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On February 25 2013 13:12 JonnyBNoHo wrote:Show nested quote +On February 25 2013 13:03 Stratos_speAr wrote:On February 25 2013 10:55 JonnyBNoHo wrote:On February 25 2013 10:48 Stratos_speAr wrote:On February 25 2013 08:02 JonnyBNoHo wrote:On February 25 2013 07:31 mcc wrote:On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it. Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest. There is no competition to be had in the world of healthcare. The vast, vast majority of patients are involuntary consumers and are not in a position to choose one hospital over another depending on price. I don't think that's accurate. You don't get cancer surgery on a whim you schedule the procedure in advance. If you can demonstrate otherwise I'll gladly change my opinion. The medical industry is actually very averse to competition. As an involuntary consumer, you don't have the luxury of taking the time to evaluate and decide what service you want when you need to call an ambulance or run to the emergency room. This is why there is one number to call for emergencies. Think of a situation where there were two competing hospitals with competing emergency services in the area. For this to work, there would need to be A) a system for individuals calling for an ambulance to pick a hospital to go to while under the duress of the situation, or B) different phone numbers for them to call so they can choose their hospital by virtue of who they call. Both of these are incredibly impractical, and this is why it is set up so that 9-1-1 just gets you an ambulance that goes to a particular hospital. If it weren't set up this way, then competition would be snuffed out by the ambulance service that is lucky enough to be on the receiving end of 9-1-1 calls. Furthermore, not all hospitals are equal. Hospitals are set up in a fashion so that their specialties are utilized. If competition were to ensue, then the level 1 trauma centers in a metro area would run all of the other hospitals out of the out-patient business necessary to keep them afloat. This is a similar problem to a privatized school voucher system; you'd force many hospitals out of business, leaving many people in less urban areas with long travel times to get to a hospital. There is literally nothing about the medical industry that is in favor of privatized, competitive healthcare. You'd end up with some hospitals monopolizing emergency healthcare and others monopolizing everyday out-patient healthcare. Both of these would, no doubt, be necessary for a hospital to survive on a competitive business model. Competitive healthcare is completely illogical and the socialized health systems in every other developed nation that put ours to shame shows us exactly this. No one is arguing for competition during 911 calls. Quit being stupid.
You didn't read my post. If there is no competition on 9-1-1 calls, then one or two hospitals would get a monopoly on emergency ambulance care, which would, then and there, run many hospitals out of business. Functioning healthcare systems that are good for the consumer are, by their very nature, anti-competitive.
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On February 25 2013 12:47 Gonff wrote:Show nested quote +On February 25 2013 12:16 Nyxisto wrote:
i really don't understand why the fear of regulation is so huge. it may be an american thing (and no i'm not trying to make an anti-american post or something like that, it's just that most of the posts that share the kind of tone i want to talk about come from american posters) but many posts seem to share the view, that privately run businesses are the heaven of competition and efficiency, and that companies owned by state are run bei lazy monkeys who don't get anything done.
I find it kinda odd that people are still advocating a deregulated market in the healthcare sector. There isn't really any good argument in this thread even after 16 pages , which explains why people who have an accident and need to get treatment fast and are forced to visit the nearest hospital and can't choose between alternatives is not a problem in a free market. Instead people advocating deregulation simply switch to other topics.
Its not like every patient on this planet is treated for cancer, in fact most people who may need medical help may either have had an accident, and in that case you can't choose where to go, or they may have something that requires such simple treatment that driving 60 miles to treat it may be more expensive than just going to the nearest hospital/clinic.
And coming back to state owned/regulated businesses, they're actually doing pretty well. If we for example take the police, or public transport companies, yes they may all be a little bit slow and have some of the typical problems that are associated with state-run organisations, but in fact most of them work pretty reasonably.
It's not like our trains here are all three ours late and crashing into each other just because the "Deutsche-Bahn" is a public corporation. I completely agree with this post. As a rhetorical question, why don't doctors themselves take more accountability on the subject of skyrocketing medical costs for their patients? It's not like they have no idea that the people they are treating will suffer tragic consequences from debt. All doctors swear oaths to do no harm. Can an argument be made that doctors do in fact harm their patients when they prescribe those patients treatments they know will cause permanent social/economic harm? Or how about the potential harm those patients may suffer when they decline to seek future treatment because they're still paying for the last drug? Much like the doctors in the Time article who stood up to the cancer drug company for overcharging and caused it to cut prices by 50% (down to the level of other comparable drugs with comparable effectiveness), maybe there is potential for doctors to make a big difference here? I honestly don't know how I come down on this, but the one thing that I do know is that it seems odd that we ignore the possibility that doctors could maybe make a difference if they took accountability for the cost of the treatments they prescribe. Edit: I'm not proposing that doctors just decline to treat patients overall if they know those patients are poor. I'm just offering the idea that maybe a visit to the doctor's office should involve a frank discussion that considers the patient's overall economic situation and tries to take that into account when forming a treatment plan (perhaps cutting out some surplus diagnostics or something).
I agree that more could be done by doctors in this respect. But you can only expect so much from people in a system that so incentivizes them to do the opposite. The system needs to be fixed.
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On February 25 2013 13:15 Kyrao wrote:Show nested quote +On February 25 2013 12:47 Gonff wrote:On February 25 2013 12:16 Nyxisto wrote:
i really don't understand why the fear of regulation is so huge. it may be an american thing (and no i'm not trying to make an anti-american post or something like that, it's just that most of the posts that share the kind of tone i want to talk about come from american posters) but many posts seem to share the view, that privately run businesses are the heaven of competition and efficiency, and that companies owned by state are run bei lazy monkeys who don't get anything done.
I find it kinda odd that people are still advocating a deregulated market in the healthcare sector. There isn't really any good argument in this thread even after 16 pages , which explains why people who have an accident and need to get treatment fast and are forced to visit the nearest hospital and can't choose between alternatives is not a problem in a free market. Instead people advocating deregulation simply switch to other topics.
Its not like every patient on this planet is treated for cancer, in fact most people who may need medical help may either have had an accident, and in that case you can't choose where to go, or they may have something that requires such simple treatment that driving 60 miles to treat it may be more expensive than just going to the nearest hospital/clinic.
