Re: The Role of Government in a Libertarian Free Market
On Sat, Aug 15, 2009 at 9:23 PM, Rceebergerrceeber...@comcast.net wrote: It is worth noting that this guy is one of the most respected members on this list Decide that with a vote, did you? He seems rather a hot-head to me. I was going to ask him to explain what set him off, but evidently he would rather call me names and then stalk off then discuss it. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
On 8/16/2009 1:09:53 AM, John Williams (jwilliams4...@gmail.com) wrote: On Sat, Aug 15, 2009 at 9:23 PM, Rceebergerrceeber...@comcast.net wrote: It is worth noting that this guy is one of the most respected members on this list Decide that with a vote, did you? One would have to be quite dense to not notice after over a decade on the list. Once again, your default position is to assume that others are stupid. Do you actually think your feeble attempts to place others in a defensive position are not recognized for what they are? He seems rather a hot-head to me. Normally Charlie is level headed and even tempered. Perhaps it was just an off day. I was going to ask him to explain what set him off, but evidently he would rather call me names and then stalk off then discuss it. Normally, that would be my gig. xponent The Subversive Maru rob ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
Dan wrote: One thing to remember about experimentation: 99.99% of experiments fail; What's the criteria for success? An experimental form of governance (or some aspect of governance) may not yield a completely successful law or system of laws, but I'm relatively certain that important knowledge can be gleaned from any well designed experiment forming the basis for further experimentation and eventually a more successful law or system. they do not achieve the goals they set out to achieve. In physics, theorists have come up with tens if not hundreds of thousands of wrong theories. Shelly Glashow, who I mentioned, said he came up with 5 new theories per day. Only one of his really paid off...and it paid off big. Most experiments in physics don’t find the new and exciting thing they are looking for; they just find that the 2 sigma signal they spent 2 years getting more data on disappear. I'm not sure physics experiments where there is generally one right answer and thousands of wrong ones are comparable to social experiments where there is seldom one correct answer and often many acceptable solutions to a problem. Furthermore, a correct answer in physics will remain correct whereas a social system is always fluctuating not only from year to year but from one location to the next. Economic studies have shown that, for average entrepreneurs, the business ends up failing and costing money. We are fortunate that we have these folks, because every once in a while they come up with something that _really_ benefits everyone. But, even averaging the winners in, the average person taking a risk on a new business loses money. Am I wrong in guessing that very few new businesses are experimental Finally, we do have experimentation in government. California and Texas have very different governments; and very different sets of problems. California is wining the race down to failure, it seems.because Texas doesn't have much of a housing problem and is not about to go bankrupt. I don't think that this is an experiment in any useful sense of the word. You may argue that these are minimalistic changes; and they are. I would argue that they are apples and oranges. Doug ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
On Sat, Aug 15, 2009 at 11:44 PM, Rceebergerrceeber...@comcast.net wrote: One would have to be quite dense to not notice after over a decade on the list. Once again, your default position is to assume that others are stupid. Do you actually think your feeble attempts to place others in a defensive position are not recognized for what they are? I'm sorry that you feel that way. I did not say and I do not think you are stupid. I was just curious about this respect ranking. Do you rank above or below Mr. FUCK YOU in respect on this list? Is this respect ranking secret, or can anyone view it? ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
Charlie wrote: I do occasionally blow up. Once when I was accused of racism, once when a private discussion I'd had with someone was forwarded to the list, and ISTR Nick and I talking completely at cross-purposes. I was really annoyed on Friday night, partly 'cause I'd got home after drinking with a couple of friends in the pub, and an acquaintance of one of them was spouting anti-vaccination lunacy. And when I asked a couple of simple questions, I received the reply Oh, so you're science. That figures. There's no arguing with simpletons like that. And we seem to have more nut cases than ever before. Birthers??? Ay Yi Yi. Doug ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
The Atlantic has a thoughtful article by David Goldhill on health care and health insurance reform. It is long, but I think well worth reading. I've also included below a few paragraphs that I thought were particularly interesting. http://www.theatlantic.com/doc/print/200909/health-care | I’m a Democrat, and have long been concerned about America’s lack | of a health safety net. But based on my own work experience, I also | believe that unless we fix the problems at the foundation of our health | system—largely problems of incentives—our reforms won’t do much | good, and may do harm. To achieve maximum coverage at acceptable cost | with acceptable quality, health care will need to become subject to | the same forces that have boosted efficiency and value throughout | the economy. We will need to reduce, rather than expand, the role | of insurance; focus the government’s