America has the most effecient health care system in the world

[ponderingturtle]

America must have the most effecient least costly health care system in the world right? This is because we are the only developed nation to have such competition with profit as the motivator, and that make everything more effecient.

Is this true?

[ImaginalDisc]

America must have the most effecient least costly health care system in the world right?


Define efficiency in this context. Most people treated per dollar spent? Longest life expectancy per dollar spent. Longest life expectancy of treated patients per dollar spent? Largest proportion of monies spent towards treatment, with lowest administrative overhead and profit? There's a lot of wiggle room there.

[ponderingturtle]

Define efficiency in this context. Most people treated per dollar spent? Longest life expectancy per dollar spent. Longest life expectancy of treated patients per dollar spent? Largest proportion of monies spent towards treatment, with lowest administrative overhead and profit? There's a lot of wiggle room there.

Is it true for any of those?

[steverino]

I saw comedian Emo Philips live, and he had a good story:

My father needed major heart surgery. He had to mortgage his house here in Chicago to pay the medical bill. Too bad he didn't live in Canada. We would have inherited the house.

[Beerina]

Define efficiency in this context. Most people treated per dollar spent? Longest life expectancy per dollar spent. Longest life expectancy of treated patients per dollar spent? Largest proportion of monies spent towards treatment, with lowest administrative overhead and profit? There's a lot of wiggle room there.

They just talked last night about how European countries with universal health care had better longevity, etc.

Give 'em 50 years with cheap McDonald's and Burger King and Wendy's, then we'll see.

Oh, and don't forget to take out increased gun violence. It may reflect badly on the US, but has nothing to do with quality of health care systems.

Oh, and don't forget to take out increased car accidents due to a far higher fraction of the population owning cars and those that do driving many more miles.

Of course, don't forget to adjust for "drag on future development" that socialized medicine (with great restrictions on profits) will have. What's that? This can't be done because nations share technology?

I guess we'll never know how much that dragging freeloaderism affects future deaths.

But what good is "free medical care" in the year 2100 if you only have year 2070 medical care? Or 2050? Or 2020? Has socialized medicine done anything? Or is it an uncalculably murderious proposition that slides in under the radar in the ultimate case of "the road to Hell is paved with good intentions"?

[Azure]

Canada is by far not efficient. We have our flaws too...

[gnome]

half the problem is that it isn't nearly as competitive as it ought to be.

[Solitaire]

U.S. Headed For Financial Trouble as seen on Sixty Minutes (http://www.cbsnews.com/stories/2007/03/01/60minutes/main2528226.shtml)

I'll bet a nickel that when Shank sees this he'll mention the broken window fallacy.
Rising health care costs reflects rising consumer demand, but that demand grows the economy.
Growth in the economy increases government revenue just like supply side economics.
The increased government revenue will pay for the health care cost, problem solved.
:)

[RandFan]

America must have the most effecient least costly health care system in the world right? This is because we are the only developed nation to have such competition with profit as the motivator, and that make everything more effecient.

Is this true?No. Faulty premise I'm afraid. Our health care system is seriously messed up precisely because we have removed market forces.

Market:
Person X wants Y and shops to find the best price for Y. If Person X can't afford Y then person X waits until he or she can afford Y.

Health care:
Person X pays a third party. Person X wants Y. Person X doesn't consider price to get Y. Person X never putts off acquiring Y. There is little or no motivation for the the merchant of Y not to raise prices therefore health-care almost always, if not always, rises much faster than inflation. Thank the dear lord we don't have such a system for purchasing just about any other goods or service that are needed on such a regular basis. We only die once and we don't get in car accidents nearly as often as we get sick.

I think that health-care is seriously broken and we will likely need to go to a national system.

[RandFan]

Rising health care costs reflects rising consumer demand. And demand is rising largely due to the removal of market forces. Shane would be correct to note that this artificial rise in costs are not helping the economy.

[PogoPedant]

They just talked last night about how European countries with universal health care had better longevity, etc.

Give 'em 50 years with cheap McDonald's and Burger King and Wendy's, then we'll see.

Oh, and don't forget to take out increased gun violence. It may reflect badly on the US, but has nothing to do with quality of health care systems.

Oh, and don't forget to take out increased car accidents due to a far higher fraction of the population owning cars and those that do driving many more miles.

Of course, don't forget to adjust for "drag on future development" that socialized medicine (with great restrictions on profits) will have. What's that? This can't be done because nations share technology?

I guess we'll never know how much that dragging freeloaderism affects future deaths.