And coming back to state owned/regulated businesses, they're actually doing pretty well. If we for example take the police, or public transport companies, yes they may all be a little bit slow and have some of the typical problems that are associated with state-run organisations, but in fact most of them work pretty reasonably.
It's not like our trains here are all three ours late and crashing into each other just because the "Deutsche-Bahn" is a public corporation. I completely agree with this post. As a rhetorical question, why don't doctors themselves take more accountability on the subject of skyrocketing medical costs for their patients? It's not like they have no idea that the people they are treating will suffer tragic consequences from debt. All doctors swear oaths to do no harm. Can an argument be made that doctors do in fact harm their patients when they prescribe those patients treatments they know will cause permanent social/economic harm? Or how about the potential harm those patients may suffer when they decline to seek future treatment because they're still paying for the last drug? Much like the doctors in the Time article who stood up to the cancer drug company for overcharging and caused it to cut prices by 50% (down to the level of other comparable drugs with comparable effectiveness), maybe there is potential for doctors to make a big difference here? I honestly don't know how I come down on this, but the one thing that I do know is that it seems odd that we ignore the possibility that doctors could maybe make a difference if they took accountability for the cost of the treatments they prescribe. Edit: I'm not proposing that doctors just decline to treat patients overall if they know those patients are poor. I'm just offering the idea that maybe a visit to the doctor's office should involve a frank discussion that considers the patient's overall economic situation and tries to take that into account when forming a treatment plan (perhaps cutting out some surplus diagnostics or something). I agree that more could be done by doctors in this respect. But you can only expect so much from people in a system that so incentivizes them to do the opposite. The system needs to be fixed.
Yeah I think you're right on this point. Implementing even just a few of the systemic changes that the article's author suggested would almost certainly make a much greater difference than just telling doctors, "watch out for your patients' finances."
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On February 25 2013 13:15 Stratos_speAr wrote:Show nested quote +On February 25 2013 13:12 JonnyBNoHo wrote:On February 25 2013 13:03 Stratos_speAr wrote:On February 25 2013 10:55 JonnyBNoHo wrote:On February 25 2013 10:48 Stratos_speAr wrote:On February 25 2013 08:02 JonnyBNoHo wrote:On February 25 2013 07:31 mcc wrote:On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it. Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest. There is no competition to be had in the world of healthcare. The vast, vast majority of patients are involuntary consumers and are not in a position to choose one hospital over another depending on price. I don't think that's accurate. You don't get cancer surgery on a whim you schedule the procedure in advance. If you can demonstrate otherwise I'll gladly change my opinion. The medical industry is actually very averse to competition. As an involuntary consumer, you don't have the luxury of taking the time to evaluate and decide what service you want when you need to call an ambulance or run to the emergency room. This is why there is one number to call for emergencies. Think of a situation where there were two competing hospitals with competing emergency services in the area. For this to work, there would need to be A) a system for individuals calling for an ambulance to pick a hospital to go to while under the duress of the situation, or B) different phone numbers for them to call so they can choose their hospital by virtue of who they call. Both of these are incredibly impractical, and this is why it is set up so that 9-1-1 just gets you an ambulance that goes to a particular hospital. If it weren't set up this way, then competition would be snuffed out by the ambulance service that is lucky enough to be on the receiving end of 9-1-1 calls. Furthermore, not all hospitals are equal. Hospitals are set up in a fashion so that their specialties are utilized. If competition were to ensue, then the level 1 trauma centers in a metro area would run all of the other hospitals out of the out-patient business necessary to keep them afloat. This is a similar problem to a privatized school voucher system; you'd force many hospitals out of business, leaving many people in less urban areas with long travel times to get to a hospital. There is literally nothing about the medical industry that is in favor of privatized, competitive healthcare. You'd end up with some hospitals monopolizing emergency healthcare and others monopolizing everyday out-patient healthcare. Both of these would, no doubt, be necessary for a hospital to survive on a competitive business model. Competitive healthcare is completely illogical and the socialized health systems in every other developed nation that put ours to shame shows us exactly this. No one is arguing for competition during 911 calls. Quit being stupid. You didn't read my post. If there is no competition on 9-1-1 calls, then one or two hospitals would get a monopoly on emergency ambulance care, which would, then and there, run many hospitals out of business. Functioning healthcare systems that are good for the consumer are, by their very nature, anti-competitive.
Says you. Frankly I don't see how that makes any sense at all.
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CA10824 Posts
On February 25 2013 13:25 Gonff wrote:Show nested quote +On February 25 2013 13:15 Kyrao wrote:On February 25 2013 12:47 Gonff wrote:On February 25 2013 12:16 Nyxisto wrote:
i really don't understand why the fear of regulation is so huge. it may be an american thing (and no i'm not trying to make an anti-american post or something like that, it's just that most of the posts that share the kind of tone i want to talk about come from american posters) but many posts seem to share the view, that privately run businesses are the heaven of competition and efficiency, and that companies owned by state are run bei lazy monkeys who don't get anything done.
I find it kinda odd that people are still advocating a deregulated market in the healthcare sector. There isn't really any good argument in this thread even after 16 pages , which explains why people who have an accident and need to get treatment fast and are forced to visit the nearest hospital and can't choose between alternatives is not a problem in a free market. Instead people advocating deregulation simply switch to other topics.
Its not like every patient on this planet is treated for cancer, in fact most people who may need medical help may either have had an accident, and in that case you can't choose where to go, or they may have something that requires such simple treatment that driving 60 miles to treat it may be more expensive than just going to the nearest hospital/clinic.
And coming back to state owned/regulated businesses, they're actually doing pretty well. If we for example take the police, or public transport companies, yes they may all be a little bit slow and have some of the typical problems that are associated with state-run organisations, but in fact most of them work pretty reasonably.
