The Free Market Is Not Another Form of Rationing
As the health care debate rages, many conservatives have correctly argued that government-run “universal care” will lead to medical rationing. To control costs, the socialized health systems of Canada and Great Britain routinely restrict patients’ access to expensive services. A Canadian with a possible brain tumor might wait months for his government-approved MRI scan, whereas an American can receive one within days.
Liberals will typically counter that a free market is just “another form of rationing” — but by price rather than government decree. It is unjust, they say, that patients with money (or good insurance) can receive MRI scans whereas those without money cannot. Hence, they contend, the government must intervene to guarantee a supposedly fair distribution of medical services.
Too often, conservatives then concede this moral high ground to the liberals and defend the free market on purely economic grounds — e.g., a free market would lower costs for everyone. This is a serious mistake. Supporters of the free market should not allow opponents to characterize the marketplace as a form of rationing, let alone an unjust one. Instead, supporters should defend the free market as morally just because it respects individual rights.
To do so, one must properly define “rationing.” As the writer Ayn Rand noted:
“Rationing” has a specific meaning of its own. It means: to distribute in a certain particular manner — by the decision of an absolute authority, with the recipients having no choice whatever about what they receive; it also means that all the recipients involved have an equal claim to that which is being rationed, and are entitled to an equal share.
Examples include sugar rationing during World War II and gasoline rationing during the 1973 oil crisis, when the government dictated the terms and conditions of sugar or gasoline sales.
But in a free society, the government should not be regulating such sales at all. Producers — not the government — created the sugar (or gasoline) in the first place. Hence, they have the moral right to sell it to willing consumers on any mutually acceptable terms. There is no “just” distribution of sugar or gasoline apart from the voluntary exchanges between producers and consumers in a free market.
While Dr. Hsieh makes many good points, the core of his argument – that markets do not ration, is flawed. It might have been best if he had consulted Thomas Sowell (whose book, Basic Economics, should be on everyone’s essential reading list) on the issue.
Sowell does, in fact, use the term “price rationing” to describe the actions of the market, and how the price mechanism sends signals to both producers and consumers – and, as a result, controls the distribution of a scarce resource.
We do ourselves a disservice by resorting to linguistic jui-jutsu to avoid having to admit what consumers and voters can clearly see – that health care is a resource and access to it must be controlled by SOME means. We should acknowledge that fact, lest we want to destroy our own credibility, an then move on to explain why price rationing is superior to all other forms, in that it encourages an increase in supply, a reduction in price, and shields individuals from the partisan fiat of government force.
Trying to pretend the market is not what it is will simply discredit our well-reasoned objections.
Be advised:
Keeping hospitals, labs, and family doctors 100% busy is conscious, albeit secret, Canadian policy.
This is the best way to cut unnecessary (due to doctor’s opinion) tests, procedures, and treatments. When hospital has 100% utilization of its facilities, it has no financial incentives to perform unnecessary tests, surgeries, and treatments.
This is effective way to control health care costs (while delivering on average good results), but unavoidable consequence is long waiting times for procedures, and quite often – tragical premature loss of lives and preventable months of suffering.
In my opinion one of the ways health care costs in this country are controlled is through “collective bargaining”. When an insurance company partners with a business who employs thousand of people they can go to a doctor, dentist, or hospital and bargain for a lower fixed price for procedures.
The doctor, dentist, or hospital might reluctantly agree to a ‘fixed’ price in order to gain thousands of customers. It’s like Hertz getting a fleet of cars for a cheaper price, or a company getting cheap airline tickets or hotel rooms because they have hundreds of business travelers.
I think of it as Walmart World. In this mix are small business etc. and individuals that have no collective bargaining power. They, by not being part of a collective, often pay double, triple, quadruple for the same procedure that a person who is part of a group.
So, it seems this country’s mixed economy sometimes benefits capitalists and the social part of the economy lets some people slip through the cracks. That is what this argument is about. What do we do with the people who slip through the cracks? We are aware of them and now that we are aware, we must do something. It would be nice to have a conversation about it.
We have so many social programs: Social Security, Medicare, Medicaid and on and on and on, yet we still have citizens who are suffering because of the high cost of health care. One thing we all have in common is that we get sick and we die. I don’t see what the harm is in trying to help as many people as we can, and try to reduce waste, and uncover abuses that are preventing us from helping those who really need it.
I know that the American People are sick and tired of their hard earned money going toward taxes and fees, while they watch their savings and disposable income shrink. I think most want to help but are disgusted with the corruption and waste that goes on in the government AND the private sector. I’ll speak for myself in saying I have close to zero confidence that the government will make a difference and it will just be another avenue for waste corruption to travel down.
Indeed, Al. Keeping medical staff running at full capacity is the type of optimization of utility that governments come up with, when their only concern is votes. In private markets, the multitude of competing forces balances things out more smoothly and automatically takes all needs into account.
If we must ration… and so long as scarcity exists we will have to, then price rationing is the best way to do it. The only other option is to ask the Health Fairy.
I’ve often heard that “you can’t put a price on a human life.” It’s a nice sentiment but it’s completely false. We do it all of the time. Suppose a child has cancer. How much would we as a society (via insurance or government spending) be willing to pay to save that child’s life? A million dollars? Quite likely? A billion dollars? $100 billion? The entire US budget? No, it won’t happen. At some point, we say that we can’t afford to pay any more to save a life. At that point, we’ve put a price on that life. Opportunity costs being what they are, we have to decide what we’re willing to give up in order to save that life.
Insurance companies have finite resources, so there will always be a point where they’ll deny further treatment. It’s irrational to expect a company to bankrupt itself to treat any individual or group of individuals. Government does the same thing, they just have the ability to take more money in taxes or print more money. Even then, there comes a point where treatment is and should be denied. It doesn’t matter whether it’s an “evil profit-seeking insurance company” or a government “death panel”, we have to stop paying at some point.
I heard one radio commentator point out that one large American city (I think it was Philadelphia) has more MRI machines than all of Canada. If that is true, then investors in the American city has made the determination that the market supports paying for so many of those expensive MRI machines, while someone in Canada has determined they don’t need so many. Which is serving the people better, competition that leads to lower prices and faster service or scarcity that saves tax dollars but results in long delays in treatment? I would hope the answer is obvious.
Thanks for the excellent article, Dr. Hsieh. People who try to equate government force with voluntary exchange have to be called on their error and you’ve provided great ammunition.
Ken: You should read Dr. Hsieh’s article again, and then address his actual arguments. The Sowell mistakenly uses the word rationing is irrelevant to the facts. The linguistic jujitsu is being perpetrated by those who want to erase the distinction between coercion and freedom.
Lynn, the problem with collective bargaining is that it takes the power out of the hands of the one most affected by the decision and forces them into monopolies.
In fact, with today’s employer-provided health insurance, we ALREADY have collective bargaining. The employer negotiates on behalf of the employees – generally based, not on the benefit to the employee, but the cost to the employer. And, if an employee doesn’t like the insurance he gets, that’s too bad.
As far as your WalMart example goes (as I understand it), it’s rather flawed. We are not the competitors against WalMart; we are the customers. Your collective bargaining solution would force us to, en masse, go to Sears to shop, because that’s who our employer… or the state has a contract with (nothing against Sears – I’m a big fan of Craftsman tools, myself).
In short, its collective bargaining that got us into this mess – aided by government intervention via the wage caps from over a half-century ago. It is individual choice and government minding its own business that will get us out of it.
You say you have zero confidence that the government will make a difference. I believe your instincts are right, but you’re not looking far enough ahead. If we give the government the power to control our health coverage, and they can’t improve things, then they end up entrenching the inefficiencies that exist, at best, and more likely introduce new problems. All this while taking away our ability to fix the problems, ourselves, even at a higher cost. Or, if they do leave the ability intact, the cost to the individual will be all that much higher. Add into that the incentives and disincentives created by the confidence that comes with these inefficiencies being law.
In other words, when the government takes action, because it has the power to force compliance, even the status-quo becomes a disaster.
What Ken and Lynn seem to have completely missed in the article is that “Health Care” is NOT a “resource” like trees or oil or water. “Health Care” is a SERVICE. As in; “Goods and Services”.
People spend hundreds of thousands of dollars and years of their lives, often going deeply into debt in the process, to become Doctors and Nurses. Once they have reached this level of education and are fully certified, they then either hang out a shingle on their own, or join a larger group of professionals to sell a service to the public. That service is Health Care. It’s not a resource to be exploited, it’s a service offered to anyone who can pay for it.
If we as a country try to say that Health Care is a “right” what we are really saying is that Doctors and Nurses are REQUIRED BY LAW to treat anyone and everyone regardless of their ability to pay. Put more simply, we ENSLAVE Doctors and Nurses to the nebulous concept of the “greater good”. This is not only morally wrong, IT IS EVIL.
There can be no public good done when we demand slavery and servitude from people simply because of the profession they have chosen.
“A Canadian with a possible brain tumor might wait months for his government-approved MRI scan, whereas an American can receive one within days.”
An American without insurance doesn’t even get an MRI.
And a Canadian doesn’t wait months.
You are a liar.
“Sowell does, in fact, use the term “price rationing” to describe the actions of the market,…”
True as far as it goes but I think you miss that he is making Mr. Hsieh’s point, not yours. Namely that Price and Command rationing are different in kind not just effectiveness. And that difference cuts to the question of what kind of society do we wish to live in – free or controlled. That is a political struggle, not a purely economic one. His entire book, “A Conflict of Visions” addresses this question of the ideological origins of this political struggle. To claim Sowell could see free vs command anything as having similar roots is just not so.
If an employee doesn’t like the insurance he gets, he can find another employer. My employer’s human resources manager made a phone call to a big name health care HMO, and got an employee friend’s cancer treatment moved up in their priority list. His lung was removed within a few weeks, and 20 years later he still works with us.
I work in a very competitive business, and good employees are prized. We get the best health care available, and even retirees frequently return to work on key projects. Our “old guys” are a key resource.
Oh, and what does Canada have to do with it anyways?
No one is proposing a system similar to Canada’s. No one. Just another obfuscation to have the uneducated vote against their own best interest.
A point I haven’t seen – under govt-managed healthcare, there will be procedures (some life-saving, some not) and medical services that are not “cost effective” and thus not allowed. At all. Right now – if you need some sort of medical treatment prescribed by your doctor and your insurance doesn’t cover it or doesn’t cover all of it, you can pay for it yourself. But under govt-managed (and this is the exactly policy under Medicare now) if the treatment isn’t covered under the govt option – it is ILLEGAL to get it. You cannot pay for it yourself. If you want to call a free market – rationing – I can live with that because then I at least attempt to get it for a better price or have friends/family help financially. If we go under govt-managed rationing – no one will get it ever. REALLY – WHICH WOULD YOU RATHER HAVE?
jharp: Substitute England, or France, or any other socialist country where the government controls the amount of health care you receive.
The big difference between a free market approach and a centralized government approach is that, when faced with obstacles, it’s possible in a free market to receive medical care.
Poor? There are charities who are willing to help. You can raise money for operations. You can go into debt. It’s awkward, but it’s doable.
When you’re faced with a government bureaucracy that says no, however, you’re screwed.
Oh, and when they say no in Canada and elsewhere, what do the people with money do? Come to the U.S.
The implication of Mr. Hsieh’s distinction is at the heart of Sowell’s arguments for the un-constrained view of a proper society. In the case of healthcare it could literally be summed up as, “Live Free or Die”. When given the choice between being free to choose or whether granny gets a new hip replacement, I’ll take freedom every time. In other words, do you want to make the choice or do you want the government jharps to make the decision for you. I think we can all agree we would rather be dead than allow that.
Ken, your comment “the core of his argument – that markets do not ration, is flawed” seems flawed. Please look up “equivocation” in any good dictionary.
While it is true that economists often refer to the allocation of goods in a free market as price “rationing”, the concept associated with price rationing is undeniably distinct from the concept attached to the unqualified word “rationing”.
Further and importantly, Dr. Hsieh clearly defines *that* concept early on: ““Rationing” has a specific meaning of its own. It means: to distribute in a certain particular manner — by the decision of an absolute authority, …”
It is clear that a free markets do not ration in *this* sense.
And, it’s not difficult to understand that it is precisely *this* notion of rationing, in the context of health care, that disturbs and concerns the majority of citizens in the U.S. today and not the notion that health care is ‘rationed’ in the same way that cans of tuna and designer jeans are.
#9 You’re wronng. In the US if today I don’t have the money I can raise it. I can save by not purchasing other goods and services, I can work extra hours to raise money, I can borrow from friends or family, I can seek out charity. None of these options is available in Canada.
Wait times are a reality in Canada. A Quebec man sued the government and won with the Quebec Supreme Court stating access to a waiting list is not access to health care.
80% of colon ca patients in Canada are deemed to have treatable disease when diagnosed, 40% are deemed to have treatable disease when chemotherapy starts.
There’s a reason why the US has higher cancer survivorship rates than Canada and Europe. We actually treat more people and treat them sooner.
In the UK, 1 in 5 to 1 in 4 men will die of prostate cancer who, had they been in the US, would have survived. In fact US survival rates are so high that you would have to argue that NO ONE who has insurance EVER dies of prostate cancer. That is simply not true. How do hose without insurance get treated? I don’t know, but they do. They do better than the insured in other nations.
I agree completely with Paul Hsieh’s take on what constitutes rationing, and how it relates to rights. However, I think there is a better, simpler way to describe it (there’s nothing new here, but the ‘rationing’ argument is obfuscating things):
If there is always a legal way for a citizen to obtain a good or service when the citizen desires or needs it, then the good or service isn’t being rationed.
This is equality in opportunity at work, vs. equality in outcome.
If I need a medical procedure and don’t have the money to pay, but I can borrow the money (or obtain it some other way), and I can then pony up the dough and get the procedure done, then that procedure is not being rationed. So, If I can’t borrow or beg the money, I can go out do extra work for it, by delivering pizzas maybe, or something else. Most people who have a post-secondary education know exactly what that’s all about; we all took joe-jobs while we went to school to defray the tuition/residence/miscellaneous costs.
If timing is the problem, pay more, get it faster. If availability is the problem, pay more to obtain it. If price is the problem, do more work, obtain the price.
Only when people are unable (not unwilling) to work does this system break down, and that is a different issue.
Something that cannot be obtained no matter how much money you have (or how eager or willing you are to work extra hard) is being rationed. Just as Paul Hsieh says people shouldn’t get tangled up in economic comparisons of socialized vs. free-market health care, I also submit that people arguing against health care rationing would do well to not focus on “money” being the tool used to obtain health care, but instead focus on “work”/”effort”/”productivity” being the tool. Money is just a proxy.
Ken’s comments are right and wrong at the same time. Right in that many products in markets a priced at an assumption of scarcity – and thus the Sowell example is accurately reflected. But Ken is wrong that all of the health care market is subject to those constraints.
As I have taught economics over the years there are two ways to begin the discussion. The common way is to think about supply and demand curves – that leads to a discussion of scarcity and how to allocate it. The alternative is to look at exchange. James Buchanan, the winner of the Nobel in 1986, was the first one who got me on to that approach. If you begin with the problem of how people exchange things (how markets develop) then you start the discussion of economics in a very different way and ultimately end up looking at the problem to be solved not as allocating scarcity but in trying to figure out how to improve gains from trade. Dr. Hseih is correct in that any governmental solution will ultimately begin to look at allocation of scarcity.
Consider what happens if you begin the health care debate with a market based approach. Things that are plentiful – for example electronic records of patients – can help to relieve the burden of cost inflation. Are those things the full solution to the health care dilemma – of course not. But by beginning with the premise offered by Dr. Hseih you have a much wider range of possible alternatives.
Lou Shumaker:
“jharp: Substitute England, or France, or any other socialist country where the government controls the amount of health care you receive.”
England system is not even close to any resemblance of Obama Care. Not even close. You obviously don’t even understand what socialized medicine is.
“The big difference between a free market approach and a centralized government approach is that, when faced with obstacles, it’s possible in a free market to receive medical care.”
France has a wonderful system. We’d be very lucky to have a similar one. No one. No one is denied care. And it aint socialized Medicine.
And they deliver the same quality of care we get in the U.S. For 1/2 of the cost.
I hope I live long enough to see our country not inhabited with wing nut ignoramuses. I’ve seen enough.
What’s wrong with admitting that free markets are a means to ration scarce resources? This article is not only pedantic, but wrong.
Just imagine what it would be like to sit across the table from jharp pleading for medical care. That is all you need to know about why you should oppose Obamacare.
“A Canadian doesn’t wait months [for an MRI]. You are a liar.”
This Canadian waited 5 months for an MRI. The current average wait time in the province of Ontario is 100 days:
http://www.health.gov.on.ca/transformation/wait_times/providers/wt_pro_mn.html
From reading the above comments, it appears the “rationing” argument depends on one’s definition–must it involve coercion and an equal portion for everyone, or does it mean creating a framework for allocation/distribution (voluntary or otherwise) on ANY basis? Mr. Hsieh, using Ayn Rand’s definition, may reach the same conclusion but by a different route than Thomas Sowell, who uses a different definition.
Mr. Hsieh’s use of “deserve” is a little wobbly to those with a looser definition of property rights. Even “property rights” themselves are not necessarily considered sacrosanct to those on the left (“to each according to his ‘need’” (however that’s defined)).
As well described by other commentors, when there is not a limitless supply of something/anything, individuals and society must still come to terms with the allocation issue, whatever words one uses to argue one’s point.
The only reason to ration anything is because there is not enough to go around. This can’t really be said of healthcare. In Canada, because of the devolution of the healthcare system, the emigration of many doctors to greener pastures, the thing that has become scarce, especially in certain regions, is actual healthcare providers. Be careful, they might all come back.
> What’s wrong with admitting that free markets are a means to ration scarce resources?
This formulation presumes that “resource allocation” is properly done by society as a whole, rather than by individuals. That’s what’s wrong with it.
If you use the term “ration” to describe activities in a fully rights-respecting society, you’re equivocating between a benign meaning of “ration” and the more common, sinister meaning of government-enforced rationing. Not everyone who uses the term in this way is consciously equivocating, but many are – and it’s to their advantage to confuse the terms and not be precise about what they’re really advocating. That’s the real point of Dr. Hsieh’s article.
At the root, the debate over health care is a moral debate.
#9 / jharp
All hospitals will work with patients to work out a payment schedule based on what the patient can afford. This is never for the full price that is charged an insurance company. The case of an American patient not recieving an MRI due to a low bank account balance is a scenario only made possible by the left constantly promoting the falsehood that there are no other options and that privately run charities do not exist (or at least exist only in an insignificant capacity).
