reply to post by cognoscente
I actually just downloaded this very insightful paper from my University's online catalog. It's titled Equilibrium social insurance with
and is authored by De Donder and Hindriks of the University of Toulouse in France. I'm not technically allowed to
distribute this, but if you send me a private message with your e-mail address I would not hesitate to share.
Basically, it examines income polarization in the U.S. They conclude that because income disparity is so high, risk aversion tends to dominate any
political decision making process on issues that are so focal on income disparity.
It makes a lot of sense now just after reading this discussion here on the boards. Highest-income earners are positively risk-averse, meaning they
tend to oppose implementation symmetrically, and that they believe the implementation of some public health care system would impose a significant
cost on their finances, while diminishing the probability of a profitable return in terms of service. On the other hand, the lowest-income earners are
negatively risk-averse, meaning they support implementation symmetrically, but tend to burden the system in terms of its service. In the short run,
lowest-income earners take full advantage of the system, while highest-income earners are indifferent. But this problem peters out in the long run as
people realize the system isn't going to disappear. Just imagine if you were really poor; you would definitely jump at the opportunity to get all
your medical concerns addressed immediately, assuming you might believe it's not going to last forever. But when you realize it's not going to
disappear, many of these concerns become trivialized. Also, in response, bureaucratizing elements tend to create a system to reduce inefficiency in
the short term, thereby alleviating stress, even though this might have some adverse social effects on the poor, and media might jump the gun to
portray the medical industry are cold-blooded, inclusive and discretionary.
This observation definitely leads credence to the notion that a single-tiered medical system just wouldn't work politically, even though it just
might work on a technical level. The whole issue is convincing people, and since people are evolutionary predisposed to think in the short-term, it
gets rather difficult to address issues such as long-term free medical care, especially when it seems people's finances, and hence their security,
are at stake.
Perhaps if this were to be implemented on a regional level, one that supersedes state boundaries, this might be a viable strategy. What do you think
about this? A regional health insurance system would be organized along boundaries, designed to enhance political efficiency based on income
disparity. Prices would be differ region to region, with membership restricted to the category they are placed into by the federal government. And
since this is nationalized, every region would be expected to meet very high standards of medical technology and professionalism.
If Obama wants to implement a free medical insurance program then it will be very difficult to implement on a national level. I'm starting to think
that nation-states with increasing high income disparity just won't make it through this next century, as growing capitalism is apparently making
this situation worse every year. It makes a lot of sense when you look at all the different countries of the world.
Canada and Australia have a low degree of income polarization and their public health insurance industries are rarely the center of attention in any
political debate. Whoever focuses their political platforms on such non-existent issues during election times are rarely considered by voters, and
rationalized as political outliers, or a waste of time.
In the U.S. it is almost the opposite. I think this should be done a state or even better yet, a regional level, if it is to succeed. A national heath
insurance policy, after reading this paper and reflecting on the very nature of this thread, simply isn't mathematically reasonable on a political
level, unless of course we adjust equilibria by changing our cultural attitudes, which is impossible of course.
I still don't think it would be difficult to operate some sort of public health care system on a technical level, assuming people can weather through
the short-term scenario, which entails high degrees of political contention and high burdens on the system itself. I believe the emergence of
bureaucracy would address short-term rationality, and shifting cultural attitudes in the long run would address unstable political equilibria,
maximizing the expected utility of both the conservatives and liberals in terms of risk-aversion due to income disparity.
[edit on 7-3-2009 by cognoscente]