Bigger Pizzas: A Capitalist Case for Health Care Reform

good morning Hank it's Tuesday I want to return to the subject of America's fascinating the inefficient health care system and I want to make a capitalist argument for reform but first a brief defense of capitalism ok so think of the economy as a pizza the richest people get the largest portion of that pizza and the poorest people get very little of it in fact in the u.s. the poorest 40% of Americans get less than 0.3% of the pizza that's problematic don't get me wrong but the cool thing about capitalism is that thanks to innovation and competition over time the overall size of the pizza increases so even if your percentage slice of the pie doesn't increase you get more pizza this is ultimately why you probably live in a place with a refrigerator and your great-grandparents probably didn't essentially Hank over time free markets create free pizza well it's not free actually because innovation usually means like increased use of non-renewable resources and new damage to the ecosystem but whatever free pizza but and this is very important the only way to get that free pizza is to make the world safe for innovation and competition like you need innovators to create refrigerators and then you need competition to drive the prices down besides creating free pizza this also creates lots of jobs so yeah unfortunately our healthcare system sucks at facilitating this ok so in the United States most people get their insurance through their employers like the vast majority of companies with more than 50 employees offer health insurance plans that's how my family and I get our health insurance through my wife's job but if you or your spouse don't work for a big company it can be difficult to get insurance at all because insurers can deny people access to coverage based on past health problems called pre-existing conditions and this can lead all kinds of rationality because people don't want to risk this pre-existing condition stuff so they either stay at their job with a big company or they remain full-time students because those ways you're guaranteed to have health insurance example in 2008 Henry Wright graduated from college which meant he no longer had insurance so he figured he should enroll in graduate school in physics so he could keep his insurance even though what he really wanted to do was do you to be stuff fortunately for Henry at that very moment the Affordable Care Act came along saying that he was entitled to be on his parent's insurance until he was 26 and that allowed him to go work for a tiny online video company which in turn led to the creation of minutephysics and minute earth-2 of the most innovative educational projects on the internet telling us everything from what a Higgs boson is to why locust plagues happen projects have been watched hundreds of millions of times and they make us smarter but they also increase the size of the pizza but crazily if it hadn't been for this weird rule in the Affordable Care Act that you get to keep your parent's insurance until you're 26 none of it would have happened let me give you another example you and by you I mean my brother hangry and I don't mean the other people watching this video although hi Hank you have altered of colitis a chronic and very serious illness that's also extremely expensive to treat so no insurance company will ever choose to insure you now thanks to the state of Montana you currently have a so-called catastrophic coverage plan which caps your out-of-pocket health expenses at ten thousand dollars per year that's not ideal but before Montana passed that law you couldn't get any health insurance at all meaning that you were constantly at risk of like a million dollar bankrupting illness or injury so Hank back before this government subsidized health care plan came along you had to allocate every dollar you made to the I don't want to go bankrupt if I fall off a ladder fund but then when the state of Montana came along and forced insurance companies to at least offer catastrophic coverage to people like you you could suddenly use your resources more efficiently basically you could take all that gosh I don't want to fall off a ladder money and start spending it on other stuff like I don't know dftba records which now employs lots of people or you could spend money to start VidCon which now also employs lots of people then there's the Lizzie Bennet diaries and crash course and scishow and sexplanations and the brain scoop and the foundation to decrease worldsuck and subbable and the juggernaut known as 2d glasses Hank all together these investments that you've made an innovation are responsible for dozens of jobs and for a significant growing of the overall size of the pizza and none of that could have ever happened without publicly subsidized health insurance now of course Hank could have gone to work for a big company after college and it could have gotten health insurance but then there would be no nerdfighteria no VidCon no dftba records etc career decisions should be about finding the place where your talents meet the world's needs not about finding the place where you can get health insurance okay so this all took a hilarious turn recently when Henry turned 26 and aged out of his parents health care coverage he then had to apply for his own insurance and sure enough he was turned down because of the pre-existing conditions of tinnitus and tendonitis that's right he has a little bit of ringing in his ear occasionally and his knee gets sore because he runs a lot because he's so frakking healthy now of course on January 4 20:14 Henry will be eligible for coverage as everyone else will be through the Affordable Care Act but if that didn't exist he would be forced to choose between minutephysics and his health that is a ridiculous choice and that ridiculous choice has lived by tens of millions of Americans has inhibited innovation prevented job creation and it has made the pizza smaller than it ought to be Hank there are only a few things that really pissed me off in this world and one of them is small pizzas so that's my capitalist fiscally conservative case for healthcare reform for too long we have privileged employees over entrepreneurs when we need entrepreneurs like Henry and Hank to maximize economic growth Hank thank you for being the engine that drives job growth in the American economy and for giving lots of people jobs including me I will see you on Friday informational videos are allowed to be more than full minutes long as I've been open the whole time dang it sorry you saw the secret image of the set which is really just my desk


  1. Economic growth doesn't always benefit the poor. When the corporations dominating American society increase in wealth, that doesn't mean they pay their workers more. Think of the success (and consequently, wealth) of Jeff Bezos – while this has increased the size of the US economy, Amazon workers still work for little money and in poor conditions. Alas, capitalism will always benefit the rich more than the poor.

