Stop the Presses - Health Care and Profits a Poor Mix?

[Thailandnotes]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

It's a chicken/egg debate. Free markets always lead to monopolies which lead to criminal coercion via mafias vs. Statutory changes and government subsidies lead to monopolies which eliminate free markets while creating black markets. Of course it's never so simple and always cyclical.

[Ghent12]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

It's a chicken/egg debate. Free markets always lead to monopolies which lead to criminal coercion via mafias vs. Statutory changes and government subsidies lead to monopolies which eliminate free markets while creating black markets. Of course it's never so simple and always cyclical.

Perhaps it is a bit of a chicken/egg situation. However, all systems have their foibles. The weakness of a centrally-planned economy is that the economic insight of the nation is artificially curtailed to about 0.01% of its normal level, whereas the weakness of a truly free market system is that it requires continuous vigilance by citizens to keep their government under control.

Fundamentally, monopolies aren't inherently bad. It is the monopoly pricing that can be considered bad. Can you think of a single instance when a monopoly or near-monopoly or a trust has exercised monopoly pricing privilege? The anti-trust legislation against Microsoft, for instance, alleged that Microsoft had unfairly low prices for its Internet browser, and was simply a preemptive fear of something that didn't happen and probably never would have.

There's a joke I once heard that covers this troubling situation where people are not free to give things away for free (like Internet Explorer as a package deal with Windows). The original joke was apparently by Roy Aleksandrovich Medvedev:

“Three prisoners in the gulag get to talking about why they are there. “I am here because I always got to work five minutes late, and they charged me with sabotage,” says the first. “I am here because I kept getting to work five minutes early, and they charged me with spying,” says the second. “I am here because I got to work on time every day,” says the third, “and they charged me with owning a western watch."

― Roy Aleksandrovich Medvedev

The American equivalent goes like this:
So three prisoners in federal prison in America were sitting around having much the same conversation. They had all been businessmen, and the question of why they were sent to prison came up.
The first prisoner said, "I was trying to expand my business by getting more customers so I undercut the competition. They accused me of unfair pricing."
The second prisoner said, "I offered the best products in my industry so I charged more than the competition. They accused me of profiteering."
The third replied, "It was a cutthroat environment I was operating in and ultimately my competitors and I charged the same price. They accused us of collusion."

[dcarrigg]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

Purist? No. And those comparisons are completely valid. Exigent circumstances are no reason to curtail a free market.

I honestly thought you were a proud anarcho-capitalist. I did not mean offense when I called you a free-market-purist. I figured you'd wear it as a badge of honor. Sorry about that.

I still don't find the comparisons you made valid at all. Free markets are based on competent consent to contract. I find no value in the "freedom" to be forced into a contract to which one is incompetent or unable to consent. This is particularly true where violent and usurous force is executed by an entity that dwarves your own financial resources and can take advantage of you while unconscious or hold the very real, if passive, violence of ending your very life in its hands to force consent.

There's a big difference between babysitters and airline tickets and hospitalization.

Freedom to me is different than simply taking the next sucker for every penny he is worth right now today. That's not freedom. It's just greed. You can replace one word for the other. But I know the difference.

I agree with most of my friends on the right and my libertarian friends about many "nanny-state" policies. They go too far. They ruin fun. And they over-regulate many things. Not finance or insurance. But many things.

I am of the mindset that often times complexity is the problem. Complexity in government. Complexity in finance and insurance. The more layers of complexity and middle-men you add, the worse things will get for the citizen or consumer.

But I'm no free market purist.

I don't think middle-man insurance profit belongs smack in the middle of a life-or-death equation. And I think medical care is something that belongs to citizens, not consumers. One does not 'consume' healthcare.

And I do place intrinsic, non-economic, value on our Republic.

And that, I suppose, may be where we part ways.

But, I do think it is interesting to note that the "freedom" of the "free-market" healthcare system of insurance conglomerates that we have today was made possible specifically from nationally mandated wage controls after world war two.

Let freedom ring*.

So if that's freedom, then we're screwed. I had surgery about 15 months ago. I just got a $500 bill this week. I can't tell what it's for or why. I haven't even bothered to go figure it out yet. And I'm not exactly a slouch on this healthcare stuff. I don't feel free because of my opaque, indecipherable correspondence and lack of transparent pricing between an insurance middle man and my doctor.

But if that's freedom, then send me to jail. In fact, once we get rid of every last pension, I think Jail should be retirement plan numero uno. Free room and board and cards and books and exercise and you can't lose the inheritance you saved up for your family just by getting sick. Yup. Jail's not a half-bad place for a 70-something looking to ride out his days. In fact, if they get rid of Medicare, it might be the only rational option.

At least in jail my surgery would have been free.

And there'd be no paperwork over a year later asking for money out of the blue.





