Big vs Small Gov't [Derailed SurGen thread] - Page 14

On July 18 2009 00:26 Arbiter[frolix] wrote:
I note that with dreary predictability Mr Beck does not address the issue of America's shockingly poor performance in international terms in key health indicators.

On July 18 2009 00:30 Caller wrote:

well, duh, its glenn beck

On July 18 2009 00:32 Arbiter[frolix] wrote:


Well, hence the phrase "dreary predictability".

Caller wrote:

Hopelessly inefficient. With about 50% turnout, that is definitely not efficient.

The private system appears to be less efficient because there is always government interference in the market in some way or another that allows bigger corporations to muscle out smaller competitors. This has been seen in the pharmaceutical industry where Merck and Pfizer have essentailly managed to knock out or absorb many smaller competitors-thus, they own what is essentially an oligopoly.

And wtf is fair market competition-fair just means that the special interests have an advantage over everybody else.

I'm not addressing anything about the government's discoveries in major fields, because again, I feel they are true. But again, private sector specialization is what has helped to fuel the production and acceleration of these fields. DNA reagents would be even more expensive were it not for private sector dealers to compete with one another.

The models show correlation, not causality.

First of all, many of the countries with socialized systems-Japan, for instance-are highly homogeneous. America, by any means, is not homogeneous. Even France is fairly homogenous and is separated quite distinctly-the poor immigrants are in the ghettos and are in some ways excluded-both internally and externally-from the rest of the French.

America is very, very diverse, and is not just restricted to its own sphere. What may work in those countries may not work here. Not to mention America has 300 million people, whereas other countries have far less. There are many, many differences between America and other countries, any of which could impact how socialized healthcare works in this country.

The Heart and Stroke Foundation of Canada wrote:
Research also shows that the number of acute heart problems increase when there’s a significant dip in the outdoor temperature or when there’s a swing to extreme atmospheric pressure. One study found that a 10-degree drop in temperature translates into a 38 percent increased risk of a recurrent heart attack.

Caller continues...
And finally, basic economics dictates that the addition of "reducing costs" by force (in this case, through government mandate) will always bring about a reduction of supply and an increase in demand. This is elementary high school economics. If one were to quantify healthcare supply and demand increases since SCHIP, I'm fairly certain this would be quantified.

The study wrote:
In a previous analysis of Medicaid disenrollment in an agricultural community, we concluded that 10% disenrollment would increase the number of uninsured children by 21% and increase the community’s health care costs as a result of a shift in sites of care from less expensive ambulatory office sites to more expensive [emergency department]s and increased hospitalizations.

While this was addressed to someone else, I find that there are differences and that wishing them away doesn't do anything.

Government incentives backfire very easily if they are not constructed properly, mostly because people are spending other people's money to do so. And like any parent knows, if you give your kid money they will spend it. If they earn the money they won't spend it.

You completely ignore the idea that you're also removing a large amount of the incentive to be doctors. Why the fuck would I want to be saddled with 300k in debt and no pay for 10 years, even if I really want to help people?

Bullshit and bullshit. The education system would have to be radically changed-it is simply just not economical for someone to be a doctor in this country without high compensation because of the education system.

As for insurance, that's not what's gouging customers-its the prices on the uninsured that's the primary problem.

When was the last time you heard of some interesting scientific development from Europe that doesn't involve the LHC?

Agreed, but you appear to show that you have no idea how theory is developed either.

You ignore that universities and pharmaceutical companies work together or sponsor many, many lines of research.

And risky research does take place if the gain is high-see basic statistics on "expected gain."

Corporations primarily are encouraged by government regulation and the government sanctioned patent process to focus on long term drugs, rather than cures (i.e. rather coumadin than something that directly targets causes of high blood pressure).

Germ theory? Antigens? Protein-Protein interactions on the cell membrane?

This is nitpicky, but your scientific argument is flawed. There are multiple questions here, and the cowpox incident was not scientifically rigorous at all..

TanGeng wrote:
I'm not opposed to public/social health care system because of its costs, but rather over the long-term degradation with respect to quality.

