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  #101  
Old 02-10-2019, 06:09 AM
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Who is terrified of her? On the right, they call her the gift that keeps on giving. They think she's hilarious, not scary. Her 'Green New Deal' is the funniest thing to come out of Washington since Al Franken.
Is it amusing to argue against a young idealist who doesn't even have a degree in electrical engineering? How about "one of the most cited scholars in history" with over 100 books and who has, even in old age, multiple professorships? Does he make you giggle too?

All of you should do yourself a favor and take time off from yet another re-run of a 2-hour lecture by Friedman or Rothbard and watch this 13-minute YouTube. You'll also learn about Elin Ersson, a young heroine like AOC who used her seat — not in Congress but just on an airplane — to possibly save the life of a man.

Or keep giggling. You decide.
  #102  
Old 02-10-2019, 03:35 PM
UltraVires UltraVires is offline
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Have you considered taking Econ 102? Or 103? Or maybe even Econ 201? Because there's all kinds of interesting and weird and very important edge cases where the relationship isn't quite so simple. There's a whole field, economic psychology, predicated on the reality that this just isn't how humans work in the real world.

Seriously, people (most conservatives) keep coming into discussions on government actions and socialism/captialism with this Econ 101 material, and it's like showing up to a physics conference thinking that F=M*A and being shocked and dismayed when people throw out a formula like this. It's tiresome. Why yes, when it comes to who gets the tomato, the market is horribly efficient! When it comes to, say, anything related to medicine, the market is a moral and economic atrocity that needs to die sooner rather than later. Sometimes "basic economics" means "there's more to this and things get fuzzier and more complicated, but this is the simplified model we teach to toddlers to help them understand the very basics".
Yes, I took 3 semesters of college econ. Of course there is more to it. I cannot post a lengthy dissertation here. But the building blocks are what is sound in that the capitalist system has caused unmatched prosperity in the modern world. We have so much food that we have a problem with obesity. Could anyone imagine such a thing 200 years ago? We have so much food that we need people to quit eating so much of it because they are fat. So contrary to the poster above, we don't have rich people hoarding the food while the working class starves; the system has given us food in abundance.

Now, your argument is a familiar one and it is that "healthcare" is different. I mean we can get air, water, food, and shelter through the regular system and get most other items efficiently, but there is an asterisk next to "healthcare." But when you look at it, many of the problems in the healthcare system stem from the fact that we have embedded aspects of socialism in it for so long and do not allow free markets by over regulation and reliance on insurance for things that are not typically insurable.

At the outset, I put "healthcare" in quotes, because it is far too broad. The way to provide six-month checkup visits and birth control is a far different issue than how to provide open heart surgery or cancer treatment.

For routine care, having a third party pay for it is grossly inefficient. It makes as much sense as having your auto insurance cover gasoline or oil changes for your car. It causes price insensitivity because you don't care if your doctor charges $50 or $300 for an office visit because you only pay your copay regardless of price.

The supply of doctors are limited by government regulations requiring an MD to do things that a nurse can do.

So, just with that, we have eliminated the basic things which makes markets work, then we complain that the markets don't work and the proposed solution is to eliminate the markets entirely.

I'm sure you've heard all of these things, so I won't continue down this line. But there is no reason that a market based system, one that has revolutionized the world and given it great prosperity, cannot be used in healthcare.
  #103  
Old 02-10-2019, 04:49 PM
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But the building blocks are what is sound in that the capitalist system has caused unmatched prosperity in the modern world.
This is not true. What caused "unmatched prosperity in the modern world" is the controls placed on capitalism (unions, regulations, etc.). Without that, it's a handful of very, very wealthy people and a shitload of serfs.
  #104  
Old 02-10-2019, 04:52 PM
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I'm sure you've heard all of these things, so I won't continue down this line. But there is no reason that a market based system, one that has revolutionized the world and given it great prosperity, cannot be used in healthcare.
You know, in investing there is that line that goes like: "Past Performance Is No Guarantee of Future Results" but the worst thing here is that the past performance of the markets has been found all over the developed world to be not best way to deal with health care.

And the thing is that I know history, I also do know that you are mostly right when there is competition and different ways to deliver a product or service are available. I do know a lot of examples like telephony where we get better results in the long run thanks to competition. (although when one thinks about it, that was also a market failure until government broke a monopoly here) But one just needs to be aware that regarding health care, the market gets into a situation that is closer to the tragedy of the commons.

https://www.rwjf.org/en/blog/2013/08...vilege_or.html
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Either way, as a country the United States must deal with the fact that the health care workforce, facilities, and funds are available only in finite quantities. By failing to coordinate, systematize, or otherwise organize individuals’ pursuit of their rational goals in the world of health care, the U.S. population is mis-using its common resources related to health.

In this context, misuse occurs by many people and organizations with many different interests, with respect to many resources—for example: prescribing brand-name medications when generic substitutes would be equivalently effective at lower costs; opting for subspecialty care when primary care management would be more efficient; accessing emergency care and hospitalization for ambulatory-care-sensitive conditions when timely access to primary care would be of greater value; health systems’ investment in new therapeutic modalities for limited groups of patients instead of enhancing availability of existing, evidence-based approaches for large groups of individuals in the population; spending on intensive end-of-life care when advanced directive conversations earlier in patients’ lives would have indicated some individuals’ preferences for comfort care only.

