Wanna Play Doctor?: Prostitution Insurance

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An odd little tale about a mythical America where prostitution services are insured through employers and government:

Once upon a time in America, an employer came up with an idea for saving on payroll expenses. He noticed that many of his employees seemed uncomfortable with the idea of paying for sex, even though they wanted it. So he tried reducing worker salaries by $1000 a month, and instead he gave his workers an insurance card that they could present to prostitutes whenever the workers wanted their services….

Both consumers and the providers of prostitution services became accustomed to using insurance cards. Paying for sex directly was frowned upon as something no decent, middle-class person would do. Instead, the first thing that would happen when a consumer visited a brothel or a prostitute was that the consumer would present his insurance card to be photocopied.

Later in this parable, a few brave economists argue that "Americans ought to try to get over their discomfort with paying for sex." This would reduce the costs of prostitution, they say. Unfortunately,

most people, particularly prostitutes, were outraged by the economist's suggestions. The idea of paying for sex was too offensive to contemplate. So the existing prostitution insurance system kept stumbling along.

Read the whole thing at TCS Daily.

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  1. Hey, just send over a couple of those Central American gals, and we’ll forget about the whole thing.

  2. :rolleyes:

    I’d encourage Kling to try again. There has to be a smarter, and more entertaining way to make that point.

  3. I like it, it reminds me of the same argument Leonard Peikoff used in the link below. Except he uses hair care instead of prostitution.

  4. oops, click on my name for the link or use:
    http://www.capmag.com/article.asp?ID=9

  5. I agree with shecky. While he has a good substantiative point in there, unless Kling just won a bet about how many times he could refer to prostitution in a column about health care, he should have chose a better rhetorical device to express it.

  6. The problem with paying for health care out of your own pocket is that providers charge vastly higher prices to the uninsured. With my dentist, for instance, if I wanted to just pay cash, they would charge me $175 for a filling. But, since my insurance pays for it, they only charge $60. I, personally, pay nothing.

    I’ve had friends without a dental plan try to negotiate on price, and the dentists are morally outraged by the notion.

  7. This is a great analogy– spending money on prositution is just like spending money on actual medical treatment. I can’t think of anywhere this argument could possibly go off track.

    Employers spoil their employees with luxury treatment like (getting laid / medical attention), and then employees go and get all bitchy when they (go on a dry spell / die of an easily treatable disease or injury) for lack of money. After all, employees are perfectly able to (get sex / get medical care) for free if they apply themselves a little. And if they happen to be rich, they can always just pay out of their own pocket.

    If they don’t happen to be rich, and if they can’t happen to (get laid / get medical care) for free, then tough nuts. Not everyone deserves to (get laid at will / live).

  8. That was a little bit awesome 🙂 Not a serious analogy but good fun with lots of ways to work it.

    Then there was a big political debate over illegal immigration. Most people agreed that the prostitutes entering this country illegally were ruining the economy by providing better sex for much less money than Americans were willing to prostitute themselves for. They were also accused of ruining the economy because hoards of them were crossing over the boarder, at great personal risk, so they could get free sex at American tax payer expense.

  9. Hmm, did this mythical employer’s insurance also require a referral form to see a specialist prostitute?

  10. Not the best analogy, but one thing it does is put the idea of health care out of “basic human right” territory. Except that very few who consider health care a basic human right would be swayed by this because they’d never consider sex a basic human right.

    Though transplant this over to Canada, where they worry about a two-tier system of prostitution. The rich can afford the very best prostitutes, while everyone else has to settle for government appointed prostitutes. The only course to make things fair is to make any free market prostitution illegal and force everyone to use the government system, because it’s not fair that some people can afford to get premium prostitutes and avoid waiting in line all day. So naturally all the rich people and less rich who really need something fast all go out of the country, and all the good prostitutes go to the states, where they can make better money for their better services.

  11. Haha, yeah. And don’t forget about universal condom coverage and prophylactic reimportation.

  12. Talking about Canada… my doctor is from Quebec. She moved to the US because she couldn’t stand the health care system in Canada. Here’s an example of why:

    A few weeks ago, I hurt my knee. I went to the doctor. She examined and me and thought I had torn my ACL. Within four hours, I had an MRI and X-rays of the knee, which determined that I had no major damage to the ACL, but had broken my femur and tore the LCL.

