Why Is US Healthcare So Expensive? Private Insurance? No.

#264: Drum Takes On Liberal Confusion
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Before asking conservative commentators to fess up to their side's confusion, Kevin Drum in Mother Jones lists six things liberals get wrong (several have charts!), the most significant being the source of our excess healthcare spending (my commentary in green; the remainder is Drum):

American health care is expensive because of private insurance. Nope. It’s expensive because health care providers charge way more than they do anywhere else. This includes doctors, nurses, pharmaceutical companies, device manufacturers, hospitals, and so forth. Insurance adds a little bit to that, but it’s nowhere near our biggest problem.  Chart.

This is yet another reason why Medicare-For-All is a bridge too far, at least in the short run.  But, Bernie Bros won't look.  The chart is definitive.  A subsequent blog post expands on his views.

We have a retirement crisis. There’s virtually no evidence that retirement is any worse today than it used to be. Ditto for future retirement. In fact, the over-65 demographic is doing better than any other age group. That said, Social Security for the bottom third of the income distribution has always been too stingy, and we ought to increase it.

The case can instead be made that it's low-income children whose assistance would benefit everyone the most.

The black/white test score difference is all about test prep, biased tests, etc. At most, the best evidence suggests that things like test prep account for a small fraction of the black-white difference in test scores. This is important. The black-white gap in education is one of America’s biggest failures, and the only way to fix it is to acknowledge that it’s real, not to toss it off as merely a statistical artifact.

Again with the low-income children.

The 1994 crime act was responsible for mass incarceration. Mass incarceration started in the mid-70s, and by the mid-90s prison space had more than quadrupled. The 1994 crime act had only a tiny effect on prison building, and by 1998 the total number of prisoners had already begun to decline. For what it’s worth, black incarceration rates have also dropped substantially over the past couple of decades.  Chart.

See chart.

Charter schools don’t work. Some of them work, some of them don’t. Instead of pretending that they’re all failures, we should be putting our energy into figuring out why the good ones work and how we can learn from them.

Arguably not the greatest problem with charter schools (which is probably the effect public funding of charters has on public schools), but I'm always willing to look at all the evidence.

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Drum begins his post by discussing Day Care, which takes a backseat in my mind to his healthcare material.  So, I left that one out, and we have the above five of six.

Making Work Right

#263: Unions, Improved
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I've been extremely lucky at work, in not only belonging to a union, but a union as they should be.

The difference between ordinary unions and ideally configured unions, like mine, is that I'm paid a salary to do a 'normal' day's work.  If I'm productive, doing that work in less time than normal, and if I don't make any mistakes, I go home early.  My salary, meanwhile, is based on careful measurement of how much time it takes for the average, unhurried employee to do my work.

Where this measurement, or 'time management', is different from most work is that I'm in control, backed up by my union.  I'm happy, even enthused to go to work.  My unconscious, 'auto-pilot' mode is set to 'super efficient', rather than to a 'slow down' (or they'll give me more work) setting.  Once in a while I'll prefer a slower pace, which is no problem, within reason, since I'm paid the same.  My time is mine.

Everyone should have a union like mine, and a work arrangement that encourages a self-directed pace.  No employee should be subjected to an imposed fast pace, or, like most union members, an excruciatingly slow pace to avoid doing more work, or to extend overtime pay.

The 'time management' methods now being used to force workers to hurry, could just as easily be used to determine the cut-off for a normal day's work, at which time a worker is done for the day.  Or, if that worker chooses, a normal day's work ends after 8 hours.  For some jobs, like teaching, time management algorithms won't be the answer, but an overwhelming percentage of jobs can be so reconfigured.

What keeps us from a nation dedicated to these ideal unions?  Political organizing.  Simply put, there is no reason why employees can't control their own time, and reap the rewards of their own increased productivity, rather than this productivity being inflicted upon them.

The Unions-For-Salaries movement.