Regulation

Health Care Competition

If the policy elite really wanted to cut costs, they would deregulate medicine.

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The statist establishment would love a single-payer health-care system like Canada's if it were politically achievable. Barack Obama said that if we were starting from scratch, single payer is what he'd back. But, thankfully, Americans are still libertarian enough to cringe at turning the medical system entirely over to government.

So with single payer out of reach, the fans of government control have grabbed for second best: the "public option." This would be government-run health insurance that would "compete" with private insurance. (It wouldn't compete fairly because it could do something no private firm can do: milk the captive taxpayers.) But the public option is proving hard to get. Even some Democrats are nervous about it.

What's a statist to do?

Leading Democrats in the Senate say the answer might be nonprofit health cooperatives. Sen. Charles Schumer wants some method "to keep the companies honest," and if the "public competitor" can "do those things in a co-op form, I think we're open to it."

One sign that this may be the way things are heading is that the New York Times, the mouthpiece of the statist establishment, ran a front-page article last week that begins with glowing praise for a co-op where doctors have lots of time to spend with patients because of its "collaborative model of primary care." Among the media it's an article of faith that the "collaborative model" is more consumer friendly than a profit-seeking business.

The Times connects the dots in case anyone missed the point. "On Capitol Hill, those innovations have made Group Health a prototype for a political compromise that could unclog health care negotiations in the Senate and lead to a bipartisan deal. … [T]he Senate Finance Committee seems poised to propose private-sector insurance cooperatives … as its primary mechanism for stoking competition and slowing the growth of medical costs."

Give me a break. Since when is government needed to stoke competition? Competition is what happens when government lets people alone. I defy anyone to give me an example of lack of competition that doesn't have its roots in government intervention.

Since co-ops are nonprofit organizations owned by their members, the Times' story subtly implies that the profit motive is responsible for the absence of competition and higher medical costs. But that's ridiculous. In a free market without government barriers to entry, it's the quest for profit that produces competition and lower costs.

If health cooperatives were really more efficient and innovative, wouldn't they be copied all over the country? That's how the market works. When someone comes up with an innovative way of doing business, it is quickly imitated and improved on. But buried late in the Times story is the revealing fact that the co-op is "a rare survivor among the hundreds of rural health insurance cooperatives."

Hello? Don't the Times editors see the disconnect? If co-ops worked well, today there would be thousands of them. Why should taxpayers fund a method of delivering health care whose success is "rare"?

The newspaper story made another point that is a favorite of the policy elite: Preventive care will save tons of money. If that's true, there is nothing (but government) to keep people from implementing that principle. But is it true?

This seems to be one of those things we know that isn't so.

I take Lipitor. The drug may extend my life. But this doesn't lower my health-care costs. Years of pill-taking increases costs. If the pill works, I may live long enough to get an even more expensive disease. And maybe I, like millions of others, take Lipitor unnecessarily because we would never have had heart attacks. We then spend more, not less, on health care.

Health-care expert John Goodman of the National Center for Policy Analysis says there are "literally hundreds of studies from over the past 40 years that show preventive medical services usually increase medical spending … Contrary to popular belief, checkups for children and adults do not save the health care system money."

If the policy elite really wanted cost-cutting competition, they would deregulate medicine. No one has ever found a better way to stimulate competition than freedom.

John Stossel is co-anchor of ABC News' 20/20 and the author of Myth, Lies, and Downright Stupidity.

COPYRIGHT 2009 BY JFS PRODUCTIONS, INC.
DISTRIBUTED BY CREATORS.COM

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  1. I remember Quincy was a meddlesome, do-gooder type medical examiner. Jack Klugman played the role with gusto.

  2. What’s with all these libertarian-themed articles on Reason lately?

  3. If Quincy is your doctor, you must be mighty sick.

  4. Yeah some good points but the article misses the key problem with profit motive for health insurers: They always have a profit incentive to deny coverage.

  5. They always have a profit incentive to deny coverage.

    As do car insurers, home insurers, life insurers, and so forth, and so on.

    Try a new idea.

  6. The also have a profit motive to extend coverage to as many people as practical.

  7. They always have a profit incentive to deny coverage.

    Which, in a free-r insurance market, would be overridden by the competition incentive. If one company earns a reputation for denying coverage for a particular condition, their competitors could make bank by making sure everyone knows that they DO cover it.

  8. Re: Harrigan

    of course there’s a profit incentive for denial of coverage – it’s a free market system. By your logic, an auto insurer should extend coverage to a flood or fire damaged vehicle or a home insurer should extend coverage to a home destroyed by tornado force wind. If there is no profit incentive there will be no coverage.

  9. Ok let’s save everyone some time by summarizing what’s going to happen on this thread.

    1. Someone is going to tell a story about how their uncle’s girlfriend’s cousin was dropped by their insurance company as soon as they got cancer, and that happens “all the time.”
    2. Others will deny that really happens, and claim that in a free market, it would be bad business to drop customers.
    3. Someone else will state that it really is good business to drop customers who cost a lot of money.
    4. Insults will fly, and nobody’s mind will be changed.

    I say we just cut to the chase and start with step 4.

  10. Crap, posted my first comment too late.

  11. Why don’t we follow Canada’s example? I mean, what’s not to like about free health care? And the doctors make house calls – even if you’re not sick!

  12. http://hotair.com/archives/2009/07/16/a-modest-proposal-2009-edition/

    This is brilliant. There isn’t one arguement about healthcare that you couldn’t apply to legal services. People are routinely bankrupted by legal fees assocaited with divorces and child custody disputes. Millions of people forgo proper estate and tax planning because they can’t afford a lawyer. If you get charged with a crime, you face tens of thousands in legal fees if you have an income and don’t qualify for PD services. Hell, you can’t even by private legal insurance. If single payer is the answer for healthcare, why isn’t it the answer for legal services?

  13. 4. Harrigan doesn’t know what the fuck he’s talking about. You’re welcome.

  14. I say we just cut to the chase and start with step 4.

    Hear, hear! Allow me to tow the lion, then, and be the first to say: yo, fuck Kevin.

    Also, i did Harrigan’s sister, and she was really bad in bed.

  15. Nothing personal, Kevin. Had to start somewhere.

  16. I know lots of people who have gotten really sick and ran up 100s of thousands of dollars in medical bills. I have yet to meet one that was dropped by their insurance company for it.

  17. If single payer is the answer for healthcare, why isn’t it the answer for legal services?

    There’s not a lawyer in the country willing to lobby for this, but there a lots of doctors who may be very good at helping sick people but don’t know dick about insurance. In fact, it’s probably most of them. Private health insurance is only meddled by government trying to make everyone’s coverage equal when it doesn’t need to be.

  18. Nationalized lawcare.

  19. Nationalized lawcare.

    Fuck, you guys, don’t be giving the administration any ideas.

  20. I know lots of people who have gotten really sick and ran up 100s of thousands of dollars in medical bills. I have yet to meet one that was dropped by their insurance company for it.

    This is because the money is already paid by the insurance company so dropping the customer now means they will never recoup anything in future premium. Insurance companies benefit most by paying claims and hoping like hell the doctors fix the problem the first time. Reputation remains strong and least amount of money is paid out. Customer lives long life and continues to pay premiums meaning more investment income to the insurance company which is profit.

  21. So, what has kept the competition from having affordable healthcare already? What government influnce is there right now that keeps the health insurance high? You can control insurance prices all you want, but until you find a way to not pay $250 dollars for someone to take blood and look at it under a microscope, it doesn’t matter how much insurance costs. They know as long as costs for the actual healthcare are kept high, there will always be a need for some “insurer” to make money off of you while saying we don’t cover that. if health care costs were reasonable, then there would be no need for health care. Don’t get me wrong, I generally like how Mr. Stossel thinks, but if competition was going to lower costs, it already would have.

  22. Last sentence- If Health care costs were reasonable, there would be no need for insurance. There, now it makes sense.

  23. …if competition was going to lower costs, it already would have.

    It’s hard for competition to lower costs when government mandates coverages be pretty much identical. So the only things compeitors can do is try to negotiate the best rates with doctors and hospitals. The government doesn’t allow much difference in the way of what is covered, so Blue Cross and United Healthcare have to pretty much offer the same product. They have to get creative to outshine their competitors. It’s even harder because of this for new insurance companies to start up because they have no reputation and can’t offer unique packages of services.

  24. More lawyers than doctors in Congress, so this won’t pass.

    http://hotair.com/archives/2009/07/16/a-modest-proposal-2009-edition/

  25. Xeones, you shoulda had insurance. I could have sold you an expensive policy for Harrigan’s sister, made it up in volume.

  26. New competitors typically offer lower prices to get new customers in the door. When new customers are essentially kept out of the market, the established carriers can ride along at the established rates, increasing due to technology and higher doctors fees (partially due to malpractice insurance being so expensive), so the price keeps going up, all because of govt regulation.

  27. When new customers competitors

    Damnit.

  28. Son-of-a…fucking tags.

  29. It should read: When new competitors are essentially kept out of the market…

    Ugh.

  30. “Last sentence- If Health care costs were reasonable, there would be no need for insurance. There, now it makes sense.”

    If car repair costs were reasonable, there would be no need for insurance. What we clearly need is a single payer government mandated car insurance program. I apologize if you were trying to be ironic.

  31. The problem with “competition” in health care is that the consumer may be not be rational, and probably does not have true “choice”. Moreover, health care providers will “irrationally” provide services to the uninsured. To illustrate:

    Someone who wants to buy a $30K car will shop around. Who can shop around for a $30K surgical procedure? Especially when they are sick in the first place?

    People could “elect” not to buy health insurance. Just like they can elect not to buy a car. But guess what? An uninsured guy who stumbles into an emergency department with a ruptured appendix will get treated whether he can pay for it or not. The hospital gets stiffed. So who pays for that?

    I’m all for market incentives for health care. But being sick often tosses rational choice theory right out the window.

  32. But being sick often tosses rational choice theory right out the window.

    Is it possible to shop for insurance when you’re well, like you shop for auto insurance when you’re not in the middle of having an auto accident?

  33. SteveM,

    Insurance is the rational market response to your problem. I pool my risk of needing surgery with other people and pay a more affordable amount to insure agains the risk. While I certainly can’t walk away from a doctor in the emergency room, my insurance company can certainly tell doctors what is a reasonable price with some authority. My insurance company and my doctor can work it out amongst themselves. If the doctor comes to me for the difference, fine, I can pay. But I am still better off than i would have been without insurance and I can take that into account when I am shopping for an insurance policy. Insurance companies have an incentive to pay in order to keep customers.

