"Indoctrination in the virtues of market competition"

[Gabu]

Get a sense of humor, please.

I'm sorry, but this comment is a threat to his freedom; I'm afraid you're going to have to be fed to the lions now.

[phk]

John Maynard Keyenes saved capitalism.

[John Dibble]

Get a sense of humor, please.

I'm sorry, but this comment is a threat to his freedom; I'm afraid you're going to have to be fed to the lions now.

Well you should respect the fact that I like to tell idiots who have no sense of humor to get one! Anyone who doesn't respect everything I like to do should be fed to lions! And I like to feed people to lions, so you should respect my right to do that too!

[John Dibble]

John Maynard Keyenes saved capitalism.

Capitalism would have continued just fine without him.

[Gabu]

Get a sense of humor, please.

I'm sorry, but this comment is a threat to his freedom; I'm afraid you're going to have to be fed to the lions now.

Well you should respect the fact that I like to tell idiots who have no sense of humor to get one! Anyone who doesn't respect everything I like to do should be fed to lions! And I like to feed people to lions, so you should respect my right to do that too!

I'm terribly sorry, sir, but you see, the world cannot revolve around you; opebo already has it revolving around him.

[John Dibble]

Get a sense of humor, please.

I'm sorry, but this comment is a threat to his freedom; I'm afraid you're going to have to be fed to the lions now.

Well you should respect the fact that I like to tell idiots who have no sense of humor to get one! Anyone who doesn't respect everything I like to do should be fed to lions! And I like to feed people to lions, so you should respect my right to do that too!

I'm terribly sorry, sir, but you see, the world cannot revolve around you; opebo already has it revolving around him.

I'm not too worried - the world will start revolving around me once opebo is killed in the coming communist revolution, since he is one of the owning class after all.

[Gabu]

Get a sense of humor, please.

I'm sorry, but this comment is a threat to his freedom; I'm afraid you're going to have to be fed to the lions now.

Well you should respect the fact that I like to tell idiots who have no sense of humor to get one! Anyone who doesn't respect everything I like to do should be fed to lions! And I like to feed people to lions, so you should respect my right to do that too!

I'm terribly sorry, sir, but you see, the world cannot revolve around you; opebo already has it revolving around him.

I'm not too worried - the world will start revolving around me once opebo is killed in the coming communist revolution, since he is one of the owning class after all.

Oh, good.

[David S]

Our health care system is not totally free market. The government regulates it quite a bit. There's also two systems called Medicare and Medicaid - if you think that those don't have something to do with the situation, you are wrong.

For a competitive free market to work there must be choices available and the consumers must make  their decisions about what goods and services to buy, and who to buy them from based on their needs and the costs. We do this in virtually every other aspect of our lives. When we buy a house, most of us don't buy a million dollar mansion without asking about the price. We buy a house that suits our need at a price we can afford. The same is true for cars, food, clothes and most other purchases. If we can't find what we want for a good price at one store we might shop at other stores for a better price. But when we need medical care we rarely ask about the price. The doctor says you need this test, that test, and these pills, and he says your insurance will cover it or Medicare/Medicaid will cover it. So we don't question whether the tests are really needed. We don't shop for a medical facility that will do the tests at the lowest price. We don't shop for a pharmacy that will sell the pills at the lowest cost. Under those conditions  the competitive pressures that would normally keep costs down are not present and the free market does not work. Hence costs go up.

Healthcare is healthcare. If it's good, and it makes you better, why complain? As it is, only the richest people in the States can afford any sort of choice - and, through such heinous inequality, deprive 40 million of even one healthcare option besides doing without. In any case, national healthcare doesn't say you can't choose your doctor. It just means that you don't have to spend hours figuring out whether HealthNet or Aetna is a better program, or on hold on the phone trying to iron out payment snafus, or worrying about how to get your child the healthcare he needs when the doctor writes a prescription for twelve physical therapy visits - and your HMO only allows you six a year (this actually happened to my family; we're very fortunate to get PPO service courtesy of my parents' government employer).

It's not better to give lousy wages, it's better not to let business decide how well-off people are allowed to be.

1)You missed the point. Healthcare costs are higher than they should be because the system does not operate as a free market.

2) Ideally why should your employer be involved in your healthcare? What if they just gave you the money they spend on your healthcare and you could spend it on whatever health care plan you want?

3) Who should be responsible for your family's healthcare; you or someone else?