Consequently, individuals in the U.S. cannot uniformly maximize their health and therefore the aggregate population health is less than optimal. Instead, some individuals get to optimize their health while others are denied such opportunities; inefficiencies, inequities, and persistent disparities result. In other words, it seems that the U.S. health care system has many aspects of a tragedy of the commons.
And so it goes for how the corporations deal with the environment, currently the solution they are finding is to find very convenient to dump CO2 into our atmosphere with very little consequences.

Last edited by GIGObuster; 02-10-2019 at 04:54 PM.
  #105  
Old 02-10-2019, 05:24 PM
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... Very little consequences to the corporations, that is.
  #106  
Old 02-10-2019, 06:02 PM
UltraVires UltraVires is offline
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You know, in investing there is that line that goes like: "Past Performance Is No Guarantee of Future Results" but the worst thing here is that the past performance of the markets has been found all over the developed world to be not best way to deal with health care.

And the thing is that I know history, I also do know that you are mostly right when there is competition and different ways to deliver a product or service are available. I do know a lot of examples like telephony where we get better results in the long run thanks to competition. (although when one thinks about it, that was also a market failure until government broke a monopoly here) But one just needs to be aware that regarding health care, the market gets into a situation that is closer to the tragedy of the commons.

https://www.rwjf.org/en/blog/2013/08...vilege_or.html


And so it goes for how the corporations deal with the environment, currently the solution they are finding is to find very convenient to dump CO2 into our atmosphere with very little consequences.
First, I am not advocating for lawless capitalism. Laws against monopolies and price fixing, for example are needed to allow the system to work. I still do not believe that this is impossible or less likely to happen with healthcare.

The article you cite is unconvincing, especially on its basic premise:

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Originally Posted by Your Cite
Either way, as a country the United States must deal with the fact that the health care workforce, facilities, and funds are available only in finite quantities. By failing to coordinate, systematize, or otherwise organize individuals’ pursuit of their rational goals in the world of health care, the U.S. population is mis-using its common resources related to health.
The conclusion does not follow. Every product or service is only available in "finite quantities." Scarcity is the entire concept behind economics. But only in this area must we "coordinate, systematize, or otherwise organize" healthcare. It sounds like the old Soviet Union or Cuba.

The rest of the problems the article cites are a direct result of government intrusion into the market, not a good reason for more government intrusion.

What makes healthcare so fundamentally different than other necessities of life? We don't need a government run food distribution scheme, for example. Now, what we should do with healthcare, like we do with food is to provide coverage for those who cannot afford it. That isn't an argument for total control.

And under any system, even a government one, the rich will have better health care than those that are not rich, just like they have better of everything else.

Last edited by UltraVires; 02-10-2019 at 06:03 PM.
  #107  
Old 02-10-2019, 06:06 PM
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Originally Posted by UltraVires View Post
What makes healthcare so fundamentally different than other necessities of life? We don't need a government run food distribution scheme, for example. Now, what we should do with healthcare, like we do with food is to provide coverage for those who cannot afford it, like we do with food. That isn't an argument for total control.
What makes firefighting so fundamentally different? What makes road maintenance? What makes food and drug safety?

For that matter, we already do treat some healthcare differently. Active duty military members get entirely socialized health care. All their needs were met. When I was active duty, health care ceased to be a worry, since it was entirely paid for, no matter what health circumstances I faced. Obviously the government is capable of this, since they've been doing it for active duty military members for decades.

Many of us look at our system, and the system of Canada and many other countries, and see that their general outcomes are both better and cheaper than ours. And thus it's reasonable to at least consider that maybe we ought to emulate their systems. Maybe there are good arguments against it, but "socialism = bad" is not one of them, since quite clearly socialized health care systems can work well and provide good outcomes.

Last edited by iiandyiiii; 02-10-2019 at 06:08 PM.
  #108  
Old 02-10-2019, 06:14 PM
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Yes, I took 3 semesters of college econ. Of course there is more to it. I cannot post a lengthy dissertation here. But the building blocks are what is sound in that the capitalist system has caused unmatched prosperity in the modern world.
In the last 30 years, neoliberalism has freed the fetters of things like unions and regulations from many parts of the economy. It has not left capitalism looking better.

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We have so much food that we have a problem with obesity.
We have corporations whose primary goal is to get people to consume as much of their products as humanly possible. What do you expect is going to happen? They're going to find ways to get people to consume as much as possible! They don't care about public health - why should they? It's not in their advantage to care.

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Now, your argument is a familiar one and it is that "healthcare" is different. I mean we can get air, water, food, and shelter through the regular system and get most other items efficiently, but there is an asterisk next to "healthcare."
There's a pretty huge asterisk next to shelter as well, given that there are more empty homes than there are homeless people in both the UK and US (PhilosophyTube has an excellent video on the subject). We may need to put an asterisk next to "water" as well, at least in the third world. Air... I'm not sure if you're serious; to the degree that air (the thing constantly around us) can be seen as a commodity, it is actively being destroyed by capitalism, and a legal system utterly incapable of grasping with how serious pollution is.

So... Capitalism has done pretty well with food. Shelter, water, and healthcare are kind of a mess. Air is an abomination.

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But when you look at it, many of the problems in the healthcare system stem from the fact that we have embedded aspects of socialism in it for so long and do not allow free markets by over regulation and reliance on insurance for things that are not typically insurable.

At the outset, I put "healthcare" in quotes, because it is far too broad. The way to provide six-month checkup visits and birth control is a far different issue than how to provide open heart surgery or cancer treatment.

