All posts by Thomas L. Knapp

Americans’ Healthcare Upset Isn’t Really About “Insurance”

West Hospital Emergency Room. VCU Libraries. Creative Commons Attribution 2.0 Generic license.
West Hospital Emergency Room. VCU Libraries. Creative Commons Attribution 2.0 Generic license.

On December 4, someone murdered UnitedHealthcare CEO Brian Thompson near the site of the company’s annual investors’ meeting. Thompson’s killing was clearly planned rather than random, and at least appears to be job-related. As I write this, the suspect remains at large.

The establishment response, as usual with assassinations, combines “thoughts and prayers” with condemnation.

Social media responses, on the other hand, largely riff on Americans’ complaints about healthcare in general, and healthcare firms in particular. On a brief survey, I’m seeing lots of “poetic justice,” and not a little “more, please.”

I certainly feel the plaintiffs’ pains, and confess to frequently finding myself less than satisfied with my family’s (employer-provided) healthcare coverage. If this “targeted killing” is indeed a “customer dissatisfaction” incident, I guess I understand the sentiment even if I don’t approve of the particular penalty imposed upon Mr. Thompson’s person. Insert thoughts/prayers/condemnation language of your choice here.

What I don’t agree with is characterization of the whole matter as relating to “insurance.” It almost certainly doesn’t, because it’s been decades since most American healthcare companies have really offered “insurance.”

The system we’ve lived under since the early 1970s and the inception of the “Health Maintenance Organization” /  “Preferred Provider Organization” isn’t “insurance” — it’s “prepaid healthcare.”

“Insurance” is a hedged betting strategy. The customer makes a small bet that something unlikely and unpleasant will occur. The insurer makes a large bet that it WON’T occur.

To the customer, it’s worth betting $10 a month that he will suffer a heart attack, cancer, etc. and collect a large amount of money to cover his medical costs. The horrific medical emergency may be unlikely, but it’s expensive if it happens. Better $10 a month out of pocket now than $100,000 all at once later.

The insurer takes many such bets, knowing most of those heart attacks, etc. won’t happen. It will win far more often than it loses, and pay out less money than it takes in.

Does that sound like YOUR healthcare plan? Probably not.  Your plan probably at least partially subsidizes  everything from annual exams to routine vaccinations to prescriptions to diagnostic tests (chest CTs, mammograms, and colonoscopies, for example).

Yes, there’s an “insurance” component — you’ve still got that hedged bet in favor of that heart attack, the company still has one in against it — but you’re mostly just paying a middleman to partially cover stuff you’d have paid out of pocket for 60 years ago.

That middleman isn’t prepared to operate at a loss and go bankrupt.

Just as with actual insurance, you (or your employer, ever since World War 2 era tax rules began incentivizing insurance as a “fringe benefit”) WILL fork over more in premiums and “copays” for those benefits than it costs the middleman to provide them.

When a middleman (an employer) pays the piper (the healthcare company), and doctors work as the the piper’s orchestra, patient choice and patient satisfaction cease to be major incentives.

The problem isn’t the Brian Thompsons. It’s the system they — and you — are part of.

Thomas L. Knapp (X: @thomaslknapp | Bluesky: @knappster.bsky.social | Mastodon: @knappster) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

PUBLICATION/CITATION HISTORY

Hey, Joe, Pardon Me (And Everyone Else)

Usa one nickel 1984

On December 1, outgoing US president Joe Biden issued a pardon for all federal crimes his son, Hunter, “has committed or may have committed or taken part in during the period from January 1, 2014 through December 1, 2024.”

Can he do that? Yes. Constitutionally, the president exercises “Power to grant Reprieves and Pardons for Offences against the United States, except in Cases of Impeachment.”

Should he have done that? As I’ve noted before, in my opinion Biden should pardon EVERYONE convicted on unconstitutional gun and/or drugs charges, since the Constitution explicitly forbids the federal government to regulate guns and, under the Tenth Amendment, confers no authority on the federal government to regulate drugs. So those charges, at least, should never have been filed and should certainly be pardoned.

Why did he do that? While Biden the Elder correctly claims that the charges against his son were politically motivated “lawfare” aimed at using the son to damage and thwart the father, the real reason is that he IS a father.  Not many parents would, if they could prevent it, allow their children to go to prison, especially for non-violent offenses. Joe Biden just happened to have the power to prevent it. I can’t really blame him.

