CapitalistImperialistPig

By Ann Case and Angus Deaton. The authors start with a puzzle: after many years of declining mortality rates, White Americans in midlife have seen a significant increases in mortality rates in recent decades.  This trend is not seen in other rich countries, though there are bits of it in the UK and especially in Scotland.  A closer look shows that this increase in mortality is almost entirely confined to those without four year college degrees. The increase in mortality is not the only sign of social dysfunction seen in this group.  Rates of marriage, home ownership, voting and church membership have decreased, while out of wedlock births and damaged families have sharply increased, to name just a few of the many indicators cataloged by the authors. So what is killing the members of this group?  The major role is played by what the authors call deaths of despair: suicide, drug overdoses, and alcoholism.  The drug overdoses in particular were promoted by a ...

The camel gets its nose into the tent. From Willinois: Did you notice? Did you see what happened when everyone was complaining about a website? Single-payer got started in America. Vermont is using authority granted under the Affordable Care Act to start a single-payer system. Most Americans still don't know what the phrase "single-payer" even means. It had little support in Congress in 2009 and Senate "Democrats" like Nelson and Lieberman even killed the public option. But, ACA had this sweet little provision that allowed states to set up a single-payer system and now people will see it in action. You know what that means. As Senator Bernie Sanders (I-Vt.) opines, "The quickest route toward a national health care program will be when individual states go forward and demonstrate that universal and non-profit health care works, and that it is the cost-effective and moral thing to do.” Let me just save Faux Snoose and the Repubs some time: Socialism! Co...

Kevin Drum says it: The Republican Party is bending its entire will, staking its very soul, fighting to its last breath, in service of a crusade to.... Make sure that the working poor don't have access to affordable health care. I just thought I'd mention that in plain language, since it seems to get lost in the fog fairly often. But that's it. That's what's happening. They have been driven mad by the thought that rich people will see their taxes go up slightly in order to help non-rich people get decent access to medical care. That's a pretty stirring animating principle, no? It's not just the poor, of course. It's anybody with a pre-existing condition, or anybody with a family member with such a condition. It's also a big chunk of the middle class - the self-employed, entrepreneurs who haven't yet made it big, etc.

Andrew Sullivan notes that Republicans insist on selling the idea that private health care would be cheaper than government care. This argument has one slight problem: The trouble with this argument is that while it is indeed doctrinally perfect, and therefore appealing to today's brain-dead GOP base, it is empirically wrong. The private healthcare sector is far more expensive than the public and enormously inefficient - especially compared with more socialized systems abroad. Neither Andrew nor the economics profession in general seems ready to make the leap to concluding that doctrines which give wrong answers might be, er, wrong.

Why is Paul Ryan taking on Medicare, an overwhelmingly popular government program? Principled daring proclaim the conservative pundits. Bullshit, of course. Pay attention to the man, or rather insurance companies, behind the curtain says Wendell Potter. Ryan's plan would toss some trillions of dollars into health insurance company coffers over the next couple of decades, and for that kind of bucks they are prepared to take some risks - not to mention committing perhaps a billion or three to a massive disinformation campaign. Potter, a former insurance executive, was at the meetings when they plotted their strategy. Ryan et al would never propose such a fundamental reshaping of those programs unless they were confident that corporate America stands ready to help them sell their ideas to the public. Like big business CEOs, Congressional Republicans wouldn't think of rolling out Ryan's budget plan without a carefully crafted political and communications strategy and the as...

Via Brad DeLong Paul Ryan has presented his plan as essentially like the Ryan-Rivlin plan. In an interview with Ezra Klein, Rivlin disagrees: Alice Rivlin and I designed these Medicare and Medicaid reforms ,” Paul Ryan said on “Morning Joe” yesterday. “Alice Rivlin was Clinton’s OMB director… she’s a proud Democrat at the Brookings institution. These entitlement reforms are based off of those models that she and I worked on together.” But Rivlin — who is all that Ryan says she is, in addition to a former vice chair of the Federal Reserve — is not supporting the reforms as written in Ryan’s budget. I spoke with her this morning to ask why. A lightly edited transcript of our conversation follows. Ezra Klein: What struck me when I dug into the details of Ryan’s budget is that he changed the target Ryan-Rivlin had set for Medicare from GDP+1% to the rate of inflation. That seems pretty hard to achieve. Alive Rivlin: That’s a reason for me saying very strongly that I don’t support the ver...

Wolfgang - "Why is the growth in health care spending in the US outstripping that in the rest of the developed world?" because in many countries (e.g. in the European country where I live) health care spending is capped (similar to what Ryan-Rivlin proposes by the way). This means e.g. in Germany or Austria that a personal care physician has a budget for each quarter which he/she cannot exceed (and they have to stop writing expensive prescriptions when they reach their budget limit. And no this is not a joke.) If I may risk a paraphrase, Wolfgang is pointing out that the only sure way to contain medical costs is to ration what care insurance will pay for. I agree and so does Krugman. One approach to this is based on having experts evaluate the effectiveness of treatments and specify those eligible for coverage. Our Republican friends styled these as "death panels." Another approach is provide some subsidies and let insurance companies decide who gets care - that...

Like other States, Texas is feeling our economic pain , and casting around for stuff to cut. the governor has floated the idea of eliminating Medicaid. That might be an interesting experiment, since it would probably trigger the flight of Medicaid patients to other States and perhaps a nationwide collapse. I wonder if anyone has analyzed how this might work.

Brad DeLong points us to Kenneth Arrow and Uwe Reinhardt on why health care markets don't work. The central clue is asymmetric information. Arrow figured this out in 1963! The promotion of markets in health care since then has had the effect of destroying some of the social glue that helped health care function despite the markets. My favorite line (Reinhardt): In my view, when economists wax mushy on the virtue of what they call “efficiency,” it is time to run for the hills, for they are selling a preferred moral doctrine in the guise of science.

Physicians have succeeded in making an artificial trachea for a woman using her own stem cells and some donor cartilage. PARIS — Physicians at four European universities have successfully transplanted a human windpipe, using stem cells from the recipient’s own bone marrow to reline a donor trachea and prevent its rejection by her immune system, according to an article in the British medical journal The Lancet. This is an early step in the development of artificial organs based on one's own cells, but its apparent success guarantees that future efforts will be redoubled. The holy grail for such efforts is the creation of whole organs: artificial pancreas, heart, kidney, liver, and lungs. These will take a while, but some version might appear in the next decade, and in a couple or three decades, rich people might start stockpiling handy replacement parts.

Kevin Drum links to a story that shows how the times, they are a changing. Most Americans get health insurance through their employers, but this is a benefit that is rapidly being eroded. Union boss Andy Stern says: She has worked every day of her life. Her 16 year old daughter Janelle was having respiratory problems, and the doctor sent her for an x-ray. But because Lisa still owed several hundred dollars from a previous illness, the x-ray was postponed and the doctor said they would just monitor her progress. Three days later—Janelle died. She died in the richest country on earth, even though her Mom worked every day, simply because she was still too poor to afford health care. This is not the America any of us want. ... It is time to admit that the employer-based health care system is dead—a relic of the industrial economy. America cannot compete in the new global economy when we are the only industrialized nation on earth that puts the price of healthcare on the cost of our pr...