# Instead of socialized medicine...how about **URL:** \ **Category:** Great Debates\ **Created:** [October 12, 2007, 10:55pm UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524 "2007-10-12T22:55:53Z")\ **Posts on this page:** 14\ **Page:** 3
**Author:** ![BrightNShiny](https://avatars.discourse-cdn.com/v4/letter/b/7bcc69/32.png) [@BrightNShiny](https://boards.straightdope.com/u/BrightNShiny)\ **Post date:** [October 15, 2007, 3:36am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/41 "2007-10-15T03:36:31Z")
> [@](#): > > When I say this, people say, but health care is a NECESSITY. The government needs to control it. I think this is the wrong way to analyze the question. The question is whether you think people should have health care when they need it. If you don’t, then let the free market handle it. If you do, then you have to look at whether free markets can accomplish that goal. > [@](#): > > Well, food is a larger necessity, and while there are federal regs on food handling and the like, I have a choice of at least 20 supermarkets near my home, all competiting with each other on prices, service, selection, and all in all, food is affordable and plentiful. The food industry is highly regulated and subsidized. This is your free market example? > [@](#): > > Why can’t we do this with healthcare? We are stuck with, IMHO, the worst of both worlds. We don’t have the universal coverage of socialized medicine, but we do have all of the bullshit that goes along with it: the government regulations. > > Several changes I would propose: > > 1. Get rid of medical board certifications for all except invasive procedures. > > My mom is a nurse and can diagnose almost any illness I have, but she can’t do anything about it, because she can’t use hospital equipment or on to point # Board certifications are designed to address an information assymetry problem. It is difficult for most people to determine the competency of a health care provider. Part of this is because patient records are generally confidential, so the public just can’t pour through everyone’s chart to determine who is getting bad health care. You could try using malpractice claims as a proxy for competence, but a number of claims don’t ever reach the courts and a number of times the cases are sealed. Medicine is a highly complex field, and as the speciality gets more complex, it becomes more difficult to determine competency. What board certification is an attempt to do is set a floor for competency, in order to reduce the chances that people will be injured by their health care providers. It also is an attempt to make sure that if they are injured, the health care provider will have enough insurance to cover the claims. Now, we can argue as to whether medical boards do their job well, or if they can be improved in specific ways. But your solution does nothing to address the underlying problem. > [@](#): > > 1. Get rid of the need for prescriptions except for antibiotic medication. > > This would require legalization of drugs. which is a whole other thread, but think of the savings. For example: > > I am on a controlled medication and will be for the rest of my life. Several doctors have told me that. I can’t just go to the store and buy the medication. I have to go to the doctor every two months to get a new script. I am fine with the meds. Were it not for the need for script refills, I wouldn’t have been to the doctor in the last 11 years. > > Think of all of the savings to my insurance company if I could just get the drugs I medically need without paying the doctor, leading to point #3. You seem to be assuming that physician costs are what are driving medical costs up in this country. My understanding is that physician wages are being depressed. If I’m correct, then eliminating the physician isn’t going to make much of an impact over the long haul. Aside from this, once again, there is a huge information assymetry problem when it comes to medication. It is difficult for many people to know in advance how they will react to medications, particularly addictive ones. One of the purposes of the perscription system (and there are a number) is to reduce the likelihood of medication injuries. You haven’t proposed any way that this problem would be solved under your system. Another purpose of the perscription system is to limit the scope of 3rd party injuries. For example, the perscription system reduces the ability of a caregiver to accidentally give medication to his ward that causes injury. It also reduces the likelihood that someone will get doped on something and go out for a spin in their car. Now, it doesn’t prevent these things entirely, but without a perscription system, my guess is that these would be much worse. Without a perscription system, drug manufacturers would be exposed to so much legal liability, that I can’t imagine anyone bothering to manufacture certain types of drugs anymore. Why would anybody manufacture, say, morphine, when they would routinely face lawsuits stemming from people out there who use the drug