It's not like our trains here are all three ours late and crashing into each other just because the "Deutsche-Bahn" is a public corporation. I completely agree with this post. As a rhetorical question, why don't doctors themselves take more accountability on the subject of skyrocketing medical costs for their patients? It's not like they have no idea that the people they are treating will suffer tragic consequences from debt. All doctors swear oaths to do no harm. Can an argument be made that doctors do in fact harm their patients when they prescribe those patients treatments they know will cause permanent social/economic harm? Or how about the potential harm those patients may suffer when they decline to seek future treatment because they're still paying for the last drug? Much like the doctors in the Time article who stood up to the cancer drug company for overcharging and caused it to cut prices by 50% (down to the level of other comparable drugs with comparable effectiveness), maybe there is potential for doctors to make a big difference here? I honestly don't know how I come down on this, but the one thing that I do know is that it seems odd that we ignore the possibility that doctors could maybe make a difference if they took accountability for the cost of the treatments they prescribe. Edit: I'm not proposing that doctors just decline to treat patients overall if they know those patients are poor. I'm just offering the idea that maybe a visit to the doctor's office should involve a frank discussion that considers the patient's overall economic situation and tries to take that into account when forming a treatment plan (perhaps cutting out some surplus diagnostics or something). I agree that more could be done by doctors in this respect. But you can only expect so much from people in a system that so incentivizes them to do the opposite. The system needs to be fixed. Yeah I think you're right on this point. Implementing even just a few of the systemic changes that the article's author suggested would almost certainly make a much greater difference than just telling doctors, "watch out for your patients' finances."
doctors don't like practicing defensive medicine either but it's necessary unless you want to be on the losing end of a lot of lawsuits.
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On February 25 2013 13:26 JonnyBNoHo wrote:Show nested quote +On February 25 2013 13:15 Stratos_speAr wrote:On February 25 2013 13:12 JonnyBNoHo wrote:On February 25 2013 13:03 Stratos_speAr wrote:On February 25 2013 10:55 JonnyBNoHo wrote:On February 25 2013 10:48 Stratos_speAr wrote:On February 25 2013 08:02 JonnyBNoHo wrote:On February 25 2013 07:31 mcc wrote:On February 25 2013 07:22 JonnyBNoHo wrote:On February 25 2013 05:58 Kyrao wrote:
Capitalism is not some sacred infallible law like many of my fellow Americans like to believe. There are certain areas of society in which capitalist theory does not work. Healthcare is one of them. Like many people have said before me, asymmetric information, lack of competition, and price inelasticity of demand prevent a capitalist approach from being at all effective in healthcare.
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play. In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it. Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest. There is no competition to be had in the world of healthcare. The vast, vast majority of patients are involuntary consumers and are not in a position to choose one hospital over another depending on price. I don't think that's accurate. You don't get cancer surgery on a whim you schedule the procedure in advance. If you can demonstrate otherwise I'll gladly change my opinion. The medical industry is actually very averse to competition. As an involuntary consumer, you don't have the luxury of taking the time to evaluate and decide what service you want when you need to call an ambulance or run to the emergency room. This is why there is one number to call for emergencies. Think of a situation where there were two competing hospitals with competing emergency services in the area. For this to work, there would need to be A) a system for individuals calling for an ambulance to pick a hospital to go to while under the duress of the situation, or B) different phone numbers for them to call so they can choose their hospital by virtue of who they call. Both of these are incredibly impractical, and this is why it is set up so that 9-1-1 just gets you an ambulance that goes to a particular hospital. If it weren't set up this way, then competition would be snuffed out by the ambulance service that is lucky enough to be on the receiving end of 9-1-1 calls. Furthermore, not all hospitals are equal. Hospitals are set up in a fashion so that their specialties are utilized. If competition were to ensue, then the level 1 trauma centers in a metro area would run all of the other hospitals out of the out-patient business necessary to keep them afloat. This is a similar problem to a privatized school voucher system; you'd force many hospitals out of business, leaving many people in less urban areas with long travel times to get to a hospital. There is literally nothing about the medical industry that is in favor of privatized, competitive healthcare. You'd end up with some hospitals monopolizing emergency healthcare and others monopolizing everyday out-patient healthcare. Both of these would, no doubt, be necessary for a hospital to survive on a competitive business model. Competitive healthcare is completely illogical and the socialized health systems in every other developed nation that put ours to shame shows us exactly this. No one is arguing for competition during 911 calls. Quit being stupid. You didn't read my post. If there is no competition on 9-1-1 calls, then one or two hospitals would get a monopoly on emergency ambulance care, which would, then and there, run many hospitals out of business. Functioning healthcare systems that are good for the consumer are, by their very nature, anti-competitive. Says you. Frankly I don't see how that makes any sense at all.
"Here, I am going to just give you a complete monopoly on a very large chunk of the healthcare market (emergency care)".
I don't see how this is hard to understand. It's like giving, say, FOX, a complete monopoly on news, comedy, and drama TV series. Just by virtue of having that monopoly, it would already squash most competition. If you're trying to be a competitive hospital in an area where a different hospital has a monopoly on emergency care, how do you survive without such a large chunk of revenue?
Oh, and you still haven't addressed anything else in my first post explaining this.
Even if you somehow jump all of the hurdles that I've mentioned, you still have to explain a single reason to prefer a competitive, privatized healthcare system (the only attempt in a developed world being a complete failure; see our healthcare system) compared to socialized, public healthcare (which, by pretty much all accounts, is incredibly successful and cheap). Why choose the incredibly difficult option when socialized healthcare is just better?
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On February 25 2013 13:32 Stratos_speAr wrote:Show nested quote +On February 25 2013 13:26 JonnyBNoHo wrote:On February 25 2013 13:15 Stratos_speAr wrote:On February 25 2013 13:12 JonnyBNoHo wrote:On February 25 2013 13:03 Stratos_speAr wrote:On February 25 2013 10:55 JonnyBNoHo wrote:On February 25 2013 10:48 Stratos_speAr wrote:On February 25 2013 08:02 JonnyBNoHo wrote:On February 25 2013 07:31 mcc wrote:On February 25 2013 07:22 JonnyBNoHo wrote:
[quote]
Those roadblocks could just be removed. The only one which we're stuck with is inelastic demand when it comes to real insurance events (broken limb, cancer, etc.) as you say later on that's where insurance should come in to play.