My time is rather valuable so I would prefer a system that could take care of me as quickly as possible - with all the amenities that such quality would require - good transportation access - parking lots if accessed by car, quick scheduling of doctor visits, etc.

Ecael wrote:
A major benefit of government regulated system, far as I can see, lies in the ability to unify care provided and bargain collectively, but without the healthcare professionals learning from the same playbook, we are at a loss. A system is as effective as people adhere to guidelines, but when the guidelines need to be changed by location, how do we begin to start something like that? I feel that it is a difficulty that is understated from the European to American comparison.

The point I assume gchan is trying to make is that bureaucracies always lack a proper mechanism and sometimes necessarily though.

Once upon a time, gchan wrote:
Oh, and government programs are _always_ more inefficient because there is no feedback mechanism to manage them.

Caller continues in another post:
While this is correct, I fail to understand how this situation is free market. In fact, this is the very antithesis of free market health care. They are eliminating competition through force. This is oligopoly, which is NOT free-market. Get that into your head-your view of "free market capitalism" is about as distorted as the Chinese view of communism. Seriously, you confuse corporatism with capitalism. Capitalism thrives on competition. Corporatism crushes it through being big.

Aside from my inner statistician screaming at how poorly statistical and biased the survey was run (as one can see in the description of the survey, where response bias is completely unaccounted for and the offering of 50$ further encourages response bias)

The study wrote:
As in all surveys, we relied on respondents’ truthfulness. Might some debtors blame their predicament on socially acceptable medical problems rather than admitting to irresponsible spending? Several factors suggest that our respondents were candid. First, just prior to answering our questionnaire, debtors had filed extensive financial information with the court under penalty of perjury—information that was available to us in the court records and that virtually never contradicted the questionnaire data. They were about to be sworn in by a trustee (who often administered our questionnaire) and examined under oath. At few other points in life are full disclosure and honesty so aggressively emphasized.

Second, the details called for in our telephone interview—questions about out-of-pocket medical expenses, who was ill, diagnoses, and so forth—would make a generic claim that “we had medical problems” difficult to sustain. Third, one of us (Thorne) interviewed (for other studies) many debtors in their homes. Almost all specifically denied spendthrift habits, and observation of their homes supported these claims. Most reflected the lifestyle of people under economic constraint, with modest furnishings and few luxuries. Finally, our findings receive indirect corroboration from recent surveys of the general public that have found high levels of medical debt, which often result in calls from collection agencies.

Caller dishonestly continues...
one must note that your claim that healthcare costs, regardless of insurance, caused bankruptcy. So how does a single-payer plan prevent this? IT DOESN'T.

The study notes:
Our data highlight four deficiencies in the financial safety net for American families confronting illness. First, even brief lapses in insurance coverage may be ruinous and should not be viewed as benign. While forty-five million Americans are uninsured at any point in time, many more experience spells without coverage. We found little evidence that such gaps were voluntary.

Caller continues:
These special treatments that negated insurance are likely to also not be covered under a universal healthcare plan. If anything, this doesn't lower healthcare costs for the uninsured and for procedures that aren't covered. The problem and the solution have been mixed.

What did I say about your perception of the free market? Please read any classical liberal thinker, or even a microeconomics text. That being said, I hate credit cards with a passion and think this is a terrible idea. But comparing medical credit cards to a mortgage crisis caused by stupid Fannie Mae and Freddie Mac bureaucrats that thought they were indestructible is a bit unfair, wouldn't you say?

Let me put it this way.
I get a checkup every year. My demand is constant, and its clearly considered healthcare.
What if I get a checkup every month? Demand increases for me.
Normally, price controls how often I go get a checkup.
If price no longer matters, why shouldn't I get a checkup as often as I can? I'm not really paying for it per se.

This is basic economics. Stop generalizing off anecdotes.

While the nanny state metaphor is overused, the reality is that the "private system" that you interpret to be free-market is infested by government intrusions at every level, most of which cause terrible, terrible, damage.

Hello, government subsidies for organizations that initially were nonprofit but then were turned into a profit-machine by lobbyists. If this isn't the government's fault, I dunno what you think is.