I agree with your assertion that the wait time for many procedures in Canada has dropped. This happy state of affairs occured only after Canada was forced to adopt more right-wing policies at the instigation of their own Supreme Court. As to your question about how Canada is relevant: the right wing thinks it might be a good idea to look at how other countries impliment universal health care to look at the pros AND the cons of those systems.
Why the left chooses to ignore the existing options for alternate health care payment as well as challenges that foreign government-run health care systems have is confusing to me. That is behavior that I would only expect from a body of people that already had access to good health services and didn’t care about anyone else. Nonetheless the battle cry of “we don’t care what happens to the poor because we care so much about them and consider them too incompetant to do anything for themselves” seems to be the dominant meme among progressives.
As long as Agent Zero and his zombies peddle that words have the meanings they want them to have, regardless of conventional definitions, they show they belong in the same category as Adolf Hitler, Vladimir Lenin, Joseph Stalin, Vladimir Putin, Hugo Chavez, and the rest of that ilk, as opposed to Dietrich Bonhoeffer, C.S. Lewis, Mortimer Adler, et al.
Mark Wickens:
“A Canadian doesn’t wait months [for an MRI]. You are a liar.”
“This Canadian waited 5 months for an MRI. The current average wait time in the province of Ontario is 100 days:”
And what again does the Canadian system have to do with us since Obama Care is nothing like the Canadian system?
And
“In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn’t clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. “I completely freaked out,” Susan says. “I couldn’t imagine spending the summer with this hanging over my head.” After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. “The system is clearly broken,” she laments.
It’s not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. “Waiting is definitely a problem in the U.S., especially for basic care,” says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy.
There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.
http://www.businessweek.com/magazine/content/07_28/b4042072.htm
And a Canadian doesn’t wait months.
You are a liar.
A simple web search for Canada, MRI and CT shows that there’s a shortage of imaging equipment in Canada, a shortage the gov’t health system acknowledges.
I live 20 minutes from Canada and watch Canadian television sometimes (Hockey Night in Canada has much better announcers than NBC). The other day I saw an ad on CBET (Windsor) pitching a diagnostic imaging lab in suburban Detroit. They featured their CT and MRI scanning. The same company does not advertise on the Detroit stations. Why do you think that is?
If Canadians don’t have to wait for diagnostic imaging, why is a private sector company in the US marketing its services to Canadians?
BTW, I know Canadians who live and work in the US but I don’t know any Americans who have moved to Canada to take advantage of their health system.
DB:
#9 / jharp
“All hospitals will work with patients to work out a payment schedule based on what the patient can afford. This is never for the full price that is charged an insurance company.”
Utter nonsense. Self pays pay more than what an insurance company pays.
And hospitals might or might not work out a payment schedule. After you lose your house and any other assets you’ve worked your entire life to accumulate.
I would also say that the free market system allows for more people to be able to afford private care. In other systems than our own, whether mixed or single payor, private care, as opposed to government issue care, is out of reach price wise for average people like myself. In these systems, only the rich can afford the kind of care that we take for granted now. While all the rest are forced into one size fits all, stripped down, rationed care.
A two tier systems, with equally bad care for most and excellent private care for only the most wealthy. That is what we will get with Obamacare. How is that more moral?
The free market is the best wealth distribution system ever conceived bar none. It allows more people to access more goods of a higher quality than any government attempt to redistribute wealth could ever dream of. This fact makes the free market the more moral of the two options. The more rein it is given the more people are lifted up out of poverty. All other systems simply result in everyone being equally poor.
Logic of the Left:
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Clear cut logging is a form of rape of the forest.
Loggers do the clear cut logging
Loggers are rapist.
Loggers should be imprisoned.
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Terrorist interrogation is a form of torture.
Torture is evil.
Interrogators are evil.
Interrigators should be imprisoned.
*****************************************
Free enterprize is a form of rationing.
*
*
*
*
Build more prisons.
DB:
#9 / jharp
“All hospitals will work with patients to work out a payment schedule based on what the patient can afford.”
Enter Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.
He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.
http://www.nytimes.com/2009/07/01/business/01meddebt.html
It’s unreasonable to argue that buying a half-pound of meat when you want a pound because a pound costs more money than you’d like to spend is the same thing as buying a half-pound of meat when you want a pound because you have a half-pound ration card and can’t legally buy a pound.
The reason “market rationing” is fundamentally different from “government rationing” is that market rationing operates through the mechanism of choice. There’s more stuff out there than you can afford so you parcel out your money, buying more of this and less of that, according to your personal tastes and priorities.
Under government rationing, these choices are made according to government priorities and there’s very little you can do about it.
The fact is, propaganda notwithstanding, nearly anyone can get nearly any procedure. Some just have to struggle more than others to pay for it. But the procedure comes first and the paying comes afterwards, so you don’t wait while you count your pennies and run bake sales. And if you default, there’s not much the hospital can do about it.
“BTW, I know Canadians who live and work in the US but I don’t know any Americans who have moved to Canada to take advantage of their health system.”
Do ya think that might be because the Canadians won’t take them?
I am astounded at the ignorance here.
And Canada’s health care system has no resemblance to Obama care. None.
tim maguire:
“But the procedure comes first and the paying comes afterwards, so you don’t wait while you count your pennies and run bake sales. And if you default, there’s not much the hospital can do about it.”
Are you really this naive? Or are you liar?
Enter Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.
He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.
http://www.nytimes.com/2009/07/01/business/01meddebt.html?_r=1
@37. jharp: – …the fine print excluded nearly all of the treatment he received …
Gee.
Guess maybe someone should have read it then, huh.
You were saying? About being ‘naive’?
I never said that collective bargaining was flawless, I was just writing that many Insurance Companies bargain with the Medical Industry. They also pay them a certain amount each year to take on customers, which usually covers certain base procedures. They negotiate and have a larger customer base to offer in return for doctors or dentist taking less money.
A single person, a small family unit, or a small business does not have that collective bargaining power and can’t buy insurance or negotiate costs for medical procedures because they don’t have that buying power.
I used Walmart for an example because they do the same thing when they negotiate with a vendor for a product. They buy large volumes at a lower price. Small business have a difficult time competing because they do not have the bargaining power that a large company has.
The problem comes when the economy tanks, people lose their jobs, and medical costs rise at a pace faster than the cost of living, or begin to cost an unsustainable percentage of income. I understand that everyone deserves a raise, cost of living and merit, but the dollar can only stretch so far and a business that takes a few pennies from that dollar is going to fight tooth and nail to keep it and more.
The problem is that we are dealing with human lives and human health making it a very volatile topic. It’s not like talking about the high cost of fixing your car, or buying parts for it, or maintaining it. Those are things and are disposable but it’s an awful thought to think that people are too.
I think that we avoid dealing with it because it is such a hard topic to discuss and try to resolve without someone ‘falling through the cracks’.
I do think many of you are mistaking my view, here. It’s possible that I didn’t articulate it clearly.
First, the reason I didn’t address the good doctor’s other points is that I don’t disagree with them. I am an unabashed free-market capitalist and believe that’s the best cure for what ails the industry (or any other industry, for that matter).
That said, I think it’s wrong to say that the market doesn’t ration. Dr. Hseih pulls an Ayn Rand definition. Ayn Rand is a philosopher, and a an exceptional one, at that. However, Thomas Sowell is an economist, and possibly the most brilliant one left alive (after the passing of Milton Friedman). Clearly, I put more weight on Mr. Sowell’s definition than Miss Rand’s.
In this case, there is no equivocation, as Hal suggests. That I recognize that both ration does not mean I believe they are anywhere near equal. One rations based on freedom, personal choice, and the value that person has given society (as represented by their ability to pay). The other rations by government fiat. To say that I am equivocating between the two almost requires one to ignore everything that I’ve said in previous posts. Or, put another way, a Rolls Royce and a Yugo are both cars… but stating that fact does not mean they’re equal.
drtaxsacto, I’m not entirely sure how what you said means that health care is not subject to scarcity, in the economic sense of the word. The cost, time, and qualifications to become a doctor and the cost of equipment means that the supply is not unlimited. Therefore it must be scarce. The market, as you describe, creates a way to increase supply, but I don’t see that as being infinite.
Basically, resources, goods, and services are limited. The market provides the best way to allocate those, based on free choice. This does not mean that Dr. Hseih is wrong in his conclusions. Just that I disagree with the idea that it’s not rationing.
Hal, it’s clear you and I disagree on the issue of Dr. Hseih’s definition of rationing. My view of it is that most voters will feel manipulated by the definition that you use and believe that we are not being entirely honest with them. Their main issue is affordable access to health care. They realize that it can’t be unlimited, and that choices WILL have to be made. We should be up front about it, and explain why us giving control of those choices to the individual is better than giving to the government. What we can not afford to do is say that there’s no rationing taking place, and make it sound like we think no choices have to be made.
jharp: You called the author a liar. When his facts were shown to be true, you changed the subject. Somehow, I don’t think further argument with you would be productive.
This administration has already shown that they have no interest in honoring contracts: witness the financial sector’s contracts for ‘bonuses’, and the outrage they feigned when the institutions wanted to live up to their contractual obligations. Or, witness the ideas of ‘renegotiating’ mortgage contracts. Hmmm…
jharp (#9):
“An American without insurance doesn’t even get an MRI.”
Sure they do. They use something called “money” to purchase the “service”
jharp:
From the article you seem to love to selectively quote about Mr. Yurdin
“Mr. Yurdin and his wife say it was not clear that he was liable for tens of thousands of dollars in hospital bills until after he had the first two of what would eventually be four operations. St. David’s says it tried to persuade them to apply for charity care, under which the hospital would absorb much, or all, of the unpaid bills.
But the couple says a lawyer advised them to turn to bankruptcy as the way to be certain they would not be left with too much debt.”
Oh, the heartless American medical system…
Lynn, if we put the system, as a whole, on the free market, people wouldn’t need collective bargaining. Cut-throat competition would pressure insurance companies to lower costs, increase benefits, pay for preventative care, and offer terms people could live with. It’s only because of collective bargaining that they’ve been shielded from those pressures.
I’m not anti-Walmart, by any means (except that they’re supporting this bill… and their use of eminent domain in the 1990s… ok, I guess I am anti-WalMart), but I think your revision of the WalMart analogy actually hurts your point more than my original misunderstanding of it. For years, people have been reporting about how WalMart sells lower-quality goods and that their purchasing decisions have made it harder for high-quality, solid-value products to gain market share – they can’t compete with the cheap goods on the same shelf. Or WalMart just doesn’t buy the good stuff unless they lower their price to where the quality suffers.
Either way, that’s what collective bargaining has done with consumer goods, and it’s also what it’s done for health care.
Good points Tim. They have no idea what rationing is, in reality.
Wow! Jhar-dofhearing is astounded by the ignorance here! Want to argue with an actual Canadian about Canada’s healthcare problems or lack of them and what you might be in for?
goy:
” jharp: – …the fine print excluded nearly all of the treatment he received …
Gee.
Guess maybe someone should have read it then, huh.”
Yes. And what is your point?
That if he had read the fine print he would have avoided the surgery and be dead?
Or went ahead with the surgery and ended up in exactly the same spot?
64 years old and bankrupt due to poor health. America, the only country where you lose everything due to poor health.
And you ignorant fools defend this system. Shocking stupidity. Shocking.
jharp
#29 – your example is of a woman using the free market system to obtain more expedient care. And the article you cite only uses same/next-day appointments as a metric. Not emergency care. Not specialized treatments. And it ranks us at #5 out of … six. Seeing as how the United Nations maintains the Cuba has better health care than the US, I’m surprised several dozen or so other nations weren’t surveyed. My next question would be “its great they made the appointement, but did the paitent actually get to see a doctor?” I assume the answer is yes, however this study also shows that 51% of those surveyed did not see a doctor when sick. I have a cold right now. I don’t plan on seeing a doctor. There is no need for me to see a doctor. And I’m certainly not going to go into some government run queue and get in line ahead of a guy with a broken leg.
#34 – this guy got boned, no two ways about it. He was also told directly by the hospital before reciveing treatment that he was covered. He also received care. He also applied for charity but was instructed by a lawyer to decalre bankrupcy instead. We don’t know how that charity would have worked out. I would suspect that Atena’s claim that the patient and the hospital did not give an accurate summary of the events is probably bunk, especially in light of the rather lame update to their brochure. But why does this necessitate complete government control of the health care system? Especially in light of the fact that the patient in your example was able to rely on existing government measures? “More” is not the same as “better”. More of something good is not even the same as better.
Finally, given the amazingly poor VA system we currently have, why should I believe a civilian expansion of the VA system would be superior to the system we have now? Every Republican I know was stunned that John Kerry didn’t make the VA system the centerpiece of his 2004 campaign. Bush could have (and should have) done something with the VA, but didn’t. The VA system is awful, but Democrats simply aren’t at all interested in improving it. And what happens with the VA is the same thing that happens in every state system: wealthy areas get great public services while poor areas are told to count themsleves lucky they get services at all. If the Democrats had taken 10% of the stimulus money and dumped it into the VA system, they’d have made public options much more attractive, slammed the lid shut on any patriotism issues, and helped a lot of veterans at the same time.
If Democrats get the VA system functioning on something higher than a shameful level, I’ll start believing they can run a health care system. Until then, its empty promises and higher taxes.
jharp
#36 – Re: Canadians not taking Americans
Given Canada’s open-door policy on immigration, I find your assertation unlikely to be the case.
My mother had a neurological condition several years ago and was diagnosed as having either a brain tumor, stroke or Parkinsonian-related illness. The neurologist could not tell which without a scan. But it didn’t take three months to get the scan…it took fifteen months. And I now know that was actually fast! Of course, during the wait time she received no treatment at all because she couldn’t be treated until her condition was properly identified.
The bigger issue is that we currently have an adversarial system. Your insurance company owes you what it says it owes you in the contract. If they try to dodge, you can sue.
When you have the insurer and the provider as the same entity (i.e. HMO), you have a little more of a problem, because they can cut corners. But they can’t deny what the contract says they have to furnish. If they do, you can sue.
When the government is the only HMO in town, it’s only a matter of time before you won’t be be able to sue. No matter what you call it, it will be, effectively, a death panel.
And I disagree with those who say that the national health authority won’t double-cross the trial lawyers. Just watch.
DB:
“If Democrats get the VA system functioning on something higher than a shameful level, I’ll start believing they can run a health care system.”
http://www.time.com/time/magazine/article/0,9171,1376238,00.html
Until the early 1990s, care at VA hospitals was so substandard that Congress considered shutting down the entire system and giving ex-G.I.s vouchers for treatment at private facilities. Today it’s a very different story. The VA runs the largest integrated health-care system in the country, with more than 1,400 hospitals, clinics and nursing homes employing 14,800 doctors and 61,000 nurses. And by a number of measures, this government-managed health-care program–socialized medicine on a small scale–is beating the marketplace. For the sixth year in a row, VA hospitals last year scored higher than private facilities on the University of Michigan’s American Customer Satisfaction Index, based on patient surveys on the quality of care received. The VA scored 83 out of 100; private institutions, 71. Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage, whose care is provided through private health plans or HMOs, according to a study published in the April edition of Medical Care. Harvard University just gave the VA its Innovations in American Government Award for the agency’s work in computerizing patient records.
And all that was achieved at a relatively low cost. In the past 10 years, the number of veterans receiving treatment from the VA has more than doubled, from 2.5 million to 5.3 million, but the agency has cared for them with 10,000 fewer employees. The VA’s cost per patient has remained steady during the past 10 years. The cost of private care has jumped about 40% in that same period.
For those proponents of Obamacare that cite people filing for bankruptcy because of medical bills as a reason to completely overhaul the medical system, what is an acceptable amount of a sick persons assets which they should have to pay before some “stop loss” mechanism is employed? Why don’t we make it….say 55%. Would that be acceptable?
@47. jharp: - And what is your point? That if he had read the fine print he would have avoided the surgery and be dead? Or went ahead with the surgery and ended up in exactly the same spot?
You realize that you’ve boxed yourself into a false choice with your stupid straw man, right?
In fact, you didn’t even bother to read the article, which makes it clear that Yurdin not only had the wrong type of policy for someone his age, but that he was repeatedly advised of the limitations it imposed.
I’ve worked as a temp analyst for years and I know exactly what sort of policy is in question here. That’s why during those times I opted for my own private high-deductible, low-premium policy – to handle cases exactly like this. Yurdin was simply not paying attention.
There’s not enough information to judge whether or not the surgery was an emergency, or even required. Irregular heartbeat is experienced by millions of people. I have it and was advised by two cardiologists that it’s quite common and poses no health risk.
The point is that if he’d read the fine print he would have known that the surgery was not covered, and could have made other arrangements or sought care that was less expensive.
Instead, the “insurance will cover it” mindset that you and the rest of America seems to want to defend, caused him to blindly pursue surgery that he should reasonably have known would NOT be covered by his policy.
This article is a blatant attempt to confuse “limited” policies with high-deductible/low-premium policies, which are exactly the opposite. This is just one more example of NYT’s laundry list of Appeal to Emotion fallacies, trying to make a false case for socialized medicine, which is nothing more than spreading the cost (read: wealth) around.
Neither they – nor you – are persuading anyone with an ounce or more of common sense.
Metz:
“For those proponents of Obamacare that cite people filing for bankruptcy because of medical bills as a reason to completely overhaul the medical system”
Obama care is not a complete overhaul.
Currently Medicare and Medicaid comprise 35% and 11% of health care spending. Or 46%.
It is estimated that a public option would comprise an additional 10%. Bringing the number to 56%.
I don’t care how good whatever it is you are smoking is, but not even the dimmest of bulbs would call it a complete overhaul.
It’s simply a mechanism to provide competition with private insurers and get everyone covered.
I agree, it does not meet the definition of rationing in better dictionaries (poorly written ones though…). Money imposes self ‘rationing’ (vs. big R rationing where an outside force imposes it). Ie, big screen tv or paying the water and health insurance bills…
Also, actual rationing enables shortages and is used to keep artificially low prices.
If we want good service for all we need to forgo government rationing and allow prices to be high enough to allow adequate supply to reach the market. Then, if we want to help those who can not (despite their best efforts) afford the services… we can help them pay. If we try to artificially lower the price, well, we will ration and all will go with out / wait.
jharp:
#52 – yes, they reduced services and re-defined definitions of things like “10% disabled” vs “50% disabled”. Verdict? Success! Don’t believe me? Read your own link.
“By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.”
They reduced services to get that wonderful success you want for everyone. And the article even omits what has to happen to qualify as a service related injury or illness. I guess that would have spoiled the narrative.