^{*Unless you have a preexisting condition. Void on Tuesdays. Not valid in the lower 48 states, or if you have a Y chromosome. Covers 80% of eligible in-network provider coverage, unless otherwise specified. Out-of-network providers will provide you with a bill equal to or greater than 500% of the cost otherwise charged to in-network insurance companies. Please refer to the detailed explanation of benefits provided in Appendix B-2. Not valid for injuries caused by neglect or act of God. Not valid unless approved by a labyrinthian faceless insurance bureaucracy accountable to no-one. Billing rates will be decided on an ad-hoc basis by doctors, and fluctuate at random. Reimbursement rates will respond in kind. Upon utilizing this insurance product, a statement of benefits that is utterly incomprehensible by even trained healthcare lawyers with 30 years' experience will be mailed to your previous address. It will not be forwarded. Please contact our non-English-speaking customer service center in Bangladore at 888-555-5555 if you have any questions. They will be sure to answer you with platitudes and neglect to solve your problem. By purchasing this insurance product you agree to give up the right to you and your families' genomes and the contents thereof as private intellectual property of the insurance company, who will not only sell it for top dollar, but who will examine its contents to find a technicality to kick you off the policy and keep your premium dollars. Also, purchasing this product signifies explicit consent to arbitrary sums of United States Dollars being removed from your bank account by direct withdrawal at will. No further notice will be given. This policy may be altered at any time without notice. Some restrictions may apply.}

[santafe2]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

I don't think middle-man insurance profit belongs smack in the middle of a life-or-death equation. And I think medical care is something that belongs to citizens, not consumers. One does not 'consume' healthcare.

This is a core issue. Healthcare access as a for profit business is complete nonsense. These are gate keepers that along with big pharma corrupt medicine. The idea that this, like mega banking is representative of free enterprise is an utter deceit. It's FIRE. The RE half has knee capped the economy and itself for now but FI still owns the US. We'll see if that changes in our lifetime.

[don]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

This is a core issue. Healthcare access as a for profit business is complete nonsense. These are gate keepers that along with big pharma corrupt medicine. The idea that this, like mega banking is representative of free enterprise is an utter deceit. It's FIRE. The RE half has knee capped the economy and itself for now but FI still owns the US. We'll see if that changes in our lifetime.

It took decades for the abolitionists to see the end of slavery. Will it take longer to ride ourselves of FIRE . . .

[Ghent12]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

I still don't find the comparisons you made valid at all. Free markets are based on competent consent to contract. I find no value in the "freedom" to be forced into a contract to which one is incompetent or unable to consent. This is particularly true where violent and usurous force is executed by an entity that dwarves your own financial resources and can take advantage of you while unconscious or hold the very real, if passive, violence of ending your very life in its hands to force consent.

There's a big difference between babysitters and airline tickets and hospitalization.

Virtually every corporate entity the average American engages with can "dwarf [their] own financial resources," and precious few people are what one might describe as fully competent when it comes to things like any real estate transaction, any food transaction, any consumer electronics transaction, or any legal transaction. Despite whatever research is done by the consumer, there will always be gaps in knowledge, sometimes crucial. We are all just making semi-competent consent in a huge number of our transactions. There are always ways to improve the competency of consumers, but few practice such methods; as I pointed out, you can create an emergency plan to specifically cover emergency medical care.

But, I do think it is interesting to note that the "freedom" of the "free-market" healthcare system of insurance conglomerates that we have today was made possible specifically from nationally mandated wage controls after world war two.

Let freedom ring*.

We don't have freedom in healthcare today and there is no free market of healthcare in the United States. We have a situation where the government has decided that the insurance companies are the winners in the marketplace--everyone else be damned. That's not a free market any more than farm subsidies make the agriculture industry into a free market. It's as free a market in health care as the Canadian system.


Yes, consumers do consume health care just like they consume food, which is even more essential to sustaining life. In principle, nobody has a right to receive the labor, goods, and services of others; merely the right to engage in transactions to receive said labor, goods, and services. The labor, goods, and services in the healthcare industry or any other are not infinite--there are definite and real limits which means that some people will always go untreated for some things. Since the free market is empirically the most efficient at allocating scarce resources to maximize their utilization by people, that is the model we should have for health care.

[c1ue]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

The labor, goods, and services in the healthcare industry or any other are not infinite--there are definite and real limits which means that some people will always go untreated for some things

The problem is - profit based health care means that the only people who go untreated are the poor ones, and the ones who use less health care than they should are the middle class ones.

As I've repeatedly noted: you think more 'freedom' will fix the problem.

I think that this experiment does not need to be run.

Every single other 1st and most 2nd world, and even some 3rd world nations have national health care.

It can and does work.

[Ghent12]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

The problem is - profit based health care means that the only people who go untreated are the poor ones, and the ones who use less health care than they should are the middle class ones.

As I've repeatedly noted: you think more 'freedom' will fix the problem.

I think that this experiment does not need to be run.

Every single other 1st and most 2nd world, and even some 3rd world nations have national health care.

It can and does work.

