Health Care Reform

[PaulG.]

Unfortunately, the current bills in congress do not address any of this.

Be thankful. Real reform stands a much better chance of happening when the feds keep their evil little paws off of something.

[Omar Mussa]

Real reform stands a much better chance of happening when the feds keep their evil little paws off of something.

I don't understand what you mean -- do you think the insurance industry or health care industry can reform itself?

[John Lokanis]

Be thankful. Real reform stands a much better chance of happening when the feds keep their evil little paws off of something.

Actually, real reform will never happen UNLESS the government stops being bought and paid for by the health care industry (or the financial industry or the military industrial complex) and actually serves the people they were supposedly elected by. The 'market' will never reform health care (or global warming or anything else for that matter) because there isn't any profit in it. If you don't understand that, try studying the 'tragedy of the commons' problem in economics. Humans are just not wired to solve problems like this by individual actors pursuing their own best interests. The only way to solve this is by having an external authority impose a solution.

To simplify this, think of what happens if you leave your dog and your cat alone for a week. If you set out enough food and water for the week, the dog will eat it all in one day and then starve the rest of the week. The cat will eat just what it needs and survive just fine. Humans are not cats.

And since there is no way congress will ever vote to eliminate the hand that feeds them (lobbyists), we will not solve this or any other problem without a gun held to our head. And by that time it will be too late. That is not pessimism, just realism...

[Cat]

I don't understand what you mean -- do you think the insurance industry or health care industry can reform itself?

Of course it can! Just like the financial industries keep themselves under control!

Oh, wait...

[jcarmody]

Be careful where you take this argument.  There have been several studies [...]

Arguments based on data from studies conducted in a centrally planned economy don't invalidate my point, they ignore it. 

[PaulG.]

I don't understand what you mean -- do you think the insurance industry or health care industry can reform itself?

No. But our federal government, in it's current condition will most certainly make things worse. As much as I believe in states rights I don't even think the states can reform much of anything anymore. The federal government simply has way too much authority and control over too many areas of our lives.

[Grampa_of_Oliva_n_Eden]

No. But our federal government, in it's current condition will most certainly make things worse. As much as I believe in states rights I don't even think the states can reform much of anything anymore. The federal government simply has way too much authority and control over too many areas of our lives.

I recently heard Judge Napolitano (sp?) spek to this point and we still have some options.

1) There is an option for states to refuse to enforce fed laws. I believe the Whiskey Rebellion was an example of this as well as what California is doing with marijuana laws. Under normal cicumstances the fed leans on the sate thru funding to force tehm to comply.

2) I believe a majority of states can call for a constutional congress.

3) Supreme court case to challenge the previous finind of teh court that found that the "commerce" clause of the consitution gave congress the regulate everything that COULD cross state lines. This is being tested in Texas (thanks for Ron Paul by the way!) re"Guns manufactured and used only in the state are not regulated by teh fed as well as some other states.

If they did call for a consttuional congress some of things that I think could help

1) repeal the 17th (?) which made snators elected rather than appointed.

2) Term limit.

3) Abolish seriority rules that prevent a real "Mr Smith goes to Washington"

Ben

[John Lokanis]

Arguments based on data from studies conducted in a centrally planned economy don't invalidate my point, they ignore it. 

I'm not ignoring your point. I am stating a fact that the supply/demand curve does not work in all 'markets'. Especially ones were there is imperfect information provided to the participants. Healthcare is one of these. For example, as a patient with medical insurance, you do not know what a given procedure costs. Your doctor most likely does not know what the procedure costs. So, assuming the two of you together are going to figure of the correct solution to the cost/benefit equation that yields accurate supply/demand behavior is just wishful thinking.

[jcarmody]

I'm not ignoring your point.

I'm sorry for implying that; I wasn't clear. I meant that the study ignored the effect of a controlled economy. No study can learn anything about what an open market could/would do as long as the market isn't open (there are extremely high, legislatively caused, barriers to entry into the market). Let me suggest that there are many "Health Care" demands that don't require specialists or special equipment, but there are no low-cost-no-frills options because the law won't allow them.

• I worked along the Tex-Mex border one summer and took a trip into Mexico where there was a thriving over-the-counter trade in prescription drugs. These were very inexpensive, and presumably good because the trade had been thriving for a long time. There are also, oddly enough, dentist offices on many streets offering various services at deep discounts to rates north of the border.
• There was a blip in the news in the past few years about people buying prescription drugs from foreign websites and legislators jumped up and down screaming about safety and suggested new laws were needed to prevent this "dangerous" practice.
• Another example is the practice of flying to a different country to get a medical procedure. I'm thinking about an article I read where people flew, at their own expense, to India to get a surgical procedure that they couldn't afford in the US.

So, you would reasonably expect that something would cost more if you had to travel to get it, but these examples show things costing less. Call me cynical, but when someone that gets paid by folks that sell expensive drugs/treatment/insurance/whatever tells me that they're only limiting my options because they're concerned about my safety, I don't believe them. Now, if someone isn't comfortable with the low-cost option they can choose a different provider (just don't plunder my salary to pay for it ).

Call me cynical anyway; the shoe fits.

(PS - This thread is MUCH more fun then the ATE I'm debugging, although the progress I am making has increased my confidence that it will be done in 2009.)

[John Lokanis]

(there are extremely high, legislatively caused, barriers to entry into the market).

Yes, I agree with this. Now ask yourself, why is this the case? Is it really due to 'safety' issues where we have to pay the cost of all the regulation that the FDA does to keep us safe? Or is it protectionism for medical supply companies to keep a captive market where they can charge high costs for their products?

Obviously we have to balance this. We don't want antifreeze in our couch syrup, but we don't want to pay $100/day for the latest and greatest cholesterol medicine either.

You can also make the argument that in order to foster innovation in medicine, there needs to be a financial incentive for companies to invest in research. If the rest of the world is not going to pay for that, the US is stuck footing the bill. The medical industry pays lobbyists a lot of money to make sure congress keeps these 'safty' protections in place.

This is similar to the outsourcing problem. If Chinese companies had to treat their workers the same way we to (human rights, OSHA, benefits, etc) then their costs would be much higher. So, to stop outsourcing we need to insist they raise their standards. Or, we could lower ours. How do you think that would go over? 8 year olds working in sweat shops in Iowa?

So, if we want the rest of the world to compete with us on a level playing field, we need to insist they follow the same standards we do. Unfortunately, they don't want to.

So, we continue down the path we are on, deferring all the costs to future generations until the day the bill comes due, hoping it does not happen in our lifetimes...

No study can learn anything about what an open market could/would do as long as the market isn't open.

And none ever will because there will never be a free and open market. If it were to exist, it would simply appear to us as anarchy. The existence of society itself is simply a series of constraints placed on human behavior to allow us to live in a community. As long as we continue to choose to have society, we will never have truly open markets.

I am more interested in dealing with the reality of what we can do with our current system of governance to improve the situation. That is why I find those studies interesting and helpful in understanding the problem and where we might be able to fix or at least improve it.

Now back to work...