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Healthcare Reform in the US - Page 20

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IntoTheWow
Profile Blog Joined May 2004
is awesome32277 Posts
Last Edited: 2009-08-18 05:50:23
August 18 2009 05:47 GMT
#381
On August 18 2009 13:50 citi.zen wrote:
Money is, in a society where exchange is voluntary, a decent measure of a person's contribution during their lifetime. It is also relatively FAIR and UNBIASED


It's pretty easy to talk about FAIR when sitting on your comfy chair, connected to the internet.

Universal health-care is about social justice and redistribution of wealth. If we lived in an utopia where everyone was born with the same possibilities you would have a point.

Moderator<:3-/-<
citi.zen
Profile Joined April 2009
2509 Posts
Last Edited: 2009-08-18 05:55:04
August 18 2009 05:53 GMT
#382
Re: kwark

1. We are already seeing such coordinated campaigns, regulations and standards. Tobacco, to use your example, now faces national campaigns (no pro-smoking adds on TV, clear warnings on packages, subsidized anti-smoking education & add campaigns, etc. etc.). I believe this sort of campaign is independent of a nationalized healthcare system.

2. This sounds great in theory, but i fear would be hard (or at least very expensive) to implement. It requires someone other than the consumer deciding who needs what care, and when. Also, to some extent this is what insurance companies are trying to do now.

3. See previous post.

4. The externalities argument is important & used often for vaccination campaigns, etc. If you could persuade me that system A is more effective at providing care than system B, I would gladly support it.

In summary, to say that we have a moral duty to cover everyone is nice, but wishy-washy. The relevant question is "what system allows our health-care spending dollars to go further?"This comes down to costs, rather than idealistic policy. Nationalizing health care sounds grand, but I fear could make matters worse, not better. In the US I would focus on less flashy but very important gains instead, some brief but concrete suggestions under the fold.

+ Show Spoiler +
To expand coverage, I would eliminate the tax code distortions which now make it cheaper to buy insurance through your employer. This is a leftover from WWII & currently bad policy.

Expand consumer-driven healthcare plans. Preliminary results are encouraging, see link here.

Make it easier (legally) to offer high-deductible insurance to people. If people are responsible for the first 2k of costs per year, they will make better choices but still be covered when something really bad happens.

Eliminate state laws preventing competition across state boundaries between insurance companies. Huge mess currently.

Greatly reduce the expensive list of things which must be covered under the law. I should be free to decide with my doctor the sort of coverage I need, without interference from lobbyists. Combined with lack of inter-state competition above, this greatly limits the plans available to me & makes it a choice between 2 insurance companies. Surely we can do better.

Aut viam inveniam, aut faciam.
Savio
Profile Joined April 2008
United States1850 Posts
Last Edited: 2009-08-19 00:23:02
August 18 2009 06:05 GMT
#383
On August 18 2009 04:09 Velr wrote:
your far ahead?

In what? (please compare to france/germany/britain... you know the bunch ).

Please take examples that help the *common civilian* that puts the US ahead.


I think what he was alluding to was:

http://en.wikipedia.org/wiki/List_of_countries_by_GDP_(PPP)_per_capita

GDP/capita (aka wealth of your citizens):

#5 United States
#18 Britain
#21 Germany
#23 France

Also, generally speaking when the US has a recession, our unemployment rate gets up to about what those countries rates are during good years. Imagine that. We get all worked up about unemployment being high right now and we are just hitting what Europe is normally at. Compared to the US, Europe has chronically high rates of unemployment.

Hold on, looking for graphic to explain, I posted on this a few months ago.. (see the EDIT below)


To be fair though, we may have more growth because of our more free systeam, but we do also have more inequality. That is the tradeoff and it is a tradeoff that will always exist. Problem is that as you socialize individual aspects of an economy, that aspect improves, but the overall economy gets hampered. If you keep doing it you end up with major problems.

But its also hard to stomach inequality of outcome even if equality of opportunity is offered. We don't like seeing people hurt even if it is due to bad choices of their own. Its a human quality.


EDIT: Here it is:
+ Show Spoiler +
On November 01 2008 14:06 Savio wrote:
Show nested quote +
On October 31 2008 13:56 MYM.Testie wrote:
Why don't you just look at a country with a good health care system and base a model after it.
i.e. France.



Emulating France is taboo in the US. Maybe for good reason:

http://www.theage.com.au/news/business/france-pays-price-of-liberal-jobless-benefits/2005/08/30/1125302569771.html




Also, Unemployment rates:

[image loading]


That pic includes only under 25. But you all know what the numbers have been like for the last 20-30 years or so.



And more on unemployment when someone gave a retarded response trying to say the above chart was misleading:

+ Show Spoiler +

On November 02 2008 07:55 Savio wrote:
Show nested quote +
On November 02 2008 03:47 aRod wrote:
On November 01 2008 14:06 Savio wrote:
On October 31 2008 13:56 MYM.Testie wrote:
Why don't you just look at a country with a good health care system and base a model after it.
i.e. France.



Emulating France is taboo in the US. Maybe for good reason:

http://www.theage.com.au/news/business/france-pays-price-of-liberal-jobless-benefits/2005/08/30/1125302569771.html




Also, Unemployment rates:

[image loading]


That pic includes only under 25. But you all know what the numbers have been like for the last 20-30 years or so.


Savio, you need to stop posting misleading shit statistics. Of course France has lower unemployement rates for those under 25. More French go to COLLEGE and don't work from ages 18-22. The French unemployment rate is 7.5% compared to the 6.1% in the United States. More French actually finish secondary school as well. The margin of the French population enrolled in the education system does more than account for the difference.

France's healthcare system was ranked #1 by WHO, they have a top notch education system, and they sport a drove of other statistics that make the United States look like a joke.


Before making criticizing posts, you need to at a MINIMUM, learn the definition of unemployment used by economists.

Again an example of what happens when someone who wasn't taught economic theory, tries to figure it out with their "misguided common sense".


EDIT: Another interesting graphic. This data is over a 3 year average:

[image loading]



And another one (this shows employment levels rather than unemployment. Blue is USA, red is EU-15):

[image loading]


And finally, ARod, here is the data year by year on overall unemployment. It includes the USA and France:

ftp://ftp.bls.gov/pub/special.requests/ForeignLabor/flsjec.txt

Try to see the trend.

So don't try to tell me it is misleading to say that France has chronically higher unemployment than the US.



He forced me to rip him a new one.


And this doesn't mean that the US is somehow superior. All it means is that in the tradeoff between employment and minimum wage and the tradeoff between growth and equality of outcome, we are at a different point than most of Europe. We for the most part, like where we are. We like being employed and having growth. Europe likes the equality and that poor people get taken care of better than they would here. But you have to remember that there is always a tradeoff. You can't get a free lunch.
The inherent vice of capitalism is the unequal sharing of the blessings. The inherent blessing of socialism is the equal sharing of misery. – Winston Churchill
citi.zen
Profile Joined April 2009
2509 Posts
Last Edited: 2009-08-18 06:27:09
August 18 2009 06:10 GMT
#384
On August 18 2009 14:47 IntoTheWow wrote:
Show nested quote +
On August 18 2009 13:50 citi.zen wrote:
Money is, in a society where exchange is voluntary, a decent measure of a person's contribution during their lifetime. It is also relatively FAIR and UNBIASED


It's pretty easy to talk about FAIR when sitting on your comfy chair, connected to the internet.

