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Entrepreneurship and Health Care

Andrew Sullivan gets letters:

I'm an American who has also decided to leave the US ... because of my concerns over healthcare. You see, my European wife has a chronic disease that worsened soon after we moved to the U.S. two years ago. I have insurance, but with a sick wife and two children, our bills are quite high. Worse, should I ever change jobs, or get fired, I have no doubt our insurer would drop us, or at least dramatically increase our premiums.

I'm a senior exec in a software company. I've always wanted to run my own company, and I have an idea that I think will work.

But we'll move back to Europe before I take that risk. In the U.S., I just cannot be without healthcare for any length of time. I wonder how many other potential entrepreneurs are discouraged from striking out on their own for this very reason?

MIT economist Jon Gruber has looked into this, and the effect is quite significant:

Over the past fifteen years, dozens of studies have documented the detrimental impact that job lock has on the economy. These studies typically compare the mobility of workers who are at firms with insurance but do not have an alternative source of coverage (such as spousal insurance or COBRA continuation coverage) to those who do have an alternative source of coverage should they leave the firm. The studies find that mobility is much higher when workers do not have to fear losing coverage; job-to-job mobility is estimated to increase by as much as 25 percent when alternative group coverage is available. …

There are fewer direct studies of the impact of job lock on entrepreneurship. But the most convincing research, by Alison Wellington, mirrors the findings of other job mobility studies: Americans who have an alternative source of health insurance, such as a spouse’s coverage, are much more likely to be self-employed than those who don’t. Wellington estimates that universal health care would therefore likely increase the share of workers who are self-employed (currently about 10 percent of the workforce) by another 2 percent or more. A system that provides universal access to health insurance coverage, then, is far more likely to promote entrepreneurship than one in which would-be innovators remain tied to corporate cubicles for fear of losing their family’s access to affordable health care. Indeed, even the Galtians among us should be celebrating the expanded potential for individual enterprise once the chains tying them to a job that provides insurance have been broken.

It's also unclear how internalized this is: We may just have a culture in which people who care about health-care coverage don't think about becoming entrepreneurs, as they know perfectly well that they can't sacrifice the safety provided by a large employer. You've heard of learned helplessness? This is learned corporatism. A culture in which people didn't worry about health-care costs might also be a culture in which they were more willing to consider occupational risks.

So will health-care reform fix this? It will help. The various health-care plans under consideration all make life better for a would-be entrepreneur who wants to buy health insurance. The subsidies will help him afford coverage. The regulations will make sure insurers can't deny his family outright our jack up their rates. The exchanges will give him purchasing power and choice.

But the out-of-pocket costs can still prove crippling. The fact that you can buy insurance does not mean you can afford illness. If you can barely shoulder your premiums, and your out-of-pocket limit is $11,000 dollars, a few bad years could wipe you out completely. Conversely, in a country like France or Germany or Canada, an eager innovator need never worry that the budget doesn't have room for illness. You can live your life without worrying about health-care costs. I don't know exactly how much that peace of mind is worth, but surely it's worth something.

By Ezra Klein  |  September 23, 2009; 3:31 PM ET
Categories:  Health Reform  
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Comments

As a European, I have followed the health care debate in some detail and this is the central paradox which has been disturbing me for a while and I'm really glad to see it expressed here. This whole concentration on employer-based policies must surely dominate one's thinking about moving jobs and becoming self-employed. And surely that's what America prides itself on! Self-reliance! Individualism! Mobility! The truth seems to be a very Mad Men corporatist world.

Ok, self-payer seems off the agenda. Hence this unbelievably convolutated conversation about insurance companies and their civil rights. The moral argument about the less well off seems to cut no ice.

So for goodness' sake why not argue that it would make life easier for your entrepeneurs?

Ezra, I have told everyone I can that you are the go-to guy about all this. The British press spent last year lauding Obama simply so that this year can be about 'Obama Fails' headlines. We get no real reporting about US politics.

