Universal vs. Market-Based Health Care

[Kulindahr]

^ While you're looking, perhaps you can also answer my earlier question about why American taxpayers have to fund a health system that costs double per capita of any other OECD nation?

Desperation? Actually, I'm quite enjoying myself!

Where to start....

Take malpractice insurance: a friend from high school days who's now a doctor takes in over $700,000 a year. Sounds great, huh? Not so fast -- he's paying close to $400,000 for malpractice insurance, and he's never had a suit against him.

Then there's the artificial shortage of doctors -- it works like this: each medical school is allowed only so many students in each entering class, and the country is allowed only so many medical schools. How's that, you ask? It's simple: the AMA tells medical schools how many students they can have, and they decide if a university or anyone else can open a new medical school. Thus, the AMA sets the maximum number of new doctors per year. Remember supply and demand? By restricting the supply, the AMA drives up costs.

Those are my two favorite causes.

 

[HenryReardon]

And being the warm-hearted fellow you are, and with the wealth you evidently have, you didn't help someone living under your roof with medical insurance... because he hadn't earned it.

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What wealth? You are a laugh riot.

 

[HenryReardon]

Then there's the artificial shortage of doctors -- it works like this: each medical school is allowed only so many students in each entering class, and the country is allowed only so many medical schools. How's that, you ask? It's simple: the AMA tells medical schools how many students they can have, and they decide if a university or anyone else can open a new medical school. Thus, the AMA sets the maximum number of new doctors per year. Remember supply and demand? By restricting the supply, the AMA drives up costs.

:

What proof do you have that this is so?

 

[smelter]

The idea of insurance is a scam, Kulindahr. It is arguable that if insurance companies were not around, medical and pharmaceutical prices would not be so artificially inflated.

On a side note .... I love the concept of Life Insurance. The Insurance Company is betting you're going to live a long time and you're betting that you'll probably die early.

 

[Kulindahr]

The idea of insurance is a scam, Kulindahr. It is arguable that if insurance companies were not around, medical and pharmaceutical prices would not be so artificially inflated.

That the providing of payments for medical care has had a deleterious effect on the price structure does not make it a "scam". The fact that not every town can have one of every competing grocery store has deleterious effects on the price structure, too, but I'm not going to call that a scam (though here, when Safeway through the subsidiary of a wholly-owned subsidiary bought the property out from under the best grocery store in town, all the while swearing it wasn't them... and then they built a brand new store, the largest in the county, on that and the adjoining property, may qualify).

What the idea of insurance really is, is gambling, and a chance to quell unease about the future. You're buying some peace of mind against future ills, and the insurance company is hoping you will live a long and healthy life.

 

[Kulindahr]

What proof do you have that this is so?

My original source was Reader's Digest, which pointed me to other articles. I don't recall which medical journals I perused, but there was one which pointed out that it was in the interest of medical schools to ration the number of students they admitted to maximize learning, as well as to fit facilities.

As for medical schools, no accreditation board will accredit one without the AMA's benediction.

I've got miles to move in the next couple of hours, so I don't have time to do an on-line search right now.

 

[HenryReardon]

My original source was Reader's Digest, which pointed me to other articles. I don't recall which medical journals I perused, but there was one which pointed out that it was in the interest of medical schools to ration the number of students they admitted to maximize learning, as well as to fit facilities.

As for medical schools, no accreditation board will accredit one without the AMA's benediction.

I've got miles to move in the next couple of hours, so I don't have time to do an on-line search right now.

Did a little digging myself. The AMA vets medical schools because the states are too lazy to do so.

Your theory may well explain why there are so many foreign born/trained doctors in this country.

 

[Kulindahr]

Did a little digging myself. The AMA vets medical schools because the states are too lazy to do so.

Your theory may well explain why there are so many foreign born/trained doctors in this country.

That's what the Reader's Digest article argued, and the medical journal article I saw said.

Of course, if the states decided to vet med schools, who would they turn to for "expertise"?

The AMA needs a competitor -- or two.

And if Obama wants universal health care, he ought to stick funding for building a handful of new med schools around the country, for starters. The AMA is essentially a guild, and should be busted, since guilds are essentially monopolies.

