Over at the L.A. Times, Nick Gillespie and Matt Welch observe that both major parties are losing faithful adherents -- nearly 40% of Americans identify as neither Democrat nor Republican. They list seven policies that, should one party adopt them, would win libertarians -- and a lot of other Americans -- over to their camp.

Where the Votes Are

Huh.

I support each and every one of those.

So do I, give or take a little quibbling on the details.

I agree with Grillick. Weird.

You agree with me too. And I suspect with Inspy and Wile E. And probably with Dot.
Welcome to the future...brother.

I agree with most of those, although I'd like to see more. I'd rather pot be legalized for all, I'm more interested in net neutrality than internet taxes, and I'd prefer universal health care to any sort of employer-provided program.

I don't really think the list fits the main point of the article, though; I agree there's room for an emergent third party, but these seem like fringe issues to me (except for the war). There are more important things for a nascent party to rally around--environmental and energy policy, for instance, or governmental transparency and accountability, or ending corporatism.

That's because I got here first, before someone else posted something to which my contrary nature could be applied.

Here's what I don't get. Why are prescription drugs so stupid expensive if you don't have insurance? In my freshman year of college, I broke out in hives and got a prescription for some garden variety non-drowsy antihistamines. I went to the pharmacy to pick them up, but because I was new at this, I didn't know whether my school health insurance covered prescriptions and ended up paying full price for them. They came up to US$60.

In Hong Kong, I can walk into any pharmacy and purchase a box of very similar drugs without a prescription for HK$50. The exchange rate is 7.8 $HK to 1 $US. This isn't a government program or anything. That's just what the drugs cost here.

What is up with that?

A part of it, at a guess, is the Chinese government's willingness to allow, if not outright endorse, rampant theft of foreign copyrights/patents.

As for why they're expensive? Every drug that makes it to market has to not only pay for its own very extensive medical trials, but must also pay for those drugs that didn't make it out of trials because of complications/side effects/inadequate performance.

Not to mention massive marketing campaigns.

And the huge pharmaceutical profits. And their massive lobbyist armies.

Hey, the drugs coming into Hong Kong are pretty legit, and we do make an effort to enforce intellectual property laws down here. We have a completely different legal system than the rest of China.

Generic versions of the drugs are available here, but even the originals don't cost $US 60! More like US$10. We're talking about an antihistamine. Like the things people take for nasal allergies. It's not some fancy life saving drug.

Also, would de-coupling insurance from employers do anything at all to make it cheaper? Because individual policies cost an arm and a leg. My brother had to take out an individual policy for a while when his employer didn't offer any, and it was something like $250-300 a month. My parents had to give him a subsidy. I suppose in theory it might result in more competition - because employers don't really care about whether their employees are getting a good policy or not, they just go with whatever company they have a pre-existing relationship with. But insurance doesn't compete like other products. Unless they make it mandatory to have insurance, it's still going to suffer from the information asymmetry problem described by Tim Harford which will cause healthy patients to slip out of the system until only the sick are left, which pushes the premiums up.

Well, I interpreted the phrase 'de-couple insurance from employment' to mean 'provide socialised healthcare'. Good to see I don't agree with American libertarianism quite as much as it first appeared.

I've split this off from the links thread in the interests of hygiene.

Also, if we could, I'd like to focus more on employer-provided health care specifically (and the pros and cons therein) rather than national health care vs. American health care, since we've already had that discussion a lot around here.

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But the point is they're not really "fringe" issues -- perhaps they won't have as sweeping an effect as a new environmental policy, but the point is that most Americans agree on them (everyone here seems to, for example) and you could do a heck of a lot more net good in a shorter amount of time by legalizing medical marijuana and cleaning up eminent domain. Instead of arguing over issues that are so divided as to be purely philosophical at the moment, actually get something DONE. I think that's what Gillespie and Welch are arguing -- people are losing faith in their parties because the progress to useless posturing and debating ratio is so high right now. So start pushing one of these issues, and the majority of the country will support you in it.


The reason individual plans cost so much right now is because health care is all tied up with employment, which is all tied up with tax breaks -- it's a mess.



This is why the article isn't advocating for or against socialized medicine -- that's a big, divisive issue. It's saying, whatever big change we could make for more improvement, this small (in comparison) change will give some improvement (as well as opening the door for more improvement).

Employer based health insurance always seemed a bit daft to me. If you get so sick that you can no longer work, you lose your health coverage exactly when you need it the most. This is mental. The article also made a good point about most people no longer working for the same company their whole lives. I think that it's a bad idea to have a system where people are terrified of losing their jobs, changing jobs, or freelancing. Not only does it add to middle class economic anxiety, but it's a drag on labour mobility as well.

But while I think that insurance ought to be decoupled from employment, I don't think that doing this, in and of itself, will have much of an effect on premiums. The general idea is to make people more price conscious so that they only consume as much health care as they feel is absolutely necessary, and possibly buy less insurance for themselves too, right? This is supposed to reduce insurance companies' payouts, so that premiums get lowered. But there's a problem.

Under a purely voluntary individual insurance system, the number of uninsured may actually rise because instead of getting coverage automatically through their jobs, many healthy people would decide they'd rather do without insurance and have the disposable income instead. And as the Undercover Economist tells us, when healthy people take themselves out of the insurance pool, this is a bad thing. The insurance companies will have fewer healthy customers with which to subsidize the payouts to the sick ones, and then they'll have to charge higher premiums. Plus, when some of the healthy people inevitably break their legs or get pregnant or come down with food poisoning (because it can happen to anyone), a chunk of their emergency room bill is going to go on the taxpayer.

Some huge wonk would have to run the numbers, but I'd guess that the two effects would cancel one another out.
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You know what I'd like to see, though? I'd like to see the moralizing taken out of the health care debate. I found it incredibly frustrating to listen to people (on a different forum) complaining about how all the uninsured people who are driving up premiums for the rest of us must all be illegal immigrants, stupid low-income breeders, or spendthrifts overly-enamoured with big screen TVs. The uninsured are the new welfare queens. Sigh.

I don't get health coverage from my employer, I get a discount on health coverage. I still pay monthly for my insurance. If I had to independently find my own insurance, it would cost me 2-3x as much as I'm paying now. If insurance can be decoupled from employment without costing me so much more, I'm all for it. Otherwise, that's a bit too big of a strain on my income. I'd probably live uninsured for a while.