role exclusively on things | that only government can do (protect the poor, cover us against true | catastrophe, enforce safety standards, and ensure provider competition); | overcome our addiction to Ponzi-scheme financing, hidden subsidies, | manipulated prices, and undisclosed results; and rely more on ourselves, | the consumers, as the ultimate guarantors of good service, reasonable | prices, and sensible trade-offs between health-care spending and | spending on all the other good things money can buy. | But health insurance is different from every other type of | insurance. Health insurance is the primary payment mechanism not | just for expenses that are unexpected and large, but for nearly all | health-care expenses. We’ve become so used to health insurance that | we don’t realize how absurd that is. We can’t imagine paying for | gas with our auto-insurance policy, or for our electric bills with our | homeowners insurance, but we all assume that our regular checkups and | dental cleanings will be covered at least partially by insurance. Most | pregnancies are planned, and deliveries are predictable many months in | advance, yet they’re financed the same way we finance fixing a car | after a wreck—through an insurance claim. | Every time you walk into a doctor’s office, it’s implicit that | someone else will be paying most or all of your bill; for most of | us, that means we give less attention to prices for medical services | than we do to prices for anything else. Most physicians, meanwhile, | benefit financially from ordering diagnostic tests, doing procedures, | and scheduling follow-up appointments. Combine these two features of | the system with a third—the informational advantage that extensive | training has given physicians over their patients, and the authority | that advantage confers—and you have a system where physicians can, | to some extent, generate demand at will. | Do they? Well, Medicare spends almost twice as much per patient in | Dallas, where there are more doctors and care facilities per resident, | as it does in Salem, Oregon, where supply is tighter. Why? Because | doctors (particularly specialists) in surplus areas order more tests | and treatments per capita, and keep their practices busy. Many studies | have shown that the patients in areas like Dallas do not benefit in | any measurable way from all this extra care. All of the physicians I | know are genuinely dedicated to their patients. But at the margin, | all of us are at least subconsciously influenced by our own economic | interests. The data are clear: in our current system, physician supply | often begets patient demand. | Perhaps the greatest problem posed by our health-insurance-driven | regime is the sense it creates that someone else is actually paying | for most of our health care—and that the costs of new benefits can | also be borne by someone else. Unfortunately, there is no one else. | For fun, let’s imagine confiscating all the profits of all the | famously greedy health-insurance companies. That would pay for four | days of health care for all Americans. Let’s add in the profits of | the 10 biggest rapacious U.S. drug companies. Another 7 days. Indeed, | confiscating all the profits of all American companies, in every | industry, wouldn’t cover even five months of our health-care | expenses. | Cost control is a feature of decentralized, competitive markets, | not of centralized bureaucracy—a matter of incentives, not | mandates. What’s more, cost control is dynamic. Even the simplest | business faces constant variation in its costs for labor, facilities, | and capital; to compete, management must react quickly, efficiently, | and, most often, prospectively. By contrast, government bureaucracies | set regulations and reimbursement rates through carefully evaluated | and broadly applied rules. These bureaucracies first must notice | market changes and resource misallocations, and then (sometimes | subject to political considerations) issue additional regulations or | change reimbursement rates to
Re: The Role of Government in a Libertarian Free Market
On 16/08/2009, at 5:46 PM, Doug Pensinger wrote: Charlie wrote: I do occasionally blow up. Once when I was accused of racism, once when a private discussion I'd had with someone was forwarded to the list, and ISTR Nick and I talking completely at cross-purposes. I was really annoyed on Friday night, partly 'cause I'd got home after drinking with a couple of friends in the pub, and an acquaintance of one of them was spouting anti-vaccination lunacy. And when I asked a couple of simple questions, I received the reply Oh, so you're science. That figures. There's no arguing with simpletons like that. And we seem to have more nut cases than ever before. Birthers??? Ay Yi Yi. Uh-huh. Thing is, the guy wasn't thick, he was just gullible. He'd read the crap in a couple of newspapers, and a few websites, like the toss Jenny McCarthy spews out, along with the convincing to the uninitiated stuff written by a few medics and prominent journos such as RFKjr (and it pains me that the otherwise reasonably sensible Huffington Post has a science section populated by woomeisters). But like most of these subjects, it takes longer to explain why stuff is wrong than to repeat the wrongness (the so-called Gish Gallop works in all areas of woo and conspiracy). So there I am saying but if it's mercury in Thimerosal that causes autism, why haven't rates of new autism diagnosis dropped now that Thimerosal isn't in UK vaccines and vaccination rates have dropped? while I'm getting a new point about rabies vaccine to deflect. So I give up. Sigh. Oh, and the population thing came up too. Yay. Charlie. However, The Beer Was Very Very Good Maru ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
