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Healthcare Bill

I sometimes wonder what kind of innovation renaissance the USA would undergo if it really did pass proper universal coverage. Who would start her own business? What would your neighbors invent, patent, and produce? I thrill to imagine people with the liberty to start over, try something new, to make things — without the stifling terror of being left uncovered or uncoverable. I dream one day of dancing on these eggshells, like the rest of the industrialized world.

[Crossposted to/from my website. If you'd like to comment, you can do so either here or there.]



( 30 comments — Leave a comment )
Mar. 22nd, 2010 04:09 pm (UTC)
While I agree the current system is broken, I am not sure this is sound logic or going to result in a net change as you suggest.

The United States is already is one of the biggest drivers of innovation in the world. Though we are lagging behind in theoretical physics and several cutting edge fields we hold the lead in many areas of research and creation.

The question is, would be be better at this if we were more secure, or does innovation get driven by the crucible like environment we create which pushes people to strive to achieve or to become axel grease in the machine?

I am not saying that is a factual statement, its more of a open question.

Does safety create an environment where it is SAFE to try, or does the pressure of annihilation and failure create more drive to achieve?

Mar. 22nd, 2010 04:58 pm (UTC)
When I found real, affordable, health insurance, I dropped from full-time at the job that sucked all of my creative energy away to part-time and started doing freelance design and making real art again. It was one of the major final stumbling blocks. And when the recession hit, still being able to afford my health insurance kept me from hanging up my camera and hunting for a barista apron. Anecdata, to be sure, but real.
Mar. 22nd, 2010 05:47 pm (UTC)
The question is, would be be better at this if we were more secure, or does innovation get driven by the crucible like environment we create which pushes people to strive to achieve or to become axel grease in the machine?

In my experience, punishing failure leads to less innovation instead of more. If the consequences of failure are too dire, then you don't dare fail; the way to avoid failure is to either stick to what is proven or to not try at all. Take a look at businesses (or governments) that run by the Darth Boss system... they're not the hotbeds of world-changing ideas, are they?

-- Steve thinks that capitalism succeeds most on its ability to accept (or at least tolerate) the risk of failure.

PS: This is also an argument against "too big to fail" thinking. Capitalism works by allowing busted ideas to drop out of use as well allowing better ideas to prosper. If something is so big that it can't be allowed to fail, it should be reduced until its failure doesn't risk taking down everything else; or if that is unacceptable it should be handed off to the risk-averse public sector where it is less likely to take unacceptable gambles.
Mar. 22nd, 2010 06:15 pm (UTC)
People work harder for nearly limitless rewards than they do to avoid punishments. Fear of loss makes people want to be safe; greed makes them take risks.

Is it a solid, established, provable fact, like "water tends to make things wet"? No, but it's a very safe bet.
Mar. 22nd, 2010 07:51 pm (UTC)
Any halfway rational person does a risk/reward analysis. Few of us who might leave our day jobs if we had health insurance are looking at "nearly limitless rewards". Many of us who might do something else aren't even looking at rewards as lucrative as what we take home in salary now. One might be tempted to say you can't put a price on personal fulfillment, but it's not true. Having already had two surgeries in my lifetime, I can say for certain that a major illness or injury without health insurance is a price too dear to pay for any possible amount of personal fulfillment. Would I have said the same thing at 20 or 25? I don't know. But I say it without hesitation at 38.
Mar. 22nd, 2010 07:59 pm (UTC)
Sure, but I was responding to "The question is, would be be better at this if we were more secure, or does innovation get driven by the crucible like environment we create which pushes people to strive to achieve or to become axel grease in the machine?"

People aren't as driven by fear ("achieve or become axle grease") as they are by reward ("achieve to get something you want!").

It's true: health insurance won't suddenly open the floodgates, where tens of millions of Americans become entrepreneurs because they have better access to health care. But it's not fear of losing health insurance that will drive innovation, either. It's the thought of rewards that will do it.
Mar. 22nd, 2010 08:38 pm (UTC)
The United States is already is one of the biggest drivers of innovation in the world. Though we are lagging behind in theoretical physics and several cutting edge fields we hold the lead in many areas of research and creation.