You’ve ended a bunch of your posts by lamenting the level of ignorance that exists, but you can’t be bothered to read the articles in your own links. And if you’re offering the VA system as an example of excellence, I’ll stick with private care.
jharp:
“Utter nonsense. Self pays pay more than what an insurance company pays.”
Actually, it’s quite the opposite. Hospitals are much, much more likely to bargain down what they charge an uninsured person – they know they can stick an insurance company with a lot more fees. I’ve seen friends of mine haggle their hospital bills down to one-third the “standard” insurance rate.
You’re deeply wrong about the MRI thing, besides. Most hospitals will feed a poor person through an MRI without a lot of thought, since there are so many of the gadgets sitting around. Heck, one local MRI clinic was advertising walk-in MRI scans for $500 a pop because they had extra capacity… which is much less than any hospital would charge for a similar set of non-MRI scans. Some of the local clinics (Orlando, FL) had prices low enough that it was cost-effective for Europeans to fly here for a scan, then take it back to their doctors at home.
Hey Ken, how’s your little research project going? On a July 31 comment thread you made a promise. What’s keeping you?
Good luck with that argument, Mr. Hsieh!
Claiming the moral high ground by simply asserting the very principles that proponents of social justice reject is not my idea of suasion. Fighting the healthcare battle on that front is just wasted effort doomed to failure, whether conservatives cede the point or not.
If there is one constant in the liberal universe, it is the unassailable conviction that they already own the high ground. You can tell a liberal there’s no such thing as a right to healthcare till you’re blue in the face, without making a dent. They’ll counter your putatively self-evident premise with what they define as natural rights — and a Constitution which serves as a veritable cornucopia of penumbras — every time. Cost cuts and control are a feature not a bug in the liberal lexicon, and you’ll make no inroads by hauling out a conservative or libertarian dictionary.
There is only one potentially fruitful way to frame the healthcare debate. Government control and massive bureaucratic red tape will ultimately result in life-threatening delays, scarcity of critical resources and denial of care. Duking it out on that basis is hard enough with people who see government regulation as the only effective means of ensuring our collective well being. Expecting them to cede the moral high ground as well as the practical argument is pure fantasy.
3. Lynn:
“The doctor, dentist, or hospital might reluctantly agree to a ‘fixed’ price in order to gain thousands of customers. It’s like Hertz getting a fleet of cars for a cheaper price, or a company getting cheap airline tickets or hotel rooms because they have hundreds of business travelers.
I think of it as Walmart World. In this mix are small business etc. and individuals that have no collective bargaining power. They, by not being part of a collective, often pay double, triple, quadruple for the same procedure that a person who is part of a group.”
I know it seems that way but I don’t agree.
1) A lot of corporate deals are quite poor when you look into them. I’ve worked for very large ones and found that the corporate rate (from rental cars to computers) was either the same as shopping around… or worse. Never better.
2) A lot of these stories about higher rates for the uninsured are not entirely true. I’ve had a lot of medical problems lately and my bills always mention a couple discount programs if you don’t have insurance (i.e., don’t freak out over this bill. Call us if you’re uninsured for the uninsured discount or cash discount et cetera). After looking into it, it seems these ridiculous prices they put on the bill are part of an elaborate tax scam they enabled via having lobbyists put a loophole in the tax code for them. Hospitals can write off these ridiculous amounts if you don’t pay (whereas other businesses would get more scrutiny). So, they’re mostly for show. If you offer to pay out of pocket they tend to disappear (unless you’re dealing with an org that would rather have the write off than a payment… and yeah, I know they exist too).
@55 jharp
My question was not who, what, or how many are covered or not covered.
My question relates to assisting those who end up bankrupt due to medical bills. What is an acceptable amount of their assets to be paid to receive the treatment they require? I began the discussion at 55% of their assets, and once paid, that would be the end of their responsiblity.
And for those of us that actually have businesses where actual employees are involved, we understand the fallacy of the public option vs private insurance. Private insurance will disappear. Private care may not disappear, but it will exist only for those with the wherewithal to pay 100% of the cost.
Government run healthcare would be a disaster, violating the rights of doctors, patients, insurance companies, drug companies and other parties involved in providing medical services. There is already a huge amount of government regulation in health care, and doctors, insurance companies and pharmceutical companies are villified for the consequences of *government regulation.* Less government, not more is what is needed. Capitalism is the best thing that could happen to medicine, and we have very little of it right now. I want to take responsibility for my own life and my own medical decisions. I want to be able to trade on a free market for the medical services I need, which is not rationing, it is freedom to make choices. I don’t want an inept and totally unqualified bureaucrat telling me and my doctor what we can and can’t do.
Another excellent article by Dr. Hsieh. On another blog, I attempted to make the same point in a comment. But he makes it much more articulately than I could.
As for Ken’s comment (citing Sowell) on so-called “price rationing,” both Ken and Sowell are wrong to use “rationing” this way. In defining “rationing,” you need to answer the question, “As opposed to what?” And in answering it, it is wrong to hold as your reference point an imaginary Eden in which material goods grow on trees and all our needs are automatically satisfied. In other words, the proper distinction (as made by Dr. Hsieh) is not “rationing versus infinite abundance” but “(coercive) rationing versus freedom.”
An American without insurance doesn’t even get an MRI.
Not true because I’ve paid for one out of my own pocket when I didn’t have insurance nine years ago. It diagnosed gallstones.
A colleague has been struggling with kidney stones. So he could have his own clear view of what was happening he paid for an MRI out-of-pocket a few weeks back. It wasn’t needed, which is why the doctors didn’t order one. But he wanted it and was willing to pay, so he got one.
PS. While on insurance, my family and I have denied service. While not on insurance, I’ve never been denied service either and have paid for every last cent out of my own pocket.
Thanks to everyone who has commented. I just wanted to respond to one point, which is in my related blog post:
http://www.westandfirm.org/blog/2009/09/hsieh-oped-free-market-is-not-another.html
…Some commentors have stated that this argument of rationing is just “linguistic”. I disagree, and in fact that’s the key point of my piece.
It’s similar to the fallacy some people commit when they claim that newspapers choosing to publish some pieces and not others is “just another form of censorship”. That’s completely wrong. Their uncoerced choice to publish one piece over another is the *exercise* of the right free speech. In contrast, it *would* be censorship if the government told them which pieces they could not publish (or were required to publish).
Similarly, it’s a serious category error to equate uncoerced exchanges in a free market with rationing.
Rationing inherently involves compulsion, which is the exact opposite of the free market. The market is how we *exercise* our rights, and rationing is wrong precisely because violates those rights. (Thanks to Tom Stone for this analogy.)
Everyone should be aware that jharp is a troll and liar spreading misinformation.
jharp[:
“A Canadian with a possible brain tumor might wait months for his government-approved MRI scan, whereas an American can receive one within days.”
An American without insurance doesn’t even get an MRI.
And a Canadian doesn’t wait months.
You are a liar.”
No, you are the liar. Anyone coming to an ER cannot be turned away. Your example of the bankruptcy case is suspect. One great virtue of insurance companies that government does not have is the fact they can be sued. There was a case a few years ago where an insurance company made a mistake (actually the oncologist they retained to review the case treated an HMO patient differently than a private patient and got caught) in denying care and ended up with a $65 million judgement against them.
I do some UR work for insurance companies and they rely on physician reviewers and are very sensitive to the risk of suit if they get it wrong.
As usual, you know nothing of what you are blathering about.
Ken, I agree to disagree and maybe concede, it is how I think of it to try and understand what is going on.
and #61 Steven H. I agree and had the same experience that you speak of with my son. I think though, that if he had not had an advocate (me) much of the ‘secret’ bargaining with the hospital would not be known. I did a lot of research before contacting them. I think it is mostly on the hush hush and there was no revised bill or receipt of ‘paid in full’ to exchange hands.
I don’t think Americans are used to that open market bargaining like they are in other countries. I’ll give you $200 dollars for that x-ray! Alright, $210 and no more or I’ll go to the next stall! Listen the doctor down the street said she’d do the procedure for $1000 dollars, what do you say. Ah, highway robbery!
I think that you might be mistaken that there is no benefit to having the power of a corporation behind you, and I think they partner with the insurance company to get the best rates. I think the government also negotiates to get certain rates for Medicare and Medicaid.
Well, back to the only certainties in life Death and Taxes.
“DB:
jharp:
#52 – yes, they reduced services and re-defined definitions of things like “10% disabled” vs “50% disabled”. Verdict? Success! Don’t believe me? Read your own link.”
“By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.”
I read my own link fool. Lets’ put the whole thing up.
As the reforms produced results, veterans began “voting with their feet,” says Dr. Jonathan Perlin, who just resigned as the VA’s health under secretary. Hundreds of thousands abandoned private physicians and enrolled in the lower-cost and higher-quality VA care. But that created a new problem. The VA’s budget from Congress (currently about $30 billion annually) couldn’t cover the influx. By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.Veterans’ groups understandably want the health-care system expanded to accommodate vets with higher incomes and no service-related ailments. Tom Bock, commander of the American Legion, has another idea: allow elderly vets not in the system who are drawing Medicare payments to spend those benefits at a VA facility instead of going to a private doctor, as is now required by Medicare. “It’s a win-win-win situation,” he argues. Medicare, which pays more than $6,500 per patient annually for care by private doctors, could save with the VA’s less expensive care, which costs about $5,000 per patient. The vets would receive better service at the VA’s facilities, which could treat millions more patients with Medicare’s cash infusion.
But conservatives fear such an arrangement would be a Trojan horse, setting up an even larger national health-care program and taking more business from the private sector. Congress has no plans to enlarge the scope of veterans’ health care–much less consider it a model for, say, a government-run system serving nonvets. But it’s becoming more and more “ideologically inconvenient for some to have such a stellar health-delivery system being run by the government,” says Margaret O’Kane, president of the National Committee for Quality Assurance, which rates health plans for businesses and individuals. If VA health care continues to be the industry leader, it may become more difficult to argue that the market can do better.
__________________________________________________
So to sum up. The VA has been so successful and run so efficiently that for a brief time they couldn’t keep up with the increased demand. That and Bush’s unnecessary war increased the patient load while providing no new funding to the VA.
You are a liar.
jharp:
#52 – yes, they reduced services and re-defined definitions of things like “10% disabled” vs “50% disabled”. Verdict? Success! Don’t believe me? Read your own link.
“By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.”
________________________________________________
I read my own link. It is you who chose to selectively quote in order to mislead. Liar.
Let’s read the entire quote.
“As the reforms produced results, veterans began “voting with their feet,” says Dr. Jonathan Perlin, who just resigned as the VA’s health under secretary. Hundreds of thousands abandoned private physicians and enrolled in the lower-cost and higher-quality VA care. But that created a new problem. The VA’s budget from Congress (currently about $30 billion annually) couldn’t cover the influx. By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.”
So with no new funding and an onslaught of new patients due to the higher quality care than private care givers a backlog occurred and was easily solved.
How do you sleep at time after lying and misleading all day long?
You are a liar.”
Mike K,
“No, you are the liar. Anyone coming to an ER cannot be turned away.”
It is true that emergencies cannot be turned away. You can thank liberlas for that.
However 75% of the medical care in the U.S. is for chronic care.
And they get denied care every day by the thousands.
Even those with insurance.
The California Nurses Association/National Nurses Organizing Committee today blasted insurance giant CIGNA for failing to approve a liver transplant one week earlier for listen to 17-year-old Nataline Sarkisyan, who tragically died last night just hours after CIGNA relented and agreed to the procedure following a massive national outcry.
On Dec. 11, four leading physicians, including the surgical director of the Pediatric Liver Transplant Program at UCLA, wrote to CIGNA urging the company to reverse its denial. The physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant. They also challenged CIGNA’s denial which the company said occurred because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, “Nataline’s case is in fact none of the above.”.
http://calnurses.org/media-center/press-releases/2007/december/rn-s-statement-on-death-of-nataline-sarkisyan-cigna-should-have-listened-to-her-doctors-and-approved-the-transplant-a-week-ago.html
It’s fruitless to get bogged down in arguments over health care quality and costs. There’s ample evidence to show that a free market system is superior, but that is beside the point here.
It’s not about money (or quality). It’s about freedom of choice, voluntary trade, and the inalienable rights to both.
Progressives like jharp will never accept this because they oppose individual freedom, preferring coercion to enact their favored social engineering schemes. ‘Benefits to the poor’ is a very thin smoke screen. It’s simply immoral to coerce one person to aid another, when the person being coerced has violated no one’s rights.
That’s the most basic point of the article, as it should be in every discussion of health care/insurance ‘reform’, cap-and-trade, or any of the countless other efforts by the Federal Govt and its Progressive supporters to enslave some for the alleged benefit of others.
Jeff Perren:
“It’s fruitless to get bogged down in arguments over health care quality and costs.”
Yeah right. No need to discuss that our system is the most expensive in the world by double. For the same level of care.
Don’t ya know Rush says Obama Care is bad so it has to be true.
I’ve been a practicing physician for 35 years, with a career-long interest in the economics of health care, as well. In a nutshell, my thoughts are:
1. Health is not the same as health care. If we take care of our bodies (healthy habits, etc.) like some conscientious people take care of their cars or their homes or their Ipods, they usually do quite well, and bodies usually have quite remarkable powers of self-repair. The less-than-ideal US mortality rate/life expectancy statistics are quite skewed by accidental deaths (e.g., we’re a big country and drive more miles) and intentional deaths (homicide, suicide), neither of which is very reducable by “health care”. Health CARE does have a role both in prevention (e.g., Lipitor or blood pressure medication, immunizations, screening for treatable conditions in cost-effective circumstances) and treatment (cancer, heart attacks, broken bones). These health care services are usually competently performed in a timely manner (as measured by American expectations), but expensive.
2. But “expensive” compared to what? The wealthiest person on the planet 150 years ago, who, say, tore his rotator cuff or Achilles tendon, or had a hip fracture or angina or leukemia or heart failure, couldn’t buy–at any price–the medical interventions available to the average indigent Medicaid patient of 2009. Let us at least acknowledge that the average American citizen’s life is much more materially rich (healthcare, housing, nutrition, transportation, education, opportunity) that at any point in history.
3. As a result, many Americans have come to expect “only the best” for themselves, irrespective of ability to pay. Here is where “rationing” must step in. Prior to the Great Society programs of the 1960′s, the U.S. had a system of county hospitals, indigent hospitals, charity hospitals and clinics that provided health care for those unable to pay; and people with means or with insurance went to private doctors and community or relgious hospitals, paid for out-of-pocket or with health insurance. Once the government promised to pay FOR the care of indigent folks’ use of the private-pay system (e.g., Medicaid), many indigent or county hospitals closed. Of course, in an era of greatly expanded health care technology (and cost), the government is now unable to provide “the best” to all. A reversion to a two-tiered system (good for those who can pay, and good-but-not-the-best-and-with-waiting-lines for those who cannot pay) is untenable politically and–to some–morally.
4. In our still somewhat economically free society, some people will choose to spend money on plasma TVs, cable, the latest cell phones, expensive sneakers, evenings at the bar or night club, jewels for their Crocs, laptops, etc. and that’s FINE–at least until they have to come up with money for medical treatment or health insurance. Then, all of a sudden, they have no money and now attempt to exert their “right” to health care (paid for by someone else). As compassionate people, Americans have difficulty telling Chad or Latisha, “You made your economic choices to spend your money as you wish, and the consequences of your spending decisions are your problem, and your problem only. If you had wished to spend your money on health insurance, you were free to do so. Maybe you should just take a pain pill.” Until we can do that, we’ll continue to struggle with Obamacare-type “fixes” to the system.
It’s true that the free market is not a form of rationing. Rationing is fair. Rations ensure that everyone gets at least the bare minimum needed to get by. Rationing would be an improvement over the current state of affairs where tens of millions have no access to health care, while others pay exorbitant rates for coverage that is comparable to public programs.
No, the free market is worse than rationing, because it has priced so many out of a market for a very basic need. We already recognize the need for health care for the elderly in this country, and for those who are disabled. Public programs have been successfully and cost-effectively treating these populations in the USA.
In first world countries comprehensive care is freely available to all. It’s really not hard to understand that care for all is a good thing that promotes a stable and healthy society, as well as saving money, lives and families in the long run. The private market has already proved to be more expensive, and the only clear ‘benefit’ is the accrual of wealth to those to own and operate insurance companies.
I agree with the author – the Free Market is not a form of rationing. It is a means to deny to millions the basic right to see a doctor and be cared for. The market is a cruel and unusual way to operate a health care system. Thankfully there are better ways.
Peace.
DS
8. Wearyman: “If we as a country try to say that Health Care is a “right” what we are really saying is that Doctors and Nurses are REQUIRED BY LAW to treat anyone and everyone regardless of their ability to pay. Put more simply, we ENSLAVE Doctors and Nurses to the nebulous concept of the “greater good”. This is not only morally wrong, IT IS EVIL.”
Because, yeah, God forbid we put doctors into the same category with policemen and firefighters, who also are REQUIRED BY LAW
I guess we’ll just have to agree to disagree on this, Dr. Hseih. I’m using the definition used by a noted economist; you’re using one used by a noted philosopher. Both of us are saying to each other “I do not think that word means what you take it to mean.”
My fear is that there will be many who see our attempt to say it’s not rationing as deceptive.
Dana, I don’t agree with your “as opposed to what” contrast. As long as there are scarce goods, there will be rationing. The only question is how it is done. I see no reason why the comparison (if, in fact, one must be made at all) can not be with the lack of scarcity – the absolute zero of the economic world. We don’t object to the use of Pareto Efficiency just because it has never existed in this world. We don’t object to the use of a Carnot cycle to represent the maximum thermal efficiency, just because nobody has ever made one. Why does this issue get special restrictions placed on it?
8. Wearyman: “If we as a country try to say that Health Care is a “right” what we are really saying is that Doctors and Nurses are REQUIRED BY LAW to treat anyone and everyone regardless of their ability to pay. Put more simply, we ENSLAVE Doctors and Nurses to the nebulous concept of the “greater good”. This is not only morally wrong, IT IS EVIL.”
Yeah, because why would we want to compare doctors with police officers and firefighters who are REQUIRED BY LAW to investigate crimes and fight fires! Clearly, those police officers and firefighters are SLAVES TO THE GREATER GOOD! How EVIL that we require some services to be regulated so that our citizens can have basic needs met.
I’m sure in your Conservative Utopia of FREEDOM!!, a private law enforcement officer will have the right to refuse to investigate a rape or murder because oops!, the victim can’t pay, and police protection is a service, not a right. Hooray for FREEDOM! Down with the EVIL ENSLAVEMENT of law enforcement officers!
Sometimes it helps to think first and then write.
Good article but too bad the republicans don`t have the intelligence to articulate this to the public?
