Poverty Paradoxes

• Poorer Americans have more children than richer Americans but when the economy is weak the birth rate falls. 
• Poorer Americans are fatter than richer Americans but when the economy is weak and people lose weight and BTW they get healthier (except the elderly who get less healthy in a recession).
• Poorer adult Americans are less likely to married than richer Americans but it is much cheaper to be married than single and the poor economy has reduced divorce.
• Poorer Americans commit more crimes than than richer Americans but when the economy is weak crime falls. Further crime does not pay. 

Some have said the diseases of poverty in the USA are diseases of wealth. 

Why Tax Consumption

Why tax consumption rather than income. 

1. We are trying to shift some consumption from the rich to the poor or from personal consumption to a public good.
2. We are not trying to shift investment or reduce investment  because we all benefit from investment.

SS and Medicare not a Quid Pro Quo

In this election season I am seeing a lot on political ads saying that this or that group payed into Social Security and/or Medicare and so they have a claim on the system, therefore the Social Security and/or Medicare system must not be changed to help with the deficit.  But the programs are not a case where people voluntarily bough a specified future benefit.  Rather people where compelled to pay and they will receive what the democratically elected officials decide the benefit should be.  The programs have been changed before and they can be changed again.  There are no Guaranteed Social Security and medicare benefits.

Here is Ross Douthat on the payroll tax.

One Doctor on the Doctor Shortage

From the comments here.

 There is a huge international pool of capable, English speaking, newly-minted foreign-trained medical school graduates every year. Many would be happy to immigrate, do their residency training and raise their families in the US. Many are leaving countries where the monies paid under US government healthcare price controls are a relative fortune. Some leave a country like Canada, because they want to escape a socialized system where private insurance is outlawed.

HHS has total federal agency discretion to control funding and expansion of physician residency training programs. They can quickly expand the nation’s physician pool.

Furthermore, the medical profession has dramatically extended the required post-graduate training years since I graduated from Columbia College of Physicians and Surgeons in 1976. It unconscionably forces young women doctors to delay starting their families at child birth ages we recommend as optimal for our patients. . . or prevents these young women physicians from entering the medical field best suited to their talents because they don’t want to outsource raising their children.

As physicians, we have always known and discuss with each other that one of the primary reasons that training time was extended so dramatically was to delay young physician entry into the marketplace.

Dorothy Calabrese MD
Allergy & Immunology, San Clemente, CA

Often the blog comments are better than the post. 

How Republicans Get Higher Taxes and Democrats get Rising CO2 Emissions

Below is from from a NY times article titled "Taxes Show One Way to Save Fuel" by EDUARDO PORTER

According to economists crunching the numbers, this makes mileage standards somewhere between 2.4 and 13 times more expensive than a gasoline tax as a tool to reduce our use of fuel. Indeed, by some calculations, raising fuel-economy standards is more costly than climate change itself.

The same I am sure goes for Government investment in alternative energy. It is time for all of us to wake up and see that politicians from both party are scamming us. People need to realize that they are often paying a tax even when they do not write the check to the Government.

The same goes for a CO2 tax it will be cheaper and more equitable in the long run than bloowing money on AE pipe dreams sometimes run by crony capitalists.

Republican and democrat voters need to compromise on a tax rather than letting our politicians hide the tax to get Republican votes and display the alternative energy projects to get Democrat votes. With the current situation Republican voters end up with higher taxes (to spend to to tax) and Democrat voters get continually rising co2 emissions.

If you do not despise Obama and almost every Democratic congressman and you do not despise Romney and almost every Republicans congressman it is because you are not looking at the facts.

And by the way one of the worst things that you can do is encourage those not interested in the real outcomes policy to vote.

To preempt an inevitable argument: An argument can be made that Government funding of basic research is warranted but most of this alternate energy stuff is very far from basic research.

Are Children Really Expensive?

Here is an article on people not having children due to the bad economy.
In the article they have this “Children are really expensive,”

But are children really expensive?  I once worked with a single mother (she had a very low income BTW) who said “children are cheap. If you have $20 left over at the end of a week you have enough money to have a child.” I believe her. I think that most children are very cheap to have and raise, some are very expensive, those with health or behavioral problems but you can spend as much or as little as you want on an average child. The extra money we spend on them yields very little. 

As the article notes down a little lower it is risky to have a child but still people should be told that an average child is cheap.

More on High Deductible Health Insurance

Stuart Buck's post on not insuring for small health expenses got me thinking again about why people have low deductible insurance and why one of the arguments against high deductible insurance is weaker than it seems. 

The incentive alignment in health insurance is bad so why do people choose to use insurance for health expenses that they can afford. (I have a $10,000 deductible health insurance plan, partly because I want to minimize fighting with insurance companies.) one might argue that we have low deductible insurance because the deduction is better if health spending is done through an employer but that begs the question of why people would support such a tax situation.

My current explanation for why low deductible health insurance still dominates is that it gives people peace of mind, one less thing to worry about. Also when healthcare spending was just 5% of GDP it was a nice way for companies (or Governments) to that they cared.

It worked OK while health spending was below 10% of GDP but that peace of mind has become too expensive now that health spending is 18% of GDP. At 18% of GDP, we need individuals to make more of the spending decisions directly. The trade offs between spending on health care and other things can be very different for people. At 18% of GDP it is not even a sure think spending that much on healthcare increase health more that say buying a newer safer car or a gym membership or opting to work a lower paid but safer job. 

One of the arguments that people will make against very high deductible insuracen is that when one is  sick it is difficult to shop for price and that shopping for price is very difficult in health care but,  the health care industry is not that as bad as people think in this regard because patients can have GP's who do very little of the expensive care themselves who can seek the best options on behalf of their patients.  So even if the patient is too upset by the sickness to make the decisions himself they can have an advocate acting on their behalf.

I have had situations where Doctors have found much cheaper options for us after we have explained how much we will pay with our $10,000 deductible health insurance plan.