patrick.net

CBOEtrader says

The only reason this is a less than laughable point, is because we have destroyed our healthcare system w intervention already. We need far more free market spice in this soup, not less.

The military has fucked up many times. Does that mean we should disband the military?

The police have fucked up many times. Does that mean we should have no police?

This is a complete non-sequitur. The government implements some good polices and some bad policies; therefore, all polices that could possibly be enacted by the government must be bad. This is conservative right logic in a nutshell, and it's obviously wrong.

Instead of looking at whether or not a policy is implement by group A or group B, how about looking at the policy itself? The policy of socialized medicine has worked in other countries much better than the U.S. system. You statement that government policies must fail is empirically false. It is religious dogma, not engineering.

joeyjojojunior says

The free market fails miserably in markets with highly inelastic demand, such as health care.

Correct. The free market works in and only in situations where the following constraints are met.
1. Demand is highly elastic.
2. Substitute goods are readily available.
3. There are few barriers to entry.
4. There are many competitors.

Infrastructure and necessities never meet these constraints, and so free markets utterly fail at them. Free markets are best for luxury goods, electronics, software, low-skill services, restaurants, and similar things that the customer can simply walk away from if unpleased.

CBOEtrader says

You can't blame free markets for healthcare destruction, given how there isn't anything close to a free market in healthcare.

This is also true. We cannot blame free markets for the terrible healthcare system. We have to blame capitalism. The current health care system and the pre-ACA version are both the direct result of capitalism preventing free markets. Capitalists will always undermine free markets because rigged markets are more profitable and profit means everything. Capitalism and free markets are utterly mutually exclusive.

joeyjojojunior says

"You can't blame free markets for healthcare destruction, given how there isn't anything close to a free market in healthcare."

I didn't.

This is also true. Joey didn't make the claim that free markets caused this mess, but rather that free markets won't solve it, and he is correct.

There are huge costs to free markets, which is why we don't use them for sewers, the police, highways, traffic lights, the military, and lots of other things that fall into the categories of infrastructure or necessity. Hell, we don't even use free markets for agriculture. If you wanted more free markets, you should start there by revoking the farm bill and ending all farm subsidies. It's funny how republicans love to subsidize farms.

That's true. Jojo did...

Dan8267 says

This is also true. Joey didn't make the claim that free markets caused this mess,

BlueSardine says

That's true. Jojo did...

You cannot simply assert that. You must show it because it's quite clear to the rest of us that he did not say or even imply that. As such, you are making a straw man.

I said she said it.
You need to read the fine print...

Dan8267 says

You cannot simply assert that. You must show it because it's quite clear to the rest of us that he did not say or even imply that.

Dan8267 says

CBOEtrader says

The only reason this is a less than laughable point, is because we have destroyed our healthcare system w intervention already. We need far more free market spice in this soup, not less.

The military has fucked up many times. Does that mean we should disband the military?

The police have fucked up many times. Does that mean we should have no police?

This is a complete non-sequitur. The government implements some good polices and some bad policies; therefore, all polices that could possibly be enacted by the government must be bad. This is conservative right logic in a nutshell, and it's obviously wrong.

Instead of looking at whether or not a policy is implement by group A or group B, how about looking at the policy itself? The policy of socialized medicine has worked in other countries much better than the U.S. system. You statement that gove...

Straw man much? You consistently take concepts to the extreme. I never said any of this.

You claimed that government could lower healthcare costs. Our empirical evidence suggests the opposite.

CBOEtrader says

Our empirical evidence suggests the opposite.

what??

see any other developed country in the world

"Our empirical evidence suggests the opposite."

Yes, please show that empirical evidence. Because I can show a buttload of evidence that government run health care is orders of magnitude cheaper than the US cluster of a system.

joeyjojojunior says

Because I can show a buttload of evidence that government run health care is orders of magnitude cheaper than the US cluster of a system.

Yes, please share. We already have government run healthcare in the US. Our government spends more than per capita on healthcare than all but a tiny handfull of countries. Our current cluster of a system is a perfect example of the mess caused by a lack of a free market.

FP says

see any other developed country in the world

you are mistaken, but please give it a try and show us.

CBOEtrader says

Straw man much? You consistently take concepts to the extreme. I never said any of this.

This is not a straw man A straw man is a fallacy in which a person misrepresents the argument of his opponent. What I did was showed the logical consequence of your reasoning. If your reasoning leads to five conclusions and you disagree with four of them, why should I accept your reasoning?
CBOEtrader says

You claimed that government could lower healthcare costs. Our empirical evidence suggests the opposite.

