TheAgitator.com
Ezra Klein Misses the Point
Thursday, July 2nd, 2009In a post about Wal-Mart signing on to an employer mandate for health insurance, Washington Post blogger Ezra Klein says he was initially skeptical, but then read the joint letter between Wal-Mart, the Service Employees Union International, and the Center for American Progress, and pronounces himself convinced.
He notes, though, that Wal-Mart isn’t doing this for altruistic reasons, and in doing so Klein comes perilously close to grasping the concept of rent seeking and regulatory capture. But then he whiffs.
This isn’t, of course, a story of altruism. By being of use to the administration, Wal-Mart ensures that its concerns will be heard and heeded. By publicly associating itself with health reform, the company repairs some of the damage SEIU and others have done to its reputation in recent years. And, in a more macro sense, by throwing its weight behind strict cost controls, Wal-Mart makes it likelier that it gets the largest of all possible benefits: an eventual slowing in the double-time march of health-care costs.
Klein then almost stumbles onto the point again. But again it eludes him.
But health reform isn’t supposed to be about altruism. And that’s arguably the most important message of this letter. Reforming health reform [sic] isn’t just some liberal president’s agenda item. It’s good business.
Supporting new regulations is usually good business if your company is big enough to absorb compliance costs that could slow down or cripple your competitors. Even better if can you sign on early and win over a few influential opinion makers, interest groups, and politicians so you’ll have some pull over how the regulations are written.
Ezra Klein isn’t missing the point. He knows damn good and well what regulation does to small business. He’s choosing to avoid pointing out the consequences. People like Ezra aren’t stupid, just sinister.
Wait a second, health reform isn’t supposed to be about altruism? Is Klein really saying it makes good business sense for me to give money to pay for other medical bills? It might make good business sense for some businesses to reform health care in a variety of ways, but isn’t this slew of reform based on the idea that everyone should have health care regardless of ability to pay (altruism)?
It’s a (left-statist) article of faith that government is good, so the ideas of regulatory capture and rent-seeking are anathema to them. People do strange things in the name of faith.
@#1 Mattocracy
I dunno. Maybe. I mean, this is Ezra Klein we’re talking about, not Ellsworth Toohey. I tend to think he really is as dense as he comes off.
Check Ezra Klein’s bank account. I guarantee a very large deposit was just made, courtesy of Wal-Mart.
“Regulatory capture”? LOL! That’s exactly right, Wal-mart is looking to crowd out all the other mom-and-pop 200,000 ft superstores.
It’s worth pointing out, though, that if you’re really concerned about the costs of ballooning health care obligations on small businesses, single-payer takes care of that pretty handily. Of course, then minorities might get health care too, and we can’t have that!
Wal-mart’s lawyers won’t just “have some pull”, they’ll likely draft the legislation themselves.
Valid point.
OTOH it’s rather difficult to imagine that there could be a downside for Wal-Mart either way.
WalMart is also keen enough to know exactly where all this “reform” is meant to lead: a de facto single-payer, public financed system, which will eventually allow them to foist all of their health care costs onto taxpayers. Win-win indeed.
which will eventually allow them to foist all of their health care costs onto taxpayers.
..where it will costs far less to provide the same amount of care than hundreds of private heath insurance companies, thus reducing prices and saving us all a ton of money in the long run.
Yeah! Down with WalMart! Down with big, soulless corporations! Up with…. HMO’s? Hrm.
Chet
If you beleive that a government program will save you money, I have a bridge you may be interested in.
If you beleive that a government program will save you money, I have a bridge you may be interested in.
Funny example, since it’s the government that pays for bridges. Anyway, sure, I’m interested. I’ll pop by, but I have to stop by the Post Office, first. The FedEx is closer but jesus, have you seen their prices?
It is interesting to note that some voices on the blogging left agree with you:
“SEIU Got Served” by Jesse Taylor (Pandagon)
http://pandagon.net/index.php/site/comments/seiu_got_served/
Check this link:
http://www.kevinmd.com/blog/2009/07/americas-failed-attempt-at-a-single-payer-system-the-indian-health-service.html
To see how the government already failed with a single payer system.
And see http://healthcare.change.org/blog/view/the_va_the_greatest_story_never_told
to see how the government has already succeeded with one: ” In 2003, the New England Journal of Medicine crunched the numbers, comparing Medicare and the VA on a broad range of health indicators, from preventative care to chronic care to inpatient care to outpatient care. By 2000, the VA had better indicators than Medicare in 12 of 13 categories.”