In parts of the US system those roadblocks don't exist and things work fine (ex. laser eye correction or non-regulated drugs) so I'm not sure why that couldn't be extended to many other parts of healthcare. Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it. Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest. There is no competition to be had in the world of healthcare. The vast, vast majority of patients are involuntary consumers and are not in a position to choose one hospital over another depending on price. I don't think that's accurate. You don't get cancer surgery on a whim you schedule the procedure in advance. If you can demonstrate otherwise I'll gladly change my opinion. The medical industry is actually very averse to competition. As an involuntary consumer, you don't have the luxury of taking the time to evaluate and decide what service you want when you need to call an ambulance or run to the emergency room. This is why there is one number to call for emergencies. Think of a situation where there were two competing hospitals with competing emergency services in the area. For this to work, there would need to be A) a system for individuals calling for an ambulance to pick a hospital to go to while under the duress of the situation, or B) different phone numbers for them to call so they can choose their hospital by virtue of who they call. Both of these are incredibly impractical, and this is why it is set up so that 9-1-1 just gets you an ambulance that goes to a particular hospital. If it weren't set up this way, then competition would be snuffed out by the ambulance service that is lucky enough to be on the receiving end of 9-1-1 calls. Furthermore, not all hospitals are equal. Hospitals are set up in a fashion so that their specialties are utilized. If competition were to ensue, then the level 1 trauma centers in a metro area would run all of the other hospitals out of the out-patient business necessary to keep them afloat. This is a similar problem to a privatized school voucher system; you'd force many hospitals out of business, leaving many people in less urban areas with long travel times to get to a hospital. There is literally nothing about the medical industry that is in favor of privatized, competitive healthcare. You'd end up with some hospitals monopolizing emergency healthcare and others monopolizing everyday out-patient healthcare. Both of these would, no doubt, be necessary for a hospital to survive on a competitive business model. Competitive healthcare is completely illogical and the socialized health systems in every other developed nation that put ours to shame shows us exactly this. No one is arguing for competition during 911 calls. Quit being stupid. You didn't read my post. If there is no competition on 9-1-1 calls, then one or two hospitals would get a monopoly on emergency ambulance care, which would, then and there, run many hospitals out of business. Functioning healthcare systems that are good for the consumer are, by their very nature, anti-competitive. Says you. Frankly I don't see how that makes any sense at all. "Here, I am going to just give you a complete monopoly on a very large chunk of the healthcare market (emergency care)". I don't see how this is hard to understand. It's like giving, say, FOX, a complete monopoly on news, comedy, and drama TV series. Just by virtue of having that monopoly, it would already squash most competition. If you're trying to be a competitive hospital in an area where a different hospital has a monopoly on emergency care, how do you survive without such a large chunk of revenue? Oh, and you still haven't addressed anything else in my first post explaining this. Even if you somehow jump all of the hurdles that I've mentioned, you still have to explain a single reason to prefer a competitive, privatized healthcare system (the only attempt in a developed world being a complete failure; see our healthcare system) compared to socialized, public healthcare (which, by pretty much all accounts, is incredibly successful and cheap). Why choose the incredibly difficult option when socialized healthcare is just better?
The problem is that you are making suppositions without any data to back it up.
If 911 monopoly was enough to quash new entrants than there would be no need to block new entrants (or existing players from expanding). So your completely lacking in data guesswork is wrong. Completely utterly wrong. Ex. Why do retail health clinics want to exist when they don't have access to the 911 monopoly?
As for the socialized healthcare alternative I've already said that I'd be fine with it. I'm simply pointing out that a competitive system would work too. And no we don't have one, so stop that BS.
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As a rhetorical question, why don't doctors themselves take more accountability on the subject of skyrocketing medical costs for their patients? It's not like they have no idea that the people they are treating will suffer tragic consequences from debt. All doctors swear oaths to do no harm. Can an argument be made that doctors do in fact harm their patients when they prescribe those patients treatments they know will cause permanent social/economic harm? Or how about the potential harm those patients may suffer when they decline to seek future treatment because they're still paying for the last drug?
Often times the doctors are totally disconnected from the billing process. I know those of us talking here rarely see the actual price of our prescriptions and hospital visits; how is it any more difficult to suppose that doctors (in general) know here and there what is expensive and what is not, but in no direct way. They are paid by the hospital for their services, and perform what they studied to do on patients. No boogeyman here.
I join with others (or one other) in this thread proposing a deregulated industry--in modern parlance, a lightly regulated one. Insurers can be shopped for to provide benefits specific to the consumer free of the heavy hand of government describing in detail what insurance can and cannot cover and how they can do it. We got into the nitty gritty of it in this recent election season with the mandate that employer health insurance must cover the costs of contraceptives. Hospitals and doctors same thing; prices posted up front, payment plans available etc. We're not equating this with competing on a 911 call during the drive. Emergency rooms already have certain laws governing them too. Same thing with costs of insurance with prior conditions: requiring insurance companies to cover it without respecting the risk pool in terms of cost, leading to increases in costs across the board (in United States and elsewhere, known as community ratings. PPACA delves into it). This also creates the moral hazard of engaging in extremely risky behavior and knowing that you can find insurance immediately prior to any resulting operations/hospitalizations, where insurers cannot refuse you or greatly elevate the prices based on it.
Ignored also in this is one area that has shown the fruits of when competition is allowed in the market. Laser eye surgery centers have steadily declined in cost and increased in quality through the years. Obama's second cousin, once removed, Dr. Milton R Wolf said it right, back when Obamacare was grabbing headlings all over.
“Primum nil nocere.”First, do no harm. This guiding principle is a bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it.
Imagine if, like physicians, politicians were personally held to the incredibly high level of scrutiny that includes civil and financial liability for any unintended consequence of their decisions. Imagine if they were forced to spend tens of thousands of dollars each year on malpractice insurance and still faced the threat of multimillion-dollar lawsuits with every single decision they made. If so, a government takeover of health care would be the furthest thing from their minds.
Obamacare proponents would have us believe that we will add 30 million patients to the system without adding providers, we will see no decline in the quality of care for the millions of Americans currently happy with the system, and -if you act now!- we will save money in the process. But why stop there? Why not promise it will no longer rain on weekends and every day will be a great hair day?