improperly? > [@](#): > > 1. Eliminate third party payments. > > I pay $20 for a doctor’s visit. It seems reasonable and I don’t complain. But he bills my insurance $125. And since I have insurance, he does needless blood tests every six months (just to make sure everything is okay) and bills more and more. Most visits are just check weight, check blood pressure, how are you feeling, good, good, here’s a script, and out the door. How do you know the tests are needless? Insurance companies (whether private or public) have tremendous pressure and incentives to cut costs. Do you really think your insurer is happily forking over money for unnecessary testing? The purpose of insurance is to pool risk. Some people will be very health all their lives and then die suddenly (as in a car accident). Others will be very ill and rack up medical expenses in the hundreds of thousands. None of us knows where we’ll end up, but most people cannot afford to self-insure for hundreds of thousands of dollars. How do you propose to pool risk if insurance companies are eliminated? > [@](#): > > I have many more issues, but you get the general idea. Get the government out of medicine instead of socializing it. Now, I’m not talking about having the local drunk performing heart surgery, but I am saying get rid of the General Practitioners who are ripping people off for the “care” that they give. > > Thoughts? How do you stop the drunk from performing heart surgery without some sort of certification? ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [October 15, 2007, 3:41am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/42 "2007-10-15T03:41:39Z")
I’ve been to a good number of countries also without national health insurance and with virtually no effective regulations on health care providers. I’ve found that pharmaceuticals are usually cheap, one can pay lots for good health care, but the overall level of health services are abysmal. It’s like most aspects of Libertopia: somewhere in the world, one can find always find a place where doctors are unregulated, or where guns are plentiful, or where roads aren’t built by the government, or where poor people are left to their own devices. These places always suck. I can’t imagine why people would travel the world, see all the problems out there, and come back saying: “We need to adopt those policies, because they’ll work _here._” ---
**Author:** ![BrainGlutton](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@BrainGlutton](https://boards.straightdope.com/u/BrainGlutton)\ **Post date:** [October 15, 2007, 3:55am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/43 "2007-10-15T03:55:58Z")
[QUOTE=Mr. Moto] How do you square this with how medicine behaves when it is really subject to the free market, not a distorted one? [/QUOTE] Can you name a single real-world example of what you’re describing, outside the Third World? ---
**Author:** ![Declan](https://avatars.discourse-cdn.com/v4/letter/d/ecae2f/32.png) [@Declan](https://boards.straightdope.com/u/Declan)\ **Post date:** [October 15, 2007, 6:17am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/44 "2007-10-15T06:17:07Z")
[QUOTE=Voyager] In Canada, what happens to people who can’t afford dental insurance. Do they get it from the government, or do they become hockey players so they can lose their teeth honestly.? 🙂 [/QUOTE] Dental care is weird but I imagine that it makes sense to some one , I had a dentist give me two quotes , one for a root canal at 1k and yanking the tooth for a hundred bucks , the tooth got evicted. Declan ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 15, 2007, 6:55am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/45 "2007-10-15T06:55:46Z")
[QUOTE=Mr. Moto] Again, think of this next time you hear an ad for Lasik surgery. A few years ago this was unavailable, then it was an expensive luxury. Now it is something people can get by paying a few hundred bucks out of pocket. [/QUOTE] That’s probably more a result of advances in technology. 45 years ago my father had a blood clot in his leg, which spread various places. He was in the hospital for months. (Since he was working for the UN in the Congo, cost was not an issue.) A few years ago, when he was nearly 90, he had another clot. A stent was put in and he was in the hospital for two nights. Lots of surgeries are done out-patient these days. Even insurance covered procedures are becoming more efficient - but there are more of them, for things untreatable in the past. My wife had her retina reattached. It was fairly expensive, true, but in the past there would be less cost since she would have gone blind in that eye. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 15, 2007, 7:20am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/46 "2007-10-15T07:20:49Z")