Posted by: paulmiller67 | September 23, 2009 3:55 PM | Report abuse

ps that would of course be 'entrepreneurs'. No, the irony of a European making that mistake on a US website is not lost on me...

Posted by: paulmiller67 | September 23, 2009 3:59 PM | Report abuse

Recently on CNBC a couple of guests have made precisely this point, to the consternation of hosts weho would prefer to believe that "business" does not support Obama's reforms. But small business and entrepreneurs do support not only reform but the public option so they can afford their own health insurance, as does almost anyone who has been forced to deal wqith the private market. I wish they had more influence with the conservadems.

Posted by: Mimikatz | September 23, 2009 4:19 PM | Report abuse

My father was a coal miner so was his father and his grandfather. He can remember the day that his father paid off the company store. It was a good day. The company and the company store provided everything that you needed. The company typically provided the home and the store provided everything that you needed. (Ex: food, work equipment, etc.)

The current employer paid health care locks you into a similar situation as you've pointed out. From my own situation, my wife doesn't want me to change employers even though I've not been happy where I work for a while. It's because my employer has better health coverage than hers. I pay for her coverage. She doesn't get compensated for not participating, but just loses out on that benefit.

One way to help our lawmakers see that light would be to remove government intrusion into personal choices by starting with themselves. Congress should start by modifying their own benefits. Members should be forced to buy coverage in their home states. Let them increase their pay by $2500 to cover their costs and after that they get the same yearly COLA that Social Security recipients get. No more raises of 5% - 10%.

After 5 years, they can proceed to do the same thing for all civilian employees of the US government. This will remove government from the health care of a large number of people.

Continuing with this change, Medicare should be modified. Anyone on Medicare/Medicaid will receive a check so that they can buy their own coverage. Medicare would stop paying doctors and the free market can do it's thing. No more federal funding for resident positions at hospitals and everything else that Medicare does.

Posted by: just_watching | September 23, 2009 4:24 PM | Report abuse

The answer is to get government out of healthcare -- it was government interference which caused people to become slaves to company benefits.

Posted by: mdfarmer | September 23, 2009 4:31 PM | Report abuse

"The answer is to get government out of healthcare"

And another candidate for the dunce corner, preaching groundless libertarian slogans. Once you come up with an example of government-out-of-healthcare working in a world that's not inside your head, you can talk.

Posted by: pseudonymousinnc | September 23, 2009 4:34 PM | Report abuse

This is an interesting point in theory, but I think it's hard to argue in practice that universal health care has actually fostered an entrepreneurial business culture in Europe.

Posted by: tomtildrum | September 23, 2009 4:41 PM | Report abuse

I know of no studies on job lock either but the anecdotal evidence abounds, which would seem to give the argument some validity. All you need to do is get a little older and you know people in this situation.

This may also tie to a post Paul Krugman had recently. There was a study published by the Center for Economic and Policy Research (8/09) which studied developed country had the greatest percentage of its employment with small employers, self-employed, etc. With our entrepreneurial spirit one would think it would be the U.S. Of the OCED countries we had the lowest share of self-employed and among the lowest share employed in small businesses, whether that be manufacturing, technology or retail.

Posted by: scott1959 | September 23, 2009 4:47 PM | Report abuse

Ezra, the business community is the last to learn. They seem to be just fine with having the competitive disadvantage of shouldering health insurance. The Chamber of Commerce invites Glenn Beck to be a conference speaker. Anyone who wants to strike out on their own to start up a business in this country had better be prepared to lose their business to health care bankruptcy. Take a look at CNBC and look at the willful ignorance at play there. Any health care reform will be done through their opposition, not support. These idiots are all knee jerk ideologues.

Posted by: cmpnwtr | September 23, 2009 4:48 PM | Report abuse

Conversely, in a country like France or Germany or Canada, an eager innovator need never worry that the budget doesn't have room for illness. You can live your life without worrying about health-care costs


Really Ezra? There's no or relatively little medical bankruptcy in single payer systems? I would doubt that as would countless studies that show otherwise.

