(british) healthcare

[Reaver]

So far it seems like people are more interested in calling Jerome heartless than understanding that you have a government healthcare system here that's failing, which is kind of Ironic because the basis of this thread is pointing out how heartless that government system is. It's as simple as this, a government big enough to give you all the healthcare you could want is also big enough to take it away. I don't entirely agree that a 100% free market system is the solution, or feasible, but I definitely agree that going towards a more government mandated system is the wrong direction.

[Kolar]

Then explain how it's failing Reaver.

1 or 2 stories about the UK or Canadian system doesn't show it's failing, and just the same 1 or 2 stories about Americans being denied care doesn't show your system is in disarray. And I do think Jerome's ideas are without compassion or consideration of others, he doesn't generally feel the need to consider others and their needs, their suffering when you're implementing a health care system. It only matters what makes an operation or drug cost less to him which doesn't always equate to better care provided or more care provided, it isn't a simple business case.

[Reaver]

More than four in ten maternity units turn away women in labour

Lung patients 'condemned to death as NHS withdraws their too expensive drugs'

NHS chiefs tell grandmother, 61, she's 'too old' for £5,000 life-saving heart surgery

It's safe to say these aren't the only stories.

[Kolar]

Great then find the real facts and observations, don't swallow a news article, pass off something as broken and in dire need of repair without taking longer then 5 minutes of your afternoon forum excursions to get into an argument about something that is more complex then your average run of the mill business.

You guys are really big on the don't trust your Government, read between the lines kind of guys which is respectable to a degree yet you show utter stupidity that I would expect from a Neocon or Pro-lifer when it comes to the issues.

[Reaver]

Jee I'm sorry, let's wait till more people die and then I'll consult Kolar to find out if it meets his "broken" qualifications.

[Kolar]

When is it ever wrong to ask someone to dig deeper and not buy into the hype and sensationalism media can sometimes portray? Only when it serves your brand of politics?

[Zerzera]

Don't you worry Kolar, everything will be better when a company owns your newspaper, grocery store and communication lines. Just like the old days in America when there was no real government yet. God these Chinese rail road workers were happy with their jobs. They voluntarily signed up for the job, moved all the way to America for those great jobs. They were worth their money and they were free to take any other job when they weren't happy with their current. Thank God no laws fucked up that great example of pure capitalism.

I give you all credit for discussing this and looking into it, just so you will learn not to take this stability for granted. Enjoy it while it lasts..

[Galleleo]

Ok, I need a life, but here goes.

Free Market Principle
A system where buyers and sellers, motivated by self-gain, freely conduct business with the goal of making profits. Another name for this arrangement is capitalism. Prompted by neither the "pull of tradition or the whip of authority," free markets are motivated by a single factor—the human urge to acquire goods (Heilbroner, 1970).

Assumptions of the Free Market Principle
Self-interest: The desire for wealth permeates all human activity. Therefore, self-interest, or profit, motivates people to perform necessary tasks for which society is willing to pay (Smith, 1776). As Smith (1776) states: "It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from our regard to their self-interest."

Competition: Smith (1776) answers that the individual, in the process of providing for personal interests, unintentionally contributes to the economic well-being of society. The individual who overcharges for products soon learns that competitors will take away business by offering more reasonable prices. If wages are too small, workers will hire out to another employer who will pay more for their services.

Thus, the 2 laws Adam Smith gave keep each other in balance. A worker freely chooses a trade. Through such a multitude of choices, society reaps the benefit of having all its necessary tasks filled. The individual, motivated by self-interest, selects a particular task. Competition for these tasks prevents the individual from over-charging society.

Finally, the laws of the market also regulate incomes of producers. When profits in one type of business become unusually large, new producers are attracted to the business, until competition reduces the surplus of profit. In the same way, labour's wages are regulated, workers are attracted to higher paying industry until the labour supply lowers the pay scale to that of comparable jobs. By the same token, the reverse is true, when profits or wages are too low, producers or workers will leave that field for more lucrative areas.

All this is under the assumption of laissez faire, leave the market alone. The invisible hand will control the market, as indicated earlier, the individual, by pursuing his own interests, indirectly (and perhaps against his will) also takes care of the interests of others.