But what good is "free medical care" in the year 2100 if you only have year 2070 medical care? Or 2050? Or 2020? Has socialized medicine done anything? Or is it an uncalculably murderious proposition that slides in under the radar in the ultimate case of "the road to Hell is paved with good intentions"?
So to abstract your argument a little, there's this theory that says that a particular political action that's probably helping people now, is likely to kill people some time in the future. Just like global warming, right? :p

[CFLarsen]

No. Faulty premise I'm afraid. Our health care system is seriously messed up precisely because we have removed market forces.

Market:
Person X wants Y and shops to find the best price for Y. If Person X can't afford Y then person X waits until he or she can afford Y.

Health care:
Person X pays a third party. Person X wants Y. Person X doesn't consider price to get Y. Person X never putts off acquiring Y. There is little or no motivation for the the merchant of Y not to raise prices therefore health-care almost always, if not always, rises much faster than inflation. Thank the dear lord we don't have such a system for purchasing just about any other goods or service that are needed on such a regular basis. We only die once and we don't get in car accidents nearly as often as we get sick.

I think that health-care is seriously broken and we will likely need to go to a national system.

Why do you think Person X has the time to wait?

If Person X can't afford Y, and he dies while "waiting", that's OK with you?

That's "economic cleansing": Weeding out the poor.

[RandFan]

Why do you think Person X has the time to wait?

If Person X can't afford Y, and he dies while "waiting", that's OK with you?

That's "economic cleansing": Weeding out the poor.I'm not talking about life threatening situations. But even if I was this has nothing to do with the situation. I'm not advocating anything. I'm explaining why the premise of the OP is faulty.

[UserGoogol]

No. Faulty premise I'm afraid. Our health care system is seriously messed up precisely because we have removed market forces.

Market:
Person X wants Y and shops to find the best price for Y. If Person X can't afford Y then person X waits until he or she can afford Y.

Health care:
Person X pays a third party. Person X wants Y. Person X doesn't consider price to get Y. Person X never putts off acquiring Y. There is little or no motivation for the the merchant of Y not to raise prices therefore health-care almost always, if not always, rises much faster than inflation. Thank the dear lord we don't have such a system for purchasing just about any other goods or service that are needed on such a regular basis. We only die once and we don't get in car accidents nearly as often as we get sick.

I think that health-care is seriously broken and we will likely need to go to a national system.

What do you mean by "removed?" The situation in the second situation seems to not be a removal of market forces, but merely the result of the perverse demand curves that are an inevitable part of health care. Health care is something you need or you will die. Death is infinitely bad, thus people will always buy health care if they can. Thus, what you say is happening will happen. Unless I misunderstand what you're saying.

ETA: Or maybe I'm underestimating the amount of elasticity in health care decisions. That's insanely easy to do.

[Molinaro]

I have no problem with Canada's health care system. I find the comment about socialized healthcare heading towards being 30+ years behind on quality to be preposterous.

Sorry to have to refer to what I see in movies now, but I'm always taken aback when I see Americans in movies having to make a decision about going to see a doctor or not. That decision isn't made based on need, it's often portrayed as a difficult economic decision that you could end up paying for over a period of years. Now this obviously isn't the case for everyone, but there must be a fair number of people who need healthcare, but choose not to get it.

Doesn't that add up to poor health for the population in general? Are there not a significant number of people staying sick even though you have these wonderfully capable healthcare providers?

I can't call a health care system 'the best', even though it may be true of quality of services rendered, when it's simply not available to everyone.

[Dancing David]

I read somewhere that the cost of provision of service insurance has a much higher cost here in the US than in countries like Canada. Insurance adminitration was lower by a factor of 8% to 25%. So the cost of having our 'private' system is higher. The mani thing that makes prices so high in the US and other places is the profit motive. When you have a piece of tubing that costs less than a dollar to manufacture and the hospital charges $30 for it, with some middle men, it adds up considerably. Then there is the whole using an MMRI to look at a separated shoulder issue, not profit driven but standard of care driven.

[ponderingturtle]

No. Faulty premise I'm afraid. Our health care system is seriously messed up precisely because we have removed market forces.

Market:
Person X wants Y and shops to find the best price for Y. If Person X can't afford Y then person X waits until he or she can afford Y.

Health care:
Person X pays a third party. Person X wants Y. Person X doesn't consider price to get Y. Person X never putts off acquiring Y. There is little or no motivation for the the merchant of Y not to raise prices therefore health-care almost always, if not always, rises much faster than inflation. Thank the dear lord we don't have such a system for purchasing just about any other goods or service that are needed on such a regular basis. We only die once and we don't get in car accidents nearly as often as we get sick.

I think that health-care is seriously broken and we will likely need to go to a national system.