I would agree that there is LESS medical bankruptcy in single payer systems but please don't make it seem like its all roses and candy.


And the way you speak of:

a culture in which people who care about health-care coverage don't think about becoming entrepreneurs, as they know perfectly well that they can't sacrifice the safety provided by a large employer.

really again as I've said before doesn't correctly point out that many states have guaranteed issue health coverage. So I guess that culture is alive and well in Massachussetts but dead or dying elsewhere?? By the sound of you I would guess the recision rate must be 20% or more.

Posted by: visionbrkr | September 23, 2009 4:56 PM | Report abuse

"There's no or relatively little medical bankruptcy in single payer systems? I would doubt that as would countless studies that show otherwise."

You'll be providing links later, I presume.

And it's not hair-splitting to distinguish between bankruptcies that are triggered by being unable to work on account of illness, and ones that are triggered by the cost of treatment.

Posted by: pseudonymousinnc | September 23, 2009 5:02 PM | Report abuse


I think that microfinance-Nobel guy mentioned health insurance premiums for small businesses as an obstacle to the US adopting microfinancing, or it could've been one of his critics. Not sure.

Reading his book he seemed to think microfinancing could build every man woman and child their own rocketship to the moon. He touted it as a bit of a panacea.

Posted by: ThomasEN | September 23, 2009 5:03 PM | Report abuse

"Anyone on Medicare/Medicaid will receive a check so that they can buy their own coverage. Medicare would stop paying doctors and the free market can do it's thing."

Wow. Just, wow.

Just_watching, do you have any idea why Medicare was created? Because insurance companies (understandably) operate based on risk assessment, and for that reason are not going to sell coverage to the elderly, disabled, or already-sick. Under a risk analysis, it makes no sense to do so because those people are virtually guaranteed to cost more than they pay in premiums. Medicare was created because the elderly and disabled were uninsurable in the free market.

Posted by: Janine1 | September 23, 2009 5:12 PM | Report abuse

pseudo,

here you go.

http://www.fraserinstitute.org/Commerce.Web/product_files/HealthInsuranceandBankruptcyRates.pdf


and what do you do for a living for the thousandth time????

Posted by: visionbrkr | September 23, 2009 5:18 PM | Report abuse

@Janine1

You didn't pick up the sarcasm and the fact that the post was directed at the Republicans. There's no way that they would do any of that for all of their talk of keeping government out of Healthcare. If they really didn't want the government involved with health care, they would kill current effort at reform and push legislation to kill Medicare. Instead, it's all about scaremongering.

Posted by: just_watching | September 23, 2009 5:58 PM | Report abuse

Ah, the Fraser Institute, Canada's reliable fount of wingnuttery. A pity that they cherry-picked their data to fit their conclusions:

http://rabble.ca/news/2009/08/fraser-institute-spins-bankruptcy-facts

And really, truly, I'm not interested in buying what you and your buddies are selling.

Posted by: pseudonymousinnc | September 23, 2009 6:03 PM | Report abuse

"And another candidate for the dunce corner, preaching groundless libertarian slogans. Once you come up with an example of government-out-of-healthcare working in a world that's not inside your head, you can talk."

Well, I can talk, regardless, but are you talking about one that works as well as the one we have with government involvement? That will be easy.

Posted by: mdfarmer | September 23, 2009 6:09 PM | Report abuse

Visionbrkr,
Read the article you cited. It says that 15% of Canadian bankruptcies cited health and medical expenses as contributing to bankruptcy. Some of this was due to lost income...something that a single-payer system cannot do anything about.

On the other hand, in the US 62% of bankruptcies are linked to MEDICAL EXPENSES.
http://www.nchc.org/facts/cost.shtml

When are you going to stop sticking your head...where it doesn't belong? No wait a minute...you need to preserve your illusions. Keep it there.