    According to my doctor, the wait to get an MRI for a knee injury in Canada is six months. In that time period, scar tissue will form and the injury will heal improperly and you will never regain full function. In the US, an ACL tear is now a minor issue, while in Canada it is a lifetime disability.

  13. All of these analogies fail because life saving medical care is something with an infinite demand. Is there a price for something like surgery where people would rather die than pay? Perhaps a more appropriate analogy would be food– except even the cheapest sustanance would cost thousands of dollars, and a third of Americans couldn’t afford to eat on a regular basis.

  14. I thought it would have worked better with food or clothing rather than prostitution. You know–something people actually need in order to live.

  15. Except that very few who consider health care a basic human right would be swayed by this because they’d never consider sex a basic human right.

    Hmmm, it must be true – the lefties have more/better sex. Because you know if they didn’t they would be screaming about sex as a basic human right.

  16. All of these analogies fail because life saving medical care is something with an infinite demand.

    Yeah, who would deny that octogenarian a quadruple bypass, or my late alcoholic uncle a liver transplant?

    Is there a price for something like surgery where people would rather die than pay?

    How much money is spent on cosmetic surgery every year? Perhaps you could find a way to channel all of that money into only life sustaining medical care?

  17. Okapi,

    My dentist is the exact opposite. He charges me less than he would if I had insurance. He is odd, no hygenists or receptionists and he figures the cost in his head while he is digging around in your mouth. I appreciate a dentist who can do math in his head though, so it works for me.

  18. Yeah, who would deny that octogenarian a quadruple bypass, or my late alcoholic uncle a liver transplant?

    I don’t understand how this is a response to what I said. Certainly most people– even in those rare situations you describe– still want to keep on living and will pay whatever price they can in order to do so. You seems to be saying they don’t deserve life saving treatment– which may be true, if callous, but I doubt that’s how they feel about it themselves.

    And if you’re a fan of merit-based medical care, I don’t see how moving to socialized medicine hurts that in any way. Right now, your grandfather or uncle can get as many surgeries as they can afford, while the less fortunate– and perhaps more in need– go without. As they say, deserve’s got nothing to do with it.

    How much money is spent on cosmetic surgery every year? Perhaps you could find a way to channel all of that money into only life sustaining medical care?

    Hmm, maybe there should be some way to provide even poor people with life saving care, without providing everyone with free cosmetic surgery. What’s so impossible about that, again?

  19. All of these analogies fail because life saving medical care is something with an infinite demand.

    As opposed to prostitution?

  20. Certainly most people– even in those rare situations you describe– still want to keep on living and will pay whatever price they can in order to do so.

    Eh, perhaps it’s the difference between what they will pay and what we, collectively will pay. I don’t begrudge anyone any medical care that they can pay for on their own. The question arises when you, I and a lot of other people are footing the bill.

    Hmm, maybe there should be some way to provide even poor people with life saving care, without providing everyone with free cosmetic surgery.

    OK, that one sailed over your head too. As far as I know, most cosmetic surgery is paid for out of pockect, but you and I would probably agree that it is in the grand scheme of things a waste of resources. Only a leftist could turn that into the proposition that everyone should have free cosmetic surgery.

  21. Juris,

    Let’s recap. My claim was that the demand for treatment that will save one’s own life is infinite, and thus different than a luxury like prositutes. Which is why the analogy fails. You responded with the argument that certain people don’t deserve care, which did in fact “go over my head”, mostly because it’s a complete non-sequitor.

    Also, as you should know, socialized medicine doesn’t cover every expense, particularly in expensive operations towards the end of people’s natural lives– this is true even in the libertarian nightmare known as Canada. So even if your response was somehow relevant, it’s still a straw man.

    OK, that one sailed over your head too. As far as I know, most cosmetic surgery is paid for out of pockect, but you and I would probably agree that it is in the grand scheme of things a waste of resources. Only a leftist could turn that into the proposition that everyone should have free cosmetic surgery.