In fact, i don`t believe the pubs want to oppose the marxists or even care if health care passes.
Where is Michael Steele? I thought he was the be all end all once he was elected to head the republican party. Nobody ever hears from this guy or if we do he`s two weeks behind on every issue.
I hear a lot of people saying they are going t throw the bums out next year but I`ll believe it when i see it….
To jharp, David S, and all other Progressives:
If you work in the health care or insurance fields and choose to lower your costs or improve your quality or efficiency, I will not attempt to stop you. I will go so far as to advocate that you be left free to do so.
There it ends.
You do not have the right to dictate to others, using the government as your proxy, what others will do with their time, money, and efforts. I have no doubt whatsoever that both of you know that, as do Progressives in general. Give up your lust to control the choices of others. It always leads to ruin, yours first.
jharp:
#69
A liar? Let’s run down your article’s timeline again.
1) The VA is awful
2) They cut some services and broaden the distribution of existing lower-end services (i.e. family practice)
3) They can’t keep up with demand for the new services and no mention is made of what happened to patients that required beds (they were sent home to recover without doctor supervision by the way)
4) Congress does not increase spending. The VA is back to being awful by Jan 2003.
5) Later in 2003, Bush declares war in Iraq, increasing demand for the VA, not that Republicans or Democrats noticed much unless it became a talking point.
I’d flipping love to know how I’m a liar when I say the government can’t run a health care program when you cut-and-paste half a paragraph saying the government can’t run a health care program, another half paragraph where one guy wonders why Medicare patients can’t go to the VA system after the VA system has had two rounds of reduction in services in the past 10 years, and a second paragraph that asserts the VA can do better than the private sector even though there is no intrest in increasing funding. Yes, the article points out that Republicans don’t want to increase funding. For some reason they skip over the complete and total lack of increased VA spending the Democrats have been in 100% control of since 2006.
You can cry about Republicans all you want and when it comes to the VA, I’d agree. But all that’s happend to the VA is that services and funding have been cut. Democrats are not at all interested in addressing those issues even though it would be a complete slam-dunk for them. I’m supposed to believe that will change?
Sheesh. I still can’t get over the fact that you’re cutting and pasting stuff that says the government can’t run a health care program and using that as proof of terrific government services.
And by the way … it should be absolutely no surprise to you that of the VA system “Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage”
… because the same article (that you say you read) says “the VA began limiting access to only vets with service-related injuries or illness or those with low income” So unless someone is poor or has a natural death risk while over the age of 65 and in the military THEY AREN’T BEING TREATED BY THE VA! Which you know, because you say you read it. So either you’re comforatable with people not recieving treatment or you’re unable to put together that people not being treated by the VA are not recieving VA treatment.
I’ll just nitpick one point. If one person can afford better health insurance than the other, usually their is no denial of service from the doctor–frequently a payment schedule is used, because a patient in need is a patient in need. The procedure is done, the details are worked out later. That’s the present system in the US. That, to my understanding, is not the way things work in either Canada or the UK. Patients in need are ‘patients in line.’ This simply works out to a shortage of doctors in the US, because, whatever you want to say about doctors, I’ve found they can handle less income, they can’t handle being forced to not care for their patients.
@75. David S: – Rationing is fair. Rations ensure that everyone gets at least the bare minimum needed to get by.
The fact that this statement is unsupportable nonsense is beside the point, since rationing is neither desirable, nor necessary at this time.
- … tens of millions have no access to health care …
This statement is hyperbole of the most unsupportable kind. Anyone who needs it can receive critical care per federal statute (look up EMTALA).
- No, the free market is worse than rationing, because it has priced so many out of a market for a very basic need.
That might be true if the health care market were a free market.
A free market is nominally unregulated by government. Yet health care, the pharmaceutical industry and the insurance industry are three of the most highly regulated industries in our society. HIPAA anyone? EMTALA? FDA drug approval regulations? Thousands of pages of legislative legalese micromanaging these industries? Regulating a market to the point of dysfunction and then blaming the market for skyrocketing costs is the height of intellectual dishonesty, which is the one thing the left excels at.
A free market is one where the price of goods and services are determined by agreement between the provider and consumer. But how are health care prices determined? Look at any EOB (Explanation of Benefits) from an insurance company, like I’m doing right now. The provider billed $800. The insurer paid $467. Who was the consumer? Well, unless some insurance company employee got the porta-cath my wife needs for her chemotherapy, the consumer is me. Yet I had no say whatsoever in the price paid here. Insurance company lobbyists and corrupt politicians ensure that things remain this way.
Pretending that the health care market is “free” under these circumstances is absurd, and every lying liar who is lying about the “benefits” of socialized medicine knows that.
- We already recognize the need for health care for the elderly in this country, and for those who are disabled. Public programs have been successfully and cost-effectively treating these populations in the USA.
Again. Wrong.
Medicare is bankrupt. By 2012 it will only be sustainable through deficit spending. It steals more money from the general fund every year to stay afloat – that’s money contributed by U.S. Taxpayers who are NOT receiving Medicare benefits.
Medicare and DHHS employ unabashed extortion to keep people in the plan who would otherwise seek a competing alternative. If retirees choose to opt out of Medicare, their Social Security benefits are forfeit. This is the antithesis of success and cost-effectiveness.
- In first world countries comprehensive care is freely available to all.
All? Really? And is that timely access? Or is it take-a-number-go-home-and-wait-for-a-letter-in-the-mail access? There’s no evidence to support your wild assertion. As usual.
Jeff Perren:
“You do not have the right to dictate to others, using the government as your proxy, what others will do with their time, money, and efforts.”
Quite the contrary. We do.
Just as you wingnuts had the same right to dictate to me that I had to pay for your trillion dollar unnecessary war using the govt as your proxy. (minus the time and efforts of which don’t apply to either case)
Go sign up for a civics class. Most of us completed it in the 7th grade. You must have been absent that year.
goy:
“Medicare is bankrupt.”
Still riding that horse, huh?
Medicare is not bankrupt. It continues to pay for the health care of those over 65 and those who are disabled.
It is obvious that you don’t have the slightest clue as to what bankruptcy is.
Naftali:
“That, to my understanding, is not the way things work in either Canada or the UK.”
Could one of you please explain to me what Canada and the U.K. have to do with the debate?
Even the most ignorant are well aware that Obama Care is not even close to those two models.
81. DB:
“I’d flipping love to know how I’m a liar when I say the government can’t run a health care program”
Because it is a lie. And right here is your proof.
Just who has been running the VA the past 20 years? Would it be the govt?
Until the early 1990s, care at VA hospitals was so substandard that Congress considered shutting down the entire system and giving ex-G.I.s vouchers for treatment at private facilities. Today it’s a very different story. The VA runs the largest integrated health-care system in the country, with more than 1,400 hospitals, clinics and nursing homes employing 14,800 doctors and 61,000 nurses. And by a number of measures, this government-managed health-care program–socialized medicine on a small scale–is beating the marketplace. For the sixth year in a row, VA hospitals last year scored higher than private facilities on the University of Michigan’s American Customer Satisfaction Index, based on patient surveys on the quality of care received. The VA scored 83 out of 100; private institutions, 71. Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage, whose care is provided through private health plans or HMOs, according to a study published in the April edition of Medical Care. Harvard University just gave the VA its Innovations in American Government Award for the agency’s work in computerizing patient records.
And all that was achieved at a relatively low cost. In the past 10 years, the number of veterans receiving treatment from the VA has more than doubled, from 2.5 million to 5.3 million, but the agency has cared for them with 10,000 fewer employees. The VA’s cost per patient has remained steady during the past 10 years. The cost of private care has jumped about 40% in that same period.
Pete G–
Are you familiar with EMTALA? That’s the federal law that requires emergency rooms to assess and initially treat all patients who present for care, irrespective of inability to pay. Thus, hospitals and emergency department nurses and physicians are indeed required by law to treat anyone, just like your police and firefighters in your bleat above.
However, although the government provides free food stamps to reduce hunger for the poor, that does not allow a hungry person to enter a restaurant and demand free food.
How about one of you cowards addressing Cigna denying care to Nataline resulting in her death? 17 and dead. To preserve Cigna’s profits.
A proud moment for all of you I’m sure.
And people get denied care every day by the thousands.
Even those with insurance.
The California Nurses Association/National Nurses Organizing Committee today blasted insurance giant CIGNA for failing to approve a liver transplant one week earlier for listen to 17-year-old Nataline Sarkisyan, who tragically died last night just hours after CIGNA relented and agreed to the procedure following a massive national outcry.
On Dec. 11, four leading physicians, including the surgical director of the Pediatric Liver Transplant Program at UCLA, wrote to CIGNA urging the company to reverse its denial. The physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant. They also challenged CIGNA’s denial which the company said occurred because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, “Nataline’s case is in fact none of the above.”.
http://calnurses.org/media-center/press-releases/2007/december/rn-s-statement-on-death-of-nataline-sarkisyan-cigna-should-have-listened-to-her-doctors-and-approved-the-transplant-a-week-ago.html
@85. jharp: – Medicare is not bankrupt. It continues to pay for the health care …
“It” continues to pay for health care by reimbursing at rates that are 20% less than private insurers, enforced by federal law.
“It” continues to pay for health care by stealing money from the Taxpayers. This money is not “borrowed” in any conventional sense, since it will never be paid back. It is wealth redistribution, pure and simple.
“It” continues to pay for health care by extortion, forcing retirees from seeking a better alternative.
“It” will continue to pay for health care after 2012 only through extensive deficit spending.
Medicare is bankrupt by any definition you care to offer.
jharp: And hospitals might or might not work out a payment schedule. After you lose your house and any other assets you’ve worked your entire life to accumulate.
My reply:
Utter nonsense. I work for a private company that searches for private/government grants for patients who do not have insurance and cannot pay their hospital bills. We contract with hospitals in several states across the US who then refer patients to us. I know for a fact we are not the only such organization. Those that need financial assistance for medical care can usually find it.
#8 Wearyman
I agree with your general point about Ken and Lynn, but, aside from that, you are missing the fact that a government system requires the people to pay for the service; it does not only require doctors and nurses to provide it regardless of ability to pay; in fact, it does not require it at all, since they are paid.
jharp, you are a liar.
That is all.
80. Jeff Perren: “You do not have the right to dictate to others, using the government as your proxy, what others will do with their time, money, and efforts.”
Are you kidding me? That’s exactly what we have the right to do. It’s called lobbying, genius. Right wing neoconservative idiots lobbied for a bull**** War in Iraq, and I had to pay for it. So now I’m lobbying for health care, and you right wing nuts will have to pay for it.
Sounds pretty fair to me.
jharp
#87
Well, congratulations. You’ve gone from not reading your articles to not reading my posts. And you re-quoted the same section of the article that I directly address in post #81
I said: “And by the way … it should be absolutely no surprise to you that of the VA system “Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage” … because the same article (that you say you read) says “the VA began limiting access to only vets with service-related injuries or illness or those with low income” So unless someone is poor or has a natural death risk while over the age of 65 and in the military THEY AREN’T BEING TREATED BY THE VA! Which you know, because you say you read it. So either you’re comforatable with people not recieving treatment or you’re unable to put together that people not being treated by the VA are not recieving VA treatment.”
For some reason, you read the phrase “By January 2003, with hundreds of thousands waiting six months or more for their first appointment, the VA began limiting access to only vets with service-related injuries or illness or those with low income.” … then you ignore the part where it says this is after a prior cut of some services (but expansion of family care facilities) and treat it as a success.
And it would actually be a success if we accepted as fact that the only medical services people ever needed were family services.
You’ve blamed Republicans for not increasing VA funding while giving Democrats a pass for doing the same thing. I strongly suspect you would do the same if the VA program were expanded to civilians. You keep posting the success of the VA while at the same time choosing to ignore that the VA doesn’t treat people with conditions recieved after their service if those people can afford their own health care. You are deliberately ignoring the cuts in care and the Democrats’ ability to address those.
If you still don’t understand after I’ve pointed it out to you before: the VA system has healtier patients over the age of 65 because they flat out deny services to anyone that develops a health condition outside of military service that has any chance of affording it in the private system. For some reason, you take this denial of service as proof that government run service is successful.
Unfortuantely, providing health care is much harder than simply claiming people that don’t agree with you are ignorant liars. Which is what you’ll probably do after you finish ignoring the stuff I wrote about the VA system denying services and the lack of interest liberals have in correcting that (for a second time).
[i]“How about one of you cowards addressing Cigna denying care to Nataline resulting in her death? 17 and dead. To preserve Cigna’s profits.
A proud moment for all of you I’m sure.
And people get denied care every day by the thousands.
Even those with insurance.”[/i]
Well, that’s the identical situation you keep claiming is great in the VA system. Personally, I think Natalie’s case is tragic, but given your example of a solution would simply make the same tragedy public policy, I have serious doubts you’re remotely interested in the case study as anything other than a talking point.
John P:
jharp: And hospitals might or might not work out a payment schedule. After you lose your house and any other assets you’ve worked your entire life to accumulate.
My reply:
Utter nonsense. I work for a private company that searches for private/government grants for patients who do not have insurance and cannot pay their hospital bills.
_______________________________________________
Great. I have a friend whop has a friend recently caught without insurance who has been diagnosed with cancer.
No one will treat her.
Could I please have the name of your company and we will contact them for some help.
We are talking about life and death here so please hurry.
And how does your company make any money?
goy:
“Medicare is bankrupt by any definition you care to offer.”
How about we try the definition of bankruptcy?
Bankruptcy is a legally declared inability or impairment of ability of an individual or organization to pay its creditors.
Medicare is not bankrupt. You are a fool on a fool’s errand.
Jharp, this is a little one-sided, don’t you think? Were the doctors willing to do their work for free? If not, why not? Why do they not come in for your ire?
Was UCLA Medical Center willing to waive all their charges? Again, why do they not deserve your wrath for their uncharitable behavior?
Apparently you have decided to swallow, hook, line, and sinker, Obama and Congress’s demonization of health insurance companies. You ought to know that not everything you do with your car is going to be covered by your auto insurance policy. And not everything can be covered by medical insurance. Everything does have a cost and because insurance companies are forced by states to spend so much money on mandated coverages they can’t afford to be more generous with their benefits for the illnesses that should be covered.
Have you looked at CIGNA’s financial statements file with the insurance commissioner of their home state? If not, you have no basis for speculating about CIGNA’s profits. I have neither the time nor the inclination to explain how insurance works but it would behoove you and the rest of The One’s slavish followers to learn a little about it.
68. Lynn:
“I think that you might be mistaken that there is no benefit to having the power of a corporation behind you, and I think they partner with the insurance company to get the best rates. I think the government also negotiates to get certain rates for Medicare and Medicaid.”
It certainly makes it easier to not have to bother. But, on the other hand, if you get a $1000 medical bill (without insurance) I just would advise anyone to not freak and to call and ask about it. If your actually poor they might even have an aid center that can pay whats left after the cash price discount.
Also, if your in a position to, shop around. Some places will charge you 1/10th the ‘invoice’ rate if you haggle (while mentioning your going to call the competition for a bid too) before having the test done…
We argue about details, but this revolves around the liberal desire for equality of outcomes, rather than equality of opportunity. The basic premise is wrong. Since everyone is treated, it is about financial repercussions. We are worrying about people “falling through cracks” and having debt.
Where does this lead? To absurdity. Some other reasons for bankruptcy include overspending, stupidity and poor judgment, loss of a job, crime, divorces and abandonment, external financial fluctuations, etc. etc. Shall we next have the government insure us all against any of these? Because really, it’s not my fault if I’m stupid, lose a job, have an ugly divorce, if the value of my investments tanks, etc. etc.
Most of us purchase health insurance, either directly or through our employers, because we know we are likely to need it. Those who don’t do so, for whatever reason, are gambling. I don’t see any reason to pay somebody else’s gambling losses. I too see many of the “poor” with fancy clothes and cars, complaining at the food bank where I volunteer about the free food.
There is no way to remove the element of chance from life. If I am one of those who can’t in any way get insurance, bankruptcy was designed to relieve me from crushing obligations. If I can’t afford insurance, I need to learn a marketable skill and work harder. The world is not perfectible, especially not by making more laws.
(Roughly 25% of physicians are 55 or older, and many of them will simply retire rather than deal with this lunacy. I certainly can’t blame them, with the responsibility, training, stress, and overhead they carry. Sorry, don’t recall where I read this.)
Good article. Unfortunately,due to Ken hijacked the discussion with his poor interpretation of Sowells thesis and its application to Hsieh’s article, we have spent the better part of the discussion clarifying for Ken just what certain words mean in different contexts. Enough.
Later we are treated to wild lamentations from one side with threats of long lines in Socialized countries. Only to be followed by a brash chastisement from the other side that that those opposed to socialized medicine are summarily evil. These two Left and Right wing views only serve to label and distract. When,in fact, most Americans are in the middle. We agree that the least among us need to be brought along and cared for as brothers and sisters. We also know that capitalism works.
There are only two reasons to promote socialized medicine. 1) Care or the poor or less fortunate. 2) Free care for anyone who doesn’t feel like they should have to pay for it. And here we should clarify. “Healthcare Reform” is a misnomer. We are actually discussing “Payment Reform”, not the practice of medicine. By default, having the goverment control the system will eventually change the delivery of medicine.
Capitalism only works when the “Free Hand” is allowed to work unimpeded. Open all 50 states to free market competition amongst insurance companies. Prices will fall. The insurance companies will then have “collective bargaining capabilities” to demand better terms from doctors and hospitals. Allow the lawyers to persue lawsuits on any malpractice they can find. All providers are held accountable for their actions or inactions. Competition has already flooded the tort lawyers market. The average lawsuit payout has dropped precipitously. Free market brought about these changes, not government regulations.
Our president exhorts us to do something, anything. He pleads that what we have, “is not working”. That is the same propoganda he used to win us over the last time. Lets not fall for it again. No nebulous promises of change just for the sake of hope. We all agree that we can do better, but lets not make rash decisions that can never be undone.
Health care is not a right. It is a priviledge, and we have a duty to make sure that all our brothers and sisters are cared for.
I have practiced medicine and performed surgeries in multiple countries including Mexico, Hoduras, the Carribean and India. I have also personally recieved medical attention in France and Australia. (Sports related injuries on holiday). In the socialized nations the quality of care was excellent and it was “free”. And I can tell you I do not want what our president is proposing.
I would not take a court appointed lawyer if I ever find myself as a defendant in a criminal case. Its nice that we have a safety net so that everyone is defended to this fullest extent of the law. I would exercise my priviledge to hire my own attorney.
I am glad we have a Federally sponsored mail system. I am more pleased that I can use Fed Ex or UPS if I choose.
