“I believe what we need to be doing is forcefully and persistently making the case that the reason the US health ’system’ is on an unsustainable path is NOT because of the little bit of free enterprise that has survived thus far, but because of the massive distortions that have been introduced and have metastasized through government interventions beginning with WWII employer-provided health insurance incentives, then accelerating with Medicare/Medicaid, and perhaps most significantly the pervasive regulation of the health insurance market which grossly inflates the cost of coverage and so bastardizes the market the the product cannot accurately be called insurance. Any solution that fails to eliminate these interventions, and particularly one that introduces even more, can do no more than prolong the long, painful decline of the quality of US health care products and services, and the long, painful increase in the relative costs of the ’system.’”

OK. So you ARE on the right side of the debate!

(I gotta admit… you had me all confused, Jim! I must have misread your RESPONSES to something Sftor1 or someone else wrote to be what YOU believed. That was the context of my #51 comment.)

“What is needed is the very same thing that works everywhere else – food, housing, clothing, transportation, communications, etc. – and that of course is the free market.”

Exactly the point I keep making on all these health insurance/health care threads! Yes… a social safety net must be provided… but the MAJORITY of health insurance/health care provision simply CAN’T be nor SHOULD it be “provided” as a sort of social welfare program – either directly or through tax code subsidization.

“It bears noting that the US has generated by far the greatest number of advances in treatments, procedures and medications for decades, advances possible only because of free enterprise — a fantastic gift to the socialized-medicine world that cannot generate similar innovation but happily adopts it once the US has paid for its development. These advances have contributed immensely to the improved quality of life enjoyed thanks to Western medicine over the last 60 years or so. It is highly unlikely that this leadership would survive a significant shift further toward socialization.”

Yes.

YES! YES! YES!

Jim… thank GOD you’re here…!!! (*GRIN*)

“…“47 million uninsured!” when the number in question ought to be closer to 12 million.”

(*THUMBS UP*)

“We conservatives need to get away from the concession that health insurance is something that by rights ought to be provided by fellow citizens through taxes. We ought to call Medicare what it is, a welfare program. And we ought to challenge the notion that somehow it is the free market that is responsible for the high and accelerating cost of health care in the US. This notion is the opposite of the truth, and we are doing the nation and the world a disservice to permit the left to get away with that characterization.”

http://www.youtube.com/watch?v=-yWCzhhpZ2c&feature=PlayList&p=2360F9634CA6D85D&playnext=1&playnext_from=PL&index=53

God bless Jim… GOD BLESS FRANK!

Thank GOD… someone besides me finally GETS it!

BILL

“Just as we have cops to keep us safe, we need a health care system to keep us healthy.”

OK…

So my village has X cops on the payroll making anywhere from ABC to XYZ per year plus benefits, retirement, etc.

Town cops… we have Xa number making… (blah, blah, blah…)

State Troopers…

County Sheriff’s Deputies…

…and so on and so forth across the board.

Here – quick and easy as an example:

http://wiki.answers.com/Q/How_many_police_officers_are_employed_in_the_United_states

So let’s say 800,000 cops. (*SHRUG*)

(Then of course we have as “back-up” the national guard… ultimately the military… we have Homeland Security, the FBI, U.S. Marshall’s Service, Secret Service…

In other words we have quite a few (*SMILE*) folks directly employed by local/state/federal government who have either a badge and a gun or a patch and a gun. Right…??? We’re all on the same page?

So… what’s gonna be STARTING SALARY for a “government doctor” – employed by the government just as a cop is?

Hmm… and are we gonna have ONLY “federal doctors” or are we going to have “village doctors, town doctors, county doctors, state doctors” and if so which governmental body is responsible for paying each of these (plus benefits and retirement)?

A brand new cop can start as low as the “teens” (under $20K) in some small poor localities in poor states… what are we gonna start his doctor “employee peer” at?

At the other end of the scale with overtime a cop/detective can make a couple hundred grand a year in Suffolk County (Long Island, NY) if memory serves.

So… what are we gonna pay a senior surgeon working for “the government” in the same local?

How many doctors will be employed by the federal government when we change the healthcare system so it looks more like the policing system?

I’m pretty sure we have something like two and a half million doctors practicing in the United States. What’s it gonna cost to put ‘em all on “the payroll?”

Nurses too…??? (I mean… makes sense, right…???)

In fact, I suppose if all doctors are going to work directly for the government everyone in the medical field should become a government employee… right…???

I don’t know, Jim; I’ll go back to reading your posts, but this whole comparing the provision of healthcare to the provision of policing seems a bit… er… problematic.

(*WINK*)

BILL

The market does not ration – the government does.

“I am puzzled as to why Hippocratic medicine is necessarily excluded from a market economy. I wonder if you could elaborate?”
“Can I, a conservative, answer that?”