For routine care, having a third party pay for it is grossly inefficient. It makes as much sense as having your auto insurance cover gasoline or oil changes for your car. It causes price insensitivity because you don't care if your doctor charges $50 or $300 for an office visit because you only pay your copay regardless of price.
Insurance isn't a government system. That's the free market at work, because people recognize that in the case of a catastrophe, they're just going to end up dead because they can't afford health care. So they pool their resources. You say it's not a good thing to insure... But then how in the world are we to ever deal with health problems that individuals cannot consistently shoulder on their own? Health insurance didn't just spring up fully formed and demand fealty, which people begrudgingly gave it. It is the market at work.

Meanwhile, basically every other first-world country has figured this shit out - the government handles it in one way or another, and the result is a system so wildly improved over what the US has that our reaction is basically to look on you with pity and dismay. The American system is somewhere between a joke and an atrocity. You would have to pay me literally tens of thousands of dollars above what I make here per year to convince me to take a job in the USA, that's how valuable I consider the health care system here in Germany over the abortion of a system you have there.

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The supply of doctors are limited by government regulations requiring an MD to do things that a nurse can do.
This does very little to solve the problem of venture capital firms buying the rights to drugs and jacking up the prices, but sure, maybe overregulation of doctors is a problem. Got any data on that, or...?

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I'm sure you've heard all of these things, so I won't continue down this line. But there is no reason that a market based system, one that has revolutionized the world and given it great prosperity, cannot be used in healthcare.
We keep trying and we keep getting worse results than any number of countries that have some form of universal government health care. How long do you want to keep trying before the absurdity of people trying to afford insulin on GoFundMe gets to be too much for you?
  #109  
Old 02-10-2019, 06:30 PM
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What makes healthcare so fundamentally different than other necessities of life? We don't need a government run food distribution scheme, for example. Now, what we should do with healthcare, like we do with food is to provide coverage for those who cannot afford it. That isn't an argument for total control.

And under any system, even a government one, the rich will have better health care than those that are not rich, just like they have better of everything else.
<bolding mine>

Once, when I was going into anaphylaxis, the ambulance crew asked me which hospital I wanted to go to. My answer? "Whichever is fastest." Do you know what my answer is going to be every single time I am asked that question? The same.

Do you know why that is? Because at that point, I am in no way capable of making an informed decision. My biggest priority is "breathe, now".

Oh, and if I call an ambulance from my apartment, it is 100% covered by my insurance. If I call an ambulance from my office, it costs me $300. Do you know what I'm going to do every time I call an ambulance from my office? Pay $300, because I really do not have a choice. Sure, I could have a co-worker drive me, but that increases time for the "breathe, now" thing, and increases risk of an accident.

That's why healthcare is different.
  #110  
Old 02-10-2019, 06:38 PM
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<bolding mine>

Once, when I was going into anaphylaxis, the ambulance crew asked me which hospital I wanted to go to. My answer? "Whichever is fastest." Do you know what my answer is going to be every single time I am asked that question? The same.

Do you know why that is? Because at that point, I am in no way capable of making an informed decision. My biggest priority is "breathe, now".

Oh, and if I call an ambulance from my apartment, it is 100% covered by my insurance. If I call an ambulance from my office, it costs me $300. Do you know what I'm going to do every time I call an ambulance from my office? Pay $300, because I really do not have a choice. Sure, I could have a co-worker drive me, but that increases time for the "breathe, now" thing, and increases risk of an accident.

That's why healthcare is different.
Slight correction: that's one of the many reasons why healthcare is different. But they all come down to similar problems - people don't have the choice to shop around, the choice to refuse to pay some price, the choice to go to a different supplier... Capitalism fundamentally falls apart at countless points in the process.
  #111  
Old 02-10-2019, 06:47 PM
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Slight correction: that's one of the many reasons why healthcare is different. But they all come down to similar problems - people don't have the choice to shop around, the choice to refuse to pay some price, the choice to go to a different supplier... Capitalism fundamentally falls apart at countless points in the process.
Capitalism is the best way of distributing resources according to wants.

It fails miserably at allocating the resources that people need.
  #112  
Old 02-10-2019, 07:08 PM
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<bolding mine>

Once, when I was going into anaphylaxis, the ambulance crew asked me which hospital I wanted to go to. My answer? "Whichever is fastest." Do you know what my answer is going to be every single time I am asked that question? The same.

Do you know why that is? Because at that point, I am in no way capable of making an informed decision. My biggest priority is "breathe, now".

Oh, and if I call an ambulance from my apartment, it is 100% covered by my insurance. If I call an ambulance from my office, it costs me $300. Do you know what I'm going to do every time I call an ambulance from my office? Pay $300, because I really do not have a choice. Sure, I could have a co-worker drive me, but that increases time for the "breathe, now" thing, and increases risk of an accident.

That's why healthcare is different.
Emergency treatment is only a small portion of health care. The government provides for this in many other areas like with price gouging laws. You pick out an emergency area and decide the entire industry should be regulated based on that small portion.

See my post above. There is no reason why an ambulance ride to the hospital should be treated the same way by the same system as a routine doctor's visit. You can shop around for that. If you paid out of pocket, and the government got out of the way, you would see price competition
  #113  
Old 02-10-2019, 10:38 PM
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UltraVires: What iiandyiiii, Budget Player Cadet and others said.

This reminded of a documentary on the health care of places like Switzerland, they had a very similar irrational health care system like the one we have, they changed it and now even the ones that opposed it report that they should not had bothered.

https://www.pbs.org/wgbh/pages/front...tc/script.html
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PASCAL COUCHEPIN, President, Swiss Confederation: Everybody has the right to health care.