Posted by: michaelterra | September 23, 2009 6:09 PM | Report abuse

Yeah, sorry about that, just_watching. I thought it was sarcasm in the part about Congress changing their own plan, but by the end I did think you were serious. Long day, fried brain.

Posted by: Janine1 | September 23, 2009 6:12 PM | Report abuse

Re: Medical Bankruptcy Rates in Canada and the US.

First, the Frasier Institute isn't a neutral party. It is a right wing organization which dearly wants the Canadian health system to pay or reimburse payments made outside of the system.

If a report by partisans is to be taken seriously, then it must go out of its way to be fair.

A bit of googling and I found a critique that examined one item only in the report, whether the report used bankruptcy rates fairly. And they didn't. They cherry picked the years to use
See: http://www.creditslips.org/creditslips/2009/07/highly-questionable-medical-bankruptcy-figures-from-fraser-institute.html
or http://tinyurl.com/frasier-unfair

Posted by: shelgreen | September 23, 2009 6:12 PM | Report abuse

@Janine1

Even though I was being sarcastic (I don't believe that dems or repubs will do it), I'm serious about Congress buying their own coverage. I want them to have to buy their own insurance. I want them to have to do the following:
* Pay premiums with funds only provided in their pay. (No money from trust funds, spouse, 401k, etc.)
* Only allowed to participate in insurance plans that other normal citizens in their state are eligible for. (No "special" plans like the VIP loans for real estate.)
* Cannot participate in spouse's medical plan.
* Cannot use medicare while serving.
* Once retired, cannot participate in any federal plan other than medicare, unless spouse is employed by government.
* Government would cover cost of medical expense when travelling outside of the country, but only when travelling for government business. (No corporate junkets.)
* Must fully disclose cost of their insurance, provider, and availability of insurance to other citizens. This information must be made available to all citizens.

In case you didn't know, here's information about the federal plans.
http://www.npr.org/templates/story/story.php?storyId=112880933&ps=rs

Posted by: just_watching | September 23, 2009 6:33 PM | Report abuse

"That will be easy."

Step right up and stun us all. You'll be the first to attempt it on these pages.

Posted by: pseudonymousinnc | September 23, 2009 6:35 PM | Report abuse

I absolutely would not have started my company if my wife and I had not had health coverage through her job.

Posted by: jamesykwak | September 23, 2009 8:09 PM | Report abuse

sorry Pseudo i had to leave work. I do understand that was a right leaning blog and would have mentioned that in my post but again i was literally walking out the door when you posted and i wanted to post where I got it from. Again I don't want to sell you anything, I just want to know YOUR REASON for your views. You know mine. What's YOURS? I won't hold my breath.


And if you read my original post I said that I do believe medical bankruptcy is LESS in Canada but its not as if it doesn't exist. 15% to me is still a substantial number. Once we get to universality I would expect the US to be comparable to canada (assuming subsidies are where they need to be).

michaelterra,

When making your argument please use THE SAME YEAR. If you'll note the study i noted listed 2006 and 2007 while you're listing current statistics. Apples and oranges. Your argument is right, just make sure its FACTUAL and COMPARABLE.


Also how much is factored into the loss of a job, credit card debt, foreclosures, and divorce? That 62% I would expect encompasses all of that as well but just assumes that medical bills are the sole or main reason for it. That's over-extending to make your point.

Oh and pseudo what would you have me do, renounce my job, live a life as you do going from left wing blog to left wing blog spouting off talking points to whoever will listen? Does it pay well???