[QUOTE=Sam Stone] That’s a huge assumption. First, it’s a huge assumption that people would have more doctor’s checkups if insurance paid for them. I’m sure people on the margin would, but it seems to me that refusal to go in for checkups has more to do with fear of doctors and hassle than cost. Second, you’re making the assumption that regular checkups would significantly lower health care costs, and I don’t know if that’s true. Do you have a cite? [/quote] Yes indeed. [Here it is.](http://findarticles.com/p/articles/mi_m5072/is_n38_v19/ai_19949771). > [@](#): > > Major studies over the last decade showing cost savings in preventative care. One such study last year from Duke University found that preventative care saved an average $5,000 per individual per year. I don’t have a cite about what percentage of people refuse to go for checkups. If it was that big, the insurance companies would notice, I bet. There is also the problem of someone with a minor complaint that could turn into a big problem if they don’t go because of money. We had a thread a while back about a Doper who was trying to avoid hospitalization for a major heart problem because of lack of insurance and lack of pay when sick. (That’s a different problem.) > [@](#): > > It seems to me that what auto insurers would really want to do if they had to cover catastrophic mechanical damage would be to limit \*behaviour. Engines blow up when people over-rev them. Tires get worn faster when people spin them and corner hard with them, or don’t keep them inflated properly. Etc. > > With mandatory health care insurance, pressure starts to build to control people’s behaviour. Anti-smoking laws, taxes on fatty foods, John Edwards’ mandatory ‘wellness’ crap, etc. I find that level of control over my life repugnant. My life insurance is cheaper because I don’t smoke. Auto insurance now won’t cover accidents in certain conditions. But I agree that such things shouldn’t be mandatory, but rather done through education, which is working pretty well in the US. Anti-smoking laws here are more for the protection of others than for the protection of the smoker. (Or that’s the justification.) > [@](#): > > Why should health care be treated any differently in this regard than any number of other small financial problems that people raise. Sure, you could wind up needing five treatments in a bad year and be out $2500. But then, you could need to replace the roof of your house, too. Or you could get in an auto accident and have to pay out $500 in deductible. Or you could buy new glasses for the kid and they could get broken and you’ll have to buy another pair. Sure. People go bankrupt for all kinds of reasons. Do you want me to repeat the percentage who get into trouble because of health care costs again? > [@](#): > > Free people are supposed to manage their own lives. They are supposed to save money for emergencies. Yet as soon as we start talking about the scope of government health care, some people come along who want to turn it into comprehensive program that protects people from any financial risk at all, rather than just preventing them from experiencing financially ruinous medical disasters. Yup, both you and the homeless guy downtown are free to sleep under a bridge. I fail to see why forcing a ten year old kid (or an adult) to forgo a visit to the doctor to check out something worrisome is limiting his freedom. I don’t think I’d feel one bit freer if my job didn’t provide healthcare. I suppose the person getting foodstamps and not starving, the way they used to 50 years ago, is having his freedom abridged also. There are plenty of ways these people are going to experience financial risk even if healthcare is covered, so you can feel good about that. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 15, 2007, 7:30am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/47 "2007-10-15T07:30:16Z")
[QUOTE=Renob] Employers are buying health insurance for their employees, who are the consumers. So, no, employers are not the ones consuming the health care. [/quote] But employers are the consumers of insurance. I have two choices - an HMO and a PPO, so I don’t have a lot of choice here. When my employer was going to switch, they could compare every insurer, and had full time people on it. They made a more informed choice than I could have, and had a lot more negotiating power. My insurance tells me how much less they pay the doctor than the standard rate. Do you think I could get that discount? > [@](#): > > Yes, some sort of minimal regulation can co-exist with the free market. The incredibly heavy amount of regulation (along with the fact that the government pays around 50% of the health care costs in this country) has led to a situation where we have anything but a free market in health care. The government doesn’t pay for any of mine - how does Medicare and Medicaid affect my free market choices? > [@](#): > > All the evidence I’ve read indicates that government involvement makes for a far less efficient system. The system we have today in the U.S. is so inefficient because of government involvement. The problems people bitch and moan about are mainly a result of government meddling in the health care marketplace and the health insurance marketplace. The evidence is clear. Those of you who favor some sort of