T.R. REID: [on camera] Yeah. Now, see, that's striking for an American because we would certainly say everyone's entitled to an education--

Pres. PASCAL COUCHEPIN: Yes.

T.R. REID: --everyone is entitled to legal protection, if you get in trouble with the law. But we don't say that everyone's entitled to health care.

Pres. PASCAL COUCHEPIN: Why? Because it is a profound need for people to be sure that if they are struck by destiny, by a stroke of destiny, they can have a good health system.

T.R. REID: [voice-over] Dreifuss, from the opposite political camp, agrees.

RUTH DREIFUSS: I think it's a basic human right. This is really the aim and this is really the reason why I think that everybody now, or a large, large majority, would renew the confidence in this system because they see what it means to have a universal coverage.

T.R. REID: But I wondered about LAMal's impact on drug and insurance companies. Pierre Marcel Revaz is CEO of Groupe Mutuel, one of Switzerland's biggest insurance companies. What's different here is that many Swiss insurers were already non-profit, so the transformation was easier than it might be for us. Ten years on, the insurers are doing fine. As in Germany, a lack of profit has not meant a lack of competition.

PIERRE-MARCEL REVAZ, CEO, Groupe Mutuel: [subtitles] It's very competitive because each company wants to keep its old customers and get new clients. So there's extreme competition for service and price.

T.R. REID: The benefit package here is fixed -- it's the same for everybody -- so companies compete in other ways.

[on camera] Is this one of the ways you compete with other companies? You say, "We'll pay faster"?

PIERRE-MARCEL REVAZ: [subtitles] Yes, it's one of the elements of competition, but the main one is the price.

T.R. REID: [voice-over] Groupe Mutuel has a strong incentive to keep administrative costs low.

PIERRE-MARCEL REVAZ: [subtitles] Our administrative costs are 5.5. percent, so we're performing well.

T.R. REID: Do you know what that figure is in American health insurance companies? The average administrative cost is about 22 percent, and you're running at 5 percent.

[voice-over] But where the Swiss insurance companies can make a profit is on supplemental coverage for, say, better hospital rooms. This is also how they attract more customers. But what about the drug companies?

[on camera] In America, the drug companies say, "Well, if you cut the price we get for the drugs, then we won't have as much money for research and innovation." Is that a legitimate argument?

RUTH DREIFUSS: It was the same argument here in Switzerland.

T.R. REID: I'm sure.

RUTH DREIFUSS: But I can say also that the Swiss pharmaceutical industry 10 years after this struggle is not bad. In the international competition, I think the Swiss are still belonging to the top 10. And when you hear them, they are not crying about the bad shape of their industry.

T.R. REID: [voice-over] That may be because Swiss drug companies still make more than a third of their profits from the less-regulated U.S. market.

[on camera] One of the problems we have in America is that many people -- it's a huge number of people -- go bankrupt because of medical bills. Some studies say 700,000 people a year. How many people in Switzerland go bankrupt because of medical bills?

Pres. PASCAL COUCHEPIN: Nobody. It doesn't happen. It would be a huge scandal if it happens.

Last edited by GIGObuster; 02-10-2019 at 10:38 PM.
  #114  
Old 02-10-2019, 10:53 PM
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UltraVires, I think you blew past something when it came to the action of markets in society. Are you unfamiliar with the "tragedy of the commons," do you deny its historical existence, or do you consider it a good thing?

Last edited by foolsguinea; 02-10-2019 at 10:54 PM.
  #115  
Old 02-11-2019, 03:12 AM
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At this point the free market absolutists who want to argue that the free market can do a better job at providing health care feel less like economists and more like evangelists. It's ridiculous. We have so much evidence from across the world, and somehow, we're still arguing that if only the free market stepped in, it'd solve all our problems. Unbelievable.
  #116  
Old 02-11-2019, 07:02 AM
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Earlier today, I posted this in a GD thread. This might have been a better fit for it:

"Anyway, my very local paper ran a human interest story this weekend. It was about a family whose daughter, at the age of 13 was diagnosed with something like a weak blood vessel in the brain. (Unclippable uncoilable MCA) In a very difficult location. She was put on a "watchful waiting" program. About 2 years ago, when she was 17, there were signs that it was weakening further and might rupture soon. It seems to be a very rare thing, and required specialization not available locally. The family went to New York, to a Dr. Amir Dehdashti.

Among the things that were explained to them at the hospital was that a down-payment of 35 000 $ was expected before they even got to see the doctor.

The operation was successful, otherwise I guess it wouldn't have made a good human interest story. During the days in New York the family mentions passing an ambulance trying to tend to someone who'd been involved in an accident. The bleeding man did not want to go in the ambulance because he could not afford it. It did make them reflect on how they'd gotten shipped across the world to best specialists, all covered by the Norwegian health care system, while the Americans in the same city could not afford an ambulance.

Which makes me think: If you really need it, the odds of seeing the best specialists in the US are probably better for the average Norwegian than for Joe Average American. Maybe way batter. So the current US system is working quite well for us. Not so much for the nation whose people may have to refuse ambulances when injured, because they can't afford them"

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Originally Posted by UltraVires View Post
Emergency treatment is only a small portion of health care. The government provides for this in many other areas like with price gouging laws. You pick out an emergency area and decide the entire industry should be regulated based on that small portion.