  34. I say we put gems in everyone’s hands that change color when you’re 30 and then you get to Carrousel and BAM no more health care worries.

  35. As a former healthcare worker, I’ll jump into this one too because it annoys the shit out of me.

    Healthcare is a service just like any other. There is no right to it. Pay or don’t pay. We already keep too many people alive anyway. We’re constantly striving to cheat death (nature) and that costs $$$.

    Our costs are high because of many reasons but two pretty significant ones are sustaining the terminally ill and labor costs. There’s a reason why many hospitals hire “foreign” nurses and doctors… they cost less. But, you need to attract a large enough labor pool so you can’t always just get a bunch of cheap labor to help. Higher wages = higher supply of labor. Believe me, those jobs suck so to attract people into the profession, there has to be incentive.

    I also like the argument that gov’t administration of the system would cost less. Show me an efficient, cost-effective gov’t agency and maybe we’ll talk.

    Did I jump around on subjects enough?

  36. So, what has kept the competition from having affordable healthcare already? What government influnce is there right now that keeps the health insurance high?

    What portion of medical costs are now paid by government?

    How much does it cost to take a new drug through FDA approval?

    Mandatory coverage. (mentioned above)

    Progressive taxation (make health care professional cost more).

    You would be hard pressed to find an area of medical services not affected by government.

  37. One other thing Steve M. My auto body guy has me over just as much of a barrell as my doctor. I don’t know what a fair price for a paint job after an accident is. And I have a lean on the car and must get it fixed. Yet, somehow private insurance seems to work in that case. Or maybe it doesn’t. Again I ask the question, if single payer is the answer for medical care, why isn’t it the answer for things like car repair or legal fees?

  38. We don’t have free competition on health care. Many places, new facitilies and services require the facility to apply for a “Certificate of need”. These certificates limit competition in a given area, keeping healthcare costs high.

    In addition, state regulations deter new companies from entering new markets, thereby decreasing the amount of competition for health insurance.

    So no, we don’t actually have real competition in the healthcare market.

  39. But guess what? An uninsured guy who stumbles into an emergency department with a ruptured appendix will get treated whether he can pay for it or not.

    There’s an obvious solution here.

    When I was a younster living in a nice house in a development out in the countryside in Tenn, the fire department responded to a house fire down the street. They came and watched the house burn down, only making a minimal effort to ensure that the fire didn’t spread to neighboring houses.

    I asked my father why that happened. He explained that everyone in the housing development had to pay a private company for fire protection services, because the county didn’t have a fire department.

    The guy down the street didn’t feel it was necessary to pay for private fire protection.

    Too bad, so sad.

  40. @Tomcat1066:

    Great point about the certificate of need. That’s a big reason why competition is a farce in the industry. Good example of gov’t interference. In one example, the way doctors have gotten around it is to open those “Emergi-care” doc-in-the-box places. I love those things. They take insurance or credit cards and I can get seen quickly.

  41. Tomcat1066,

    Don’t forget the AMA artificially reduces the supply of doctors through state liscensing requirements.

  42. “if competition was going to lower costs, it already would have.”
    “If Health care costs were reasonable, there would be no need for insurance. There, now it makes sense.”

    I wish Stossel would actually explain the ways that government regulation keeps health costs artificially high. It would be ideal for me to pay for health insurance that covers only emergencies and major illnesses, and pay out of pocket for routine and minor issues. But insurance companies can’t offer policies like that because the government mandates thay they cover everything. You can’t claim that competition has failed to lower costs, because the government is restricting that from happening.

  43. I say we put gems in everyone’s hands that change color when you’re 30 and then you get to Carrousel and BAM no more health care worries.

    Do I get to bang Jenny Agutter? I mean, if I get to bang Jenny Agutter, as she was in the 1970’s, sign me up.

  44. Who can shop around for a $30K surgical procedure? Especially when they are sick in the first place? the cartel mandates concealment of costs until after the fact.

    If you put your car in the ditch, you *can* go to various body shops, and they will give you an estimate of costs.

    —-

    And- as far as the government fee reimbursements go, a “ceiling” quickly turns into a “floor”.

  45. SteveM,

    Roughly 1% of premiums cover the uninsured who show up at ERs. The whole notion that the uninsured are causing a significant problem is simply not the case.

    Now what does cost a lot of money is the underfunding of guess what – medicare. The low compensation levels of medicare increase premiums by roughly 10% to 15%. Also, medicare patients are far more likely to go the ER because they cannot get a GP to see them, again because compensation levels are so low.

  46. The whole system is crazy. I am young and healthy and make enough money to afford any kind of health emergency under say 10K. I don’t need them to pay for coverage under that. I should be able to buy a policy that just covers 10K+ expenses. I should be able to negotiate with my employer for more pay and less coverage.

  47. Do I get to bang Jenny Agutter? I mean, if I get to bang Jenny Agutter, as she was in the 1970’s, sign me up.

    Dude, she’s not that hot. Really. But if that’s what it takes, sure.

  48. What about when I think I have pink eye, but I have to see my GP to get freaking eye drops? The guy is a cardiologist, so I’m sure he costs 10 times what I really need to pay for a medic that would say “hmmm….red eyes, mucousy lower lids? You probably have pink eye, here take these eye drops for a week.” That visit should cost $25, $50 max, it probably costs $400. I don’t even freaking know what it really costs, that’s a huge problem too. At least I know what the auto body shop charges me when I pay through insurance.

  49. Colonel_Angus,

    I pay about $165 a month for a policy with a $3500 deductible and $0 copay and $2 million lifetime payout.

    If your “routine and minor issues” are less than $3500/yr it’s available. There’s a cheaper one with a $5000 deductible also but it wasn’t around when I signed up and I haven’t bothered to change yet.

  50. To all, I’m not saying that single payer is the answer. I’m only saying that a health care consumer is unique in how he assigns value when he buys insurance and when he demands care.

    We already have “health care competition” in that employers as true rational purchasers should be able to select a health care package from competing vendors, thereby providing the company and its employees with with “Best Value”. But that model obviously is not working.

    I think it’s a good idea to provide consumers with a benefit subsidy and allow them to select the coverage that works best for them. But why should we think that process would be cheaper than the current employer defined benefit packages? And again, what about the consumer who elects not to buy insurance? Why pays for the slob when he gets sick?

    What bothers me is the health care provisioning is indeed complex. But the only considered solutions are completely polarized. I’d rather step back at look at a system like Germany’s and ask what works about that and what does not? Can a mixed model be developed that minimizes the negatives in the trade space?

    Conservatives pointing to anecdotal English dysfunction and nothing else won’t solve the problem any more than single payer on the left.

  51. We already have “health care competition” in that employers as true rational purchasers should be able to select a health care package from competing vendors, thereby providing the company and its employees with with “Best Value”. But that model obviously is not working.

    Works really fucking fine at my place of employment.

  52. Sam- Insurance companies don’t develope new drugs for FDA approval. I don’t see how a new drug by Pfizer makes UHC charge more.

    Mandatory coverage is a problem. Kind of hard to have choice when allyou have is one option and you don’t have a choice not to take it.

    Colonel- Yes the government is restricting health care competition. You can tell by all the insurance companies complaining about how they are unable to offer competition to…..no wait, that isn’t right. Name me one insurance company that has ever complained about not being able to offer lower insurance because of the government. Insurance companies don’t want competition, it would lower their profit. If they wanted to introduce competition, I am sure the insurance companies make enough money to lobby the government to allow competition. They haven’t done that have they? Have you ever heard of an isurane company complain they are making too much money?

  53. Mr. Stossel is correct, there is little Liberty in either health insurance or health care.

    Here in OK, there was a perfect example of this recently in regards to Lasik. Opthamologists ran commercials about how it was legal for “non-doctors to stab a scalpel in the eyes of Oklahomans” one of only two States that do not require a Ph.D. to perform the procedure. Why can’t I decide if I need a full eye doctor to do this procedure? One of those who were not doctors advertised that he had performed over 1000 Lasik operations. “But he wouldn’t know about potential eye disease” was another claim. If I am having this done, I am not looking to have myself checked for disease but a certain procedure to improve my eyesight. Fortunately, we shot the idiocy down, slack-jawed yokels that we are. If you want to pay a doctor twice as much to perform it, you are free to do so.

    Deregulating medical procedures would really reduce costs. You can effectively train someone to give a flu shot in how many hours? Why do you need a nurse or doctor to do it? Why must I go to a doctor to have a skin tumor checked? You could train a person in a few days or weeks to competently triage for dozens of things.

    For those who want to wail about treatments that people can’t afford, what ever happened to humbling yourself and asking for charity? It is simply more satisfying to send government thugs to demand it?

    Why can’t I open “Marshall’s quick and easy colonoscopy for women” stand? It isn’t Liberty, but regulation.

  54. If Quincy is your doctor, you must be mighty sick.

    For the next time, there really should be, say, a “Marcus Welby, M.D.”, “Medical Center”, “Ben Casey”, “Dr. Kildare”, or “Trapper John, M.D.” image instead.

  55. SteveM,

    I will give you a sollution. How about national licensing for doctors? End all state liscensing requirements and let any doctor practice in any state. Second, fund the building of medical schools and pay for people to go to them to increase the supply of doctors. Third, increase the number of things nurses and PAs can do. Lastly, encourage companies like CVS and Wall Mart to go further into the pay for service medical field. How about that?

  56. And I have a lean on the car…

    Dang it, I thought I’d seen it all, but a lawyer who can’t spell “lien” takes the cake.

    Sorry to pick on you, John, but, damn, your spelling skillz, or lack thereof, give me much amusement.

    It reminds me of a joke I heard years ago about Abe Lincoln making fun of his opponent in court who kept pronouncing it “lion”.

    The punch line was someting to the effect of Abe saying something like “I’d be afraid if there was a lion on my property too.”

  57. Opsmit,

    Of course insurance companies don’t want competetition. That is why the government doesn’t allow it. But, perhaps we should do what is best for the country and not insurance companies.

  58. Insurance companies don’t want competition, it would lower their profit. If they wanted to introduce competition, I am sure the insurance companies make enough money to lobby the government to allow competition.