Caller wrote:While this all appears good and nice from a very frontal point of view, I would like to point out the economist Bastiat, whom was noted for his theories on "Things that are not seen."

The New England Medical Journal and the American Academy of Pediatrics are not economics journals-they are scientific and medical in nature.

Thus, costs that appear to have been cut in the medical arena actually insert themselves in other places that are not seen.

So um, is it just me, or maybe the reason is because Canada has less doctors that are paid less? And mayber there's a reason why the former is the case? http://www.oecd.org/dataoecd/46/33/38979719.pdf

The United States is very diverse. I'm sure if you took each state separately you would have major differences. Other countries are not nearly as diverse.

Secondly, an example of disaster is the US involvement in corn vs. sugar. To protect the corn farmers, the US imposed mass tariffs on sugar. The result? Americans are indoctrinated in a high fructose corn diet that has led to high rates of fat and diabetes-which coincidentally impacts life expectancy and infant mortality.

People that don't have health insurance pay much higher prices, not wait longer. In some cases, they refuse care because of these prices. The reason that's the case is because of America's fascination and connection that insurance = healthcare. Rather than fret about the uninsured, we should be asking why people need to be insured in the first place.

Funny because that's the same tactic that people use to support universal health care.

So I don't suppose it would hurt to say, look and see that public health care is funded by either taxes or borrowing. Sure you can say that people pay premiums, but can one honestly say that those will cover everything and be cheaper than a private group?

Also, taxwise, for married couples with two children, Americans pay about 11% vs. 21% for Canadians, and for unmarried couples, its 29 to 31%. There is a tax difference that's quite sizable there.

Ouch. That's some serious libel there.

So maybe it has nothing to do with the fact that this particular government report from the CBO says that the biggest pharmaceutical companies spend 40$ billion US in 2004, suggesting that your figures are completely wrong. And although the fact that they spend more on marketing is true, not only do they spend more than the government does, but other industries do as well.

PLOS wrote:
We queried CAM and IMS about the estimated value of unmonitored promotional expenditures. IMS did not provide an answer to this question. In order to validate its estimates, CAM relies on a validation committee that includes representatives from various pharmaceutical firms, including Merck, Pfizer, Bristol-Myers Squibb, Eli Lilly, Aventis, Sanofi-Synthelabo, AstraZeneca, and Wyeth. Under a confidentiality agreement, the firms supply CAM with internal data related to their detailing activity and promotional costs in the US. Through the validation committee, CAM can thus compare totals obtained through its own audits with the firms' internal data about their promotional budgets in order to evaluate if all promotion has been properly audited through its physician surveys. As a result of this comparison, CAM's validation committee considers that about 30% of promotional spending is not accounted for in its figures. CAM is unable to provide an exact breakdown of unmonitored promotion, but it believes that around 10% is due to incomplete disclosure and omissions by surveyed physicians and the remaining 20% comes from a combination of promotion directed at categories of physicians that are not surveyed, unmonitored journals in which pharmaceutical promotion appears, and possibly unethical forms of promotion. We adjusted total expenditures to account for this unreported 30%.

Are you saying that we should just stop marketing for all firms? Or is healthcare an exception?

Fun fact: Japan has been stagnating for 20 years. Maybe there's a reason for it?

Even if we were to accept that the US was special, it's not that special to demand about enormously more spending for signficantly worse outcomes. Looking at the figures for infant mortality rate per 1000 live births, we see:

US: 6.26
UK: 4.85
Canada: 5.04
Finland: 4.47
Australia: 4.75

That's a 24.2% (almost a quarter) more infant deaths than Canada and a 40% (!!!) increase over Finland. If the differences were small, I could understand. These differences however are huge!

On July 18 2009 00:44 Syntax Lost wrote:
Jesus Christ... Okay, boys and girls, time for a geography lesson. Here is a map:



Can anybody identify the countries which aren't the United States of America?

Anyhow, the point behind the comment was to illustrate that there exists a feedback mechanism for government programmes (which contradicts the claim that no feedback mechanism exists). Furthermore, there are other methods in which government programmes receive feedback. Check this video which I posted earlier that illustrates how the NHS in the UK creates competition amongst hospitals.