Universal health-care is about social justice and redistribution of wealth. If we lived in an utopia where everyone was born with the same possibilities you would have a point.



Perhaps you did not catch the real conversation we were having: this was a debate between having a panel of "experts" decide who gets how much healthcare vs. letting people purchase medical services. Throwing around the notion of "social justice" does not address the fact that you cannot save everyone all the time, and you still have to ration limited resources. The question is how: lottery? expert panel? letting people pay for services? TV show voting? some other method?

+ Show Spoiler +
In your comfy chair, connected to the internet, it is easy to speak about "moral justice" though I suppose. The how and what are mere details...
Aut viam inveniam, aut faciam.
citi.zen
Profile Joined April 2009
2509 Posts
August 18 2009 06:22 GMT
#385
On August 18 2009 15:05 Savio wrote:

To be fair though, we may have more growth because of our more free systeam, but we do also have more inequality. That is the tradeoff and it is a tradeoff that will always exist. Problem is that as you social individual aspects of an economy, that aspect improves, but the overall economy gets hampered. If you keep doing it you end up with major problems.



I am a bit troubled by how easily people who otherwise reject money as a good measure of "value" cite monetary inequality as a "problem".

I am sure 99% of the people on my street could earn more money if they CHOSE to: 2nd job, mow own lawn, fix own roof, get rid of pet dogs, etc. However, they choose a more comfortable life, more time with the family, and other things that do not show up as income per-say. On the other hand, I have friends working in law firms, going to the office every single weekend, hoping to one day make partner. Some day some of them will, earning millions each year. Is it right to then scream "OMG, INEQUALITY - TAX them?!?!?!" I have a hard time answering "yes".

I guess what I am saying is... people aren't income maximizing machines. Past some minimum standard of living some will care more about their careers, others their families, pets, weed smoking or what have you. Is this such a crazy notion???
Aut viam inveniam, aut faciam.
Savio
Profile Joined April 2008
United States1850 Posts
Last Edited: 2009-08-19 00:26:17
August 18 2009 06:30 GMT
#386
BTW, this is not for everyone but only is for those who are serious about actually wanting to understand why the US spends so much more on healthcare than the rest of the world. Like most things in life, it is more complicated than just "insurance companies are screwing them over" or "doctors are trying to make money for the hospital". Those are all shallow soundbites and serious and/or highly educated people don't pay them heed unless they are simply using them to stir up the proletariat.

This is primary literature from Standford researchers and is the best explanation I have found for the multiple causes of increased health costs in the USA. Only try to read it if you are serious. Its not too technical, but it is certainly written for an educated audience and not for cable news.

http://content.healthaffairs.org/cgi/content/full/23/3/10

I expect at least for Kwark to read it since your post was so well thought out and communicated. But I think your understanding would increase from this just like mine did.

EDIT: also, I do intend on posting about efficiency between what a real market system would be compared to a government system when I have more time, but I can't do it well right now. However, just to premise, I think that the best argument FOR government takeover of health care would be based on equity and not on efficiency. More to come...
The inherent vice of capitalism is the unequal sharing of the blessings. The inherent blessing of socialism is the equal sharing of misery. – Winston Churchill
KwarK
Profile Blog Joined July 2006
United States43187 Posts
August 18 2009 06:39 GMT
#387
Money is a good way of deciding it and I believe in the hybrid system as I said. The private option should exist in partnership with a basic public provision. However, I feel your rejection of my first point overlooked two things.
Firstly, that the existence of current Government projects to improve general health is within a system where the Government has a stake in healthcare, similar to ours. You may not have the same degree of stake as in a nationalised system but the motive to lower costs through prevention still exists. I contend that the existence of public health programs in the US does not prove that they would still exist in a fully private system.
Secondly, your free testing for early prevention schemes are nowhere near as widespread as ours and insurance based healthcare actually punishes testing rather than encourages it. The best thing to do if you're at high medical risk in an insurance based system is to keep as quiet as possible about it until it becomes a serious problem then milk the insurance for all you can. Getting tested will either keep everything the same if you're fine or have the insurance company spin you a line of bs about how the good health you claimed to have when you signed up wasn't accurate and try and fuck you over.

In regard to my second point. Your fear that a comprehensive system of healthcare would be extremely expensive is unfounded. The UK spends $2500 per person on a high level service that covers anyone. That is cheap compared to the $8000 per person currently being spent. You say that insurance companies are attempting to do this but I honestly cannot see a business motive for them to do so when the costs can so easily be passed on to their customers. I don't doubt that the free market is efficient at bringing down its own costs but when there is a 3rd party which is obliged to pick up the tab I don't see why they'd attempt to bring down overall costs.
There will always be a degree of state intervention because leaving people to die on the streets is not an option. This means that someone, either the Government or the hospital, will pick up the bill for that. That in turn means that the people will end up paying for that. But it doesn't effect insurance companies because while it may add to the overall cost of healthcare it doesn't add to their costs.

In regard to point 4, the people most at need of healthcare are the people least able to pay for it. Insurance companies have no interest in making those people more healthy because those people are not their customers. Their customers are the middle class being made ill by the lower class. And while their customers do have an interest in improving the healthcare of the lower class (reduced risk = lower premiums) you will not see groups of citizens attempting to improve the general health of the population in order to renegotiate lower health insurance premiums. Too many factors (different insurance providers, different geographic areas, different levels of interaction etc) effect this. While the people as a whole have a motive they lack the means and while insurance companies may have the means, they lack the motive. The only group with both is the Government.
ModeratorThe angels have the phone box
IntoTheWow
Profile Blog Joined May 2004
is awesome32277 Posts
Last Edited: 2009-08-18 06:48:38
August 18 2009 06:45 GMT
#388
On August 18 2009 15:10 citi.zen wrote:
Show nested quote +
On August 18 2009 14:47 IntoTheWow wrote:
On August 18 2009 13:50 citi.zen wrote:
Money is, in a society where exchange is voluntary, a decent measure of a person's contribution during their lifetime. It is also relatively FAIR and UNBIASED


It's pretty easy to talk about FAIR when sitting on your comfy chair, connected to the internet.

Universal health-care is about social justice and redistribution of wealth. If we lived in an utopia where everyone was born with the same possibilities you would have a point.



Perhaps you did not catch the real conversation we were having: this was a debate between having a panel of "experts" decide who gets how much healthcare vs. letting people purchase medical services. Throwing around the notion of "social justice" does not address the fact that you cannot save everyone all the time, and you still have to ration limited resources. The question is how: lottery? expert panel? letting people pay for services? TV show voting? some other method?

+ Show Spoiler +
In your comfy chair, connected to the internet, it is easy to speak about "moral justice" though I suppose. The how and what are mere details...


+ Show Spoiler +
The difference is that I advocate for the social justice plan, you don't.


Of course you cannot save everyone all the time. But the crossroad where we are right now (which you were discussing) lies on how the system prioritizes attention on it's users.