Socialized medicine empirically provides better health care at lower cost. Here's the evidence.
http://www.pnhp.org/facts/single-payer-system-cost
http://www.huffingtonpost.com/edwin-g-dolan/bernie-health-care-europe_b_9387966.html

Now present your evidence. This is going to be fun. People evidently haven't learned the most important lessons of PatNet, the most famous of which is never get involved in a land war in Asia, but only slightly less well-known is this. Never go in against Dan in an evidence war.

Ironman says

So, how come it works fine for other markets like auto insurance, life insurance, homeowners insurance, life insurance, business insurance?

It doesn't. You get ripped off in all those businesses.

Ironman says

Once you do your research and educate yourself, you can make that statement.

I'm sorry I didn't graduate from the University of Dumbassery like you with a degrees in animal husbandry and wifery.

Ironman says

Please do... I'll wait....

No need to wait.
http://www.pnhp.org/facts/single-payer-system-cost

#rechargeableBatteriesDumbass

1. Obesity rates are low in Switzerland, relative to most OECD countries (Figure 1). 9% of adults are obese in Switzerland, while nearly 38% are overweight (including obesity). The latest data show that the prevalence of overweight (including obesity) has increased by 3 percentage points from 2007 to 2012.

https://www.oecd.org/switzerland/Obesity-Update-2014-SWITZERLAND.pdf

Link compares obesity rates in Switzerland with USA (eye opening) as well as with other countries.

Ironman says

Yeah, you graduated from the University of Gay Fat Nerds that Fuck Goats.

Stealing more of my jokes? Clearly, you know who's your superior.
Ironman says

Trying to compare single payer in Europe to our fucked up system is like comparing apples to horseshoes or comparing your gay fat ass to Mr. Universe.

Yeah, because cancer is different in Europe as are the laws of physics and mathematics.

Yet, somehow you have no problem using a very specific implementation of socialism in Venezuela for making a universal generalization that socialism is always bad. What hypocrisy.

CBOEtrader says

 

Dan8267 says

Because of economies of scale, reduced waste and needless competition, better coordination, and elimination of redundancies, socialized

This is the promise of every socialized program. Its an evil lie.

It's not like we don't have proof. Look at all the countries that don't practice, "oh, you want to continue living ? How much will you willing to pay for that ?"

Good incomes for services provided have a place in health care, but not the profit motive to the degree it does. It's a service, and those providing it should be paid very well becasue of the amount of training involved. Big pharma ? Providing cheap drugs to Canada ? What's up with that ?

I wonder how much drug research is heavily subsidized by the govt at the University level. Then when they're hot and on the verge of a breakthrough, they go to work for a drug company.

I've worked in the healthcare industry for years. I think a bunch of you are making valid points. Here is my research and conclusions up to this point:

- Our population is fatter, unhealthier, larger and more diverse than most every other developed nation, so you can't compare healthcare administration costs as apples to apples.
- We have a lot of poor, illegal immigrants who use our healthcare system because we don't really check citizenship and have IDs like other countries do.
- The US produces the most medical innovation than any other country in the world by far. We end up subsidizing the generics and copy-cats deployed elsewhere. If the US innovation didn't exist, our healthcare options would be much more antiquated. Leftists, be careful what you wish for if you do "too much" price fixing; will get to this later. The HepC cure may have never even existed had it not been for capitalism.

What Do We Do? (my opinion only obviously)
- WE HAVE TO FIX OUR ILLEGAL IMMIGRATION PROBLEM.
- If a life-saving drug is invented, we can't let capitalism reign. We must have some level of price fixing to allow Gilead, for example, to make money but not let people die. I'm not saying this will be easy, but an independent third party (i.e., government) would need to facilitate price-setting.
- I don't think we should get rid of gov't-paid healthcare for the poor and elderly. However, Medicare/Medicaid should be 1970s level of healthcare. In other words, procedures paid for by the government shouldn't be cutting edge or uber expensive.
- Most healthcare costs come from a small percentage of the population, and from the elderly in the last years of life. That small percentage needs to pay more via cost sharing than they are today. For the elderly, we need to make more forceful decisions about providing quality of life in the their last years, vs extending their life unnaturally.
- The Right will hate this, but we need more price fixing, period. There's too much subsidy by those who pay, vs those you can't, so you end up with people paying $1500 for stitches. HOWEVER, I don't think single payer is the answer because gov't is so fucking inefficient and corrupt. Just set price ranges for procedures and drugs (by region) and let the free market deal with out claims are adjudicated, etc., and technology and automation will drive down the cost of administration. Medical device companies will have to change their cost/pricing structures to match the cost of procedures.