America has the finest health care delivery system in the world. Let’s not forget that and put it at risk in the name of reform. Desperate souls across the globe flock to our shores and cross our borders every day to seek our care. Why? Our system provides cures while the government-run systems from which they flee do not. Compare Europe’s common cancer mortality rates to America’s: breast cancer - 52 percent higher in Germany and 88 percent higher in the United Kingdom; prostate cancer - a staggering 604 percent higher in the United Kingdom and 457 percent higher in Norway; colon cancer - 40 percent higher in the United Kingdom.
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This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies - now answerable to you rather than your employer - would cover it.
This is discussion happening 3 years ago. How do we govern responsibly to assure America stays the best in the business with health care quality and delivery? By stopping the march towards those federal policies proven to result in a lack of availability and a decrease in quality of the care.
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On February 25 2013 13:49 JonnyBNoHo wrote:Show nested quote +On February 25 2013 13:32 Stratos_speAr wrote:On February 25 2013 13:26 JonnyBNoHo wrote:On February 25 2013 13:15 Stratos_speAr wrote:On February 25 2013 13:12 JonnyBNoHo wrote:On February 25 2013 13:03 Stratos_speAr wrote:On February 25 2013 10:55 JonnyBNoHo wrote:On February 25 2013 10:48 Stratos_speAr wrote:On February 25 2013 08:02 JonnyBNoHo wrote:On February 25 2013 07:31 mcc wrote:
[quote]
Asymmetric information will also remain. And market mechanisms can work in some parts of medicine, like elective plastic surgery (with exceptions), but not in most of it.
Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest. There is no competition to be had in the world of healthcare. The vast, vast majority of patients are involuntary consumers and are not in a position to choose one hospital over another depending on price. I don't think that's accurate. You don't get cancer surgery on a whim you schedule the procedure in advance. If you can demonstrate otherwise I'll gladly change my opinion. The medical industry is actually very averse to competition. As an involuntary consumer, you don't have the luxury of taking the time to evaluate and decide what service you want when you need to call an ambulance or run to the emergency room. This is why there is one number to call for emergencies. Think of a situation where there were two competing hospitals with competing emergency services in the area. For this to work, there would need to be A) a system for individuals calling for an ambulance to pick a hospital to go to while under the duress of the situation, or B) different phone numbers for them to call so they can choose their hospital by virtue of who they call. Both of these are incredibly impractical, and this is why it is set up so that 9-1-1 just gets you an ambulance that goes to a particular hospital. If it weren't set up this way, then competition would be snuffed out by the ambulance service that is lucky enough to be on the receiving end of 9-1-1 calls. Furthermore, not all hospitals are equal. Hospitals are set up in a fashion so that their specialties are utilized. If competition were to ensue, then the level 1 trauma centers in a metro area would run all of the other hospitals out of the out-patient business necessary to keep them afloat. This is a similar problem to a privatized school voucher system; you'd force many hospitals out of business, leaving many people in less urban areas with long travel times to get to a hospital. There is literally nothing about the medical industry that is in favor of privatized, competitive healthcare. You'd end up with some hospitals monopolizing emergency healthcare and others monopolizing everyday out-patient healthcare. Both of these would, no doubt, be necessary for a hospital to survive on a competitive business model. Competitive healthcare is completely illogical and the socialized health systems in every other developed nation that put ours to shame shows us exactly this. No one is arguing for competition during 911 calls. Quit being stupid. You didn't read my post. If there is no competition on 9-1-1 calls, then one or two hospitals would get a monopoly on emergency ambulance care, which would, then and there, run many hospitals out of business. Functioning healthcare systems that are good for the consumer are, by their very nature, anti-competitive. Says you. Frankly I don't see how that makes any sense at all. "Here, I am going to just give you a complete monopoly on a very large chunk of the healthcare market (emergency care)". I don't see how this is hard to understand. It's like giving, say, FOX, a complete monopoly on news, comedy, and drama TV series. Just by virtue of having that monopoly, it would already squash most competition. If you're trying to be a competitive hospital in an area where a different hospital has a monopoly on emergency care, how do you survive without such a large chunk of revenue? Oh, and you still haven't addressed anything else in my first post explaining this. Even if you somehow jump all of the hurdles that I've mentioned, you still have to explain a single reason to prefer a competitive, privatized healthcare system (the only attempt in a developed world being a complete failure; see our healthcare system) compared to socialized, public healthcare (which, by pretty much all accounts, is incredibly successful and cheap). Why choose the incredibly difficult option when socialized healthcare is just better? The problem is that you are making suppositions without any data to back it up. If 911 monopoly was enough to quash new entrants than there would be no need to block new entrants (or existing players from expanding). So your completely lacking in data guesswork is wrong. Completely utterly wrong. Ex. Why do retail health clinics want to exist when they don't have access to the 911 monopoly? As for the socialized healthcare alternative I've already said that I'd be fine with it. I'm simply pointing out that a competitive system would work too. And no we don't have one, so stop that BS.
This assumption is entirely wrong. There are a number of reasons to block new entrants, even if 9-1-1 monopoly would be enough to severely discourage competition. Regulation and system efficiency is one big reason.
Skipping all of that, address a really big point; we're talking about the problem of excessive costs of healthcare. Emergency healthcare is INCREDIBLY expensive (over $900 for an ambulance ride when I was getting trained as an EMT two years ago). How are these prices going to go down if the emergency medicine monopoly is maintained, as you have even admitted it would be?
I don't think that many people are going to argue that the free market would completely fail the healthcare industry in every aspect. The problem is that some key parts of the industry (emergency care being an example) can't operate efficiently under a free market system, and for the parts that would work under a free market system to actually work, they would have to be incredibly convoluted.
We know that socialized healthcare works and that it works very well. the ideologues in this thread and throughout the States that hate socialized healthcare because of the word "socialized" have consistently failed to give us a reason as to why we shouldn't use a system of healthcare that, throughout the developed world, is working better than ours in pretty much every single way. Freedom? You already have little to no freedom in healthcare. Economics? We already spend significantly more than any other country on healthcare. Waiting times? Only happen when it isn't actually an emergency; random anecdotal evidence is merely faulty inductive logic. Constitutionality? The Constitution can be changed; the purpose is to serve the people, and if socialized healthcare serves the people best, there's no reason to limit ourselves just because a piece of paper doesn't permit it (hell, it should be changed; it's incredibly outdated and woefully ill-equipped for contemporary needs). The only people that don't benefit from socialized healthcare as much as our system are the super-rich that want to get the the absolute best doctors/experimental treatments basically at-will. I think before we even continue this discussion, we need to address that; if there is a system out there that is blatantly better than ours, why are we avoiding it like the plague?