 

[Kulindahr]

ie: a scam. It is an anti-capitalist concept, a middleman similar to the mob, offering an unnecessary "protection" racket that allows for the price of medical expenses to be obscured and the availability of medical care to be skewed in ways violating the invisible hand. Grocery stores intend on offering all that they can for the price that they want directly to the customer---competition isn't always a guarantee, as your localized example suggests. Health insurance is a national problem, not because it isn't covering everyone, but by its mere existence.

Insurance started as shared risk associations, people banding together to pool funds against future need. Outfits such as Lutheran Brotherhood (now merged into something else) go a long ways back, and functioned in that fashion all along.

That may violate the invisible hand, but it's people acting of their own accord to deal with the more-or-less unpredictable. When insurance for profit got into the act, I suppose that shifted/skewed things in a new direction. My assessment is that what really screwed things up was when outfits such as Blue Cross assumed that what doctors, hospitals, etc. were charging were honest figures, so they just paid... and it didn't take long for some to realize that if insurance was just going to pay, they could pad the charges.

I see the point of comparison to a protection racket, but I think the point fails because insurance is voluntary; nothing says you have to have it. Give Obama's ideas free reign, though, and we'll once again be asking that the difference is between the mob and the government.

 

[Kulindahr]

To address the topic directly...

I believe there should be universal health care, but I don't believe that it should be supplied or mandated by the government, at least as presently conceived. At this point, the government's role should be to dismantle barriers to health care, not add any structures to the existing mess.

For starters, address the medical school problem. Washington is playing with an economic package; let them include funding for at least three new medical schools, so the supply of doctors can be increased.

Second, deal with the ridiculous cost of malpractice insurance. We once understood that doctors aren't gods, that they make mistakes even when doing their very best. No American in his/her right mind would have, in my grandparents' time, dreamed of suing for more than the cost of dealing with the results of a medical mistake; now, people try to get rich off it. The change has come from a number of things, including the loss of a sense of honor, but to a great extent due to, IMO, the greed of lawyers.
Here is one place I would regulate: set a flat rate for attorneys in such cases. Further, slap a penalty on attorneys for any case declared frivolous.
Then tax any award over the actual cost of dealing with the outcome of a medical mistake at the rate of 66.66% -- and feed the income to hospitals as reimbursement for caring for the poor.

From another direction, since Americans can't seem to resist playing with the tax code, give every individual a tax credit for the cost of an annual physical. I don't recall any figures at the moment, but things I've read indicate that just the preventive value of an annual physical for every American would cut health care costs drastically.

Of course, to be able to give that many physicals, we need more doctors....

 

[HenryReardon]

To address the topic directly...

I believe there should be universal health care, but I don't believe that it should be supplied or mandated by the government, at least as presently conceived. At this point, the government's role should be to dismantle barriers to health care, not add any structures to the existing mess.

For starters, address the medical school problem. Washington is playing with an economic package; let them include funding for at least three new medical schools, so the supply of doctors can be increased.

Second, deal with the ridiculous cost of malpractice insurance. We once understood that doctors aren't gods, that they make mistakes even when doing their very best. No American in his/her right mind would have, in my grandparents' time, dreamed of suing for more than the cost of dealing with the results of a medical mistake; now, people try to get rich off it. The change has come from a number of things, including the loss of a sense of honor, but to a great extent due to, IMO, the greed of lawyers.
Here is one place I would regulate: set a flat rate for attorneys in such cases. Further, slap a penalty on attorneys for any case declared frivolous.
Then tax any award over the actual cost of dealing with the outcome of a medical mistake at the rate of 66.66% -- and feed the income to hospitals as reimbursement for caring for the poor.

From another direction, since Americans can't seem to resist playing with the tax code, give every individual a tax credit for the cost of an annual physical. I don't recall any figures at the moment, but things I've read indicate that just the preventive value of an annual physical for every American would cut health care costs drastically.

Of course, to be able to give that many physicals, we need more doctors....

The best way to solve the malpractice system is to introduce some sort of Tort reform.