How price and demand works, is as follows:

When demand goes up, prices lower. When prices go up, demand lowers. And via this route the free market keeps itself in balance.

Underlying Assumptions of the Free Market (Parker, 2005)

1. Information is Abundant
A free market assumes there is perfect information and everyone is able to get all the information needed

2. People act as Homo Economicus (Economic Man)
Basically what it means is that humans act as a rational and self-interested actor who desires wealth, avoids unnecessary labour, and has the ability to make judgements towards those ends (Persky, 1995)

3. Markets are Open
This means that everyone can enter and leave markets when they please. One underlying assumption of this, is that free markets are often of such size that 1 single player (buyer or seller) has no effect on the overall market (prizes, demand).

Ok, so basically, that is what a free market entails, and the assumptions made on which it works, or what is needed to make it work.

Critique on the assumptions in general
Self-Interest: Tons of studies in the field of Experimental and Behavioural Economics (as for instance Holt, 2006 shows) have shown that people do not only act out of self-interest. And as Adam Smith (1776) himself has stated: when people do not act out of self-interest, they generally help society less than when they act out of self-interest.

The abundance of information: In no way is there perfect information in any market. In economics (and other fields) you have to deal with both Hidden Information (ex ante) and Hidden Action (ex post). Both have to do with the information asymmetry that exists on every market.

People act as Homo Economicus: First off all, people are bounded rational (Simon, 1976). Economists such as Thorstein Veblen, John Maynard Keynes and Herbert Simon criticise Homo economicus as an actor with too great of an understanding of macroeconomics and economic forecasting in his decision making. They stress uncertainty and bounded rationality in the making of economic decisions, rather than relying on the rational man who is fully informed of all circumstances impinging on his decisions. They argue that perfect knowledge never exists, which means that all economic activity implies risk.
Next to this, there is plenty of research to back up the claim that people do not act as Homo Economicus in the market situation (Tversky, 1995; Holt, 2006, Heinrich, Boyd, Bowles, Camerer, Fehr, Gintis and McElreath, 2001)

Markets are Open: In no way, form or shape are all markets open. For instance, Microsoft.

Now, lets look at a different definition:
A free market is a market in which prices of goods and services are arranged completely by the mutual consent of sellers and buyers. By definition, in a free market environment buyers and sellers do not coerce or mislead each other nor are they coerced by a third party (Rothbard).

I bolded that part for a specific reason. It states that in a free market, people do not coerce or mislead each other. There are varies theories out there that state that opportunistic behaviour is a very real threat in markets, see for example Coase (Opportunity Costs).

A look specifically at the healthcare sector
Ok, lets assume that the way a free-market in the Healthcare sector is supposed to work is without insurance companies. So the hospitals are all privately owned and work as companies, meaning you pay your bills directly to the hospitals.

Problems with this system would be (besides the previously mentioned flaws in the free market theory): demand does not go up or down when the price changes. When prizes of health care rise, people do not get into less accidents, nature does not cause less heart attacks, etc. This leaves the opportunity for companies to charge ridiculously insane amounts of money to make profits. From what I understand (but could not find hard figures on this, so I might be wrong on this) government owned and run hospitals (thus, those that allow anyone to get treatment) have a hard time enough to break-even, let alone make profit. Thus in a free market system, where companies would exist to make profits, prizes would already be higher than they are now. Even if I am wrong on this though, the demand/prize still stands. Given that when someone is in dire need of a hospital, he/she will not have the time to carefully examine and weigh their options, let alone have the time to travel longer distances for better price ratios, the competition factor is flawed in this too. When you go out to buy yourself a new bed, in theory (!!) you can compare all the prizes and qualities of possible beds of various company to make the most rational, best choice (see comments earlier). Next to this you have the ability to travel further than just the closest store to get your bed. When you are in need of healthcare, you do not have the possibility of taking a couple of days to compare all possible hospitals to make the best, most rational choice, nor do you have the time to travel further than the nearest possible hospital.

