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Convincing Liberals to Deregulate Health Care

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gotlucky Posted: Thu, Apr 19 2012 6:53 PM

I was thinking about some of the arguments that could be used to try and convince liberals to deregulate health care.  Some things I came up with:

Part of the problem is that not only does the American government regulate the supply of doctors and keeping it artificially low, but it also increases demand with many laws (e.g. Emergency Rooms cannot refuse to help, Massachusetts mandates each person have health insurance).  So, obviously, with supply low and demand high, it should come as no surprise that there are very high costs.

The problem of supply can be fixed easily, just stop regulating the supply of doctors.  Now, the first objection any good liberal will have is to exclaim, "But how will we protect people from quacks and bad doctors?!"  Firstly, the obvious response is, "How do you know your mechanic isn't screwing you now?  Don't you ask around for references?"  Another is to mention the Better Business Bureau.  But this does not ever really work.

So how do we make it a moral issue for the liberal?  Well, regulating the supply of doctors does not hurt the elite class and the wealthy.  They have the wealth and resources to obtain the best medical care possible.  No, regulating the supply hurts the middle and lower classes, as they are the people in society who have to keep track of their wealth and resources the most, and they do not always have the wealth to obtain good health care.  Now, that is why liberals say that we should regulate it, but what if you were to propose deregulating the supply?  Do people really need the best trained doctors for simple and common ailments?

Let's look at it.  If you want to check your eye prescription, you don't need an eye doctor anymore to do this (if it was ever needed).  Technicians actually do the checking.  They work the machines.  Well, you might have a doctor that does it personally, but many do not.  Also, many eye glasses stores have their own doctors available so that they can check your prescription on site.  Obviously, they do not need to be trained medical doctors in order to do this, though they may be now because of law.

Another thing to consider: EMTs.  They are not trained doctors, though they have some training.  But we entrust EMTs with emergency situations.  We won't trust people who are adequately skilled but not certified doctors for simple ailments, but we will trust people perhaps less knowledgable with our lives in emergency situations?

One more: My girlfriend was telling me about a book she read (I believe it was the book Complications), and the author was telling about some country where people, not trained doctors, were performing the same surgery over and over again.  They had lower failure rates than in America, where the surgeons are trained doctors.  I'll find the source for you all.  But wouldn't this fly in the face of everything the liberal expects?

Now to attack demand: for the liberal, it is obvious to believe that the state must pay for people's health care.  This is much harder to attack on a moral level.  So, I think the only way to really attack it is to point out what it was like before the state got involved.  Many of you have probably read Welfare before the Welfare State, but I suggest you read it if you haven't.

Does anyone have any other ideas on how to convince a liberal on this particular subject?

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Bert replied on Thu, Apr 19 2012 7:07 PM

Present them with facts that the healthcare industry has been more regulated and with increasing regulation and government influence the costs have gone up, simply show them that it's not a "free-market."  Break their fixed idea of what they believe it is, and show them what it really is.

For example,

Friedman noted that 56 percent of all hospitals in America were privately owned and for-profit in 1910. After 60 years of subsidies for government-run hospitals, the number had fallen to about 10 percent. It took decades, but by the early 1990s government had taken over almost the entire hospital industry. That small portion of the industry that remains for-profit is regulated in an extraordinarily heavy way by federal, state and local governments so that many (perhaps most) of the decisions made by hospital administrators have to do with regulatory compliance as opposed to patient/customer service in pursuit of profit. It is profit, of course, that is necessary for private-sector hospitals to have the wherewithal to pay for healthcare.

[...]

For example, while medical expenditures rose by 224 percent from 1965–1989, the number of hospital beds per 1,000 population fell by 44 percent and the number of beds occupied declined by 15 percent. Also during this time of almost complete governmental domination of the hospital industry (1944–1989), costs per patient-day rose almost 24-fold after inflation is taken into account.

As well as,

With all this regulation and expensive healthcare, Americans receive only a mediocre quality of care. The United States is far from achieving the lowest world infant mortality and death rates. Fatalities from incorrect healthcare treatment are the third-leading cause of death in the United States after heart disease and cancer. Over 225,000 people die each year from doctors' mistakes: 12,000 deaths occur each year due to unnecessary surgery; 7,000 deaths are due to medication errors in hospitals; 20,000 deaths are due to other hospital errors; 80,000 are due to infections in hospitals; and 106,000 due to the negative effects of drugs.

Instead of being on the defensive get on the offensive, and shoot back at them it's burdened with regulation and bureaucratic oversight.  If they try to rebuttle, ask them to explain how it's a "free-market" and not regulated.

EDIT: A while back I came across an article that surveyed doctors thoughts on more government regulation, and a lot of them had a sense of leaving the healthcare industry if it became "socialized" beyond what it is now.  If you can find sources from a doctors perspective on the negative influence of government oversight it may help.