Are those innovations owned by the people who actually did the work of inventing them, or by the corporations that they worked for at the time?
Mar. 23rd, 2010 12:55 am (UTC)
That is a different argument and few individuals own innovation anymore, once we stood on the shoulders of giants, now we stand on pyramids of giants standing on other giants. IP is rarely the sole property of the individual.

Mar. 22nd, 2010 04:12 pm (UTC)
Agreed! I know many people are overjoyed re: this legislation, but having read a very skeletal outline of what passed yesterday, I'm still a bit juberous. I *hope* it will eventually pave the way for the kind of innovation you mention. It's quite depressing to consider how much creativity we must be stifling just b/c people often have to stay in jobs they hate for their health.
Mar. 22nd, 2010 04:56 pm (UTC)
Yeah. I firmly believe that a single-payer system could well lead to far more capitalism and entrepreneurship than any other government effort would; if the folks screaming about "socialism" weren't enraptured by big business, they might even see that. Maybe someday....
Mar. 22nd, 2010 04:57 pm (UTC)
That's such an awesome, beautiful point. I really really hope this bill goes through.
Mar. 22nd, 2010 05:02 pm (UTC)
Word. People who rail against universal coverage like to blithely ignore how hard it is to be an entrepreneur or an artist in a world where health insurance (and therefore health care) is tied to working somewhere that offers an affordable group plan.

And giving some people a subsidy so they can buy minimal insurance that they then can't afford to actually use (because of deductibles and co-pays) isn't universal coverage.
Mar. 22nd, 2010 05:16 pm (UTC)
As an Australian, I live in a country where this is so. It's meant that people who need the help can get it (for the most part).

There are waiting lists for elective surgeries, etc. but for every day stuff I just take my health care card and medicare card, see the Doctor and sign a form.

No cost to me. I also get reduced cost prescriptions, etc.

This is because I am a low income earner.
At higher income levels I'd pay private health insurance.

I've been stunned by the attitude of people who don't want sick people to get the help they need and get back into the workforce.

Surely that's better for your economy.
Mar. 22nd, 2010 06:44 pm (UTC)
You must not have gotten the memo--no one "deserves" access to health care. You're supposed to kick and claw and work yourself to death for it. Whereupon your family is dropped because their only coverage was through your employee insurance plan.

:D (This is less a grin than a rictus.)
Mar. 23rd, 2010 01:29 am (UTC)
Depending on which side of politics you stand, that was either an accurate statement or sarcasm.

But I wonder how the new system (just passed through congress in the States) will work.

Hopefully if will allow people who desperately need treatment but can't afford it, to make the decision to get it.
Mar. 23rd, 2010 01:54 am (UTC)
I'm American, and when my partner died last year, his medications cost a little over $1K per month and he paid out of pocket, full price, for all his medical care and medications, because he was uninsurable after his COBRA ran out in 2003. I leave it as an exercise for the reader whether I was being genuine or sarcastic above.

I do not think that the system provided for in the current bill will fix things--it would not, for example, have kept my partner alive longer, from what I can tell--but I hope it can be a foundation for a sustainable system, and hopefully not too far in the future.
Mar. 23rd, 2010 02:19 am (UTC)
I'm sorry to hear of your loss. The system is never fair. Why is it that humans can be so cold to each other at times?

I'm sure you were being genuine in the above entry. I hope though that this will lead to more positive changes there.
Mar. 23rd, 2010 10:25 am (UTC)
Amen from a fellow Australian!

If the US had a medical system like we did, I'll bet their general healthcare overhead wouldn't be as much as it is now.