Saying there's no feedback mechanism for government programmes is just pure ignorance, lying or both.

Wait what? So the government was responsible for this because of interference? Do you have any actual evidence to support this claim? Because as we all know, oligopolies could never form if there were no government...

This is also a No True Scotsman fallacy.

My usage of the expression fair market was to try to cover the market situation described by gchan where the government does interfere to prevent corporations from engaging in anti-competitive practices. I avoided using the expression "free market" because he was clearly describing a need for some government inference.

Saying that the private sector is responsible for some discoveries does not prove that they're more effective. I'm not trying to say that there is no need for private sector R&D, but rather that the calim for them to maintain obscene profitability otherwise R&D would dry up is absurd. Plenty of R&D is performed without a profit motive at all.

The models show correlation, not causality.

Oh for fuck's sake, this is just pure sophistry on your behalf and you know it. If you can't see how quality of health would follow from the quality of healthcare provided (an obvious fucking mechanism for describing the correllation), you're a moron. What would it take for it to be more obvious? The US healthcare system to dress up in stiletto heels, a tight skirt with big flashing neon signs saying "Here's the fucking problem!" before you see the causality?

And yet manages provide a higher quality of healthcare for all its citizens compared to the US.

You're just cherry-picking examples here. Australia and Canada both are not homogeneous (much like the US) yet enjoy far better quality of health than the US.

Once again you're just try to appeal that the US is special without posting any hard evidence that it represents a significant problem to the US that makes the system unworkable like in other countries. Furthermore, it's not like other countries don't have to contend with their own unique healthcare problems. For example, Canada (and other nothern countries like Sweden, Finland and Norway) has to contend with its nationwide cold weather and snow shovelling, yet they still live longer.

The Heart and Stroke Foundation of Canada wrote:
Research also shows that the number of acute heart problems increase when there’s a significant dip in the outdoor temperature or when there’s a swing to extreme atmospheric pressure. One study found that a 10-degree drop in temperature translates into a 38 percent increased risk of a recurrent heart attack.

This is completely unsupported by evidence in reality. If you had actually read the study I posted about SCHIP, or even the part that I quoted, you would have noticed...



As illustrated by the study, improving access to healthcare reduces costs as people are able to utilise preventative care over emergency care which is significantly cheaper. Preventing people from accessing preventative care by allowing allow companies to price the care beyond the means of what poor people (particularly poor sick people) are able to pay, removes access and only pushes the burden onto emergency care. In essence, by reducing demand you're just playing a shell-game. You're reducing demand in one place only to see it appear somewhere that costs you even more!

All you're really doing by appealing to the special nature of the US is introducing a red herring. Nothing has been shown how this represents a significant impediment that cannot be contended.

Now you're just nitpicking. Here's a revolutionary idea: Why not pay the doctors that work in less attractive regions more money? This is not remarkably difficult for a government...

The point, which goes whizzing way above your head, is that if a private clinic cannot operate at a profit in a remote region, then it's impossible for it to set up shop. No amount of free market will magically make profitability appear out of thin air. You need the government in these cases to provide incentive for doctors to work in these areas and no amount of private industry will change that. And I'm not sure where you're getting the idea that governments can't pay people...

You're full of shit. Doctors have to pay exorbitant education fees in the UK which operates with the NHS. They're not super-rich like US doctors but its a far-cry from "uneconomical".

Once again, you're full of shit and have provided absolutely no evidence whatsoever to support this claim. As it has been previously proven in this thread, the US insurance industry has enormously higher overhead compared to a single public insurer. According to the interview with the ex-industry insider (former VP of CIGNA, no less), it routinely engages in practices to deny coverage, gouge customers and disenroll the sick in order to appease its shareholders. They are gouging you! They're admitting that they're gouging you. They're doing so in the interests of their share-holders. Do the heavens need to realign and spell it out for you?

Bwahahaha! Congratulations on showing that you're a completely ignorant on matters in the rest of the world. Example from my own university. We also have one of the top radio research laboratories in the world.

