Bob Hayes Online

Go, Mr. Simberg, go!

Just click on it.

This is an outrage. An outrage, I say!

Scott Adams of Dilbert fame has a suggestion for asthmatics: eat lots of apples, pears, grapes, garlic, and onions. He claims it greatly reduced his asthma’s severity.

I have no inherent interest in asthma, but my mother sometimes suffers and it’s easier for me to post this link and tell her “check my blog” than it is to send her the URL directly.

Why not start health care reform with tax reform?

There are two key problems that everyone agrees exists with regard to healthcare. Problem one is that it’s really expensive to get old and die. Problem two is that it’s really expensive to have something terrible happen to you and need tons and tons of medical care. There is disagreement about *why* these things are problems, disagreements about motives, etc., but everybody agrees that these two things are problematic.

Problem one we haven’t solved, but we have a quasi-kludge half-solution in place. It can and should be improved, but old people get their medical bills paid for more or less and they don’t have to bankrupt their families in order to pass away decently. So hooray, there, no doubt we’ll work on making it better, but let’s not **** with it right this minute.

Problem two is the problem of catastrophic care. It’s expensive. You get cancer, you lose your house. As has been pointed out to me, if something expensive were to happen, it would be a terrible financial blow. We wouldn’t go bankrupt, because there are assets, but it would surely suck. It would be far worse for people with fewer familial resources.

There are other problems that exist, but everybody agrees these are acute ones, so let’s focus on them for a moment.

Some people are lucky; they have nice health plans that cover even catastrophic events, while also providing good coverage for more routine and preventive care. Those plans tend  to be expensive, making those people relatively expensive to hire, so as a general rule, only people who contribute relatively large amounts of social capital to their employers are able to get this type of coverage. Most people make do with much less impressive plans which provide a partial shield, but still leave patients owing for large sums when disaster strikes. Ironically, the people with the gold-plated policies tend to be the people who could absorb a ten or twenty thousand dollar loss without grievous harm, while the people who are destroyed by such a debt are the ones with the sketchy pay-most-of-it policies.

Some people have no care coverage at all, reasoning (like me) that their best option for healthcare expenses is to pay for it 100% out of pocket for routine matters, and suffer the loss to capital in case of true crisis. Others pursue the strategy, though without the resources, owing to improvidence, ill fortune, or whatever. Some of these people tend to impose big costs on the system as a whole, since they tend to be the ones showing up at the ER. (Hey, I paid my bill.)

Right now all the people with employer-provided care are getting a substantial tax break, because they don’t pay tax on the large income that their plan represents. Some people propose taxing the benefits; I think that instead of doing that, we should extend the tax break to everyone, and we should count health benefits as income.

Anyone who purchases any health insurance plan, whether comprehensive or catastrophic, gold-plated or bare-bones, whichever they prefer – should get to write off 100% of that expense as a deduction from their income. People whose employers provide coverage stay status quo ante – they lose nothing. Their income has gone up nominally (“holy cow, IBM is paying $19000 a year for my health plan?”) but they get $19000 lopped off their income on the 1040, so they end up with no change.

People who buy coverage with their own money will get a whacking great tax cut, depending on their income levels. No idea what this would cost – tens of billions at the very least.

On the other hand, it would require no bureaucracy and no interference with private choice – and it would greatly encourage people to buy health coverage for themselves, particularly as their incomes rise. We WANT people like me to go out and buy expensive coverage which we then never use; it helps pay for the ER visitors.

This proposal doesn’t do much for the poor, I’ll grant you. Fine – let’s do a block transfer with another NIT-style mechanism and issue $1000 “health care credits” to people at 200% of poverty line. It won’t cost all that much, and again, it gives people an incentive to do something smart but doesn’t coerce their behavior.

The result of this policy would be a strong increase in the demand for private health coverage, leading to greater investment in health care capital, human and financial varieties. It requires no federal power grabs, no objectionable redistribution – no human among us objects in principle to helping very poor people see the doctor – and most lovely to those who care about freedom, no coercion or forced behavior. Although it can be sold to Republicans as involving a tax cut, since all these people would start getting a tax break, in truth we should recognize that it would involve a small but real nominal tax increase or reduction in services elsewhere, since we’re giving people money back on their existing tax levels, but I’ll forgive any liberals who choose to finesse that point. I think it’s worth the expense.

Frustrated by scam telemarketing calls from a dishonest extended-warranty company, an Ohio man snapped on the phone and apparently made some threats.

No, he shouldn’t have said that he would come and burn down their building. That was wrong. But at the same time, does he really need to be locked up? Nobody thinks he meant it, that he poses any genuine danger. He was just frustrated with having to deal with these scammers.

Free Charles!

This is fascinating – it almost sounds like the backstory to a 1920s SF saga.

…Hilarity ensues.

Well, perhaps “hilarity” is stretching a point, but I smiled.

Buzz Aldrin is apparently more energetic than I thought. He has a crackling editorial in the Post today on getting on with Mars colonization. Hear, hear!

We went to the Moon. (If you disagree, don’t bother to post your ‘argument’. Buzz is an old man, he doesn’t have the energy to go around punching *everybody*.)

It’s time to go back, although not in the same way. We’ve done the Christopher Columbus thing – now it’s time to do the John Smith thing.