Oh, and it may not be entirely free market now, but our healthcare system is the evolution of an attempt at free market healthcare when healthcare was first becoming a real industry. So yes, this is the result of an attempt at the market handling it. Regulations are the result of us attempting to fix the faults in the market.
TL;DR
We need a reason to prefer free-market healthcare over socialized medicine. We don't have one yet.
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On February 25 2013 14:04 Stratos_speAr wrote:Show nested quote +On February 25 2013 13:49 JonnyBNoHo wrote:On February 25 2013 13:32 Stratos_speAr wrote:On February 25 2013 13:26 JonnyBNoHo wrote:On February 25 2013 13:15 Stratos_speAr wrote:On February 25 2013 13:12 JonnyBNoHo wrote:On February 25 2013 13:03 Stratos_speAr wrote:On February 25 2013 10:55 JonnyBNoHo wrote:On February 25 2013 10:48 Stratos_speAr wrote:On February 25 2013 08:02 JonnyBNoHo wrote:
[quote]
Sure, but other markets have plenty of asymmetric information too and they work fine. Systems (competition for one) can be put in place to keep those with more information honest. There is no competition to be had in the world of healthcare. The vast, vast majority of patients are involuntary consumers and are not in a position to choose one hospital over another depending on price. I don't think that's accurate. You don't get cancer surgery on a whim you schedule the procedure in advance. If you can demonstrate otherwise I'll gladly change my opinion. The medical industry is actually very averse to competition. As an involuntary consumer, you don't have the luxury of taking the time to evaluate and decide what service you want when you need to call an ambulance or run to the emergency room. This is why there is one number to call for emergencies. Think of a situation where there were two competing hospitals with competing emergency services in the area. For this to work, there would need to be A) a system for individuals calling for an ambulance to pick a hospital to go to while under the duress of the situation, or B) different phone numbers for them to call so they can choose their hospital by virtue of who they call. Both of these are incredibly impractical, and this is why it is set up so that 9-1-1 just gets you an ambulance that goes to a particular hospital. If it weren't set up this way, then competition would be snuffed out by the ambulance service that is lucky enough to be on the receiving end of 9-1-1 calls. Furthermore, not all hospitals are equal. Hospitals are set up in a fashion so that their specialties are utilized. If competition were to ensue, then the level 1 trauma centers in a metro area would run all of the other hospitals out of the out-patient business necessary to keep them afloat. This is a similar problem to a privatized school voucher system; you'd force many hospitals out of business, leaving many people in less urban areas with long travel times to get to a hospital. There is literally nothing about the medical industry that is in favor of privatized, competitive healthcare. You'd end up with some hospitals monopolizing emergency healthcare and others monopolizing everyday out-patient healthcare. Both of these would, no doubt, be necessary for a hospital to survive on a competitive business model. Competitive healthcare is completely illogical and the socialized health systems in every other developed nation that put ours to shame shows us exactly this. No one is arguing for competition during 911 calls. Quit being stupid. You didn't read my post. If there is no competition on 9-1-1 calls, then one or two hospitals would get a monopoly on emergency ambulance care, which would, then and there, run many hospitals out of business. Functioning healthcare systems that are good for the consumer are, by their very nature, anti-competitive. Says you. Frankly I don't see how that makes any sense at all. "Here, I am going to just give you a complete monopoly on a very large chunk of the healthcare market (emergency care)". I don't see how this is hard to understand. It's like giving, say, FOX, a complete monopoly on news, comedy, and drama TV series. Just by virtue of having that monopoly, it would already squash most competition. If you're trying to be a competitive hospital in an area where a different hospital has a monopoly on emergency care, how do you survive without such a large chunk of revenue? Oh, and you still haven't addressed anything else in my first post explaining this. Even if you somehow jump all of the hurdles that I've mentioned, you still have to explain a single reason to prefer a competitive, privatized healthcare system (the only attempt in a developed world being a complete failure; see our healthcare system) compared to socialized, public healthcare (which, by pretty much all accounts, is incredibly successful and cheap). Why choose the incredibly difficult option when socialized healthcare is just better? The problem is that you are making suppositions without any data to back it up. If 911 monopoly was enough to quash new entrants than there would be no need to block new entrants (or existing players from expanding). So your completely lacking in data guesswork is wrong. Completely utterly wrong. Ex. Why do retail health clinics want to exist when they don't have access to the 911 monopoly? As for the socialized healthcare alternative I've already said that I'd be fine with it. I'm simply pointing out that a competitive system would work too. And no we don't have one, so stop that BS. This assumption is entirely wrong. There are a number of reasons to block new entrants, even if 9-1-1 monopoly would be enough to severely discourage competition. Regulation and system efficiency is one big reason. Skipping all of that, address a really big point; we're talking about the problem of excessive costs of healthcare. Emergency healthcare is INCREDIBLY expensive (over $900 for an ambulance ride when I was getting trained as an EMT two years ago). How are these prices going to go down if the emergency medicine monopoly is maintained, as you have even admitted it would be? I don't think that many people are going to argue that the free market would completely fail the healthcare industry in every aspect. The problem is that some key parts of the industry (emergency care being an example) can't operate efficiently under a free market system, and for the parts that would work under a free market system to actually work, they would have to be incredibly convoluted. We know that socialized healthcare works and that it works very well. What justifiable reason is there to not use this system then?
If the real cost of an ambulance ride is $900 changing to a socialized healthcare system won't change that fact.
The only way to save money is to change how things are done.
Ex. A single payer system can save on admin costs - only one payer.
Let me readdress this monopoly point. My cable company has a monopoly. Yet if enough of us don't like the service we can demand a new cable company take over. Different cable companies exist and their services and prices are transparent. That makes informed decisions possible (a good thing). In other words monopolies need not be static things. They can exist if necessary but can change and evolve when necessary.