No more rhetoric. Tell our president to go back and try again
Dr. Hsieh:
I disagree with your statement that “There is no automatic ‘right’ to goods or services that must be produced by another — that would be state-sanctioned theft or slavery.”
Health care is not like other goods. We are all compelled to resort to it at some point, and are not completely free “buyers.”
China’s hospitals work on a strictly cash-payment-as you-go basis. If your wife gets cancer, you mortgage your house and spend all your money (and that of whatever relatives are willing to contribute). When the money runs out,if your wife is not yet cured, tough; she is left to die. That model seems to comport with Dr. Hsieh’s statements above; but do any readers here think it’s just?
Dr. Hsieh also assumes that ability to pay reflects desert or merit, when in fact it might just as easily reflect luck, corruption, or (in some countries) access to the right cronies or membership in the right dominant group. The market is always only one mechanism that assigns the ability to pay. The real world never completely fits with abstract libertarian models. How does an heiress “deserve” quality health care more than someone who happened to have been born poor? We don’t all start out on the same starting line.
The Hippocratic Oath requires (or used to) treatment of any in need, not just those who could pay.
Rights are just claims we have on each other. Even though the concept of “the commons” is frequently abused by liberals, I don’t believe in going to the libertarian extreme and denying that the commons exist.
Libertarians are sometimes overly afraid of “rights talk,” since it is so often used by liberals to empower an activist government agenda. Yet rights do not necessarily always imply government action. All children have a right to be loved, but can the government love a child? No, only parents can. But recognition of such a right can limit certain government actions and incline it towards strengthening families. Some rights and freedoms are negative
Tonestaple:
Jharp, this is a little one-sided, don’t you think? Were the doctors willing to do their work for free? If not, why not? Why do they not come in for your ire?
Was UCLA Medical Center willing to waive all their charges? Again, why do they not deserve your wrath for their uncharitable behavior?
___________________________________________________
You are a moron. Cigna is in the business of pooling risks. And then then refused to pay when they were legally obligated to pay. And a 17 year is dead as a result.
And your utterly moronic solution is to have the hospitals and doctors work for free?
Though I’ll credit you with having the courage to respond, unlike the other yellow bellies here, you have done nothing but displayed your ignorance.
Let’s cut the Gordian knot here.
If expense is the primary imperative, what’d going to be more expensive, a system without a high paid interface of government bureaucrats or one without?
And if “equality” is the primary imperative, what effect will this have on the population as a whole? After all, the costs of having an MRI scan is pretty damn high. If EVERYBODY is entitled to have them, it will be too expensive collectively for ANYBODY to have them. Do you really want to live in a world like that in the name of “equality?”
Leishman, with your 35 years experience as a physician, I surmise that you have seen a number of things. One, the more affluent tend to be more healthy. Two, more resources are devoted to the patient near the end of the patients life, than at any other time.
So, why not build a system around these realities, rather than what a patient wants.
In other words, let doctors practise medicine, and frankly not turn some patients into walking laboratories.
Because one of my aunts, the only sister of my mom who is younger than her, abused prescriptions
and is now suffering from Alzheimer’s. She was, and still is, a fussbudget, but that is only part
of the picture.
So, let the bills be paid, overhead lowered so that there is more money winding up to pay doctors and nurses, and less money to those who shuffle paper.
@98. jharp: – How about we try the definition of bankruptcy?
No problem. In fact, I’ll give you an advantage. I’ll demonstrate that Medicare is not only financially bankrupt, but morally and intellectually bankrupt as well.
Pay attention.
“Bankruptcy is a legally declared inability or impairment of ability of an individual or organization to pay its creditors.”
Okay. Medicare derives “income” from four basic sources, these are:
1. Directly withheld payroll taxes, seized at the point of a gun and/or threat of imprisonment from working taxpayers.
2. Medicare member premiums which – because they typically come out of the money that members receive from Social Security benefits – are essentially a wash in terms of overall federal revenue. That is, it’s “income” in name only – it is ultimately little more than a transfer from one federal accounting line to another.
3. Taxes – again seized at the point of a gun and/or threat of imprisonment – on the Medicare benefits that are paid out on behalf of members. Essentially, this is a tax on the benefit that has been paid for via a tax.
4. State transfers – once again, these are coerced through federal threats of withholding State funding of various programs paid for by each State’s resident Taxpayers.
What a scam, eh?
Together, these sources of income don’t come anywhere near the amount required to pay Medicare’s creditors. In order to do that – which they do, by the way, at a rate that is 20% lower than private insurers, backed up by federal law – the Medicare system must steal an increasing amount of money each year from the federal budget’s general revenue fund.
You might wish to parse this theft as “borrowing”, even though the resulting “loan” earns no interest and will never be repaid in any case, i.e., it is not “borrowing” by any conventional definition one will find. It is speciously “legalized” theft of Taxpayer dollars to pay for a federal entitlement, i.e., redistribution of wealth.
All that said, even if it WERE “borrowing”, since the Medicare system has no other source of income available to pay this NEW creditor – the U.S. Taxpayer – it is perpetually in default on that debt.
As of this year, and going forward, Medicare is so completely incapable of meeting its expenses that by 2012 it will be forced to rely on deficit spending to make up the shortfall. So not only can it not sustain operations through the outright theft of U.S. Taxpayer dollars, in two years it will have to borrow from the Chinese, et al., in order to continue operation. Again, since Medicare has no financial resources available to pay THAT new creditor, it will remain perpetually in default on that debt as well.
Each year, the Trustees of the Social Security and Medicare trust funds release – i.e., they legally declare – these facts, that is, they outline precisely how Medicare is perpetually in default and unable to pay its creditors without the theft of U.S. Taxpayer dollars. They provide detailed accounting of Medicare’s expenses, income and the amount it takes from the general fund to make up for the difference (see Chart D for history and projections).
Therefore – based on your definition – Medicare is financially bankrupt.
The Medicare system is based on intellectually bankrupt reasoning, as demonstrated by the fact that it is allowed to operate at an increasing deficit, annually, with the clear understanding that at some point the piper must be paid and the system will have to be shut down – those retirees in the plan at that time will be left in the lurch.
The Medicare system is based on morally bankrupt reasoning, as it must resort to extortion in order to maintain its membership. Retirees who wish to opt for an alternative to Medicare are robbed, through federal policy, of the Social Security benefits they’ve paid into for decades.
Oh yeah… QED.
david–
Not sure I understand your comment as pertains to walking laboratories.
Yes, the affluent tend to be more healthy, although the death rate for all of us is 100%–it’s just a question of when! The affluent smoke less, eat fewer non-nutritious foods and statistically have higher IQs. But correlation does not necessarily mean causation.
End of life care is another matter. My dad died of cancer in his assisted living facility and never entered an ICU. Same for my father in law who had a stroke–three days in the hospital for comfort care and it was over. But often when a patient is sent to the ICU, where care is most expensive, the doctor doesn’t know in advance who will be at death’s door and RECOVER, with years of useful life ahead, and who will go on and die despite all attempts at treatment. When the doctor’s unsure of the outcome, not many families say, “Oh, don’t spend the money, let’s just let grandma die and save the money for someone else.” In fact, I have never heard a family member say something to that effect. Terminal cancer is one thing, but major trauma or temporary kidney failure is another. Same for neonatal ICU care.
If a pro football team pays big bucks for a new quarterback, and the team wins the Super Bowl, it appears to have been a great investment. When the team finishes dead last, in retrospect it may not seem to be money well-spent. Team owners, like doctors, try to do the best they can with the information available at the time.
#106
So, let the bills be paid, overhead lowered so that there is more money winding up to pay doctors and nurses, and less money to those who shuffle paper.
It is intrinsic, in the nature of government bureaucracies, that the most money comes to those who shuffle paper. And given the opportunity they multiply at a rate like bacteria on road kill on a hot and sunny day.
I, for one, don’t want to give them the opportunity.
“Health care is not like other goods. We are all compelled to resort to it at some point, and are not completely free ‘buyers.’”
Unlike food? Shall we socialize all food-related payment methods? (Not to mention we’re already far down that path, of course, with all the idiotic regulations on agriculture, and the even more insidious subsidies…)
Will it be ObamaRestaurant insurance next? Or, at least ObamaGrocery Care?
@103 David Murray
Unlike many of the other comments, this is a polite, reasoned argument against Dr. Hsieh’s positions. The whole health care debate rests on fundamental ideas, including ones you mention like what “rights” are.
While I think you’re incorrect on every serious point, I strongly applaud your lack of malice and your attempt to ground the debate on fundamentals. This is something advocates of any position would do well to emulate.
Aren’t there about 100 million self-described liberals in this country? Why don’t they all get together on Facebook and form an insurance company that does all of the wonderful things they claim ObamaCare will do and just don’t let anyone who isn’t a liberal sign up for it? I know why, which is because they need the cash from people like me, guys whose free-market views have led them to actually do something with their lives and make some money, rather than sitting around on my *ss waiting for some politician in DC to sign some law making my life better. The only thing I ever took from the government was student loans, which I am paying back. And these people want me to subsidize their health care? I. Have. My. Own. Bills. To. Pay. Get. Your. Own. Money.
BTW, Lehman Brothers had $600 billion dollars in assets when it filed for bankruptcy. The problem was that it had even more than that in liabilities. Same as Medicare. That’s how Medicare is bankrupt.
Jeff Perren:
“Health care is not like other goods. We are all compelled to resort to it at some point, and are not completely free ‘buyers.’”
“Unlike food? Shall we socialize all food-related payment methods?”
You are right unlike food. You can’t be denied the right to buy food. They have to sell to everybody. And have to offer everybody the same price.
Unlike health insurance.
And then there are the dual consequences of rationing as Dr. Hsieh (correctly) defines it (because “price rationing” is a term of art, “rationing” a commonly understood term): the black market, and special privileges. Example of the latter: I went to high school on a military base in Great Britain in the 1980s; every man, woman, and child received a ration card for (IIRC) gasoline, alcohol, and cigarettes. Ration cards of minors had the alcohol and cigarette blocks blacked out.
Except my friend, who was the daughter of the wing commander; her cigarette blocks were always juuuust fine. (No, she wasn’t 18; she was the youngest in our class and wouldn’t turn 18 until halfway through her freshman year of college.) (No, it wasn’t that her parents smoked and children of smokers had cigarette rations that their parents, but not they, could use; my dad smoked but hers did not, and my sister’s, brother’s, and my ration cards did not entitle us to cigarettes.) It didn’t seem to be a fluke; every time she got a new card, it was the same.
There was no particular need for a black market in that time and place, since if you ran out of rations you could buy what you wanted “on the economy” – though I was a silly teenager and didn’t consider the difference in price.
goy:
Pay attention.
“Bankruptcy is a legally declared inability or impairment of ability of an individual or organization to pay its creditors.”
_________________________________________________
A long post doesn’t help you idiotic statement that “Medicare is bankrupt”. Are you really this ignorant?
Read the first part “Bankruptcy is a legally declared…” And then stop and think.
Are you claiming that Medicare has “legally declared” anything? Good grief!
Save your time with the long posts. It only confirms your ignorance.
“Are you kidding me? That’s exactly what we have the right to do. It’s called lobbying, genius. Right wing neoconservative idiots lobbied for a bull**** War in Iraq, and I had to pay for it. So now I’m lobbying for health care, and you right wing nuts will have to pay for it.
Sounds pretty fair to me.” Dale
Understood. A “right” is anything a large or influential enough group can get the Federal Govt to do. Now, if those pesky Jews don’t want to give up their property or donate their time to worthy causes, why we can just break a few shop windows and they’ll fall right in line!
“Just as you wingnuts had the same right to dictate to me that I had to pay for your trillion dollar unnecessary war using the govt as your proxy. (minus the time and efforts of which don’t apply to either case)
Go sign up for a civics class. Most of us completed it in the 7th grade. You must have been absent that year.” jharp
Got it. Goods and services delivered on the free market by private individuals engaged in what should be voluntary trade is no different than Constitutionally designed national self-defense provided by the Federal Govt under that charter.
Apparently, we were taught very different things in civics class. But then, you may be younger than I; I understand things have changed a bit in 7th grade in the past 30 years.
116. Anonymous:
Go sign up for a civics class. Most of us completed it in the 7th grade. You must have been absent that year.” jharp
Got it. Goods and services delivered on the free market by private individuals engaged in what should be voluntary trade is no different than Constitutionally designed national self-defense provided by the Federal Govt under that charter.
A very poor way to put it as it clearly is not a free market.
But yes, Medicare and a public insurance option pass Constitutional muster just well as the military. How someone can’t understand that is astounding.
“Apparently, we were taught very different things in civics class.”
No. I’m sure it was pretty much the same. It is just that you obviously failed to grasp what is rather obvious. Or you are a liar.
@115. jharp: – Are you claiming that Medicare has “legally declared” anything?
Yes. And I provided the link where they did so.
Cover your eyes. Stick grapes in your ears. Yell “LALALALALALALALALALALAAAA” all you like.
It doesn’t change the facts: as clearly demonstrated, Medicare is a morally, intellectually and financially bankrupt institution.
QED.
“You are right unlike food. You can’t be denied the right to buy food. They have to sell to everybody. And have to offer everybody the same price.” jharp
No, “they” don’t.
There is no such thing as the “right to buy food.” There is only the right of voluntary trade. I.e. you can offer money (or labor, etc.) in exchange for food at a certain price. The seller has the right to accept the deal, or to turn it down. The seller has the right to set the price for you at $X and $Y for someone else, or the same person different amounts at different time, under different conditions, or anyway he likes. The buyer has the right to offer to pay more, less, or the same as someone else or something different at different times. It happens all the time.
That’s called freedom. You should recognize it. It’s the thing you’re against.
P.S. In the case of an insurance company denying a claim, there may be in given circumstances a violation of contract, one that a party has a right to press and the government has an obligation to enforce.
Somehow, I don’t think Progressives are all fired up about enforcing contract law in health care/insurance. They simply want to force others to provide a good or service at a price and under conditions they deem “fair” — even if it means turning the providers into slaves.
@117. jharp: – … Medicare and a public insurance option pass Constitutional muster just well as the military.
Wrong.
“Healthcare is a personal service, not a group service such as National Defense, Law Enforcement, and Fire Suppression. Each of those entities do not serve the individual, they serve the community as a whole. The police are under no obligation to protect you personally; if you need that, you need to hire someone. Fire departments suppress fire for the good of the area; if your building needs to be sacrificed so be it. Should you need better protection, again, you need to have your own equipment and staff. The Armed Forces? Well, 9/11 should tell you that even with their protection from foreign threats you are far from personally protected from harm. And should an armed force actually fight on US soil, you would find quite quickly, the fight is not about protecting you personally or your personal property, but protecting the freedom and sovereignty of the US as a whole.”
“I agree with your assertion that the wait time for many procedures in Canada has dropped.”
I’m sorry, but this is provably false.
As a person who lived in Canada for many years, I greatly tire of the left-wing romanticism regarding that country. It’s a great place, in its own way. But its health care system is an unmitigated disaster.
Their own politicians routinely state as much in their major publications. Even as it stands – long wait times, inability to get a GP without getting on a months-long wait list (if you’re lucky), lack of quality care and preventive medicine/screenings, et cetera – it has been going bankrupt for years. They keep finding new things to tax to keep dumping more money in it, and it keeps blowing past cost estimates and budgets.
You are more likely to be denied life-saving care in Canada or Britain than you are in the US. True, part of this is because of our extremely litigious society, but there it is. Socializing medicine does not fix the real problems we have in health care. It only exacerbates them – which shouldn’t be a surprise, since all the problems in our health care system were caused by government in the first place.
It is endlessly frustrating how the statist can pitch ‘solutions’ that one only needs to look around the world to see don’t work. Then, when you list all the problems with their ‘solution’, they immediately accuse you of ‘lying’ or ‘being in the pocket of big business’. Actually, I work for a small business, but I still mostly like my health care. I’d love real reform that helped drive prices down. The free market is the only way to do that.
GOVERNMENT REGULATION HAS NEVER DRIVEN DOWN PRICES AND NEVER IMPROVED QUALITY. NEVER.
In common usage, the term “rationing” is sometimes used to describe market forces such as the price mechanism and supply and demand (Ken’s reference to Sowell). Nevertheless the fact remains, the term rationing stems from the war time government-imposed system of distributing specific goods…i.e., force is the essential ingredient that defines rationing. In the free market, force is necessarily absent, because all legal private associations are voluntary. The legal use of physical force is the exclusive domain of government.
It is force that is conveniently ignored by Ken’s perspective. Far from being a mere “linguistic jui-jutsu”, the issue of force vs. voluntary association is fundamental to the alternative of dictatorship vs. freedom. It is otherwise intelligent thinkers like Thomas Sowell who do the greatest damage to the cause of freedom by perpetuating the Left’s equivocation of government and private action. (I am assuming Ken’s accuracy in regard to Sowell.)
Rationing is government distribution of goods and services, as in both World Wars. It is force, and nothing else. There is no coercive central distributive authority outside of government (or government controlled quasi-private insurance giants), only millions of individuals producing and trading by voluntary mutual consent. But however one chooses to define rationing, the choice is stark. The choice is voluntary human association or brute bureaucratic state force; earned wealth or the unearned; market justice or “social justice” (wealth redistribution); the dollar or the gun; freedom or slavery.
Dr. Hsieh has done a masterful job of differentiating between government rationing and market freedom.
So jharp says that as long as medicare doesn’t formally declare bankruptcy,and keeps running at a deficit,funded with tax dollars generated by governmental extortion,it’s financialy solvent.So what jharp is really saying is that if you parse the language enough,he can twist anything to fit his protean argument.The figures don’t lie,but liars figure,eh jharp.How many times has a Canadian,with practical experience,refuted your assinine assumptions about socialized health care,only to have a discorteous response reflexively thrown their way?You are a fascistic,disingenuous liar and a colossal fool.
goy:
@115. jharp: – Are you claiming that Medicare has “legally declared” anything?
Yes. And I provided the link where they did so.
__________________________________________________
Really? I missed it. Care to post it again?
And what bankruptcy court is hearing the case?
You are an utter buffoon. When you find yourself in a hole the first thing to do is STOP DIGGING.
AtheistConservative:
“I agree with your assertion that the wait time for many procedures in Canada has dropped.”
I’m sorry, but this is provably false.
As a person who lived in Canada for many years
_______________________________________________
The Canadian health care system has nothing to do with ours.
Obama Care does not even remotely resemble the Canadian system.
And why you ignoramuses keep bringing it up like it is relevant is blatantly dishonest.
goy:
@117. jharp: – … Medicare and a public insurance option pass Constitutional muster just well as the military.