    You have hit it on the head, but still don’t get it. The reason that anything but Liberty is the only thing that reduces costs is just as you say. It is easier and more certain to simply lobby the government, than actually perform more efficiently. So you are conceding that this is corporate welfare for insurance companies but still favor it?

  59. Isaac,

    It is not my spelling skills, it is my typing skills. When I stop and take my time, I can spell quite nicely thank you. When just goofing off on a conference call banging things out, not so much. Regardless, the point I made is still a valid one.

  60. It’s fucking insane to have (or ever have had) health insurance tied to your employer. Drop the tax subsidy, require employers to pass whatever the currently pay in insurance on to the employee and let everyone go buy their own damn insurance. Instant, over-night competition!

    Healthcare reformed.

    If you’re a bleeding heart you can require that insurance companies accept all applicants and cap the premium at twice the company’s average premium.

    Personally, I’d let natural selection take care of the uninsurable and toss some chlorine in the gene pool.

  61. BTW, here are few ideas I posted someplace else:

    You guys are not looking at the big picture. Mandating doctors treat Medicare/Medicaid patients is easy enough. The government just make accepting those patients a condition for maintaining a medical license.

    The other issue you side-step is surfacing and debating other feasible ways to minimize “rationing”. Services are rationed when there is a shortage of service providers relative to demand. Simple enough. Then the policy question is, how to increase the number of service providers? Well you only have to look at the Wall Street carnage to find a huge cohort of smart people with suddenly nothing to do.

    There was a story in the NY Times recently about some NYU grads who took jobs as “interns” on organic farms. Imagine that, NYU grads working as field hands for free. Of course the young people rationalized living in a tent and picking strawberries as “growth” experience because it was an organic farm. But the fact is that they are almost unemployable in our collapsed low value services-centric economy. From the farmer’s much more utilitarian perspective, these college grads with $100K of student debt were cheaper labor than the Hispanics he would have hired.

    You think those intelligent kids may be motivated to work as General Practitioners now if a transition program were crafted for them? Except for brain surgery, most medicine is not brain surgery. Thousands of intellectually capable people get rejected from medical school every year because of slot restrictions, not their ability to pass a licensing exam.

    How about this? Establish a Federal medical college akin to the military academies. Use the same commitment standards. I.e., educate the students for free and attach a 5 year commitment in which the graduates are assigned to primary care facilities as salaried employees. Set up 4 regional schools with classes of 1,000 each and in 5 years the United States will pump out 20,000 more physicians per year.

    Why would this work? What you have to recognize is that America will become poorer in the future because it chewed up its future with debt it cannot afford. Physicians will have much less professional latitude to bail out of medicine and do something else that pays more. I have to think that making even just $100K per year as a primary care doc comfortably working as a 40 hr/wk employee with no debt will soon be viewed as not a bad life.

  62. Isaac – I assumed John meant “I have to lean on the car”, thereby demonstrating that necessity does not destroy the argument for a free-market.

  63. Kinnath- change your place of employment. Have your prescription costs triple. No competition there, only one policy to choose from.

    Some minor changes that would work, fix Cobra. How is it legal to double your cost just because you have left that company? You still have the EXACT same insurance policy through the same company, but now they can double up on what they charge you. On that same note, why is it the company you worked for can deduct your cobra payments from their taxes? Am I not paying those payments? Why does the company get the tax perk?

  64. That is a novel interpretation AO. The larger point is that the arguments made for single payer healthcare can be made for lots of other sectors of the economy. Indeed, we do not have “autocaide” or “legalcare” yet those sectors seem to function just fine. I would say that legal fees associated with divorce probably bankrupts people just as often as healthcare costs do. Yet, liberals never demand a single payer national program for legal services. You could socialize lawyers just as easily as you socialize doctors.

  65. Kilroy – I pay much less than that even, but I have a small copay ($10-15 or something)…

    Course, I’ve never used insurance for anything in my life and am 26 and healthy… As are most of the people within the inflated statistics people are throwing around about the “uninsured”.

    Hell, I didn’t even bother to have insurance for about 6 months, so I would have been part of those statistics for that time. I wasn’t in any danger of dying or being bankrupt.

    But yeah… to Colonel Angus and everyone else who apparently doesn’t have a clue how our extremely convoluted system got to be what it is right now, and why it’s entirely the result of regulation & government intervention:

    “I wish Stossel would actually explain the ways that government regulation keeps health costs artificially high.”

    All is explained, HERE.

    I know I’ve linked people to this article half a dozen times whenever these issues come up, but it’s astonishing to me how few people understand even the basics of government involvement since the 40s.

    For a minor overview:
    1. FDR’s wage controls in the 40s pushed employers to find a new way to compete for talent – thus they started providing benefits, including health care, which was still legal under a certain percentage at the time.
    2. Further tax incentives ensconced that system by providing special benefits to insurance provided by employers that weren’t eligible for individuals buying their own insurance… Thus we embarked on a road where everyone quit paying for their own or paying attention to costs.
    3. The AMA & Congress control the supply of doctors by limiting the number of licenses per year and by limiting the amount of funding provided through government grants to prospective medical students… This ensures doctors have limited competition and thus can charge more for their services.
    4. Government disallows competition for services, as discussed somewhat above. Where you should be able to go see a nurse or an EMT for a cold, a broken bone or many of the smaller medical problems, you are required to see a doctor instead (and… review #3 and consider what artificially increased demand and artificially decreased supply means to cost)
    5. $1 Billion per drug FDA approval costs. WTF.
    6. HMO Act of 1973
    7. Medicaid & medicare underpay for services, thus pushing costs onto private payers as medical suppliers try to make up the difference…

    Look, I can go on and on with this, but there are thousands of regulations on the health care sector. Ironically, it’s the only sector of the US economy I can think of that is more regulated than the Financial industry, and yet in both cases the average American has the dumbass idea that they’re both unfettered, wild-west style free markets.

    The Health Care market is by far the most controlled by the US Government, and as government has tightened it’s grip over the last 50 years, costs have shot up dramatically… Go figure.

  66. Case in point… Opsmit:

    “Kinnath- change your place of employment. Have your prescription costs triple. No competition there, only one policy to choose from.”

    Review again why insurance is tied to employment and why competition for individual plans is incredibly difficult.

  67. http://www.fff.org/comment/ed1100d.asp

    … I don’t wish to frighten or panic anyone, but do you realize that there is no government department or agency in existence that plans for the delivery of food to your community? That’s right – it happens all by itself without any government plans, directives, or guarantees.

    When you walk into the grocery store and see all those shelves filled with things to buy, no government planner has made it happen. No bureaucrat has sat at his desk and figured out “demand curves” relating every item to every person in your community. No government employee has calculated how much of each cereal, vegetable, drink, pasta, and the thousands of other things on your grocer’s shelves will have to be produced to satisfy your individual demand and the demands of the other consumers in your community. …

    …Suppose, however, that during the Great Depression, the U.S. Department of Food had been established to protect the American people against starvation and the vicissitudes of the market. Suppose that from the 1930s on, all grocery stores in the United States were government-owned and that no one had been permitted to own a private grocery store. There would, of course, be less variety and fewer choices with respect to groceries, but everyone would undoubtedly feel a sense of comfort and security over the fact that the government was in charge of the “public grocery stores.”

    Now suppose I came along and said, “I believe we ought to separate food and the state. Let’s fire all the government food workers, sell off the state grocery stores, and turn the entire process over to the free market.”

    What would be the reaction of most people? “We can’t do that. Food is too important an item to be left to the free market. How could we be sure that there would be enough food for everyone? What if one city didn’t receive any food and another received all of it? What if grocery stores forgot to order food one day? For that matter, what if no one opened grocery stores in our community? What about the poor? How would they eat, especially when the rich would be buying everything? You place too much faith in the free market. This program favors the rich. The burden of buying groceries falls most heavily on the poor.” …

    …Yet, when it comes to the supplying of food to hundreds of thousands of grocery stores all across America, people do have faith and confidence in the miracle of the free market. After all, when was the last time you heard someone calling for government grocery stores? …

  68. Also, medicare patients are far more likely to go the ER because they cannot get a GP to see them, again because compensation levels are so low.

    Seward, aren’t medicare patients also far more likely to go the ER because they actually suffer more medical emergencies (chest pains in the middle of the night etc)?

    Until they got my mother’s pacemaker and medications stabilized she was calling 911 on a biweekly basis. One time the paramedics just gave here a couple of big old huffs of oxygen and told her to go to the urgent care clinic in the morning but they did it with the consultation of a doctor and further more told her to call them any time she had the same symptoms.

    Those emergency calls cost a shitload, and on one of her trips to the hospital the consulting physician charged in the high hundreds for his contribution from his remote location.

  69. “Ironically, it’s the only sector of the US economy I can think of that is more regulated than the Financial industry, and yet in both cases the average American has the dumbass idea that they’re both unfettered, wild-west style free markets.”

    Most Americans are not dumbasses. But they only have the time and the inclination to know what the media and their civics classes tell them. The reason why Americans don’t understand what you explained so well above is because the Left controls the media and the schools and ensures that no one ever explains those things to the American people.

  70. Mandating doctors treat Medicare/Medicaid patients is easy enough. The government just make accepting those patients a condition for maintaining a medical license.

    You can’t really be this stupid. Doctors are already dropping Medicare and Medicaid patients like hot rocks because they have to work 50 hrs/week just to break even. Do this and watch the already serious shortage of general practitioners grow to epidemic proportions.

  71. Opsmit – I’ve never seen a case where COBRA doubled the premiums, but that might just be limited exposure to it on my part. As far as the employer deducting it, well, they really don’t. You’re giving them the money, so they’re reducing their expense. They pay the bill and it increase by the same amount you paid. In other words, it’s a wash.

    You can deduct the payments you make for COBRA as a regular Schedule A deduction, subject to the 7.5% AGI limits blah blah blah.

  72. Opsmit,

    You won’t hear the large insurance companies complain about the government restricting competition because they actually enjoy the barriers to entry and mandates that basically fix prices for them. Getting rid of the regulation would open up competition whether they like it or not.

  73. Marshall- I haven’t agreed to anything about insurance companies, nor do I think the government plan in the works is the end all answer either. There are actual government run medicine in other countries that work. You wouldn’t know that from anything here, you would think it was only Canada and Great Britain that have universal healthcare.

