Health Insurance Might not be Good for Everyone

Steve Randy Waldman‏ of interfluidity called this thread: Thread, counterintuitive and disheartening. (Here is Aaron Carroll saying that Medicaid access may not have increase opioid deaths and of course that Medicaid expansion may still net out positive.)

It could for a number of reasons be that the current western healthcare (beyond the basics that you do not need insurance to get) is not good for those at the low end of diligence, IQ, conscientiousness scales.

Here are some possible reasons why:

• MD’s often do not explain enough and nobody follows up.
• Protocols are sometimes too complicated and require too much attention. 
• Opiates are too tempting.
• etc. 

If true it could explain:

• Why the more educated (a good measure of the above traits) are getting healthier faster than the less educated. 
• Why the health/income gradient is greater in Canada than the US. Everyone gets access to healthcare in Canada.
• Why Medicaid does not seem to improve health.
• Why the PPACA (Obamacare) looks like it did not save lives. 
• Why some groups with less access to healthcare have greater life expectancy.
• The states leading the pack in overdoses all expanded the program.
  
  Read more at: http://www.nationalreview.com/article/449171/medicaid-opioid-problem-has-it-made-epidemic-worse
   

U.S. Age-Adjusted Mortality Rates per 100,000 (Annual, 2002–2015)

And BTW  on the opioid epidemic being deaths of despair:

New Hampshire has the second highest opiate death rate in the US.  Very good economy in NH. These epidemics come and go look more like viruses than anything caused by despair. 
So why would West Virginia be the leader in overdose deaths, because it has been loosing its best and brightest for a long time leaving a higher percent on the lower end of diligence, IQ, conscientiousness scales, the most susceptible.

Here is another thing I just came across on 11/30/2018, length of life is down for the third year in a row in 2018 just a few years after the final provisions of the PPACA (Obamacare) were enacted.


And there is this:

The effect of requiring consumers to obtain prescriptions for pharmaceuticals on mortality is examined for a sample of middle‐income countries. In countries enforcing the requirement, infectious disease mortality is no lower and poisoning mortality is higher than in those not enforcing the requirement. A broader measure of government intervention—public expenditures on health relative to GDP—is shown to have moderately adverse effects on overall life expectancy.

Note the last line (maybe I'm reading it wrong).

A broader measure of government intervention—public expenditures on health relative to GDP—is shown to have moderately adverse effects on overall life expectancy.

Related links:

The Amish and the marginal value of health care

The Amish and the marginal value of health care

The Amish and themarginal value of health care

Ironic Health Links 
Hanson on Health
Wealth and retirement might not be good for everyone!
Has Medicaid Made the Opioid Epidemic Worse?  

Exploring the Paradox of U.S. Hispanics' Longer Life Expectancy

This is related in that it's one reason that free Government health insurance might be bad for some people. Some people might be working longer because they want to maintain health insurance: Early Retirement May Be The Kiss Of Death, Study Finds

Why I am Against the Minimum Wage

2 recent minimum wage studies here and here.

So here is why I'm against the minimum wage:

1. Idle hand are the devils workshop. Young men not working get into more trouble than those with jobs. I would rather not take the chance of even putting a very small number of people out of work.
2. Anyone working full time in the developed world is really not living in poverty. See: How I Live on $7,000 per year.
3. Unemployment is depressing. The Grave Evil of Unemployment
4. People often learn skills on the job and BTW you would have to make internships pay minimum wage to be fair.
5. Jobs integrate younger and older people and older people's life styles are generally better.
6. If you consider the difference in pay between the market rate and the minimum wage rate a tax, fair in my mind, the tax falls on employers of low wage labor in the short run and consumers of products produced by low wage labor in the longer run, why tax them more than others? BTW Dear Republicans even if you do not call it a tax it's still a tax, so  you might want to support a higher taxes to fund an hourly wage subsidy or a UBI.
7. Many people are already working for less than minimum wage.  WHy Drug Dealers Live with there Mom's
8. Black youth unemployment is already much to high. 
9. An hourly wage subsidy would be so much better. 

And yes, I would get rid of it all together and leave it to individuals, unions to work out wages.

BTW statistics and be tricky and when you read economic studies, you need to think about what could have gone wrong on the study and how they could be biased, but statistics are much better than stories (anecdotes). Statistics and theory are the best we have. The old saw "There are three kinds of lies: lies, damned lies, and statistics." has truth to it but again statistics are better than the alternatives.

Playing off Arnold Kling's Clarifying his Null Hypotheses on Schooling

Here is Arnold answering: The null hypothesis: do I really believe it?

My null hypothesis says that spending more (inflation adjusted) on schooling than was spent in 1960 (that's about 1/3 of what is spent today) has no positive effect on measured student academic outcomes.

Also that only a tiny fraction (perhaps .1%) of schools are good or bad schools. The rest are judged good or bad because they have good or bad students. So parents should relax and only try to avoid the worst .1% of schools and not pay more for a home in a “good” school district.

My mother has told me that her parents went to school for just 1 year, yet they where educated. They were not superstitious as many where in their era. They could read and write and do arithmetic. They read books. They owned and ran a barber shop they speculated on real-estate (but lost most but not all of it in the great depression) and sent their son to Brown University. School is not only place people learn.

Perhaps 3 years of formal schooling would be enough for most people. Nevertheless in the modern world we'd need something for them to do so maybe keeping most in school to 16 is a good idea, not so much for education but to keep them out of trouble. The Amish drop out early and do OK.

For a modern example, the guy who invented this car claims to have dropped out of school at 14 years old.

Also, if we cannot teach children more and it looks like we cannot, we should focus on teaching the most valuable stuff.

What are the Best Things We Could Do for the Poor Through Government

• End the War on Drugs and give amnesty to all non-violent drug prisoners, and criminal justice reform with the aim of reducing incarceration rates. What has done more economic harm to the poor than having their working-age men locked away
• Hire more and better police. See here. Poor people are too often victims of crime and fraud. It is better to live on a corner of the roof than share a house/neighborhood with crime and violence (or biting insects see below).
• Allow any subdividing and residential building that increases overall density and some that does not. 
• Wipe out the mosquito. This seems like it can't be done but I heard about it on NPR see here.

Plan from the Niskanen Center: Universal Catastrophic Coverage

This plan from the Niskanen center: Universal Catastrophic Coverage — Or How the Senate Can Fix the AHCA

Is similar to my compromise proposal.

 

A Healthcare Compromise

I think that they are a little to people with above average income but I like it otherwise. They say it would be cheaper than the ACA. So why are we stuck with the ACA and AHCA?