Touche salesman.
This may be about more than the union.
People forget that Wal-Mart has another reason to get on the good side with the Obama administration regarding health care: scores of Wal-Mart stores have medical clinics, and the number of clinics has been rising rapidly. Perhaps Wal-Mart expects to gain medical customers under ObamaCare. Perhaps Wal-Mart’s clinics hope to get special financial considerations for being among the first to support ObamaCare.
Chet, I was a VA physician from 2003-2008. The VA got such great scores on the monitored health indicators because its administrators threw every resource possible at them, even the worthless or clinically outdated indicators, even if more important quality issues were ignored, so that the administrators could garner good PR for meeting the indicators and pocket their bonuses.
In truth, quality declined due to the monomaniacal focus on the monitored indicators. (Other important quality issues were ignored.) One of the good indicators for diabetes care was dropped from the monitoring list in 2005. Immediately, VA facilities pulled the monitoring and reminder program off their computers. I asked why it was removed, and the administors replied that only monitored indicators get computer support. They were afraid that retaining ‘useful but not monitored’ indicators would “distract” the doctors. Doctors had no say in that decision, and that aspect of diabetes care declined.
I’ve often heard that Wal-Mart is in favor of raising the minimum wage. Can anyone guess why?
Chet,
My wife is a physician at a VA hospital, and trust me, you don’t want that kind of care. She treats cancer patients. Although there are multiple machines that could treat the veterans’ cancers IN THE SAME HOSPITAL SYSTEM in the SAME city (but not technically in the VA), they are required by the rules to drive hundred of miles to our state capitol, where the only VA hospital with the actual machines located inside the VA is. Every single VA patient from the ENTIRE state has to go to a single hospital to get treated. As you can imagine, there are pretty lengthy waiting lists to get treatments on those various machines, which means that with aggressive cancers, many lose quite a bit of actual life on earth. Sure, it’s easy to treat the VA patients’ delays as negative externalities, that is, until it happens to you or someone you love.
My wife always says: “We already have universal healthcare. It’s called the VA and it SUCKS!”
Dr. T, that may be, but even if that’s true it’s a betrayal of the VA’s exemplar care, not a refutation of it. The VA continues to lead the private industry, even on indicators that are impossible to fake.
Sorry, it’s neither here nor there. It just continues to be amusing how libertarians keep standing up in favor of the status quo in health care – an enormous conglomerate of huge moneyed interests that works against public health, physician prerogative, and consumer choice.
Chet, refuting claims that single-payer won’t work in driving down costs and increasing care quality does not automatically equate to being in favor of the status quo. It’s just an example of not being in favor of one option that has been suggested, which is likely to be rammed down our throats like the prescription drug benefit, TARP and various bailouts.
Chet, do you watch a lot of Fox News? They love that “if you don’t agree with me 100% you must be evil and stupid and unquestioningly in favor of the most absurd alternative that I can imagine” shit. On the other hand, so does the Huffington Post…
I’m a small biz owner and I support single-payer. Private practice and public financing sounds great to me.
From #15 (Chet’s article): “It represents, with no exaggeration, the best health care system currently operating in the United States of America.”
I don’t even know where to start with this one.
Chet, the status quo is government run healthcare.
The problem isn’t so much who pays, it’s the fact that our government continues to reduce the supply of healthcare. The VA is a prime example. Limited facilities and staff creating long lines and wait times. That drives up costs, not insurnace companies and no profit seeking companies. Get rid of certificates of needs, stop creating qoutas for med schools, create some tort reform to reign in malpractise insurance, and maybe people could afford health care on their own. Until our government allows supply to meet demand, it’s going to be expensive no matter who pays.
>>>>>>where it will costs far less to provide the same amount of care than hundreds of private heath insurance companies, thus reducing prices and saving us all a ton of money in the long run.<<<<<<
I am a government worker. My observations on everything from flashcards to million dollar purchases is that government run anything is MORE expensive not less. There is not a single item we purchase that couldn’t be found cheaper at our local stores or amazon, but we are not allowed to use those resources.
Chet, you are simply wrong about the fact it would cost less.
Chet, the status quo is government run healthcare.
I wish.
There is not a single item we purchase that couldn’t be found cheaper at our local stores or amazon, but we are not allowed to use those resources.
