[SpardaSon21]

I believe Liberator is primarily talking about the federal government, not state or local ones.

[General Battuta]

If empirical evidence suggests that the government can do something better and cheaper than corporations than I see no reason why it shouldn't be done.

[Sushi]

If empirical evidence suggests that the government can do something better and cheaper than corporations than I see no reason why it shouldn't be done.

I do!

Think of Locke's "social contract" theory, which I think is pretty accurate: government works because we give up some of our freedom in exchange for increased security and prosperity. The more power we give government (in any form), the less we keep for ourselves... all but anarchists agree that it's worth giving up some personal freedom in order to have a stable and prosperous society. The rest of the arguing is about which freedoms/powers should be granted to the government (and to what degree). Libertarians favor granting as few powers as they can get away with, socialists tend toward giving the government more power. Elected Republicans and Democrats, IMHO, both tend to grab more power but disagree about which specific powers should be given to the government.

Based on this, one argument for keeping the government out of certain things is that the gains in efficiency/security are not worth the price in freedom. I'm not trying to make any specific case for keeping government in/out of something, just pointing out that there is room for such a case...and that before granting the government any power, people should take into account the cost in personal freedom as well. It can't, and shouldn't, be left out of the equation.

[General Battuta]

There are negative freedoms, too: freedom from fear, freedom from illness. I would argue that the government is granting additional freedom and safeguarding these securities.

[SpardaSon21]

By "freedom from illness" I assume you mean socialized health care?  While that sounds nice, a problem that presents is that those who do use health care are subsidized by those that don't, which isn't fair to the non-consumers of care.  You also end up in a situation where no-one knows or cares about the costs of health care because someone else is paying for it, and there is little incentive to keep costs down.  Our current health care system is just like that, except instead of the government paying for everyone's health care its insurance companies.  If the health care industry operated on the free-market principles of choice and competition with doctors forced to compete for patients, you would find costs would greatly decrease.

[iamzack]

Uhh.. no.

[General Battuta]

By "freedom from illness" I assume you mean socialized health care?  While that sounds nice, a problem that presents is that those who do use health care are subsidized by those that don't, which isn't fair to the non-consumers of care.  You also end up in a situation where no-one knows or cares about the costs of health care because someone else is paying for it, and there is little incentive to keep costs down.  Our current health care system is just like that, except instead of the government paying for everyone's health care its insurance companies.  If the health care industry operated on the free-market principles of choice and competition with doctors forced to compete for patients, you would find costs would greatly decrease.

That hasn't been the case historically.

Instead you get a lot of witch-doctoring and snake oil types.

[SpardaSon21]

Did you hear me say anything about eliminating licensing requirements or anything that would lead to a decrease in quality of doctors?  No.  All I said was if doctors had to compete for customers just like everyone else, prices would fall due to increased competition.

[iamzack]

Yeah, except doctors will never need to compete for customers. Consumers compete for doctors.

[Rian]

Did you hear me say anything about eliminating licensing requirements or anything that would lead to a decrease in quality of doctors?  No.  All I said was if doctors had to compete for customers just like everyone else, prices would fall due to increased competition.

Not necessarily. People tend to be very resistant to change in this area, which means that they tend to stick with the same provider even when they could obtain cheaper or better quality care elsewhere. There are a lot of reasons for this, not least the fact that there's a lot of trust invested in the doctor-patient relationship and starting over with a stranger can be intimidating.

Competition is not an economic panacea. It works in ideal cases, when all parties are fully informed and making purely logical decisions, but in healthcare in particular I doubt that ideal case could ever be reached. Information imbalances are pervasive, people base their decisions on convenience or personal recommendations, and in the face of too much choice (as would be present in a totally free market) patients have been demonstrated to favor the simplest or most familiar option over the empirical best option. All of these factors tend to blunt the useful effects of competition.