I had always been impressed by the fact that there are a surprising number of individuals who never use their minds if they can avoid it, and an equal number who do use their minds, but in an amazingly stupid way. - Carl Jung, Man and His Symbols
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gotlucky replied on Thu, Apr 19 2012 7:18 PM

I especially like the first quote you provided, as it compares then and now.  Very good links, thanks!

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gotlucky replied on Thu, Apr 19 2012 7:50 PM

Nice, JJ.  yes

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Wheylous replied on Thu, Apr 19 2012 9:26 PM

Friedman noted that 56 percent of all hospitals in America were privately owned and for-profit in 1910. After 60 years of subsidies for government-run hospitals, the number had fallen to about 10 percent. It took decades, but by the early 1990s government had taken over almost the entire hospital industry.

Ah, yes. I too am fond of quoting that.

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Neodoxy replied on Thu, Apr 19 2012 10:06 PM

Healthcare is probably the most nonsensical subject floating around today in modern politics. The idea that the United States has a free market in healthcare is idiotic and the absolute failure of the healthcare industry in America and in other countries is a testament to the failure of government interaction within the market. 

  1. The government regulates who can become a doctor, which drives up the scarcity of doctors, which drives up the price.
  2. The government regulates certain procedures and who has to be present for certain operations. For instance, for procedure X, which a nurse or PA could deal with and instead a doctor must be present. This drives up scarcity, decreases supply, and raises price.
  3. Government implicitly subsidizes insurance companies by making such benefits tax-free. This adds a layer of bureaucracy where there wasn't one before and increases demand because now people don't have to pay out of pocket, instead things are covered by the insurance package. This increases demand and raises price.
  4. The FDA takes literally up to a decade to approve drugs. This means that  not only does it take new drugs a long time to come out, but it makes it harder to produce competing drugs, oftentimes granting monopolies in drug production, granting a monopoly price and increasing costs.
  5. The government dictates how many hospitals there can be in an area, decreasing supply and increasing costs.
  6. State governments oftentimes prohibit insurance companies from providing healthcare across state lines, limiting competition and granting a monopoly price.
  7. The government, state and federal, oftentimes provide subsidies for certain people receiving healthcare, increasing demand and increasing price.
  8. The government allows people to sue doctors ungodly amounts for "malpractice", causing doctors to have to charge more for their services in order to be able to pay their insurance and justify their continued practice, increasing price and decreasing supply. 
  9. The government often dictates what health insurance has to cover, increasing the price that health insurance has to charge for each unit of services
  10. The government prevents price discrimination on the part of health insurance companies. It's akin to having an unsafe driver. You have a person who has a higher chance of needing medical care and they're charged the same as a person who's in perfect health. The bad driver is charged the same as the safe driver, even though one has a much lower chance of paying than the other. This means that everyone, except those at a disadvantage, will be charged more. This oftentimes causes people to opt out of healthcare, because they're not likely to have anything bad happen to them, this means that the SAFE AND HEALTHY PEOPLE stop receiving health insurance, leaving the rest to pay higher premiums, probably higher than they would have been no mater who you are.
  11. The government forces hospitals to take people in emergency rooms no matter what, increasing demand from what it would have been. This increases demand and price.

Try this on your liberal friends:

This here's a supply and demand graph. It symbolizes the determinants of price. The government does EVERYTHING THAT IT CAN, everything that we've talked about, to move that there upward sloping curve to the left, and the downward sloping curve to the right. That results in A HIGHER PRICE. 

So either you acknowledge that the government is a great deal of the problem, or you deny supply and demand. I also find the simple argument: The market is cheap with most things, car insurance isn't exactly killer, but why health insurance? Why the health industry? 

This, in conjunction with the above causes, would lead one to believe that the problem is the government. "Capitalist Greed" doesn't exactly cover it. 

At last those coming came and they never looked back With blinding stars in their eyes but all they saw was black...
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Another thing to consider: EMTs.  They are not trained doctors, though they have some training.  But we entrust EMTs with emergency situations.  We won't trust people who are adequately skilled but not certified doctors for simple ailments, but we will trust people perhaps less knowledgable with our lives in emergency situations?

I'm a Medic and in a PA program for ER medicine - can you rephrase this question please.  I honestly don't understand it (as in, I am assuming I am reading it wrong) and how it relates to convining people in deregulated health care

"As in a kaleidoscope, the constellation of forces operating in the system as a whole is ever changing." - Ludwig Lachmann

"When A Man Dies A World Goes Out of Existence"  - GLS Shackle

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gotlucky replied on Fri, Apr 20 2012 6:10 AM

vive la insurrection:

I'm a Medic and in a PA program for ER medicine - can you rephrase this question please.  I honestly don't understand it (as in, I am assuming I am reading it wrong) and how it relates to convining people in deregulated health care

Certainly.  Obviously you are trained for emergency medical situations and are training to learn even more.  But God forbid if you were to treat low income patients without the proper licensing from the state.  Doesn't make sense that it should be that way.  Does that make more sense?

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lol, still don't know if I'm reading you.