  2. Anyone else get confused when he referred to Henry turning 26, forgetting he talked about youtuber named Henry and thinking he was referring to his son? I was like "Whoa! John is embarking on a crazy hypothetical journey here, in which to explain preexisting conditions he has given his son tinnitus and a trick knee." I was just thinking about how much I liked that in the future, John assumes his son will run a lot and be in great physical shape when I figured out that he was talking about a different Henry.

  3. i love how John and Hank are brothers who are knowledgeable about mostly different topics. I think it would be awesome to have a sane sister who knows a lot about the government, politics, and history. Sure, we wouldn't be able to talk to each other in-depth about Fibonacci, programming, and sci fi but that's what friends are for!

  4. When you post videos about controversial subjects, and the squids of anger come out with tentacles waving, do you ever find it necessary to delete especially vitriolic comments? I rarely read the comments under news articles because they tend to be so venomous, but I’m usually impressed by the tenor of comments for VlogBrothers. Not always though! Once in a while I see the discussion devolve into flame wars, and I wonder if it ever reaches a point where some administrative purging is necessary.

  5. Tries to make a case for capitalism and ends up arguing a case democratic socialism within a market economy. Cool.

  6. A flaw in your argument started at the beginning when you said that when the pizza grows the poor get more pie even if their percentage doesn't grow. Say the pizza is 100 slices. The top 50% get 60 slices, the bottom 50% get 40 slices. Then, the pizza doubles in size to 200 slices, but the rich have more power and use that power to take more pizza. Top 50% gets 180 slices, bottom 50% gets 20 slices. There is an example of the pie growing, and the top not only get more pizza slices, they also cut into the poor's slice of the pie.

  7. I suffer from UC too… Yep super expensive to treat. I've found it's easier to suffer with the illness rather than suffer with the expense.

  8. No—I disagree with some of the comments especially the ones that praise John for his Oratory skills—they should qualify him to run for Congress. Skilled verbiage does not make the man. Obama had great oratory skills and was not a man of substance. Trump has no oratory skills and is hardly a man of substance. In the presidential lineage substance disappears within the form of the person. Form is more important than content in the capitalist world order.
    John is actually better than Congress. Congress would hold his development back, he would not never rise above the social creature he is in Congress. The only thing that would transform John is to spend 2 years living in poverty or in prison. Or in total isolation in the wilderness with little means for survival but for his own body and what he can fashion from nature the tools to assist him in his survival. There he can witness first hand environmental degradation by industry. The reason I say this has to do with perspective. What is missing in John's critique of capitalism is the point of view the oppressed subject. Earth is an oppressed subject under capitalist industry as is humanity. This lack of perspective would make him a very poor legislator in Congress, frustrated, potentially we could lose John to a conversion from legislator into a radicalized religious freak reacting to the contradictions of capitalism and not understanding the inner logic of those contradictions. I suspect he would have few allies in Congress and be railroaded by Congress itself. The foregoing institution has no will or insight into itself as an agency for transformation.

  9. ACA was the only reason minute physics came to be…Really? So the United States is a wonderful country where dreams can be realized but only if the federal government creates a appropriate entitlement?

  10. Uh no. We have refrigerators because of the price caps, anti trust laws, union rights, and minimum wage enforced by the square deal, new deal, four freedoms, war on poverty and Nixonomics. Capitalism does nothing but create 4 – 8 years of fake growth that does nothing but lower interest rates, increases the value of stocks and the value of the dollar. That cycle of fake growth is inevitably followed by decades of recession because it always creates speculation followed by bubbles and bubbles always burst. It was socialist that realized that if the majority of people have spending money they buy things. Demand increases capital and the value of stocks and the dollar increases. The right wing rich focus only on bubbles and ignore consumption because they're pigs that want to be a monopsony on products so they can parade their wealth. The best example of this is sugar. In the 17th and 18th century if you were not born into the nobility and you were not born into the wealthy owners of royal monopolies then you had to know a smuggler just to buy sugar. There was no scarcity of sugar. Sugar was abundantly grown in Brazil, Cuba, the Dominican republic, Haiti, Jamaica, the Bahamas, Barbados etc. There was no shortage of sugar. The right wing rich just wanted to own sugar for the sake of owning sugar. The reason why the right wing rich commit tax evasion is because over sized bank accounts is the new sugar. A multi millionaire can do everything a billionaire can do. The right wing rich just want an over sized bank account for the sake of having an over sized bank account. Supply side economics is nothing but a giant case of fraud so the right wing rich can commit tax evasion, corporate manslaughter and pollution with impunity. If conservatives were serious about supply side economics then the tax cuts and deregulation would be conditional. If the fiscal conservatives were not the legislative arm of the right wing rich than the right wing rich would only receive tax cuts and deregulation if the rich did pay 100% of the nominal rate, raise wages, increased jobs in America, lowered prices, fully compensated widows of corporate manslaughter and didn't pollute.