single-payer system just don’t to actually examine how the current U.S. system works and why it’s flawed. You prefer to call it “free market” and then say that because the “free market” hasn’t worked in the U.S., we need to go to a single-payer system. Saying that the U.S. system even resembles the free market shows that you don’t know what you are talking about. And that of course explains why foreign single payer systems are cheaper with better results than ours. How many cites do we have to give you people for you to open your eyes? Medicare is more efficient than private insurance in terms of overhead. I cited that already. I feel like I’m waving a fossil in front of a creationist - no matter how often I give evidence, they still won’t open their eyes to look at it. ---
**Author:** ![Renob](https://avatars.discourse-cdn.com/v4/letter/r/8c91f0/32.png) [@Renob](https://boards.straightdope.com/u/Renob)\ **Post date:** [October 15, 2007, 1:35pm UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/48 "2007-10-15T13:35:23Z")
[QUOTE=Voyager] But employers are the consumers of insurance. [/quote] But they are not the consumers of health care. It makes no sense to have a third party pay a fourth party for a service consumed by you. > [@](#): > > I have two choices - an HMO and a PPO, so I don’t have a lot of choice here. When my employer was going to switch, they could compare every insurer, and had full time people on it. They made a more informed choice than I could have, and had a lot more negotiating power. My insurance tells me how much less they pay the doctor than the standard rate. Do you think I could get that discount? I’m not saying go without insurance. I’m saying that individuals should purchase their own insurance. > [@](#): > > The government doesn’t pay for any of mine - how does Medicare and Medicaid affect my free market choices? Well, there have been some studies that link the astounding growth in the cost of health care to the advent of government health care programs like Medicare. Government also affects your free market choice by heavily regulating the industry. It limits the number of doctors, nurses, and health care facilities. It forces insurance companies to cover certain ailments. It sets rates. All these things drive up the price of your health care and reduce your choices. > [@](#): > > And that of course explains why foreign single payer systems are cheaper with better results than ours. How many cites do we have to give you people for you to open your eyes? Medicare is more efficient than private insurance in terms of overhead. I cited that already. I feel like I’m waving a fossil in front of a creationist - no matter how often I give evidence, they still won’t open their eyes to look at it. Because your “evidence” is bogus. Medicare is only slightly more efficient in terms of overhead than private insurance. Furthermore, many things considered “overhead” for private insurance don’t exist for Medicare, so it’s not really a fair comparison. [Cite](http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf). There are also a variety of studies that illustrate that, yes, socialized medicine does control cost, but produces long wait times and higher mortality rates. [Cite](http://www.cato.org/pub_display.php?pub_id=3627). I know your frustration about how people refuse to look at the evidence. > [@BrightNShiny](#): > > Ok, I’ll think of it as a faulty economic argument. You and the other “free marketeers” in this thread are pointing at goods and services which have elastic supply-demand curves and trying to apply those lessons to goods and services which have inelastic supply-demand curves. It is my understanding that the vast majority of health care consumed in the U.S. is not for emergency care. If it’s not emergency care, you can shop around for it. Furthermore, I’m fine with individuals purchasing insurance. I think that if we removed the government subsidy for employer-sponsored care we’d have people actually purchasing true health insurance – high deductible policies to cover truly emergency or unexpected incidents. That’s the way the system should work. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 15, 2007, 5:21pm UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/49 "2007-10-15T17:21:43Z")
[QUOTE=Renob] But they are not the consumers of health care. It makes no sense to have a third party pay a fourth party for a service consumed by you. I’m not saying go without insurance. I’m saying that individuals should purchase their own insurance. [/quote] First of all, employer paid health care is not at the mandate of the government, but comes purely from private companies making deals with employees and insurance companies. Do you want government to get involved in banning this? Second, my employer also pays into my 401(K). Is that also offensive to you for some reason? They pay life insurance also. We have the common menu of benefits, where I get a certain amount of dollars, choose what I want, and pay more if I go over. (And get money back if I go