Pie's never free ... Planet Money talks breast pumps and the ACA

I could honestly recommend virtually every Planet Money podcast ever produced as "must listen" material -- their crew does a great job of looking at both very complex and regular everyday issues and making them approachable and informative.  If you have an interest in economics or business at all, I highly recommend adding their podcasts to your brain consumption.

Their most recent episode talks about the impact of federal legislation (specifically the ACA, aka "Obamacare") on the breast pump market, and poses some good questions in the mind of the listener in terms of when it is really appropriate to legislate private market activity and when it isn't.

If I was King (or a noble dictator), I'd reform our healthcare system in a way that de-links health insurance from employment, which would allow for more career mobility in our country and, frankly, make it a lot easier for businesses to do business (instead of devoting so many resources to being healthcare insurance providers).  The tradition of health insurance being a part of an employment package is a somewhat artificial construct dating back to the days of wage controls in WWII.  In other words, it arose as a workaround to existing government regulation that were distorting the job market.  Similarly, today, one could assume that if employers got out of the business of providing healthcare insurance, salaries may well rise by roughly the amount that employers were previously spending on health insurance (as many/most people today are making their job decisions factoring in the value of the health insurance perks).

I'm also definitely in favor of some basic level of universal healthcare insurance.  We already have universal access to healthcare -- it just happens to be incredibly inefficient and creates terrible incentives both on a cost and care basis.  Federal law requires that anyone showing up to a healthcare facility with urgent healthcare needs must be given treatment.  Without that law, a possiblity exists that people would be left to die simply because they couldn't pay for the healthcare services they needed.  As a society, we've deemed that scenario to be one we can't morally or ethically stomach, so we've put a mandate in place to prevent that from happening.

So why do we need univeral healthcare insurance?  Absent a person having healthcare insurance (or such large sums of money available to them that they are essentially self-insured), we run into two problems: 

1. The very real situations where people simply can't afford healthcare insurance (and don't have the ability to pay for needed treatments out-of-pocket), and they end up utilizing more expensive versions of healthcare (waiting until it's really bad and then hitting the ER, etc.) rather than being proactive and utilizing cheaper forms of healthcare; and
2. The same general scenario, except from people who can afford health insurance, but simply gamble that they won't need it, knowing that they can just freeload in the event that they ever do need it. 

As in the case of breast pumps above, nothing is ever "free," so those higher costs in both scenarios are borne indirectly by the rest of society, driving up healthcare costs for everybody who does pay their own healthcare costs.

My "back of the envelope" solution to our healthcare reform needs would be to have a base level of health care insurance that would be either [Plan A] mandated to be purchased by the individual, with support for those who can't afford it; or [Plan B] a system where everyone gets vouchers that would pay for a minimal amount of private healthcare insurance (essentially a voucher that would purchase enough insurance to cover basic needs to keep people healthy and to prevent them from losing everything in the event that they get sick/injured, but nothing extravagent).  I'd leave it up to a vote of the people (I would be a King/Dictator of the people, of course) to collectively decide which option they preferred, depending on how much they were willing to pay in taxes. 

For Plan B, people could pay for more generous insurance coverage over the voucher amount out of pocket.   

I wouldn't have any mandates in terms of what specifically was covered.  If people didn't want, say, breast pumps covered by their insurance, they could buy a policy that didn't cover that sort of thing.  Same with contraception, etc.  One can make the argument that subsidizing breast pumps is good for society, and it may be on some level, but at the end of the day, I'm not generally in favor of subsidizing people's life decisions (including their decisions to have kids) unless the benefit to society is very clear and so compelling that the benefit to society far outweighs the cost to society.  In this particular instance, I don't think the math favors the mandatory breast pump coverage.  As the economist in the podcast argues, if a strong benefit to society argument can be made for the use of breast pumps/breast feeding, it seems like a better approach would be to provide subsidies only for those women/families who can't otherwise afford their own breast pumps as opposed to making it a benefit available to everyone. 