This is indeed true. Plenty of private corporations do sponsor university research. This, however, does not detract from my point that R&D would dry up without obscene profits.

Yes, corporations do perform risk assessments. However, you fail to account that enormous amounts of research ends with failure to produce anything marketable which tends to force a lot of areas to rate quite lowly in the eyes of a corporation. This process of risk assessment drives corporations to direct their investments towards results that allow for the highest profitability (and not necessarily the areas of greatest medical need). Sure, they can still pump money into "high-risk" research if the potential rewards are suitably high, but they certainly hedge their bets and focus on things which are more likely to be "sure things" which does leave a gap in what their research can actually cover.

Corporations primarily are encouraged by government regulation and the government sanctioned patent process to focus on long term drugs, rather than cures (i.e. rather coumadin than something that directly targets causes of high blood pressure).

Evidence that it's the government's responsibility rather than the fact that it's simply more profitable to focus on long-term drugs over cures?

No true Scotsman once again. This is the practical result of introducing free market conditions to healthcare. Pretending that it doesn't fit your preconceived notion of being a free market--despite clearly operating far more freely than socialised healthcare systems--is at its very heart a No True Scotsman.

Aside from my inner statistician screaming at how poorly statistical and biased the survey was run (as one can see in the description of the survey, where response bias is completely unaccounted for and the offering of 50$ further encourages response bias)

Okay, you either didn't read the entire study or you're outright lying. Which is it?

The written questionnaire distributed at the time of bankruptcy filing invited debtors to participate in future telephone interviews, for which they would receive $50; 70 percent agreed to such interviews. We ultimately completed follow-up telephone interviews with 931 of the 1,771 debtor families, a response rate of 53 percent.15 The telephone interviews, conducted between June 2001 and February 2002 using a structured, computer-assisted protocol, explored financial, housing, and medical issues. Many debtors also provided a narrative description of their bankruptcy experience.

Caller dishonestly continues...
one must note that your claim that healthcare costs, regardless of insurance, caused bankruptcy. So how does a single-payer plan prevent this? IT DOESN'T.

Are you honestly so thick that you can't figure that out for yourself? Here, let me hold your hand and walk you through it:

People are not bankrupted due to medical problems in single payer systems due to the fact that:
a)Everybody has coverage.
b)Nobody is dumped by the insurance.
c)They do not engage in recission.
d)There are no caps.
e)Decisions over treatment are made by your doctor and require no approval from insurance industry bureaucrats.
f)There are minimal to no co-pays whatsoever.
g)You don't have your premiums jacked up if the insurer considers you a higher risk (by getting ill, for instance).

I challenge you to find any bankruptcy statistics that show that under a socialised healthcare system, there is a significant number of people that are bankrupted due to medical expenses.

(Hint: These statistics don't exist because virtually no one is bankrupted due to medical expenses under socialised medicine.)

The study specifically points out that people that lost their coverage rarely lost it by choice. Its a fact that the insurance companies dump you. Their methods can vary from case to case, but they do find a way.

Caller continues:
These special treatments that negated insurance are likely to also not be covered under a universal healthcare plan. If anything, this doesn't lower healthcare costs for the uninsured and for procedures that aren't covered. The problem and the solution have been mixed.

You're just making shit up. What fucking special treatments? Do honestly have any clue how universal healthcare actually works? Insurance companies in the US are specifically dumping people from plans when they represent a high liability to them. They routinely deny care or tenuous grounds in the interests of their share-holders. Evidence of this abounds and has been posted earlier. This simply does not happen under a single-payer system because there are no share-holders and no incentive for the insurance to disenroll people.

The costs are reduced because access has been improved (bringing more focus to preventative care) and through risk pooling (the whole fucking point behind insurance).

What did I say about your perception of the free market? Please read any classical liberal thinker, or even a microeconomics text. That being said, I hate credit cards with a passion and think this is a terrible idea. But comparing medical credit cards to a mortgage crisis caused by stupid Fannie Mae and Freddie Mac bureaucrats that thought they were indestructible is a bit unfair, wouldn't you say?