You said money was a fair and unbiased way to measure a person's contribution (to what?). This is the argument im attacking. It does not get away from your point.

I'm attacking income as a FAIR and UNBIASED source for a person's contribution. I don't think it works that way. Inequality happens, specially in the US. The US has one of the highest rates of relative poverty between industrialized countries.

This doesn't mean that the US is spending more money just in health-care, but that it's gross product is unevenly distributed. I think that with a free-market model this inequality will just accentuate, because of it's very profit principles. You have more, you get access to more. That's why I think your first argument is flawed and why the system should turn into one that tries to turn that scale a little more into the middle.

edit: grammar.
Moderator<:3-/-<
IntoTheWow
Profile Blog Joined May 2004
is awesome32277 Posts
August 18 2009 06:51 GMT
#389
Kwark's last paragraph is way better written and explain what I want to say.
Moderator<:3-/-<
Savio
Profile Joined April 2008
United States1850 Posts
Last Edited: 2009-08-18 07:00:23
August 18 2009 06:56 GMT
#390
On August 18 2009 15:39 Kwark wrote:
The best thing to do if you're at high medical risk in an insurance based system is to keep as quiet as possible about it until it becomes a serious problem then milk the insurance for all you can.


The best way to predict the way people would behave in an alternate reality like this would be to use comparisons of similar service and how they actually behave rather than just stating something that defends your overall opinion.

For me, it seems reasonable to look at other forms of insurance. I was talking to another student the other day about how car insurance works great in the US while health insurance doesn't and that that is due to the fact that the government highly regulates the health insurance and MOSTLY due to the fact that health insurance is mostly employer based rather than individual.

My fellow said something about how people wouldn't go to preventive care appointments if they had to pay for them and only if you tax them then have government pay so the immediate cost is 0 will they go to preventive medicine appointments (you hear this a lot). But ask yourself....do people change the oil in their cars? Does that cost money up front? Is is a preventive practice? What about poor people, do they ALSO change the oil in their car?

So going back to your original statement that "The best thing to do if you're at high medical risk in an insurance based system is to keep as quiet as possible about it until it becomes a serious problem then milk the insurance for all you can." the question is: Do people in the car market (which is insurance based), feel that their best option is to not take care of their car until the "becomes a serious problem then milk the insurance for all you can". Do they purposefully forgo getting new tires or repairing old ones so that they can wait, get in an accident, then milk the insurance?

In general people are smarter than we give them credit for. We change our oil. We buy car insurance that fits us individually and since it is a more free market than health insurance, it is cheap, easy to change, and it works really really well. Imagine if government took over the job of car insurance and paying for emergency repairs, getting you towing service fast and even roadside assistance......does that sound nice to anyone?

The truth is that insurance as system is really good and does a great job at making us better off when it is for the most part left alone (like any aspect of a market, Government can usually only do harm to overall efficiency).

The reason health insurance doesn't do a good job is because government has tried to direct it and control it and replace it for certain groups altogether so the whole method that market uses to set prices is ruined.

I don't see why we don't focus on removing the harm government has done rather than trying to think of how government can get more involved in an effort to THIS time...fix it.
The inherent vice of capitalism is the unequal sharing of the blessings. The inherent blessing of socialism is the equal sharing of misery. – Winston Churchill
KwarK
Profile Blog Joined July 2006
United States43187 Posts
Last Edited: 2009-08-18 07:26:55
August 18 2009 07:24 GMT
#391
The difference between car insurance and health insurance though is that if you don't have car insurance and get into a huge crash the Government isn't obliged to spend however much it takes to buy you a new car. They'll say you fucked up, walk. Such an approach regarding health is less likely in these times and thus it makes much more sense to perform free maintainance on all cars, regardless of whether they're insured. The cost of checking the tread on someones tyres and then replacing them if needed is less than the cost of repairing a smashed up car after the crash.
ModeratorThe angels have the phone box
Aegraen
Profile Blog Joined May 2009
United States1225 Posts
August 18 2009 07:25 GMT
#392
On August 18 2009 03:55 VegeTerran wrote:
Show nested quote +
On August 17 2009 21:18 Aegraen wrote:
To understand the problems with Government intervention I urge everyone to read this.

Murry Rothbards - Power and Market.

I will spoiler the corresponding chapter on Government Intervention:

+ Show Spoiler +
We have so far contemplated a free society and a free market, where any needed defense against violent invasion of person and property is supplied, not by the State, but by freely competitive, marketable defense agencies. Our major task in this volume is to analyze the effects of various types of violent intervention in society and, especially, in the market. Most of our examples will deal with the State, since the State is uniquely the agency engaged in regularized violence on a large scale. However, our analysis applies to the extent that any individual or group commits violent invasion. Whether the invasion is “legal” or not does not concern us, since we are engaged in praxeological, not legal, analysis.

One of the most lucid analyses of the distinction between State and market was set forth by Franz Oppenheimer. He pointed out that there are fundamentally two ways of satisfying a person’s wants: (1) by production and voluntary exchange with others on the market and (2) by violent expropriation of the wealth of others.[1] The first method Oppenheimer termed “the economic means” for the satisfaction of wants; the second method, “the political means.” The State is trenchantly defined as the “organization of the political means.”[2]

A generic term is needed to designate an individual or group that commits invasive violence in society. We may call intervener, or invader, one who intervenes violently in free social or market relations. The term applies to any individual or group that initiates violent intervention in the free actions of persons and property owners.

What types of intervention can the invader commit? Broadly, we may distinguish three categories. In the first place, the intervener may command an individual subject to do or not to do certain things when these actions directly involve the individual’s person or property alone. In short, he restricts the subject’s use of his property when exchange is not involved. This may be called an autistic intervention, for any specific command directly involves only the subject himself. Secondly, the intervener may enforce a coerced exchange between the individual subject and himself, or a coerced “gift” to himself from the subject. Thirdly, the invader may either compel or prohibit an exchange between a pair of subjects. The former may be called a binary intervention, since a hegemonic relation is established between two people (the intervener and the subject); the latter may be called a triangular intervention, since a hegemonic relation is created between the invader and a pair of exchangers or would-be exchangers. The market, complex though it may be, consists of a series of exchanges between pairs of individuals. However extensive the interventions, then, they may be resolved into unit impacts on either individual subjects or pairs of individual subjects.

All these types of intervention, of course, are subdivisions of the hegemonic relation—the relation of command and obedience—as contrasted with the contractual relation of voluntary mutual benefit.

Autistic intervention occurs when the invader coerces a subject without receiving any good or service in return. Widely disparate types of autistic intervention are: homicide, assault, and compulsory enforcement or prohibition of any salute, speech, or religious observance. Even if the intervener is the State, which issues the edict to all individuals in the society, the edict is still in itself an autistic intervention, since the lines of force, so to speak, radiate from the State to each individual alone. Binary intervention occurs when the invader forces the subject to make an exchange or a unilateral “gift” of some good or service to the invader. Highway robbery and taxes are examples of binary intervention, as are conscription and compulsory jury service. Whether the binary hegemonic relation is a coerced “gift” or a coerced exchange does not really matter a great deal. The only difference is in the type of coercion involved. Slavery, of course, is usually a coerced exchange, since the slaveowner must supply his slaves with subsistence.