    Insurance companies are corrupt. They do not care about anything except their own profit, not the people who are paying them for coverage. They do not want competition, or they would already be offering it.

    kilroy has it correct, have the company I am working for just give me the money, instead of it being the requirement for the company, and I will choose my own healthcare. Now that will drive down costs and spur competition. Why doesn’t Mr. Stossel come up with alternatives that work instead of just complaining about the government running something? I mean one alternative, like the one mentioned by Kilroy, might not be a bad idea to include in the article instead of just analogies about what else the governent can’t run.

  74. Regardless, the point I made is still a valid one.

    Yes, John, it was.

    I’m sorry I get distracted by your novel spelling styles. 🙂

  75. Isaac, the prefered term I beleive is “spelling anarchist”. 🙂

  76. What about when I think I have pink eye, but I have to see my GP to get freaking eye drops?

    Hell, you could self-diagnose for something so obvious and relatively benign as pink eye. My daughter gets it a couple times of year at daycare, yet every time we have to go to the doctor to get the Rx to get the $10 drops from CVS. WE KNOW its pink eye! We should be able to buy such a drug without a prescription every friggin time. This is one of many things that could reduce insurance costs thus making it more available to the general public. But it is forbidden by our masters.

  77. I still want to attack that stat that gets thrown out all the time about “47 million people without health insurance.” Who are these people? How many of them have cell phones, internet, cable/sat TV? How many of them are making a car payment of >$300/mo? It’s hard to feel sorry for them. In fact, I’m proud of them because they know how to prioritize.

  78. Citizen,

    We all know health rationing makes good sense. But, did you know that it’s popular too?

    http://www.youtube.com/watch?v=UrwdZ2bX-oc

    It is! Citizens from around the country have embraced the chance to give a lot–and take a little.

    Are you up for the challenge?

    The Health Administration Bureau: dedicated to ensuring that all Americans, regardless of age (where appropriate) and need (where appropriate), receive adequate health care.

    http://www.youtube.com/watch?v=UrwdZ2bX-oc

    Best Regards,
    Health Administraiton Bureau

  79. Sean- Ok, then lets fix it. You have some interesting points and I am reading your link. I would like to assume that you actually harass your senator and congressman as opposed to just coming here and typing in your opinion. I mean we can all come here and yell and scream, and watch absolutly nothing at all happen. That is the American way. Wonder why the Ins companies and government never come up with these ideas…..oh, they like the status quo. Maybe it should be illegal for insurance companies to lobby congress. Well…maybe it should be illegal for anyone to lobby congress, but that is another topic.

    Ska- Went from last job where I was paying approxiamtly 100 a paycheck for insurance to over 400 a month for insurance. Ummm…I don’t remember sending my old job any payments for insurance that they sent to the insurance company. I was sending it directly to them, so I am not quite sure what the old company was paying. I paid those payments, I should get the tax deduction. It is the exact same policy I had when I worked there, they just have ore of a chance to rip me off now.

    Colonel- What are the downsides of Kilroy suggestion then?

  80. Re: Jordan | July 16, 2009, 1:44pm | #

    Mandating doctors treat Medicare/Medicaid patients is easy enough. The government just make accepting those patients a condition for maintaining a medical license.

    You can’t really be this stupid. Doctors are already dropping Medicare and Medicaid patients like hot rocks because they have to work 50 hrs/week just to break even. Do this and watch the already serious shortage of general practitioners grow to epidemic proportions.

    Jordon, nope given the wrecked economy, what else would those guys do for a living? Those docs have nowhere else to go. Put ’em on salary, pay ’em $100K a year. It’s either primary care or selling pencils from a steam vent like the rest of us…

  81. Good one, John.

    Nick, it’s also interesting that if those drops are prescription they cost roughly fifty percent more than OTC.

    I went through a phase of getting frequent ear infections in the eighties and would end up gettinf a scrip for Polysporin Eye/Ear Drops (polymixin/ bacitracin). Here they cast me about ten bucks. I took a trip to Canada one year and got an ear infection. I was able to get the same thing OTC for about six (and that was when the loony was worth about sixty cents).

    Note that they are eye and ear drops, so maybe that’s what you got.

    I finally learned how to deal with the ear infections when I went to a doctor who gave me directions for a mixture the Corpsman used to make up for dependent familes when he was in the Navy. Apparently in the summer they would get a constant stream of kids in the base hospital with ear infections from swimming.

  82. Jordon, nope given the wrecked economy, what else would those guys do for a living? Those docs have nowhere else to go. Put ’em on salary, pay ’em $100K a year. It’s either primary care or selling pencils from a steam vent like the rest of us…

    So you’re advocating that all doctors be employed by the government? You really want to make the private employment of doctors illegal? So, we’ll restore health care competition by eliminating it, eh?

    By the way, I’m sorry to tell you this, but all Doctors have a bachelors degree. The job prospects for skilled employees are still quite good. Doctors will simply flee the industry or the country.

  83. Ok Opsmit:

    “Sean- Ok, then lets fix it. You have some interesting points and I am reading your link. I would like to assume that you actually harass your senator and congressman as opposed to just coming here and typing in your opinion.”

    My Senators are Barbara Boxer & Diane Feinstein and my Congressman is Henry Waxman…

    So… While I’ve emailed and called a number of times, I can expect very little representation from them.

    “Wonder why the Ins companies and government never come up with these ideas…..oh, they like the status quo. Maybe it should be illegal for insurance companies to lobby congress. Well…maybe it should be illegal for anyone to lobby congress, but that is another topic.”

    You are confusing cause & effect here.

    Companies lobby congress only because congress has the power to help, hurt or even destroy their businesses (and thus their livelihoods). If congress did not have such massive powers over the economy, there would be no need to send millions of dollars in lobbyists & campaign contributions to Washington in order to bribe or influence the lawmakers.

    Worse, if you remove the ability for people to petition congress, you are not only expressly violating the constitution, any pretext at “representative democracy” is gone and all you have left is an oligarchy. The big, rich companies are staffed & managed by the same guys who are in government… these are the guys who went to Harvard & Princeton together. Even if they couldn’t use money to influence congress, most of the time, all it would take is picking up the phone and calling an old Yale roommate for these guys.

    Example:
    “Hi, George, yeah… you remember me, we were in Skull & Bones together at Yale! Yeah… Oh, the kids are great, thanks for asking! Hey, the reason I called is cause I’m the CEO of MegaDrug Corp now and I need you to help me out with something… it seems we’ve got some competition for our new cholesterol drug from some smaller companies and I was wondering if you could help pass a new law to beef up licensing requirements? I mean… that’d really help us out here and it’d be easy to do, just tell the American public that the smaller companies aren’t “safe” enough and they need to be subject to stricter scrutiny… it’ll be an easy sell!

    Yeah… Thannnnkkkksssss!”

    If you want to limit the power of these gigantic corporations, then the first step is to quit handing lawmakers the power to grant them monopolies & near monopolies.

  84. Jordon, nope given the wrecked economy, what else would those guys do for a living? Those docs have nowhere else to go. Put ’em on salary, pay ’em $100K a year. It’s either primary care or selling pencils from a steam vent like the rest of us…

    You’re assuming that the shortage will be from doctors leaving the profession. What you’re missing is that now there is less incentive to become a doctor. As natural attrition kicks in, there won’t be new replacements to take over those patients.

  85. “It’s either primary care or selling pencils from a steam vent like the rest of us…”

    Or another country.

  86. Or another country.

    Medical havens can join tax havens out in the Carribean.

  87. Like the rest of us? I dunno about anyone else but while I’m only working half time, I’m sitting from my cushy desk inside working in my field and still earning enough to pay my bills… Steam vent?

  88. “Medical havens can join tax havens out in the Carribean.”

    Maybe there I’d be able to buy (or sell) a kidney and possibly even mortgage my corpse to get a bypass operation (or a new boat).

  89. Sean-
    I was just saying that Stossel should go in to more specific details about regulations like your article has, because he dumbs down his articles too much. You misread what I wrote.

  90. Somehow I doubt a mere cadaver would be worth enough for a boat 🙁 If only though…

  91. Oh – sorry Colonel…

    I agree, he does – but he writes for ABC and affiliates usually.

    One of the things I love about Reason Magazine is that in general they at least link to other articles and studies and such. It’s not always any “works cited” bibliography, but it’s usually enough to demonstrate that the writer isn’t just pulling shit out of their ass.

    Sad to say, I just can’t say that for most news sources and most especially not any of the “mainstream” ones. ABC, CNN, CBS, MSNBC, FOX, New York Times… You name it… They never EVER support their claims with anything you can actually read for yourself! It’s ridiculous. Especially in the age of T3h Interwebz.

    The fact that people just trust most journalists editorials and the “facts” they contain is often baffling to me.

  92. Re: Jordan | July 16, 2009, 2:12pm | #

    Jordon, nope given the wrecked economy, what else would those guys do for a living? Those docs have nowhere else to go. Put ’em on salary, pay ’em $100K a year. It’s either primary care or selling pencils from a steam vent like the rest of us…

    So you’re advocating that all doctors be employed by the government? You really want to make the private employment of doctors illegal? So, we’ll restore health care competition by eliminating it, eh?

    By the way, I’m sorry to tell you this, but all Doctors have a bachelors degree. The job prospects for skilled employees are still quite good. Doctors will simply flee the industry or the country.

    Yeah right, bachelor degrees in what? Biology? Pre-med? Trying getting into a new line of work with those degrees.

    And leave the country? To go where? Canada? England? Mexico? (Oh those people have plenty of money to pay exorbitant medical fees.) Why would you think doctors are not in the same US economic crapper along with everybody else? You think they’re immune from the rules?

    BTW, it doesn’t have to be the government who pays doctors a salary. I agree about free competition on the supply side, open up the med schools to anyone who can pass the licensing exam and let docs compete for jobs like everybody else.

  93. Sean W. Malone, thanks for that link!

    An entirely new system of health care financing was created during the decades of the 1940s and 1950s. Government encouraged the development and expansion of provider-oriented insurance plans that ultimately distorted the health care delivery system. Employer-provided plans offering first-dollar (front-end) and routine care coverage contributed significantly to the rise in health care costs. The preponderance of employer-provided insurance worsened the position of those without health plans because of the inflationary effect of third-party payment.

    I’ve been saying that for years. And not just because I’m self-employed.

  94. Somehow I doubt a mere cadaver would be worth enough for a boat 🙁 If only though…

    You might want to check out this Reason piece about what a cadaver is worth, just not to the original owner.