under, which is not likely.) Exactly how is this bad, or any different from them giving me the money? Like I said, they choose better than I do. Do you doubt this is possible? If so, I hope you don’t own any mutual funds, which is also accepting that experts can choose better than we can. Now, some people have said that employer paid insurance was a mistake, since it took the pressure off the need for government paid single payer plans. I think a case can be made for that, but I doubt that’s where you are going. > [@](#): > > Well, there have been some studies that link the astounding growth in the cost of health care to the advent of government health care programs like Medicare. Medicare started in 1965 or so, and I remember the ads decrying it and predicting doom if it was enacted. I don’t remember any talk of a health costs crisis for over 20 years after this. I have heard people complaining that Medicare doesn’t pay enough, so doctors must charge more for other patients, but that would just increase the drive for efficiency, wouldn’t it? That would be a plus from your perspective - and mine too, in fact. > [@](#): > > Government also affects your free market choice by heavily regulating the industry. It limits the number of doctors, nurses, and health care facilities. It forces insurance companies to cover certain ailments. It sets rates. All these things drive up the price of your health care and reduce your choices. Does government limit the number of doctors, or does the AMA? We have a nursing shortage, and a problem is not enough slots in nursing schools. The reason for that, for California colleges, is that every student gets the same amount from the state, and since it costs more to train a nurse, the colleges lose money. They’re working on special grants for nursing education, to remedy this. A while back nurses were not being paid well, but it seems this has turned around - free market at work. California does have minimum numbers of nurses required, but that is the opposite of what you claim, and is necessary so that facilities don’t cut back on nurses to increase profit at the expense of patients. Government does set rates for what it pays for - not for anything else. I know forcing companies to cover birth control is controversial, but for anything else I’m not aware of regulations - though it would make sense to force insurance companies to be more or less equivalent, to avoid surprises. > [@](#): > > Because your “evidence” is bogus. Medicare is only slightly more efficient in terms of overhead than private insurance. Furthermore, many things considered “overhead” for private insurance don’t exist for Medicare, so it’s not really a fair comparison. [Cite](http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf). There are also a variety of studies that illustrate that, yes, socialized medicine does control cost, but produces long wait times and higher mortality rates. [Cite](http://www.cato.org/pub_display.php?pub_id=3627). It would have been nice if your second cite had given actual numbers on the summary page. [Here’s one](http://www.yesmagazine.com/article.asp?ID=1503) directly comparing Canada to the US - especially useful since Canada used to have our kind of health care coverage. [Here’s](http://www.truthout.org/cgi-bin/artman/exec/view.cgi/64/22666) another about infant mortality rates ansd life expectancies for more countries. Forget about Cuba - I actually only care about comparable countries. As for Medicare, we’ve been through this and I still fail to see how the salaries of some government managers make up for the huge difference in this gigantic program. > [@](#): > > I know your frustration about how people refuse to look at the evidence. Oh, the irony! > [@](#): > > It is my understanding that the vast majority of health care consumed in the U.S. is not for emergency care. If it’s not emergency care, you can shop around for it. Furthermore, I’m fine with individuals purchasing insurance. I think that if we removed the government subsidy for employer-sponsored care we’d have people actually purchasing true health insurance – high deductible policies to cover truly emergency or unexpected incidents. That’s the way the system should work. Then all those without employer sponsored health insurance should be running out to buy it right now. I’ve already mentioned how early visits save money in the long run - how would your plan address this? How would making it relatively more expensive for employees to get insurance help anything? If private cases exerted downward pressure on prices, we’d see that now. Actually, the reverse is true since those with less likelihood of needing insurance don’t get it, leaving the pool full of people who will need it, making the insurance more expensive. Thus the move for mandating insurance. ---