Instead I choose to help the consumer of healthcare manage their way through the system. As i've said before I'm not a CEO, I'm not even a manager. I don't work for an insurer, I'm simply helping the healthcare consumer navigate through the system. if the system were to disappear and you had your single payer there still would be a need for my services as not every doctor and hospital would accept a medicare for all. I have clients that I help with Medicare (that i don't get paid for I might add). I have a client in Canada that we help with their policies that honestly are as costly as the US policies and they simply are "buy up" provisions to the state sponsored care. Basically it pays the extra for a semi-private room instead of a hospital ward. Am I OK when I help them but EVIL when I advise consumers in the commerical markets in the US? If I left my job then my clients would be lost within the systems they are in.

I've been trying to think of a comparable position to what I do within another industry and you'll laugh, likely mock me (as if I care) but its as if I was an army doctor (assuming you're against war). Is that Army doctor evil for treating patients on a battlefield? Would you be happy if I left my clients to figure out the complexities of the healthcare system themselves? again as i've said in an earlier post here are 3 things i did today:

Posted by: visionbrkr | September 23, 2009 8:31 PM | Report abuse

1-helping a client of mine whose doctor never mentioned they didn't accept her insurance and billed her $1500. I spoke to the office manager for the third time and got them to write it down to $93.

2-helped a client of mine who is having surgery on Friday find a home health aide that is participating with his insurance and has the services he needs when he comes out. He's racked up $500,000 in total bills to date (of which his insurer has paid all but $5,000 which is his cap for this year). In fact he wanted to change earlier this year but I told him not to because if as expected he was going to have another surgery he would have a new cap with the new insurer.)

3-worked with a client of ours whose son has autism in helping to find a provider who handles ABA therapy and is covered under their insurance plan.

Posted by: visionbrkr | September 23, 2009 8:34 PM | Report abuse

visionbrkr....in the interest of clarification (and not to be combative), the only states that have guaranteed issue individual health insurance are: NY, NJ, MA, ME, VT and WA. That does not mean these policies are affordable or not subject to recision.

I bring this up because you referred to "many states" that allow this in your 4:56 post, have mentioned this before, and while many in your neck of the woods do have access to guaranteed issue, the vast majority of the population of the country do not have access to this (unless you count high risk pools---I do not since they are truly unaffordable for most)

Posted by: scott1959 | September 23, 2009 8:58 PM | Report abuse

scott,

don't worry, I know whose combative and whose not from the regular posters around here. You are right and as I've mentioned before sometimes I need to "slap myself" that I live and work in a state that is much better off than the rest of the country in many ways relating to healthcare. I also will state that as per the attached (and via HIPAA) no state in the union has more than a 12 month pre-ex condition exclusion so this idea that the uninsured will never be covered for their expenses is just wrong and NEVER talked about. Sure we should all have what MASS. has for example and hopefully we get there this time around at reform. I wish we had gotten there in '94 because if so then at least for me and my state we'd have an individual mandate and selfishly for me costs would go down in NJ.

http://www.statehealthfacts.org/comparetable.jsp?ind=352&cat=7


The fact that they're not affordable is less a factor (IMO) of insurers and their profits as to the system as its set up now in a FFS model. As i've said in another post today go back to capitation with incentives not to reduce care and I think you'll see costs go down. Also when you get everyone covered and get people going to doctors instead of the ER we'll see costs go down too.

Its funny a large complaint is about insurers profits and as I've mentioned before the top 10 insurers profits in 2006 (when insurers profits were healthier than today) was 15.3 billion. Sure that's a lot and that could insure a lot of the uninsured but when you look at the fact that banks will make 38 BILLION this year in overdraft fees alone, not profits, just overdraft fees it kind of puts it into perspective for me a bit.

Posted by: visionbrkr | September 23, 2009 10:36 PM | Report abuse

"Would you be happy if I left my clients to figure out the complexities of the healthcare system themselves?"

As I said on the earlier thread, your work exposes the failings of healthcare in American. You're a mechanic for a clunker, and for every person you help, there are dozens who are left SOL, because There Is No System, and what there is instead of a system is morally and economically bankrupt.

I don't have any problem with the existence of a well-regulated supplementary insurance market. Plenty of people in the civilized world make a living from selling those products, and don't have to come up with bizarre fantasies about people who point out the failings of the American system.