I agree with this, I just think that health care is not an area that competition produces effecency. In consumeable goods and such competition is great, but health care you often do not have a choice(to bad you got into a car accident in the wrong place, you do not go to your prefered facility).

Increasing competition can not work, because you do not have an enviroment where the consumer has a choice to abstain from purchase.

To really put competition into medicine, you would need to legalize throwing people on the street to die if they can't pay.

[Garrette]

I read somewhere that the cost of provision of service insurance has a much higher cost here in the US than in countries like Canada. Insurance adminitration was lower by a factor of 8% to 25%. So the cost of having our 'private' system is higher. The mani thing that makes prices so high in the US and other places is the profit motive. When you have a piece of tubing that costs less than a dollar to manufacture and the hospital charges $30 for it, with some middle men, it adds up considerably. Then there is the whole using an MMRI to look at a separated shoulder issue, not profit driven but standard of care driven.Bolding mine.

I'm far from an expert, but I think you're mistaken.

Hospitals have a very low margin overall, even if a particular item is considerably marked up (iirc from my time working in an ancillary department of hospitals, an aspirin administered in the Emergency Room will cost more than the same aspirin administered in a non-critical patient's room).

Look here for a discussion of margins in healthcare (http://www.healthcareitnews.com/story.cms?id=4440).

[shuize]

Someone please explain how a "national system" is going to reduce costs. I'm certainly no expert, but it seems to me in order to reduce costs there will have to be a trade-off somewhere else. What's the old saying, "cheap, fast, good, pick two." (Living in Japan where there is national health care, I'd say you actually only get 1.5: "cheap" and "so-so")

Off the the top of my head, the only solutions I can think of that would lower "costs" to the patient would either involve denial of service or increased taxes. Of course, in the case of increased taxes, that's not really lowering costs as much as it's just shifting the cost somewhere else. Which, as noted above, would likely only increase demand.

Ex: "Hey, since I'm not paying hardly anything for it, maybe I'll have the doctor retape this bandage for me."

Before you say that example is silly, I have seen exactly that sort of thing in Japan. Especially among the elderly who have nothing better to do than hang around at the doctor's office all day chatting it up with friends. (I'd be curious to know the actually percentage of the Japanese population spending their time in doctor/hospital waiting rooms on any given day. I'd be willing to bet that even with half the population the numbers would dwarf the U.S.)

I don't know, maybe that's a good thing. But it sure is a pain in the ass trying to get in to see a doctor here when one has a legitimate medical concern.

[Dancing David]

Bolding mine.

I'm far from an expert, but I think you're mistaken.

Hospitals have a very low margin overall, even if a particular item is considerably marked up (iirc from my time working in an ancillary department of hospitals, an aspirin administered in the Emergency Room will cost more than the same aspirin administered in a non-critical patient's room).

Look here for a discussion of margins in healthcare (http://www.healthcareitnews.com/story.cms?id=4440).


I am not saying that the hospital runs a high margin, I would say that about the network of production and distribution. Even a little cup to pee in has a very high cost to the end user. Just an observation.
I do not feel that the hospital is the one making the money on the deal. More opinion.

[RandFan]

What do you mean by "removed?" The situation in the second situation seems to not be a removal of market forces, but merely the result of the perverse demand curves that are an inevitable part of health care.In all actuality the forces have been removed. Let me give you an example, if we all payed into a food co-op and could go buy any food and as much food as we wanted from the local store would the prices remain stable? No. Demand for quantity and quality would rise and the price for quality and quantity would rise.

Health care is something you need or you will die.The vast majority of doctors visits are not life and death issues.

[RandFan]

I agree with this, I just think that health care is not an area that competition produces effecency. In consumeable goods and such competition is great, but health care you often do not have a choice(to bad you got into a car accident in the wrong place, you do not go to your prefered facility).

Increasing competition can not work, because you do not have an enviroment where the consumer has a choice to abstain from purchase.

To really put competition into medicine, you would need to legalize throwing people on the street to die if they can't pay.No. You would need to remove the third party pay system. Life threatening situations are a minority of cases.

[RandFan]

Someone please explain how a "national system" is going to reduce costs. I'm certainly no expert, but it seems to me in order to reduce costs there will have to be a trade-off somewhere else. What's the old saying, "cheap, fast, good, pick two." (Living in Japan where there is national health care, I'd say you actually only get 1.5: "cheap" and "so-so")

Off the the top of my head, the only solutions I can think of that would lower "costs" to the patient would either involve denial of service or increased taxes. Of course, in the case of increased taxes, that's not really lowering costs as much as it's just shifting the cost somewhere else. Which, as noted above, would likely only increase demand.

