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Originally posted by SergeantX:
Making health care a government provided service will present all kinds of ugly problems and be tremendously wasteful.

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Originally posted by Storymark:
Yeah, we've got plenty of people who want the plan to fail, want it to be a wastefull disaster, and will do whet they can to make sure it is one.

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Originally posted by Wulfenstar:
FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

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Originally posted by SergeantX:
Insurance is the problem, not the solution.

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Originally posted by citizen:
Why do you say that. The world wide trend for national health services are that they are cheaper and outperform private-only care.

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Originally posted by Wulfenstar:
FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

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Originally posted by SergeantX:
Because I'm comparing it to a sane environment where health care would be treated as any other market supplied service. But that's not what we have, and something we'll likely never allow.

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Originally posted by citizen:

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Originally posted by Wulfenstar:
FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

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As I said, Public healthcare systems out perform private ones, and they're cheaper, it's win win.

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That said, government run health care would still operate without the "healthy" restraints of market reality. It will be much easier to spend beyond our means when it's simply a matter of more deficit spending.

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Originally posted by citizen:
In fact, the assumption that everything can work on a free market paradigm, including Health Care, would be one reason for Americas current system I think.

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Originally posted by Kwicko:
I'm struggling to see where the "healthy restraints" of market reality have really helped in the current economy.

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Are you saying that the free market makes it impossible to wildly overspend and get itself into an enormous credit crisis comparable to a huge deficit?

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Let's see... Estimates are that the current shitstorm of economic calamities have put the economy some $50 trillion in the red- wealth that has simply VANISHED.

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Originally posted by SergeantX:
The interesting bit is how this factored in with the creation of the AMA and it's movement to regulate health care. The regulation campaign began as a reaction to the waves of immigration in the late nineteenth and early twentieth century. That meant lots of immigrant doctors eager to undercut the prices of their American counterparts. Thus the AMA was born.

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Originally posted by citizen:
So it's a natural consequence of Free market bastardised through normal American protectionism.

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Free Market principles won't make something cost less than their cost of supply.

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That's fine for a car, if you can't afford a Porsche you can get a Honda, but if you can't afford an MRI?

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Originally posted by SignyM:
If you're really interested, try going here...

http://democrats.com/single-payer-petition

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It's the end of the world as we know it, and I feel fine.

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Originally posted by SergeantX:
Prices depend on the buyers willingness to pay. Insured patients don't care and will gladly 'pay' anything as long as they're covered.

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Originally posted by SergeantX:
Then you get an X-ray. Which would be better than nothing. Currently the options are Porsche or nothing.

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Originally posted by citizen:
No, it's not that simple. Do you really think any service provider will provide their service at a cost because customers can't pay the break-even or profit price? Get real.

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Assuming that a free market will magically put any treatment in the price range of whatever you're willing to pay is a pipe dream.

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Originally posted by SergeantX:
Then you get an X-ray. Which would be better than nothing. Currently the options are Porsche or nothing.

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Except that's the option of Porsche or a three course meal at Lafeate, second table to the back. X-Rays and MRI machines are for completely different things.

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Originally posted by SergeantX:
If no one can afford a service, or no one is willing to pay the price asked, the seller of the service has two options. He can figure out a way to lower costs, or write that service off as too costly. THAT's reality. And its the reality that's masked by the current insurance schemes. It would also be masked by providing health care as a government service.

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Assuming that you can make high costs go away with legislation and mandates is the pipedream.

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What free markets are good at is discerning what's realistic from what isn't.

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This is related to what I was getting at in a previous post. We think we can raise the quality of health care for everyone just by passing regulations.

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I assumed you understood I was speaking figuratively. The point is, the current situation is a choice between expensive health care, or none at all. In a more sane environment, there would be some middle ground. What we've done is essentially outlawed low-cost (and, yes, lower quality) health care.

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If no one can afford a service, or no one is willing to pay the price asked, the seller of the service has two options. He can figure out a way to lower costs, or write that service off as too costly. THAT's reality. And its the reality that's masked by the current insurance schemes. It would also be masked by providing health care as a government service.

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Originally posted by citizen:
No, the reality is that the cost to the end consumer can't go below the cost of providing it. The reality is that all you'd have is fewer people getting medical care, not that you'd have everything suddenly becoming cheap enough for everyone to buy, for the same reason that not everyone drives Porsches.

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Not in all circumstances. Some things just aren't cut out for a free market paradigm.

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Regulation doesn't cause people to over charge

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Medical procedures aren't outlawed because they cost less and won't make someone enough money, they're outlawed because they have no medical benefit and kill people.

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In a free market system a rich man may throw away millions on treatments that are completely useless, just on the slim chance of one working. While a poor man may die for want of a simple procedure that's out of their price range.

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Originally posted by rue:
BTW - I'm really a fan of expert systems - they'll out-do a doctor any day. If we could get national health care using expert systems, I'd want to be first in line.

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Originally posted by SergeantX:
I've made that point three or four times now. I can't tell if your really trying to deny that it's the case, or just ignoring it. If you're ignoring it, then we should probably end the conversation. Otherwise, how can you pretend that any given health care service comes in one variety?