**Author:** ![Renob](https://avatars.discourse-cdn.com/v4/letter/r/8c91f0/32.png) [@Renob](https://boards.straightdope.com/u/Renob)\ **Post date:** [October 15, 2007, 5:57pm UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/50 "2007-10-15T17:57:09Z")
[QUOTE=Voyager] First of all, employer paid health care is not at the mandate of the government, but comes purely from private companies making deals with employees and insurance companies. Do you want government to get involved in banning this? [/quote] No, it shouldn’t be banned. However, it also should not be subsidized like it is today. Either individuals should receive the same tax breaks corporations get for purchasing health care or the employer tax breaks should be eliminated. The government has subsidized the employer-sponsored health insurance model and that’s the reason it is so prevalent today. > [@](#): > > Medicare started in 1965 or so, and I remember the ads decrying it and predicting doom if it was enacted. I don’t remember any talk of a health costs crisis for over 20 years after this. I have heard people complaining that Medicare doesn’t pay enough, so doctors must charge more for other patients, but that would just increase the drive for efficiency, wouldn’t it? That would be a plus from your perspective - and mine too, in fact. You might want to read Amy Finkelstein’s [work](http://www.nber.org/~afinkels/papers/Finkelstein_Medicare_April06.pdf) on how Medicare spending affected overall health care spending in the U.S. > [@](#): > > Does government limit the number of doctors, or does the AMA? Government limits doctors, nurses, and other health care professionals through licensing. In many states it also limits the number of health care facilities through certificates of need. Many states also limit what types of procedures certain professions can do. > [@](#): > > Government does set rates for what it pays for - not for anything else. I know forcing companies to cover birth control is controversial, but for anything else I’m not aware of regulations - though it would make sense to force insurance companies to be more or less equivalent, to avoid surprises. If you are unaware of the huge number of mandates put on health insurance by state legislatures, then you really need to do some [reading](http://www.cahi.org/cahi_contents/resources/pdf/MandatesInTheStates2007.pdf) on how health insurance works in the U.S. > [@](#): > > It would have been nice if your second cite had given actual numbers on the summary page. > [Here’s one](http://www.yesmagazine.com/article.asp?ID=1503) directly comparing Canada to the US - especially useful since Canada used to have our kind of health care coverage. [Here’s](http://www.truthout.org/cgi-bin/artman/exec/view.cgi/64/22666) another about infant mortality rates ansd life expectancies for more countries. Forget about > Cuba - I actually only care about comparable countries. Of course, infant mortality is measured differently in the U.S. than in other nations. And, controlled for things like murders and car accidents (things that have little to do with our health care system), U.S. life expectancy rates do quite well. > [@](#): > > As for Medicare, we’ve been through this and I still fail to see how the salaries of some government managers make up for the huge difference in this gigantic program. Again, if you think that’s all there is to this question then you need to do a little more reading. > [@](#): > > Then all those without employer sponsored health insurance should be running out to buy it right now. I’ve already mentioned how early visits save money in the long run - how would your plan address this? How would making it relatively more expensive for employees to get insurance help anything? If private cases exerted downward pressure on prices, we’d see that now. Actually, the reverse is true since those with less likelihood of needing insurance don’t get it, leaving the pool full of people who will need it, making the insurance more expensive. Thus the move for mandating insurance. Again, eliminate government policies that prevent health insurance from being real insurance (insurance pays for high cost, low probability events, not routine care). Eliminate government barriers which prevent nurses and others from opening quick care clinics. Let health care consumers have the freedom to choose and health care professionals have the freedom to meet these choices. Right now the government places huge roadblocks in the way of this happening (usually at the behest of doctors and other professionals who do not want competition). I’m not saying this would be perfect. We’d obviously need some sort of subsidy for the lowest-income people to obtain care or insurance. But it would fix many of the problems of our current system as well as avoid the problems and higher taxes that come with single-payer systems. ---
