More fun with for-profit medicine

[Ghent12]

Re: More fun with for-profit medicine

The problem is: how many in Canada and the UK is the system not working for?

I'll bet you dollars for donuts that the ratio in the US is far, far, far higher.

The fact that the health care systems in all of the of the 1st world and most of the 2nd world aren't perfect doesn't override the equal fact that they work far better and at a far lower cost than what is in the US.

You are making the situation black and white when it obviously is not. Your straw man holds no water in this discussion. You claim that the systems in those countries work "just fine" when they actually do not for a huge majority of people in all systems. It is a matter of tradeoffs. People in Britain, for example, are more likely to be able to see a doctor for most things but are less likely to survive it once they do. Perhaps that has something to do with all the foreign-born doctors? Or perhaps it's systemic--capping the "costs" as you call them (incorrectly) of health care has the same result as putting a price cap on every other good or service. More is demanded and less is supplied. The reason why Britain has systematically worse hospitals and why its health care providers are of lower quality generally is because they have traded off a more efficient system of allocating resources for one that guarantees access--access to poor quality. The Soviets did the same thing but for virtually every aspect of life, thus enabling everyone to have equal access to poverty. There are insufficient incentives to provide truly high quality care under the British or similar systems.

That being said, we here in America have taken the opposite tack. We have sided with insurance companies at the expense of consumers, thereby creating a Byzantine fascist (literal definition of fascist) system.

American, British, Canadian and all other systems so heavily interfered with by government are all about as equally "free market" as each other. Maybe it's time that medicine at large becomes more like the much freer types of medicine--cosmetic surgery.

[c1ue]

Re: More fun with for-profit medicine

The US health care system hasn't resembled a free market since the rise of managed care in the 70s. The integration of large pharma and its subsequent finalization have made things even worse. If you ask me a free market would be a step in the right direction. The rise of these large "non-profit" hospitals isn't really conducive to free market forces either.

I don't say that a free market cannot work to improve health care in the United States, but I do say that clearly a free market isn't necessary to improve health care in the United States. I further say that the possibility of a "true free market" improving health care in the United States is both unquantifiable as to cost/benefits and highly risky, whereas the costs and effects of socialized medicine is very well understood.

I do also note that the monopolization of health care by the state as exists in Canada is equally unjustifiable.

You are making the situation black and white when it obviously is not. Your straw man holds no water in this discussion. You claim that the systems in those countries work "just fine" when they actually do not for a huge majority of people in all systems. It is a matter of tradeoffs. People in Britain, for example, are more likely to be able to see a doctor for most things but are less likely to survive it once they do. Perhaps that has something to do with all the foreign-born doctors? Or perhaps it's systemic--capping the "costs" as you call them (incorrectly) of health care has the same result as putting a price cap on every other good or service. More is demanded and less is supplied. The reason why Britain has systematically worse hospitals and why its health care providers are of lower quality generally is because they have traded off a more efficient system of allocating resources for one that guarantees access--access to poor quality. The Soviets did the same thing but for virtually every aspect of life, thus enabling everyone to have equal access to poverty. There are insufficient incentives to provide truly high quality care under the British or similar systems.

Please provide some evidence of the above assertions:

1) That a huge majority of the people in "those countries" do not have a health care system that works just fine. A huge majority I will take to be at least 60%, and "those countries" would be defined as any 1st world nation.

2) People in Britain, for example, are more likely to be able to see a doctor for most things but are less likely to survive it once they do.

I would be interested to see this data, although in reality this isn't itself meaningful. For one thing, maybe fewer people in Britain need to see doctors.

3) The reason why Britain has systematically worse hospitals and why its health care providers are of lower quality generally is because they have traded off a more efficient system of allocating resources for one that guarantees access--access to poor quality.

Again, how about some data? I also note that the UK permits private health care, and this private health care is far cheaper than its equivalent in the US.

The Soviets did the same thing but for virtually every aspect of life, thus enabling everyone to have equal access to poverty.