I’ve also argued that Biden should pardon his predecessor and successor, Donald Trump, for all the stuff he’s been accused, and even convicted, of. Since Trump is clearly going to get away with his crimes — many of them publicly confessed and even bragged about by Trump himself —  a pardon is just about the only way to officially and indelibly inscribe his guilt on the public record.

And hey, while he’s on this pardon subject, how about the rest of us?

Yes, all of us — or at least most of us.

Biden could save the taxpayers a lot of money by issuing a mass pardon for all non-violent federal crimes committed prior to the date of the pardon. Rape, murder, etc., no. Drug “crimes,” unconstitutional weapons charges, financial crimes, etc., yes.

The federal prison system would immediately be done with capacity problems, and could at least temporarily cut staff and various costs (food, medical care, etc.) in a big way.

The Department of Justice would instantly clear most of its existing case backlog, and get rid of a whole bunch of prospective future prosecutions. Some of its prosecutors could return to the private sector and those who remained could concentrate on the future and the most vile existing cases instead of chasing drug sales and small-beans embezzlement from past decades.

Have YOU committed a federal crime? Have I? Probably. There are so many laws on the books that it’s impossible to know, let alone obey, all of them.

Did you know, for example, that you can be imprisoned for up to five years and fined up to $10,000, (see 31 U.S.C. § 5111) for leaving the country with more than $5 worth of nickels?

Wouldn’t it be nice to sleep well in the knowledge that all your trivial past offenses have been erased?

Pardon us, Joe.

Thomas L. Knapp (X: @thomaslknapp | Bluesky: @knappster.bsky.social | Mastodon: @knappster) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

PUBLICATION/CITATION HISTORY

Netanyahu, Gallant, and “That Juris-My-Diction Crap”

On November 21, the International Criminal Court issued arrest warrants for Hamas military chief  Mohammed Diab Ibrahim al-Masri (aka Mohammed Deif), Israeli prime minister Benjamin Netanyahu, and  former Israeli defense minister Yoav Gallant, all on charges of war crimes and crimes against humanity.

It’s unclear whether Deif remains alive.  Hamas’s official statement on the warrants was a call to “expand the scope of accountability to all criminal occupation leaders.”

The more interesting reaction comes from the Israeli regime, which has announced its “intention to appeal to the court along with a demand to delay implementation of the arrest warrants” … while simultaneously reiterating its pre-existing denial of the ICC’s jurisdiction over Israel, Israeli actions, or Israeli citizens.

Well, which is it going to be? Does the ICC have jurisdiction or doesn’t it? If it doesn’t have jurisdiction to issue the warrants, it doesn’t have jurisdiction to hear an appeal of those warrants.

The Israeli jurisdiction claim is based on the fact that Israel is not a member state of the International Criminal Court.

But the state of Palestine IS a member state of the International Criminal Court, and the alleged actions for which the warrants were issued took place in Palestine, not Israel.

ICC jurisdiction comes in two flavors:

First, jurisdiction over citizens of member states who allegedly commit war crimes or crimes against humanity, no matter where those crimes are committed.

That’s the jurisdiction which applies to Mohammed Deif. His alleged crimes were committed in Israel, but since the state he resides in is under ICC jurisdiction, Deif is under ICC jurisdiction.

Second, jurisdiction over war crimes or crimes against humanity allegedly committed in ICC member states, regardless of who, from where, allegedly commits them.

That’s the jurisdiction which applies to Netanyahu and Gallant. The alleged crimes were committed in Palestine.  Netanyahu’s and Gallant’s Israeli citizenship doesn’t exempt them from ICC jurisdiction any more than me being from the United States would exempt me from prosecution in, or extradition to, Poland for a murder I stood accused of committing in Warsaw.

It’s that latter jurisdiction which Netanyahu and Gallant deny — but which they would necessarily have to recognize to enjoy standing to appeal the warrants.

Instead of making up their minds, they’re resorting to the usual Israeli regime policy of loudly demanding their own absolute exemption from, while crying everyone else’s absolute obligation to, “international law” and “rules-based order.”

Naturally, they’re backed up on that dodge by their friends in Washington, DC, who proclaim the same policy for both the US regime and its Middle East welfare client.

But those exceptionalist demands are clearly wearing out their welcome elsewhere. Netanyahu and Gallant probably shouldn’t plan near-future vacation trips to ICC member states.

Thomas L. Knapp (X: @thomaslknapp | Bluesky: @knappster.bsky.social | Mastodon: @knappster) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

PUBLICATION/CITATION HISTORY