Tone deaf git of the month award

I’m always amused to see Ivy league professors with tenured appointments and gold-plated group health insurance explaining how the individual market for health insurance works pretty well for, well, quite a few of the well people in it. But this award is not for Mark Pauly.

Today there’s a long piece in the Wash. Post (essentially paid for and scripted by Kaiser Family Foundation—which may be the future model of health care journalism). In it, we see this paragraph:

Experts define the underinsured as those forced to spend at least 10 percent of their income on health care, excluding premiums. But the nonprofit Center for Studying Health System Change found recently that financial pressures on families increase sharply when out-of-pocket spending on medical bills exceeds 2.5 percent of family income. New York’s Commonwealth Fund has reported that 72 million adults under age 65 had problems paying medical bills or were paying off medical debt in 2007, up from 58 million in 2005. Many had insurance, and 39 percent said they had exhausted their savings paying for health care.

Yup, even people with insurance are in real trouble. Two days ago I met a woman in her early 20s who faces 3 more years paying off extra bills from emergency ankle surgery 2 years ago. And yes she had insurance–just not very good insurance.

And so we have around 25% of adults having problems paying medical debts. And of course that’s a 2007 number—in other words pre-recession. So in order to be “balanced,” they get a quote from a resident member of the loony right. And for our tone deaf git of the month award we select this wonderful piece of empathy.

Economist Thomas P. Miller of the American Enterprise Institute, a conservative Washington think tank, said he believes the problem of medical debt has been exaggerated and is a symptom of the broader economic crisis. The solution, he said, should not be "to kill people with kindness" by requiring an overly expansive and expensive benefits package that could "preempt the use of resources for other purposes."

In other words, screw you poor people, you’re on your own and the system works fine.

I just wonder what Tom Miller would think if, instead of being a highly paid pundit at a corporate tax dodge promoting front organization
conservative think-tank, he was instead a young person entering the
workforce while having to spend the next three years paying off medical
debt incurred through no fault of his own.

Would it per chance change his opinion? Or would he be
happy pulling himself up by his bootstraps encouraged that as he didn’t have an
"overly expansive and expensive benefits package", he’d cheerfully using
his "resources" for the "other purpose" of paying his credit card company for the next five

In any event I’m feeling Olbermanish this morning, so he wins the first tone deaf git of the month award.

And yes, point of care fees that cause debt and hardship
(and bankruptcy) are the BIGGEST problem in American health care,
whether you have good, some or no insurance. The point of care is completely the wrong
place to charge people money for health care services and anyone with
half a brain who’s looked at the data realizes that….or if they
haven’t they should go talk to Bob Evans & Maurice Barer about the zombies.

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Some of the commenters here just plain live in la-la land. I have insurance and my husband is a doc so I feel blessed to have insurance. But it’s really not a matter of virtue. It should, I believe, be a matter of necessity. This scenario is typical of what I see all of the time in some permutation or other. I just did a casual google for the price of an appendectomy. I didn’t work very hard at it but I found a cost that showed the range of cost of appendectomy in Tennessee in 2004. Looks like the… Read more »


Deron, if you think healthcare reform is tough just try cultural reform. I’d like to get lower cost healthcare IN MY LIFETIME. Cultural contributors to bad health are more easily dealt with through taxes to pay for bad habits. Do you think if we avoided cigaratte taxes to control consumption and pay for health problems and instead focused on changing attitudes we’d be in the same position with smoking rates, especially with all the counter ads by cigarette manufacturers? We can also change our tax code to subsidize fresh fruits and vegetables from corn (also cattle feed) and wheat. You’d… Read more »

Deron S.

Obesity and teen pregnancy are only two measures. My point is they are not only contributing to our high costs, but they also shine a light on deeper societal issues that we must address. You come across as a liberal and I probably come across as a conservative. However we probably want the same result, a lower cost, higher quality healthcare system. You often reference our economic crisis and address issues such as greed. That’s a core issue needing addressed. Bailouts in that sector and single payer in the healthcare realm are workarounds that allow us to avoid deeper issues… Read more »


So your saying equalizing obesity and teen pregnancy rates would cut U.S. healthcare costs in half? I guess to argue that you’d have to show both were half U.S. rates. As for teen pregnancy I guess you’ll have to get the religious fundamentalists to allow actual sex education with condom use demonstrations and not just the delusional abstinence dogma.

Deron S.

Peter – My point about comparing the rates of obesity, etc. between the U.S. and your comparison countries is that single payer is not the reason they have lower per capita spending than we do. You have not controlled some very important variables in your assessment of that issue. Not only do the obesity and teen pregnancy rates add direct cost to the system, they paint a picture of a society that is very different than that of the “other industrialized countries” that are often mentioned. It would be irresponsible and lazy to simply hand over the keys to CMS… Read more »


Since Reagan presidency of de-regulation ideology we’ve had 12 massive bailouts not including the latest or Enrons robbery of de-regulated energy markets (Cheney’s Friend). Dems spineless accomodation of this failed policy is because electorate only could see low taxes, not future costs. I’m no friend of Barney Frank, but (I’m assuming) your hero (at least for 4 years) George Bush, could have used his “political capital to spend” to enact regulations – but he also was an anti regulator. TARP funds administered secretly by Paulson (a Republican) and Wall Street buddy. Barney Frank being gay is not the issue but… Read more »


Barney Frank is a Republican? I seem to remember watching a Video of Democrats refusing to regualte Fannie and the mortgage companies. I believe it was mostly liberals who got the friends of Tony? mortgage deals. Who was Barney Franks lover and what deal did he get.
WHo just voted to release TARP money? It wasn’t the republicans.
You got your parties and your facts mixed up Peter.


“Peter – Your homework assignment is to compare the teen pregnancy and obesity rates of the U.S. and Canada. If that doesn’t work for you, compare the U.S. and France.” What’s your point and what does it matter? Nate, I guess with all those false poor people that’s why food banks have seen doubling of users. Better come to NC and visit all those owner owned homes that have been passed down to children who can’t afford repairs, or insurance, many even without indoor plumbing. Somethings wrong with your definition of poor unless it’s an African living in a refugee… Read more »


to drive a stake through the claim our poor our suffering so bad; Understanding Poverty in America by Robert E. Rector and Kirk A. Johnson, Ph.D. Seventy-eight percent have a VCR or DVD player; 62 percent have cable or satellite TV reception. Seventy-three percent own microwave ovens, more than half have a stereo, and a third have an automatic dishwasher. Ninety-seven percent of poor households have a color television; over half own two or more color televisions. The average poor American has more living space than the average individual living in Paris, London, Vienna, Athens, and other cities throughout Europe.… Read more »