Great analysis! I didn't know many of the details, of course, but some years ago when I first heard the term "single payer" I thought: You want a single payer to pay for THIS? That poor payer!
I hadn't heard the Ed Lazear story about Gosplan's use of the Sears Catalog before. I had heard something similar: Will the world revolution encompass the whole world? No. We'll leave Switzerland capitalist so we know where to set prices.
On health care I once heard [for real], maybe later 1970's, a British communist visited the Soviet Union and needed some hospital treatment. Upon his return home he was asked how the Soviet medicine establishment was. He replied: No problem! Just like the NHS.
One of my pet peeves is this "Isn't (food, shelter, job, health care, ...) a basic human right?
My brutal answer is, everyone should have the right to live by themselves in a state of nature. But if they want to live in a society built by others, they have to contribute to that society. TANSTAAFL!
The companion answer is disgust at people who have such low opinions of us, their fellow human beings, that they think we will not help the destitute, that we will let people die in the gutter, and therefore government must force people to pay taxes so the kind, benevolent, all-seeing all-knowing government can provide the charity we would be glad to provide on our own. A friend delivers food and prescriptions on his snowmobile, no charge even for gasoline, just because he wants to. It's what people have done since time immemorial. The only people who get left out of personal charity are the hermits who don't want human friends and the criminals who don't deserve it. Even the hermits would find charity if they could tolerate accepting it.
Few would let a child near a red hot stove, yet we allow our politicians/lawyers near matters economic. We should not be surprised when terrible things happen.
I have long wondered why medical procedures have rediculous list prices and the Medicare/insurance cost is a single digit of the list price. Due to the excellent obfuscation by the providors and the government, it remains a mystery to me and many others. However, if you are hospital and your list price is a zillion dollars for a minor procedure then when you provide that minor procedure to an indigent you can claim that you have provided the community with a zillion dollars of free medical care. Also, how is it a hospital is a charity when it is run for the benefit of specialist physicians making seven-figures from that hospital?
I am a libertarian at heart, and my instincts agree with much said here. But I've never heard a fundamental question addressed. If there is not universal coverage - which does not need to mean providers - what are we do with people who chose not to pay for coverage? Unless we are willing to turn people away at the emergency room doors - "sorry, you chose not to be covered" - how does this work? If we're not prepared to allow people to pass away if they chose not to buy coverage, whether subsidized or other, and most of us can't quite bring ourselves to do this, what do we do with these people? How does this work without allowing people to pass away because of their choices, whether misguided or not?
Two comments - my wife had a spine procedure 6 years ago, the bills totaled $260,000. Then the “negotiated rate” was applied and it magically dropped to $56,000. Where did the missing $204,000 go? Would a person without insurance get stuck with the whole $260,000 bill? It’s all “funny money”.
The whole concept of insurance was to protect against low probability events that an individual couldn’t shoulder on their own (like one’s house burning down). And yet we seem to expect health insurance to pay for the routine costs of living like regular checkups, colds & vaccinations, or expect insurance to cover healthcare costs for the chronically ill (where losses are guaranteed - like buying fire insurance on a house that is already burning). This isn’t insurance, it’s a massively complex & inefficient tax system where the more affluent subsidize the less affluent. And by routing the routine healthcare costs through the bill insurance / deal with the rejection / get paid $0.50 on the dollar we have massively inflated costs.
Great analysis! I didn't know many of the details, of course, but some years ago when I first heard the term "single payer" I thought: You want a single payer to pay for THIS? That poor payer!
I hadn't heard the Ed Lazear story about Gosplan's use of the Sears Catalog before. I had heard something similar: Will the world revolution encompass the whole world? No. We'll leave Switzerland capitalist so we know where to set prices.
On health care I once heard [for real], maybe later 1970's, a British communist visited the Soviet Union and needed some hospital treatment. Upon his return home he was asked how the Soviet medicine establishment was. He replied: No problem! Just like the NHS.
You might want to check that link to " WSJ editorial board writes," as it appears to go to the US Health Care/Myth" site
One of my pet peeves is this "Isn't (food, shelter, job, health care, ...) a basic human right?
My brutal answer is, everyone should have the right to live by themselves in a state of nature. But if they want to live in a society built by others, they have to contribute to that society. TANSTAAFL!
The companion answer is disgust at people who have such low opinions of us, their fellow human beings, that they think we will not help the destitute, that we will let people die in the gutter, and therefore government must force people to pay taxes so the kind, benevolent, all-seeing all-knowing government can provide the charity we would be glad to provide on our own. A friend delivers food and prescriptions on his snowmobile, no charge even for gasoline, just because he wants to. It's what people have done since time immemorial. The only people who get left out of personal charity are the hermits who don't want human friends and the criminals who don't deserve it. Even the hermits would find charity if they could tolerate accepting it.
Few would let a child near a red hot stove, yet we allow our politicians/lawyers near matters economic. We should not be surprised when terrible things happen.
I have long wondered why medical procedures have rediculous list prices and the Medicare/insurance cost is a single digit of the list price. Due to the excellent obfuscation by the providors and the government, it remains a mystery to me and many others. However, if you are hospital and your list price is a zillion dollars for a minor procedure then when you provide that minor procedure to an indigent you can claim that you have provided the community with a zillion dollars of free medical care. Also, how is it a hospital is a charity when it is run for the benefit of specialist physicians making seven-figures from that hospital?
I am a libertarian at heart, and my instincts agree with much said here. But I've never heard a fundamental question addressed. If there is not universal coverage - which does not need to mean providers - what are we do with people who chose not to pay for coverage? Unless we are willing to turn people away at the emergency room doors - "sorry, you chose not to be covered" - how does this work? If we're not prepared to allow people to pass away if they chose not to buy coverage, whether subsidized or other, and most of us can't quite bring ourselves to do this, what do we do with these people? How does this work without allowing people to pass away because of their choices, whether misguided or not?
Two comments - my wife had a spine procedure 6 years ago, the bills totaled $260,000. Then the “negotiated rate” was applied and it magically dropped to $56,000. Where did the missing $204,000 go? Would a person without insurance get stuck with the whole $260,000 bill? It’s all “funny money”.
The whole concept of insurance was to protect against low probability events that an individual couldn’t shoulder on their own (like one’s house burning down). And yet we seem to expect health insurance to pay for the routine costs of living like regular checkups, colds & vaccinations, or expect insurance to cover healthcare costs for the chronically ill (where losses are guaranteed - like buying fire insurance on a house that is already burning). This isn’t insurance, it’s a massively complex & inefficient tax system where the more affluent subsidize the less affluent. And by routing the routine healthcare costs through the bill insurance / deal with the rejection / get paid $0.50 on the dollar we have massively inflated costs.