  95. Yeah right, bachelor degrees in what? Biology? Pre-med? Trying getting into a new line of work with those degrees.

    There are a lot of positions that simply require a degree, some of them are pretty good paying eventually.

  96. You’re assuming that the shortage will be from doctors leaving the profession. What you’re missing is that now there is less incentive to become a doctor. As natural attrition kicks in, there won’t be new replacements to take over those patients.

    Don’t overlook reduced productivity. Why should these guys work hard if they aren’t going to make good money?

    Medical havens can join tax havens out in the Carribean.

    My hospital isn’t terribly far from Mexico. It would not be inconceivable that we would set up a cross-border operation (so to speak) for patients who can pay cash. If we can get good volumes there, I can guarantee you that’s where our good doctors will go to practice.

  97. Insurance companiesGovernments are corrupt. They do not care about anything except their own profit, not the people who are paying them for coverage. They do not want competition, or they would already be offeringallowing it.

    FTFY.

  98. Fair point. Lack of productivity would definitely increase the impact of a doctor shortage.

  99. Yeah right, bachelor degrees in what? Biology? Pre-med? Trying getting into a new line of work with those degrees.

    Try engineering, biochemistry, and genetics. Do you actually know any doctors?

    Why would you think doctors are not in the same US economic crapper along with everybody else? You think they’re immune from the rules?

    As I said before, job prospects for skilled employees are still quite good.

    And leave the country? To go where? Canada? England? Mexico?

    Medical tourism to coutries like India and Costa Rica is already on the rise. Considering the fact that many U.S. physicians come from foreign countries in the first place, and also the fact that the cost of living in these countries is extraordinarily cheap, there are already many incentives to practice in these places. Turning doctors into conscripts would only exacerbate this situation.

    BTW, it doesn’t have to be the government who pays doctors a salary. I agree about free competition on the supply side, open up the med schools to anyone who can pass the licensing exam and let docs compete for jobs like everybody else.

    Then why are you blathering about setting their salaries to $100,000 per year?

  100. Re: You’re assuming that the shortage will be from doctors leaving the profession. What you’re missing is that now there is less incentive to become a doctor. As natural attrition kicks in, there won’t be new replacements to take over those patients.

    Don’t overlook reduced productivity. Why should these guys work hard if they aren’t going to make good money?

    You guys are dense. Don’t you get it? The American economy is cooked. Stick a fork in it.

    Wall Street in going, going, gone. The cushy low value make-work jobs in the “knowledge economy” were an illusion sustained by debt and are going away. The internet is crushing sales and marketing jobs out of the economy by the thousands every month.

    So what exactly are these “attrited” doctors going to do for a living? They are going to bail to where? New college grads are going to do what?

    The smart shitter poly-sci major at Cornell who thought he would parachute fat and happy into a pharma rep job? Uh uh, ain’t gonna happen. Medicine with modest income maybe the best opportunity out there.

    And commuting to Mexico for primary medical care? No way Jose. And people will only cross borders for elective care if it’s cheaper. Now why would that be? Because Mexican doctors charge less perhaps? Out of pot into the fire for the doctors that try that one.

    Go figure. It ain’t hard…

  101. It would not be inconceivable that we would set up a cross-border operation (so to speak) for patients who can pay cash.

    Really.

    Already exits, plus you get a nice vacation as part of the deal.

  102. SteveM,

    i fail to see how “fuck the doctors they can work for nothing and like it” is a very good healthcare policy. I mean why don’t you just draft them into indentured servitude. Further, even if what you are saying is correct and people with advanced degrees have no choice to but to slave away for low wages in the Obamaclinic, long term people will just chose not to be doctors.

  103. Kilroy… It does me no good to sell the use of my cadaver for when I’m dead if I can’t buy a yacht with the money now 😛

    And yvw, Tricky – that paper is full of valuable information for anyone willing to seek it out.

    I keep having bare-knuckle flame wars with people on this stuff because it seems just about no one in the United States has the slightest clue why anything is the way it is and what role government has played in the past. I can only explain it by chalking it up to shitty government schools.

  104. Wall Street in going, going, gone. The cushy low value make-work jobs in the “knowledge economy” were an illusion sustained by debt and are going away. The internet is crushing sales and marketing jobs out of the economy by the thousands every month.

    Of course we all know that economies never expand again after contracting. There’s still a gaping hole in our economy where candle-makers and buggy-whip manufacturers used to be, right?

    Want a decent job? Get a technical degree or learn a trade.

    And commuting to Mexico for primary medical care? No way Jose. And people will only cross borders for elective care if it’s cheaper. Now why would that be? Because Mexican doctors charge less perhaps? Out of pot into the fire for the doctors that try that one.

    Once again, you’re only looking at the demand side of the coin. If people deem the cost and stress of medical school to no longer be worth the reward, then they will simply stop going. Furthermore, if the prospects in another country are better, then doctors are highly mobile. If I can get rich practicing a specialty in Costa Rica, why would I work for slave wages as a general practitioner here?

  105. SteveM,

    We already have “health care competition” in that employers as true rational purchasers should be able to select a health care package from competing vendors, thereby providing the company and its employees with with “Best Value”.

    They provide the best value for the employer, not necessarily for the employee. Of course that is the way GOVERNMENT set it up. This isn’t natural; this is the way the GOVERNMENT created the system we have. All coming out of the glorious administration of FDR.

    As for forcing doctors to take medicare or putting controls on their wages, watch the number of new and established doctors as they seek other professions. That’s what has happened in other countries that tried similar non-sense.

    You guys are dense. Don’t you get it? The American economy is cooked. Stick a fork in it.

    If this the basis of your argument then you aren’t really worth talking to.

  106. Sean:

    “It does me no good to sell the use of my cadaver for when I’m dead if I can’t buy a yacht with the money now :P”

    That’s precisely why I used the words “mortgage my corpse”. Though you should also be able the will the proceeds from your corpse if you so desired, but you can’t.

  107. John – I was confronted by exactly Steve’s argument just yesterday in a “debate” over this piece of shit Peter Singer article:

    Why We Must Ration Health Care

    Singer starts off with a complete and utter failure to understand the difference between actual rationing and free price systems in a market economy, and then proceeds to fail miserably in any solutions because he assumes costs are static.

    His opening example is that there is a drug that costs $54,000 that will keep you alive another 6 months and your insurance won’t pay for it.

    He first claims that this is rationing because you’re unable to get the treatment you need to stay alive – not recognizing that your relationship with your insurer is ostensibly voluntary and contractual and you agreed to that scenario in advance, and that you still have a myriad of other options from charity, to savings, to an extra mortgage on your house to figure out how to pay for it (and thus the decision of how much your extra 6 months of life is worth is up to you and thus, explicitly NOT “rationed”).

    Then as a result, since any inability to get what you want is “rationing”, he immediately goes to government as solution and argues that it should be totally ok with us for some bureaucrat to decide a teenager’s life is worth more to save than a geriatric widow’s is…

    And all of that completely misses the obvious problem.

    If a drug is $54,000 the problem itself is scarcity… So the solution is to make more of the goddamn drug, until there is more than enough for anyone who needs/wants it!

    Assuming the world is constant and that resources (especially the man-made ones) are fixed is about the dumbest thing I ever hear reportedly “smart” guys talk about and yet here we have a 5 page turd in the NY Times by a world-renowned bio-ethicist engaging in pure stupidity…

    What’s worse is I discovered this piece of shit from D.J. Grothe’s Facebook where most of his “Point of Inquiry”-loving, supposedly-skeptic friends were all raving about it. Fuck… It makes me feel like we’ve skipped time back to 1900 when all the academics were advocating Eugenics and forced sterilization….

    Fuck Peter Singer.

    /rant

  108. You guys are dense. Don’t you get it? The American economy is cooked. Stick a fork in it.

    Wall Street in going, going, gone. The cushy low value make-work jobs in the “knowledge economy” were an illusion sustained by debt and are going away. The internet is crushing sales and marketing jobs out of the economy by the thousands every month.

    Right. Of course, this has never happened before. I mean, a stock market collapse and banking system collapse have never happened before in American history, so obviously we are deluded to not recognize your genius.

    What’s that? Oh yeah, we’ve had stock market crashes and banking collapses and been just fine. Oops. You lose there.

    So what exactly are these “attrited” doctors going to do for a living? They are going to bail to where? New college grads are going to do what?

    These “attrited” doctors are doing things like…oh, I don’t know, retiring or dieing. That’s just two examples. I’m sure there are more.

    As for what new college grads will do, who knows. There looks to be a lot of growth in government to employ them since med school doesn’t look like that good of an option.

    ,i>The smart shitter poly-sci major at Cornell who thought he would parachute fat and happy into a pharma rep job? Uh uh, ain’t gonna happen. Medicine with modest income maybe the best opportunity out there.

    You’re assuming that the poly-sci major is only looking at the health care sector for employment. Perhaps he decides to go to law school, or work at education. The fact is that the actions you suggest will shape the entire range of decisions that a student will make.

    And commuting to Mexico for primary medical care? No way Jose. And people will only cross borders for elective care if it’s cheaper. Now why would that be? Because Mexican doctors charge less perhaps? Out of pot into the fire for the doctors that try that one.

    That’s how things may stand now, but if the level of care increases significantly above what can be had in the US at a competitive price, then people will jump across the border in a heartbeat for healthcare.

    Go figure. It ain’t hard…

    I don’t know…you seem to be having some trouble with it after all.

  109. Two wildly divergent points, but I think both are important.

    1) Health insurance for anything but urgent, catastrophic care will never, ever make sense. Right now, I pay premium into one giant pool that covers me if I get colorectal cancer and also covers me if I get the flu and go see a doctor. That is ridiculous and unworkable, and will always, always, always result in abuses.

    It’s akin to if your auto insurance covered accidents, but also covered oil changes and brake pades – of course people would get their oil changed with new pads to boot as often as they felt like it, the cost is diffuse and hidden from them.

    Insurance, in general, can only work in circumstances where the coverage only protects against events that are always rare and always adverse.

    2) I work for a commercial auto-insurance company. We have less than 1% of even the _commercial_ market share, and still float billions per year – in fact, our total assets are over $50B for this tiny company.

    Given the bail-out mania going on, do we really think the administation will let health insurers with trillions in assets fail [as they inevitably will, the “public plan” will have infinite money, or no customers. and the latter is not an election-winning option]? Aren’t we just spending a trillion dollars to create a situation where private insurers will be forced out of the market, resulting in bailout after bailout for unspeakable trillions?