All aspects of a free market in healthcare would fail? Really? Even the parts that are completely successful now (laser eye surgery, non Rx drugs, etc.)?
Edit:Oh, and it may not be entirely free market now, but our healthcare system is the evolution of an attempt at free market healthcare when healthcare was first becoming a real industry. So yes, this is the result of an attempt at the market handling it. Regulations are the result of us attempting to fix the faults in the market.
No, no, no. Look at the history of the system. It wasn't always a costly mess. Things have slowly been getting costlier and costlier slowly over time. It's an industry that's been allowed to get bloated. And what do you think allowed that bloat? Market forces? Hell even the basis of healthcare finance, employer paid insurance, is an accident of history - employers used it as a work around to wage controls during WW2.
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The entire topic has a lot of moving parts, but it's really not hard to explain in the USA. It comes down to 3 things:
1) We like our new, shiny stuff. (I believe, all else being equal, it drives something like 10% of our cost inflation compared to everyone else)
2) Lawyers and the response to Lawyers. (Overly cautious doctors, especially the surgeons. Defensive medical testing and a push to treatments with directly verifiable outcomes)
3) State & Federal Legislation.
But it's really the regulations. People are trying to downplay it, but that's really the name of the game. People respond to incentives, and sub-groups respond to further increase the incentives for themselves.
There are different insurance requirements for every State. You don't need Chiropractic coverage? Well, doesn't matter, you have to have it. Your subfield wants to make more money? Force everyone to carry coverage. Nurses not being paid "enough"? Increase requirements to 4 year degrees that serve no purpose. GP's business threatened by Walk-in Clinics and Nurse Practioners? Eliminate Walk-in Clinics and require a NP to work under a GP.
There was money in the water and it really wasn't the Patients, it's the Insurance company's. Finding a way to bill them more is the name of the game for companies that deliver medical services.
The end result is very, very real costs, but the system has gotten badly inefficient because you can't buy "Insurance". What you're buying is managed, pre-paid "I might need X, Y or Z" medical services. So, of course its expensive. And they'll change the regulations next year for billing (or, every year, really), so there's an entire sub-industry around explaining the new rules to everyone.
And the initial "cause" of all of this was the tax preference for employer-bought health insurance. Given the nature of the Middle Class, especially under Income Tax system in several time frames, taking extra money in Health Care benefits was a wise move, from a value point of view. Back when health insurance had a legitimate value curve. So, *everyone* was responding to incentives. Once Insurance became the major source of medical dollars, the interest groups worked hard on all of the States Legislatures to cover X, Y or Z treatments as requirements in all insurances.
So the truth is the only way to "unwind" the issue is to blow up much of the protectionist regulation. And not just a small amount, but a lot of them. And, good luck on that. You can't fix the system when the system itself wants to be the way it is. You'll all complain and still pay because every interest is aligned against it.
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Oh, and from personal experience, the "coincerge" or "off-the-gird" doctors are great. The office has exactly 1 person that deals with all paper work and scheduling, yet the place is hopping. Costs are completely transparent and upfront. (And you can still bill your insurance on the backside, you just have to pay up front)
It's also nice to be treated as the person paying. They really do treat you very well, as they want your service again.
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If the real cost of an ambulance ride is $900 changing to a socialized healthcare system won't change that fact.
We all know it isn't, but what you're proposing wouldn't change that price.
The only way to save money is to change how things are done.
And that's what we're proposing. Our system really isn't socialized much at all. Socialized systems have been proven to work better at much cheaper prices.
Ex. A single payer system can save on admin costs - only one payer.
Let me readdress this monopoly point. My cable company has a monopoly. Yet if enough of us don't like the service we can demand a new cable company take over. Different cable companies exist and their services and prices are transparent. That makes informed decisions possible (a good thing). In other words monopolies need not be static things. They can exist if necessary but can change and evolve when necessary.
And the situation with cable is completely different from healthcare. Healthcare customers are involuntary customers that have little to now power in their market (even less than cable customers).
All aspects of a free market in healthcare would fail? Really? Even the parts that are completely successful now (laser eye surgery, non Rx drugs, etc.)?
Good thing I didn't say that. You need to stop being such an ass and READ MY POSTS.
The history argument is irrelevant to the point discussed.
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On February 25 2013 14:50 Stratos_speAr wrote:Show nested quote +
If the real cost of an ambulance ride is $900 changing to a socialized healthcare system won't change that fact.
We all know it isn't, but what you're proposing wouldn't change that price.
Sure it would. More suppliers in the market, particularly new entrants would lead to new ways of providing services. It doesn't mean that every ambulance ride in every market would fall in price. But some would, and that would put pressure, over time, throughout the system.
And that's what we're proposing. Our system really isn't socialized much at all. Socialized systems have been proven to work better at much cheaper prices.
Sure, they work much better than a system where an industry can essentially dictate it's own cost structure. That's not saying a whole lot but I'm not arguing it either.
Show nested quote +
Ex. A single payer system can save on admin costs - only one payer.
Let me readdress this monopoly point. My cable company has a monopoly. Yet if enough of us don't like the service we can demand a new cable company take over. Different cable companies exist and their services and prices are transparent. That makes informed decisions possible (a good thing). In other words monopolies need not be static things. They can exist if necessary but can change and evolve when necessary.
And the situation with cable is completely different from healthcare. Healthcare customers are involuntary customers that have little to now power in their market (even less than cable customers).
Some are, but some is not all. You keep going round and round this point. Just because 911 service exists and is a good thing does not justify all the other regulatory baggage that exists. Healthcare is not a this or that thing, parts can be this parts can be that. You can have government regulated universal coverage for emergency care only and leave the rest to a less regulated system if you chose.
Show nested quote +
All aspects of a free market in healthcare would fail? Really? Even the parts that are completely successful now (laser eye surgery, non Rx drugs, etc.)?
Good thing I didn't say that. You need to stop being such an ass and READ MY POSTS.
OK, misread you there. My bad.
The history argument is irrelevant to the point discussed.
No it isn't. You are saying that the US system is a "free market system" as evidence that market reforms won't work. The regulatory nightmare that exists today is neither a free market system itself nor is it a response to free market failures.