I very much credit and appreciate your effort, but again in my opinion it falls short. I explain:

“As soon as that stage III cancer patient hears that some hospital has the brand-new whiz-bang Neutrino-Beam machine to treat stage III cancer, he’ll demand it, cost be damned.”
–First, I grant the point that ever-improving medical technology is a major driver in the cost of care. But far from the only one. The only way he can ‘demand’ it, is if he is covered under a government program. Private insurance either covers it or doesn’t.

“Most of us don’t want to live in a society where the poor and unemployed have to die of diseases that the rich can afford to treat.”
–No doubt we all want to live in a world where nobody has to die from any treatable condition. That world does not and cannot exist. Health care goods and services are just that — goods and services. They are economic goods. Socialized medicine does not eliminate inequities between rich and poor consumers of medical care, even in Great Britain, the most socialized of all. The only reason such disparities are such a bedrock issue for advocates of socialized medicine is their political framework – egalitarianism raised to paramount importance. Rousseau. Marx. No matter how the US finances care, most of the rest of the world’s human population does not have access to the care we do. Does that make it unjust? No, it makes it a scarce resource. Period. Should we be expected to provide top-notch food, clothing, and housing for everyone in America because we don’t want to see somebody have to eat Kraft mac n cheese, wear the same pants every day, or deal with a basement that floods every time it rains? What makes these goods morally different than health care? I wouldn’t want to see people starve, but I would address that with voluntary charity. The same goes for basic health care. Socialized medicine will only take us in the direction of Canada and Britain, where not only do the poor not have access to the best medical technology and medications, but NOBODY has access.

We ought to provide — voluntarily — the best care we can to the poor in America. We should not be coerced into providing as much as can be extracted from us for those of our fellow citizens who are most favored by the federal government. Attempts to do so will only exacerbate the misallocation of resources and bastardize the provider-insurer-consumer relationship in such a way that inflation in health care continues apace. I am fairly certain you cannot refute this point: costs cannot be controlled by external price controls. That mechanism has never worked in history – because it can’t. It is contrary to the laws of economics. Simply not wanting to accept the implications of scarcity does not eliminate scarcity. The question is what is the most effective, economical, productive, just solution to that problem. As always, despite its bad name (as you say, “Social Darwinism”) free enterprise is not Darwinian – it benefits everybody. What does control costs are improvements in productivity and efficiency which cannot be imposed. Free enterprise and its profit motive and competitive structure are the only proven principles for producing goods and services that consumers want at the best price. Centralization limits the experimentation with solutions, so very few innovations come out of it. Free enterprise radically expands those experiments, and the ones that prove to be most effective win out, and they benefit everyone. Socialism does nothing more than shift the costs, it destroys incentives and leads to misallocation of resources and inefficiencies. (Obama’s claim that the Public Option is competition is fraudulent, and his claim that government is going to make the ’system’ more efficient is a joke.)

“There’s no way to alleviate that except by government intervention, or by sending those poor patients to go begging to various private charities.”
– Government intervention is the worst way to alleviate it (centralization’s impact, above). That is what has exacerbated health care inflation for the last 60 years. There’s no way to alleviate discrepancies in the availability of care entirely, but we have progressively provided more and better care to the poor and elderly by way of advances in medical care delivery, medicines, treatments and procedures – most of which are available thanks to the incentives and capital provided by the free market. Destruction of free enterprise in medicine, which is what we are contemplating here, will doom us all to the same fate enjoyed by all previous victims of socialism: we will all be equally miserable (with the exception of the politically powerful and their favored groups).

Can I, a conservative, answer that?

The law of supply and demand assumes that beyond a certain price, a buyer will refuse to pay. Therefore, the demand curve intersects the supply curve at some reasonable price.

But that almost never happens with health care for serious illnesses like cancer, heart disease, kidney failure, etc. Because nobody wants to die just because their health care is expensive. Hence a patient with stage III cancer is going to demand whatever health care it costs to save his life, cost be damned. IOW, in health care, we price a patient’s life as if it’s INFINITE. Hence the supply-demand curve won’t intersect at a price that’s reasonable–it intersects at a price that is limited only by supply.

And sure enough, surveys have shown that one of the biggest, if not the biggest, driver of health care costs is advancing technology. As soon as that stage III cancer patient hears that some hospital has the brand-new whiz-bang Neutrino-Beam machine to treat stage III cancer, he’ll demand it, cost be damned.

Society is forced to ration care. I have kidney failure. Back in the 1960s, there just weren’t anywhere near enough dialysis machines to go around. And committees went to work, reviewing the backgrounds of kidney patients, deciding who would get dialysis and who would be left to die. It was a literal death lottery, and most kidney patients didn’t win.