Wrong.
_________________________________________________
Ahhh, I see. Medicare, in place since 1965, is unconstitutional.
As are the interstate highways.
It’s gotta be tough going being a wingnut these days. Always that ugly thing called the truth that makes you look like the uneducated ignorant fools that you are.
Stick to the teabagging and shout downs. That’s all your ignorant base can comprehend.
Thank you Dr. Hsieh for another great editorial. And though economics are of course important, I really appreciate that you’ve chosen to focus on the more fundamental moral issues–and done it so adroitly to boot!
#78 Pete G. “Sometimes it helps to think first and then write.”
You should take your own advice.
Re police: There would be no reason for the law if the government would not enforce it. However, there is some room for and actual usage of private “police, i.e., security patrols, armed guards, private detectives, and so forth. Re firefighters: The requirement that the government provide them is less clear, I admit, but this only means that private firefighters would be more acceptable than private police.
However, there’s a more general reason why certain services ought to be provided by the government: When it is impossible or nearly impossible for an individual to buy a given service, owing to the very nature of the service (not any inability to pay), the government is the only possible provider. For example, you could not pay truckdrivers to use mudguards, even if you only got splashed a few times a year and could easily afford it, because it is impossible to predict which truckdrivers would splash you.
Now, clearly, there is no such obstacle to individual buying of medical care, nor anything the government does which would make it illogical for the government not to provide it. Therefore, a government that simply takes it over, and prohibits private buying or even significantly damages the possibility of private buying, violates the rights of the individual.
McBride:
“So jharp says that as long as medicare doesn’t formally declare bankruptcy,and keeps running at a deficit,funded with tax dollars generated by governmental extortion,it’s financialy solvent.”
Yes. That is what I am saying.
Or more simply put. Medicare is not bankrupt.
By you fools logic the United States of America is bankrupt.
As well as every college student who borrows money to pay tuition.
Let it go. It’s flat out false. Just because Rush and Hannity and O’Reilly say it does not make it true.
Oh, and McBride, I’ll say it again. The Canadian system HAS NOTHING TO WITH US.
NO ONE IS OR HAS PROPOSED A SYSTEM SIMILAR TO CANADA’S.
Why is that so hard to understand?
I wouldn’t care how inefficient or expensive private coverage is, the Federal government has no, zero, nada, Constitutional authority to create a national health care plan. Why the heck people aren’t being more vocal about that fact is driving me insane.
Obamacare is unconstitutional!
“But yes, Medicare and a public insurance option pass Constitutional muster just well as the military. How someone can’t understand that is astounding.”
Sorry but they don’t. If they do please cite where in the Constitution one would derive that authority.
“I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence (OBAMACARE – mine), the money of their constituents.” – James Madison
#113 jharp
“You are right unlike food. You can’t be denied the right to buy food. They have to sell to everybody. And have to offer everybody the same price.
“Unlike health insurance.”
That’s nonsensical. One seller of food is not required to offer people the same price that another seller offers, but if you’re talking about the same seller, the analogy to insurance does not hold, because, with food, the cost to the seller does not vary with who the buyer is.
Your messages consist largely of insults mixed with specious arguments. I would like people to notice that a rational discussion is not what people like you want. What you want is violence – insults and abuse will do until you get enough power to make winning by violence likely enough. If you think this assessment is too extreme, just ask yourself how “arguments” like yours would ever persuade someone who valued rational discussion. They obviously could not.
jharp is at it again!
So Obama care is’t Canada,England,Sweden,France, Etc.
Then what is it jharp!
please explain to all of us dumb people!
Da Da Da Da Da
I thought so!
Every country above has goverment care and all have extended wait times over the US.
Aknowledge this first.
We win that argument not you. NEXT
The cost of total expenditure to the average taxpayer will go up.
Goverment cant do anything cheaper than the private sector.
Name me one! You can’t We win that point also. NEXT
I have a friend who is a CEO of a large metropolitan hospital in PA. The hospital he manages has a ratio of 60% Goverment care (Medicare, Etc.) and 40% of the care is for private insurance patients. His revenue from medicare and other goverment agencies is 40%. He makes up for the loss with private donations. Now tell me how he will manage to pay additional costs for goverment care when he receives 2$ for every 3$ work.
TAXXXXXXESSSS!!!!
Oh yeah, I forgot, jharp said we could save on toilet paper. He would stop spewing all his crap!
jharp…I noticed that you were continuously posting today. Are you retired? On vacation? Home sick? Or is this your day job, to post in forums like this (my guess)? Or are you cheating your employer? Or, most likely, are you a government employee?
Just wondering how you have the time to post continuously.
jharp only shows up for Obamacare discussions. One has to assume that jharp is being paid for the comments and interaction, otherwise you would have seen jharp show up elsewhere…Now and Then, at least, is a general purpose Leftist.
I must be in heaven, there are so many harps here.
There’s one argument I haven’t addressed yet, the one about “You guys forced us to pay for the Iraq War, so now it’s fair for us to force you to pay for ObamaCare.”
This is such a silly non-sequitur, I’ll respond in an equally silly way.
Tell ya what.
The war will have lasted about 10 years (once they get all the way out), and cost about 1 trillion dollars. (Much of that cost would have been incurred anyway, even if the troops went nowhere, but never mind.)
I’ll ok you forcing the American taxpayers to pay for 1 trillion dollars worth of health care/medical insurance for 10 years, but all insurance companies, doctors, etc participate voluntarily. After 10 years, it expires.
How’s that sound?
Leishman, when I refer to walking laboratories, I refer to the not un-common practise of patients consulting more than two doctors, and they wind up with plenty of prescriptions that would be sufficient for more than a healthy person. But, that has to deal with prescribing.
When too much money is spent on people who shuffle papers, ergo not enough is spent on doctors and nurses. Therefore, a model which assigns a higher priority to the practise of medicine, rather than keeping paper shufflers busy.
I recommend “Code Blue” by Dr. David Gratzer to put more flesh on what I said.
134. Kevin S:
None of the above.
I’m self employed and my business is seasonal. Thus, plenty of free time on occasion.
Is health care rationed? Sure. I pay an insurance company for the prospective costs of my health care — but that’s ok by me, because they only want my money. If I decide not to pay the money, we part ways and there are no hard feelings.
If the government provides my health care, then it won’t just want my money. It’ll want my obedience, too: “lose weight, report for mandatory calisthenics at 0645, don’t eat this or that, don’t expect much once you’re no longer a productive citizen–who did you vote for, again?” etc. etc. etc. And if I should decline to pay the money, you can be damned well sure that we won’t part ways without hard feelings on somebody’s part.
“The Canadian health care system has nothing to do with ours.”
Standard troll tactic – when defeated on a point, change your argument.
The point was that no socialized system can be shown to be better than our slightly-free-market system; that, in fact, all of them can be shown to be significantly worse. The further point was that all the problems with our system are the direct result of government intervention.
This is all irrelevant to the specifics of Obamacare, but only because nobody knows what Obamacare is. We know a lot of the horrible details the Democrats want, we know what went into various drafts of bills, but there is no definitive form. In fact, he just announced that he was going to draft, on his own, a bunch of lofty goals and present them – something he probably should have done before getting on the soapbox.
The only unifying factor amongst all the different types of Obamacare that have been pitched is that they are all awful, they exacerbate the problems that exist, they generate government-backed monopolies thus giving more money to the ‘greedy special interests’ that you profess to hate, they worsen care, they cost exorbitant amounts of money and only cost more as time goes on.
Namely, every version of Obamacare that has been pitched has failed to meet a single one of Obama’s own lofty, preachy goals.
Socialized medicine always does. And that’s where it all comes full circle: your endgame is not an effective solution. The only effective solution is removing the existing government regulations and opening up health care as a free market.
sure.
Political seasons (ok, granted, we’re sorta in a political off season)? Self employed, as in being paid to post for Obamacare; self employed as in being a political hack? Still just wondering. I would bet that the majority of people posting to this site have real jobs.
“I’m self employed and my business is seasonal. Thus, plenty of free time on occasion.”…being older, my memory is not what it once was, but this rings a bell from a previous Q&A at this site with someone else who wrote quite similar posts…
Note also, that jharp did not deny being paid to post on Obamacare, only that jharp is self employed…a rather ambiguous declaration.
137. Jeff Perren:
There’s one argument I haven’t addressed yet, the one about “You guys forced us to pay for the Iraq War, so now it’s fair for us to force you to pay for ObamaCare.”
This is such a silly non-sequitur, I’ll respond in an equally silly way.
Tell ya what.
The war will have lasted about 10 years (once they get all the way out), and cost about 1 trillion dollars. (Much of that cost would have been incurred anyway, even if the troops went nowhere, but never mind.)
I’ll ok you forcing the American taxpayers to pay for 1 trillion dollars worth of health care/medical insurance for 10 years, but all insurance companies, doctors, etc participate voluntarily. After 10 years, it expires.
How’s that sound?
____________________________________________________________________
Fair enough for me. And then it get’s reviewed and changes are made for the parts that don’t work.
You teabaggers are good negotiators if nothing else. You blow a trillion for nothing and we try to spend a trillion to benefit all Americans and it comes out as a compromise.
I think you won’t do nearly as well when this is over.
Re jharp: “I’m self employed and my business is seasonal.”
It all makes sense now. No wonder you’re dying for free government handouts. Does your “plenty of free time” include sharpening your mower blade perhaps? Or are you more of an “agricultural” (ie apple picker from across the border) type?
Get a real job jharp or man up and pay for health care like every other self-reliant grown-up does. Why should you get a free ride (and I’m not referring to your John Deere)?
Kevin S: You are good!! My hats off to you. I think you’ve cracked the nut that is jharp!
Jharp-you so full of it your slipping on it.Canadians do have to wait for tests and scans because of a lack of equipment and personnel.A friend of mine needed surgery on his stomach and had to get on a waiting list.In the meantime he had to wear a bag around his waist for almost a year so his waste didnt poison his insides(his intestines werent working properly) and had to empty it everyday.Almost one year Jharp.This is why canadians who do have money go south to get treatment since they can get it right away.
This is why leaders from other countries come to America for medical treatment because it is more advanced than their own “universal” healthcare systems and in some cases like Mid-East countries NO healthcare systems.
Your own ignorance of the “universal” healthcare system is whats astounding here.
I know this is way earlier in the comments, but:
jharp @ 20:
“England system is not even close to any resemblance of Obama Care. Not even close. You obviously don’t even understand what socialized medicine is.”
You go on to say:
“France has a wonderful system. We’d be very lucky to have a similar one. No one. No one is denied care. And it aint socialized Medicine.
And they deliver the same quality of care we get in the U.S. For 1/2 of the cost.”
jharp @ 125:
“The Canadian health care system has nothing to do with ours.
Obama Care does not even remotely resemble the Canadian system.”
I take it then you believe Obamacare will be more like the French system of public health insurance. According to wikipedia, in France, public health insurance is mandatory. There is private health insurance, but it is relegated to paying for what the public insurance does not. Reimbursements to physicians are through the publicly funded insurance funds. Deductions are automatic from paychecks into these public funds. Public insurance requires co-pays and deductibles (the wiki article provides some examples).
This is “universal coverage.” The article says 77% of all health care spending is covered by the government. It says that in France they tax you 5.25% for universal coverage on income, and 3.95% on benefits (pensions).
We’re already getting taxed at 2.9% for Medicare as a payroll tax. Do you think we can simply bump this up to 5.25% (and charge Social Security recipients a 3.95% tax on their benefits) and get universal coverage like France?
People will still want supplemental policies to cover co-pays and things the “universal” coverage won’t. But is this doable? If not, why not?
well written Paul, thank you. you have cut right to the whole issue.
it really is a case of do the people want individual rights or not. and I say that most do want individual right.
only those who do not know what is really at stake would give up their freedom and that many of those are not actually aware that they are giving up their rights and freedom. …WE SEE A LOT OF THEM HERE.
As a dual citizen of both Canada and the US, with the documentation to prove my status,birth certificate and passports; I can speak through personal experience about both systems. Although I am fortunate to be very healthy, I have had injuries working with livestock in both countries and have received excellent emergency care in both countries.
However, since my physician in Canada was a friend of mine, he would unload some of the frustration that comes with Socialized Medicine. He told me that 50% to 80% of the people in his office because they were bored and they wanted attention from a doctor. There was nothing wrong with them, but a visit to the doctor breaks up the monotony of a welfare day. Of course my friend’s nature made people think that he was really interested in their pathetic neurosis, so they came by the hundreds for a few minutes with the doctor. He made a fortune, but it nearly drove him to insanity. He retired early and moved to New Zealand.
The point is, we should be thankful to be able to provide the welfare class with entertainment and attention while we are at work and drawing an ever decreasing paycheck each week. This is wealth redistribution on the Marxist model, fight it or learn to love it.
Has anyone noticed where jharp is getting his information? He provides links to articles from Newsweek, Time and then of course there is the New York Times. Funny, he considers this tabloid style news the real deal. He picks up a copy of Newsweek when in line at the grocery store. He reads it and condsiders himself well informed. Or perhaps he sits artfully posed on display at some city sidewalk cafe reading his New York Times while sipping on his frothy cappuccino. Hardly the intelectual I’d say. In fact he really strikes me as a young impassioned fresh out of school college kid. Go easy on him boys.
Let’s see…Boris was a global-warming trollbot…apparently jharp is an Obamacare trollbot…Shadow…hard telling…Now and Then, well…just an apologist for the global killing machine known as Leftism. As a couple of others here have said, just ignore them; they’re being paid to place posts…(well, maybe not Now and Then, those aren’t really literate).
stop feeding the trolls
…they (as you can see)use contradictory arguments in the same piece. they are ideoligically unable to debate honestly since they are not open minded and willing to look at both sides. they are unwilling to apply critical thinking to ..well most anything.
they are the jailers in different times or societies. or they are leaders (not real leaders but part of the governing regime) of those societies. or they are the true believers who have an axe to grind against their neighbour.(they are the ones who want to take what you earned for themselves under the guise of equality …they are the ones who take it from you and claim to give it to the poor) …did I just describe MARXISM ? I HOPE SO BECAUSE WHETHER THEY KNOW IT OR NOT THAT IS WHAT THEY ARE)
and yes they are our neighbours !
No doubt David S. believes that the those rationing lines in the Soviet Union of old were the model of justice and fairness.
jharp, do you think it’s possible to disagree without being disagreeable? You come across as very angry and not very rational. If I could be so bold as to offer a suggestion, you might try addressing people’s points and then try *not* calling them names. I’m just saying.
http://markepstein.wordpress.com/
MARK EPSTIEN followered your link ..great site
Ken said:
“I’m using the definition used by a noted economist; [Dr. H is] using one used by a noted philosopher.”
The problem is, Ken is making a rationalistic Appeal to Authority. Dr. H identifies the author of the definition but, additionally, provides the facts of reality which actually support that definition. Ken does not. He simply says because he considers Mr. Sowell “possibly the most brilliant” economist alive, he puts “more weight on Mr. Sowell’s definition than Miss Rand’s.” However, Ken does provide an inadvertent clue as to why he accepts Mr. Sowell’s definition. He says:
“We should … explain why us giving control of those choices to the individual is better than giving to the government.”
This is the problem premise. NO ONE ‘gives’ control of those choices to the individual. Individuals have that control BY RIGHT. And it is the government which is trying to VIOLATE that right by attempting to forcibly take control of those choices AWAY from the individual.
This is the point Ken keeps missing. He proceeds from the premise that some unspecified “authority” GRANTS this control – and that people must ‘choose’ to whom this authority ‘gives’ this control. That is the opposite of the truth. Each individual possesses such control naturally. By RIGHT. By the mere fact of being human.
Ken’s false premise thus leads him to identify the *exercise* of rights and the *violation* of rights to be the SAME thing – to be ‘giving control’ (as he puts it) of choices – ie to be rationing. Obviously the *exercise* of rights and the *violation* of rights are NOT the same thing. As such, the attempt to classify them as the same (rationing) is to engage in a blatant contradiction – one which has already been identified: equivocation.
By accepting this contradiction, Ken accepts the fundamental premise of his opponents – and loses his argument before he has even begun it.
Now Ken says:
“What we can not afford to do is say that there’s no rationing taking place, and make it sound like we think no choices have to be made.”
No. The truth is, what we cannot afford to do is claim the violation of rights (rationing) is the same thing as the exercise of rights (trade). THAT is the choice to be made here. There is NO other.
Finally, Ken says:
“My fear is that there will be many who see our attempt to say it’s not rationing as deceptive.”
Then, like Ken, such individuals must be educated. They must be taught the fundamental difference between trade and rationing – between rights and their violation. Dr. H’s article is a very good step in that direction.
What we cannot do – what we must not do – is let “fear” stand in the way of such education.
@124. jharp: – I missed it.
Not surprising. But there’s a simple solution: go back and re-read the post.
@126. jharp: – Medicare, in place since 1965, is unconstitutional.
Yes. I’ll be sure to quote you.
@jharp, David S., et. al.
I’m curious. From all you’ve written, I think it reasonable to assume that you assert, if you haven’t actually done so, a right to health care, which for all practical purposes, means medical care and treatment without regard to cost or personal expense; that regardless of ability to pay, care and treatment should be provided. Ok. But my question is simply this: From whence does this right derive? Natural law? Ecclisiastical law? The US Constitution? If you think any of these, then I believe that would news to many who make a study of such things. So where exactly?
Many have asserted such a right, you would not be the first. It’s not enough to respond by writing some variation on “Well, in a civilized society…” That may well be true, but it doesn’t answer question asked. Where does this right come from?
hmpf. America hasn’t had a free market system in place since 1913 and arguably not since before the Civil War.
#152 TakomaGirl
“Has anyone noticed where jharp is getting his information? He provides links to articles from Newsweek, Time and then of course there is the New York Times. Funny, he considers this tabloid style news the real deal. …”
Yes, good point. That’s what many leftists do in comments threads, not only on this site. It’s not that those sources are all wrong; they’re OK to use in certain ways. But the way these people use them is usually not OK; e.g., the cover of Newsweek says “the climate is crashing,” and they say, “See, the climate is crashing. Why are you lying about this, wingnut moron?”
I would like to recommend everybody to re-read comment #74 by Dr. Leishman.
Dr. Leisman: I can tell you how problems you described are working out in Canada.
Health care is financed by federal and provincial sales taxes, and this way everybody are forced to pay their share, even tourists and illegals. This way every Canadian is garanteed to get health care treatment from birth to death, regardless of employment, pre-existed conditions, and alike. Nobody is fined for not having health insurance, because only total fool or mentally ill homeless will not enroll if 90% of premiums are already paid for. There are no restrictions on spending per patient: everybody got treated according to his medical needs. Naturally, the system is not desighned to be top-notch, and there is rationing. Expensive treatments are rationed by budgetary restrains: every hospital has its yearly budget, and doctors (not buorocrats) decide who will get treatment first, and who will have to wait.
