Yogi Berra’s Pizza Slices and the Healthcare Pie


The (apocryphal) story goes like this:

Seems Mantle, Berra and Whitey Ford went looking for a bite to eat after a night game in Baltimore (I think) and stopped in at a pizza parlor. They each ordered a large one, and when the waitress asked Yogi whether he wanted his sliced in eight pieces or four, he shot back, “Four. I don’t think I can eat eight.”

It’s funny because we know he will be eating the same amount of pizza either way. The Republicans spent all their time on the air yesterday trying to convince us the pie of healthcare costs can be reduced by how they slice it up:

Alabama Representative Mo Brooks to CNN’s JakeTapper on the how the AHCA will save most people money: “[The plan] will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool . . . That helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy. And right now, those are the people—who’ve done things the right way—that are seeing their costs skyrocketing.”
The issue of paying for health care is central to understanding who we are as a people. We either care about each other, or we don’t.

What we hear about in the news is the average cost of providing health care in this country, and while it is much higher, over $10,000 per person this year—almost double on a per capita basis than the rest of the civilized world, like all averages, it does not tell the whole story and why it is we cannot—not if we care to be a Christian people—allow what the republicans are proposing to become law.

10% of Americans consume 2/3 of all health care spending. Half the people in the country account for 2.7 % of the cost. https://meps.ahrq.gov/data_files/publications/st455/stat455.pdf

The result is that 1%, about 2.3 million people each incur about $234,000 per year, while 50% incur less than $600. Calculations are from the 2012 study referred to above (see tabular computation at the end of this piece).

To be plain: this one percent incurs $749 billion in health care costs each year. The $8 billion proposed to assist people with this cost would be laughable were it not so craven.

The Republicans were all over the Sunday morning talk shows, saying that people with pre-existing conditions would be treated better under their plan than previously. This one percent is made up almost entirely of people with pre-existing conditions.

The other related issue is that of cost increases from year-to-year. No, it is not the fault of Obamacare: all Obamacre did was tried to spread the cost across all groups, enabling those with the most need to get some relief. This issue is complex and depends on a lot of calculations, and I learned a long time ago the set of people who like numbers is fairly small, so I try to keep them to a minimum in each post.

Is it fair or right that someone living in this country—the richest in the history of countries—should have to die because they cannot afford to pay $234,000 per year?

Yeah, yeah, I know: they made bad life choices.

I was totally healthy when, out of the blue, rheumatoid arthritis looked me over, decided I was born with the wrong genes, and viola—I had a pre-existing condition that made it impossible to buy insurance unless I was able to get employed somehow by a company with an existing policy. When we started our consulting company in 2000, we could not get anyone to write a policy for us because of this. We found a workaround, but I wonder: how many people are trapped in dead-end jobs because of the need for health care for themselves or their families?

The dollars are going to be spent. We have not decided—yet—to let people die in the streets. The question is who will pay for it? Will we continue to believe we are all in this together or be glad we are healthy and do not have to incur more than $500 or $600 a year in costs?

Before you answer, think of your family and co-workers.

The Trump Presidency dismayed me because of what it said about how a large portion of this country thinks. If this health bill becomes law, it will be a deathblow to our belief that we all need each other.

I pray for saner heads in the Senate.



 People in Cohort  Percent of Health Care Dollars Consumed  Total Health Care Dollars Expected 2017  Per Capita Cost
99th%        3,200,000 22.70%       749,100,000,000          234,094
95th to 99th      12,800,000 27.30%       900,900,000,000            70,383
91st to 95th      16,000,000 16.00%       528,000,000,000            33,000
51st to 90th    128,000,000 31.30%     1,032,900,000,000              8,070
Bottom 50%    160,000,000 2.70%         89,100,000,000                557
Total population    320,000,000 100.00%     3,300,000,000,000            10,313


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