At 02:51 AM Sunday 8/16/2009, John Williams wrote: The Atlantic has a thoughtful article by David Goldhill on health care and health insurance reform. It is long, but I think well worth reading. I've also included below a few paragraphs that I thought were particularly interesting. http://www.theatlantic.com/doc/print/200909/health-care I'm only a little way into the article, but I take it Semmelwies is no longer mentioned in the medical school (or pre-med) curriculum? . . . ronn! :) ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
Rob wrote: LOL.I'm the cellar dweller! Yea, that's true, but we know why. That's where all the best list wines are kept. Dan M. mail2web - Check your email from the web at http://link.mail2web.com/mail2web ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
At 10:15 AM Sunday 8/16/2009, David Hobby wrote: John Williams wrote: On Sat, Aug 15, 2009 at 11:44 PM, Rceebergerrceeber...@comcast.net wrote: One would have to be quite dense to not notice after over a decade on the list. Once again, your default position is to assume that others are stupid. Do you actually think your feeble attempts to place others in a defensive position are not recognized for what they are? I'm sorry that you feel that way. I did not say and I do not think you are stupid. I was just curious about this respect ranking. Do you rank above or below Mr. FUCK YOU in respect on this list? Is this respect ranking secret, or can anyone view it? John-- Hi. Seriously, are you trolling, or just dense? : ) We rank respect the way most communities do--completely informally. Everyone has their own sense of who they respect, and we don't ever need to pool them to produce a hierarchy. Yes, Charlie is someone I respect. His posts are thoughtful, and when he argues, he does it in a fair and constructive way. ---David Hint, hint, Maru FWIW the _Atlantic_ article is well worth reading carefully. I've already forwarded the link with my recommendation to a couple of other lists, and got a couple of comments back. Unfortunately, that's about exhausted my energy for this morning, so I am going back to bed for awhile. I might also pass along this link to another first-person account about the costs of the current system I came across a couple of days ago: http://www.time.com/time/politics/article/0,8599,1916193,00.html . . . ronn! :) ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
FWIW the _Atlantic_ article is well worth reading carefully. I've already forwarded the link with my recommendation to a couple of other lists, and got a couple of comments back. The problems the article lists are real; I won't argue that the present system is really messed up. However, the solution of having high deductables has been tried; and the results are counterprodutive. People under those conditions eschew paying for services until they reach crisis porportions, then they go in. They gamble that things will get better on their own, and if they lose, they only risk their deductable. Obama, yesterday, was right on target when he said there was no single silver bullet for this problem. But, we do know things can be better, because we are paying twice as much as the average developed country per person with worse than average results. FWIW, I've discussed this with numerous professionals (including my brother-in-law who is one of the few doctors who take Medicaid paitients and patients who can pay only part of their bill, a friend who was the chief administrator of a hospital ranked one of the 100 best in the US, before she went on to an even better hospital, and others who develop new products and are frustrated with how hard it is to get them past regulations and into use. Ironically, one of the things that John is ralling about has become the rallying cry for the anti-government groups: any attempt to decrease the spending of hundreds of thousands on the last month of life so mom or dad could painfully exist the world in four weeks insteasd of four days. Thank God my sister was a hospice nurse, so we knew enough to discuss this and let dad die when gangrine formed in his legs at 90 when his circulation dropped. We could have had an expensive painful amputation, used extrodinary measures, and he would have lived a couple more years in agony and dementia. We chose to let him die. Counseling on this is not a death panel, and Congressmen villifying this after promoting it is some of the worst bad faith I remember in politics. Dan M. mail2web.com Enhanced email for the mobile individual based on Microsoft® Exchange - http://link.mail2web.com/Personal/EnhancedEmail ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 4:05 AM, Ronn! Blankenshipronn_blankens...@bellsouth.net wrote: I'm only a little way into the article, but I take it Semmelwies is no longer mentioned in the medical school (or pre-med) curriculum? I think that the guidelines Goldhill refers to are more systematic and comprehensive than anything Semmelweis discussed. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
On Sun, Aug 16, 2009 at 8:15 AM, David Hobbyhob...@newpaltz.edu wrote: Hi. Seriously, are you trolling, or just dense? : ) We rank respect the way most communities do--completely informally. Not trolling. Possibly dense. There is that reference to we again, which is what led me to believe that there was some pooled resource that was being referenced. Everyone has their own sense of who they respect, and we don't ever need to pool them to produce a hierarchy. That is what I was wondering about. Yes, Charlie is someone I respect. His posts are thoughtful, and when he argues, he does it in a fair and constructive way. So, you consider his post to me thoughtful, constructive, and worthy of respect? ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