The best one I've come across is a loser pays system. That is, if you file a frivolous lawsuit and lose, then you have to pay your costs and the defendant's costs.

Under the current system, lawyers file suits that they know are unfounded in the full in certain knowledge that 9 times out of 10 they will get money thrown at them to make them go away.


A loser pays system would put a stop to that.

Needless to say, the trial lawyers and their friends in power - mostly democrats - don't want that.

 

[smelter]

The best way to solve the malpractice system is to introduce some sort of Tort reform.

The best one I've come across is a loser pays system. That is, if you file a frivolous lawsuit and lose, then you have to pay your costs and the defendant's costs.

Under the current system, lawyers file suits that they know are unfounded in the full in certain knowledge that 9 times out of 10 they will get money thrown at them to make them go away.


A loser pays system would put a stop to that.

Needless to say, the trial lawyers and their friends in power - mostly democrats - don't want that.

Rich Republican guys like you Henry can afford to hire the best lawyers, but what about the rest of us poor folks?

 

[HenryReardon]

Rich Republican guys like you Henry can afford to hire the best lawyers, but what about the rest of us poor folks?

A. I'm not a Republican.
B. I'm not rich.

What utter nonsense.

 

[Kulindahr]

You just explained how medical costs have gotten out of hand, but then you say that the health insurance mafia is voluntary?

Like what?

Just because a system drives costs up doesn't make it involuntary.

And that answers your question: Obama's plan would make it non-voluntary, and that would be like the mob, a real protection racket.

You need a break -- you're usually more astute than this.

 

[Kulindahr]

The best way to solve the malpractice system is to introduce some sort of Tort reform.

The best one I've come across is a loser pays system. That is, if you file a frivolous lawsuit and lose, then you have to pay your costs and the defendant's costs.

Under the current system, lawyers file suits that they know are unfounded in the full in certain knowledge that 9 times out of 10 they will get money thrown at them to make them go away.


A loser pays system would put a stop to that.

Needless to say, the trial lawyers and their friends in power - mostly democrats - don't want that.

I knew I was forgetting a good idea.
The "loser pays" system is an item from Roman law we would do well to import. Much of Roman law is authoritarian and statist, but this bit is just sensible. It might not even hurt to go so far as to allow another thing Roman law did: if in the eyes of the court it seems warranted, the accuser could be put on trial -- or, in this case, the loser might not only have to pay, but also be saddled with damages for wasting the other party's time.

Yeah -- most of the Democrats in Congress are lawyers, and many of them are trial lawyers. That's always seemed wrong to me; I don't think lawyers should be allowed to hold positions where they can make laws.

 

[Kurn]

Bovine Excreta.

Our founding documents do not promise life, liberty, and free health care.

Our founding documents are a pact in which we commit ourselves as citizens to the common defense. Disease is an attack on the nation.

 

[Kurn]

Actually, the USA has the best health care in the world.

The ideologues who believe this are victims of their self-defeating lack of observation and perception. I especially mean most Republicans on this issue. They look to the world as if they are determined to be ignorant. They look to the world as if they are weak-minded because they can't figure out how We, the USA, can very well do this with a little ingenuity and really caring about bettering our country.
We have numerous examples of what to do and what not to do around the globe. We have our own traditions of personal sovereignty and integrity to appeal to if the social conservatives would just shut the fuck up and think about it.
We also have burgeoning possibilities for lowering the costs of health care on many technological fronts.

 

[HenryReardon]

Our founding documents are a pact in which we commit ourselves as citizens to the common defense. Disease is an attack on the nation.

Now there is a prime example of convoluted rationalizing.

 

[HenryReardon]

The ideologues who believe this are victims of their self-defeating lack of observation and perception

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The fools who believe otherwise are walking around in a fog of self delusion.

We also have burgeoning possibilities for lowering the costs of health care on many technological fronts.

Sure we do, and the end result will be, as it is elsewhere in the world, rationing of health care.

 

[HenryReardon]

] can afford to hire the best lawyers, but what about the rest of us poor folks?

Actually, you missed the point. Wy am I not surprised?

In the kinds of cases under discussion, lawyers take them on a contingency basis - their pay is a percentage of what they win. The client pays nothing.