Posted by: pseudonymousinnc | September 23, 2009 11:31 PM | Report abuse

Speaking as someone that started my own company 4 years ago, this is a total non-issue. I was able to get health insurance with no difficulty at all. Our policy now covers nearly 75 people. There are numerous brokers that help pool small companies together, and you can use a co-employment company like Administaff if you want to take advantage of large company rates.

If this is stopping anyone from being an entrepreneur, they might be too stupid to run a company.

We need more entrepreneurship in health care- "the Innovator's Prescription" covers this brilliantly. It is the ridiculous overhead in our general hospitals (90% of the total cost), competing to offer the latest and greatest services and offering all services in order to get better deals with the insurance companies that need to go. The broken Medicare system reinforces the worst practices in medicine.

Posted by: staticvars | September 24, 2009 12:05 AM | Report abuse

As I said on the earlier thread, your work exposes the failings of healthcare in American. You're a mechanic for a clunker, and for every person you help, there are dozens who are left SOL,

Posted by: pseudonymousinnc | September 23, 2009 11:31 PM | Report abuse

So I should stop helping people then, right? So the Army doctor in the war in Iraq should let the soldier bleed to death so he doesn't continue an evil war? Were you one of those that were SOL because you didn't have the likes of me helping you? Is that why you're so bitter towards me and my profession??


staticvars,

its funny had I suggested PEO's as a solution and that this is a non issue I'd be branded as a shill. PEO's have their place but there are pitfalls to it as well (lack of choice of insurance providers, admin costs that run high and severely eat into insurance savings in some situations). When they first started the savings were much greater than they are now and they also allowed employers to remain with one insurer for a longer period of time and now many PEO's change year to year like many employers. A better way is the exchange idea. The more I hear of that the more I like it. If structured properly it would allow employers the ability to hang onto key employees but also give those employees the freedom and flexibility to choose between countless insurance providers and in turn provide insurers competition that keeps them honest even without a public option. And again the idea of large company rates is a red herring. As i've said before I've recently become privy to the insurance rates of a certain bailed out insurer that was "too big to fail" supposedly. That insurer is now being broken up. Their rates for over 100,000 employees are higher than a client of mine with 1500 employees and my client has richer benefits. Size doesn't help if claims are high. Size only helps with the admin cost which normally averages 25% of the overall cost.

Posted by: visionbrkr | September 24, 2009 8:17 AM | Report abuse

tomtildrum is correct. If the topic of Klein's post is entrepreneurship, what's left out of the discussion (and we can only guess as to why Klein and those he quotes leave it out) is the relative number of entrepreneurs in the regions being referred to.

If European socialism hasn't completely killed entrepreneurial activity, then they just haven't been at it long enough.

Posted by: msoja | September 24, 2009 9:37 AM | Report abuse

There is an issue here that is far greater than whether or not entrepreneurs experience job lock because of the inability to get/pay for health insurance.

ALL American businesses are paying astronomical sums of money to provide health insurance coverage that ranks poorly when compared to most other developed nations.

Entrepreneurs are just the more visible example of how the cost of health insurance cuts into new business development for companies and salary growth for employees.

Posted by: anne3 | September 24, 2009 11:03 AM | Report abuse

--"American businesses are paying astronomical sums of money to provide health insurance coverage that ranks poorly"--

All thanks to government intervention and distortions in the: tax code, insurance businesses, medical business.

Posted by: msoja | September 24, 2009 11:17 AM | Report abuse

This has been my argument for health care reform all along.

I'm self employed, originally not by choice, but because I could not find a full time job when we moved to SF from NYC two years ago. I have valuable skills and I have had a lot of success finding gigs that pay pretty well. I'm even beginning to enjoy striking out on my own and being an entrepreneur.