Curiously enough, writers on political economy have recognized only the third category as intervention.[3] It is understandable that preoccupation with catallactic problems has led economists to overlook the broader praxeological category of actions that lie outside the monetary exchange nexus. Nevertheless, they are part of the subject matter of praxeology—and should be subjected to analysis. There is far less excuse for economists to neglect the binary category of intervention. Yet many economists who profess to be champions of the “free market” and opponents of interference with it have a peculiarly narrow view of freedom and intervention. Acts of binary intervention, such as conscription and the imposition of income taxes, are not considered intervention at all nor as interferences with the free market. Only instances of triangular intervention, such as price control, are conceded to be intervention. Curious schemata are developed in which the market is considered absolutely “free” and unhampered despite a regular system of imposed taxation. Yet taxes (and conscripts) are paid in money and thus enter the catallactic, as well as the wider praxeological, nexus.[4]

In tracing the effects of intervention, one must take care to analyze all its consequences, direct and indirect. It is impossible in the space of this volume to trace all the effects of every one of the almost infinite number of possible varieties of intervention, but sufficient analysis can be made of the important categories of intervention and the consequences of each. Thus, it must be remembered that acts of binary intervention have definite triangular repercussions: an income tax will shift the pattern of exchanges between subjects from what it otherwise would have been. Furthermore, all the consequences of an act must be considered; it is not sufficient to engage in a “partial-equilibrium” analysis of taxation, for example, and to consider a tax completely apart from the fact that the State subsequently spends the tax money.

2. Direct Effects of Intervention on Utility

A. Intervention and Conflict

The first step in analyzing intervention is to contrast the direct effect on the utilities of the participants, with the effect of a free society. When people are free to act, they will always act in a way that they believe will maximize their utility, i.e., will raise them to the highest possible position on their value scale. Their utility ex ante will be maximized, provided we take care to interpret “utility” in an ordinal rather than a cardinal manner. Any action, any exchange that takes place on the free market or more broadly in the free society, occurs because of the expected benefit to each party concerned. If we allow ourselves to use the term “society” to depict the pattern of all individual exchanges, then we may say that the free market “maximizes” social utility, since everyone gains in utility. We must be careful, however, not to hypostatize “society” into a real entity that means something else than an array of all individuals.

Coercive intervention, on the other hand, signifies per se that the individual or individuals coerced would not have done what they are now doing were it not for the intervention. The individual who is coerced into saying or not saying something or into making or not making an exchange with the intervener or with someone else is having his actions changed by a threat of violence. The coerced individual loses in utility as a result of the intervention, for his action has been changed by its impact. Any intervention, whether it be autistic, binary, or triangular, causes the subjects to lose in utility. In autistic and binary intervention, each individual loses in utility; in triangular intervention, at least one, and sometimes both, of the pair of would-be exchangers lose in utility.

Who, in contrast, gains in utility ex ante? Clearly, the intervener; otherwise he would not have intervened. Either he gains in exchangeable goods at the expense of his subject, as in binary intervention, or, as in autistic and triangular intervention, he gains in a sense of well-being from enforcing regulations upon others.

All instances of intervention, then, in contrast to the free market, are cases in which one set of men gains at the expense of other men. In binary intervention, the gains and losses are “tangible” in the form of exchangeable goods and services; in other types of intervention, the gains are nonexchangeable satisfactions, and the loss consists in being coerced into less satisfying types of activity (if not positively painful ones).

Before the development of economic science, people thought of exchange and the market as always benefiting one party at the expense of the other. This was the root of the mercantilist view of the market. Economics has shown that this is a fallacy, for on the market both parties to any exchange benefit. On the market, therefore, there can be no such thing as exploitation. But the thesis of a conflict of interest is true whenever the State or any other agency intervenes on the market. For then the intervener gains only at the expense of subjects who lose in utility. On the market all is harmony. But as soon as intervention appears and is established, conflict is created, for each may participate in a scramble to be a net gainer rather than a net loser—to be part of the invading team, instead of one of the victims.

It has become fashionable to assert that “Conservatives” like John C. Calhoun “anticipated” the Marxian doctrine of class exploitation. But the Marxian doctrine holds, erroneously, that there are “classes” on the free market whose interests clash and conflict. Calhoun’s insight was almost the reverse. Calhoun saw that it was the intervention of the State that in itself created the “classes” and the conflict.[5] He particularly perceived this in the case of the binary intervention of taxes. For he saw that the proceeds of taxes are used and spent, and that some people in the community must be net payers of tax funds, while the others are net recipients. Calhoun defined the latter as the “ruling class” of the exploiters, and the former as the “ruled” or exploited, and the distinction is quite a cogent one. Calhoun set forth his analysis brilliantly:

Few, comparatively, as they are, the agents and employees of the government constitute that portion of the community who are the exclusive recipients of the proceeds of the taxes. Whatever amount is taken from the community in the form of taxes, if not lost, goes to them in the shape of expenditures or disbursements. The two—disbursement and taxation—constitute the fiscal action of the government. They are correlatives. What the one takes from the community under the name of taxes is transferred to the portion of the community who are the recipients under that of disbursements. But as the recipients constitute only a portion of the community, it follows, taking the two parts of the fiscal process together, that its action must be unequal between the payers of the taxes and the recipients of their proceeds. Nor can it be otherwise; unless what is collected from each individual in the shape of taxes shall be returned to him in that of disbursements, which would make the process nugatory and absurd. . . .

Such being the case, it must necessarily follow that some one portion of the community must pay in taxes more than it receives back in disbursements, while another receives in disbursements more than it pays in taxes. It is, then, manifest, taking the whole process together, that taxes must be, in effect, bounties to that portion of the community which receives more in disbursements than it pays in taxes, while to the other which pays in taxes more than it receives in disbursements they are taxes in reality—burdens instead of bounties. This consequence is unavoidable. It results from the nature of the process, be the taxes ever so equally laid. . . .

The necessary result, then, of the unequal fiscal action of the government is to divide the community into two great classes: one consisting of those who, in reality, pay the taxes and, of course, bear exclusively the burden of supporting the government; and the other, of those who are the recipients of their proceeds through disbursements, and who are, in fact, supported by the government; or, in fewer words, to divide it into tax-payers and tax-consumers.

But the effect of this is to place them in antagonistic relations in reference to the fiscal action of the government and the entire course of policy therewith connected. For the greater the taxes and disbursements, the greater the gain of the one and the loss of the other, and vice versa. . . .[6]

“Ruling” and “ruled” apply also to the forms of government intervention, but Calhoun was quite right in focusing on taxes and fiscal policy as the keystone, for it is taxes that supply the resources and payment for the State in performing its myriad other acts of intervention.

All State intervention rests on the binary intervention of taxes at its base; even if the State intervened nowhere else, its taxation would remain. Since the term “social” can be applied only to every single individual concerned, it is clear that, while the free market maximizes social utility, no act of the State can ever increase social utility. Indeed, the picture of the free market is necessarily one of harmony and mutual benefit; the picture of State intervention is one of caste conflict, coercion, and exploitation.