    OK, Let’s do another recap. My intial claim here was that you never see people negotiating with surgeons– that no one would pay $50,000 for life saving surgery, but would rather take the morgue than spend $100,000. I didn’t explicitly say “life saving” there, but it should have been obvious from context to all but the most extreme pedants. Again, this is another way in which health care analogies usually fail. In any case, you responded that people waste money on cosmetic surgery all the time– which again, in the context of life saving treatment, is a complete non-sequitor.

  22. Hmm, maybe there should be some way to provide even poor people with life saving care, without providing everyone with free cosmetic surgery. What’s so impossible about that, again?

    Not providing everyone with free cosmetic surgery is easy: just don’t do it ™.

    Providing poor people with life saving care is less easy. It requires resources—trained people, sterile equipment, space with the proper infrastructure, drugs, other consumables, and so on ad nauseum.

    So, who is going to pony up the resources?

    And who is going to decide how they are allocated?

    What are the limits of “poor”? Of “life saving care”?

    There is a trade-off between the unit cost of care and the saftey of individual procedures. How should we choose where to make it? Should the answer be different for PoorCare ™, than for free market transactions? Should we make everyone work through the same beuaracracy, and what do we do when that organization does something stupid?

    There is another trade-off between cost and flexibility, and the same questions apply.

    How do we deal with the time-evolution in the paramters of the problem?

    There is nothing simple about policy decisions in this realm, and I don’t know that I’d trust anyone who says that there is.

  23. There is no question that everyone should have all of the health care they need.

    There is only a question of who should pay for it.

    Quit bitchin’ at each other and offer a solution.

    CB

  24. I know prostitution insurance. I own prostitution insurance. I don’t know what the article is getting at, but it has nothing to do with prostitution insurance.

  25. Okay. Now I’ve recently seen people compare health care to:
    1)expensive meals in restaurants
    2)international air travel
    3)prostitution

    Guys? Give it up. It’s a dumb line of argumentation. It only serves to convince onlookers that you’re rich and clueless. Talk to few people with serious medical conditions and no insurance. Or, if you’re scared of the poor, then talk to some doctors about it. But seriously, you’re not doing yourself any favors here.

  26. My intial claim here was that you never see people negotiating with surgeons

    That must be the explanation for why the news contains all those stories about how people don’t travel to cheaper countries for medical care.

  27. You don’t pay to have sex with a prostitute.
    You pay to have her leave after the sex is over.

    I’d like to buy Politician Insurance to cover a similar expense.

  28. which again, in the context of life saving treatment, is a complete non-sequitor.

    By the way, bringing up life-saving treatment is a complete non sequitur with respect to the original article.

    The parable decries the condition that all health care — even the cheap health care that bloody well should come out of pocket — is covered by typically employer provided insurance, and that paying for it normally, like you would anything else, is considered odd at best and anathema at worst.

  29. My intial claim here was that you never see people negotiating with surgeons– that no one would pay $50,000 for life saving surgery, but would rather take the morgue than spend $100,000.

    And you speak to me of straw-men? Don’t light any matches near the above hypothetical.

    People don’t negotiate prices on most things they buy, though when they do it’s usually on the big-ticket things.

    People don’t negotiate for health-care services because for the most part whatever negotiation that takes place is handled through intermediaries. Why should I care what my insurance company negotiates with the doctor? Now, if I actually had to pay for it myself, that might just be a little different.

    The demand for healthcare (and let’s leave aside the life-saving canard) is substantially higher when the cost is heavily subsidized.

  30. Well I’m not sure there’s much use in continuing a discussion with people who consider talk of saving lives a “canard” within the context of medicine and health care.

  31. There is no question that everyone should have all of the health care they need.
    There is only a question of who should pay for it.
    Quit bitchin’ at each other and offer a solution.

    Very well…

    1. Eliminate the tax bias for employer-provided health insurance.
    2. Eliminate physician licensing laws.
    3. Eliminate requirements for prescriptions, except for drugs such as reserve antibiotics that involve actual public health concerns.
    4. Eliminate Medicare.