John Williams wrote: On Sun, Aug 16, 2009 at 8:15 AM, David Hobbyhob...@newpaltz.edu wrote: ... Yes, Charlie is someone I respect. His posts are thoughtful, and when he argues, he does it in a fair and constructive way. So, you consider his post to me thoughtful, constructive, and worthy of respect? That one, not so much. But I tend to take a running average. His is still better than yours. : ) ---David ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
One thing that is often discussed in reference to health insurance is that if someone is unexpectedly afflicted with a chronic condition, their health insurance premiums will usually increase drastically. Health insurance for someone diagnosed with a chronic condition might go from $2,000 a year to $10,000. Many people would be unable to pay the higher amount, and cite this as a reason for making health insurance non-voluntary with a very large risk pool. However, having health insurance premiums unexpectedly increase is the sort of personal risk that can itself be insured against. Sometimes called health status insurance, such insurance pays out a lump sum or as an annuity if an event occurs that drastically raises health insurance costs. Here is an article discussing health status insurance: http://www.cato.org/pub_display.php?pub_id=9986 ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
When you reach a point where the suggested solution to ridiculously overpriced health insurance is to take out an insurance policy on your insurance ... perhaps it's a sign that you ought to consider some other system. Patrick On Sun, Aug 16, 2009 at 12:24 PM, John Williamsjwilliams4...@gmail.com wrote: One thing that is often discussed in reference to health insurance is that if someone is unexpectedly afflicted with a chronic condition, their health insurance premiums will usually increase drastically. Health insurance for someone diagnosed with a chronic condition might go from $2,000 a year to $10,000. Many people would be unable to pay the higher amount, and cite this as a reason for making health insurance non-voluntary with a very large risk pool. However, having health insurance premiums unexpectedly increase is the sort of personal risk that can itself be insured against. Sometimes called health status insurance, such insurance pays out a lump sum or as an annuity if an event occurs that drastically raises health insurance costs. Here is an article discussing health status insurance: http://www.cato.org/pub_display.php?pub_id=9986 ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 12:28 PM, Patrick Sweeneyfirefly.ga...@gmail.com wrote: When you reach a point where the suggested solution to ridiculously overpriced health insurance is to take out an insurance policy on your insurance ... perhaps it's a sign that you ought to consider some other system. Actually, charging a high price for health insurance for someone who is almost certain to incur high costs is not ridiculous at all, but rather perfectly rational. That is exactly how insurance should work. For example, consider auto insurance. Drivers who are at higher risk of accidents pay higher premiums. With health insurance, if premiums are not higher for people who are likely to have high expenses, then there is a strong incentive for healthy people to carry no health insurance until they get an expensive condition, and then purchase health insurance. The idea of purchasing insurance against an unexpected expensive event is also perfectly rational. Health status insurance is as reasonable as life insurance. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
John Williams wrote: On Sun, Aug 16, 2009 at 12:28 PM, Patrick Sweeneyfirefly.ga...@gmail.com wrote: When you reach a point where the suggested solution to ridiculously overpriced health insurance is to take out an insurance policy on your insurance ... perhaps it's a sign that you ought to consider some other system. Actually, charging a high price for health insurance for someone who is almost certain to incur high costs is not ridiculous at all, but rather perfectly rational. That is exactly how insurance should work. For example, consider auto insurance. Drivers who are at higher risk of accidents pay higher premiums. With health insurance, if premiums are not higher for people who are likely to have high expenses, then there is a strong incentive for healthy people to carry no health insurance until they get an expensive condition, and then purchase health insurance. The idea of purchasing insurance against an unexpected expensive event is also perfectly rational. Health status insurance is as reasonable as life insurance. John-- It does strike me as a kludge, though. To continue your example of car insurance, I don't believe that anybody markets insurance against having your car insurance premiums rise dramatically. I'd guess that Patrick is expecting health insurance to have health status insurance already built into it. ---David ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 1:47 PM, David Hobbyhob...@newpaltz.edu wrote: I'd guess that Patrick is expecting health insurance to have health status insurance already built into it. One would think the whole point of health insurance is to provide you with health care (more precisely, the funds to acquire such) should you fall ill. Both of us are playing the odds. I'm betting that I'll need some expensive procedure I can't afford on my own someday; the insurer bets I don't. But if I do fall ill, for the insurer to raise my rates rather than provide the agreed-upon care seems like dirty pool. And to suggest that I ought to insure my insurance policy (and perhaps to be certain, I ought to insure the insurance on my insurance?) seems like a sign of massively broken system. For anyone but the insurers, at least. Patrick ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 1:47 PM, David Hobbyhob...