Sorry, but you're way off base here. I've spent considerable time in Russia, and no one there thinks the present 'free market' system - even though it is backed up by a national socialized health care system - is better than it was during Soviet times.

The 'access to poverty' you speak of apparently involves a lung cancer survivor being sent, all expenses paid, from St. Petersburg to Sochi for 2 week sanatorium stays, for an at risk pregnant women to lie in the hospital for 2 months for free in order to ensure safe delivery of her baby, and so forth.

I wouldn't mind this poverty. In contrast I got charged $25K for a total of 2 hours operating room plus 5 hour overall hospital sojourn, and which didn't even fix the problem.

[Ghent12]

Re: More fun with for-profit medicine

Sorry, but you're way off base here. I've spent considerable time in Russia, and no one there thinks the present 'free market' system - even though it is backed up by a national socialized health care system - is better than it was during Soviet times.

The 'access to poverty' you speak of apparently involves a lung cancer survivor being sent, all expenses paid, from St. Petersburg to Sochi for 2 week sanatorium stays, for an at risk pregnant women to lie in the hospital for 2 months for free in order to ensure safe delivery of her baby, and so forth.

I wouldn't mind this poverty. In contrast I got charged $25K for a total of 2 hours operating room plus 5 hour overall hospital sojourn, and which didn't even fix the problem.

Good thing you acknowledge that Russia doesn't have a free market system now, via your half quotation marks. If you want to speak to the true merits or demerits of communism, you need only look at their disastrous farming practices as an example. The Soviet Union had and Russia still has today some of the best farmland available in the world, yet feeding their people has always been difficult. This is due entirely to the generations spent under centralized planning of agriculture, where the highly specialized mundane knowledge of farming was not allowed to grow and flourish with the farmers as it would have under a more market-oriented structure--things were controlled from central authority. You cannot farm a distant land from your capital, yet that is precisely what the Soviets tried which resulted in their repeated failings in agriculture output despite having truly great farmland. The current failings of Russia under a much more market-oriented system in virtually all respects is no surprise given that they have to start essentially from scratch when it comes to human capital--other than in some sciences and relatively few other trades, there is only one generation of unchained development in human capital in their entire economy.

Speaking of human capital, when Britain socialized their healthcare system the doctors that already practiced medicine in Britain were essentially trapped. Highly specialized professionals are among the most easy to "exploit" in terms of any type of laborer. Over the period since nationalization, Britain has had a rapid increase in foreign-born doctors who, as a general rule, have lower-quality training and education than native-grown doctors. There are some complications other than just the generally lower quality of their doctors, such as the more than twenty thousand of them that don't speak English well enough to speak with their patients.

Price controls, such as those used in Britain to "control costs" have the same results for everything. To the extent that they are effective, more is demanded and less is supplied. In the case of health care, the more that is demanded is relatively straightforward, and the less that is supplied often takes the form of reduced quality. This is fundamental economics, which I know you disagree with, but that's what it is.

You use anecdotes as evidence in support of the systems you describe, but anecdotes are no substitutes for real evidence. The evidence suggests that socialized medicine offers broader availability at the expense of time and quality. The evidence also suggests that semi-fascist medicine offers higher quality and faster results at the expense of pricing many out of the market. From history, however, we know that a much more market-oriented health care system offers great availability and service at low costs. As you would say, "the studies are out there, go find them and read them." In this case, however, they are not really all that hard to find.

[Polish_Silver]

Re: More fun with for-profit medicine

Great example of what's wrong with the current system. Suppose you walked into a car dealer and said "i need wheels today--I'm desparate!" They would try to soak you, but probably there is a used car lot across the street with prices painted on the windshield. Or you could spend 10 minutes on Craig's list and find 5 cars for sale close to your home.

Guess what? People do not buy cars using insurance ! They pay for them by saving up, or by borrowing. Car buyers have incentive to shop around. Car sellers have to compete for business, and prices are fairly transparent.