See my post above. There is no reason why an ambulance ride to the hospital should be treated the same way by the same system as a routine doctor's visit. You can shop around for that. If you paid out of pocket, and the government got out of the way, you would see price competition
Well. There is an area of economics called health care economics. Ironically founded by an American, Kenneth Arrow. It is an area where professional health care economics people spends quite a lot of man-hours working on how markets and health care interact.

And they partially agree with you, UltraVires. Things like emergencies, serious illnesses etc is an area where markets break down. It is because of what is known as price elasticity. A measure of how easy it is to refuse a purchase if you find the price too high. If the customer do not have the ability to refuse a purchase, prices will obviously skyrocket. Or at least rise until other mechanisms than the normal supply and demand kick in. Which may happen at stratospheric prices.

Markets tend to work in areas such as Lasik and liposuction, where life and health is not at stake.

Where they disagree though, is that the market would handle all the other aspects of health care would work well under a market. There is a scale from utterly borked to well-functioning, after all.
A health care market does have other problems. For example, there is an extreme asymmetry in information, customer demand is irregular and unpredictable, sellers profit motive is in conflict with his role as caretaker of the patients health, product uncertainty, high barriers to entry, price discrimination and lack of pricing clarity, for health care insurance the customers most in need of the product are the least attractive customers... that is only a partial list of the first health care economics papers list of ways health care does not function like a normal commodity in a market.
Many have been identified since, I think.
  #117  
Old 02-11-2019, 08:05 AM
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Earlier today, I posted this in a GD thread. This might have been a better fit for it:

"Anyway, my very local paper ran a human interest story this weekend. It was about a family whose daughter, at the age of 13 was diagnosed with something like a weak blood vessel in the brain. (Unclippable uncoilable MCA) In a very difficult location. She was put on a "watchful waiting" program. About 2 years ago, when she was 17, there were signs that it was weakening further and might rupture soon. It seems to be a very rare thing, and required specialization not available locally. The family went to New York, to a Dr. Amir Dehdashti.

Among the things that were explained to them at the hospital was that a down-payment of 35 000 $ was expected before they even got to see the doctor.

The operation was successful, otherwise I guess it wouldn't have made a good human interest story. During the days in New York the family mentions passing an ambulance trying to tend to someone who'd been involved in an accident. The bleeding man did not want to go in the ambulance because he could not afford it. It did make them reflect on how they'd gotten shipped across the world to best specialists, all covered by the Norwegian health care system, while the Americans in the same city could not afford an ambulance.

Which makes me think: If you really need it, the odds of seeing the best specialists in the US are probably better for the average Norwegian than for Joe Average American. Maybe way batter. So the current US system is working quite well for us. Not so much for the nation whose people may have to refuse ambulances when injured, because they can't afford them"



Well. There is an area of economics called health care economics. Ironically founded by an American, Kenneth Arrow. It is an area where professional health care economics people spends quite a lot of man-hours working on how markets and health care interact.

And they partially agree with you, UltraVires. Things like emergencies, serious illnesses etc is an area where markets break down. It is because of what is known as price elasticity. A measure of how easy it is to refuse a purchase if you find the price too high. If the customer do not have the ability to refuse a purchase, prices will obviously skyrocket. Or at least rise until other mechanisms than the normal supply and demand kick in. Which may happen at stratospheric prices.

Markets tend to work in areas such as Lasik and liposuction, where life and health is not at stake.

Where they disagree though, is that the market would handle all the other aspects of health care would work well under a market. There is a scale from utterly borked to well-functioning, after all.
A health care market does have other problems. For example, there is an extreme asymmetry in information, customer demand is irregular and unpredictable, sellers profit motive is in conflict with his role as caretaker of the patients health, product uncertainty, high barriers to entry, price discrimination and lack of pricing clarity, for health care insurance the customers most in need of the product are the least attractive customers... that is only a partial list of the first health care economics papers list of ways health care does not function like a normal commodity in a market.
Many have been identified since, I think.
The market for healthcare does not function well because it is shot through with intervention after intervention. It could be that a single payer system would be better than the demsoc mess we have now, but that is not what market advocates are defending.

The idea that true free markets wouldn’t provide insurance for emergencies is nonsensical.
  #118  
Old 02-11-2019, 08:12 AM
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The market for healthcare does not function well because it is shot through with intervention after intervention. It could be that a single payer system would be better than the demsoc mess we have now, but that is not what market advocates are defending.

The idea that true free markets wouldn’t provide insurance for emergencies is nonsensical.
Where is the money in providing emergency health care (or any sort of expensive treatment) to low income people? How could that work from a market perspective?
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Old 02-11-2019, 08:24 AM
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Where is the money in providing emergency health care (or any sort of expensive treatment) to low income people? How could that work from a market perspective?
Emergencies are rare and coverage would be inexpensive. Indeed it would be much less expensive than payroll taxes which are shouldered by low income people.
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Old 02-11-2019, 08:34 AM
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Emergencies are rare and coverage would be inexpensive. Indeed it would be much less expensive than payroll taxes which are shouldered by low income people.
Maybe emergencies are rare on average, but there are low-income folks out there who get really sick and need very significant treatment quite frequently. What is the free-market solution for them? Why would any insurance company agree to cover someone that they thought likely would need very expensive care very frequently if they had the option to say no?
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Old 02-11-2019, 08:36 AM
Grim Render Grim Render is offline
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The market for healthcare does not function well because it is shot through with intervention after intervention. It could be that a single payer system would be better than the demsoc mess we have now, but that is not what market advocates are defending.