@newpaltz.edu wrote: It does strike me as a kludge, though. To continue your example of car insurance, I don't believe that anybody markets insurance against having your car insurance premiums rise dramatically. I do not think there is a as large a risk of such a dramatic rise in auto insurance premiums. Possibly auto insurance premiums could go up 5x after 2 DUI's, but short of that, I cannot think of anything that would result in such a thing. And that is relatively unlikely, compared to developing a chronic condition at some point in one's life. I'd guess that Patrick is expecting health insurance to have health status insurance already built into it. New ideas can be difficult to get used to. Perhaps they could be bundled together for those who prefer it. But it would be a bundle -- the two types of insurance are fundamentally different, since one pays a lump sum or equivalent (like life insurance) for a single event, and the other pays out many payments for multiple events. Perhaps yet another flavor would be to have health insurance like life insurance, in that you lock yourself into a contract for many years. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
On 15 Aug 2009 at 20:00, John Williams wrote: On Sat, Aug 15, 2009 at 7:51 PM, dsummersmi...@comcast.netdsummersmi...@comcast.net wrote: That's a true statementbut the problem with failure with radically new government is that the failures are horrid: (e.g. the French Revolution, the Cultural Revolution, Pot Pol). Which suggests that we need lots of very small scale experiments, so failures are small. Islands. Huxley's idea :) AndrewC ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 2:05 PM, Patrick Sweeneyfirefly.ga...@gmail.com wrote: On Sun, Aug 16, 2009 at 1:47 PM, David Hobbyhob...@newpaltz.edu wrote: But if I do fall ill, for the insurer to raise my rates rather than provide the agreed-upon care seems like dirty pool. That is only true if you had an agreement with the insurance company that lasted longer than a month or year. All insurance has a time period either explicit or implicit. Most of today's individual health insurance plans have a short time period. The premiums are low for healthy people because the chances of a healthy person needing costly care over a short period is relatively low. If, on the other hand, one signed a health insurance contract for a lifetime policy (or even, say 10 years) with a fixed premium, then the premium would be higher than that for a short period policy, since the chances of needing prolonged, costly care are higher over a longer period. A long-term policy or a bundled health-insurance / health-status-insurance policy may be preferable for some people. But personally, I don't like to be locked into anything that I can avoid. I would prefer to have flexibility to change my health insurance providers...even every year if I want. Having separate health insurance and health status insurance would be a benefit for me, allowing me more choice. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On 16 Aug 2009 at 14:08, John Williams wrote: New ideas can be difficult to get used to. Perhaps they could be bundled together for those who prefer it. But it would be a bundle -- the two types of insurance are fundamentally different, since one pays a lump sum or equivalent (like life insurance) for a single event, and the other pays out many payments for multiple events. And immediately you're creating the concept that as aoon as anything happens, your insurance will go up, because the risk to the insurer that you'll not be paying them anymore has been pushed to another party. Hence, you're simply creating a situation where health insurance costs will generally be higher, with less people able to insure themselves, and only the people able to afford both the insurance and the insurance for the insurance able to ensure there's some sort of cap on their healthcare costs. More, you're discouraging routine healthcare, because it's immediately less in the interest of insurers to pay for it because of people's insurance on the insurance paying out, etc. AndrewC ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 2:32 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: Many people won't go for checkups if they have to pay out of pocket, and they will ignore dangerous conditions for too long. Did you read the article, or just the excerpts I posted? This was discussed in the article. Sure, evidence is that because you'd be punishing people financially when they wanted proper preventative care, they'll be paying out more in the longer run. No, there was nothing suggested that would punish people for preventative care. And you still have the exact same condition of many people being one illness from poverty, a refusal to cover pre-existing conditions and no way for poorer people to get the care they need for those conditions, leading to a need for chronic care rather than far cheaper accute care. Dealing with the poor was discussed in the article, as was mandatory catastrophic insurance for all. As for the other things, please see the article I referenced in another post about health-status insurance. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 2:38 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: And immediately you're creating the concept that as aoon as anything happens, your insurance will go up, because the risk to the insurer that you'll not be paying them anymore has been pushed to another party. I do not see how this follows. Perhaps you have misunderstood health-status insurance. Did you read the article? ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