    That should get rid of most of the state meddling in the market that we can, given the mandate offered. So now to what the government can do, rather than what it can get out of the way of…

    5. Provide an adequate government safety net. Do not require that it be as good as the best money can buy. It won’t be. Accept it.


  32. 2. Eliminate physician licensing laws.
    3. Eliminate requirements for prescriptions, except for drugs such as reserve antibiotics that involve actual public health concerns.

    Mike, these may not be completely compatible.

    I could agree with your point 3, but that leaves us in need of a license to perscribe those drugs that are regulated.

    A system where the state qualifies agencies that qualify physicians might be workable… You get competing Medical Associations, and the best doctors presumably get certified by more than one of the best associations.

    Then you introduce PoorCare ™:

    5. Provide an adequate government safety net. Do not require that it be as good as the best money can buy. It won’t be. Accept it.

    a poor alternative for health care, and you still need to answer some of the questions above. In particular about the source of the funds, and the definition of “adequate”.

    What a headache.

    The upside is, we’re rich enough for this to be amung our biggest ppverty driven problems. Life could be worse, and was for our grandparents.

  33. Well I’m not sure there’s much use in continuing a discussion with people who consider talk of saving lives a “canard” within the context of medicine and health care.

    Most healthcare is not about saving life, but I suspect you know that and now don’t want to play.

  34. A system where the state qualifies agencies that qualify physicians might be workable… You get competing Medical Associations, and the best doctors presumably get certified by more than one of the best associations.

    That’s a fair idea, but it still may be overkill. The government could simply require that the dispensing pharmacist have a particular CDC certification. He knows the rules for the drug, and he’s responsible for calling your physician and being convinced it is being responsibly prescribed.

    The upside is, we’re rich enough for this to be amung our biggest ppverty driven problems.

    Yep. My main point is that most of the problems with health care today have nothing whatsoever to do with providing health care to the poor. Yet so many of those problems have arisen out of an attempt to provide health care to the poor and scaling what should be a fairly limited problem into one of GDP threatening levels.

  35. MikeP – thanks for offering a solution.

    I am TRYING to get a handle on what SHOULD be done. I don’t know. If I was made benevolent despot of the USA tomorrow (something I frequently fantasize about), I don’t know what I’d do. That’s why I am asking.

    What CAN be done? What’s fair? What’s right? I’m pretty sure that marketizing (??) healthcare is the right direction, but I hate feeling bad (I’m western European, can’t help it) when people who made bad choices, combined with bad luck, can’t have everything they want. Hmmmm… they can’t have big screen TVs either… but that doesn’t make me feel bad. Wonder why that is?

    CB

  36. Prostitution insurance is a big scam designed to line the pockets of prostitution insurance companies. I once forgot my safeword with this dominatrix and I had to fill out forms for months. What a nightmare. I didn’t sign up for this kind of masochism.

  37. I didn’t sign up for this kind of masochism.

    Well obviously you need to negotiate better.

  38. Comparing physicians to prostitutes?

    What a waste of good lawyer jokes!

  39. Food or clothing are better analogies? Let’s see: I haven’t visited a doctor for almost five years. However, surprisingly, I’ve eaten food and worn clothing on many occasions.

    Also, when I buy food, I’m not paying to feed all the people who can’t afford food, and I’m also not paying for extra food for people who want seconds. However, with medical care I’m currently forced to do both.

  40. Health insurance IS prostitution insurance. Trust me.

  41. Food or clothing are better analogies? Let’s see: I haven’t visited a doctor for almost five years. However, surprisingly, I’ve eaten food and worn clothing on many occasions. Also, when I buy food, I’m not paying to feed all the people who can’t afford food, and I’m also not paying for extra food for people who want seconds. However, with medical care I’m currently forced to do both.

    Yet I daresay healthcare is still more vital to your health than prostitution (jokes about your desperate need to get laid notwithstanding). And if the government passed as many laws for food as they have for health care, you WOULD be paying for those who can’t afford food and those who want seconds. That’s the point of the analogy.

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