The idea that true free markets wouldn’t provide insurance for emergencies is nonsensical.
Actually, poorly regulated markets work poorly, and more heavily regulated ones work better, See the US versus the German system for example.

Otherwise I refer you to the entire body of health care economics work and all the real-world experience. The Handbook of Health Economics by Culyer and Newhouse might be a good start.
  #122  
Old 02-11-2019, 08:41 AM
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Emergencies are rare and coverage would be inexpensive. Indeed it would be much less expensive than payroll taxes which are shouldered by low income people.
It boggles the mind that medical expenses are the #1 cause of bankruptcy since the free market has been providing these inexpensive catastrophic health care plans that you speak of.
  #123  
Old 02-11-2019, 08:57 AM
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Maybe emergencies are rare on average, but there are low-income folks out there who get really sick and need very significant treatment quite frequently. What is the free-market solution for them? Why would any insurance company agree to cover someone that they thought likely would need very expensive care very frequently if they had the option to say no?
The free market solution would be for them to receive voluntary aid in charitable contributions. If they were decent members of society, there would be plenty forthcoming. If they were antisocial, probably not much but still some.

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Actually, poorly regulated markets work poorly, and more heavily regulated ones work better, See the US versus the German system for example.

Otherwise I refer you to the entire body of health care economics work and all the real-world experience. The Handbook of Health Economics by Culyer and Newhouse might be a good start.
So you think I’m defending poorly regulated markets? That’s your mistake.

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It boggles the mind that medical expenses are the #1 cause of bankruptcy since the free market has been providing these inexpensive catastrophic health care plans that you speak of.
Free market? In healthcare? IN THE USA?
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Old 02-11-2019, 09:02 AM
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Free market? In healthcare? IN THE USA?
Is there ANYTHING that can't be blamed on regulation? OK, some other country then that has these low cost catastrophic plans that are working well for low income people? Or is this another libertopian fantasy?
  #125  
Old 02-11-2019, 09:04 AM
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The free market solution would be for them to receive voluntary aid in charitable contributions. If they were decent members of society, there would be plenty forthcoming. If they were antisocial, probably not much but still some.
This sounds like a hope and a prayer, not a solution. Especially with bigotry so endemic to our society -- if someone belongs to a race, religion, sexual orientation, etc., that their neighbors generally find inferior or otherwise less acceptable, then there seems little chance of such charity being offered. Some of us would prefer some sort of government policy backstop that ensures such folks get treatment that does not rely on the moods and feelings of their neighbors.

But at least we've gotten to the bottom of this particular aspect of the issue.
  #126  
Old 02-11-2019, 09:14 AM
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The free market solution would be for them to receive voluntary aid in charitable contributions. If they were decent members of society, there would be plenty forthcoming. If they were antisocial, probably not much but still some.
Voluntary aid is not a market feature. Giving stuff away without recompense is not how markets function. That this is considered necessary is rather an indication that market failure has occurred.

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So you think I’m defending poorly regulated markets? That’s your mistake.
I don't think so. Which markets do you think is more regulated in healthcare, the US, Norway, or Germany ? Which market do you think work better?
You're basically trying to substitute the expression "poorly regulated" for "underregulated"
  #127  
Old 02-11-2019, 10:29 AM
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This sounds like a hope and a prayer, not a solution. Especially with bigotry so endemic to our society -- if someone belongs to a race, religion, sexual orientation, etc., that their neighbors generally find inferior or otherwise less acceptable, then there seems little chance of such charity being offered. Some of us would prefer some sort of government policy backstop that ensures such folks get treatment that does not rely on the moods and feelings of their neighbors.

But at least we've gotten to the bottom of this particular aspect of the issue.
So bigotry is mitigated by forcing members of the hating group to pay for healthcare of the hated group.

Unfortunately your solutions thus far have a disintegrating effect on civil society.

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  #128  
Old 02-11-2019, 10:37 AM
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Voluntary aid is not a market feature. Giving stuff away without recompense is not how markets function. That this is considered necessary is rather an indication that market failure has occurred.



I don't think so. Which markets do you think is more regulated in healthcare, the US, Norway, or Germany ? Which market do you think work better?
You're basically trying to substitute the expression "poorly regulated" for "underregulated"
So regulation is about quantity, not quality. How do you meadure it? Gross tonnage or volume?
  #129  
Old 02-11-2019, 10:58 AM
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So bigotry is mitigated by forcing members of the hating group to pay for healthcare of the hated group.
The effects of this particular type of bigotry are mitigated with the proposed solution, yes. Seems better than just hoping they'll chip in for health care for people they hate.

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Unfortunately your solutions thus far have a disintegrating effect on civil society.
IMO your solution would do far, far more damage to civil society than mine.
  #130  
Old 02-11-2019, 11:17 AM
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So regulation is about quantity, not quality. How do you meadure it? Gross tonnage or volume?
Well, you could probably make a GD thread on that subject alone. But I'd say coverage. National standards for nurses, physicians, etc. National legislation stating that you have a right to all medically necessary healthcare. Or legislation that mean people don't fall between the cracks in a Krankenkasse system. Standards for institutions that graduate health care workers. Etc, etc.
  #131  
Old 02-11-2019, 08:38 PM
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Ocasio-Cortez Team Flubs a Green New Deal Summary, and Republicans Pounce



"Trump Team Flubs Policy Rollout, and Democrats Pounce"

-Headline you will never see in the NYT

Last edited by Dacien; 02-11-2019 at 08:43 PM.
  #132  
Old 02-11-2019, 08:50 PM
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Ocasio-Cortez Team Flubs a Green New Deal Summary, and Republicans Pounce



"Trump Team Flubs Policy Rollout, and Democrats Pounce"

-Headline you will never see in the NYT
I can't tell if you're trying to argue that the NYT is too harsh towards Trump, or not harsh enough.
  #133  
Old 02-11-2019, 08:58 PM
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I can't tell if you're trying to argue that the NYT is too harsh towards Trump, or not harsh enough.
They wouldn't include anything at all about the Democrats' reaction, or refer to it as a "flub". There's a charitable concession on their part toward AOC in the whole affair that would never be afforded to the current administration.