Obama, yesterday, was right on target when he said there was no single silver bullet for this problem. But, we do know things can be better, because we are paying twice as much as the average developed country per person with worse than average results. I have heard, but have been too lazy to confirm, that there is a GDP per capita health care spending curve, and as a very affluent country the USA is almost right where it should be on that predictive model. What is whacked is that relative to our per capita spending (which meet expectations) we get crappy *public* health results. So health care savings probably are not in the works--unless we move off the health care spending / per capita income curve. We can improve typical health care outcomes, but that will produce a lot of health care reform losers. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On 16 Aug 2009 at 14:44, John Williams wrote: On Sun, Aug 16, 2009 at 2:32 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: Many people won't go for checkups if they have to pay out of pocket, and they will ignore dangerous conditions for too long. Did you read the article, or just the excerpts I posted? This was discussed in the article. Yes, you're simply refusing to accnowledge the actual results of the policys proposed... none of this is things which have not been seen when you push routine costs onto people and make new ways for them to be charged (as their status insurance can be cancelled, as well as their normal insurance). Sure, evidence is that because you'd be punishing people financially when they wanted proper preventative care, they'll be paying out more in the longer run. No, there was nothing suggested that would punish people for preventative care. Pushing routine prevenative costs onto people does exactly that, wereas basic cover being assured (companies cannot refuse to offer it) and a pool assigned to companies based on patient risk does the exact opposite (because it's in the company's interests to monitor acute conditions and to catch problems early, saving themselves money). And you still have the exact same condition of many people being one illness from poverty, a refusal to cover pre-existing conditions and no way for poorer people to get the care they need for those conditions, leading to a need for chronic care rather than far cheaper accute care. Dealing with the poor was discussed in the article, as was mandatory catastrophic insurance for all. As for the other things, please see the article I referenced in another post about health-status insurance. This isn't something you can say just concerns the poor, it affects the vast majority of Americans. And I've seen the article, it's simply wishful thinking that there has to be a way to Be Better. No, it'll just raise premiums and reduce cover again. AndrewC ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 3:34 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: Yes, you're simply refusing to accnowledge the actual results of the policys proposed... What exactly am I refusing to acknowledge? to be charged (as their status insurance can be cancelled, Health status insurance cancelled? Not if there is a contract. It is like life insurance. Do you worry about life insurance being cancelled? Pushing routine prevenative costs onto people does exactly that, Having people pay for a service is a punishment? So am I being punished when I pay my auto mechanic to change the oil? ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On 16 Aug 2009 at 15:52, John Williams wrote: On Sun, Aug 16, 2009 at 3:34 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: Yes, you're simply refusing to accnowledge the actual results of the policys proposed... What exactly am I refusing to acknowledge? That you'd simply once again reduce the number of people with proper insurance, drive older workers onto the grey market and reduce the scope of insurance-covered healthcare. to be charged (as their status insurance can be cancelled, Health status insurance cancelled? Not if there is a contract. It is like life insurance. Do you worry about life insurance being cancelled? As yes, good and equivalent example. Firstly, in many cases life insurance is unavaliable. Secondly, the premiums depend on precisely the same issues which drive up health insurance, so if you're a bad health risk or have prexisting conditions you're very unlikely to be able to get status coverage at a deacent price or at all in the first place, or if you can the amount of increae you could would be limited. Then there are exclusions which cover a lot of activites, and in many cases, for example, flatly exclude claims happening outside America. And yes, there's no reason to believe that they wouldn't be cancelled if the company providing health insurance claimed that there was a fraudlant application, because of course fraud on the policy means the insurance on the policy is invalid. And they can allways have their own standards to investigate as well, with their own cancelation procedures. Pushing routine prevenative costs onto people does exactly that, Having people pay for a service is a punishment? So am I being punished when I pay my auto mechanic to change the oil? I'd suggest you read up on the basics of preventative medicine, and look at the prices of simple doctor's visits in America. A better analogy is pay roads, where every major road is one. AndrewC Dawn Falcon ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