Then there is such a thing as the ambulance service. Given that all hospitals are companies and privatised, they would either have their own ambulance service (depending on the cost/benefit of course) and I think it is quite obvious what is negative about each hospital having their own ambulance service. Or they outsource to a company specialising in the ambulance service. If this would be the case, and a person would be in dire need of an ambulance service, and upon arriving they find the person to be unconscious, they have no way off asking to what institution the patient wants to go. Because he might have his preference based on earlier performed comparisons between hospitals and the cost/quality ratio he felt was best. So there is a chance he gets taken to a hospital he does not want to go, assuming the hospital is at least decent enough to take care off him without knowing his information before hand, this can deliver all kinds of problems afterwards. Imagine that you want to buy a television from Samsung, but Sony decides to deliver you are television and sends you a bill afterwards which is 1000 dollar higher than the Samsung television, I am sure you do not wish to pay that bill as you did not choose the Sony television.

[Galleleo]

Without a doubt, it is possible to think of many, many more problematic situations arising around the ambulance service.

But, my biggest objection would be, that privatising hospitals gives them an unprecedented luxury position in which it is really easy to create huge buffers in their prices. And I have no even mentioned pharmaceutical companies yet, whose competitive positions in the market would be stronger. Hospitals need the drugs to provide the care, as there are no longer any restrictions on the prizes hospitals can charge (as I explained with the failing competition), it is easier for pharmaceutical companies to up their prices to hospitals, because they have the dominant positions against hospital, certainly when it is about new drugs, which for at least a period of time, belong to one pharmaceutical company.

What I haven't explicitly said in my post yet, is that with government support, A LOT of people will not be able to pay for their medical bills in a free market. In a free market their is no incentive for a hospital to give free care to those who cant afford it. And as you can see right now in America, there are a lot of people who cannot afford to pay their insurance. But when it dire need, they can go to the government owned ERs, or to clinics who provide free heath care.

That is all for now, I hope I kept some line in this story, as I do not feel like reading it over a couple of times and stuff.

Literature
Heilbroner, R. (1970) The Wordly Philosophers. New York: Washington Square Press.
Heinrich, J., Boyd, R., Bowles, S., Camerer, C., Fehr, E., Gintis, H. and McElreath, R. (2001) In Search of Homo Economicus: Behavioral Experiments in 15 Small-Scale Societies. American Economic Review 91 (2), pp. 73– 78.
Holt, C. (2006) Markets, Games, & Strategic Behavior. Boston: Pearson Addison Wesley.
Parker, B. (2005) Introduction to Globalization & Business London: Sage
Persky, J. (1995) Retrospectives: The ethology of Homo Economicus. Journal of Economic Perspectives, 9(2), pp. 221-231.
Rothbard, M., N. Free Market, The Concise Encyclopedia of Economics:
Simon, H. (1976) Administrative Behavior (3rd ed.), New York: The Free Press
Smith, A. (1776) The Wealth of Nations. London: Hayes Barton Press
Tversky, A. and Fox, C. R. (1995). Weighing risk and uncertainty. Psychological Review, 102, 269-283.

[Squeezer]

I just read all of that and reminded myself that I hate economics. :greedy:

[Jerome Scuggs]

Problems with this system would be (besides the previously mentioned flaws in the free market theory): demand does not go up or down when the price changes.

Have you also considered the other law of economics stating when supply goes up, price goes down? Given this law, you see automatically how limiting supply (ie licensing boards, for starters) begins distorting an otherwise "free market"'s prices.

Also, you're taking the industry as "a whole". As soon as one hospital starts charging more... than another can just as easily drop their prices to get more customers and therefore reap a bigger profit (go read up on 'economics of scale'). And given human nature, people are more willing to profit off of helping someone, than hurting someone, given they have a choice.

Also.. how does your model account for HMO's? Medicaid? Aforementioned licensing boards?

[Cops]

oh, and cops:

http://www.nationalpost.com/news/wor...html?id=405747

a great read. i laughed, i cried.

So they did one thing good, that doesn't excuse the fact that they're a shite company.

It's like Nike handing out shoes to Katrina victims and hoping that people excuse the fact that they hire child labor in third world countries.