See, this is the sort of absurd, overly simplistic analysis that completely drains the credibility from your side. Cliff is probably beyond all hope but is this the kind of justification the rest of you find compelling? Seriously? Health care isn’t like anything you can buy at Amazon. It’s a fundamentally different type of good. (And anyway as an employee of the USDA a few years ago I didn’t see anybody have any problems buying something they needed from a “local store or Amazon.” The inefficiencies of government are largely exaggerated, and often can’t compare to the absurd inefficiencies of the private sector.)
Apropos of nothing Wal-Mart has already done more to reduce health care costs to American citizens then any one entity.
http://i.walmart.com/i/if/hmp/fusion/genericdruglist.pdf
Not to mention once Wal-Mart did it everyone else jumped on the band wagon. Target, Safeway, Kroger, Giant, Walgreens ect…
Absurd and overly simplistic? Go back and read your own posts. You link to biased articles making ridiculous claims that VA care is so awesome. Any veterans can tell you differently. Did we forget about how outraged everyone was when we found out Walter Reed was giving out shitty care to vets coming back from Iraq?
You make statements like “it will costs far less to provide the same amount of care than hundreds of private heath insurance companies” with nothing to support that claim.
And you completely ignore the policies our government has implemented that has played a signicant role in the rising costs of healthcare in America.
If that isn’t enough, there is still the fundamental question of “should we force people to pay for the healthcare of others?” Should we be forced to pay for the healthcare costs of Obama’s lung disease that he will develope from his smoking habit? Or pay for the healthcare costs of people who refuse to exercise and eat shitty food? If we have a universal healthcare system, will it suddenly be ok to start dictating every part of our lives from our salt intake to forcing us into gym memberships? The slope is steep and slipery.
“The inefficiencies of government are largely exaggerated, and often can’t compare to the absurd inefficiencies of the private sector.”
To be fair to Chet, the inefficiency isn’t always a natural consequence of government. Sometimes it’s just due to the graft and corruption endemic to our faceless unaccountable bureaucracy. But mostly it’s a natural consequence of extra layers of overhead costs and lack of competition.
Chet: “Health care isn’t like anything you can buy at Amazon. It’s a fundamentally different type of good.”
Bullshit. There is no way in the world that you can make that case because it’s simply not true.
#19, Emerson: “I’ve often heard that Wal-Mart is in favor of raising the minimum wage. Can anyone guess why?”
Offhand, because it would do more damage to Target and K-Mart. Wally World and Sam’s Club do pay above minimum wage even for cashiers (granted, not MUCH, but enough that a minimum wage increase wouldn’t bother them).
I personally would rather eat broken glass than go into a Wal-Mart or Sam’s Club nowadays (I used to /work/ for a Sam’s Club, yay). Frankly, the service has become spotty and slipshod; emblematic of this is the Wally World habit of having fifteen lanes in their front checkout — with only one manned.
You link to biased articles making ridiculous claims that VA care is so awesome. Any veterans can tell you differently.
No, not “any” veterans – just the ones who have reason to complain, which are a small minority. Most veterans will tell you that they had adequate and attentive care. How do I know that? Because most veterans have said exactly that in surveys. You know, that’s something the private sector doesn’t do – monitor quality of care in the system. How long do you have to wait for a procedure in the US? Nobody knows, because nobody keeps track. The only reason you know about waiting times in Canada and the UK is because the government measures waiting times, so that they can be managed; in the US, nobody’s really keeping track, so liars are able to say “we don’t wait in the US”, which everyone knows is false but no one has any data to contradict.
Did we forget about how outraged everyone was when we found out Walter Reed was giving out shitty care to vets coming back from Iraq?
That’s your best example? The one hospital the VA tried running like a private insurer would? Wow, amazing. What a compelling case for the status quo.
If that isn’t enough, there is still the fundamental question of “should we force people to pay for the healthcare of others?”
It seems like that question has been answered. If you buy health insurance, you’re paying for other people’s healthcare and they’re paying for yours. The very concept of insurance is you paying for other people’s carelessness, negligence, and bad luck. And they pay for yours.
If you think that’s a fundamentally flawed concept, go cancel your insurance policies. All of them. Once you’ve accepted, though, that healthcare is a public good it makes sense to have it publicly administered.
There is no way in the world that you can make that case because it’s simply not true.
It simply is true. Look, you will never need a book, or a burger, so bad that if you don’t get it right then at whatever price, you will die. You can be in that situation with healthcare, though, which is why a market can’t deliver health care the way it delivers burgers and books. I mean you can need healthcare so bad you’re not even conscious. How are the unconscious supposed to shop around?
I mean, obviously. What is wrong with you people?