So, I see this as a CAREFUL balance of free market and gov't intervention. If we lose too much free market, we lose innovation and increase gov't corruption and inefficiency. If we allow too much free market, we get outrageous pricing and certain portions of the population left out to die.

just any guy says

- Our population is fatter, unhealthier, larger and more diverse than most every other developed nation, so you can't compare healthcare administration costs as apples to apples.

- We have a lot of poor, illegal immigrants who use our healthcare system because we don't really check citizenship and have IDs like other countries do.

- The US produces the most medical innovation than any other country in the world by far. We end up subsidizing the generics and copy-cats deployed elsewhere. If the US innovation didn't exist, our healthcare options would be much more antiquated. Leftists, be careful what you wish for if you do "too much" price fixing; will get to this later. The HepC cure may have never even existed had it not been for capitalism.

just any guy says

What Do We Do? (my opinion only obviously)

- WE HAVE TO FIX OUR ILLEGAL IMMIGRATION PROBLEM.

A brilliant observation and one that could tantalizingly get enough bipartisanship support.

I have trouble believing that illegal immigration is causing the burdensome and exorbitant healthcare costs. The people that crowd the parking lot at all the health campuses every day all day doing who knows what, are all regular white fat Americans. And tons of old people causing traffic on the roads just to go to their daily appointments that yield virtually no benefit. I don't participate in any of that bullshit.

People with kids in sports should pay a butt load more as well. Twenty five years ago, none of that existed and we seemed to do better with the injuries. Now there's a med express on every corner with a queue around the block. I don't think anyone would be any worse off if all of those just disappeared

errc says

I have trouble believing that illegal immigration is causing the burdensome and exorbitant healthcare costs. The people that crowd the parking lot at all the health campuses every day all day doing who knows what, are all regular white fat Americans. And tons of old people causing traffic on the roads just to go to their daily appointments that yield virtually no benefit. I don't participate in any of that bullshit.

People with kids in sports should pay a butt load more as well. Twenty five years ago, none of that existed and we seemed to do better with the injuries. Now there's a med express on every corner with a queue around the block. I don't think anyone would be any worse off if all of those just disappeared

Think the Illegal issue is more of an issue with certain states. I had a Doctor friend that worked ER in an area that got flooded with illegals after another hospital in a Hispanic area had to shut down the ER, he suddenly started having tons of people with no insurance and no way to collect.

The illegal immigrant issue is a significant problem. I've seen it first hand over and over and over. The Left has politicized this issue so much that there's a great level of cognitive dissonance. This is why I've been banging the drum on this issue here on Pat.net for so long. It's a no-brainer

One more thing to add what I stated above. We have to have the individual mandate for this to work. However, we need to ensure we provide catastrophic options for healthy individuals so that they're not subsidizing the sick too much, but that we're not "directly" on the hook for when catastrophe strikes a seemingly healthy individual...it's baked into the actuarial model. And, we need to ensure cost-sharing with each plan assigned to an individual or family. If there's no cost-sharing, there's no skin in the game and services will be over-used.

I notice that programs that make the kids sit in groups and work on problems together are really popular with teachers. hahaha

CBOEtrader says

Regardless, a tiny country with one dominant civilized culture group that shares a strong patriotic loyalty to each other can do a lot of things that our 500 million multi-cultural society cant...like enact socialized health care system that doesn't degrade into a venezuelan nightmare.

You can't compare the us to Switzerland.

If you cannot compare the U.S. to Switzerland, then you cannot compare the U.S. to Venezuela either, and so any attempt to show failures of socializing in other nations are not applicable to attempts at socialization in the U.S. That principle goes both ways.

It's funny how one side of the argument over basic economic strategies loves to point out the failures of bad implementations of socialist policies by governments with many other problems, but hate it when competent governments demonstrate successful socialist policies.

In actuality, it makes far more sense to compare the U.S. to Switzerland than to Venezuela. The former two are rich countries with politically and socially stability and are highly developed. The latter meets none of those conditions. Consequentially, socialist policies implemented in the U.S. would be more like those in Switzerland than Venezuela. Anti-socialists don't like this because it's clear evidence that socialism, when used wisely, works.

Furthermore, it would be utterly impossible to run a society without socialism. You could have no military, no police, no streets, no sewer system, no electric grid, no lighthouses. Your society would be a third-world hell hole with para-military gangs constantly waging wars on the streets.

just any guy says

The illegal immigrant issue is a significant problem. I've seen it first hand over and over and over. The Left has politicized this issue so much that there's a great level of cognitive dissonance.