I'd also borrow a lot of ideas from the ACA, such as creating the Health Insurance Exchanges, so people could competitively shop for insurance plans in an easy-to-understand online marketplace.  I'd also implement a lot of electronic records and other tech-laden ideas to increase the efficiency of our entire healthcare system.  The HMO we currently use seems to do a really good job of both providing quality healthcare service and keeping costs down, so to the degree that my crown could encourage the geographic expansion of their HMO model, especially into rural areas, I'd have my minions strongly consider such a plan.

This is really just an incredibly rough draft that popped into my head while listening to that podcast, so I'm sure much of it is complete garbage when examined by people who know a lot more about these topics than I do, so I welcome that input to tell me where I'm wrong, or where more thought/info is needed, or even if I got something right.

After I fixed all of our nation's healthcare woes, I would immediately resign as King/Dictator, as I truly can't stand either monarchies or dictatorships, and I'd hate to be that emotionally conflicted for too long.   

Assault Weapons

I'm still trying to come to firm ground on this whole gun debate. One area that I'm really struggling with is the "assault weapons" part of the discussion.

Even some "conservatives" like Ronald Reagan actively supported "assault weapons" bans, but I haven't been able to be completely sold either way from what I've seen and read to date.

Here's how I think it frames up (and I am totally open to anyone providing arguments/evidence that any of these legs isn't accurate):

• Assault weapons make it easier for a shooter to kill large numbers of people in the shortest amount of time possible as compared to their slower and lower capacity gun cousins.

• Lots of people derive a lot of joy out of owning and recreationally shooting these "assault weapons."

• The Second Amendment doesn't preclude bans on "assault weapons," as per the holding of the SCOTUS Heller case (and passively reinforced by the fact that the previous federal assault weapons ban was never shot down by the SCOTUS).

It seems it would be completely Constitutional for "assault weapons" (and I will continue using scare quotes here, as I realize there is no formal category of weapons known as "assault" weapons) to be banned, so that issue appears to be off the table.

So for me, like I outlined in my original blog post, the whole argument comes down to determining whether the benefit of these weapons in our society (the pleasure people derive from owning/shooting them, which is something that I think does deserve consideration in these kinds of issues) outweighs the cost to society (the infrequent mass shooting that results in more dead than otherwise would have resulted).

Does this sound like a good framework to work from? And if so, how would you argue/weigh the relative cost/benefits of these weapons for our society?

Infotainers ... ripe ground for cynics

Glenn Beck seems less able to hide his insincerity than most, but it's still nice to see this Avlon article exposing the "chase the money" mindset of these kinds of public figures.

It really does beg a question that I've often asked myself -- how much of the mindless partisan crap that the radio and TV show hosts and print political hacks write is stuff they truly believe, and how much of it is performance art manufactured to entertain the audience they are targeting (in order to enrich themselves, of course)?

I suspect the fans of many of these hyper-partisan entertainers would be deeply disappointed if they were to discover the truth about what most of these people actually think about the issues of the day, and how little they truly value the intellect of their own audiences.

One moves to the "pro-genetically modified" camp

I'm not an expert in the field of genetically modified organisms, but I've also never seen any evidence that would convince me that there was any danger to be found from those technology-enhanced food sources.  I also come from an ag background (so I tend to lean in favor of advances that could make farmers/ranchers more efficient/profitable) and worked in college for a short time in a lab that was doing genetic research on ways to make crops more resistant to pests and drought.

So I do have a bias coming in ... although, again, I would change my mind quickly if evidence was presented that showed a causal relationship between GMOs and adverse impacts on the environment/human health.

The subject of this article is impressive to me not so much because the guy moved toward my view on the topic (although that does play a small role in its allure to me, as we all like to feel like we're "right" as a way to feed our egos), but more because he was willing to publicly admit that, after reviewing all of the available evidence, he completely changed his mind.

We humans are too often so enamored with our own opinions and conclusions that we never let additional information into our skull, for fear that we may not be able to reconcile that information with the opinion we already hold ... and we'll be damned if we'll ever even consider totally abandoning our original opinion.

So ... kudos to Mr. Lynas.  I'm not sure if you are now right or wrong (although I have my own knee-jerk opinions), but either way, you have the guts to question your own views and admit when you reach a point of deciding that your previous view was flawed.

May more activists and others with strongly held opinions follow your same path of critical introspection.