B. Democracy and the Voluntary

It might be objected that all these forms of intervention are really not coercive but “voluntary,” for in a democracy they are supported by the majority of the people. But this support is usually passive, resigned, and apathetic, rather than eager—whether the State is a democracy or not.[7]

In a democracy, the nonvoters can hardly be said to support the rulers, and neither can the voters for the losing side. But even those who voted for the winners may well have voted merely for the “lesser of the two evils.” The interesting question is: Why do they have to vote for any evil at all? Such terms are never used by people when they act freely for themselves, or when they purchase goods on the free market. No one thinks of his new suit or refrigerator as an “evil”—lesser or greater. In such cases, people think of themselves as buying positive “goods,” not as resignedly supporting a lesser bad. The point is that the public never has the opportunity of voting on the State system itself; they are caught up in a system in which coercion over them is inevitable.[8]

Be that as it may, as we have said, all States are supported by a majority—whether a voting democracy or not; otherwise, they could not long continue to wield force against the determined resistance of the majority. However, the support may simply reflect apathy—perhaps from the resigned belief that the State is a permanent if unwelcome fixture of nature. Witness the motto: “Nothing is as permanent as death and taxes.”

Setting all these matters aside, however, and even granting that a State might be enthusiastically supported by a majority, we still do not establish its voluntary nature. For the majority is not society, is not everyone. Majority coercion over the minority is still coercion.

Since States exist, and they are accepted for generations and centuries, we must conclude that a majority are at least passive supporters of all States—for no minority can for long rule an actively hostile majority. In a certain sense, therefore, all tyranny is majority tyranny, regardless of the formalities of the government structure.[9][10] But this does not change our analytic conclusion of conflict and coercion as a corollary of the State. The conflict and coercion exist no matter how many people coerce how many others.[11]

C. Utility and Resistance to Invasion

To our comparative “welfare-economic” analysis of the free market and the State, it might be objected that when defense agencies restrain an invader from attacking someone’s property, they are benefiting the property owner at the expense of a loss of utility by the would-be invader. Since defense agencies enforce rights on the free market, does not the free market also involve a gain by some at the expense of the utility of others (even if these others are invaders)?

In answer, we may state first that the free market is a society in which all exchange voluntarily. It may most easily be conceived as a situation in which no one aggresses against person or property. In that case, it is obvious that the utility of all is maximized on the free market. Defense agencies become necessary only as a defense against invasions of that market. It is the invader, not the existence of the defense agency, that inflicts losses on his fellowmen. A defense agency existing without an invader would simply be a voluntarily established insurance against attack. The existence of a defense agency does not violate the principle of maximum utility, and it still reflects mutual benefit to all concerned. Conflict enters only with the invader. The invader, let us say, is in the process of committing an aggressive act against Smith, thereby injuring Smith for his gain. The defense agency, rushing to the aid of Smith, of course, injures the invader’s utility; but it does so only to counteract the injury to Smith. It does help to maximize the utility of the noncriminals. The principle of conflict and loss of utility was introduced, not by the existence of the defense agency, but by the existence of the invader. It is still true, therefore, that utility is maximized for all on the free market; whereas to the extent that there is invasive interference in society, it is infected with conflict and exploitation of man by man.

D. The Argument from Envy

Another objection holds that the free market does not really increase the utility of all individuals, because some may be so smitten with envy at the success of others that they really lose in utility as a result. We cannot, however, deal with hypothetical utilities divorced from concrete action. We may, as praxeologists, deal only with utilities that we can deduce from the concrete behavior of human beings.[12] A person’s “envy,” unembodied in action, becomes pure moonshine from the praxeological point of view. All that we know is that he has participated in the free market and to that extent benefits by it. How he feels about the exchanges made by others cannot be demonstrated to us unless he commits an invasive act. Even if he publishes a pamphlet denouncing these exchanges, we have no ironclad proof that this is not a joke or a deliberate lie.

E. Utility Ex Post

We have thus seen that individuals maximize their utility ex ante on the free market and that the direct result of an invasion is that the invader’s utility gains at the expense of a loss in utility by his victim. But what about utilities ex post? People may expect to benefit when they make a decision, but do they actually benefit from its results? The remainder of this volume will largely consist of analysis of what we may call the “indirect” consequences of the market or of intervention, supplementing the above direct analysis. It will deal with chains of consequences that can be grasped only by study and are not immediately visible to the naked eye.

Error can always occur in the path from ante to post, but the free market is so constructed that this error is reduced to a minimum. In the first place, there is a fast-working, easily understandable test that tells the entrepreneur, as well as the income-receiver, whether he is succeeding or failing at the task of satisfying the desires of the consumer. For the entrepreneur, who carries the main burden of adjustment to uncertain consumer desires, the test is swift and sure—profits or losses. Large profits are a signal that he has been on the right track; losses, that he has been on a wrong one. Profits and losses thus spur rapid adjustments to consumer demands; at the same time, they perform the function of getting money out of the hands of the bad entrepreneurs and into the hands of the good ones. The fact that good entrepreneurs prosper and add to their capital, and poor ones are driven out, insures an ever smoother market adjustment to changes in conditions. Similarly, to a lesser extent, land and labor factors move in accordance with the desire of their owners for higher incomes, and more value-productive factors are rewarded accordingly.

Consumers also take entrepreneurial risks on the market. Many critics of the market, while willing to concede the expertise of the capitalist-entrepreneurs, bewail the prevailing ignorance of consumers, which prevents them from gaining the utility ex post that they expected to have ex ante. Typically, Wesley C. Mitchell entitled one of his famous essays: “The Backward Art of Spending Money.” Professor Ludwig von Mises has keenly pointed out the paradoxical position of so many “progressives” who insist that consumers are too ignorant or incompetent to buy products intelligently, while at the same time touting the virtues of democracy, where the same people vote for politicians whom they do not know and for policies that they hardly understand.

In fact, the truth is precisely the reverse of the popular ideology. Consumers are not omniscient, but they do have direct tests by which to acquire their knowledge. They buy a certain brand of breakfast food and they don’t like it; so they don’t buy it again. They buy a certain type of automobile and they do like its performance; so they buy another one. In both cases, they tell their friends of this newly won knowledge. Other consumers patronize consumers’ research organizations, which can warn or advise them in advance. But, in all cases, the consumers have the direct test of results to guide them. And the firm that satisfies the consumers expands and prospers, while the firm that fails to satisfy them goes out of business.

On the other hand, voting for politicians and public policies is a completely different matter. Here there are no direct tests of success or failure whatever, neither profits and losses nor enjoyable or unsatisfying consumption. In order to grasp consequences, especially the indirect consequences of governmental decisions, it is necessary to comprehend a complex chain of praxeological reasoning, such as will be developed in this volume. Very few voters have the ability or the interest to follow such reasoning, particularly, as Schumpeter points out, in political situations. For in political situations, the minute influence that any one person has on the results, as well as the seeming remoteness of the actions, induces people to lose interest in political problems or argumentation.[13] Lacking the direct test of success or failure, the voter tends to turn, not to those politicians whose measures have the best chance of success, but to those with the ability to “sell” their propaganda. Without grasping logical chains of deduction, the average voter will never be able to discover the error that the ruler makes. Thus, suppose that the government inflates the money supply, thereby causing an inevitable rise in prices. The government can blame the price rise on wicked speculators or alien black marketeers, and, unless the public knows economics, it will not be able to see the fallacies in the ruler’s arguments.