Ex: "Hey, since I'm not paying hardly anything for it, maybe I'll have the doctor retape this bandage for me."

Before you say that example is silly, I have seen exactly that sort of thing in Japan. Especially among the elderly who have nothing better to do than hang around at the doctor's office all day chatting it up with friends. (I'd be curious to know the actually percentage of the Japanese population spending their time in doctor/hospital waiting rooms on any given day. I'd be willing to bet that even with half the population the numbers would dwarf the U.S.)

I don't know, maybe that's a good thing. But it sure is a pain in the ass trying to get in to see a doctor here when one has a legitimate medical concern.I honestly don't know. Perhaps there is no good solution. I've been without healthcare for some time now. I simply can't afford it. I don't take the medications I need and I don't see a doctor for my health problems. I just don't have the money. Period.

[ponderingturtle]

No. You would need to remove the third party pay system. Life threatening situations are a minority of cases.

So are counting say cancer as not life threatening, or what?

How do you deal with patients inability to pay, do you let them die? In a properly free market, the answer is yes you do.

[RandFan]

So are counting say cancer as not life threatening, or what?

How do you deal with patients inability to pay, do you let them die? In a properly free market, the answer is yes you do.I'm not advocating a "properly free market" whatever that is. I assume you mean "true free market".

I'm currently in favor of national health care so obviously I don't advocate letting patients die. The point was about efficiency and free market economics. If the health care system were free of the third party pay system it would absolutely be more efficient. That fact does not mean that it would solve all of the social problems associated with health care or that everyone would be able to afford health care. That's not the point of my argument.

[Admiral]

So are counting say cancer as not life threatening, or what?

How do you deal with patients inability to pay, do you let them die? In a properly free market, the answer is yes you do.

If you actually want to do something for such people, then stop using tax money! Use a private charity that pays for people that absolutely need it!

People say that they want to solve problems through goverment action. Well, sort of- they just want to solve problems with other people's money. There are three ways to for goods to exchange hands: They can be traded for other people's goods in a mutually beneficial exchange (commerce), they can be given as a gift (charity), or they can be taken by force (taxes). Civilized people deal with each other in the first two ways- barbarians deal with others in the third way.

Not only are private charities far more morally justifiable- they work far, far, far better. Think about this: If you decided to give money to an organization for hurricane relief, would you donate it to the Red Cross, or to FEMA? If you wanted to give money to an organization for helping poor people get houses, would you give it to Habitat for Humanity, or to the Department of Housing and Urban Development?

(I apologize in advance if you're not from the US and are unfamiliar with any of my examples).

Private charities are effiecient and effective. They make it very clear how efficiently they get the money to the places the people that give the money want it to go- after all, their reputation is what leads people to give money to them. They work very hard to make it attractive for people to donate- they run rallies, they have celebrities speak for their cause, they have letter-writing campaigns, they promise certain benefits like plaques and memorials to the best donors. They go to a lot of trouble to make sure that money meant to support families with cancer doesn't go to bandaging someone's foot repeatedly.

Taxes? Well, they show up at your house with guns if you don't pay them. Then beauracrats spend it however they think is effective with little to no accountability.

One final note- only private charity promotes freedom. Why? Because people get to choose where their money goes, and it doesn't have to go to causes they don't support. Christians can give to Christian charities, Muslims to Muslim charities, skeptics can donate to the JREF, some people donate to children's hospitals while some prefer to donate to animal shelters while some prefer to donate to hurricane aid... And you, if you choose, can pay to charities that support families with cancer.

[casebro]

My guess is thata "national system" would have tons to gain by eliminating the litigation, and fear of litigation, that drives up cost. I've heard that in California, 60% of medical tests are done so the Doctor can prove he did the right thing.

How does malpractise work in Canada? After a screw up, does the doctor say "I'm sorry", and that's the end? Or does the doctor pay $200,000/year for protection?

Maybe the U.S. only needs a national system of malpractise insurance, handled by one stingy company? Single Payer, anybody?

[gnome]

Regarding charity vs. taxes... personally I feel there is a stigma attached to seeking charity rather than setting up a tax-supported solution. Also, a problem of role. Charity is there to work when the system fails... not to BE the system. If too many people require charity, it's a sign that something's wrong.

I don't want to be able to afford healthcare because kind people are doing me a favor. I want to be able to afford it because we've found a smart and fair method as a community.

[Schneibster]

If you want to fix medicine in the US, you need to fix insurance first. And they have lots of money. Good luck to us all.

[Admiral]

Regarding charity vs. taxes... personally I feel there is a stigma attached to seeking charity rather than setting up a tax-supported solution.

