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Darth Paradox

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Politics time [Jul. 30th, 2009|08:31 pm]
Darth Paradox
Nobel-Prize-winning economist Paul Krugman writes: Why markets can't cure healthcare

A concise, astute argument against all the "let the free market fix it" advocates. It seems to come down to the fact that market theory generally only applies to markets of fungible commodities, and health care is neither fungible nor a commodity.


[User Picture]From: partiallyclips
2009-07-31 03:45 am (UTC)
There are certain human endeavors in which making money is not the central reason we do it. Defense, education, public safety, infrastructure, lawmaking, criminal justice, and health care, for a good start. The drive to make money in these endeavors is usually at odds with the core mission. The push to privatize and/or emphasize for-profit solutions in these and other such areas is a disingenuous public swindle.
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[User Picture]From: darthparadox
2009-07-31 04:03 am (UTC)
Pretty much. In this case, one need look no farther than the fact that an insurance company's profit is literally directly proportional to the amount of health care they weasel out of paying for.
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[User Picture]From: voiceofkiki
2009-07-31 06:02 am (UTC)
The truth of the medical system really hit me one night when I was chatting to a friend who lived in New Zealand. We were both fairly young and neither of us had any idea of the way health care was handled outside our respective countries. The conversation basically went like this:

Me: I've had this headache for 3 days. I hope it goes away soon.
Her: What did the doctor give you for it?
Me: I haven't been to the doctor. I can't afford it.
Her: Since when do you have to pay to see a doctor?
Me: Since... ever?
Her: What kind of 3rd world shithole do you live in?
Me: Um... America?
Her: WTF?!

That was the first time I realized how underprivilaged I was in the eyes of the rest of the modern world. It was also the first time I remember feeling ashamed of where I lived. I've only had about three years of my life where I knew that if I got sick, I could go to a competent doctor.

Things are better for me now that I've moved to IL. I'm actually getting some health care under the state. In GA, I was literally told I had to be "knocked up" or have small kids before I could hope to get any state help. That was also the system that looked at my father during the height of my mother's illness and told him that it was "a shame" that he still lived with us. It seems the state had no proviso for a functioning family with a father included. They told him that if he weren't in the picture, my mother and I could get all the help we would need. Fortunately, one of my father's friends found him before he pulled the trigger on the gun that night.

This is the system we're living with, folks. It is a system that would deny a child one parent if it dares to want things like food and health care. And it would have denied me both parents in short order due to the terminal nature of my mother's illness.

If anyone dares tell you our health care system works, please... please tell them that tidbit from my childhood. I beg you. Maybe if more people see the reality of the situation, they might get angry enough to do something about it.

Maybe... but I doubt it.
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[User Picture]From: darthparadox
2009-07-31 04:26 pm (UTC)
That's horrifying, and I know you're just one among many with stories like this. The system is fucking broken, and I'm going to be pissed if Congress manages to fuck this chance at reform up.
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[User Picture]From: misterflames
2009-07-31 07:55 am (UTC)

Voice of Experience.

Darth Paradox knows me personally, even visited me with his lovely wife-of-the future in the hospital, the day after my amputation.

I didn't have a lot of problems with my medical insurance, so long as I had it and could pay for it. My disability insurance, on the other hand, was a completely different story. Once I lost that and required treatment again, the hospital worked with various agencies to get me on Social Security and state insurance here in Washington, primarily so they could get paid, I think. laugh The market can work sometimes, even most of the time, but I will agree that it is not an ideal solution for everything.

Admittedly, I'm crazy. (Yup, doctors agree. Part of the reason I'm on SSI is that I'm chronically depressed with suicidal tendencies.) If someone tried to get in my face about the contradiction of an anarchist on gov't assistance, I would honestly reply that since I'm not permitted honorable suicide, I do what I must to reduce the burden of others for my welfare. But there are so many other concerns that need to be addressed here as well.

First off, there's the problem with illegal immigration bankrupting the system, which is causing problems in border states. This is bothersome not only because of that, but because the problem is the responsibility of ultimately those who want to run health care, too. Their track record does not assure me.

Secondly, some honest debate would be a pleasure, with some facts to chew on rather than emotional pleas and the worst cases brought forward. That one is another keep dreaming, though, but again, explains my own lack of confidence here in the government, as opposed to the market or private citizens working things out.

My main concern, though, is what will happen once we get to the point where it will be seen as an obligation to restrict certain things, for your own good and to keep costs down. People yammering about taxing fatty foods seems to be silly, but I don't care for giving them a somewhat legitimate reason for it. Especially since it will probably turn into the tax situation for cigarettes, as a way to get funding from a captive audience.

I don't trust government, ultimately. Yes, this is a thorny, complex problem, and we need to work on a solution for it. But considering the track record of the government for fixing things, are we sure we want to hand over the keys to them?

Besides, I offer this thought concerning government care: Imagine the most hated politician around. Do you seriously want him running your health insurance? Because it *will* happen, count on it. The last several presidents have been nothing but polarizing, after all, as have most every candidate for the last thirty years, at least.

P.J. O'Rourke put it very well, indeed: "Giving money and power to government is like giving whiskey and car keys to teenage boys." Sure, something must be done, but can we have a bit more information, please?
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[User Picture]From: darthparadox
2009-07-31 03:54 pm (UTC)

Re: Voice of Experience.

there's the problem with illegal immigration

This is a reason to improve our border security and immigration controls, not a reason to not fix the health care system. And it's not a problem that doesn't exist today anyway, as you point out.

