make enough money for their own care?

We have accepted inequality to the extent that it is considered your own fault, for instance, if you haven't made enough money to afford a big house or a fancy car. (Never mind for now whether that applies to having any housing at all.)

But do we want to live in a world where the amount of money you make dictates whether you have any health care?

Some would evidently say yes.