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Sure, but health care isn't one them. We've been sold a bill of goods that it is, and it's exactly the reason things are so fucked up.

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sigh.... you know that's not what I said. Try to at least argue against my actual points. Regulation establishes a minimum level of quality that may be too expensive for some people.

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If medical regulation were limited to such cases, I'd not be complaining. But that's not the way it works. It's far more political than that and involves deliberate turf protection on the part of several vested interests. The AMA uses regulation and its control of medical schools to artificially limit the supply of doctors. Big Pharma actively campaigns against low cost alternatives with no evidence of risk.

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And this comes down to the crux of our disagreements in general, doesn't it? What you find appalling about a free market is that it allows some people more perks and privileges "merely" because they have more money.

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The thing is, that kind of inequality happens in any case, regardless of the economic system. The difference is, in systems where such differences aren't determined by income, they're sorted out in other, less explicit, ways. Your ability to get special favors is dependent on social status, political connection, or your ability to navigate the bureaucracy.

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Maybe you'd like that better, but I find money to be a far more honest representation of someone's value to society than their ability to play politics. Most people make money because they provide a service that other people want or need. Those that don't are leeches and criminals and would do their thing regardless of economic system. But a free economy allows people to earn extra comforts and perks honestly and openly. I don't see that as a bad thing.

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Originally posted by citizen:
You're misrepresenting the role of regulation. You're trying to portray it as stopping viable treatments that work, because they don't cost enough, or because they're not as effective as other more expensive ones. That is nonsense. Complete sash. Fallacy. Regulation stops treatments that DON'T work, not ones that "aren't as effective".

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And no sarge, before you try to say it, people can't be experts in their own health and medicine, medicine is an incredibly complex subject that people have to study full time for years to get any proficiency at. The sum of Human knowledge in medicine is so vast even experts have to specialise.

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If medical regulation were limited to such cases, I'd not be complaining. But that's not the way it works. It's far more political than that and involves deliberate turf protection on the part of several vested interests. The AMA uses regulation and its control of medical schools to artificially limit the supply of doctors. Big Pharma actively campaigns against low cost alternatives with no evidence of risk.

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It doesn't work that way in any national healthcare system I've ever come across. Just because the Quasi-Free Market Protectionist Corporatist American system works that way, doesn't mean the only viable alternative is Laissez Faire Free Market, that would be a false dichotomy.

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I find it funny that when I point out one of the ways that, the free market paradigm as applied too healthcare, will produce more waste than a public one, kinda rubbishing your assertion (that you've still not backed up, btw) that the Free Market will automatically produce less waste, you've gotten personal.

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Very emotive, full of the vim and verve I've come to expect of your arguments.

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I don't want human worth to be balanced solely on their earnings. No I don't consider a CEO's life to be worth more than a cleaners. No I don't consider a Nurses contribution to society to be less worthy than Brad Pitts, even if his is better compensated. In fact in that last one, at least I'd say the worth to society is quite the opposite.

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You try to dismiss the poor as criminals, presumably to make the thought of letting them die and denying them sufficient medical care more palatable, but in reality successful criminals can actually be quite well off. I'm not talking about the Junkie that steals car radios to fund they're habit, obviously they're worthless to you, I'm talking groups like organised crime, that can be immensely profitable. In which case, it can only be assumed that a rich Mafioso injured in a turf war, is worth more to society than a Nurse who has saved countless lives, at least too you.

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I want to put care in the hands of Doctors, medical professionals making the decision on medical grounds, apparently you want to put those decisions in the hands of bank managers, making the decisions on the basis of a bank balance.

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I distinctly remember you making arguments against someone's worth being decided by what they contribute to society. Frankly, beyond the fact that I find the argument that someone's right to medical care is based on their worth to others, it seems more of a communist, than libertarian argument.

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Originally posted by citizen:
Regulation stops practices that have no medical benefit, but will only cause harm injury or death.

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Originally posted by canttakesky:

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Originally posted by citizen:
Regulation stops practices that have no medical benefit, but will only cause harm injury or death.

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Take midwifery, for example. Midwifery, as I understand it, is permitted and even paid for by National Health in Britain. But it is outlawed in certain states in the USA.

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Originally posted by canttakesky:
This is patently untrue, Cit. How do you explain different regulations in different countries? How can the same practice be safe and have medical benefit in one country, but not another?

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Originally posted by canttakesky:
Take midwifery, for example. Midwifery, as I understand it, is permitted and even paid for by National Health in Britain. But it is outlawed in certain states in the USA. So, is midwifery a practice that has no medical benefit? Or are the regulations in the USA more controlling than it needs to be about a safe, beneficial, and low-cost option for the right group of women?

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Originally posted by SergeantX:
Regulation limits less expensive alternatives and makes the overall costs of doing business higher. You claim it only limits specific treatments that are dangerous and ineffective but that's simply not true.

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Whether they are experts isn't the issue. It's whether they have the right to decide for themselves.

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Laissez faire wouldn't be "ideal" either, but it would be the best in terms of respecting individual sovereignty and freedom.