All that aside, even in a perfectly competitive situation there's no guarantee that prices would fall far enough to be affordable. Healthcare is expensive, and there's no way to get around it. No matter how far prices fall, there will be people who cannot afford to pay. A sudden accident or cancer diagnosis can bankrupt a family overnight—even a relatively wealthy one with substantial savings, since cancer treatments can cost tens or hundreds of thousands of dollars—and without health insurance to distribute risk this would happen even more frequently.

Finally, Britain, which has a universal healthcare system, spends less than half as much per capita as the US does. So does France. And Germany. And Canada. And the Netherlands. And so forth. Why not go with what works instead of putting our faith in abstract principles that have had no demonstrable success in this area?

[MP-Ryan]

Did you hear me say anything about eliminating licensing requirements or anything that would lead to a decrease in quality of doctors?  No.  All I said was if doctors had to compete for customers just like everyone else, prices would fall due to increased competition.

Not necessarily. People tend to be very resistant to change in this area, which means that they tend to stick with the same provider even when they could obtain cheaper or better quality care elsewhere. There are a lot of reasons for this, not least the fact that there's a lot of trust invested in the doctor-patient relationship and starting over with a stranger can be intimidating.

Competition is not an economic panacea. It works in ideal cases, when all parties are fully informed and making purely logical decisions, but in healthcare in particular I doubt that ideal case could ever be reached. Information imbalances are pervasive, people base their decisions on convenience or personal recommendations, and in the face of too much choice (as would be present in a totally free market) patients have been demonstrated to favor the simplest or most familiar option over the empirical best option. All of these factors tend to blunt the useful effects of competition.

All that aside, even in a perfectly competitive situation there's no guarantee that prices would fall far enough to be affordable. Healthcare is expensive, and there's no way to get around it. No matter how far prices fall, there will be people who cannot afford to pay. A sudden accident or cancer diagnosis can bankrupt a family overnight—even a relatively wealthy one with substantial savings, since cancer treatments can cost tens or hundreds of thousands of dollars—and without health insurance to distribute risk this would happen even more frequently.

Finally, Britain, which has a universal healthcare system, spends less than half as much per capita as the US does. So does France. And Germany. And Canada. And the Netherlands. And so forth. Why not go with what works instead of putting our faith in abstract principles that have had no demonstrable success in this area?

And to extrapolate on that, supply and demand economics assumes that the bargaining power lies with those who provide the demand.  However, the supply of health care resources, especially human resources (that is, doctors, nurses, technicians, etc) is considerably less than the demand for them - so much so that even with true free-market competition, the health care sector can dictate prices and people will pay them.

True free market principles apply to very few things in life because some form of regulation is always necessary... which is precisely why the idea of true capitalism, and even of the United States as a capitalist republic, is a fallacy.  The US Health Care is already partially socialist in nature - it actually encompasses the worst of both worlds, so much so that virtually anything would be an improvement.  Conservatives, however, are unwilling to see that.

I will also take this opportunity to point out that while Canada's health care coverage is significantly better for everyone in the country than the American system, ours is an absolute joke compared to Europe, and Scandinavia in particular.  North America should be looking at countries like Sweden and Norway as examples of how to run a health care system, instead of bickering over how much a failed ideology should be incorporated into health care.

[StarSlayer]

Oh they do look across the pond, though they are only looking for the biggest horror stories they can find.

[Liberator]

Well, here a rub that I heard today, that I found chuckle worthy.

You realize that without the US's current medical system that the UK, Germany, France, Canada, ect probably couldn't hand out free or almost free medical care of the class and quality that they do.  America developed most of the technology the other countries use.  So if America went to the same system as the UK, then who would pay for the development of new treatments or more efficient technologies?

[iamzack]

So what you're saying is, if people didn't have to compete for basic health care, medical innovations wouldn't happen?

[Flipside]

Same people, the treatments are produced by groups like Glaxo-Smith-Kline, not Medicare or Insurance groups, market values will still remain the same, the difference is in the profit margins being claimed by the middle-men.