It is ironic that those writers who complain of the wiles and lures of advertising do not direct their criticism at the advertising of political campaigns, where their charges would be relevant. As Schumpeter states:

The picture of the prettiest girl that ever lived will in the long run prove powerless to maintain the sales of a bad cigarette. There is no equally effective safeguard in the case of political decisions. Many decisions of fateful importance are of a nature that makes it impossible for the public to experiment with them at its leisure and at moderate cost. Even if that is possible, however, judgment is as a rule not so easy to arrive at as it is in the case of the cigarette, because effects are less easy to interpret.[14]

It might be objected that, while the average voter may not be competent to decide on policies that require for his decision chains of praxeological reasoning, he is competent to pick the experts—the politicians and bureaucrats—who will decide on the issues, just as the individual may select his own private expert adviser in any one of numerous fields. But the point is precisely that in government the individual does not have the direct, personal test of success or failure for his hired expert that he does on the market. On the market, individuals tend to patronize those experts whose advice proves most successful. Good doctors or lawyers reap rewards on the free market, while the poor ones fail; the privately hired expert tends to flourish in proportion to his demonstrated ability. In government, on the other hand, there is no concrete test of the expert’s success. In the absence of such a test, there is no way by which the voter can gauge the true expertise of the man he must vote for. This difficulty is aggravated in modern-style elections, where the candidates agree on all the fundamental issues. For issues, after all, are susceptible to reasoning; the voter can, if he so wishes and he has the ability, learn about and decide on the issues. But what can any voter, even the most intelligent, know about the true expertise or competence of individual candidates, especially when elections are shorn of virtually all important issues? The voter can then fall back only on the purely external, packaged “personalities” or images of the candidates. The result is that voting purely on candidates makes the result even less rational than mass voting on the issues themselves.

Furthermore, the government itself contains inherent mechanisms that lead to poor choices of experts and officials. For one thing, the politician and the government expert receive their revenues, not from service voluntarily purchased on the market, but from a compulsory levy on the populace. These officials, therefore, wholly lack the pecuniary incentive to care about serving the public properly and competently. And, what is more, the vital criterion of “fitness” is very different in the government and on the market. In the market, the fittest are those most able to serve the consumers; in government, the fittest are those most adept at wielding coercion and/or those most adroit at making demagogic appeals to the voting public.

Another critical divergence between market action and democratic voting is this: the voter has, for example, only a 1/50 millionth power to choose among his would-be rulers, who in turn will make vital decisions affecting him, unchecked and unhampered until the next election. In the market, on the other hand, the individual has the absolute sovereign power to make the decisions concerning his person and property, not merely a distant, 1/50 millionth power. On the market the individual is continually demonstrating his choice of buying or not buying, selling or not selling, in the course of making absolute decisions regarding his property. The voter, by voting for some particular candidate, is demonstrating only a relative preference over one or two other potential rulers; he must do this within the framework of the coercive rule that, whether or not he votes at all, one of these men will rule over him for the next several years.[15]

Thus, we see that the free market contains a smooth, efficient mechanism for bringing anticipated, ex ante utility into the realization of ex post. The free market always maximizes ex ante social utility as well. In political action, on the contrary, there is no such mechanism; indeed, the political process inherently tends to delay and thwart the realization of any expected gains. Furthermore, the divergence between ex post gains through government and through the market is even greater than this; for we shall find that in every instance of government intervention, the indirect consequences will be such as to make the intervention appear worse in the eyes of many of its original supporters.

In sum, the free market always benefits every participant, and it maximizes social utility ex ante; it also tends to do so ex post, since it works for the rapid conversion of anticipations into realizations. With intervention, one group gains directly at the expense of another, and therefore social utility cannot be increased; the attainment of goals is blocked rather than facilitated; and, as we shall see, the indirect consequences are such that many interveners themselves will lose utility ex post. The remainder of this work is largely devoted to tracing the indirect consequences of various forms of governmental intervention.



--------------------------------------------------------------------------------

[1]A person may receive gifts, but this is a unitary act of the giver, not involving an act of the receiver himself.

[2]See Franz Oppenheimer, The State (New York: Vanguard Press, 1914):

There are two fundamentally opposed means whereby man, requiring sustenance, is impelled to obtain the necessary means for satisfying his desires. These are work and robbery, one’s own labor and the forcible appropriation of the labor of others. . . . I propose . . . to call one’s own labor and the equivalent exchange of one’s own labor for the labor of others “the economic means” for the satisfaction of needs, while the unrequited appropriation of the labor of others will be called the “political means. . . . The state is an organization of the political means. (pp. 24–27)

See also Albert Jay Nock, Our Enemy, the State (Caldwell, Idaho: Caxton Printers, 1946), pp. 59–62; Frank Chodorov, The Economics of Society, Government, and the State (mimeographed MS., New York, 1946), pp. 64ff. On the State as engaging in permanent conquest, see ibid., pp. 13–16, 111–17, 136–40.

[3]This is to be inferred from, rather than discovered in explicit form in, their writings. As far as we know, no one has systematically categorized or analyzed types of intervention.

[4]A narrow view of “freedom” is characteristic in the present day. In the political lexicon of modern America, “left-wingers” often advocate freedom in the sense of opposition to autistic intervention, but look benignly on triangular intervention. “Right-wingers,” on the other hand, severely oppose triangular intervention, but tend to favor, or remain indifferent to, autistic intervention. Both groups are ambivalent toward binary intervention.

[5]“Castes” would be a better term than “classes” here. Classes are any collection of units with a certain property in common. There is no reason for them to conflict. Does the class of men named Jones necessarily conflict with the class of men named Smith? On the other hand, castes are State-made groups, each with its own set of violence-established privileges and tasks. Castes necessarily conflict because some are instituted to rule over the others.

[6]John C. Calhoun, A Disquisition on Government (New York: Liberal Arts Press, 1953), pp. 16–18. Calhoun, however, did not understand the harmony of interests on the free market.

[7]As Professor Lindsay Rogers has trenchantly written on the subject of public opinion:

Before Great Britain adopted conscription in 1939, only thirty-nine percent of the voters were for it; a week after the conscription bill became law, a poll showed that fifty-eight percent approved. Many polls in the United States have shown a similar inflation of support for a policy as soon as it is translated to the statute books or into a Presidential order. (Lindsay Rogers, “‘The Mind of America’ to the Fourth Decimal Place,” The Reporter, June 30, 1955, p. 44)

[8]This coercion would exist even in the most direct democracies. It is doubly compounded in representative republics, where the people never have a chance of voting on issues, but only on the men who rule them. They can only reject men—and this at very long intervals—and if the candidates have the same views on issues, the public cannot effect any sort of fundamental change.