However, I do not enjoy being 100% dependent on my husband's health insurance. This makes both of us less mobile in the marketplace, less able to take calculated risks with our work, more dependent on his employer, and paranoid about where health care will come from in the future. Outrageous health insurance prices is one of the reasons I'm hesitant to grow my business and hire people even though I easily could right now.

Our international colleagues don't have these pressures. No one can tell me that this doesn't impact our ability to compete with them.

Posted by: jennifer8 | September 24, 2009 11:45 AM | Report abuse

"So I should stop helping people then, right?"

Do whatever the heck you like: just don't come here expecting moral validation for it, or your attempts to blame everyone but yourself. The American way of healthcare is a cruel, incoherent, wasteful and immoral thing. Your work is really just a symptom.

(And if your negotiations don't point to fraud, waste and abuse in the non-Medicare sector, then I don't know what definitions you're using.)

Now, to msoja, one of the silly libertarian slogan-spewers:

"All thanks to government intervention and distortions in the: tax code, insurance businesses, medical business."

Once more, msoja, you have the chance to get out of dunce corner by showing an example of a healthcare system without such "government intervention and distortions" that exists outside of your head. Step up.

Posted by: pseudonymousinnc | September 24, 2009 11:59 AM | Report abuse

@pseudonymousinnc: Your insults do not address the original point. Part of the problem with the current health care system, the one mentioned in Ezra's article, is health insurance being linked to employment. There is no reasonable doubt that this linkage increased dramatically (and predictably) due to government tax policy. In that sense, government caused the very problem you are complaining about.

Posted by: enoriverbend | September 24, 2009 1:21 PM | Report abuse

@enoriverbend: you miss the fundamental point of my repeated question to libertarian ideologues who whine about "collectivism" (see other threads) and want to "get government out of healthcare".

Until they can produce an example of a successful healthcare system without government involvement -- regulatory, funding or otherwise -- then they're talking through their hats. msoja, kingstu01 and the other slogan-chanting residents of dunce corner seem to have problems doing so.

Posted by: pseudonymousinnc | September 24, 2009 1:49 PM | Report abuse

--"Until they can produce an example of a successful health care system without government involvement -- regulatory, funding or otherwise -- then they're talking through their hats."--

That's nonsense. Just because corruption is rampant does not invalidate the view that corruption is bad. If one can't get the government completely out of all the "businesses" it shouldn't be in, one should still attempt to get it out of them as much as possible.

What we keep learning over the last century is that even with the strong prescriptions against government meddlign built into the Bill of Rights, government still creeps toward totalitarianism. That ought to be obvious to even those of average mind, like I suspect pseudonymousinnc is. It ought, even, to be scary. Yet, there continues the headlong rush into the maw of more of it by even those like Klein, who ostensibly have some education.

It's ridiculous.

Posted by: msoja | September 24, 2009 6:51 PM | Report abuse

I'll take that as an abject failure wrapped in a dodge, msoja.

"those of average mind, like I suspect pseudonymousinnc is."

Oh, your Rand-pants are showing, dunce. Now back to dunce corner with you.

Posted by: pseudonymousinnc | September 24, 2009 7:28 PM | Report abuse

--"I'll take that [...]"--

You may take it, but you didn't answer it.

You would have been happy to live as a serf under a feudal lord, I guess.

Others have higher aspirations. Others are of the notion that they can be their own governors, and not despots.

Have you heard of self-government? In what possible way can collectivist health care be a part of it?

Posted by: msoja | September 24, 2009 9:59 PM | Report abuse

You're just spewing out slogans, msoja.

Go back to your Atlas Shrugged reading group, or Megan McArdle's blog, where you'll be patted on the head and treated like you're the head of the class.

Have you heard of a healthcare system without government involvement that delivers outcomes that match the best with government involvement? If so, tell us about it. If not, you have nothing to add to the discussion other than bafflegab and bunkum.

Posted by: pseudonymousinnc | September 25, 2009 1:40 AM | Report abuse

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