 

Are you essentially saying there isn't any need to call the architect of a house if you're plumbing goes out - just call a plumber who probably even has a decent shot to solve your problem probably (though not neccisarily)  even better than the architect?  If that's the case, yes that is true

"As in a kaleidoscope, the constellation of forces operating in the system as a whole is ever changing." - Ludwig Lachmann

"When A Man Dies A World Goes Out of Existence"  - GLS Shackle

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...I wish we could stop calling them liberals, bastardizes the language. They are not liberals, they are moderate socialists. We are liberals.

apiarius delendus est, ursus esuriens continendus est
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I thought you were a "minarchist"?

 

 

 

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Neodoxy replied on Fri, Apr 20 2012 9:46 PM

Low blow James, low blow.

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Minarchist replied on Fri, Apr 20 2012 10:03 PM

I thought you were a "minarchist"?

I am, as I define the term - which I did in my first post and in my profile, as you well know.

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John James replied on Fri, Apr 20 2012 10:15 PM

Minarchist:
I thought you were a "minarchist"?

I am, as I define the term - which I did in my first post and in my profile, as you well know.

I wish people would stop making up their own definitions for words, "bastardizes the language."

 

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gotlucky replied on Fri, Apr 20 2012 11:23 PM

vive la insurrection:

Are you essentially saying there isn't any need to call the architect of a house if you're plumbing goes out - just call a plumber who probably even has a decent shot to solve your problem probably (though not neccisarily)  even better than the architect?  If that's the case, yes that is true

I think it's a pretty close analogy.  There are varying levels of knowledge in different professions.  For instance, in physics, you might have:

  1. world renowned researchers and/or world renowned professors
  2. somewhat recognized researchers and/or somewhat recognized professors
  3. researchers and/or professors
  4. graduate students
  5. undergraduate students
  6. high school teachers
  7. high school students

‚ÄčObviously, this order is not necessarily correct on an individual level, but it's probably accurately generally.  Suppose that you are studying physics and want a private tutor.  Which number on the list you would want as a tutor would depend upon your wants, needs, and resources.  If you are a high school student, you might actually settle for another high school student as your tutor.  If you are a graduate student, it's highly unlikely you would want a high school student as your tutor (the exception being if he is particularly knowledgable).  What the state does with medicine, is it decrees by law that you must have at the very least a researcher or professor as your private tutor, or you could have someone lower on the list as long as they are supervised by at least a researcher or professor.  That's what I see as unnecessary and wasteful in the medical world, especially for people in the lower class and middle class.

It would be wonderful if everyone had the knowledge of a world class researcher or professor, but it is not the case.  So why waste some people's skills because some other group of people have deemed it "bad" to do so?

Am I doing any better?

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Wanted to make sure you caugh this too.  Might prove useful.  Entertaining, and also tackles the most popular nonsense.

 

 

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NEPHiLiX replied on Sat, Apr 21 2012 5:25 AM

 

I've always found that experience of alternative systems is usually the best antitode to at least trip up the pro-regulation crowd. When you try and contradict them regarding the existing system, they have a million anecdotes and examples to throw at you to make you out to be some utopian dreamer. But share with them your knowledge of a system that flourishes without regulation and suddenly they're the ones at sea without an anchor or compass. 
 
I lived in Canada, the US and now I'm living in Korea and, I have to say, Korea has by far the best health care I've ever encountered in terms of availability, cost and quality. In two years, after at least a dozen visits to the doctor and two specialists (we have an infant), our total costs so far have yet to top $100 (including medication) after two years! On average, a visit to a premium doctor (one not covered by national health insurance) will run us about $3-4 and the medication will usually run an extra $2 or less. The equipment they use is cutting edge and everything is pristine (this is true even among non-premium doctors, but with premium doctors you get LCD screens playing nonstop Pororo in the waiting rooms even though you're never waiting longer than 5 minutes). The hospitals here are exceptional, and a one week stay in a private room costs less than a single half day spent in a 4-man common room at a US hospital. 
 
It's exceptionally affordable, there are no lines, and that's with no insurance. Yes it's true that basically everyone in Korea has national health insurance, but it actually only knocks the price down by about 10-20%. So rather than paying $5 you're paying $4.50 or $4. 
 
PS: the same goes for dentistry.
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Making the argument that midwives are banned by the government here is not a bad place to start IMO.  A lot of liberal women like midwives, but they wrongly think that the market has restricted them rather than the government.

Also, the poor and middle class WILL have to pay for public health care if it comes here as it is in other liberal countries.  Every country with public health insurance has higher payroll tax and a VAT as well as a more regressive income tax.  People making $50k/yr here would be paying at least 1/2 of their income in taxes if we had fully public health insurance.

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Yep, finally got it now.  Thanks

"As in a kaleidoscope, the constellation of forces operating in the system as a whole is ever changing." - Ludwig Lachmann

"When A Man Dies A World Goes Out of Existence"  - GLS Shackle

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