  110. There is an editorial in today’s Investor’s Business Daily that reveals some of the provisions of the House democrats proposed healthcare legislation.

    Included are provisions that would prevent the issuance of any new private healthcare insurance polices after the law is enacted.

    And it would also do away with the healthcare savings accounts.

    So Obaam’s and the democrat’s idea of “competition” between a public system and private insurance is to cripple all the private systems so that they can’t stay in business.

    Follow the link:

    http://www.ibdeditorials.com/IBDArticles.aspx?id=332548165656854

  111. Sean Malone,

    Singer is awful. Yeah, the sollution is to pay the 54K to stimulate more production of the drug. Further, even under Singer’s hypo, I can at least try to change my circumstance. I can go to my family. I can go to charities. I can sell everything I own. I have a chance. With a government bureaucrat I have no chance. At that point, I am nothing but a piece of machinery owned by the govenrment. They look at me and determine if I have enough production left in me to justify the expense of fixing me and that is that.

  112. I don’t think it’s useful to make the primary distinction the one between statist and non-statist (or, more colloquially, big gov. vs. small gov.) A big state can help its people or hurt them — same with a small state.

    The question is, who controls the state? In the U.S., our state is controlled by a very small group of people who shape policy in their own interest. The state will fail the people, no matter its size, so long as this disparity remains.

    I for one think health care should be a human right.

  113. Fack… Gilbert. Thanks.

  114. Shorter Clint:

    “If only the right people were in charge”

    and…

    Longer Clint on Health Care “Rights”:

    “I should have the ability to force other people to provide me a scarce good & their highly skilled services because I need what they do and don’t believe I should have to offer anything of value in exchange.”

    …and then… I read the first paragraph of his link… to an article he, himself wrote. And it made my brain hurt.

  115. To quote Clint:

    “I think it’s clear that we’re not going to win guaranteed coverage on the strength of arguments alone. We have to take our interests into our own hands and demand it.

    It’s our right.”

    Yeah… umm… you’re not going to win guaranteed coverage on the “strength” of your arguments because your arguments are idiotic tripe that are the same arguments I might use for justifying any other variety of slavery & theft. Asshole.

    And your reading of the Constitution & more importantly the Declaration of Independence to infer a “right” to health care from a “right to life” is idiotic. You have the right to Life, LIBERTY, and the Puruit of Happiness you jackass…

    Liberty means that – yes, you are free from coercion, and ALSO you can’t conscript other people into providing for your needs on the basis of “need” or “want” or any other reason… Because… *GASP*… YOU DON’T FUCKING OWN THEM!

    Convenient that you forget that part.

  116. Given the bail-out mania going on, do we really think the administation will let health insurers with trillions in assets fail [as they inevitably will, the “public plan” will have infinite money, or no customers. and the latter is not an election-winning option]?

    Of course not. Obama and Congress are setting them up to be nationalized as a step toward single-payer.

  117. I wonder if Clint gets a strong wireless signal from the back porch of his plantation.

  118. R C Dean, I can’t believe I didn’t think of that before.

    I would be surprised if they aren’t thinking along those lines.

  119. I can’t wait for the entitlements to start rolling in…GRAVY TRAIN!!!

    The path to America’s demise is a candyland of free goodies. a real candyland!

  120. Free enterprise will save it? Yup, free enterprise is why we have all those manufacturing jobs in the US still…..oh, wait, those all went to China. Well at least free enterprise is why we have all the technology jobs….oh, wait, those have been sent to India. Well I am sure there is somethign free enterprise does well that hasn’t been shipped overseas yet for 1 more dollar in profit.

  121. Opsmit,

    I guess that whole 200 years of quality and stnadard of living improvements don’t count. Take a look at how people actually lived in the past sometime.

  122. Free enterprise will save it? Yup, free enterprise is why we have all those manufacturing jobs in the US still…..oh, wait, those all went to China. Well at least free enterprise is why we have all the technology jobs….oh, wait, those have been sent to India. Well I am sure there is somethign free enterprise does well that hasn’t been shipped overseas yet for 1 more dollar in profit.

    Yeah all of our people graduating with engineering degrees just head straight for the nearest McDonalds upon graduation. Get a clue.

  123. “Free enterprise will save it? Yup, free enterprise is why we have all those manufacturing jobs in the US still…..oh, wait, those all went to China.”

    WTF Man… Please learn some history. Don’t you understand that it’s precisely because we DON’T have free enterprise here that our manufacturing jobs went to China??

    I mean seriously – you have to recognize that the US has the second highest corporate tax rate in the world. We have an extremely fettered market and it’s much much worse in various states, and that’s not even talking about the Union rules & wage controls (read: “Minimum Wage”) that increase unemployment and continually push businesses that only require low-skilled or unskilled labor and want to remain competitive internationally away to other places.

    Geesh…

    When jobs are leaving to China & India and America has actually low tax rates, no wage controls and doesn’t have an insane number of barriers to market entry for most companies… then we can talk about “free enterprise”.

  124. Shocking headline:

    When government taxes the shit out of businesses & individuals, imposes wage and price controls, imposes fees, tariffs & excessive requirements for doing business and generally hamstrings them as much as possible… Entrepreneurs take their business elsewhere.

    See: California.

  125. R C Dean, I can’t believe I didn’t think of that before.

    The question isn’t “are you paranoid?”, its “are you paranoid enough?”.

  126. John- Ok, when did it stop? We are talking about now, not 200 years ago. You should talk to Sean. I am not sure of 200 years of innovation to paraphrase, if business had it’s choice of wages. So without big business, no innovations would have ever happened?

    Jordan- Not a bad idea. I have actually worked in the engineering field, Mickey D’s may not be a bad idea. According to your previous post, there are people with engineering degree’s that can become Dr’s. How many engineer’s you know went to medical school after getting the civil enginerring degree?

    Sean- So there should be no minimum wage? There probably shouldn’t be and age limits then. We can go back to the turn of the century where children worked 16 hour days and got paid .50$. I see you point, if there were no controls, then companies would treat their employee’s right with a decent wage and working hours right? It sounds like you want China right here. Why don’t we start a post about slave labor and how much that would benefit free enterprise?

  127. Not a bad idea. I have actually worked in the engineering field, Mickey D’s may not be a bad idea.

    Then you must be one pathetic engineer.

    How many engineer’s you know went to medical school after getting the civil enginerring degree?

    Is this a joke post? My wife went to med school after getting a Biomedical Engineering degree. She had all kinds of engineers in her class, and even a 40 year old lawyer.

  128. jordan- Never said I was an engineer, but thanks to jumping to conclusions.

    Joke post? Seriously? So she got a BIOMEDICAL engineering degree? So something in the actual medical field? I guess all those other engineers, you know the civil and mechanical and transportaion engineer’s took 4 years of engineering courses so when they were done, they could do it all over again for the pre reqs for pre med? I would think those two lines of study would have different course paths. Or are you saying these engineer’s went back to school cause they couldn’t get an engineering job? Obviously the 40 year old lawyer went back. I doubt it took him that long to pass the bar.

  129. Re: Jordon

    “Then you must be one pathetic engineer…

    …My wife went to med school after getting a Biomedical Engineering degree…”

    It’s amazing how a horse’s ass can reveal himself with just a few inane posts.

    P.S. I hope your wife studies psychiatry. She’ll need it…

  130. The question is, who controls the state? In the U.S., our state is controlled by a very small group of people who shape policy in their own interest.

    That is true of any other place in the world as well. The very first prerequisite of any government is to keeps itself in power. Some would say the only way to do that is to keep increasing that power.

  131. I guess all those other engineers, you know the civil and mechanical and transportaion engineer’s took 4 years of engineering courses so when they were done, they could do it all over again for the pre reqs for pre med? I would think those two lines of study would have different course paths.

    Then you would guess mostly wrong. All engineering degrees are very science heavy. It’s not difficult to satisfy the prereqs for med school and earn an engineering degree in 4 years, and certainly not difficult within 5 years.

    It’s amazing how a horse’s ass can reveal himself with just a few inane posts.

    P.S. I hope your wife studies psychiatry. She’ll need it…

    Steve, I’m going to help you out since clearly reading is not your strong suit. Please reread what I wrote:

    She had all kinds of engineers in her class

    I’m going to assume that you understand what those words mean. Please let me know if you need further assistance. By the way, I’m also an engineer if that wasn’t apparent, so I know quite a few other engineers and had many friends in college (also engineers) who went on to med school. So kindly fuck off.

  132. Jordan- Sounds like you had many friends in college that were “pathetic” engineers also. Or maybe, they thought being an engineer sucks. personally, I think you guys are the smartest dumb people on the planet. I always say, if engineers how to use what they designed, shit would work better.

  133. And that is it for me, argue\debate with you later……

  134. Re: Jordan
    She had all kinds of engineers in her class…

    blah, blah, blah…

    Steve…So kindly fuck off.

    Jordon, thanks for exquisitely proving my point.

    P.S. Your wife…poor thing…

  135. Sounds like you had many friends in college that were “pathetic” engineers also.

    *Shrug*. I’ll take someone who aspires to med school over someone who aspires to work the counter at McDonalds and mooch off of others anyday.

  136. Ok, Steve. If cryptic one-liners are the best you can do, I’m going to remove the fork from the U.S. economy and stick it in you.

  137. “Sean- So there should be no minimum wage? There probably shouldn’t be and age limits then. We can go back to the turn of the century where children worked 16 hour days and got paid .50$. I see you point, if there were no controls, then companies would treat their employee’s right with a decent wage and working hours right?”

    Ok… WELL…

    First, if you’ve ever traveled around the world, especially to 3rd World countries, you’ll notice that kids work all the time. This is not because some evil company forces them into slave labor – but because they are poor and to keep from starving, everyone in a family works. Unfortunately this also describes a solid 99% of human history.

    It was property rights, free enterprise and an economic system based around the right of individuals to make their own choices – it was the power of free choice & Capitalism – which ended the need for entire families to work by increasing the amount of available real wealth (like food & housing) in the world to a point where it was inexpensive and readily available to most all people.

    And secondly… Companies that want good employees would (and do!) absolutely pay more and provide incentives to work there. You realize that the vast majority of Americans are well above minimum wage, right? If your argument is that employers have no incentive to pay high wages, then we’d all be working at the minimum wage, wouldn’t we?