If there is, there certainly shouldn't be- it's much more honorable to take a gift from somebody than to steal something from them.

Also, a problem of role. Charity is there to work when the system fails... not to BE the system.

Evidence? Isn't a system that doesn't rely on coercion, and instead promotes freedom, better than a system that relies on coercing money from people and forcing them to spend it a certain way (and doing it ineffectively)?

If too many people require charity, it's a sign that something's wrong.

No, I'd say that if too many people rely on government, it's a sign that something's wrong.

On another thread, I asked Tony what the justification for taxes was, since people shouldn't be allowed to steal from other people. His response was that in some situations, people had a right to take from other people. Even if that were true, wouldn't it be much better to have an alternative that didn't involve regular use of force? Isn't a society of giving better than a society of taking?

Charity relies on society's ability to take care of itself through freedom. Government states that society has to be forced to take care of itself.


I don't want to be able to afford healthcare because kind people are doing me a favor. I want to be able to afford it because we've found a smart and fair method as a community.

It might be democratic, but it's certainly not fair. If 45% of the population doesn't want to pay for universal health care, but the other 55% does, then the majority gets to force the minority to pay.

Real community comes from people coming together. It doesn't come from holding people at gunpoint. Government is NOT a place where people come together, it's a place where the majority gets to tax the minority.

[Molinaro]

I can't understand feeling that mistrustfull of the government. If I had that little trust in my governement I'd spend my every waking minute trying to change the system.

I like that I pay taxes.
I like that the government uses some of that money to provide healthcare for everyone.

And to the malpractice question asked earlier.. I've never met anyone here in Canada who has sued anyone for anything.. let alone over healthcare.

[gnome]

Evidence? Isn't a system that doesn't rely on coercion, and instead promotes freedom, better than a system that relies on coercing money from people and forcing them to spend it a certain way (and doing it ineffectively)?

Do you consider it coercion to live in a democratic society, and to abide by the results of a vote you participated in, even if the vote doesn't go your way?

What if most of the people that live there are comfortable with that arrangement, and in fact prefer it that way (subject to Constitutional limitations)? I know libertarians aren't much for an implied social contract... but how many people would choose to leave if it were made explicit? I'm guessing very few.

[Admiral]

I can't understand feeling that mistrustfull of the government. If I had that little trust in my governement I'd spend my every waking minute trying to change the system.

I do what I can. :)

But seriously- I wouldn't call it mistrusting THE government, I'd call it mistrusting government in general. I'm not a conspiracy theorist.

I like that I pay taxes.
I like that the government uses some of that money to provide healthcare for everyone.

If you like paying taxes, great: give the money to private organizations that pay for health care (charities, hospitals, and so on). Or how about this: make taxes voluntary to pay. That way, since you feel it's good that you pay them, you would get to pay them, but you don't have to force others to.

The truth is that you don't just like paying taxes, you like forcing other people to pay their taxes too. If everyone who paid taxes liked paying taxes, we could make it optional and the system would still work perfectly. Right?

[Whoracle]

If you actually want to do something for such people, then stop using tax money! Use a private charity that pays for people that absolutely need it!

People say that they want to solve problems through goverment action. Well, sort of- they just want to solve problems with other people's money. There are three ways to for goods to exchange hands: They can be traded for other people's goods in a mutually beneficial exchange (commerce), they can be given as a gift (charity), or they can be taken by force (taxes). Civilized people deal with each other in the first two ways- barbarians deal with others in the third way.

Not only are private charities far more morally justifiable- they work far, far, far better. Think about this: If you decided to give money to an organization for hurricane relief, would you donate it to the Red Cross, or to FEMA? If you wanted to give money to an organization for helping poor people get houses, would you give it to Habitat for Humanity, or to the Department of Housing and Urban Development?

(I apologize in advance if you're not from the US and are unfamiliar with any of my examples).

Private charities are effiecient and effective. They make it very clear how efficiently they get the money to the places the people that give the money want it to go- after all, their reputation is what leads people to give money to them. They work very hard to make it attractive for people to donate- they run rallies, they have celebrities speak for their cause, they have letter-writing campaigns, they promise certain benefits like plaques and memorials to the best donors. They go to a lot of trouble to make sure that money meant to support families with cancer doesn't go to bandaging someone's foot repeatedly.

Taxes? Well, they show up at your house with guns if you don't pay them. Then beauracrats spend it however they think is effective with little to no accountability.

One final note- only private charity promotes freedom. Why? Because people get to choose where their money goes, and it doesn't have to go to causes they don't support. Christians can give to Christian charities, Muslims to Muslim charities, skeptics can donate to the JREF, some people donate to children's hospitals while some prefer to donate to animal shelters while some prefer to donate to hurricane aid... And you, if you choose, can pay to charities that support families with cancer.