  11. I totally agree that no one should be refused health care because of preexisting conditions. I also think that health insurance should pay out a fixed dollar amount instead of a blank check (after deductible/co pay) – that way the patient has the incentive to find the lowest cost, highest quality provider, and those high quality, low cost companies will win in the marketplace, so they can help even more people, thus growing the pizza.

  12. I think that balance here is essential.  In my limited understanding of the situation, it seems to me that for capitalism to function most efficiently, it is necessary to take a socialist approach to certain matters, particularly health and education.  If the government ensures that everyone is healthy and educated, this will allow the individual to reach their maximum productivity.  There are other things that seem to be best run by bigger government (Adam Conover makes the case in his study of privately owned prisons, which Hank also backs up with his video on mass incarceration), but I don't pretend to have an exhaustive list.

  13. This is rather confusing are you stating that the benefit of healthcare reform is from allowing risk taking or that the industry of insuring risky people can basically only exist as a monopoly or what???

  14. But doesn't it make more sense to collaboratively make better pizza and divide it evenly in the first place?

  15. The ACA doesn't go nearly far enough. The NHS is really quite excellent over here in Britain. I would highly recommend universal healthcare free at the point of use. it solves these problems that you speak about.

    And perhaps you could also re-slice the pizza rather than waiting for it to get bigger. Not necessarily equal slices, I'm not sure that would work but more equal than it is at the moment. Effective Reform rather than revolution.

  16. I'm 26 and can get Medicaid with my negligible income. But, as relevant to those with less common and difficult conditions:

    I'll be forfeiting financial assistance to see physicians across state borders (I've been to many research hospitals in different parts of the country, all necessary to get diagnosed, be supplied with treatment ideas, and just to discuss my condition with someone who knows what they're talking about). I'll also risk losing the local doctors that tolerate me (far too many physicians don't cope with complicated cases–"patient abuse" is common, where the doctor will verbally undermine you and cast you aside), and risk losing my medications that aren't ultra cheap or common i.e. anything that works (gotta stay cheap).

    Public insurance in the US is a dice roll in terms of quality care. On the plus side, US has diagnostic prowess, whereas in Canada I was wasting away, taking months between useless referrals. In the US I bounced between doctors, went to places like the Mayo Clinic, and got diagnosed and some viable medications all in a year. Shame we can't strike a balance between saving the wallet and not wasting precious years of your life (seeing US doctors at least have improved my condition so I'm not bedridden and useless like I was when I was waiting in Canada).

    Disclosure: I'm a dual citizen that was attending (and failing, thanks to the health issues) university in Canada and then moved in with my parents who were living in the US.

    To continue the comparison, I'll also say Canada has MUCH better disability policies. So–

    US: save on time and morbidity with prompt access to specialists and subspecialists
    Canada: save on money, better long-term care (disability and medications)

  17. With the government forcing insurance companies to accept people with preexisting conditions, would insurance companies raise prices?

  18. insurance is a business, its purpose is to generate money, you dont get big profits if you have to pay out a lot of claims, so its in their interest to challenge every claim and try to get that money back…
    there is no room for profiteering in medicine
    like working on treatments and not cures because you get an ongoing patient/customer

  19. I'm soo grateful for the ACA, without it, I'd have to work full time at a min wage job to afford my healthcare and gas money alone, now I can work part time and be a student, so someday I won't have to settle for a min wage job.

  20. "Special financial incentives" – legal bribes insurance companies pay to their doctors for denying testing and treatment.

  21. Nice Wooden Shoes on your shelf there, Mr. Green! Did you get them from Holland (MI) or Holland (NTL)?

  22. The "ridiculous choice" to work for a larger company in order to get health insurance has nothing to do with capitalism, it follows from regulations linking health insurance to employers going back to the 1950's.

    This video did not discuss actual capitalism, which would mean no such regulations causing such ridiculous choices.

  23. At this point we should audit all Obamacare infrastructure too: audit the entire federal government, really. Expose any and all corruption they haven't totally buried.

  24. I was also helped by the 26 year old rule. I had to get my wisdom teeth extracted and without that clause I would've been up poop creek without a poop paddle

  25. It is very expensive to live without a refridgerator. If poor people did not have them they would be even poorer, buying fresh food in small quantities every day.

  26. Because your piece of the pizza gets bigger – LOL!
    Inequality is the corrosive element (proven by science) so it is very relevant just how large your slice is in comparison to others. Has nothing to do with your tiny slice getting bigger and has everything to do with the immorality and injustice of 10 people splitting .5 slice while 1 person gets the other 7.5 slices. Doesn't matter how big the slices are, what matters is that one person feels "ENTITLED" to 7.5 slices. The injustice inherent in that was not achieved organically as propagandists that work for them will have you think. It has to be TAKEN from the other 10 people in various ways.

  27. And does the pizza of capitalism continue to grow forever? Therein lies the problem. It doesn't. Environmental pollution, non-sustainable resources…"but whatever". We'll just blind ourselves to that point and go on with the argument that it actually works. We'll just pay later…later…later

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