Imagine an article explaining how Trump simply flubbed a policy rollout, how Democrats pounced on a flub, and explained how it was simply a flub. It would never happen. Instead, they'd skewer his purported dishonesty.

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  #134  
Old 02-12-2019, 01:57 AM
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At least half of the attention Ms OAC gets is the shrill cries of tighty-rightys rolling on the carpet and tearing their hair. From my position on the conservative wing of the extreme left, what I like most about her is her zest and enthusiasm.

Is she dumber or more extreme that Louis Gohmert. Love to test that first part, give them each a thousand bucks to play with, and sit them both down to a table with a deck of cards or a checkerboard, and may the best person win. We already know what would happen, only question would be how long it take.

And Hell, in the House, a gust of air off the streets of Brooklyn qualifies as "fresh".
  #135  
Old 02-12-2019, 09:22 AM
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What makes firefighting so fundamentally different? What makes road maintenance? What makes food and drug safety?
I don't understand why your side resorts to these strawman arguments. Being in favor of capitalism does not mean privatizing police forces. Being for lower taxes and less government spending does not mean that we don't want spending on roads.

These basic functions have become government functions for a variety of reasons, probably most importantly the inability to exclude non-payers. We cannot have a private company put up street lights on my street because if I refuse to pay, there is no remedy. You cannot blindfold me at night or refuse to allow me to drive on the roads, bar nighttime delivery to my house, or prevent my guests from coming over.

We cannot have a private military for the same reason. We protect the boarders, but oh, UltraVires didn't pay, so we will let those Russians come in so long as they only sack his house.

For healthcare, there is no reason it cannot be treated like food where competition and consumer selection, along with modest government regulation, can efficiently allocate scarce resources to those who need it. And before you say, well, we all need it, we don't all need the same thing, which is my objection with using the broad category of healthcare and regulating it all the same.
  #136  
Old 02-12-2019, 09:29 AM
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I don't understand why your side resorts to these strawman arguments.
It's not a strawman argument. It's a genuine desire to understand why, in your view, certain services/functions can and should be socialized while others should not.

The thing is, we're generally in agreement on most services and functions (even with AOC and Bernie!) -- we all agree that firefighting, police, etc., should be socialized, while most currently capitalist industries should remain non-socialized, though we might disagree on the extent of some regulations. The disagreement is on a handful of important industries -- most notably, health care.

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Being in favor of capitalism does not mean privatizing police forces. Being for lower taxes and less government spending does not mean that we don't want spending on roads.
This first sentence continues a straw man that you've used earlier -- that AOC, Bernie, or other Democrats/liberals/progressives in favor of various versions of public-funded health care are not "in favor of capitalism". I'm in favor of capitalism, just not on every single service and function. Same as you. The difference is just, as I said before, in a small number of industries/services/functions. And there are, in fact, people in favor of privatizing road maintenance, firefighting, food/drug safety, and many more currently socialized functions and services.

I'm happy to stop asking these questions when you stop saying or implying that those in favor of medicare-for-all or other government-involved universal health care are against capitalism.

Capitalism is great, in general. That's not in conflict with proposals for medicare-for-all, or other universal health care systems.

Last edited by iiandyiiii; 02-12-2019 at 09:31 AM.
  #137  
Old 02-12-2019, 10:18 AM
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OK, first off: Things like the military, police, universal healthcare, free college, guaranteed minimum pensions etc are not socialism. They are social programs. Thats not the same as socialism, any more than having social skills means you are a socialist.

The word "social" can in fact be used in many ways, and is not limited to socialism.

Social spending can happen in socialist countries (like Cuba) and it can happen in very capitalist ones. (Like Scandinavia). Generally it works much better if you have a really capitalist economy for an engine.

Socialism is an economic system, not a set of social policies.

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For healthcare, there is no reason it cannot be treated like food where competition and consumer selection, along with modest government regulation, can efficiently allocate scarce resources to those who need it. And before you say, well, we all need it, we don't all need the same thing, which is my objection with using the broad category of healthcare and regulating it all the same.
I've actually listed quite a few reasons why further upthread:
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Well. There is an area of economics called health care economics. Ironically founded by an American, Kenneth Arrow. It is an area where professional health care economics people spends quite a lot of man-hours working on how markets and health care interact.
...

A health care market does have other problems. For example, there is an extreme asymmetry in information, customer demand is irregular and unpredictable, sellers profit motive is in conflict with his role as caretaker of the patients health, product uncertainty, high barriers to entry, price discrimination and lack of pricing clarity, for health care insurance the customers most in need of the product are the least attractive customers... that is only a partial list of the first health care economics papers list of ways health care does not function like a normal commodity in a market.
Many have been identified since, I think.
For example, Your doctor has spent six years gathering specialist information about a very, very broad and complex subject. He knows much much more about this than the average patient. He is in a position where he is the seller of treatments while at the same time being responsible for your treatments being evidence-based and appropriate, and not excessive. It is very difficult to become a doctor.