Canadians have the right to seek and purchase medical care outside of the system, but here is the rub: since almost all hospitals are public-run, it is prohibited to hospitals to sell to the “rich” right to go ahead of the line. Luckily, there is option to “go South” to US, where treatment could be obtained much faster. This way “moral dilemma” of having two-tier health care system is exported out of Canadian government jurisdiction. About 65% of Canadians have supplementary private health care insurance, which will pay for most tests, like MRI, and some (except for really expensive) procedures, with affordable deduction. More expensive supplementary insurance policies, covering all treatments, are available from US insurers.
As you rightfully noticed, many people decide that government coverage will suffice, and do not pay for additional coverage. And of course they demand “the best” when they got ill, and mull and yell and complain about horrors of Canadian health care system, forgetting that they decided not to pay for upgrade.
As I’ve pointed out elsewhere, “free markets” don’t work for health care. For one thing, when people who bandy about the term “free market,” what they are really referring to a competitive market where knowledgeable people are free to choose among competing vendors for products or services, hence putting pressure on the vendors to keep prices low while maintaining or increasing quality or features. For this to work in a health care scenario, the “buyers” would need to be able to know the range in prices for medical treatments they are interested in and then shop around for the best deal by a doctor, clinic, and/or hospital.
The problem is that most people have no idea of how good or bad their doctors or affiliated hospitals are, don’t like switching doctors regardless, have no easy access to comparative costs of even standardized treatments, and are are willing to pay almost anything to resolve an immediate serious ailment. For centuries if not millennia doctors were bound by moral codes like the Hippocratic Oath. The much more recent emphasis on profit is essentially at odds with and even undermines these underlying ethic codes — becoming a doctor is not suppose to be like becoming an investment banker. One is *suppose* to an ancient and honored form of public service while the other is just a way to potentially make lots of money regardless of quaint notions of morality. And one is all about “free markets” while the other is not and should not be.
DrCTR whines that I’ve “hijacked” the discussion by bringing up facts. In this way, DrCTR reminds me quite a bit of the Obama administration, in slandering those whose points they can not dispute.
Mike Zemack suggests “It is force that is conveniently ignored by Ken’s perspective.” Mike, I’m ignoring nothing. I’m saying that Dr. Hseih’s usage of the term is inadequate and improperly constrained. In the eyes of the voters, if it looks like a duck, and quacks like a duck, then it’s rationing. What the voters are worried about is that someone, other than them, will be able to decide whether or not a treatment is paid for. In their eyes, THIS IS RATIONING. That is what you are conveniently ignoring.
RadCap, on the other hand, starts by accusing me of an appeal to authority, by citing Thomas Sowell, while accepting Dr. Hseih’s appeal to authority by citing Ayn Rand. Dr. Hseih does not, as RadCap asserts, only list Ayn Rand as the author of the quote, but uses her definition, wholesale. His next paragraph does not justify his definition, but rather cherry picks examples.
Thus, I guess that appeals to my authorities are bad, appeals to Dr. Hsieh’s are good.
As expected.
RadCap then tries his hand at a little bit of psychoanalysis. And fails miserably. In response to me, he writes “This is the problem premise. NO ONE ‘gives’ control of those choices to the individual. Individuals have that control BY RIGHT. And it is the government which is trying to VIOLATE that right by attempting to forcibly take control of those choices AWAY from the individual.”
While I agree with what he says, there, I have to wonder if it’s REALLY all that different than what I said (only in less space). Really, RadCap, is complaining about what boils down to a difference in writing styles the best you can do?
All this, of course, makes me wonder if, when he writes “However, Ken does provide an inadvertent clue as to why he accepts Mr. Sowell’s definition,” has he ever read anything by Mr. Sowell? If he had, he would realize that “I’m assigning statist views to Ken that he doesn’t really hold, and then using those strawviews to connect him to the noted defender of free markets, Thomas Sowell” is an absolute and irrational non-sequitor.
Now, I don’t mind if y’all disagree with my views on the subject. But could you please at least disagree with MY VIEWS, instead of attacking me or making up views that I do not hold?
Or is this the best that the denizens of Pajamas Media can do?
jharp:
In a free society, you have no business, much less any “right” to determine what anyones interests are, much less lecture any adult on the subject. Just because you have a thieving mob backing you up in trying to steal from doctors and hospitals what isn’t rightfully yours to “give” to someone else you deem “worthy” based on their income doesn’t make you or your ideas right or good. It just shows that you will use the government to do your thieving for you.
The guy with the brain tumor who needs treatment could care less about semantics, and could care less who’s in charge of rationing. He just doesn’t want to die simply because doesn’t have the money or because he couldn’t get care soon enough. To say that he doesn’t “deserve” treament because he didn’t earn enough money to pay for it plays right into the democtrats argument.
BC, the Hippocratic oath doesn’t say a word about payment or lack of payment for treatment. It isn’t a priestly oath of poverty. It doesn’t even require that a physician administer treatment; the nearest it comes to that is in this sentence: “I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.” and that arguably, in the context, is an instruction as to how to administer treatment not when to administer treatment.
As I asked in #160, from whence does this presumed right come?
@164. BC: – As I’ve pointed out elsewhere, “free markets” don’t work for health care.
Keep pointing it out. People will keep ignoring your drivel because you fail to comprehend that the health care market in the U.S. is not a free market.
A free market is at least nominally unregulated by government. Yet health care, the pharmaceutical industry and the insurance industry are three of the most highly regulated industries in our society. HIPAA anyone? EMTALA? FDA drug approval regulations? Thousands of pages of legislative legalese micromanaging these industries?
Regulating a market to the point of dysfunction and then blaming the market for skyrocketing costs is the height of intellectual dishonesty, which is the one thing the left excels at.
A free market is one where the price of goods and services are determined by agreement between the provider and consumer. But how are health care prices determined? Look at any EOB (Explanation of Benefits) from an insurance company, like I’m doing right now. The provider billed $800. The insurer paid $467. Who was the consumer? Well, unless some insurance company employee got the porta-cath my wife needs for her chemotherapy, the consumer is me. Yet I had no say whatsoever in the price paid here.
Furthermore, through legislative price-fixing, government combines both of these ills by dictating what reimbursement can be paid for health care funded through Medicare and Medicaid. Again – NOT a free market.
Health care is “broken” precisely because there is no free market to keep routine health care costs down. Take an economics course.
@164. BC: – For centuries if not millennia doctors were bound by moral codes like the Hippocratic Oath. The much more recent emphasis on profit is essentially at odds with and even undermines these underlying ethic codes …
BC, you lefty trolls need to get your talking points and conflicting stories straight.
Zeke ‘Mengele’ Emanuel claims that health care costs have increased BECAUSE OF obeisance to the Hippocratic Oath, not in spite of it.
Zeke’s stupid comment is patently absurd on its face, of course. Any doctor will happily tell you that whenever they’re overly “thorough” it’s because the attorneys running our federal government refuse to enact tort reform, and because… “insurance will cover it”. The Democrats’ and the incumbent Hope’n'Change® Administration’s health care plan is a shining example.
“The guy with the brain tumor who needs treatment could care less about semantics, and could care less who’s in charge of rationing. He just doesn’t want to die simply because doesn’t have the money or because he couldn’t get care soon enough.” [Carl]
First, if that guy is truly concerned about that possibility (and what reasonable person wouldn’t be?), he should be first in line, and loudest, in advocating a free market in health care and various means of paying for it.
Second, whether it plays into Democrats views, Republicans, or that of anyone else, no one has a right to have their health care coercively paid for by others. It’s immoral to rob Dr. Paul Hsieh to pay Peter Cottontail, no matter how cute, pathetic, or even tragic a bunny he may appear.
Here’s a simple message to all looters and control freaks, no matter their need, motives, or goals: Keep your damn dirty paws off my wallet and my life!
To goy: as I pointed out in other threads, health care costs stayed within the average rise of the CPI until about 1960, when it started creeping up at a slightly faster rate. It didn’t really start to rise rapidly until the 80′s, when all of Reagan’s screwing around made things much worse.
That link you included is to an *opinion* piece at the WSJ, and those things these days tend to have about as much credibility as a teary eyed Glenn Beck. Indeed, when I looked through the article, there obviously a lot of “interpretation” going on. The article also cites the “National Bureau of Economic Research” in an attempt to put a lie to Emanuel’s co-authored comment that went, “The United States is No. 1 in only one sense: the amount we shell out for health care. We have the most expensive system in the world per capita, but we lag behind many developed nations on virtually every health statistic you can name.” The problem is that the NBER does little beyond pointing out when recessions start and stop, and is no position to make any sort of expert comment on how good or bad US health care is.
And if you do get cancer, you might want to think about a trip to France, regardless of your health care coverage is in this country.
Paul Hsieh has written a great article. We need ammunition like this if we’re to get the kind of health care reform that is just and meaningful.
Thanks to Dr. Hsieh for providing it!
Health care costs are not like the costs of commodities. Cost is usually related to supply, and the supply of health care is very much determined by policy. The availability of doctors, and nurses is very much determined by government and professional group politics. If the government invested in flooding medical schools with medical students and the needed facilities for their training, the payoff on that investment would be returned many times over by the very much reduced costly of Dr’s fees.
172. BC: – … as I pointed out in other threads …
Sorry. All you’ve done in any of the threads I’ve seen containing your commentary is to support my thesis at every turn. You should get that ADHD looked at. Or maybe a trip to France is in order if you think their system is so fantastique.
- … health care costs stayed within the average rise of the CPI until about 1960, …
Wrong. If you look at the chart you cheerfully provided, you’ll see that health care costs were right in line with CPI long after 1960. In fact, they began to diverge in the mid-70s, as various forms of more comprehensive health care insurance or insurance plans (like HMOs) were more widely adopted. This is all well documented in the book you cited a while back, but which you clearly never actually read (The Rise and Fall of HMOs). Your Reagan-phobia doesn’t explain that divergence at all. Neither does technological innovation, which was happen in all other commodity sectors as well without sending their costs through the roof.
Reagan didn’t “screw around” with health care. He pushed to take funds from programs the federal government had no authority to maintain, and send them back to the States to do what THEY determined was in THEIR Taxpayers’ best interests. Sorry you didn’t care for the outcome but it wasn’t the federal government’s money, and it certainly wasn’t YOUR money.
In terms of insurance company regulation or lack thereof, consumers are the ones who keep choosing to pay for a routine cost of living in the most inefficient and stupid manner possible. They have been duped by slick promises, corrupt politicians and laziness into believing that this will work in the long term. The facts prove otherwise. No one – certainly not Reagan – forced consumers to buy into comprehensive plans that now support a virtual monopoly of insurance companies which control the price of health care, all money transactions for health care and even access to most health care.
- That link you included is to an *opinion* piece at the WSJ, …
Oh do give it a rest with your insipid and desperate Poisoning the Well fallacies, okay? There was no “interpretation” involved in THE DIRECT QUOTE from Zeke ‘Mengele’ Emanuel, which is diametrically opposed to your nonsensical assertion. Take your issue up with Zeke instead of lamely deflecting to the messenger, troll.
@174. Albert: – Health care costs are not like the costs of commodities.
Right now, that’s correct. But not for the reasons you cited.
Commodity routine health care is no different from any other routine cost of living expense we incur. What makes health care goods and services unique is how we pay for them. Instead of paying for them directly, like all other routine costs of living, we pay through an insurance company. This is a direct misuse of insurance, which is a tool for mitigating risk, not for paying for a routine cost of living. That company has its own set of priorities, profit motive, business interests, regulations and other factors which ultimately add up to a conflict of interests when it comes to skyrocketing health care costs. The result is pretty indisputable.
A collection of comprehensive health insurance companies control access to most health care – not the government or government policy. They control the price and they also control virtually all transactions that aren’t handled by Medicare as well. This is as close to a monopoly as can be found outside of a single-company scenario. Health care costs will never reach an equilibrium with other routine costs of living unless that monopoly is dealt with and a free market is allowed to flourish around health care.
To goy: yeah, I used a more detailed and accurate chart at one point that showed the divergence at 1960, and I also used a better book reference, but the health care “debate” has since flooded Google with rivers and lakes of useless crap so finding things I had used just a month earlier has gotten insanely tedious. This is where Usenet kills blog sites: if I posted something intricately detailed and linked in Usenet, I can always easily reference it later. But with the blog sites, I think should start saving my better links for future reference.
This is too nice of an afternoon for politics — I’m taking a break….
@83. goy:
RE: 75. David S: – Rationing is fair. Rations ensure that everyone gets at least the bare minimum needed to get by.
The fact that this statement is unsupportable nonsense is beside the point, since rationing is neither desirable, nor necessary at this time.
I would argue that rationing is both desirable and necessary at this time. Health care is a public good, not simply an individual purchasing decision. We all benefit when more people have health coverage. There is no reason that we should not ensure at least a basic ration of health care for all our citizens. It would not only improve the health of the nation, it would also reduce the overall cost of health care. The current system is not desirable, nor is it necessary at this time. For-profit insurance is a poor substitute for true health care.
- … tens of millions have no access to health care …
This statement is hyperbole of the most unsupportable kind. Anyone who needs it can receive critical care per federal statute (look up EMTALA).
Critical care does not equal health care. Study the plight of the 40 million+ who are unable to access health care. Emergency rooms are not the answer, and your flippant dismissal of millions of your fellow citizens is hyperbole of the most unsupportable kind.
- No, the free market is worse than rationing, because it has priced so many out of a market for a very basic need.
That might be true if the health care market were a free market.
If the market did not face government regulation, the situation would be even worse. Health care is a public good – it makes no sense to leave each individual to fend for himself when it comes to the health of our people. It makes moral, political and financial sense.
- We already recognize the need for health care for the elderly in this country, and for those who are disabled. Public programs have been successfully and cost-effectively treating these populations in the USA.
Again. Wrong.
Medicare is bankrupt.
Medicare will never be bankrupt. Deficit spending is not bankruptcy. You may not like Medicare, but seniors do, and it will be there for them, despite your fantasies.
- In first world countries comprehensive care is freely available to all.
All? Really? And is that timely access? Or is it take-a-number-go-home-and-wait-for-a-letter-in-the-mail access? There’s no evidence to support your wild assertion. As usual.
There are more than thirty countries with better access and better outcomes than the USA, and all of them spend less per capita and cover everyone. The evidence is everywhere, and you have seen it before. We are the only western country that provides better health care for the incarcerated than we do for the general public. Think about it. Millions of your fellow citizens pay taxes to support health care for criminals that they can’t access without getting arrested.
This is not the land of the free or the home of the brave when children are put to death by their so-called “health insurance” company.
It is time to make this right.
Peace.
DS
Thank you, Dr. Hsieh, for honing in on an important distinction: rationing is not the same as a person making a choice about what to do with their money.
A ration is a “fixed allowance” of a finite, short amount of a good or product that is not easily replenished. I.e., there is a limited supply to go around, such as food and water for shipwrecked sailors on a desert island, or gasoline when the government institutes price controls on oil (as it did in the early 1970’s).
When I want something that is rationed, I have to sit and wait to have it doled out to me by some authority figure. I don’t make the decision about what I get or not; someone else makes that decision for me. I don’t think, I don’t judge, I just present my “need” and the government decides what, if anything, I get.
In contrast, when the realities of my pocketbook limit me in buying a new coat, or a medical procedure, I don’t say to myself, well, I can’t have more than my “fixed allowance” of this Fall’s new clothes, or my “fixed allowance” of physical exams! I evaluate what I want, how much it is, what’s available, do I like it, do I want it, is it a necessity, can I afford it, will it be on sale next week, would the doctor take installment payments, etc. In short, I choose what I value most from many alternative values- which is not rationing but choice. There is no rationing when I’m able to make my own decision on what I can afford. I’m not a passive recipient waiting for a “piece of the pie” to fall in my lap, but an active doer, gathering facts, thinking deciding, choosing. Thus my final choice is the best one possible because it’s based on my judgment of the facts and my hierarchy of values.
This is why my mind must be free to make the decisions that maintain and cultivate my values, whether it’s a new Fall coat or a new medical procedure to safeguard my health. I want the responsibility of thinking and deciding, which is the necessary corollary to living as a free individual. My life is my responsibility, not someone else’s.
Roxanne Albertoli
Ken asserts:
“RadCap…starts by accusing me of an appeal to authority, by citing Thomas Sowell, while accepting Dr. Hseih’s appeal to authority by citing Ayn Rand.”
This accusation is false, as an actual reading of my statement makes clear. I said that Ken provides nothing but the appeal to authority whereas Dr. H provides an appeal to the facts of reality which support the definition identified by Miss Rand. In other words, Ken engages in ANOTHER equivocation. He treats an arbitrarily accepted premise and a premise accepted on the basis of an appeal to facts of reality as the SAME. They are most definitely NOT the same and it is unfortunate that Ken does not recognize that fact.
“Dr. Hseih does not, as RadCap asserts, only list Ayn Rand as the author of the quote, but uses her definition, wholesale.”
Now Ken is adding to his fallacy count by creating a straw man. It was NEVER claimed Dr. H “only lists Ayn Rand as the author of the quote”. This is a blatant fabrication on Ken’s part.
And *of course* Dr. H “uses her definition, wholesale” – for, as explicitly stated, he has *validated* her definition by reference to the facts of reality, something Ken fails to do with his own definition. That in fact is what MAKES Ken’s acceptance of Dr. S’s definition fallacious.
After a few personal swipes, Ken makes an ADDITIONAL false accusation:
“RadCap then tries his hand at a little bit of psychoanalysis. … In response to me, he writes “This is the problem premise….”
I hate to break it to Ken but identifying a premise as false is NOT psychoanalysis.
Ken then goes on to quote me: “NO ONE ‘gives’ control of those choices to the individual. Individuals have that control BY RIGHT. And it is the government which is trying to VIOLATE that right by attempting to forcibly take control of those choices AWAY from the individual.”
Then he says:
“While I agree with what he says, there, I have to wonder if it’s REALLY all that different than what I said (only in less space).”
In other words, Ken simply proves MY point. He FAILS to recognize the difference between his stated position (control is GIVEN to either individuals or government by some unidentified ‘authority’) and my position (rights are not GIVEN, they are possessed naturally and any attempt by the govt to take that control is a violation of those rights).
Ken states there is NO difference between these two premises. He claims it just “boils down to a difference in writing styles”. Put simply, he continues to practice the fallacy of equivocation here. He continues to act as if some THIRD PARTY *granting* control of an individual’s choices to that individual is somehow the *same* as the individual possessing that control BY RIGHT.