    Further – if your argument had any merit at all… then when FDR imposed wage controls in the 1940s, businesses would not have started providing benefits such as health insurance! But… they did.

    The fact is, you need to dig a little deeper here.

    Anyway, aside from the reality that virtually all economists recognize that wage controls cause unemployment, simple math is all you need.

    If you’re an employer and you have $100,000 a year with which to employ people… and the minimum you can find people willing to do your available jobs at the level of workmanship you’ll accept is $10,000 a year, then you can employ… let me check… umm… 10 people.

    If however, a law is passed that requires you to pay no less than $25,000 a year to your employees…. Now you can afford 4.

    So what does this mean in terms of secondary or tertiary effects?

    Wellllll…. For one thing, 4 people aren’t as productive as 10, so you can’t produce as much of your product, and thus can’t sell as much and thus you, and the world at large is poorer as a result. Secondly, the only people you’re going to employ are people who are worth over $25,000 a year in profits – which means you’re going to avoid employing the more marginal workers if at all possible.

    I mean… it’s obvious, but if you were going to employ 10 and now you can only employ 4, you’re going to pick the best of the bunch, right? So the 6 workers who don’t get employed are likely to be the ones who have fewer skills and as such are already on the bottom rung of the economy.

    Soooo… I hope I’ve made it clear enough – Minimum Wage laws primarily hurt the poorest & least skilled members of our society.

    So NO. We shouldn’t have minimum wage laws.

  138. Als… Consider this:

    Union legislation are just another side of wage & supply control. They limit the number of members allowed to join and then use laws to force employers to only be allowed to hire those few members for jobs. Then, they use their position of power to negotiate higher-than-market rates for wages.

    This is great for the members of the union, but really shitty for society at large, because it means…

    A. We’re paying more for services than we should.
    B. There are fewer jobs available
    C. Productivity is decreased leaving us all with a lower amount of real wealth to go around.

    What’s this got to do with health care?

    The AMA is a union. A particularly powerful one for rich, educated workers.

  139. “There’s not a lawyer in the country willing to lobby for this”

    I am. When should I start?

  140. # Xeones | July 16, 2009, 12:38pm | #
    # Nationalized lawcare.

    # Fuck, you guys, don’t be giving the
    # administration any ideas.

    “You have the right to remain silent. Anything you say can and will be used against you in a court of law.

    “You have the right to the attorney that we provide for you. If you can afford a different attorney, too bad. Only public defenders are admitted before the bar.”

  141. Opsmit wrote, “We can go back to the turn of the century where children worked 16 hour days and got paid .50$”

    BLS CPI calculator says, “$0.50 in 1913 has the same buying power as $10.89 in 2009.” Fifty cents probably went even a little bit further in the late 1800s and early 1900s than they did in 1913. A kid who had a home could sustain himself on that amount of money, and perhaps even save some for other necessities, or to contribute to the family cookie jar.

    There wasn’t that much child labor going on in those days (at least, not much which wasn’t in the context of ENTIRE FAMILIES going to work in the factories or farms — in those days, everyone had to do his or her part to keep the family going). Also, child labor was on the wane when the labor laws were passed. The main selling point of the labor laws was to “save the children,” but the main (and intended) effect of the laws was actually to “save the union labor adults.” Child labor was competition for them.

    Things could definitely get bad for kids as the 19th century drew to a close. But invoking that time in sensationally melodramatic ways, without even the context of inflation-adjustment, only serves to quash reasonable discussion about the issues.

  142. SteveM: The transportation sector also has a mix of “voluntary” and “emergency” demand. Sometimes you can shop for a car or an airline fare with plenty of lead time, and sometimes, you suddenly have an urgent need to go from point A to point B by a particular time, or at least as quickly as possible, with the penalties for failure sometimes being unpleasantly life-changing, or even life-ending. Also, the skills, talent, experience, and sophisticated, expensive capital equipment and infrastructure needed to deliver fast, reliable transportation in the modern day is comparable to the corresponding aspects of providing health care.

    Even so, a free market in transportation goods and services has pushed availability and convenience of transportation up, and costs down, to the point where most people, most of the time, can get both their routine and emergency transportation needs met for reasonable prices. When have you ever heard of anyone being driven to bankruptcy because of the cost of a trip they had to make? When have you ever heard of anyone seriously proposing, much less demanding, that people should carry comprehensive “transportation insurance” or be members of a “transportation maintenance organization”?

    The key thing to keep in mind is that, in those circumstances when you must go somewhere NOW, may not be thinking rationally and have no choice but to travel, the free market in transportation is ready to provide you with numerous, reasonably priced options, in part because it has already built up an infrastructure to provide routine, voluntary, non-urgent transport. Just so, the health care infrastructure that supports routine or preventive care, in which costs are pressed down through competition and other market forces, will also serve to bring down the cost of emergency care and heroic measures. We can have health care that is as available and affordable as transportation, with most people having little or no need to “be insured” at all. A true free-market option needs to be on the table.

    Pay attention to what Malone posted in this thread at 1:40pm on July 16th. I worked in medical informatics for ten years and can confirm his list of factors that contributing to the high cost of health care. In particular the sweetheart deals that government has cut with the provider unions (such as the AMA), and the strict control of medical devices and drugs, have not so much guaranteed high quality of goods and services as they have created artificial scarcity in captive markets for politically well-connected providers and vendors. We have bought the line that strict regulation of the health care industry protects society, but if we are truly honest about wanting to cut costs even as we maintain high availability or quality of care, we need to examine the regulatory regime and at very least jettison the parts of it that are in conflict with those goals.

  143. health care competition…
    ___________________
    Britney
    The best place for the best ENTERTAINMENT

  144. nice post..
    ___________________
    Britney
    The best place for the best ENTERTAINMENT

  145. Because deregulation worked so well in the financial sector, why not try it in the medical industry too? Brilliant.

  146. Wow, amazing. Only libers I guess can find a positive outlook for 9 year olds working 16 hour days, hell, they are even getting a good wage at .50$ a day. Ingenious Sean, I guess if you had traveled to these third world countries, you would realize that most of those kids can’t read or do math, but hey as long as they have a factory job making cheap stuff for us here then it all evens out.

    Jordan- You actually know people who aspire to work at McDonalds and want to “live off others”? Seriously? Really easy to generalize isn’t it?

    Sean- Sounds like you know alot about economic theory. Problem is theory never stands the same in practice. You can constantly say that, for example, if you cut the corporate tax rate to nothing, the company will spend more for their employee’s and expand and hire more people……..or not, and just keep the extra cash as profit. The problem with the “free enterprise system” is it relies on ethics and morals, both of which seriously start lacking when the dollar takes hold. But at least you are optimistic. personally, I am not that trusting.

  147. Jesus, this guy is pathetic. So too is Reason for bothering to publish his blithering idiocy. ABC has kept him around as a boy toy to the neanderthal right wing, but he’s been a punchline, a kind of human running joke, among those with any brains for some years now.

  148. “The AMA is a union. A particularly powerful one for rich, educated workers”

    The ABA too. I’ve got no problem with them writing the bar exam, but they shouldn’t be able to regulate who can take it, and anybody who passes should be admitted to the bar.

    “Hell, you can’t even by private legal insurance”

    Since I have private legal insurance, albeit only for a few specific areas of liability, I’m reasonably certain this is incorrect.

    “I should be able to buy a policy that just covers 10K+ expenses”

    As with private legal insurance, this insurance product is available to the public too. Shop around.

    “Healthcare is a service just like any other”

    One of the more worrisome misconceptions amongst our politicians. In fact, healthcare is not “just a service”. It’s a luxury good that requires considerable economic activity to provide for those who can’t afford it. Many politicians don’t seem to grasp that, or realize that decreeing it a right is not going to change that reality.

  149. Can Stephen Chapman be forced to read this article 100 times? Maybe then he would start to appreciate that the best way to make a pro-liberty argument is to just come right out and say it.

  150. Having worked in government at the Federal and local levels for many years, I am confident that government health care will mean two things:

    (1) Quality will decline horribly. Face it; we’d screw up a box lunch. The waste is legion. Innovation is non-existent. Political environments do not foster excellence. The incentives and reward system foster something else entirely. Failure is not punished, only its disclosure.

    (2) Inequality will be worse. We give very different treatment for politicians and their special intersts than regular citizens. The rich will still get first class treatment. But instead, the middle class and poor will get screwed because they won’t have options.

    Is this the hope and change we wanted?

  151. but if competition was going to lower costs, it already would have.

    your ignorance assumes there is some sort of “free market” competition as now. There is not.

  152. Jesus, this guy is pathetic. So too is Reason for bothering to publish his blithering idiocy. ABC has kept him around as a boy toy to the neanderthal right wing, but he’s been a punchline, a kind of human running joke, among those with any brains for some years now

    How typical of a left wing leach. Note you did not post or address one fact on this topic.

    Want to take a guess as to why that is?

  153. Beware the Canadian single payer system. In the last 10 years the costs have gone from 90 billion to 160 billion can $, and this in a population of less than 35 million people.
    If there had been measurable improvements this might just be acceptable but….

  154. Sean W. Malone,

    “I should have the ability to force other people to provide me a scarce good & their highly skilled services because I need what they do and don’t believe I should have to offer anything of value in exchange.”

    Wow, what a *perfect* characterization of my views. You must have a direct line to my muse, Mr. Malone.

    Anyway, back in reality, humans have rights and chief among them is the right to life, which, under any reasonable definition, includes the right to basic and necessary healthcare (without enormous debt).

    The “thing of value” that’s offered is tax money.

  155. Sean,

    “Yeah… umm… you’re not going to win guaranteed coverage on the “strength” of your arguments because your arguments are idiotic tripe that are the same arguments I might use for justifying any other variety of slavery & theft. Asshole.”

    Right, whereas your argument is that universal health care is “slavery” (not extreme at all) and that I’m an asshole.

    “And your reading of the Constitution & more importantly the Declaration of Independence to infer a “right” to health care from a “right to life” is idiotic. You have the right to Life, LIBERTY, and the Puruit of Happiness you jackass…”

    In democracies that actually function, as opposed to ours, the right to life is an umbrella for the right to basic health care. Anything less is regressive. Thanks for the ad hominem, again.