So if I get into bad car accident on the way home tonight, but by long term prognosis is that I will be fine after a few surgeries and a few weeks in the hospital, at a cost of a 6 figures or so, you propose that I pay for this with private charity if I have no insurance. Seriously, how do you propose I go about doing that? How do I privately raise about a 100 grand to pay for the medical bills of a person whose going to be fine and presumably going to live for quite awhile longer?

[gnome]

If you like paying taxes, great: give the money to private organizations that pay for health care (charities, hospitals, and so on). Or how about this: make taxes voluntary to pay. That way, since you feel it's good that you pay them, you would get to pay them, but you don't have to force others to.

The truth is that you don't just like paying taxes, you like forcing other people to pay their taxes too. If everyone who paid taxes liked paying taxes, we could make it optional and the system would still work perfectly. Right?

Boy isn't this familiar territory... but ok, here we go again. This would be a fantastic idea except for tax benefits that could be called non-separable... that is, the entire community receives the benefit whether they have paid for it or not--or to put it another way, there is no way to keep the benefit from someone that chose not to pay. There's more of those than you think.

If payment is voluntary there is an incentive to claim that you don't want the benefit (so that you don't have to pay for it), while still enjoying it as everyone else picks up the slack.

[DanishDynamite]

As ImaginalDisc said, it all depends on what you mean. Have a look at this (http://dll.umaine.edu/ble/U.S.%20HCweb.pdf) googled link. For some reason I can't cut and paste from there, but have a look at the table on page 4. The US spends the most in the world as % of GNP, yet it lags behind in many measurements, such as infant mortality rate or life expectancy.

The article also mentions that it is estimated that between 19.3% and 24.1% of total dollars spent on health care in the US goes to administration.

[gnome]

Admiral... perhaps we should take the derail out of both threads and continue our discussion in a new thread?

[Schneibster]

See, what "private health care" advocates don't get is, they're already paying taxes- but they have no say in how they're spent. And the people collecting them are more interested in how much they can keep than in how many they can help. You don't get to vote on what the insurance company does with the money. If the government does it, at least you get to vote on it. So the question is not, "do you want government controlling your health care," the question is, "do you want to have a say in it or not?" And it's just that simple.

[gnome]

You can always vote with your feet, and... change jobs, I guess...

[RandFan]

You can always vote with your feet, and... change jobs, I guess...My health has made it difficult for me to find a different job. You can't always.

[Beerina]

So to abstract your argument a little, there's this theory that says that a particular political action that's probably helping people now, is likely to kill people some time in the future. Just like global warming, right? :p

Well, if you'll note, the worst predictions of out of control global warming will have less impact on quality of life in a free society than, say, adopting communism would. Humans, as usual, can directly destroy their own quality of life far more easily and quickly than any natural (or pseudo-natural, in this case) disaster would.

[Beerina]

Why do you think Person X has the time to wait?

If Person X can't afford Y, and he dies while "waiting", that's OK with you?

That's "economic cleansing": Weeding out the poor.

If you make sure the poor gets it by reducing profits at drug and technology companies, might you end up causing a net increase in deaths? Witness two examples:

1. People pushed to require airlines to give free seats to babies. Well, you get nothing for free, so this cost would be amortized across all the other passengers, increasing their tickets by a dollar or two or five. Yet, with millions travelling every year, this will statistically reduce travel a little bit as some people pass the breaking point of being able to afford it. They will drive instead, and be at higher risk of death.

Net effect: More deaths. Now consider it's estimated that said rule would have saved only 2 baby lives over the past 20 years, and that in one of those cases, the baby lived anyway since he flew up into an overhead compartment (that Chicago crash on film that goes end over end.) Yet you'd probably induce dozens of increased deaths driving a few tens of thousands (out of hundreds of millions) to the roads.

2. There was an episode of some crime show about 5 years ago where the detectives were about to "catch" a lawyer who was helping many death row clients give up on appeals and start praying to Jesus. The lawyer pointed out that, if he made shrill appeals for every little thing, like the detectives thought he should, he'd get far fewer reviews, and thus would save far fewer people from reprieve. So he saved his appeals to just the good stuff that would work. Net effect: more lives saved, even though it seems unsavory at first glance.*

* Note this was a story, I have no idea if it's bases on reality or not, and just serves to illustrate the proposal that you can do what seems to be the best thing, yet end up with a...decidedly suboptimal result.