**Author:** ![BrightNShiny](https://avatars.discourse-cdn.com/v4/letter/b/7bcc69/32.png) [@BrightNShiny](https://boards.straightdope.com/u/BrightNShiny)\ **Post date:** [October 16, 2007, 2:52am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/51 "2007-10-16T02:52:06Z")
[QUOTE=Renob] It is my understanding that the vast majority of health care consumed in the U.S. is not for emergency care. [/QUOTE] I listed other reasons why segments of the health care market exhibit price inelasticity. I can list more, but you’ll probably ignore those as well: treatments for which there is low demand (so there will be few practicioners), specialities which require advanced training (and also, consequently have few practicioners). > [@](#): > > If it’s not emergency care, you can shop around for it. Really? How do you shop around for goods or services that are exhibiting monopoly or oligopoly behavior? Treatments that are under patent protection are going to be subject to very little price competition. I should also point out that there is an area between immediate emergency care and completely elective care. The shorter a time frame required for treatment, the less ability there is to shop around. > [@](#): > > Furthermore, I’m fine with individuals purchasing insurance. I think that if we removed the government subsidy for employer-sponsored care we’d have people actually purchasing true health insurance – high deductible policies to cover truly emergency or unexpected incidents. That’s the way the system should work. And what should happen under your system is that people who need insurance will be dumped by their insurance companies. There is little-to-no financial incentive for an insurance company to insure someone who is going to need expensive treatment. Under your system, a lot of people will be walking around uninsured. ---
**Author:** ![sqweels](https://avatars.discourse-cdn.com/v4/letter/s/f19dbf/32.png) [@sqweels](https://boards.straightdope.com/u/sqweels)\ **Post date:** [October 17, 2007, 4:44am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/52 "2007-10-17T04:44:16Z")
[QUOTE=BrightNShiny] Really? How do you shop around for goods or services that are exhibiting monopoly or oligopoly behavior? Treatments that are under patent protection are going to be subject to very little price competition. I should also point out that there is an area between immediate emergency care and completely elective care. The shorter a time frame required for treatment, the less ability there is to shop around. [/quote] Indeed people are, in effect, being tortured into doing business with entities that are under little market pressure to lower their prices. How about we create a separate sector whereby the currently uninsured can get affordable healthcare, but subject to certain limitations? I’m thinking of some sort of combination of the OP’s plan and government employees providing care. ---
**Author:** ![SnakesCatLady](https://avatars.discourse-cdn.com/v4/letter/s/4af34b/32.png) [@SnakesCatLady](https://boards.straightdope.com/u/SnakesCatLady)\ **Post date:** [October 17, 2007, 1:12pm UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/53 "2007-10-17T13:12:43Z")
[QUOTE=sqweels] Indeed people are, in effect, being tortured into doing business with entities that are under little market pressure to lower their prices. How about we create a separate sector whereby the currently uninsured can get affordable healthcare, but subject to certain limitations? I’m thinking of some sort of combination of the OP’s plan and government employees providing care. [/QUOTE] I’m uninsured, and the idea of “government employees providing care” gives me cold chills. I was married to Mr. SCL for 5 of the 8 years he was in the Army, and the wide range in competence of the doctors I saw during that time frame was nothing short of astounding. I had an outstanding hand surgeon, but then there was the doctor who lanced a huge boil on the inside of my thigh and told me “I don’t write for pain meds.” Not “You don’t need pain meds” but that he didn’t prescribe them under any circumstances. There was the doctor how called a tech in at 3am to do an MRI when he thought I had had a stroke. Then there was the dentist who (after having a discussion in my hearing about how to bend the anesthetic needle to inject through the roof of my mouth and _try_ to hit that nerve) yelled at me to “stop crying, you’re making me nervous”. Not all doctors can graduate at the top of the class. 😉 ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [October 29, 2007, 5:22am UTC](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524/54 "2007-10-29T05:22:11Z")
[QUOTE=Mr. Moto] Look, the OP is an unworkable libertarian dream. And yet, we cannot escape the fact that in areas of medicine untouched by either private insurance or government entitlement agencies (not regulatory agencies, which are a different matter entirely) costs are controlled quite well, and availability of care is expanding. Again, think of this next time you hear an ad for Lasik surgery. A few years ago this was unavailable, then it was an expensive luxury. Now it is something people can get by paying a few hundred bucks out of pocket. [/QUOTE] Eh, that’s a matter of new technology becoming cheaper. Nothing to do with some imaginary general tendency of markets to lower prices of established procedures. [Previous page](https://boards.straightdope.com/t/instead-of-socialized-medicine-how-about/422524.md?page=2)