    “Liberty means that – yes, you are free from coercion, and ALSO you can’t conscript other people into providing for your needs on the basis of “need” or “want” or any other reason… Because… *GASP*… YOU DON’T FUCKING OWN THEM!”

    But it apparently doesn’t mean that, if you’re poor, you have the right to stay alive — or to stay alive without massive debt if you need surgery.

    All this talk about liberty is absurd. Liberty is impossible if you’re dead or in unmanageable debt.

    Thanks for dancing.

  156. “I wonder if Clint gets a strong wireless signal from the back porch of his plantation.”

    Not sure what this means. Am I slave owner?

  157. In the article:
    “I defy anyone to give me an example of lack of competition that doesn’t have its roots in government intervention.”

    Standard Oil.

    “John | July 16, 2009, 12:33pm
    I know lots of people who have gotten really sick and ran up 100s of thousands of dollars in medical bills. I have yet to meet one that was dropped by their insurance company for it.”

    Why would the insurance co. drop their coverage when they can just deny the claim and keep collecting the premium? Profit motive says “no” on that option!

  158. The health care debate is heating up. The American people are smarter than Congress thinks. As they read the bill they are noticing a few things.
    Making it illegal to purchase a new commercial plan – page 16
    Nowhere in the bill does it require that the taxes raised must be spent on health care.

    And that’s just two of the things the American people are discovering.

    Follow the debate at http://www.ilovebenefits.wordpress.com

  159. I will give you a sollution. How about national licensing for doctors? End all state liscensing requirements and let any doctor practice in any state.

  160. Why do we need to end state licensing to do this? Just erect a system of national licensing right alongside state systems and don’t let the AMA anywhere near the national system.

  161. I don’t get why Tony and Chad and these other authoritarians keep ignoring that costs for all medical expenses would go WAYYYYYYY down if we actually had a free market. We keep explaining it to them, but then they keep claiming that people would go bankrupt paying for their medical expenses directly.

    Just a few things that jack up the price of medical care
    1. The tax-write-off disparity between employers and individuals – you can’t write off health insurance costs
    2. Insurance being forced to provide damn near EVERYTHING even if you know you’re not going to need it. Some of the things insurers are forced to cover for ALL people are ridiculous – like wigs – and in some cases cosmetic surgery I think.
    3. The $800 MILLION it takes to MAYBE get a drug approved. You could buy a freaking COUNTRY for that money. Seriously, what the hell testing costs $800 million? What are they making the drug companies do?; test the physical properties of the drug – see if it makes a good flame retardent? Testing it on every animal in existence? I mean really – $800 MILLION!
    4. Insurers/doctors being forced to provide coverage to millions of people severely undercost because of medicaire/caid. They have to cover those costs somehow. Guess who does that.
    5. The very fact that most medical care is provided by insurance means that people consume way more medical services than is necessary and doctors and hospitals know they can charge more – i.e. the price mechanism is screwed up.
    6. Massive ridiculous litigation. This isn’t true just for the medical industry but industry in modern America in general. Like the old-woman-hot-coffee-McDonald’s story. I even once heard a story on the radio where a guy says some woman’s kid was running around like crazy in a pizza shop he worked in, and twice they warned her that the kids might hurt himself. Woman didn’t stop the kid, and sure enough he ran straight into the counter, and the pizzeria had to pay a million dollars (I don’t remember if it was a settlement). Somewhat of an off-topic example, but the idea is the same. Closer to home – a surgeon posted on these Reason discussion boards that he his revenue/income was $200,000 per year and he was paying $80,000 in liability insurance per year. Someway and somehow our court systems find people liable for damage WAY too easily, and that IS a function/fault of government.
    7. Lack of choice of cheaper service for little things. You HAVE to go to a doctor for a LOT of things that could be diagnosed by cheaper, lesser trained people. And any time you need a drug that is under the government’s need-a-prescription list, you need to see a doctor, again in lieu of someone lesser trained and cheaper writing you a prescription.
    8. Massive under-supply of doctors and facilities. The government controls licensing, and according to some other posters, they just flat out refuse to allow more than a certain number of people to take the bar. And trying to build a hospital, or anything else important for that matter, involves massive costs because of all the various zoning and land use restrictions.

    There was more that the other commentors have gone over that I can’t remember off hand.

    Not to mention that if libertarian policies were more widespread, EVERYTHING would be cheaper, and more people would have more of their money to spend (less taxes). In a libertarian country, there would be no restrictions on oil drilling the vast oil fierlds we know we have off the gulf coast and California coast and in ANWAR – so the plastic that sheathes the MRI machine, and that sterile-y wraps the syringe would be cheaper. Natural gas pumping stations wouldn’t have to meet ridiculous efficiency standards, so running the autoclave to sterilize the instruments would be cheaper. Etc. All these things add up.

    Anyway, the point is medical care would be a lot cheaper. The $10,000 broken leg Chad was talking about might only cost $1,000 from accident to removal of the cast weeks later. Or even less.
    It’s not far fetched all the ridiculous government regulations I mentioned above and the ones I missed MASSIVELY jack up prices. If you can’t see how these RIDICULOUS policies jack up the price… well, there’s no denying it, unless you’re being dishonest. Nobody would expect any other industry to work under these rules and then complain about the price. If the farmer had to sell tons of corn to “farmicaid” consumers at severely under cost, then I’d EXPECT corn to be more expensive. And the same with the other laws.

  162. And yes all that does mean that the price of medical care would quickly become much lower if those rules weren’t in place – like the other poster said, the market corrects surprisingly quickjly.

  163. Oh yeah – another cost-raiser – for a lot of states, insurance companies aren’t allowed to compete across-states – i.e. in New Jersey, you cna only biuy insurance from New Jersey insurers.

  164. Oh.

    I guess what I =was saying is that, in other words – with a truly free system poor people would NOT be incapable of paying for medical care. They WOULD be able to receive medical care.

  165. >They always have a profit incentive to deny >coverage.

    >As do car insurers, home insurers, life >insurers, and so forth, and so on.

    >Try a new idea.

    Try actually rebutting the argument. The point is that private health insurance will always guarantee that people go without health care.

    And to whoever is comparing people to cars: NICE.

  166. >They always have a profit incentive to deny >coverage.

    >Which, in a free-r insurance market, would be >overridden by the competition incentive. If one >company earns a reputation for denying coverage >for a particular condition, their competitors >could make bank by making sure everyone knows >that they DO cover it.

    Sounds great! I wonder why that isn’t currently happening…

  167. >4. Harrigan doesn’t know what the fuck he’s >talking about. You’re welcome.

    You’re right. Health insurance companies never deny coverage. What was I thinking?

  168. Mr. Stossel, While your general points are good, I would urge you to do your own research. Referencing Goodman’s paper, for instance, didn’t help your case. It was full of unsupported claims (that haven’t held up to reviews such as by Cochrane Collaborative) and flawed and poorly interpreted research (the Tuomilehto study, for instance) as to lose credibility.

  169. “Not sure what this means. Am I slave owner?”

    Judging by your comments you’d like to be one, or maybe a little dictator.

    Interesting how you reference the Declaration of Independence to support your twisted belief that have a “right” to healthcare. Maybe in all your concern over how other countries do things, you forgot what it was that ignited the rebellion that led to the document in the first place. Couldn’t have been taxation, no, if that was so you wouldn’t be using it to argue for further crushing us with tax burden so you can have your imaginary “right.”

    Honestly, I have far more respect for a thief who puts a gun in my face to rob me than for a gutless coward who has the government do their robbing for them.

  170. Earth to Sandy, come in over. Did we read the same article? Maybe I’m not too bright, could you point out to me where Stossel referenced “Goodman’s paper,” I can’t seem to find that part in the version I just read.

  171. “Jesus, this guy is pathetic. So too is Reason for bothering to publish his blithering idiocy. ABC has kept him around as a boy toy to the neanderthal right wing, but he’s been a punchline, a kind of human running joke, among those with any brains for some years now.”

    Now, Johnny, I realize you were talking to Jesus, but I couldn’t help but overhear, and both you and I know you wouldn’t feel the need to revert to the argumentum ad hominem crap if you had any valid points to argue. Since we both know this, don’t you imagine Jesus probably knows too? Given the likelihood that Jesus does know and wouldn’t approve, and the rest of us aren’t going to fall for it, you might want to keep that kind of thing to yourself, or at least restrict it’s use to among your Liberal friends who also favor the personal attack approach, you’re all so clever with all those “brains,” surely you’ll sucker each other every time.

  172. Ratdog,

    “Maybe in all your concern over how other countries do things, you forgot what it was that ignited the rebellion that led to the document in the first place.”

    Yeah, I forget. Were we rebelling against the British Empire trying to nationalize health care?

    “Couldn’t have been taxation, no, if that was so you wouldn’t be using it to argue for further crushing us with tax burden so you can have your imaginary “right.”

    Crushing us with tax burden? Are you serious? We’re the richest country in the world. We can afford to pay a few more bucks so people down the street don’t have to die early from a lack of proper health coverage. This mindset of taxes=bad is disgusting and based on little more than selfishness and callousness toward your fellow Americans.

    “Honestly, I have far more respect for a thief who puts a gun in my face to rob me than for a gutless coward who has the government do their robbing for them.”

    What is that, a John Wayne quote or something?

  173. earth to Ratdog:
    “Health-care expert John Goodman of the National Center for Policy Analysis says there are…”

  174. What about actually deregulating medical proceedures. Does it really take a doctor to take a throat culture and give it to a lab? Does a 30 minute vasectomy that cost $850 really have to be done by a urologist with 8 years of education? If we deregulate the simple stuff the doctors will compete for the really technical stuff that requires 8 years of education which would bring down prices across the board.

  175. “I defy anyone to give me an example of lack of competition that doesn’t have its roots in government intervention.”

    Standard Oil
    Ma Bell

  176. “I defy anyone to give me an example of lack of competition that doesn’t have its roots in government intervention.”

    Default Swaps – 100% Unregulated…BOOM

  177. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won’t get the full deal by just doing regular skill english reading for those books. In other words, there’s more to the books of the Bible than most will ever grasp. I’m not concerned that Mr. Crumb will go to hell or anything crazy like that! It’s just that he, like many types of religionists, seems to take it literally, take it straight…the Bible’s books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on…the Bible’s books were written by people with very different mindsets…in order to really get the Books of the Bible, you have to cultivate such a mindset, it’s literally a labyrinth, that’s no joke

  178. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane.

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