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Historical US healthcare costs in brief:
US system used to be comparable in terms of cost. That changed slowly over time:
+ Show Spoiler +
Link
As costs have risen they've been pushed away from consumers to the government and tax-free employer sponsored insurance (see: orange bar "out of pocket"):
+ Show Spoiler +
Link
Ever wonder why your employer doesn't want to give a nice guy like you a raise? He already thinks he did (typical B-schoolers are jerks like that) due to rising healthcare costs (if you don't have insurance than continue to think he's a jerk, or do so regardless - it's all in fun):
+ Show Spoiler +
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On February 25 2013 15:16 JonnyBNoHo wrote:Show nested quote +On February 25 2013 14:50 Stratos_speAr wrote:
If the real cost of an ambulance ride is $900 changing to a socialized healthcare system won't change that fact.
We all know it isn't, but what you're proposing wouldn't change that price. Sure it would. More suppliers in the market, particularly new entrants would lead to new ways of providing services. It doesn't mean that every ambulance ride in every market would fall in price. But some would, and that would put pressure, over time, throughout the system.
We've already been over this. You admitted that it would be ridiculous to try to put competition into emergency medicine, and so that wouldn't be there to drive costs down.
Sure, they work much better than a system where an industry can essentially dictate it's own cost structure. That's not saying a whole lot but I'm not arguing it either.
The problem is that you're trying to argue that a market that is unique when compared to the vast majority of other markets can somehow work in the same fashion as these markets and turn out a better product at cheaper prices for the consumer. That's kind of a stretch. Furthermore, You have yet to provide a reason as to why a competitive market would be preferable to socialized healthcare.
Some are, but some is not all. You keep going round and round this point. Just because 911 service exists and is a good thing does not justify all the other regulatory baggage that exists. Healthcare is not a this or that thing, parts can be this parts can be that. You can have government regulated universal coverage for emergency care only and leave the rest to a less regulated system if you chose.
Again, unnecessary and convoluted. Why split the system into privatized and socialized? Where is the proof that it will be any good at all? We have plenty of proof that a socialized system can work very well. Burden of proof is on you to show that a market system will actually be a benefit compared to a socialized one. IF I granted that all your theories were correct, of course it would be better than what we have now; almost anything would be. However, we're not looking for "better than now", we're looking for "the best that's reasonably possible". Socialized medicine provides top quality healthcare at cheap prices with little to no drawbacks (should your government actually manage their budget correctly). Furthermore, I think you're underestimating how many patients are "involuntary consumers".
No it isn't. You are saying that the US system is a "free market system" as evidence that market reforms won't work. The regulatory nightmare that exists today is neither a free market system itself nor is it a response to free market failures.
It is irrelevant because no point will be brought out of this discussion that we can't already get from anything else (if a point is brought out at all). It's unnecessary banter.
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On February 25 2013 05:25 Sated wrote:
Number one reason I won't relocate to America, right here. For all its flaws, I wouldn't trade the NHS for the world.
Don't worry, if you're an illegal immigrant you can go to the emergency room for free. If you are a citizen, you will have to pay taxes for not having insurance, just for existing - taxes. Unless you are poor. Then the other citizens pay your taxes. I had a girlfriend's roommate who was here from Mexico go to the ER. Ran up a $16,000 bill (really easy to do) and walked out without paying a dime. Uncle Sam picked that one up. My grandmother works in a hospital in California and told me she sees half the population walk out with medicaid paying for their new anchor baby (you might not know what that is but basically even if you are undocumented, you can have a baby for free here, automatically a US citizen and you automatically have a claim to citizenship) and the other half goes home owing tens of thousands of dollars that they'll pay for years with interest because they have a job. And then California wonders why they're broke.
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On February 24 2013 20:49 Doublemint wrote:Show nested quote +On February 24 2013 20:00 Bill Murray wrote:
a lot of people, including a mod i see, are kind of strawmanning here; i feel you're missing his point
i see you address that in terms of funds, but that's the purpose of it all - we don't want the money to run out
my real problem with all of this dips into our Capitalist society as a whole. It's ok for the blue collared man to get fucked, and have to mortgage his home, only to have it taken by a bank, but when the bubble bursts on wallstreet... bailout!!!
That isn't Capitalism, it's Socialism, and that's where this country is headed
2nd amendment be damned right now, I'm worried about my 1st. My voice is barely even heard over the convoluted social media with yolosluts trying to put up duckfaces when i do give a damn. I do give a damn. Absolutely correct. It basically is "Socialism for Managers". As soon as this scheme where banks hold the tax payer hostage is not tackled ("Too big to fail, sorry you can't take money from us or you will get hurt too in the process", that's where the main financial problems come from in mere numerical terms. Bailouts, people losing jobs, losing their home, losing their insurance, can't pay their bills and provide a good environment for their children, need assistance from somewhere - most of the time it's the government with a safety net. That's doing huge economic damage. While the Dow hits over 14k again. Something is terribly wrong here.
This begs a question.
How come the apostles of capitalism, bankers, businessmen, et cetera, are the first ones to betray their own ideology?
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On February 25 2013 17:01 theinfamousone wrote:Show nested quote +On February 25 2013 05:25 Sated wrote:
Number one reason I won't relocate to America, right here. For all its flaws, I wouldn't trade the NHS for the world. Don't worry, if you're an illegal immigrant you can go to the emergency room for free. If you are a citizen, you will have to pay taxes for not having insurance, just for existing - taxes. Unless you are poor. Then the other citizens pay your taxes. I had a girlfriend's roommate who was here from Mexico go to the ER. Ran up a $16,000 bill (really easy to do) and walked out without paying a dime. Uncle Sam picked that one up. My grandmother works in a hospital in California and told me she sees half the population walk out with medicaid paying for their new anchor baby (you might not know what that is but basically even if you are undocumented, you can have a baby for free here, automatically a US citizen and you automatically have a claim to citizenship) and the other half goes home owing tens of thousands of dollars that they'll pay for years with interest because they have a job. And then California wonders why they're broke.
Fixed for emphasis.
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EPT![[image loading]](https://dl.dropbox.com/u/72070179/NHS.jpg)
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