Re What the Republican Health Plan Gets Right

["Dave Farber" <farber () gmail com>]

Begin forwarded message:

> From: Dave Crocker <dcrocker () gmail com>
> Date: May 7, 2017 at 8:00:16 PM EDT
> To: dave () farber net, ip <ip () listbox com>, Dewayne Hendricks <dewayne () warpspeed com>, Mark Blacknell <mb () 
> blacknell net>, Sidney Karin <skarin () ucsd edu>, John Day <jeanjour () comcast net>, Steve Papa <spapa1999 () gmail 
> com>
> Subject: Re: [IP] What the Republican Health Plan Gets Right
>
>
> There are two basic problems with the opinion piece.  The first is that the author's focus on very narrow examples 
> means he is pretending to not understand that complex systems involve complex trade-offs and effects. This in spite 
> of his medical training with it's in-depth explication of biological construction and (mis)behavior.  Designing 
> something as complex as health care system requires difficult trade-offs in incentives, costs and benefits.  Focusing 
> one's concerns on one (frankly minor) imperfection or another -- such as an elderly patient who sees him too often -- 
> is childishly irresponsible distraction.
>
> The second problem is the author's apparent failure to understand the risk-sharing that is inherent in any insurance 
> scheme.  The 'undue' higher costs borne by those who are more healthy, and who subsidize those less healthy, is 
> largely an accident of fate; they could be -- and often are -- the unlucky ones with an expensive illness.
>
> And then there is the meta-problem with having a thread like this here, where folk take something that is 
> fundamentally -- and in this case irretrievably and odiously -- flawed and attempt to nit-pick details, as if a 
> random good bit in any way counteracts the overarching horribleness of the design.
>
> Discussing any of the details of this mean-spirited, broken proposal takes away from discussing something serious and 
> useful.
>
> When a design is massively flawed, don't try to focus on its problems. Start over.
>
> d/
>
> -- 
> Dave Crocker
> Brandenburg InternetWorking
> bbiw.net



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