Instead of Obama care, why not have an ear marked health care tax? If you paid the tax, you get a voucher, which you could use to buy private sector insurance, or enroll at tax paid public clinics, or what ever. I don't like mandatory private sector insurance at all! We need more competition and choice, not mandatory payments to insurance companies.

[Thailandnotes]

Re: More fun with for-profit medicine

In this case, however, they are not really all that hard to find.

“Market oriented healthcare” turns up plenty of links, but most near the top are articles you have to pay for. The phrase also has many different meanings. To some it means less regulation of the insurance industry. To others it means cutting the insurance industry out of healthcare altogether.

[c1ue]

Re: More fun with for-profit medicine

Good thing you acknowledge that Russia doesn't have a free market system now, via your half quotation marks. If you want to speak to the true merits or demerits of communism, you need only look at their disastrous farming practices as an example. The Soviet Union had and Russia still has today some of the best farmland available in the world, yet feeding their people has always been difficult. This is due entirely to the generations spent under centralized planning of agriculture, where the highly specialized mundane knowledge of farming was not allowed to grow and flourish with the farmers as it would have under a more market-oriented structure--things were controlled from central authority. You cannot farm a distant land from your capital, yet that is precisely what the Soviets tried which resulted in their repeated failings in agriculture output despite having truly great farmland. The current failings of Russia under a much more market-oriented system in virtually all respects is no surprise given that they have to start essentially from scratch when it comes to human capital--other than in some sciences and relatively few other trades, there is only one generation of unchained development in human capital in their entire economy.

Russia has had periodic failures; the reality is that agriculture in much of Russia is even more highly dependent on weather because much of the land is relatively marginal.

The view that farming is somehow successful only under individual proprietorship is also false; for one thing Russian peasants have since time immemorial acted in a highly collective fashion - very different than in Western Europe. This is one reason why Marxist-Leninism took root so strongly in Russia rather than elsewhere. The failures of collectivizing agriculture in Russia - as well as other examples as in Cambodia - are more to do with unskilled workers, lack of training, and lack of equipment as much as any ideology. For one thing, the failure rates of 'free market' farmers in the early colonies was even higher.

Be that as it may - agriculture isn't medicine.

Socialized medicine can and does work.

You also failed to provide the requested information which you espoused:

Please provide some evidence of the above assertions:

1) That a huge majority of the people in "those countries" do not have a health care system that works just fine. A huge majority I will take to be at least 60%, and "those countries" would be defined as any 1st world nation.

2) People in Britain, for example, are more likely to be able to see a doctor for most things but are less likely to survive it once they do.

I would be interested to see this data, although in reality this isn't itself meaningful. For one thing, maybe fewer people in Britain need to see doctors.

3) The reason why Britain has systematically worse hospitals and why its health care providers are of lower quality generally is because they have traded off a more efficient system of allocating resources for one that guarantees access--access to poor quality.

Again, how about some data? I also note that the UK permits private health care, and this private health care is far cheaper than its equivalent in the US.

Nor has this information been posted in iTulip previously.

Data, not talk.

[labasta]

Re: More fun with for-profit medicine

Wow....I'm at a loss for words......


I did like that article on the Cheesecake Factory.....good choice......as that place seems to have a huge amount of complexity in it's menu breadth/depth, in it's volume, in it's consistency, in it's innovation with an ever changing menu, and it's ability to accurately predict/forecast demand and minimize waste.....all while making a profit and offering perceived high value.

Why can't the healthcare industry provide the same?

Because obviously there is no free-market healthcare in the "good" ol USA.

The article was gracious enough to show us the solution, stating that in Mexico the $40,000 drug costs $100 plus administration costs. Let's add 100% markup for the hospital and say $200.

Mexico has a free-market in health care and the USA does not. The US seems to have a highly regulated (read stitched up) healthcare system which protects it from competiton. That is the real reason why we have politicians in the first place, to stitch up markets and ban competiton, after all, authoritarian monopolists like the government and its corporations just hate competition.