Imagine the most hated politician around. Do you seriously want him running your health insurance?

No more than I want him personally running the military, the justice system, or the transportation infrastructure. But the system as a whole works reasonably well when measures are taken to separate politics from policy. We know that's possible, even if it hasn't happened so much recently.

I certainly don't have a problem with gathering more information. But I just can't agree with the assertion that the government is sufficiently untrustworthy that the current, horribly broken system is unquestionably better.
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[User Picture]From: misterflames
2009-07-31 07:04 pm (UTC)

Re: Voice of Experience.

Per Immigration, I would agree that it's not a reason to fix health care. However, it *is* a reason that government may not be the best answer for it, since they have demonstrated time and again that they are already ill-suited for the tasks they have taken before. Giving more work to something that has proven itself unable to do the work it has presently is a recipe for disaster.

The issue I have here is that the people proposing solutions are thinking in terms of Hammer and Nail, as in "If all you have is a hammer, then everything looks like a nail." Not everything needs a government program.

This is why I want to see the facts and the options. I'm skeptical here, for good reason. Governments the past century have killed more people than fast cars, cigarettes, and fatty foods. If they're the best solution here, then present the case. Otherwise, I want more ideas, more thought, and less fevered emotion and demagoguery.

The present set up kinda works. I remain an example of that. It can work a lot better, but I'm a Murphyist. I firmly believe that it can always get worse.
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[User Picture]From: thecrazyfinn
2009-07-31 03:03 pm (UTC)
Actually he provides exactly zero arguments as to why a free market solution doesn't work. And he ignores the fact that the US system was quite functional as a free market system until government incentives turned it into a directed market system during WW2 (When the government made health insurance a tax-free benefit to allow alrge firms to give effective wage boosts during a wage freeze).

He also deals with the market dynamics issue solely by handwavium. There is NO data out there to indicate that a free market solution won't work, most health care is fungible and a commodity already (even in the US system, low-level care is completely fungible). And market theory does NOT only apply to markets of fungible commodities, but rather to markets of all types. Fungible commodities are simply the ones where supply, cost of production and demand are essentially the sole determinants of cost.

Frankly, the article is typical Krugman. State a position, make a few easily disabused arguments and then stand on his status as a Nobel-Winning Economist. He's long-ago turned into a shill for the moderate left.
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[User Picture]From: darthparadox
2009-07-31 04:13 pm (UTC)
The "fungible commodities" thing was my own interpretation; I may have gotten that wrong.

He certainly doesn't make any rigorous, scientific arguments - it's a blog post, not a peer-reviewed publication - but I found his points convincing all the same. If you have an example of a free-market system actually working, I'd love to hear it, and I'm sure Krugman would too.

Of course, my definition of "working" is "everyone gets the care they need", not "everyone gets the care they need unless they're poor or their condition is serious enough that insurers won't touch them with a ten-foot pole", so I might be a bit predisposed against the free-market concept in this case.
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[User Picture]From: kazriko
2009-07-31 04:49 pm (UTC)
My one thing that I would say about government takeover of healthcare, just like their takeover of the education system.

If they're forcing it on everyone else, they should eat their own dogfood. Thus far, the politicians have been utterly unwilling to do that. Obama, while kicking poor minority students out of DC private schools on the insistence of the unions, still sends his kids to the same private school he forced them out of. When asked at a conference if he would put his own kids in his health care program he dodged the question while making it clear that he would not.

In countries that have this kind of healthcare, the rich and the politicians always have an out that lets them get around the crappy system that they created.
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[User Picture]From: darthparadox
2009-07-31 05:06 pm (UTC)
Obama, while kicking poor minority students out of DC private schools on the insistence of the unions

That's a new one by me. Do you have a link?

If they're forcing it on everyone else, they should eat their own dogfood.

I completely agree. I'd love to see the salaries and benefits of governmental policymakers pegged to, say, those at the 25th percentile in the general populace. I think it'd be tremendously effective at actually forcing the government to work for the common good.

But for what it's worth, the government employees are on a government-run health system right now. And if the public option provided to the general public is the same system, I'd be happy with that.
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[User Picture]From: kazriko
2009-07-31 05:14 pm (UTC)
The problem is that the government employees are not on the same government program that they are going to force everyone else onto, and the senators and congressmen are especially not on the same program. Ted Kennedy, in whose name they're pushing this bill, would be dead right now under the program he's trying to push everyone else into. The plan that the government elites have is basically unlimited healthcare.

Another thing that those pushing health care reform refuse to do is put in a bill saying that there will be no rationing of health care.


This is a more recent one, it seems like they finally nagged Obama into continuing it for existing students, but they're still killing it off for new students. This has been ongoing for months though.
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[User Picture]From: fiercekitty
2009-08-01 02:02 am (UTC)

This fellow says it better than I can

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[User Picture]From: fiercekitty
2009-08-01 02:06 am (UTC)

This one is good too

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[User Picture]From: tcdohl.dreamwidth.org
2009-08-01 07:05 am (UTC)

As it happens, that's about the most constructive thing I can say on the matter. We (meaning not me, obviously, you know what my finances are like) just had to pay $1500 for medication, and we have to wait for a $1450 reimbursement at the mercy of my insurance - all because we're outside the coverage area of my school. Hopefully we'll get it, pending the approval of our claim. It's like playing a lottery, where at risk is your livelihood and the ability to take drugs that get you out of bed each day and apparently cost $18 a 2mg pill. The process is wrong, the prices are wrong, the system is fucked, and I don't care what happens as long as change does in fact happen.
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