[9]It is often stated that under “modern” conditions of destructive weapons, etc., a minority can tyrannize permanently over a majority. But this ignores the fact that these weapons can be held by the majority, or that agents of the minority can mutiny. The sheer absurdity, for example, of the current belief that a few million could really tyrannize over a few hundred million active resistants is not often realized. As David Hume profoundly stated:

Nothing appears more surprising . . . than the easiness with which the many are governed by the few and the implicit submission with which men resign their own sentiments and passions to those of their rulers. When we enquire by what means this wonder is effected, we shall find that because Force is always on the side of the governed, the governors have nothing to support them but opinion. It is, therefore, on opinion that government is founded; and this maxim extends to the most despotic and most military governments. (David Hume, Essays, Literary, Moral and Political [London, n.d.], p. 23)

See also Etienne de La Boétie, Anti-Dictator (New York: Columbia University Press, 1942), pp. 8–9. For an analysis of the types of opinion fostered by the State in order to obtain public support, see Bertrand de Jouvenel, On Power (New York: Viking Press, 1949).

[10]This analysis of majority support applies to any intervention of rather long standing, carried on frankly and openly, whether or not the groups are labeled “States.”

[11]See Calhoun, Disquisition on Government, pp. 14, 18–19, 23–33.

[12]Elsewhere, we have named this concept “demonstrated preference,” have traced its history, and have directed a critique against competing concepts. See Murray N. Rothbard, “Toward a Reconstruction of Utility and Welfare Economics” in Mary Sennholz, ed., On Freedom and Free Enterprise (Princeton, N.J.: D. Van Nostrand, 1956), pp. 224ff.

[13]Joseph A. Schumpeter, Capitalism, Socialism and Democracy (New York: Harper & Bros., 1942), pp. 258–60. See also Anthony Downs, “An Economic Theory of Political Action in a Democracy,” Journal of Political Economy, April, 1957, pp. 135–50.

[14]Schumpeter, Capitalism, Socialism and Democracy, p. 263.

[15]For a further discussion of these points, see Man, Economy, and State, pp. 886–91.

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This is something everyone should read and should be required in School in Economics classes and Government classes. While I disagree on privatized militaries, the rest is demonstrative of the wreckless nature of Government intervention into markets and any form of Government control, subsidies, and other intrusions.


You really have no clue about how the industrial countries developed, if there had ever been a free market with no goverment invention we'd all probably still be pursuing our comparative advantage trading fish, how did the industrial revolution happen? Not from a free market. It happened beacause of goverment protectionism through tariffs to protect the industries in their infancy.

To take a more current technology we're does the internet and computers come from? It's funded by public money developed at places like MIT then when it's been made profitable it's handed over to private interests for them to make money of it. The public takes the risks and the profit is handed to private interests. Let South Korean economist Ha Joon Chang explain how it works



Still not convinced have Noam Chomsky explain the Free Market Fantasies for you:


+ Show Spoiler +
http://www.youtube.com/watch?
v=Au2AiBfcxAs&feature=PlayList&p=CA173FFB99A9DB92&index=1




Actually you don't know how the industrialized countries started.

Watch this:



Watch from 3:50 to the end.

I'll take the advice and word from an Economic Nobel Laureate over a Linguistic Professor, wouldn't you?
"It is easy to be conspicuously 'compassionate' if others are being forced to pay the cost." -- Murray N. Rothbard -- Rand Paul 2010 -- Ron Paul 2012
KwarK
Profile Blog Joined July 2006
United States43187 Posts
Last Edited: 2009-08-18 07:40:57
August 18 2009 07:40 GMT
#393
Argument from authority or appeal to authority is a logical fallacy, where it is argued that a statement is correct because the statement is made by a person or source that is commonly regarded as authoritative. The most general structure of this argument is:

Source A says that p.
Source A is authoritative.
Therefore, p is true.

This is a fallacy because the truth or falsity of the claim is not necessarily related to the personal qualities of the claimant, and because the premises can be true, and the conclusion false (an authoritative claim can turn out to be false). It is also known as argumentum ad verecundiam (Latin: argument to respect) or ipse dixit (Latin: he himself said it).


From http://en.wikipedia.org/wiki/Argument_from_authority

And yes, I am aware of the irony here.
ModeratorThe angels have the phone box
Caller
Profile Blog Joined September 2007
Poland8075 Posts
August 18 2009 12:46 GMT
#394
On August 18 2009 16:40 Kwark wrote:
Show nested quote +
Argument from authority or appeal to authority is a logical fallacy, where it is argued that a statement is correct because the statement is made by a person or source that is commonly regarded as authoritative. The most general structure of this argument is:

Source A says that p.
Source A is authoritative.
Therefore, p is true.

This is a fallacy because the truth or falsity of the claim is not necessarily related to the personal qualities of the claimant, and because the premises can be true, and the conclusion false (an authoritative claim can turn out to be false). It is also known as argumentum ad verecundiam (Latin: argument to respect) or ipse dixit (Latin: he himself said it).


From http://en.wikipedia.org/wiki/Argument_from_authority

And yes, I am aware of the irony here.

From that same article:
On the other hand, arguments from authority are an important part of informal logic. Since we cannot have expert knowledge of many subjects, we often rely on the judgments of those who do. There is no fallacy involved in simply arguing that the assertion made by an authority is true, the fallacy only arises when it is claimed or implied that the authority is infallible in principle and can hence be exempted from criticism: It can be true, the truth can merely not be proven, or made probable by attributing it to the authority, and the assumption that the assertion was true might be subject to criticism and turn out to have actually been wrong. If a criticism appears that contradicts the authority's statement, then merely the fact that the statement originated from the authority is not an argument for ignoring the criticism.

Savio's statement wasn't that Milton Friedman was infallible, it was that Milton Friedman is likely to be a better expert on the field than Noam Chomsky. That isn't the fallacy. The fallacy would be if Savio had stated "Milton Friedman is an economic genius, here's what he had to say about the crisis," implying that Milton Friedman is right about the situation.
Watch me fail at Paradox: http://www.teamliquid.net/forum/viewmessage.php?topic_id=397564
Caller
Profile Blog Joined September 2007
Poland8075 Posts
August 18 2009 13:12 GMT
#395
On August 18 2009 16:24 Kwark wrote:
The difference between car insurance and health insurance though is that if you don't have car insurance and get into a huge crash the Government isn't obliged to spend however much it takes to buy you a new car. They'll say you fucked up, walk. Such an approach regarding health is less likely in these times and thus it makes much more sense to perform free maintainance on all cars, regardless of whether they're insured. The cost of checking the tread on someones tyres and then replacing them if needed is less than the cost of repairing a smashed up car after the crash.

Another difference is that unlike car insurance, the Government doesn't already have a program leaking funds to give car insurance to a select but large part of the population that happens to be very vulnerable to car accidents. But why would you make all maintenance be free on cars,regardless of insurance? That's just... wat.
Unless you mean it'd be better for the government to pay for people to perform maintenance on cars. If that's the case, then why would our costs change from now?

Consider:
A) Major point from health care advocates is that America spends more money on healthcare than any other nation.
B) Solution is to collectivize the costs under the government, so that uninsured can get care at an affordable rate.

This doesn't do anything to change healthcare costs, as the government is still likely to pay a "fair market" price for procedures, which all too likely would be decided by "experts," by which I mean AMA sycophants and insurance companies.

