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Tuesday, September 18, 2007

Dennis York just isn't funny anymore

by folkbum

There was little doubt, back in the olden days, when we had to chisel out our blog posts on slabs of granite, that the psuedonymous "Dennis York" was fantastic, a highlight of the Wisconsin blog community. He was conservative, sure, but independent-minded and, more importantly, funny. You can read his stuff here still.

Eventually, he came out as Christian Schneider and got a Real Job working at the decidedly unfunny Wisconsin Policy Research Group. There, he often blogs about health care policy, and seems to be the WPRI's point-man for stupid arguments against Healthy Wisconsin, the Democrats' plan for universal health coverage in the state. For example, he pioneered the argument that Healthy Wisconsin would suck uninsured ne'er-do-wells into the state to bleed us dry. That argument was just demolished by He-Man Seth Zlotocha. Yet it keeps rearing its ugly head, most recently in an op-ed by noted Republican Woman Charlotte Rasmussen, and perhaps most embarassingly by Leah Vukmir. Seth knocked down a bunch of Schneider's other bad arguments against Healthy Wisconsin, in fact titling that post "Healthy Wisconsin Deserves Better." It does--and it could have had it from Dennis York.

Too bad we're dealing with Christian Schneider instead.

His most recent abominable post is a dreadfully painful attempt to make everyone who's ever been screwed by their insurance company feel better about themselves, because of how much worse it could get:
However, free markets aren’t always pretty. Once people are shopping around for cost-effective medical care, the people selling those services will do everything they can to lure people in to their shop. Suddenly, you might see knee replacements being sold on TV by some bald, sweaty salesman with a limp. [. . .]

And what’s next? Are we going to see ads for “Crazy Larry’s Prosthetic Hut?” (Where a new limb won’t cost you an arm and a leg?) Will women be getting their gynecological exams at ”The Love Doctor?” (Cervix with a Smile?) Is Burger King going to offer up a coupon for a free arterial stent with the purchase of five Whoppers? (Of course, it will be the Whoppers that cause you to need the surgery.)
I'm not sure how long he spent on "cervix with a smile," but it doesn't make up for the rest of the post. Believe me, what I elided was no funnier. The best bits are here.

But worse than being unfunny, it's deceptive and painfully wrong. It is an unconscionably poor argument for market-based health care. The worst a market-driven approach can get is not bad commercials; it's killing patients by denying care. I don't think any of us who have ever had to spend hours on the phone, days in a row, months at a time to get legitimate claims covered are even remotely comforted by the thought of bad commercials. ("At least the Muzak was nice--no ads for Crazy Larry while I was on hold!")

In the market, the patients may be the customers, but they are not the ones insurance companies will have to please. (Face it--I don't care how much "competition" there is for any given slice of the medical pie--it's still the insurance companies that will rule the day.) The companies have to please investors, and to do that, they have to turn a profit. Every dollar they pay your doctor (or Crazy Larry) is a dollar they can't count as profit. Their incentive is to spend as little as possible on you. Period.

One of the single biggest expenses for insurance companies is the bureaucracy, between 20% and 25% of total health care dollars, by most estimates. Insurance companies could save a lot of profit there if they could cut that cost. But a significant amount of that spending on bureacracy is designed simply to deny claims or delay them so long that patients give up fighting. The industry must be making a whole lot of return on their investment in that bureaucracy--that's why they won't cut it.

In the end, it's not Crazy Larry we need to worry about when relying on "the market" for health care. It's Christian Schneider, and his lame excuses for what is an inhuman system. When the insurance company's profits are up, you know it's because somewhere, a patient is getting screwed. And that's just not funny.

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