Recently I read a National Geographic article about health care costs per capita around the world. The US outstripped the next ranking country by nearly seven times! It was shocking.
Mar. 22nd, 2010 05:27 pm (UTC)
*firm nod*
Mar. 22nd, 2010 05:32 pm (UTC)
I have friends in the UK who have done exactly that - they both run their own IT Training business. They’re free to do so because they don’t have to carry the personal burden of being bankrupt over her diabetes, any car accidents, etc. It’s a freedom we can only dream of here. We have to choose jobs here based on our benefits, not what’s right for us, not what we’re best at, not where we could contribute most. We’re chained to a job that will provide benefits for our family – a few are lucky enough to find that job to be the one that they enjoy, but most? Most are working to pay the bills and would do something entirely different if they could. Plus, more peopel healthy and working means more money into the economy anyway, so I see a win. People avoiding care until they're so sick that an acute issue becomes a chronic problem is a drain on our resources. Fix folks up before they get bad, then they get to continue to contribute to the economy.
Mar. 22nd, 2010 05:49 pm (UTC)
I make this point all the time. Usually to point out why BigComps generally oppose universal health care. That is, as long as only larger, bigger companies can afford to offer health care, they both a) draw from the most talented labor pool, and b) scare their employees into not setting up entrepreneurial competitors that'll eat their lunch.

In other words, from the BigComps point of view, the status quo isn't a bug, it's a feature.

This despite the fact so many of them would be greatly more competitive on a global scale. Boeing vs Airbus (to name a local example) -- which one do you think spends more on health care, even if one calls it a "tax" and the other an "insurance premium"? Do the words matter to the bottom line? GM vs Toyota. Oracle vs SAP. Citibank vs Deutsche Bank. Motorola vs Nokia. Pick your field, every single one of our global competitors spend less on health care per employee than we do, giving them a huge advantage.

So, yes, health care reform is hugely business-friendly. The GOP opposing it is unsurprising, as since 1950, GDP growth is higher during Democratic administrations than Republican ones. The irony of the supposedly "fat cat" Republicans delivering such poor economic results to their patrons is a large one.
Mar. 22nd, 2010 06:31 pm (UTC)
It would be wonderful, and it's what we all want -- well, except for the well-greased members of our legislature who have passed this "bill" that apparently isn't actually completely written yet. Insurance company moguls are celebrating the biggest corporate windfall in history right now, and what the fallout of the bill will be on everyday people is yet to be seen. Speaking only for myself, uninsured and with a pre-existing, if my husband and I (above the poverty line, but maybe qualifying for subsidies) have to lose 8% of our income for "affordable" insurance, we will be wiped out. Right now, it's time to hang on and wait to see what will happen. I do think some people will be helped by this, and that part will be great.
Mar. 22nd, 2010 07:04 pm (UTC)
I think the world would be much different - probably a lot more creative types and boutiques and community that appears because people are finally able to do what they are passionate about without having to worry whether sickness will bankrupt them, or in the case of smaller businesses, employee sickness will bankrupt them.

It would probably be a lot better place.
Mar. 22nd, 2010 09:14 pm (UTC)
It shames me, having lived in Europe for a few years, that some of the poorest, least stable nations which can't provide their citizens with much in the way of jobs, education, or even reliable police and road workers, manage to rank higher than the US on their healthcare.

But this problem, as in all things, we shall overcome, someday.
Mar. 22nd, 2010 09:29 pm (UTC)
i agree with you, cherie.
Mar. 23rd, 2010 01:51 am (UTC)
What do you call a waitress getting treatment for her cancer?

Mar. 23rd, 2010 04:04 am (UTC)

It's funny because it's true :-(
Mar. 23rd, 2010 04:31 am (UTC)
Good questions.
Mar. 23rd, 2010 10:19 am (UTC)
I'm thinking about all the mothers (anywhere from age fifteen to thirty-five) who will not have to live in fear of financial crunch when they discover they are pregnant.
Mar. 23rd, 2010 01:39 pm (UTC)
Yes, that! Not to mention maternal mortality rates for the US are both grossly underreported and, even with underreporting, much worse than countries with socialized medicine (and better reporting systems for maternal and infant deaths). The numbers are depressing. It's amazing how much we do not value giving mothers time to give their children a good start in life. I know several women who have HAD to go back to work 2 weeks after delivery - that's not good for them or their babies, but they've had no other choice.
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