If your result is to maximize saving lives and increasing quality of life, your best bet is to rocket technology ahead the fastest. And that occurs fastest in a society with a free, open market. And the demand for cures is fearsome in its power.

[PogoPedant]

Well, if you'll note, the worst predictions of out of control global warming will have less impact on quality of life in a free society than, say, adopting communism would. Humans, as usual, can directly destroy their own quality of life far more easily and quickly than any natural (or pseudo-natural, in this case) disaster would.
Oh.

I thought that the (http://www.newscientist.com/article/mg18925393.700;jsessionid=DIIKDMPIHBCA) worst-case (http://answers.yahoo.com/question/index?qid=20070226165348AAMnN6e) for global warming (http://living.scotsman.com/index.cfm?id=76062006) was rather grim.*

And tax-funded health-care is to communism like an itch is to cancer, but you already knew that, right? ;)

*You did say worst-case, and I don't think the commies ever submerged a any major metropolis.

[Kaylee]

Large insurance companies, Medicare and Medicaid don't pay the same prices for health services that individuals do. They are the 800 lb gorillas that can negotiate excellant prices for themselves. As a result, uninsured individuals pay much more for health services.

Large corporations can negotiate better prices for health insurance coverage than smaller companies and individuals can. As a result, smaller companies and individuals pay much more for health insurance coverage, per individual.

Also most individuals are divorced from the process of choosing health providers and insurance companies. The large corporations choose for them. This has negative consequences for individuals.

The current way of handling health in this country really only works for a privileged few -- mainly the upper management of the health insurance companies.

I believe that most people would be better off with universal coverage with everyone in the same insurance pool. Given the political realities in the USA, it will be difficult to make that happen.

[Admiral]

My health has made it difficult for me to find a different job. You can't always.

The fact that I'm only one person has made it difficult for me to influence an election.

In response to Scheibster:

Majoritarianism is bogus both morally and practically. It assumes that as long as you get a chance to vote, you're having a say in the decisions. Well, is the same true of gang rape? One woman, three rapists are in a room: "Let's take a vote." Do you have a right to take her rights from her just because you let her VOTE?

In a consequentialist sense, majoritarianism doesn't work nearly as well as markets, simply because majoritarianism doesn't account for a diversity of needs. If America voted on which computer system we would use, Americans would be forced to use Windows. If the country voted on what food we'd all eat for dinner, everyone would have hamburgers.

So, Scheibster, as I sit down to dinner tonight, being forced to eat hamburgers when I'd rather have pizza, while checking my email on a Windows computer when I'd rather use a Mac, I'll be sure to thank the libertarian socialists for letting me at least have a vote. Imagine if we were a privatized society- I wouldn't have ANY say in what I ate!

ETA: I am NOT arguing against democracy. All government should be democratically elected. I'm saying that we should limit the power of government as much as possible so that we can limit this tyranny of the majority.

[gnome]

My health has made it difficult for me to find a different job. You can't always.

They really need a sarcasm font. :P

[Beerina]

Oh.

I thought that the (http://www.newscientist.com/article/mg18925393.700;jsessionid=DIIKDMPIHBCA) worst-case (http://answers.yahoo.com/question/index?qid=20070226165348AAMnN6e) for global warming (http://living.scotsman.com/index.cfm?id=76062006) was rather grim.*

And tax-funded health-care is to communism like an itch is to cancer, but you already knew that, right? ;)

*You did say worst-case, and I don't think the commies ever submerged a any major metropolis.

I'm glad you dug out two links. Let's look at their descriptions vs. what could happen with a radical communist dictatorship.

The first merely notes that some of the lower countries would suffer severe problems. Food and mass migration would be an issue, but "sudden drowning" would not.

The second, the old guy merely flat-out claims "billions" will die -- yet it's already been estimated that were modern society to collapse, billions would die because old-school farming could not support the large numbers of people. And heavy communism would get in the way of a free market coming to the rescue of said people. Hence a radical dictatorship (of any type) that slammed the door shut on free enterprise could very well result in billions starving.

So, yes, my thesis remains intact. Thanks!

[Beerina]

They really need a sarcasm font. :P

:rolleyes: They do :rolleyes: have a sarcasm :rolleyes: smilie. :rolleyes: Or is that :rolleyes: too :rolleyes: obvious?


P.S. I love your comments! :rolleyes:

[PogoPedant]

I'm glad you dug out two links. Let's look at their descriptions vs. what could happen with a radical communist dictatorship.

The first merely notes that some of the lower countries would suffer severe problems. Food and mass migration would be an issue, but "sudden drowning" would not.