All these things make him different from your grocer.

And it means that his work behaves differently in a marketplace. And that is just the beginning of the differences.
  #138  
Old 02-12-2019, 01:33 PM
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I don't understand why your side resorts to these strawman arguments. Being in favor of capitalism does not mean privatizing police forces. Being for lower taxes and less government spending does not mean that we don't want spending on roads.

These basic functions have become government functions for a variety of reasons, probably most importantly the inability to exclude non-payers. We cannot have a private company put up street lights on my street because if I refuse to pay, there is no remedy. You cannot blindfold me at night or refuse to allow me to drive on the roads, bar nighttime delivery to my house, or prevent my guests from coming over.

We cannot have a private military for the same reason. We protect the boarders, but oh, UltraVires didn't pay, so we will let those Russians come in so long as they only sack his house.

For healthcare, there is no reason it cannot be treated like food where competition and consumer selection, along with modest government regulation, can efficiently allocate scarce resources to those who need it. And before you say, well, we all need it, we don't all need the same thing, which is my objection with using the broad category of healthcare and regulating it all the same.
You've covered roads and military, and I disagree on roads. I would also not that throughout the majority of history of humanity, you were not protected by the military, you *were* the military. Remember militias and the second amendment? That was because the early country could not guarantee the safety of it citizens through means of force. It is a very recent and pretty socialistic thing that we have a large standing army with no draft.

There is no reason that the road outside your home would not be a toll road. You would have to pay to come to or to leave your house, it would charge any delivery drivers, as well as your friends.

We do not need streetlights. If you want light in front of your house, you can install a light in your front yard. I've only spent a brief period of time living in a place with public streetlights, so they do not make a good example of any sort of universal truth.

Fire, police, food and drug safety, and education are all things that the free market could provide.

If you don't pay your police protection, then you don't get to report crimes, and crimes against you will not be prosecuted.

If you don't pay your fire protection, then if your house is on fire, the firefighters will only be concerned with making sure it doesn't spread to homes that did pay up.

If you want safe food and drugs, then there will be a private company that will rate and ensure that what you are ingesting is safe. If you don't pay to subscribe to their newsletter, then you don't get to know about recalls due to salmonella contamination.

It is very easy to exclude non-payers for those services. We just find the consequences of doing so to be much more costly than just paying for everyone to be covered by those services.

Given the relative states of healthcare between private and public systems, it does seem as though healthcare is one more thing that can be exuded to non-payers, but it is much less costly to everyone to just cover everyone.
  #139  
Old 02-12-2019, 02:40 PM
Evil Economist Evil Economist is offline
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For healthcare, there is no reason it cannot be treated like food where competition and consumer selection, along with modest government regulation, can efficiently allocate scarce resources to those who need it. And before you say, well, we all need it, we don't all need the same thing, which is my objection with using the broad category of healthcare and regulating it all the same.
The key to actually understanding economics is to: 1) build your model (which you have done here), and then 2) compare your model to the real world to see the ways in which your model is inaccurate (and therefore if your model needs to be amended).

You've done the first part, but not the second part. For example, if your model predicts good outcomes from "modestly regulated" healthcare, but you look around the world and see that no wealthy country anywhere has implemented "modestly regulated" healthcare, then that should tell you that there's a problem with your model. (It's common to think, "well, then the real world is wrong," but that way lies Libertarianism, and madness).

By the way, your examples of military and street lights both invoke the concept of "externalities". I.e., you are saying the free market for those goods doesn't function well because of the externalities. You should be aware that the market for healthcare also has externalities.
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Last edited by Evil Economist; 02-12-2019 at 02:42 PM.
  #140  
Old 02-12-2019, 03:47 PM
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For healthcare, there is no reason it cannot be treated like food where competition and consumer selection, along with modest government regulation, can efficiently allocate scarce resources to those who need it.
We have been trying this for decades, and the results are a mixture of extremely high costs leading to half a million bankruptcies annually, and 20-something million people without insurance.

You can't say the same thing about food. Yes, there are hungry people in the U.S., but it doesn't take someone with specialized training to deliver a meal, who will then bill someone (either the hungry person or the local government) a couple hundred dollars for 25 minutes of work. Further, usually people don't end up in dire straits one day needing $100,000 worth of vegetables or they will die.
  #141  
Old 02-12-2019, 09:58 PM
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The free market solution would be for them to receive voluntary aid in charitable contributions. If they were decent members of society, there would be plenty forthcoming. If they were antisocial, probably not much but still some.
If in order to make your system viable you have to assume that the vast majority of people are good and decent and primarily interested in the well being of their fellow man, then you might as well assume that the vast majority of people is willing to work hard for the common good and embrace communism as a viable system.

Particularly since the greed is good morality that underlies the free market ideal is diametrically opposed to this assumption.
  #142  
Old 02-13-2019, 01:41 AM
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So bigotry is mitigated by forcing members of the hating group to pay for healthcare of the hated group.

Unfortunately your solutions thus far have a disintegrating effect on civil society.
Cite?
  #143  
Old 02-13-2019, 10:25 AM
Evil Economist Evil Economist is offline
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Cite?
You just have to look at the extremely successful and cohesive Libertarian societies across time to see how they promote a superior form of civil society. Such as for example....well, I can't think of one right now, but I'm sure there's been thousands.
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