One douchebag saying that a country is better off without a government isn't proof and you won’t ever fucking convince me or most people that tearing down a government will be beneficial to the citizens. It’s like overthrowing Castro or Saddam, they both brought order to the country regardless that they were terrible fucking people. Do yourself a favor and keep your libertarian anarchist bullshit to yourself. You can't prove a working system other than free markets (it goes against our nature to allow them to ever exist), it's also NOT A SOLUTION to healthcare. If you think corporations don't need to be regulated then you don't know anything about big business. You also don’t understand the realities of politics or viable solutions to problems. Hoping the world is different wont magically make it that way, knocking Universal Healthcare and labeling us a socialist state is a) fucking rude b) flat out wrong.

You can quote all the jack asses who are anti-government but meet some people who have lived in countries where a government has been taken down. Tell me how many Semolians you actually know, how many other than reading some bullshit internet sources said “hey Jerome, I liked living in a country where there was no sense or order or security”. That’s complete bullshit; the Semolians want good governance not NO GOVERNANCE.

Semolians are displaced, raped, tortured, used, and abused in any despicable way possible. The lack of healthcare in this country is disgusting and it’s a fucking insult to say these people are happy. How many refugees have you met? How many refugees has your country accepted? What involvement does your country have in Somalia? Back the fuck up, you know NOTHING of this culture or the people, you're completly UNEXSPOSED TO SOMOLIA. If you want to meet someone come to Canada and meet one of my mother’s students who was brutally RAPED when she was 2! I bet she's happy that her families dead and that some man raped the shit out her, I mean why would anyone ever want police or laws.

Keep reading your bullshit rhetoric but stop trying to apply it to real life.

[Jerome Scuggs]

And I do think Jerome's ideas are without compassion or consideration of others, he doesn't generally feel the need to consider others and their needs, their suffering when you're implementing a health care system. It only matters what makes an operation or drug cost less to him which doesn't always equate to better care provided or more care provided, it isn't a simple business case.

I'd like to take the time to sort of deal with this issue, because I feel once I get it straight, you might respect and/or understand where I am coming from.

For starters, take a look at this thread. I feel my position there can be called many things, none of them 'heartless'. Quite the opposite, I would consider it a very respectful and - dare I say - 'compassionate' view.

The same logic that is at the root of that position the same the basic logic I use when setting out my positions of other things. But since you're obviously not getting how respecting individuals is not 'heartless', I suppose I'll explain.

When you boil it down, humans as individual actors have certain 'natural' rights that exist as a result of our own de facto existence. Property rights, for instance, considering our body is our property and thus some natural right must exist to respect that, else every human is a slave. Stemming from this is also the natural liberties we enjoy - the liberty to act as an individual without coercion or violence.

From these rights we derive (once again, through the process of logic), that the most ideal form of organization is mutual cooperation. The alternatives are coercion and violence (or threats of them). Thus, the idea of government in any form is a moral evil. The State's entire existence3 is predicated on the use of coercion with which it serves as the end-all be-all justification of its existence. Why do you think murder is the one right we as citizens do not enjoy, but is actively used by the State?

No government can ever render man truly free. If you insist otherwise, feel free to not pay your taxes - and see how quickly you are coerced into prison. This is why I firstly oppose universal health care - because I oppose of the idea of government. Call this 'extremist', call it 'radical', but do not call it heartless. First and foremost, it is my intention to observe and uphold every single human individual's right to exist, right to be free, and right to defend (and own) his/her property. My position comes from my firm belief and love for humanity, in its entirety, because of the amazing feats that we as individuals achieve. Individuals are at the heart of our entire civilization - individuals are the thinkers, the artists, the poets, the leaders, the brains and the strength of any idea or action that has changed the world. As such, and because of my compassion, I fight against coercion and slavery in any form - even when it has overtly good intentions.

This basic axiom - that humans act - is also at the core of my belief in economics. Economics is nothing more than that - the study of how humans act. Given that we are each conscious individuals and we act, at our own discretion, through logic once again we derive two types of interaction: cooperation and coercion. Economics fleshes out the laws that are an implication of the fact of human cooperation.

At the heart of my economic belief is the notion that only an individual can ever know what's best for himself and therefore should be free to exist as such, cooperating with other humans through market exchange as opposed to government coercion. Is this heartless - the belief that I do not know what's best for my neighbor? Am I heartless for not considering my views superior to his, and am I heartless if I don't force him to do something that someone else says is better for him? If so, then maybe I am heartless. But if you asked me, I'd say I'm modest. I don't put on airs about knowing what's best for other people, and I expect other people to let me alone as well.