I don't really care if CA or any of the other border states want to kick Mexicans out. But if this was the main issue, you would expect everything to be working smoothly in the non-border states where immigration isn't a big issue. That's not really the case, so I doubt that fixing the immigration issue will solve much.

just any guy says

- Our population is fatter, unhealthier, larger and more diverse than most every other developed nation, so you can't compare healthcare administration costs as apples to apples.

Weight is a part of health care. A lot of people in the US think that doctors will just fix them if they get sick and that getting sick is just a genetic crap shoot. They don't realize that their own lifestyle will have a tremendous impact on how healthy they are. They also don't realize that doctors can't really 'fix' heart disease, cancer, etc. With heart disease, they can save your life if you are lucky. But they cannot reverse the disease. With Cancer, they can prolong your life with some of the less aggressive types. But the more aggressive ones will probably just kill you 'pretty quickly' regardless of what a doctor does.

Also, with regard to Obesity, 34% of Americans were obese in 2014. This is compared to 28-29% of people in the UK, Canada, New Zealand, Australia, and Mexico. That's not a huge difference - pun intended.

It's hard to believe that diversity of genetic backgrounds complicates the work of doctors all that much. Diversity of genetic material probably helps an individual, but I may be wrong on that. Correct me if you know something about that.

YesYNot says

But if this was the main issue

I never said it was the main issue. Healthcare is a very complex issue to solve with numerous factors to consider. Illegal immigrants using our healthcare system without paying for services is a problem...period.

I know your ideology says otherwise, but it's mistaken. I have first-hand experience with this.

It's hopeless. People muddle the issue with irrelevant details instead of looking at the big pucture.

How can removing the middle man, streamlining and simplifying the administration, removing the for-profit element, improving preventive care, and regulating services and costs does not make health care better and more affordable?

http://content.healthaffairs.org/content/31/8/1803.full.pdf+html

Or how about this? US compared to EU countries is an apples to oranges comparison. You are literally comparing white people with healthy lifestyles to obese black people. Im assuming facts are acceptable since this is thunderdome.

FP says

It's hopeless. People muddle the issue with irrelevant details instead of looking at the big pucture.

How can removing the middle man, streamlining and simplifying the administration, removing the for-profit element, improving preventive care, and regulating services and costs does not make health care better and more affordable?

A monkey could take a dump on our current system and it would be more affordable.

just any guy says

I know your ideology says otherwise, but it's mistaken. I have first-hand experience with this.

Having seen a few illegals going to the ER does not mean you know how significant a burden on the system they are.

FP says

Having seen a few illegals going to the ER does not mean you know how significant a burden on the system they are.

You're wrong. Having worked as an executive in the health plan for one of the largest health systems in the nation, I know what the burden was based on actual payor data as well as interacting with hospitals and physicians in 6 different states. Don't tell me my business.

CBOEtrader says

http://content.healthaffairs.org/content/31/8/1803.full.pdf+html

Or how about this? US compared to EU countries is an apples to oranges comparison. You are literally comparing white people with healthy lifestyles to obese black people. Im assuming facts are acceptable since this is thunderdome.

Why did you ignore the hispanics? They are as many as the blacks?

We have a problem of cultural choices. We choose to eat too many ho-ho's and shoot each other.

FP says

It's hopeless. People muddle the issue with irrelevant details instead of looking at the big pucture.

How can removing the middle man, streamlining and simplifying the administration, removing the for-profit element, improving preventive care, and regulating services and costs does not make health care better and more affordable?

In the words of Trump, healthcare is A LOT hard to solve than you think. If it were as trivial as you make it out to be, it would've been solved by now.

just any guy says

FP says

Having seen a few illegals going to the ER does not mean you know how significant a burden on the system they are.

You're wrong. Having worked as an executive in the health plan for one of the largest health systems in the nation, I know what the burden was based on actual payor data as well as interacting with hospitals and physicians in 6 different states. Don't tell me my business.

Give me the numbers then, don't just blablabla me.

FP says

just any guy says

FP says

Having seen a few illegals going to the ER does not mean you know how significant a burden on the system they are.

You're wrong. Having worked as an executive in the health plan for one of the largest health systems in the nation, I know what the burden was based on actual payor data as well as interacting with hospitals and physicians in 6 different states. Don't tell me my business.

Give me the numbers then, don't just blablabla me.

Roughly 15% of the uninsured were illegal immigrants. It was obviously worse in CA (upward of 25%) vs other states, but consider that a rough average. It's not just about the cost, but it's also about the experience that other legal and/or insured patients go through as it pertains to wait times.

FP says

Why did you ignore the hispanics? They are as many as the blacks?

Stats suggest the hispanic population does not harbor the same cultural plague as our black communities, and are therefore not as noteworthy.