On 16 Aug 2009 at 11:45, dsummersmi...@comcast.net wrote: FWIW the _Atlantic_ article is well worth reading carefully. I've already forwarded the link with my recommendation to a couple of other lists, and got a couple of comments back. The problems the article lists are real; I won't argue that the present system is really messed up. However, the solution of having high deductables has been tried; and the results are counterprodutive. People under those conditions eschew paying for services until they reach crisis porportions, then they go in. They gamble that things will get better on their own, and if they lose, they only risk their deductable. Exactly! Except very often, if they lose, they have problems which will allways plague them or at the least will take longer and be more difficult to cure. before she went on to an even better hospital, and others who develop new products and are frustrated with how hard it is to get them past regulations and into use. To be fair, that problem is in no way limited to America. AndrewC ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On Sun, Aug 16, 2009 at 4:10 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: , so if you're a bad health risk or have prexisting conditions you're very unlikely to be able to get status coverage at a deacent price or at all in the first place, That is not the way health status insurance works. A pre-existing condition has little bearing on health status insurance. Health status insurance is insurance against an unexpected future chronic and costly condition developing. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
On 16 Aug 2009 at 16:30, John Williams wrote: On Sun, Aug 16, 2009 at 4:10 PM, Andrew Crystalldawnfal...@upliftwar.com wrote: , so if you're a bad health risk or have prexisting conditions you're very unlikely to be able to get status coverage at a deacent price or at all in the first place, That is not the way health status insurance works. A pre-existing condition has little bearing on health status insurance. Health status insurance is insurance against an unexpected future chronic and costly condition developing. Either it will have a higher premium to cover pre-existing conditions, or it only covers things not caused by the pre-existing condition. Given the Human body is a system, the second makes it trivial to deny claims because they're linked to the pre-existing condition. AndrewC ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
John Williams said the following on 8/16/2009 5:08 PM: On Sun, Aug 16, 2009 at 1:47 PM, David Hobbyhob...@newpaltz.edu wrote: It does strike me as a kludge, though. To continue your example of car insurance, I don't believe that anybody markets insurance against having your car insurance premiums rise dramatically. I do not think there is a as large a risk of such a dramatic rise in auto insurance premiums. Possibly auto insurance premiums could go up 5x after 2 DUI's, but short of that, I cannot think of anything that would result in such a thing. And that is relatively unlikely, compared to developing a chronic condition at some point in one's life. The analogy between auto and health insurance fails in one regard: Most of the time, a 5x increase in auto insurance premiums is a direct result of decisions by the covered person. Many of causes for increases in health insurance premiums are outside the control of the covered person. Should this play into the plans? I don't know. --[Lance] -- GPG Fingerprint: 409B A409 A38D 92BF 15D9 6EEE 9A82 F2AC 69AC 07B9 CACert.org Assurer ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
Lance A. Brown wrote: John Williams said the following on 8/16/2009 5:08 PM: On Sun, Aug 16, 2009 at 1:47 PM, David Hobbyhob...@newpaltz.edu wrote: It does strike me as a kludge, though. To continue your example of car insurance, I don't believe that anybody markets insurance against having your car insurance premiums rise dramatically. I do not think there is a as large a risk of such a dramatic rise in auto insurance premiums. Possibly auto insurance premiums could go up 5x after 2 DUI's, but short of that, I cannot think of anything that would result in such a thing. And that is relatively unlikely, compared to developing a chronic condition at some point in one's life. The analogy between auto and health insurance fails in one regard: Most of the time, a 5x increase in auto insurance premiums is a direct result of decisions by the covered person. Many of causes for increases in health insurance premiums are outside the control of the covered person. Should this play into the plans? I don't know. --[Lance] I've heard people say that insurance reform should discriminate between lifestyle risks and inherent risks. So insurance could charge someone with type II diabetes more, but not someone with type I diabetes. You could charge more to people who, smoke, are over weight, who don't exercise, or who practice un-safe sex. You couldn't charge more because of sex, age, or a prior cancer--except to the extent it was caused by a lifestyle choice. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
Trent Shipley wrote: Obama, yesterday, was right on target when he said there was no single silver bullet for this problem. But, we do know things can be better, because we are paying twice as much as the average developed country per person with worse than average results. I have heard, but have been too lazy to confirm, that there is a GDP per capita health care spending curve, and as a very affluent country the USA is almost right where it should be on that predictive model. What is whacked is that relative to our per capita spending (which meet expectations) we get crappy *public* health results. So health care savings probably are not in the works--unless we move off the health care spending / per capita income curve. We can improve typical health care outcomes, but that will produce a lot of health care reform losers. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com http://economix.blogs.nytimes.com/2008/11/14/why-does-us-health-care-cost-so-much-part-i/?apage=2 An additional insight from the graph, however, is that even after adjustment for differences in G.D.P. per capita, the United States in 2006 spent $1,895 more on health care than would have been predicted after such an adjustment. If G.D.P. per capita were the only factor driving the difference between United States health spending and that of other nations, the United States would be expected to have spent an average of only $4,819 per capita on health care rather than the $6,714 it actually spent. Health-services researchers call the difference between these numbers, here $1,895, “excess spending.” That term, however, is not meant to convey “excessive spending,” but merely a difference driven by factors other than G.D.P. per capita. Prominent among these other factors are: 1 trent:bad/. higher prices for the same health care goods and services than are paid in other countries for the same goods and services; 2 trent:bad/. significantly higher administrative overhead costs than are incurred in other countries with simpler health-insurance systems; 3 trent:good/. more widespread use of high-cost, high-tech equipment and procedures than are used in other countries; 4 trent:/good. higher treatment costs triggered by our uniquely American tort laws, which in the context of medicine can lead to “defensive medicine” — that is, the application of tests and procedures mainly as a defense against possible malpractice litigation, rather than as a clinical imperative. There are three other explanations that are widely — but erroneously — thought among non-experts to be cost drivers in the American health spending. To wit: 1. that the aging of our population drives health spending 2. that we get better quality from our health system than do other nations, and 3. that we get better health outcomes from our system ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: A Real Free Market in Health Care
John Williams wrote: On Wed, Aug 12, 2009 at 3:59 PM, Trent Shipleytship...@deru.com wrote: John Williams wrote: There are billions of people around the world with worse healthcare than virtually everyone in the United States. If the goal is to redistribute wealth to improve healthcare because of the belief that everyone should have a chance to live and be healthy, then why not focus on redistributing wealth from people in the US to the people in the world who have far worse health care than those in the US? Why not? The basic reason is that people are both tribal and self-interested. Would this be an accurate expansion of that? It is ethical to take wealth from some people in order to help other people with less resources, but only if all of those people are in the same political boundary? Whether it is ethical or not depends on what ethical system you adhere to. It sounds like a reasonable ethical proposition to me. Many Americans would find no fault with it. If so, then why is the political boundary more important than the fact that there are other people outside the political boundary who are much worse off than most of those inside? And when I say why, I am not looking for a sociological answer about tribes, but rather an argument about ethics. The people outside the boundary are not my responsibility. They are not my people. Furthermore, they don't participate in my moral economy. The status of the poor in my country has an immediate effect on me. I may be among the poor, and if I am not I may have feelings for my fellow countrymen, and even if I don't there is a real cost to tripping over the hungry and homeless in the streets, and the crime associated with extreme poverty. Poverty is a society wide expense. Poverty in another country is an external expense, especially if it is a result of unfair global capitalism favoring the metropole or of old style colonialism. And as every business student knows, and externalized cost is a good cost. ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
Re: The Role of Government in a Libertarian Free Market
Original Message: - From: Trent Shipley tship...@deru.com Date: Sun, 16 Aug 2009 15:19:16 -0700 To: brin-l@mccmedia.com Subject: Re: The Role of Government in a Libertarian Free Market Obama, yesterday, was right on target when he said there was no single silver bullet for this problem. But, we do know things can be better, because we are paying twice as much as the average developed country per person with worse than average results. I have heard, but have been too lazy to confirm, that there is a GDP per capita health care spending curve, and as a very affluent country the USA is almost right where it should be on that predictive model. Well, the curve would have to be a specially shaped curve for that to be true. In 2 minutes I found: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2004ra nk.html and https://www.cia.gov/library/publications/the-world-factbook/rankorder/2004ra nk.html Note how Norway per capita GDP is 20% higher than that of the US, yet it's percentage of GDP spending on health care is only 58%. Looking further we see that it's infant mortality rate is just of half of the US's, http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate and its life expectency is 19th in the world compared to the US's 45th http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy I've been to Norway many times and know a number of Norwegians. It's government is one of the more socialistic governments in Europe and is far more intrusive in the ecconomy than the US's. I can't do a scatter plot here, but, if you did a polynomial fit that predicted this, you would need as many orders as data points. :-) So, with only 5 minutes of work, I have pulled up data falsifying this propaganda. Dan M. Dan M. mail2web.com What can On Demand Business Solutions do for you? http://link.mail2web.com/Business/SharePoint ___ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