[Shira]

1)You missed the point. Healthcare costs are higher than they should be because the system does not operate as a free market.

2) Ideally why should your employer be involved in your healthcare? What if they just gave you the money they spend on your healthcare and you could spend it on whatever health care plan you want?

3) Who should be responsible for your family's healthcare; you or someone else?

The solution is simple:
1 - Make Medicare pay for al subscribed medication
2 – Extend Medicare to the whole population

Q: Where the money will come from?
A: From taxes.
Q: Am I suggesting adding more burden on the people?
A: Absolutely no. Just the opposite.  The total tax hike will be substantially lower than the amount a person is now paying directly and indirectly

[John Dibble]

1)You missed the point. Healthcare costs are higher than they should be because the system does not operate as a free market.

2) Ideally why should your employer be involved in your healthcare? What if they just gave you the money they spend on your healthcare and you could spend it on whatever health care plan you want?

3) Who should be responsible for your family's healthcare; you or someone else?

The solution is simple:
1 - Make Medicare pay for al subscribed medication
2 – Extend Medicare to the whole population

Q: Where the money will come from?
A: From taxes.
Q: Am I suggesting adding more burden on the people?
A: Absolutely no. Just the opposite.  The total tax hike will be substantially lower than the amount a person is now paying directly and indirectly

You obviously just don't get it, do you - all that'll do is raise prices more, because nobody will care how much it costs because it will be paid for, so companies will have no reason to keep prices low because the government will ALWAYS pay for it.

And yes, you will be raising the burden - on the healthy who don't need to pay anything right now. You'll be seizing their money that they otherwise did not need to spend on medicine, decreasing the amount of money they'd have for their other needs.

[cwelsch]

Can you refer to his explanation as to where the money goes?
There are numbers by which health care system is evaluated and measured: life expectancy, infant mortality and average health care cost per person. All these three numbers in our country are bad compare to other countries.

First of all, there's the inherent unreliability of statistics - across regions and countries, languages and customs.  Unless you had the same group doing all the same studies, it's unreliable.  What counts as stillborn in italy might count as infant mortality in the US, for example.  Moreover, there's the incentive to lie to give the appearance of better staistics, whenever the people compiling the statistics can gain a benefit from a better score.

Statistics are always at least potentially unreliable.

life expectancy - is skewed by other habits such as eating, reckless activities, etc. plus a preponderance of legal and illegal immigrants are less healthy than the average American in behavior and less likely to regularly visit a doctor, so it skews numbers

infant mortality - again, immigrants tend to come from unhealthy places; moreover for no good reason anyone can find, black mothers seem to have very low birth weights of their babies, and Europe has very few black people; it's also been suggested that American health care might tally infant deaths differently, or that it might end up saving a baby for a few days or hours that end up dying, rather than being still born (which might be tallied differently)

cost per person - this is a bad argument.  Why is LOWER cost a good thing?  If this were an education debate, the left side would all be arguing that per-pupil spending should be higher, but suddenly they see per-patient spending as something that needs to be low.

If anything, it seems to me to be a problem that Europeans don't spend enough money on health care to meet demand.  The free market doesn't promise you low costs, it promises you low costs after meeting demand.  If that means something is expensive, then there must be low supply or high demand.


I notice what you didn't include was anything about waiting hours and lines.  A LOT of Europeans and Canadians end up dying on waiting lists for surgeries and doctors.  Similar waiting lists in the US can be a few weeks or a day, even.  For example, breast cancer treatment in the UK can often take nearly 3 months - in the US surgery can be scheduled for the next week or within a few days (almost immediately, in other words) and with cancer, that kind of timing is critical.

It's amazing to me that people always forget to include this type of wait time in their analyses of health care.  The reason why they wait so long for these treatments has several causes:

1) They have to suffer by the legislative budgeting process; hospitals generate their own revenue so they can spend whenever they have money and don't have to wait for Parliament to get around to it

2) We pay our doctors much better than they do; in other countries, it doesn't pay very well to be a doctor, so there's a strong incentive to practice in the US or to enter another profession; as a result, they have doctor shortages

3) THEY DON'T SPEND ENOUGH.  The lower per-patient spending is a minus.  Sure, they're spending less, but you get what you pay for.  They didn't put enough money into their hospitals and so their hospitals don't have the equipment and materials to meet demand.  They have staffing shortages, bed shortages and oftentimes medicinal shortages.