This is straying from the topic of the thread, but the point was to highlight the process of issuing credit to those unable/unlikely to pay it back and then packaging that debt and playing pass-the-parcel with a ticking time-bomb, and this is something we see from free markets operating in the real world. But anyway, back to the thread.

If this were true, we'd see this problem occur in real life in places that don't charge for simple check-ups. Fact is, it doesn't. While it's true that you will see some people go to the doctor more frequently for trivial matters, you won't see that much change that it creates a serious problem in the healthcare system.

But don't let something like real evidence get in the way of your worldview.

While the nanny state metaphor is overused, the reality is that the "private system" that you interpret to be free-market is infested by government intrusions at every level, most of which cause terrible, terrible, damage.

Hello, government subsidies for organizations that initially were nonprofit but then were turned into a profit-machine by lobbyists. If this isn't the government's fault, I dunno what you think is.

Notice the fact that the serious problems arose after the private industry took over? Blaming the government here is like blaming a knife manufacturer for someone being stabbed.

This is just pure sophistry on your behalf. The evidence overwhelmingly supports public healthcare and you've not provided a single shred of credible evidence that shows otherwise.

Ad hominem.

Where? Where are the costs inserting themselves? Point them out.

Can't access your link for some unknown reason. Nevertheless, the Canadian system achieves much better health outcomes with fewer doctors. Could it be that they're being... *gasp* ...more efficient?

Canada contends with the same problems with corn syrup. Australia has a comparable obesity rate. Other nations have to contend with their own unique problems too, like I described earlier. Yet, they all still achieve far better outcomes with regards to healthcare.

Do you even understand the concept behind risk pooling? Do you have any idea how much treatment can cost for serious medical problems? Having a child in the US will cost upwards of $20,000 without insurance. Do you think that a young couple can seriously afford that?

Of course public healthcare is funded by taxation, but the WHO data specifically takes into account both public and private healthcare spending. It shows very clearly that Canadians spend less on healthcare.

As I said, looking just at taxation is a red herring because the details of actual healthcare expenditures are made very clear by WHO.

Puh-lease! I demonstrated clearly how both the video and Aegraen were being both dishonest and stupid. It's about at libelous as saying that Ted Bundy was a murderer.

I cannot access the report you're linking to for some reason. Can you provide another source?

As illustrated by the study, improving access to healthcare reduces costs as people are able to utilise preventative care over emergency care which is significantly cheaper. Preventing people from accessing preventative care by allowing allow companies to price the care beyond the means of what poor people (particularly poor sick people) are able to pay, removes access and only pushes the burden onto emergency care. In essence, by reducing demand you're just playing a shell-game. You're reducing demand in one place only to see it appear somewhere that costs you even more!

On July 18 2009 02:40 TanGeng wrote:
You have to lay the blame where it belongs for "pricing the care beyond the means of poor people." - the HMO lobby and its government stooges. BTW stooge number one in the US is Ted Kennedy, senior senator of Massachusetts.

On July 18 2009 03:02 Kwark wrote:
The question is whether to scrap it in favour of a two teir system in which there is a national health service as well as a private option (with insurance etc if people want it) as we have in Britain or whether it all becomes private. That said, no reasonable society will let people die on its streets without medical attention so the latter is unlikely.

On July 18 2009 03:20 zeppelin wrote:


Yes because the benevolent free market wants to lower healthcare prices so badly but that mean old senator won't let them because their company has been hijacked by lobbyists. Those poor executives just trying to do what's best for everyone but the government and their own employees have plotted against them!

The fact that HMOs have a lobby (which certainly isn't lobbying for lower prices) tells you all you need to know about the supposed instinct of private companies in giving the customer the best deal possible.

If there was no government regulation, these lobbies wouldn't just go away. The same insurance lobbyists would just focus their lobbying on employers, lawyers, hospitals, and insurance companies to get more and more profits for their employers. That is their job. That is literally what they are hired to do.

The barriers to entry in the health insurance game (especially if insurance companies affiliate with doctors and hospitals and employers) are so high that the concept of a free market is completely invalidated. If you think insurance companies are overcharging, you can't just start a new healthcare business, especially when Blue Cross or Aetna or whoever else would have entire teams of lobbyists at their disposal to lobby every doctor and hospital in your state to not accept your insurance just to remove you as a threat.