Soviet Russia "worked" too, by some definitions.
Nationalized healthcare "works" by your standards. I prefer to have a much more efficient system of distribution of goods and services.

[Ghent12]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

The problem is - profit based health care means that the only people who go untreated are the poor ones, and the ones who use less health care than they should are the middle class ones.

That's not true at all, actually. Poor people do consume fewer goods and services, that is true, but their needs are met in a free market better than in any other type of economic structure. Poor people might indeed have more limited access to care at one given point in time than in a nationalized healthcare system, but in ten years' time a person at that same level of poverty would have far better access for the same price, even though it would also be more limited than people at other levels of income.

Poor people get by with all the other facets of modern living, such as cars, abundant food, housing, and etc. Healthcare is no different at all. A free market doesn't mean that poor people are left in the cold--it fundamentally means the exact opposite of the survival of the fittest jungle struggle. It means that poor people can live now, instead of dying as they would have long ago, because people are free to pursue the profit motive to the extent of their desires and that drives productivity and availability of goods and services up. It's empiric. I would much prefer a healthcare industry akin to the consumer electronics industry, where government interference is light by comparison. The quality of service goes up rapidly as costs come down almost continuously? Yes, please!


Compare poor people in North Korea to poor people in South Korea. Poor people in East Germany to poor people in West Germany. Make those comparisons both at the time of separation and at the latest moment when they were still separate (in the case of Germany) or right now (in the case of Korea). Compare poor people in Soviet Russia to poor people in the United States. Also, try not to fall into your common fallacy of, "The United States is a rich country, and the USSR was a poor one," because that truly is a fallacy--the USSR had far and away better natural wealth than its neighboring countries, but its system of economic distribution (hardcore communism) was fundamentally inept at efficiently distributing them.

[flintlock]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

And I think all of those comparisons are invalid. I know you are a free market purist. I am not. It is not worth rehashing such things.

Agree. I used to think that the markets would take care of everything also. Then I realized everything doesn't always have to fit nicely into a "white or black", simple minded philosophy just to satisfy some anal retentive sense of order . The optimum almost always lies somewhere in between. Finding the optimum solution on this issue will be a long, complex, and costly process. Were are still in the early innings of this. More likely it will take generations and a lot more suffering and waste, and may never be fully resolved. Comparing the experience of socialized medicine in foreign nations is not completely applicable because how much of their resources and knowledge only came about because of the profit motive in other countries? Eliminate that and you may quash medical advancement. Then again, how much more advancement do we need when we can't pay for the level of heathcare we have now??? The sooner people can let go of their rigid beliefs on this subject the better.

[flintlock]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

Perhaps the best solution would be some sort of basic socialized health plan with better off patients allowed to buy up into a private plans that offer better and faster care. But that will never happen with the egalitarian mindset of today. Everyone feels entitled to the latest and greatest available, and they want it yesterday. Sometimes I wonder how many of us really realize how much better off we are today in regards to heath care than just 100 years ago? Health problems scare people, and when they get scared they get irrational. That's at least part of the problem.

There are so many problems with the system today, from so many angles, its hard to know where to start.

[Ghent12]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

That's a reasonable compromise, although that still would retard resource availability for the society as a whole. It might "feel" like the right thing to do, to help out those who are in need, but honestly if it is not profitable to do so then it is not sustainable to do so. Such help comes at the expense of other things in the society, and that has numerous unforeseeable negative consequences. It is a political compromise worth considering, but it is absolutely sub-optimal.

[Thailandnotes]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

but honestly if it is not profitable to do so then it is not sustainable to do so.

It's an ideological argument that waxes and wanes through the decades and circles back to the last line of the article originally posted at the beginning of this thread..."Improving the delivery of social services like health care and pensions may be possible without increasing the burden on American families, simply by removing the profit motive from the equation."

[don]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

It's an ideological argument that waxes and wanes through the decades and circles back to the last line of the article originally posted at the beginning of this thread..."Improving the delivery of social services like health care and pensions may be possible without increasing the burden on American families, simply by removing the profit motive from the equation."

Basic healthcare only works if it's not for profit, something along the lines of the old county hospitals, many of which were closed down to pave the way for HMOs. Same goes for a subsistence income for seniors too old to work.

[c1ue]

Re: Stop the Presses - Health Care and Profits a Poor Mix?

Poor people do consume fewer goods and services, that is true, but their needs are met in a free market better than in any other type of economic structure.

Do you have some actual data behind this, or are you merely repeating belief?

And note that using US data isn't appropriate because the US is a wealthy country - not so much due to its free market as to Europe's tendency to destroy itself regularly in the previous century.

Apples to apples data comparison of US poor vs. EU poor - who is better off?

As for North vs. South Korea - let's see.

South Korea: billions of dollars in US investment since apartheid.
North Korea: trade embargoed for decades. Diplomatically isolated. Bad government.

Yep, that's a valid comparison. Not.