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I don't recall "getting personal" about it, but I've not addressed it because it's moot.

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Waste in the free market is an individual decision. If a millionaire spends gobs of money on useless treatment, it's not my concern. My concern is with wasting taxpayer money which is not an individual decision.

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Society feels differently. I tend to agree with you (not a big Brad Pitt fan), but capitalism is more democratic then that and lets people express their values through their spending choices. We may not agree with those choices, but how do we justify overriding them?

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Wow.. this is completely off the rails. I said no such thing. Maybe you're riffing on my comment about "leeches and criminals" which was exactly NOT about the poor, but rather the organized criminals, corporate con-men and corrupt politicians who don't make their money honestly. The point had nothing to do with justifying euthanizing the poor or whatever strawman you're working on here.

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I want to put those decisions in the hands of patients. Yes, patients with more money will have more choice. I don't have a problem with that.

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You distinctly remember wrong, and apparently don't understand what characterizes a 'libertarian argument'.

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Originally posted by citizen:
I think a statement that capitalism is democratic is just plain silly.

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Which is why I changed it after re-reading.

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That's the problem with saying that one's wage determines ones worth, the only way you can support the argument is by ignoring that it doesn't.

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Society hasn't made any sort of decision about how much people should earn. It's arrived at where it is through market and economic forces.

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How much someone is paid tends to have very little to do with their "worth" or any sort of objective stand point about how much they mean to society.

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I made no concious or subconcious decisions about how much the actors in the film were worth to society, and I'm willing to bet no one else does either. I paid what I thought the film was worth to entertain me for a certain length of time, the "worth" of the actors didn't even enter my mind.

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It will lead to more waste. You're trying to wriggle out of that, but it will, and it was you're assertion that it won't, an assertion you've yet to support.

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I wish to see any working libertarian ideal that says the mob should be able to decide a persons "worth" or right to health, no matter how directly or indirectly.

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Originally posted by SergeantX:
I guess it depends on what you mean by "democratic". In terms of allowing people to freely and accurately express their values it is. It's also more granular in its expression of those values, particularly in contrast to "majority rules", which results in one-size-fits-all decisions that often trample the values of the minority.

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And what are market forces, if not people making decisions about what they value and how much?

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But you made a decision about how much they, or rather the product they helped produce, were worth to you. How much they are worth to society is just the summation of everyone making those kinds of value choices.

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Wriggling? Nope, no wriggling here. I said nationalized health care would lead to tremendous waste and be onerous to the government financially. That's all. Now, that's a guess, based on the other programs our government operates - and I think it's a reasonable one. I specifically didn't say it would be more or less wasteful that private care. I don't even bother comparing it private care because the two types of waste of an entirely different nature. One is waste paid for my private interests voluntarily, the other is waste of taxpayer money by government.

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We're not talking about mob rule, see my earlier comments

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Originally posted by citizen:
Except this one size fits all thing is exactly what you're aiming at. You're making the assumption that the best method to judge societal worth is money.

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But we made no judgement about their worth to society, so I don't see how those decisions can be used to make any statement of how valuable someone is to society.

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I specifically didn't say it would be more or less wasteful that private care. I don't even bother comparing it private care because the two types of waste of an entirely different nature. One is waste paid for my private interests voluntarily, the other is waste of taxpayer money by government.

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Oh come on. You said that the free market system would be less wasteful. I'm saying it's more.

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Originally posted by SergeantX:
My point was just that money is a reflection of how much people value that person or the services they provide. That seems pretty obvious to me. If you don't believe that that should determine the amount of health care they have access to, well, that's a different argument.

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But if that is your opinion, how do we decide differentials in health care? Would everyone have exactly the same options? Would that be enforced?

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As a hypothetical, would you insist that doctors expend exactly the same effort to save a ne'er do well, three-time, drunk driver injured in a head-on collision, as they do to save the brain surgeon driving the car he hit?

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You seem to see "value to society" as something different than an aggregate of the value to members of the society. If so, what does this mean, and how is it determined?

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Hmmm I don't know how else to put it. I really don't recall saying this and if I did I apologize because I know it not to be true.

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If someone in the private realm wants to waste money on pointless health care, it's none of my business. If my elected representative wants to waste tax money, it is.

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Citizen wrote:

In a free market system those decisions would be in the hands of a patient desperate for any slim chance of hope, no matter how objectively minor and overly costly it is.

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Sarge wrote:

And this comes down to the crux of our disagreements in general, doesn't it? What you find appalling about a free market is that it allows some people more perks and privileges "merely" because they have more money.

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Sarge wrote:

Maybe you'd like that better, but I find money to be a far more honest representation of someone's value to society than their ability to play politics. Most people make money because they provide a service that other people want or need. Those that don't are leeches and criminals

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Originally posted by AgentRouka:
Just for clarification.. all midwifery? Or just certain levels of accreditation?

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Originally posted by Kwicko:
Okay, Sarge, here you're really losing me.

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Earning money honestly does reflect that people voluntarily value what you do - enough to pay you for it.

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