The UK pays exactly the same for treatment as middle-men in the US, something which shows if you need medicines that are currently not available on the NHS (such as certain newer treatments for Alzheimers etc). If anything, the increase in competition will create an increase in the need to create more effective, less expensive techniques for producing medicine, which will lead to greater proliferation and availability for countries that would otherwise have no treatment for certain diseases available, which leads to a healthy level of competition, which is known as capitalism.

Edit: Let me put it like this, if a Pharmaceutical company stumbled on a cure for Diabetes, Epilepsy or even the common Cold etc, they would do everything in their power to destroy it, and to remove any evidence of its existence, because they make far more money in selling regular doses of treatment than a single cure. THAT is where the medical system shouldn't even really be getting involved with the 'free market'.

[Ghostavo]

Well, here a rub that I heard today, that I found chuckle worthy.

You realize that without the US's current medical system that the UK, Germany, France, Canada, ect probably couldn't hand out free or almost free medical care of the class and quality that they do.  America developed most of the technology the other countries use.  So if America went to the same system as the UK, then who would pay for the development of new treatments or more efficient technologies?

You know that non-US based pharmaceuticals also do research, right?

Bayer comes to mind fairly quickly, you know, the guys who invented the term aspirin!

[Kosh]

By "freedom from illness" I assume you mean socialized health care?  While that sounds nice, a problem that presents is that those who do use health care are subsidized by those that don't, which isn't fair to the non-consumers of care.  You also end up in a situation where no-one knows or cares about the costs of health care because someone else is paying for it, and there is little incentive to keep costs down.  Our current health care system is just like that, except instead of the government paying for everyone's health care its insurance companies.  If the health care industry operated on the free-market principles of choice and competition with doctors forced to compete for patients, you would find costs would greatly decrease.

Our healthcare does (in theory) operate on free market principles and our costs are sky high. Please explain this discrepency.

America developed most of the technology the other countries use.

Like what?

So if America went to the same system as the UK, then who would pay for the development of new treatments or more efficient technologies?

Why not paid researchers? Often these days corporations from many industries partner with university labs, so why not use the same principle but with a socialized setting?

Bayer comes to mind fairly quickly, you know, the guys who invented the term aspirin!

And they did it under Imperial Germany's *gasp* SOCIALIZED HEALTHCARE SYSTEM!!!!!!!!!!  (another thing we can thank the Germans for)

[mxlm]

Uh, the folks defending America's existing healthcare system are aware that it's about as free as Nelson Mandela circa 1988, right? The present system only came into being as a result of price/wage fixing during WWII; employers couldn't compete with wages, so they offered benefits. And then started getting tax breaks for those benefits. Yes, tax breaks; the present system continues in part because of unbearably stupid government meddling. Only in part, of course.

Tying healthcare to employment is the worst idea ever, especially from a free market perspective (labor mobility, and the lack thereof. Also additional precariousness; not only do you lose your job, you lose your chemotherapy. Tough luck). So basically, if you're a free marketeer, you should hate the present system and want serious reform. If you're not, the same applies (though the reform you want would presumably be different).

And the idea that the for-profit model is super awesome...well, no. Read the New Yorker's article comparing the Mayo Clinic (nonprofit, awesome) with Texas (for profit...less awesome).

]If that was true, wouldn't Ron Paul be President today?

Hell- Obama's campaign was basically 'I'm from the government and I'm here to help' and lots of people voted for it.[/color]

I was quoting Reagan, who's basically the patron saint of the GOP. I think the statement's absurd, but I also think it's a decent, if hyperbolic, encapsulation of the conservative vision.

To be fair, those words built modern Germany, most of Western Europe, the Phillipines, Japan.

Meh. Without such a painfully short sighted treaty at Versailles, you don't get fascism/Hitler/WWII/50 million dead. Without Commodore Perry you don't get a century of imperial Japan. The Philippines were doing a pretty good job of kicking out the Spanish before the Spanish/American War.

If we're being fair

[Nuclear1]

Well, here a rub that I heard today, that I found chuckle worthy.