The AMA is a very strange organization. Many of the decisions that have been made in the name of safety and security of peoples' health has led to a virtual monopoly on healthcare. By making the medical student path so difficult compared to other countries, it artificially reduces the supply of medical students to an increasing demand. Consider:
In European countries, the typical premed and medical school education is something like this:
4 Years-Major in College, Medicine
2 Years-Graduate Medical School/additional undergraduate years
2 Years-Residency/Specialization

For about 8 years of no income, and in which tuition is something like 8-15k USD a year.

Now Compare the American Path:
4 Years-College, must be top 10% of class in top universities, or valedictorian/salutatorian in lesser ones:
4 Years-Medical School
1 Year-Internship, in addition to one in the last year of Med School
2 Years-Residency
2 Years-Specialization (optional)

Which makes about 13 years of no income, and where tuition is about 50-60k a year. Not to mention it's much harder to get into medical school here than in other countries.

Unless you want to argue whether this difference is sufficient to discourage some medical students, in which case I would say that in my school, University of Chicago (which is decent), has a 50% admissions rate to medical school among all students who are interested. If all qualified students were admitted (meaning decent GPA and MCATs and whatnot), that would be along the lines of 85%, instead.

So with an artificially reduced supply of incoming doctors. compared to increasing Americans which need healthcare, basic economics dictates the following:

Supply vs. Demand, assuming the same increases for each area:
When Demand increases and Supply stays the same, Price Rises
When Supply decreases and Demand stays the same, Price Rises
When Supply decreases and Demand increases, Prices Rises, but more, depending on magnitudes.

And thus it's fairly obvious that this is a cause of high healthcare costs.

This isn't also including how hospitals are shutting down due to lack of funds and of picking up costs from ER patients that are unable to afford treatment. There used to be two hospitals in my home area, which served about 175,000 people. Now there is one, because the other was unable to bear with the financial strain of large numbers of those unable to pay or refusing to pay.

Supply needs to be expanded, and the AMA's goals here,while appearing to further the public good, is actually one of the reasons of the healthcare crisis.

I already expressed my views on other causes of healthcare pricing in previous posts that have been kindly ignored in favor of yelling at Aegrean.
Watch me fail at Paradox: http://www.teamliquid.net/forum/viewmessage.php?topic_id=397564
citi.zen
Profile Joined April 2009
2509 Posts
Last Edited: 2009-08-18 13:30:54
August 18 2009 13:29 GMT
#396
kwark, to #4 above: even if we agree that universal coverage is desirable, the question of "how do we get there" remains unanswered. The two main options are: reform the current system (badly needs it, as I suggested above; see my suggested list of improvements as well); or, nationalize health-care. Universal coverage can be achieved under either delivery system, the important thing is which is better and more cost effective?

I am not at all convinced that a state-run system is better, since much of today's problems with the insurance system is government-inflicted. There are so many fucking distortions in the tax code, federal and state legislation that its hard for people to make correct choices. Various interest groups, lobbyists and unions have huge sway over regulation (a working democracy for better or for worse). I am very skeptical to give these same people even more control!

Caller above begins to touch on another topic: quality. I do have access to both European and US health care, and I wouldn't ever consider going to Europe for anything serious. In the same spirit: R&D is SO much more vibrant in the US (goes for almost any science, look at where the top research centers and universities are). This is a huge benefit to the entire world - a positive externality that gets mentioned way too little, and the result of the same system you vehemently oppose. For young people in particular, giving up on 30 years of research to experiment with what could be better coverage for older ones will have HUGE consequences down the road.
Aut viam inveniam, aut faciam.
Savio
Profile Joined April 2008
United States1850 Posts
August 19 2009 00:37 GMT
#397
On August 18 2009 16:24 Kwark wrote:
The difference between car insurance and health insurance though is that if you don't have car insurance and get into a huge crash the Government isn't obliged to spend however much it takes to buy you a new car. They'll say you fucked up, walk. Such an approach regarding health is less likely in these times and thus it makes much more sense to perform free maintainance on all cars, regardless of whether they're insured. The cost of checking the tread on someones tyres and then replacing them if needed is less than the cost of repairing a smashed up car after the crash.


Actually, I don't think that is the reason. People buy car insurace, (among other reasons), because if you don't, you get fined and/or go to jail. This is ok because it works. Just because people are required to buy insurance, does not ruin the competition that keeps the car insurance market working so well.

So we should have the same in health care. Require every person to have health insurance (this is one part of Obama's plan I support). However, if you are going to do this, you HAVE to get government regulations off of insurance. There should be a minimum package you have to have (such as emergency medical treatment), just like in car insurance you are only required to have liability. Then you have to get rid of medicare and medicaid. These giants are so big that they ruin the market system for determining price. The only reason procedures cost to much in the US is because the government decided that in billing for medicare and medicaid, procedures get reimbursed with a lot of $$$ while visits do not. They are so big that the rest of the market follows it. The competition that insurance companies would then face would require them to offer fast, convenient and good service AND require that they cut costs. That applies downward pressure on the price of pharmaceuticals (which because medicare and medicaid are government funded, there is virtually no market pressure for pharmaceuticals to lower drug prices....so they don't).

Virtually every problem we face in health care was created by government intervention. And now we are talking about forming a government intervention to fix the problems created by government intervention.

Go figure.
The inherent vice of capitalism is the unequal sharing of the blessings. The inherent blessing of socialism is the equal sharing of misery. – Winston Churchill
MoltkeWarding
Profile Joined November 2003
5195 Posts
August 19 2009 00:48 GMT
#398
So we should have the same in health care. Require every person to have health insurance


You know, there are trapeze artists who enjoy the achievement of walking tightropes without the insurance of safety nets. There are figure skaters who prefer risking the quad-quad over the triple-triple in their minute of glory. There are people who enjoy similar philosophical approaches to life. Admittedly, this is a minority taste, but isn't that the entire basis of the argument between majoritarian compulsion vs individual liberty?
Yurebis
Profile Joined January 2009
United States1452 Posts
August 19 2009 01:01 GMT
#399
Food is even more essential to life than healthcare, why are we not seeing 'food rationing' reform for those in need? And home reform, job reform. The poor need all these things or else they become a burden. Why not let the state handle everything?

Short answer is, FUCK DA POOH LEECE! haha. The government is inefficient and corrupt. How about lifting some of the >40% in taxes and let the poor... not be poor, huh.
Power corrupts. Absolute power corrupts absolutely.
MoltkeWarding
Profile Joined November 2003
5195 Posts
August 19 2009 01:20 GMT
#400
I read both kwark's arguments and the link which savio provided. The fatal shortcoming I find in both, and perhaps I earlier alluded to it, is their dependence on (low-variate) quantitative analysis to represent actual conditions. I haven't accessed nearly enough medical services across enough countries to make such sweeping international comparisons (and I suspect I am not the least experienced among you in such matters.) Of course the inexperienced fall back on numbers, but just reading through the link savio provided, it must occur to everyone the highly theoretical basis on which all these arguments are founded. GDP is supposed to represent real "wealth." Good health care is equated with life expectancy. We are mobilizing language in the process with such weird neologisms as "preventive healthcare."

I find all such arguments unconvincing without some first-hand anecdotes of how the system actually works.
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