On a side note, there are much cheaper alternatives to detoxification of snake or scorpion venom. One alternation is intravenous vitamin C. Costs about £250 (total cost) in the UK if you can find someone to administer it privately. That solution is also very good for you too as it will take a lot of the other chronic poisons out of you that have built up in your body over time. You'll never see it though in any form of institutionalised medicine whether the regulated institutionalised medicine is "private" (USA) or "public" (UK) because there is no money in it for the drug companies who pay the regulators (politicians) and its enforcers (FDA) to make sure it never does.

Obamacare makes the workers pay for it, whereas at the moment the worker (no plural), at least in theory, pays for it. Either way, the medical industry will get its immoral share of the pie through the barrel of a gun. It is all the same and it is all a stitch up.

[c1ue]

Re: More fun with for-profit medicine

Mexico has a free-market in health care and the USA does not.

Uh, actually not true.

http://www.nytimes.com/2011/01/30/wo...pagewanted=all

This rickety infrastructure served as the base of the new Seguro Popular, or popular insurance, which was begun in 2004. Any Mexican can sign up. A broad package of basic medical services is guaranteed, along with medicine and coverage for some catastrophic illnesses. The program was designed to charge a yearly fee based on income, but in practice hardly anybody pays because, the government argues, most of the participants are too poor.

[Ghent12]

Re: More fun with for-profit medicine

I think it's fair to say that the agriculture discussion belongs in a separate thread, and I'm sorry for using it as an example. We'll just have to agree to disagree, lest we be swept off topic too much.

“Market oriented healthcare” turns up plenty of links, but most near the top are articles you have to pay for. The phrase also has many different meanings. To some it means less regulation of the insurance industry. To others it means cutting the insurance industry out of healthcare altogether.

You're right that it does have many different meanings. What it means to me, and what it should mean to any student of economics, is to actually have a more market-oriented structure. It means the government is not involved as much in terms of "supporting" patients, doctors, insurance companies, or so forth. It means government doesn't pick sides and help out the squeakiest wheels. It means to allow customers and firms to assume their natural adversarial roles, without propping up the firms like in America and also without working to the detriment of the firms, as in Britain.

Socialized medicine can and does work.

So does the post office--doesn't mean there's not a better system that works for more people at a lower true cost and a lower price.

Fact is, all systems "work" in that they provide what they are supposed to to an extent. The current fascist (economic definition) system we have now in America "works" and likewise significantly more market-based systems "worked" when they were around. The failings of socialized medicine are readily apparent to any who seriously study the subject--the de-emphasis on quality is a natural outcome of any nationalized system, as are shortages in other ways which are unable to meet the rising demand. The failings of fascist healthcare, as in America, are also readily apparent--the capture of the system by corporations is monumentally detrimental to the consumer in terms of driving up the price. The failings of market-based medicine are not as readily apparent--while the customer is king in such a system, it is prone to market capture either via the state directly (socialist, like Britain's NHS) or by corporations indirectly (fascist, like American healthcare policy). The real cost of a market-based system is political vigilance.

The real questions for any economic system are: who gets what, and how is that determined? That's the beauty and the appeal of market-based systems, which have the best track record in allocating scarce resources.

[c1ue]

Re: More fun with for-profit medicine

So does the post office--doesn't mean there's not a better system that works for more people at a lower true cost and a lower price.

I'm still waiting for the data I requested.

I also note that while the post office does work - perhaps not ideally - at the same time there has never yet been a 100% free market for univesally mandated mail access which has worked. Sure, there have been 'free market' post services for centuries now, but having a service which only the 1% can use is what the 'free market' has historically delivered to in postal services.

Just as today historically the 'free market' in health care has delivered to the same 1%. Everyone else had to deal with medicine men and witch doctors.

Thus while you continually decry the various forms of socialized health care, I still await the damning data you say you have.