Left to its devices, the free market will ration based on ability to pay. A gazillionaire will get the state-of-the-art Neutrino-Beam machine; a poor person will get a pain-killer till cancer kills him. That inevitably leads you to Social Darwinism–a society based on survival of the fittest, where “fittest” equates to “richest.”

Most of us don’t want to live in a society where the poor and unemployed have to die of diseases that the rich can afford to treat. And doctors don’t want to cure rich patients while leaving poor patients to die. There’s no way to alleviate that except by government intervention, or by sending those poor patients to go begging to various private charities.

“sftor1 // Aug 9, 2009 at 2:40 am

Let’s stop nibbling around the edges. There is no reason not to admit that health care is not a market. The Hippocratic Oath is diametrically opposed to the corporation’s fiduciary responsibility to its shareholders. Irreconcilable, period. Health care is not suitable as a business. Just as we have cops to keep us safe, we need a health care system to keep us healthy. No less. That means breaking the health care oligarchs once and for all, and putting in place a system that delivers to all Americans. If Republicans can’t see that this is the only durable solution, they should at least get out of the way. It is not an abdication of capitalist principles, just an admission that there a certain things that are too important for businesses to handle. Sort of like national defense.”

I am puzzled as to why Hippocratic medicine is necessarily excluded from a market economy. I wonder if you could elaborate? This question is one that I pose to every proponent of socialized medicine with whom I attempt to exchange ideas; thus far, I have received no cogent arguments in support of that position. This is naturally my humble opinion, and would be disputed by the few who have actually given a response – one of whom is Spartacus – but, as in his case, it typically comes down to something like ‘our society has made a value judgment that we are not going to allow the elderly to die for lack of health insurance.’ See if you can spot the weakness of that argument. That’s right, it has nothing to do with economics, nothing to do with whether or not the solution actually effectively solves the problem, in the long term, and without unacceptable compromises to other important values.

I think it is great that you are proud of Norway’s system. I am not familiar with it, so I will not attempt to use it for comparison, although when I get a chance I will familiarize myself with it, as I am willing to entertain alternative solutions with an open mind. When it comes to other state solutions, however, such as Canada, Great Britain, Sweden, France — there are fundamental and serious flaws in the argument for socialized care, and while the systems are viable for the time being, they are all on trajectories that appear to me to be unsustainable fiscally and as a consequence morally.

The so-called conservatives or New Majoritarians on this site, for the most part, appear to be willing to settle for half-measures in addressing this issue. I believe what we need to be doing is forcefully and persistently making the case that the reason the US health ’system’ is on an unsustainable path is NOT because of the little bit of free enterprise that has survived thus far, but because of the massive distortions that have been introduced and have metastasized through government interventions beginning with WWII employer-provided health insurance incentives, then accelerating with Medicare/Medicaid, and perhaps most significantly the pervasive regulation of the health insurance market which grossly inflates the cost of coverage and so bastardizes the market the the product cannot accurately be called insurance. Any solution that fails to eliminate these interventions, and particularly one that introduces even more, can do no more than prolong the long, painful decline of the quality of US health care products and services, and the long, painful increase in the relative costs of the ’system.’

What is needed is the very same thing that works everywhere else – food, housing, clothing, transportation, communications, etc. – and that of course is the free market. The all-encompassing interventions currently in place are what is responsible for the extraordinary growth in HC costs. Employer provided insurance contributed to the elderly being priced out of health insurance, which then created the hue and cry for Medicare/Medicaid, which then accelerated the inflation in the health care and insurance markets, bringing us to the unfortunate pass at which we find ourselves: serious contemplation of measures we know to have failed everywhere else. It bears noting that the US has generated by far the greatest number of advances in treatments, procedures and medications for decades, advances possible only because of free enterprise — a fantastic gift to the socialized-medicine world that cannot generate similar innovation but happily adopts it once the US has paid for its development. These advances have contributed immensely to the improved quality of life enjoyed thanks to Western medicine over the last 60 years or so. It is highly unlikely that this leadership would survive a significant shift further toward socialization. The whole world will pay for that.

The health care ‘crisis’ in the US is a manufactured one, with liberals exaggerating the problems in the current market in order to justify draconian measures that otherwise would be untenable. Overstating the number of bankruptcies, for instance, is one tactic. Exaggerating the true number who can’t afford insurance but are not eligible for current programs is another – one they browbeat us with incessantly, “47 million uninsured!” when the number in question ought to be closer to 12 million.

We conservatives need to get away from the concession that health insurance is something that by rights ought to be provided by fellow citizens through taxes. We ought to call Medicare what it is, a welfare program. And we ought to challenge the notion that somehow it is the free market that is responsible for the high and accelerating cost of health care in the US. This notion is the opposite of the truth, and we are doing the nation and the world a disservice to permit the left to get away with that characterization.