More on Health Policy Considerations

Today’s New York Times has an op-ed piece extolling some of the virtues of the Republican plan for health insurance; one take-away from it (featured by the NYT) is that “5 percent of Americans generate more than 50 percent of health care expenses.”

So what? Before I retired in 2002, my medical expenses were minimal. Since then, however, I have had  a number of medical problems. In other words, the smug feeling I used to have about others who populated the health care system has given way to the reality of (what I should have known, as a statistically savvy person) the difference between cross-sectional and longitudinal analyses. Cross-sectionally, 50 percent is pretty scary, unless you realize that that 50 percent is primarily populated by the likes (and age) of me. Longitudinally, however, the data may show a different story, with perhaps 10 percent of the population never having major problems throughout their life, and have paid (as insurance should) for the difficulties that they luckily never experienced.

The author of the op-ed noted that his 93-year-old father “just received a $50,000 catheter-inserted aortic valve, which was covered by Medicare.” Is he suggesting that his father should have just sucked it up and lived in pain or in a wheelchair for the next few years of his life? Doesn’t he realize that Medicare is just what he recommends, that his father and those like him are using Medicare to “save their own money for just this sort of rainy day,” with the proviso that we may not all need that umbrella? Insurance, whether for cars or homes or health, is meant to spread the risk.

Author: Mike Maltz

Michael D. Maltz is Emeritus Professor of Criminal Justice and of Information and Decision Sciences at the University of Illinois at Chicago. He is currently an adjunct professor of sociology at the Ohio State University His formal training is in electrical engineering (BEE, Rensselaer Polytechnic Institute, 1959; MS & PhD Stanford University, 1961, 1963), and he spent seven years in that field. He then joined the National Institute of Law Enforcement and Criminal Justice (now National Institute of Justice), where he became a criminologist of sorts. After three years with NIJ, he spent thirty years at the University of Illinois at Chicago, during which time he was a part-time Visiting Fellow at the US Bureau of Justice Statistics. Maltz is the author of Recidivism, coauthor of Mapping Crime in Its Community Setting, and coeditor of Envisioning Criminology.

4 thoughts on “More on Health Policy Considerations”

  1. I think part of the is the power of dystopian propaganda (and the failure to counter it). The US right wing has for decades been pushing the lie that social safety-net programs won't be there for current working-age people when they retire. And if you believe those lies (or believe in the power of the right wing to make those lies a reality) then it makes perfect sense that you should begrudge any of your taxes that go to a program whose fruits you expect you will never enjoy. Especially because that money is money that you could be saving individually to guard against exactly such eventualities.

    Oh, wait.

  3. It would help if more people knew and took to heart the insight of Susan Sontag: "Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

  4. The delusion of total autonomy goes wider than health. Throughout human history and even prehistory, each able-bodied adult has had to support another person, child, oldster, sick, pregnant and nursing, disabled. Some of this today is disguised by elaborate mechanisms of private profts and dividends as well as taxes and insurance, but it's still there. The glibertarians seem to reject the simple truth of mutual dependence.

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