RIGHTS and GRANTS are NOT the same – a fact Ken appears incapable of grasping.
The point is, Ken says he is afraid to state the only choice here is between rights and the violation of rights – between trade and rationing. But it is precisely that choice which must be explicitly identified and emphasized. Equivocating between rights and grants – between trade and rationing – is NOT the way to do that. It is the acceptance of the enemy’s premises – and thus of defeat at the very outset.
I’m attending a Town hall meeting with my congress-critter tomorrow. I’ll mention this if I can get a word in edgewise
@178. David S: – I would argue that rationing is both desirable and necessary at this time.
Over 80% of America would disagree with you, since they’re satisfied with their health care and their insurance plans. But go ahead and soil yourself…
- Health care is a public good, not simply an individual purchasing decision.
Oh give it a rest. Public health is a public good. Like clean water. Flu shots (sort of). Sanitation. CDC monitoring of viruses, research, etc. Things that fall under the heading of general (as opposed to individual) Welfare. Individual health is a personal decision – not your choice to make, not your area to dictate, not an area the federal government has any authority to legislate in.
- The current system is not desirable, …
Agreed. Break the insurance companies’ proxy monopoly that controls the price, all transactions and access to most health care. Get the government OUT Of the price-fixing business. Allow the free market to move routine health care costs back into equilibrium with other routine costs of living. Government-controlled, socialized medicine will never do those things without more onerous legislation. Neither will rationing.
- For-profit insurance is a poor substitute for true health care.
I completely agree, and have been telling people this for years. Consumers should be paying for health care directly. Insurance is a tool for mitigating risk. The only rational way to use insurance in the context of health care is to insure against catastrophic illness or injury with a low-premium/high-deductible policy. Rand demonstrated that people with such policies consumed less health care with no difference in health outcomes. You want to improve the situation? Convince people to stop abusing group insurance to pay for their health care.
- Critical care does not equal health care.
Maybe in your Bizarro World. In the real world, however, critical care is the very most important kind of health care – the kind that saves people’s lives. You have yet to demonstrate that anyone lacks access to this sort of health care. You can’t because access to critical care is mandated by federal law. Routine health care, on the other hand, is a personal responsibility – just like other routine costs of living like transportation, food, water, clothing, housing, etc. Your hyperbole and fantasies about 40M people aren’t believable, much less persuasive.
- If the market did not face government regulation, the situation would be even worse.
That’s your opinion. And it’s not supported by any facts you’ve cited, as usual. Anyway, I’m glad you see that the health care market is NOT free, and that you can’t blame the free market for skyrocketing health care costs.
- Medicare will never be bankrupt. Deficit spending is not bankruptcy.
There is no practical difference between endless, increasing deficit spending and functional bankruptcy. The one and ONLY situation where this can be maintained is when there is still money left to steal from the Taxpayer and money left to borrow from outside sources. No company gets away with doing business like this. Only the government – with the power of legal prosecution and the muzzle of a gun – can get away with it. Eventually, the Chinese, et al., will get tired of buying worthless paper. Eventually, the 90-100M Americans who are paying income tax on behalf of the entire U.S. population will simply get tired of having their wealth confiscated. Then you’ll see exactly how bankrupt Medicare is. So will every person who depends on it.
- You may not like Medicare, but seniors do, …
Riiiiight. Which is why DHHS has to use extortion to keep seniors in the plan – robbing them of Social Security benefits they’ve worked a lifetime for if they choose to opt out of Medicare and go with a competing plan that has better reimbursement, allowing them to see better doctors and get better care. You really have absolutely no clue what Medicare’s about.
Have you ever actually spoken with an elderly person about what a clvsterfvck it is to deal with Medicare? Ever had to deal with Medicare yourself? I mean with a serious, non-routine illness, not just the Prozac, Xanax, Effexor and Abilify you take every day. It’s far from comprehensive, and there’s no rhyme or reason to what percent it covers in a given situation. It requires additional, costly supplements to provide the same coverage as competing plans. It soaks up almost every SS COLA increase, and you don’t have a choice but to fork over the money. It’s a bureaucratic nightmare to deal with when it screws up. And doesn’t help at all in submitting supplementary claims for stuff it doesn’t cover. No sane person would “like” Medicare. Only someone who has no idea how it works would make such a stupid statement.
- There are more than thirty countries with better access and better outcomes …
Apples, oranges, etc. When you get an Amendment passed that gives Congress the authority to legislate individual health care for every citizen in the U.S., let’s talk. Until then, you’re out there with the rest of FDR’s repealed, unconstitutional “New Deal” programs.
- It is time to make this right.
If that’s your goal – which, clearly, it is not – then do something to bring commodity, routine health care costs back into equilibrium with other routine costs of living. Stop looking to the government to solve all your problems, like a six-year-old looking for the protection of Mommy. Face the facts. Study some economics. And the Constitution. Stop letting other people hand you your opinions. Grow up.
@177. BC: – I used a more detailed and accurate chart at one point that showed the divergence at 1960, …
Sure. Now that your chosen references have proved you wrong, you want to find something new. I get that.
When you do, remember that Reagan wasn’t President in 1960, so your Reagan-phobia won’t explain any divergence in the numbers there. Neither will appeals to “innovation”, since all other sectors have had money poured into innovation without experiencing the skyrocketing costs we’ve seen in health care.
Comprehensive (and comprehensive-style) plans’ memberships grew steadily beginning in the mid-70s (see your book) and continued apace until some 70% of the working population is now covered under such plans. The health care these people consume is artificially increased because “insurance will cover it”. The care their doctors prescribe in order to be “thorough” – i.e., to limit liability – is pursued because “insurance will cover it”. The insurance companies who process the claims for ALL this health care set the prices and control access, forming the closest thing you will find to a monopoly outside of a single-company situation.
The only way to fix the health care problem is to open it back up to a truly free market, break the insurance companies’ monopoly, and get the government out of the business of selling insurance.
This article is total garbage. Free markets dont work in healthcare. Never has never will
@182. goy:
Over 80% of America would disagree with you, since they’re satisfied with their health care and their insurance plans.
That’s only true if you don’t count folks who lack insurance. Fuzzy math. More than 75% of Americans support a public option.
But go ahead and soil yourself…
Coprophilic much?
Public health is a public good.
A rare point of accord.
Individual health is a personal decision
Hardly. Childhood leukemia is not a choice. There is more to health care than the market can address.
- The current system is not desirable, …
Agreed. Break the insurance companies’ proxy monopoly that controls the price, all transactions and access to most health care.
I call this the ‘public option’.
Government-controlled, socialized medicine will never do those things without more onerous legislation. Neither will rationing.
American exceptionalism? It works everywhere it has been tried. Why not here?
- For-profit insurance is a poor substitute for true health care.
I completely agree, and have been telling people this for years.
Consumers should be paying for health care directly.
That solves nothing. Consumers who can’t afford insurance can’t afford care at retail.
Insurance is a tool for mitigating risk. The only rational way to use insurance in the context of health care is to insure against catastrophic illness or injury with a low-premium/high-deductible policy.
Single payer also works well, and costs less.
- Critical care does not equal health care.
Maybe in your Bizarro World. In the real world, however, critical care is the very most important kind of health care – the kind that saves people’s lives.
Most Americans die from non critical causes. It is the same world you live in, where most bankruptcies are due to medical bills, and the poor cannot obtain basic care.
Routine health care, on the other hand, is a personal responsibility – just like other routine costs of living like transportation, food, water, clothing, housing, etc.
All of us have roughly predictable and equal needs for the commodities you list. Health care aside, of course. That’s why pooling resources makes sense.
Your hyperbole and fantasies about 40M people aren’t believable, much less persuasive.
I guess accuracy is not a factor in your calculus. 40M is a conservative estimate, whether you accept it or not. There is not any dispute.
- If the market did not face government regulation, the situation would be even worse.
That’s your opinion.
Supported by the evidence of all of human history.
- Medicare will never be bankrupt. Deficit spending is not bankruptcy.
There is no practical difference between endless, increasing deficit spending and functional bankruptcy.
Health care reform is clearly the only solution. But there is a difference.
Eventually, the 90-100M Americans who are paying income tax on behalf of the entire U.S. population will simply get tired of having their wealth confiscated.
Confiscated? That’s a laugh.
No sane person would “like” Medicare.
Except one who understands that it’s better than nothing.
When you get an Amendment passed that gives Congress the authority to legislate individual health care for every citizen in the U.S., let’s talk.
Let me know how your constitutional challenge to Medicare turns out…
- It is time to make this right.
Stop looking to the government to solve all your problems, like a six-year-old looking for the protection of Mommy.
We the People are the government, in case you forgot. Coming together to address our collective needs is the basic purpose of our government.
Stop letting other people hand you your opinions. Grow up.
Take your own advice, then we can talk.
Peace.
DS
One thing proponents of universal health systems also forget is that the countries that have them have almost uniformly done away with the tort system. That means if a doctor kills you in France, he doesn’t get to practice as a punishment. However, your (or your estate’s) recovery is virtually nil. In New Zealand, for another example, has a health system like a big no-fault worker’s comp system. Someone hits you in a car, you get taken care of for the rest of your life…no lawsuit though.
I am really not judging these systems here, but I am always surprised that this aspect is almost never discussed by either proponents or opponents of european-style systems.
@185. David S: – That’s only true if you don’t count folks who lack insurance.
Most of whom “lack” insurance because they either don’t want it, don’t see the need for it or haven’t been enrolled in it, though eligible, due to bureaucratic laziness, inefficiency or apathy. Exaggerating the ranks of the “uninsured” was debunked long ago, Zippy. You should try to keep up.
Childhood leukemia is not a choice.
Perfect example. Childhood leukemia is not known to be a communicable disease, Zippy. Therefore, it is not something that falls under the rubric of public health outside of funding for research to treat it. It is an individual affliction that has to be treated on an individual basis.
Here’s the inconvenient truth you socialist trolls keep ignoring: there is no “individual welfare clause in the Constitution that gives government the authority to legislate collective funding for individual treatment.
There’s an American Cancer Society and similar organizations for a reason. Someday, when you manage to pull your head out of the sophomoric Borg socialist mindset you’ve stuck it in, you’ll recognize this and go apply your efforts at a charitable institution to do some good instead of constantly crying out for help here with your bottomless pit of tired talking points, groundless assertions and easily debunked bullsh!t.
- I call this the ‘public option’.
Then you prove yourself to be as stupid about business as you are ignorant of the Constitution. Breaking up a monopoly doesn’t require a ‘public option’. A ‘public option’ will only transfer the monopoly control of all health care, currently enjoyed by these insurance companies, over to the government. Willfully choosing to hand control of one’s life over to a government as ineffectual, unaccountable, corrupt and systemically broken as the one we have now requires an astounding level of either ignorance or stupidity.
- American exceptionalism?
You’re being intentionally obtuse, as always. American exceptionalism has been driven by the free market. Put health care in a free market and you’ll see how that exceptionalism functions.
- That solves nothing. Consumers who can’t afford insurance can’t afford care at retail.
And just exactly how many Americans can’t afford routine health care NOW? You forgot to provide any hard numbers on that, as usual. Not insurance – basic, routine health care. You’ll never find this data. Know why? Because the health care market is completely distorted by a proxy monopoly of insurance companies who completely control the price of health care. Providers bill $X and they pay $X-Y. It’s never the same and it’s as opaque as possible, because the LAST thing the insurance company wants their customers to know is whether or not they could afford routine care without the product that brings them their profit.
The insurance monopoly and the moronic manner in which we pay for routine care have all encouraged prices to skyrocket at rates in excess of 400% of inflation, Zippy. President Bush – a former oil guy who knew what to do – resolved the oil price bubble by popping it last year on July 14 with one deft action. The health care price bubble, while slightly (and only slightly) more complex than the oil market, can be dealt with using the same basic strategy: opening up the market.
Do we nationalize utilities because “some” people can’t afford heat? No.
Do we nationalize food production because “some” people can’t afford food? No.
The list goes on and on, and it’s one you can’t dispute so you pretend that health care is somehow more critical than food (!) and the ability to NOT freeze to death (!!). Your ‘argument’ is as vapid as it is stupid.
- Single payer also works well, and costs less.
Maybe in your fantasy world, but not in this reality. This would be one of the reasons why Medicare is bankrupt.
- Most Americans die from non critical causes.
Wrong, Zippy. Most Americans die from heart disease – a critical health condition requiring immediate, critical care either in the form of surgery or medication. No person entering a medical facility with a life-threatening heart problem can be turned away for lack of ability to pay, per federal statute. Read a book.
- All of us have roughly predictable and equal needs for the commodities you list. Health care aside, of course.
Wrong. And as always, you provide not the slightest evidence that routine health care is any different from any other routine cost of living. See above.
All of us have roughly the same statistical likelihood of needing routine health care during our lifetime. It’s catastrophic illness or injury that are the exceptions. Find an actuary and have them explain this to you. Insurance – a tool for managing UNLIKELY events that pose a financial RISK – makes no sense in that context. Pooling resources is the most idiotic way to pay for any routine cost of living that is not consumed uniformly per unit of time – it’s simple economics.
Prices will rise to the level the market will bear. In a corrupted, broken market – like the one controlled by the insurance company monopolies – this dynamic becomes distorted. If the price of medical services for 500 people (e.g., per year) is allowed to expand into the space defined by 1000 people in a group, guess what – the price will increase to the point where no single individual can afford it. And guess what else – that’s precisely what we’ve seen ever since comprehensive health insurance came to be more widely adopted. As group sizes have grown, costs have skyrocketed at rates approaching the exponential. All of this is verifiable by a third grader with a web browser. Not to recognize it requires willful blindness.
- 40M is a conservative estimate
Repeating this lie over and over and over won’t make it any more valid than Gore’s fake climate crisis religion, Zippy.
- Supported by the evidence of all of human history.
Again, no evidence you’ve actually produced, as usual.
- Except one who understands that it’s better than nothing.
That’s the whole problem with your insipid False Choice fallacy. There are alternatives. The government blocks the use of those alternatives through extortion. You are actively supporting that extortion because you have a socially suicidal, collectivist agenda, Zippy. That makes you an accessory.
- We the People are the government, …
Not as far as this administration is concerned. The majority oppose the snake oil legislation you’re hawking; the majority disapproves of BHO’s actions as president to date; the majority rejects the behavior of Congress and would fire the lot of them if given the choice. Yet this government still persist in their efforts to seize control over the health care market. You’re a naive and sad little troll, Zippy.
“Coming together to address our collective needs is the basic purpose of our government” [David S]
No, it’s not. The basic purpose of the Federal Govt is the protection of certain individual rights. A need does not alone create a right.
To coerce Dr. Paul to pay for Peter Cottontail’s health care is immoral, and your feeling sorry for (and trying to make us feel sorry for) Peter Cottontail, does not change that elementary principle.
I live in a un-incorporated area of my State with less taxes and less regulation, but I do notice that some people who live in the ‘free-er’ area use their freedom to trash the yard and junk the house.
How many ‘free’ market advocates live in gated communities where regulations could strangle a moose.
In my neighborhood the cars parked on the lawn with grass covering the top of the wheels and debris lying around with the soffits hanging and the paint chipped all had Ron Paul stickers on them. Funny.
Totally free markets only work when all parties are honest brokers and don’t ration their integrity depending upon the situation. They also honor their neighbors freedom to live without being damaged by their neglect and their ‘freedom’.
To goy (183): Do you ever post anything that’s not really dopey? And are you blind as well — even this less detailed chart I used later shows the creeping divergence from the CPI after 1960 if you bother to look hard enough. Gawd….
190. BC: – Do you ever post anything that’s not really dopey?
Do you ever STOP projecting your lack of knowledge and desperation on this topic onto others?
Do yourself a favor. Just take in the entire graph all at once first.
See that gargantuan difference way off on the right there? That’s what we’re dealing with now, not the little, tiny, if-I-squint-and-look-sideways-through-a-shot-glass difference that’s barely detectable between 1960 and about 1975 – which is nothing more than health care’s variation from the mean.
The point where the lines diverge coincides precisely with the effects one would expect from the HMO act in 1973. The government mandated group policies (in the form of HMOs) and soon after, price increases were the result. That got worse as the policies morphed into increasingly comprehensive plans AND the group sizes got larger. Pretending NOT to see that requires a conscious, willful blindness on your part. No other factor of the market explains it.
BTW, ever done any actual data, signal or spectrum analysis BC? Separating out ANY ONE specific component / sector price from an average like this would show some minimal variation from the mean down in that noise. That’s why it’s called a mean – it’s a composite of numerous data which are all changing at very slightly different rates. When you separate one part out, like the author of the chart did, you see it as a separate component of the average. You don’t see health care really break away from the mean until about the mid-70s – exactly where my assessment predicts it would.
God, do they teach people ANYTHING in high school anymore???
folks,
do you notice how posters like jharp disappear after they’re exposed as only posting on a single issue?
BTW BC, if you’re really interested in understanding the nature of this issue as it’s evolved since the ’50s, and you want to investigate the reason for what you see as a divergence in health care costs from the CPI mean starting around 1967 or 68 (at least based on visual inspection of the chart you found), consider that Medicare had a significant effect at that time.
I’ve corresponded with Dr. Drew Foy on this, and he’s researching causal factors that point to Medicare triggering the advent of government mandates in health care (like HMOs). If there’s any statistically significant variation by health care costs from the CPI mean prior to 1974 or 5, the first thing to look at is the effect of Medicare, begun in 1965 and now effectively insolvent and bankrupt (or would be, if it were a private enterprise). It’s the best example in existence of why single-payer is not feasible.
Here’s the thing. HMOs were a statutory entitlement for health care. They failed to live up to the government’s expectations, so an alternate plan was pursued: giving employers tax breaks for providing (increasingly) comprehensive plans.
The failed HMO model has been resurrected in a slightly different form in Massachusetts, where employers are now once again required to provide health insurance benefits – and anyone not insured through their employer is fined if they don’t get a private policy when the State decides they can afford one.
This was the test case for “Obamacare”, and it transformed health benefits into an entitlement. That program has failed too. Not only have the costs of the program overall been much higher than predicted, but the increase in health care insurance cost in Mass. – which Romney promised would go down – has actually increased at a significantly higher rate than in other states during the same time.
This is of course exactly what one would expect. When the consumer is forced to purchase a product, artificially increasing the demand for that product, the price of the product (in this case, health insurance) is artificially increased as well.
Ultimately, this entire issue is a market problem, not a governance problem. State and federal government needs to break up the insurance companies’ proxy monopoly, get OUT Of the way and let the free market handle it.