They ought to open up the market and realize there's a simple reason health costs will rise: it costs a lot of money to save lives and improve health.  In America, we're spending more money on our health care.  As a result, we have better doctors, more doctors and more beds.  We don't have horrible wait times because we spend the money necessary to get a top-quality product.

Maybe the Europeans pride themselves on buying the Geo Metro of health care, but I'd rather have a Cadillac.

Why don't you analyze:

- wait times for critical surgeries
- waiting lists for doctor appointments
- doctor migration and brain drain

[Shira]

You obviously just don't get it, do you - all that'll do is raise prices more, because nobody will care how much it costs because it will be paid for, so companies will have no reason to keep prices low because the government will ALWAYS pay for it.

And yes, you will be raising the burden - on the healthy who don't need to pay anything right now. You'll be seizing their money that they otherwise did not need to spend on medicine, decreasing the amount of money they'd have for their other needs.

What I suggested is more or less the health care system in Britain, Germany, Sweden and many other countries. These countries are not dictatorships. If the people there did not want this system, the system would have been abolished long time ago. The people here are indoctrinated and brainwashed to believe that a national healthcare system is something bad. Once they they’ll taste it they won’t be willing to return to the current system.

[Fmr. Gov. NickG]

Health care, particularly prescription drugs, is particularly ill-suited to free market competition due to the supply and demand characteristics of the product. 

The cost of researching and manufacturing a prescription drug is huge up front and then almost negligible on the margin.   It therefore has a diminishing marginal cost to supply at all points on the supply curve.   In this way, the product looks like a public utility, the classic "natural monopoly". 

In cases of products with "natural monopoly" characteristics, monopolistic pricing (pricing above true competitive price) is inevitable absent government action, either nationalization or regulation. 

Drugs aren't competitively priced, because each drug is only manufactured by a single firm, due of course to intellectual property laws.  Basically, the company sets a price and everyone who wants the drug just has to suck it up and pay it. 

Even in cases where different firms manufacturer competing similar drugs, there is almost no price competition.  Why do you see so much drug advertising, but those ads never include prices?  Why is it that when Cialis and Levitra came on the market, Viagra didn't respond by reducing their price?   I believe there is a lot of implicit collusion going on in the drug industry.  They recognize that their industry is naturally monopolistic, and so even when they are given a chance to compete on price, they decline to do so on the chance the public might catch on and demand lower prices for drugs in non-competitive markets.  I'm not really sure if they are doing anything in violation of anti-trust laws, but they are certainly violating the spirit of the free market, which demands price competition to function.

[John Dibble]

You obviously just don't get it, do you - all that'll do is raise prices more, because nobody will care how much it costs because it will be paid for, so companies will have no reason to keep prices low because the government will ALWAYS pay for it.

And yes, you will be raising the burden - on the healthy who don't need to pay anything right now. You'll be seizing their money that they otherwise did not need to spend on medicine, decreasing the amount of money they'd have for their other needs.

What I suggested is more or less the health care system in Britain, Germany, Sweden and many other countries. These countries are not dictatorships. If the people there did not want this system, the system would have been abolished long time ago. The people here are indoctrinated and brainwashed to believe that a national healthcare system is something bad. Once they they’ll taste it they won’t be willing to return to the current system.

We're not brainwashed - there are cons to a 'single payer'(absolutely ridiculous term considering everyone pays for it through taxes) system, I've heard people from countries voice complaints, some of which cwelsche illustrates in his post above. Also, I think that YOU are the indoctrinated one - you have been indoctrinated to view national healthcare as a good thing.

Now, while we're on this topic, I came across an interesting find which I'd like to put on the table. Haven't read it all myself, but it's a pretty good read so far. Twenty Myths about Single-Payer Health Insurance.

Here's some interesting info on the oh so superior British system:

"Nine-year-old Tony Clowes, in a hospital to have the tip of his right index finger reattached after an accident with a bicycle chain, died under anesthetic from lack of oxygen when a breathing tube became blocked. The $1.50 tube, designed for one use only, had been in use for six weeks. Evidence emerged that reusing the disposable tubes was common practice across the country to reduce costs.

George Mitchell, Sr., 73, who was undergoing treatment for bladder cancer at Scotland’s biggest cancer treatment center, was sent off in a taxi to a hotel with no access to medical care before the treatment was finished because the hospital was short of beds. Hospital officials said it was a mistake.

Five times as many patients in England and Wales died from receiving the wrong medicine in 2000 as a decade earlier. Britain’s Audit Commission said hospital pharmacies don’t have the computer systems needed to keep pace with modern medicine."