Is that heartless?

The capitalist accepts the fact that we, as individuals, can never truly know enough information - quite frankly, it's impossible. Everyone who goes into business selling a product will never truly know if his product is the best, or if people actually want it, until people themselves decide by choosing to buy or not buy his product. The market, in effect, serves as the most democratic and clear form of competing ideas. If this wasn't true, then governments would have achieved their goals the second the first code of laws (hammurabi's?) was passed. But lawmakers can and will never be able to fully grasp the bigger picture.

Historically we can see this. Almost every piece of legislation has failed to meet its ultimate goal, as well as having terrible side-effects, which often completely negate the good intent of the bill. For instance - Prohibition created mob rule and gang violence. Then look at anything the government's ever touched - Drugs, Education, Welfare, National Security, Monetary Policy - do you not see a weird parallel between all of them?

Once you create a 'model', it works as long as the variables remain constant. But here's life: it changes. Unexpectedly. Alot. So fast, even most businesses, who make decisions daily, even hourly, can sometimes miss something and lose money... it happens all the time, it's business. Unless your politicians can adjust the micro-economic delicacies of their models quickly - I'd be impressed if they could respond to a major crisis in a week - you quickly see how million and millions of built-up factors can slowly rot the model. Just look at America's economic situation and the Fed's role in it. (Heh, great example, because now the Fed claims it needs more power and wants to nationalize banks.)

Here, then, we see the significance of the original post, which you still fail to miss. You say "1 or 2" people isn't a bad thing (how heartless you dick), but you're missing the point: twenty years ago, the idea that someone would be turned down was ludicrous, because the model was working. But when you've set up a model that relies on so many variables... soon, things change. And now people are starting to see that the government isn't the end-all, that that can't provide for everyone... and so now people are going to die. Not because of anything they chose - they're dying because someone else decided, years ago, that it would be better for that person, who is dying now, to have socialized healthcare.

So, who the fuck are you to call me an "extremist", when you're literally gambling peoples' lives away - and they have no say in it?

While you're stuck on the level of a single policy - healthcare, in a single period - 2008, I am considering the implications of the policy on many levels - short-run, long-run, philosophical, ethical, physical, political, economic... so yes, with that sort of objectivity (ironic, the individualist knowing what's best for everyone) i guess you could say that i am heartless inasmuch as i didn't look at people in need RIGHT NOW and put their problems before all else, including rational discussion of the policy. But considering that ultimately I am viewing this policy in the interests of every single human being ever - I'd say I'm being fairly pro-people here.

[Galleleo]

Have you also considered the other law of economics stating when supply goes up, price goes down? Given this law, you see automatically how limiting supply (ie licensing boards, for starters) begins distorting an otherwise "free market"'s prices.

Licensing boards? I thought we were talking about free markets? As in no regulations from a government?

Also, you're taking the industry as "a whole". As soon as one hospital starts charging more... than another can just as easily drop their prices to get more customers and therefore reap a bigger profit (go read up on 'economics of scale'). And given human nature, people are more willing to profit off of helping someone, than hurting someone, given they have a choice.

Go read my post, specifically the competition part and how it fails in the Healthcare sector.

Also.. how does your model account for HMO's? Medicaid? Aforementioned licensing boards?

The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options.

HMOs are regulated at both the state and federal levels. They are licensed by the states, under a license that is known as a certificate of authority (COA) rather than under an insurance license. [3] In 1972 the National Association of Insurance Commissioners adopted the HMO Model Act, which was intended to provide a model regulatory structure for states to use in authorizing the establishment of HMOs and in monitoring their operation.

Medicaid is the United States health program for individuals and families with low incomes and resources. It is an entitlement program that is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities. Being poor, or even very poor, does not necessarily qualify an individual for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income.

I am sorry, am I just wrong here, or were you talking about Free Markets, as in NO GOVERNMENT INTERFERENCE? Did you not say: Get rid of the government?

My model assumed a Free Market.

[Jerome Scuggs]

It’s like overthrowing Castro or Saddam, they both brought order to the country regardless that they were terrible fucking people.

i take it back. this is all i needed to hear from you. fucking fascist.