On July 18 2009 03:40 TanGeng wrote:


Lobby private individuals based on what!? If they aren't competitive in pricing or the merits of their service and business model, doctors, employers, and patients will have none of their BS. Do you seriously think that insurance agencies have a competitive advantage when they force patients to jump through hoops to receive care, doctors to jump through hoops to provide care, and then charge employers an exorbitant amount of money to insure their employees?

What does else does a HMO lobby have to offer to private individuals? They can't just bribe the politician by contributing to some campaign slush fund. There aren't dinners that they can lure people to for an easy sale. These private individuals have a real stake in the game. They'll either be paying for it, receiving the care, or being paid by the insurance companies. A small contribution of money or a little VIP treatment by the lobbyists and the CEO isn't going to cut it.

I think the business model of the HMO is flawed. So I would never start an HMO to compete with existing HMOs. But my ideal business model for providing health care is ILLEGAL because of state laws, so I couldn't provide competition even if I wanted to. The barriers to entry that you speak of are artificial ones created by the government.

Many doctors have come to the same conclusion. There are some that have tried alternative means of providing medical care to people. Their business usually are targeted by the government for shutdown despite being very popular and successful with the public. Most of the time government bureaucrats give some reason like, "Ensuring Public Safety," "Not Fully Compliant Operations," or "Non Compliance with Regulations."

On July 18 2009 03:02 Kwark wrote:
That said, no reasonable society will let people die on its streets without medical attention so the latter is unlikely.

On July 18 2009 05:49 shmay wrote:


When the levies broke in New Orleans, where did the bulk of the help come from? Common people, while government infamously bungled it. When the fires broke out in California (sorry, I'm using examples that are local to me and I know of), the aid for the refugees was lead almost entirely by volunteer citizens, while government again stagnated.

A completely private system != letting people die on the streets; it simply means leaving the aid to the citizens, not government.

On July 18 2009 05:15 zeppelin wrote:
Aetna Insurance Group: "We will give you, Mercy General Hospital, $x million a year to make Aetna your exclusive healthcare provider. All doctors associated with Mercy General will only accept billing through Aetna, patients who carry any other insurance must carry full price."

Mercy General Hospital: "Deal"

*some months later*

Bystander: "Help! 911! There's been an accident! The driver is unconscious and bleeding badly!"

911 dispatch: "Dispatch an ambulance and fire crew to the scene, route the victim to Mercy General Presented By Aetna, it's the only hospital in the area."

If the victim has insurance through Cigna, they will be on the hook for everything. In a free market, they would be free to take their money elsewhere. But this isn't a free market. If a hospital partners with an insurance provider (and without government regulation, there is literally no reason for them to not do this), an emergency victim does not have a choice if they are dying or unconscious, they are taken to the closest place for medical care.

As long as enough people get in car accidents, have heart attacks, go into labor, have seizures, contract pneumonia, etc. within geographical reach of the hospital and have no other place to go, this model will be successful and healthcare providers know it.

You can't vote with your wallet because emergencies aren't something you can predict. If you're on vacation and you have to go to the hospital and they don't take your insurance, congratulations you're bankrupt. What are you going to do, tell your family and friends to change providers? What if they're the only game in town?

And if every insurance company uses partnerships with medical providers to raise barriers to entry (which you'd better believe they would do), you would not have an alternative.

On July 18 2009 05:56 zeppelin wrote:


Maybe the government bungled it because the government was being run by people who don't believe government can or should solve problems. That doesn't prove government "doesn't work", it proves only that the people governing did not want it to work.

Why was the Apollo Program so much more effective than any attempted private space venture so far? How did that lurching inefficient government bureaucracy do better than the finest and most efficient businesses using technology that predated the VCR?

Hint 1: private enterprise doesn't go into business if there isn't a reasonable profit potential

Hint 2: Not everything that is beneficial for society is profitable

Hint 3: "government is inefficient" is a very successful meme propagated by people far richer than any of us in order to have poor people advocate for them to have more avenues of profit-taking