Health care and risk-taking

Mickey Kaus pauses in his relentless career of liberal-bashing in general and Obama-bashing in particular (he’s still hoping for GM to go belly-up) to recall a point that he and Megan McArdle have both made: to maintain a culture of risk-taking, you need a social safety net, including health coverage. Asking people to bet their bankroll on a new venture or a new job is reasonable. Asking them to bet their lives, and their kids’ lives, isn’t.

Update Matt Yglesias makes a related point: high unemployment makes workers less free to resist bad behavior by employers and supervisors by increasing the cost of quitting. (And of course if quitting means losing your health insurance it’s even worse.) To you and Matt and me, that’s a bug. But to Mitt Romney and his fellow malefactors of great wealth, it’s a feature. What’s the point of being able to fire people if firing doesn’t really hurt? (It’s almost as much fun as having your friends hold them down while you cut their hair.) Romney’s personal bullying tendencies aside, there’s clearly an advantage to employers if employees are seriously afraid of losing their jobs.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact:

9 thoughts on “Health care and risk-taking”

    1. Interesting article, Bruce.

      Norwegians perceive value from the services they pay for in their taxes. If Team Obama wants to push back on the “taxes are always evil” meme that dominates our culture, they will need to have some images of how people have been turning to the public sector for many things which everyone sees as valuable.

      This might be a video of firefighters battling huge blazes in the West, with a voiceover reminding viewers that there are ways in which we are all in this thing together and that the firefighters did not ask anyone for their insurance information before going toward the flames. Or it could show people going to public cooling centers when the record heat waves were making pavements buckle as power failed.

      Mitt Romney is on record chastising Obama for calling for more public servants like cops and firefighters. He speaks for those who hold a certain viewpoint about public goods and common efforts and bonds of community: it is every man for himself. This is widely held because the conservatives have been master hypnotists for the last three decades or more, inducing a trance state in which certain phenomena are made to disappear even when the trance subjects are staring straight at them.

      Ending the trance phenomena of negative hallucination will take some effort and skill. I hope that someone will be equal to the task.

      1. It is as if the internet got invented and this culture forgot everything it knew.
        And so this Mickey Klaus idea comes off as something bright and shiny.
        Once upon a time we knew “turbo capitalism” didn’t work and we had to have instead “managed capitalism” to soften all the blows.
        Didn’t the world know that thru and thru and thru?

        Not any more apparently as we skew towards a planet of libertarian apes where each chimpanzee in the urban forest is out for himself.
        And thumps its chest and says: “I am man, man, man…”

        And now Ed Whitney suggets commercials reminding people why they pay taxes and explaining the basics of civics:

        This might be a video of firefighters battling huge blazes in the West, with a voiceover reminding viewers that there are ways in which we are all in this thing together and that the firefighters did not ask anyone for their insurance information before going toward the flames. Or it could show people going to public cooling centers when the record heat waves were making pavements buckle as power failed.

        And Ed is not wrong. Along those lines I suggest the Democratic Party buy 1 hour of prime time TV and explain the ACA with charts and numbers.
        In the simplest cleanest language possible. Bring the president on board. Do it. Explain it. Sell it.

        Because if I read one more time that “Americans like the ‘parts’ of the plan, but not the plan itself” I am going to throw my monitor out the window…
        It it time for this damn country to grow up and quit acting like a spoiled juvenile chimps…

        Or as Jared Bernstein put it recently:

        The Inane “Is It a Tax?” Debate: R’s are viciously attacking the ruling because it introduces a new “tax” on people who don’t have coverage. As I and many others have stressed, this tax is a free-rider penalty. It is a PRF—a personal responsibility fee for not saddling the rest of us with your health care costs, thereby imposing an implicit tax on the rest of us. And it hits 1-2% of the population. You thought personal responsibility was supposed to be a conservative value? Not, apparently, when the dreaded tax word is invoked. But, really, a pox on both houses here. Despite the fact that the SCOTUS ruling calls it a tax—I mean, it doesn’t just call it a tax, it says the reason we can do this is because Congress can tax–D’s are working overtime to not pronounce those dreaded three letters. Weirdly, they now have an ally in this Kabuki theater, Gov Romney! I get it: silliness pervades in an election year…but really? Seriously?!? Taxes happen in societies—according to a Supreme Court justice from a saner time, they’re “the price we pay for a civilized society.” And in this case, they’re the price we pay to offset a negative externality by which the behavior of a small minority of citizens imposes a cost on everyone else. To be ashamed to make that case is to cede the field to Norquist and co.


  1. I am not much of an entrepreneur, but I have made my living mostly as a self-employed professional. That would have been much harder, perhaps impossible, had not my wife had a job (governmental, as it happens) with good benefits, crucially including family health insurance. There are millions like me, and for us the system heretofore has “worked”. But it shouldn’t be that way; there is no good reason why my ability to choose that lawful and productive (free enterprise!) career path should depend on fortuitous access to such a jury-rigged arrangement. Perhaps, to the benefit of society, it won’t for future generations, if the good guys continue to win this battle.

  2. Word to this … I tried to interest my Bluedog Democratic Congresscitters in this, saying that the fastest route to the small business startups he was caling for was government either proving single payer like I had in the military or, at the very least, letting anyone unemployed tap their retirement savings to pay mortgage or rent, health insurance, and small biz startup costs from retirement accounts without the damn 10% early distribution penalty. I mean, if depressed demand is the problem, then let those of us with lots of assets set aside for retirement spend some of them now, both helping us get through a rough patch and rebuilding demand for goods and services.

  3. There are a couple of posts at Crooked Timber (starting here) baiting libertarians with the pretty obvious point that the standard workplace is full of coercion. The employment relationship and the capitalist firm exist because of the Coase theorem of the impossibility of coordination entirely by contract. So the employment contract is peculiar, like feudal homage: it replaces contractual autonomy with temporary personal hierarchical subordination, an obligation to obey the superior’s unknown future commands (within a range, unless it’s slavery). Undefined hierarchical subordination creates a lot of space for abuse by superiors. This leads straightforwardly to a case for countervailing power in the form of unions and workplace regulators.

    This is entirely different from the Stiglitx – Akerlof argument for wide intervention to correct the inefficiencies resulting from asymmetric information within contracts, such as unemployment and excessive working hours for those who do get jobs.

    Either way, universal health care is immensely liberating for the typical employee, and greatly increases the number of those who can afford to tell a bullying employer or manager to stuff it. This is no doubt one reason why the plutocrats hate it, against their purely economic self-interest. Many want to be rich because they like bullying others, not because they want to retire young and drink Bollinger on their yachts with starlets.

  4. BTW, Crooked Timber has had several recent discussions on this. The end result, as usual, has been to show that (the type of) libertarians (who show up on comments) are psychotic.

  5. Mickey WHO, now? I seem to remember a journalist named Mickey Kaus back in the 1980s. Probably not the same guy, though.

  6. Didn’t Marx kinda point at this with the “reserve army of the unemployed” line? The insistence on wielding government power to improve the already-overwhelming bargaining position of large employers with respect to workers is one of the reasons that one sometimes considers the f-word is not entirely out of line as a description of the post-modern republican party.

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