The second, the old guy merely flat-out claims "billions" will die -- yet it's already been estimated that were modern society to collapse, billions would die because old-school farming could not support the large numbers of people. And heavy communism would get in the way of a free market coming to the rescue of said people. Hence a radical dictatorship (of any type) that slammed the door shut on free enterprise could very well result in billions starving.

So, yes, my thesis remains intact. Thanks!

I disagree.

First, I should note that this is pedantry, as I'm going with the worst-case I found on a quick google. The examples are extremes and quite possibly hyperbole, while communism has already been done. (Also, there were three links :P)

Communism did rule a large swath of the world. Moreover, communism did collapse (well, in one case at least). Billions did not die. Not even millions.

It seems you have this idea that communism equals the complete and utter destruction of society. Real world examples (Soviet, Cuba, China) suggests that it merely means a worse quality of life than in non-communist neighbours. My advice: stop fearing communism and just be happy that it will never become a likely contender ever again.

For your thesis to work you need to show that communism will necessarily lead to a situation where knowledge of modern farming is lost and no research is ever done to amend the situation.

[boooeee]

Large insurance companies, Medicare and Medicaid don't pay the same prices for health services that individuals do. They are the 800 lb gorillas that can negotiate excellant prices for themselves. As a result, uninsured individuals pay much more for health services.
I'm not sure if that is necessarily true. Uninsured individuals definitely get billed more than an insurance company which can use its clout to negotiate lower payment rates. However, it is my understanding that often, the ratio of what is paid by an uninsured individual versus what is billed can be quite low.

A hospital is a business and they know that even if they bill an uninsured person $500,000 for their cancer treatment, they are most likely not going to get anything. So, they'll negotiate lower terms with the individual since something is better than nothing. If you get $500,000 bill, you'll probably not bother paying any of it. If you get a $20,000 bill with monthly payments spread out over a few years, you'll probably pay up.

I don't have hard data on this (just anecdotes), so it is possible that my understanding is incorrect.

[gnome]

I disagree.

First, I should note that this is pedantry, as I'm going with the worst-case I found on a quick google. The examples are extremes and quite possibly hyperbole, while communism has already been done. (Also, there were three links :P)

Communism did rule a large swath of the world. Moreover, communism did collapse (well, in one case at least). Billions did not die. Not even millions.

It seems you have this idea that communism equals the complete and utter destruction of society. Real world examples (Soviet, Cuba, China) suggests that it merely means a worse quality of life than in non-communist neighbours. My advice: stop fearing communism and just be happy that it will never become a likely contender ever again.

For your thesis to work you need to show that communism will necessarily lead to a situation where knowledge of modern farming is lost and no research is ever done to amend the situation.

I honestly believe that the communist revolution in China led to the deaths of millions.

http://en.wikipedia.org/wiki/Great_leap_forward

Presented as a summary, not evidence (I understand that wikipedia is not perfectly reliable). If some parts are questionable, further citations are welcome.

[Modified]

I'm not sure if that is necessarily true. Uninsured individuals definitely get billed more than an insurance company which can use its clout to negotiate lower payment rates. However, it is my understanding that often, the ratio of what is paid by an uninsured individual versus what is billed can be quite low.

A hospital is a business and they know that even if they bill an uninsured person $500,000 for their cancer treatment, they are most likely not going to get anything. So, they'll negotiate lower terms with the individual since something is better than nothing. If you get $500,000 bill, you'll probably not bother paying any of it. If you get a $20,000 bill with monthly payments spread out over a few years, you'll probably pay up.

I don't have hard data on this (just anecdotes), so it is possible that my understanding is incorrect.

Probably true to some extent, but not for the little stuff. My last medical charges were for stitching up a cut hand. The insurance company paid $239 out of $556 charged by the hospital and $168 out of $420 charged by the doctor, so about 42% of the total. Uninsured patients might get an interest-free loan on that amount, but I doubt they'd have much luck getting the amount lowered.

[PogoPedant]

I honestly believe that the communist revolution in China led to the deaths of millions.

http://en.wikipedia.org/wiki/Great_leap_forward

Presented as a summary, not evidence (I understand that wikipedia is not perfectly reliable). If some parts are questionable, further citations are welcome.

Good point. I had actually forgotten all about the great leap forward. :(

[Admiral]

Good point. I had actually forgotten all about the great leap forward. :(

Don't forget about the Cultural Revolution- a horrific attempt by Mao to take over the minds and lives of citizens through slavery and slaughter.

(Let me note that my views on the Cultural Revolution, or on communist China in general, have nothing to do with my political beliefs. Trying to rewrite history to mitigate the horrors of communist governments is no more acceptable than denying the Holocaust because of anti-Semitic beliefs).