You might also care to take a gander at Myth No. 4.

[phk]

John Maynard Keyenes saved capitalism.

Capitalism would have continued just fine without him.

No, the Great Depression nearly destroyed its credibility, he cleverly engineered to survive longer than what it should have.

[phk]

Those percentages, being as they are a percentage of money within the budget of the entitiy concerned, are very clear: administrating a private system is one-eighth as efficient as administrating a public system. When you consider an entire public system up against the totality of a private healthcare industry, then we see how much smaller that 3% is. That is why most Europeans would never favor going to an Amerian-style system.

Like I said - we could spend a fraction of the amount we currently spend in the structure of a socialized healthcare system, and have far and away the best care in the world.

Also, once again, let me remind you that Canada's system is relatively low-ranked among socialized systems. It requires reform, just as the American and British systems do. But we see the benefits of socialized healthcare in France, Germany, Benelux, Scandinavia, Japan, and elsewhere, even. These countries pay less and get more - and nobody is determined not to deserve any care at all based on socioeconomic status, as 40 million are here. Personally, if it takes a little extra wait for a non-urgent appointment on my part so that somebody else can get the most basic care, I'm willing to wait. Do you think it's due process to deny life to people based on whether they can afford health insurance?

[Gabu]

John Maynard Keyenes saved capitalism.

Capitalism would have continued just fine without him.

No, the Great Depression nearly destroyed its credibility

In whose eyes?  I'm fairly sure that people were still making purchases after the Great Depression.

[opebo]

John Maynard Keyenes saved capitalism.

Capitalism would have continued just fine without him.

No, the Great Depression nearly destroyed its credibility, he cleverly engineered to survive longer than what it should have.

Perhaps even indefinitely!  Particularly if we could get these silly right-wing plutocrats to stop behaving in what is, in the long run I believe, a self-destructive manner.  But people will be gluttonous.

[A18]

I think the 1970s and 1980s utterly discredited socialism.

[dazzleman]

I think the 1970s and 1980s utterly discredited socialism.

I agree, but a lot of people aren't smart enough to have gotten the message.  Being liberal means never having to acknowledge that you've been wrong about every major issue in the last 40 years.

[Shira]

The following is the last paragraph in one of many letters to NYT responding to Krugman's article.


"Mr. Krugman's column further vindicates the efforts of Hillary Rodham Clinton and others to promote a single-payer system, a plan that was defeated, in part, by fear of bureaucratic cost. I hope that a groundswell of support will lead to reconsideration of universal health care."

Sanford Pariser, M.D.
Boca Raton, Fla., April 22, 2005

I recommend  everyone to read all five very interesting responses to Krugman's article:
http://www.nytimes.com/2005/04/23/opinion/l23krugman.html

[John Dibble]

Shira, stop deleting and reposting the above - just leave it where it is and those that want to read it will.

[Shira]

1)You missed the point. Healthcare costs are higher than they should be because the system does not operate as a free market.

In West European countries and in Japan, Australia, Israel and Canada the healthcare system does not operate as a free market, but cost per capita is substantially lower, while life expectancy is higher than here: In Japan by 3.5 years. In Sweden by 3.1 year. In  Canada by 1.1 year and in Israel by 0.9 years. (All these numbers are from 1998, but I assume that not too much has changed)

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The employer should not be involved!
Medicare should be extended to the whole population

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The health of individual is not totally under his/her control. You can not say to a person: “It’s not my fault that you could not quit smoking”.

BTW: If we consider only the economical aspect of ailing person, it well could be that a non-smoker overall is more expensive than a smoker. The non-smoker lives approximately 5 years longer than the smoker, so he/she is more likely to suffer from the geriatric illnesses which are very expensive.

[phk]

I think the 1970s and 1980s utterly discredited socialism.

They discredited State-Capitalism.

[TheresNoMoney]

I'd also say that whatever the problems with the current health care system, one run by the government would be worse.  I favor incremental change, not a goverment takeover. 

Health care wouldn't be "run by the government", it would be paid for by the government. You would have greater choices than you have now in dealing with an HMO. You would pay less than you have now. 45 million peple would have health insurance they currently lack.

It would also save $286 billion a year in paperwork, actuarial costs, and other inefficiences.

We would pay less, have more choice, and it would save 18,000 lives a year and 50% of bankruptcies. Why are conservatives so against it? As far as I can see, it's strictly blind idealogy.