You realize that without the US's current medical system that the UK, Germany, France, Canada, ect probably couldn't hand out free or almost free medical care of the class and quality that they do.  America developed most of the technology the other countries use.  So if America went to the same system as the UK, then who would pay for the development of new treatments or more efficient technologies?

You know, whenever someone goes up and makes an outlandish claim of "WITHOUT AMERICA THE REST OF THE WORLD WOULD BE ****!!!1", they should have some sort of graphs and/or scientific evidence suggesting a link between regulation of health care, advancements in medical technology, and the development of government-funded health care in Europe and much of the British Commonwealth.  They would also take into account certain demographic factors, such as population, the average citizen's immunity to certain diseases, and general political tides which fostered an environment for the development of universal healthcare.

But if you just want to take cute little one-liners from the Glenn Beck ultrarightwing playbook of "AMERICA ROXXXX EUROPE SUX AND IS SOCIALIST AND SOCIALISM = COMMUNISM AND COMMUNISM MEANS WE'RE GONNA BE RUSSIAN AND I DONT WANNA LEARN RUSKIEEEEEEEEEEEEEEEE" and provide zero evidence supporting your claims other than inflammatory statements you heard on the Rush Limbaugh show, then that's fine too!

You know, you can still be a loving, patriotic American and still admit we have room for improvement.  There's no point in being the greatest country in the world when 40 million of our people are at risk of never being able to afford medicine or surgery, simply because we treat healthcare in the same way we treat plumbing or cell phone service, as automobiles or television--something that is really, really, really, really, really important to have in today's society, but if you can't afford it, you're SOL, don't expect anyone to help you out.

But thing is, it's entirely different.  A person's health should not be at the mercy of their pocketbooks and their salary.  It's not just an individual responsibility; it's individual responsibility combined with the responsibility of his neighbors and countrymen to ensure every man and woman is physically fit to provide a service or contribution to society.  Someone in bed trying to cure his H1N1 by drinking broth, or someone convinced rubbing Copenhagen dip into his bee-sting wound will keep him from going into anaphylactic shock aren't going to be active innovators or lucrative tradsmen; in fact, nearly the opposite.  It's only in society's best interests potentially-productive individuals are brought out of sickness to be an active member in achieving the society's end goals.

Even if not just that, on a more humane level, it should be among the most noble and valiant objectives of the self-proclaimed "greatest Christian nation on Earth" to have mercy on the sick and expect its citizens to show compassion for each other.  You'd think the party which has been enforcing it's Christian policies on society for the last several years would be all for Americans putting off buying their next plasma TV or Corvette to "do unto others as you would have them do unto you" or show an ounce of human compassion.  Instead, we live in a society where uncontrolled capitalism, which maximizes CEO profits by minimizing responsibility to the consumer, has been made inseparable from a religion which extols the weak and poor as "great" and "inheritors of the earth"; yet an economic system which would be prove fruitful to widespread healthcare coverage is demonized, made taboo, indeed, equated with "godlessness", "atheism", and America's greatest enemy of the 20th century (which, in itself, was a bastardization of the basic concepts of true socialism).

Yeah, American innovation and place in history has been part of the catalyst for the rapid development of some areas of the world, but it should be acknowledged that America wasn't the sole cause for all things praiseworthy; Americans didn't invent the wheel...it wasn't an American city which developed democracy, and it wasn't the AMA that wrote the Hippocratic Oath.  We're extremely young as far as nations are concerned and we still have a whole lot to learn; right now, we have a tendency to act like a class of arrogant teenagers who think they know better than their parents...it's about time we realized that maybe the people who have been around longer than us have some ideas as well.


Alright, sorry, I've been doing that a lot recently.  TLDR as necessary, I'm off my soapbox.  I just don't know how many times I need to tell the extreme rightwing the same damned thing.

[Sushi]

Nuclear:

Sorry to say, but your post looks like this:




No worries, I think you had some good points in there somewhere, but my eyes glazed shut.