Economics Questions

Re: and...another debate with polish friend

cab21 — Thu, 13 Sep 2012 10:16:48 GMT

if a facist system were to go into place,

sure, that could cut costs on our current medical system

put in features such as

eugenics,

population control

mandated health and diet programs

basicly, if the state decides when people live or die, bullets are cheap, euthanaisa is cheap.

Re: and...another debate with polish friend

David B — Wed, 12 Sep 2012 17:08:09 GMT

It absolutely cannot be better. If you remove the profit motive quality and quantity go down. It's a necessary fact. In fact grey and black markets in will appear. You seemed to say what the problem is and he just isn't getting it, it's the price problem. Prices give us all of the aggregated information about the market for the goods and services. The high prices currently in the system seem to be signalling that there's a greater demand for goods and services and there is a woefully small supply.

Market's could rapidly fulfill these needs. If one goes and looks we'll find that regulations in healthcare are causing supply issues, profit issues, insurance issues, and forcing prices to remain high or grow. It can only get worse. If one completely socializes medicine you will have two sources of medicine. One (socialist) that's constantly shrinking in quantity and degrading in quality. If the doctor's can't make profits to account for the high demand and the frustratingly deteriorating quality of the service they can provide, they will leave the field. We will lose a higher percentage of the "best and brightest" to other professions.

The other system will be a black market one that rich people have access to. But the underground/illegal nature of that market will also be a damper on quality. New research and drugs will not appear in the market at a high rate and will not be safe for consumers. They'll get FDA approval with a long list of side effects (including death), and if the state doctor prescribes it, and you die, you'll have no recourse, because it was approved and legitimate.

It takes time for the socialist economic model to destroy the existing attitudes, capital, and work ethic. During that time it may appear to be "working", but slowly it will eat away at the healthy core of any system it takes over, fascist control or socialist control is irrelevant the side effects are the same. The health care system is decaying at the very time when demand is booming. Socializing it just accelerates the implosion. So the question I have for your friend is, just how quickly do you want the baby boomers to die off? If you want it to be faster, then let's socialize medicine in the US.

Re: and...another debate with polish friend

xahrx — Wed, 12 Sep 2012 16:42:26 GMT

"Remember, he is not necessarily claiming that it is working, just that it works better than america's more fascist style of medicine. "

That may be the case. If Social Security were changed from the cluster #$%@ it is now to a direct welfare transfer program for the elderly, it might last a while longer before imploding. Put a means test on it, it may last indefinitely simply because people are willing to tolerate it for longer. Seems to me the basic premise would then be that simple short cons are easier to maintain and longer lasting that complex long cons; your basic ponzi scheme seems to outperform the whole Nigerian Prince thing. From what I know of some of the foreign medical systems, they are much simpler, take from the rich to give to the poor types of programs at base.

Re: and...another debate with polish friend

The Texas Trigger — Wed, 12 Sep 2012 08:06:28 GMT

Yeah, this is a problem I ran into also.

Remember, he is not necessarily claiming that it is working, just that it works better than america's more fascist style of medicine.

It's hard to keep in mind what the debate is really about: his claim that for a medical system the Free Market < Socialized medicine < American Fascism.

Re: and...another debate with polish friend

cab21 — Wed, 12 Sep 2012 07:31:00 GMT

i don't understand how the countries can be in debt and then say their system is working?

and...another debate with polish friend

The Texas Trigger — Wed, 12 Sep 2012 06:53:03 GMT

Ok, so I will try to be brief. Just another debate with my Polish friend. Interesting debate I think also.

it is about socialized medicine. He knows that obamacare is not socialized medicine.

This is the question of the debate: Is the healthcare system of the US pre-Obamacare better than a full-fledged socialized, single-payer, "tax-payer funded" system?

Here are the beginning assumptions (some of which i disagreed with but felt that accepting them for the sake of argument didn't render the debate totally null)

(1) We both agree that a totally free market healthcare system would be better than a socialized one - I have convinced him of this a while ago.

(2) Where we disagree (but cannot know one way or the other) is his assumption that, in reality, there is almost no hope of ever achieving a totally free-market healthcare system. I suppose I agree this is true if there is still a state in existence at all, but that point aside, he asked that I assume that it is not possible that we could have a free-market system (as in the public and the powers that be would never allow it to be totally free). Because the debate was which is better - current vs socialized - I accepted this assumption for the sake of argument. This also made the debate very difficult, because my natural tendency is to go to "well, you also have to get rid of this thing, which causes that." But, I had to stick to defending all of the bullshit in the current system because my contention was that it is still better.

I will be summarizing a lot, as the debate was about two hours

Ok, so it began with his saying that, basically, the pre-obama care US healthcare system was very Fascist. "Yes," he agreed, "patents, licensing, and third party payers create problems that are terrible." We agreed on this. He claimed that, if for the sake of argument a free-market isn't a realistic possibility in the near-future, then totally socializing the system over the current system, or even over Obamacare, would be better.

He claimed, "the reason we would be better off in a totally socialized system is because the current system has resulted in exorbatantly high prices for medicine."

I agreed on the latter half of his assertion that our current system did result in unnecessarily high prices. then asked, "why do you think that is?

Him: "I don't know for sure, but I can clearly see that the prices are high. I would guess its due to protections the government has granted to the AMA and big pharma, but most of all, I suspect that this third party payer system has resulted in an environment where people will abuse their health insurance and also, the doctors will order marginally helpful tests when compared to their prices, knowing the insurance companies will pay it, and because of this, the patient won't refuse the various tests and drugs if it means a better possibility of health at no extra cost past the premium one way or the other."

I agreed, telling him that he was right that it was mainly for these reasons that medicine is so expensive, among a few others. So, I asked, "how/why would socializing medicine fix this problem? I mean, isn't a single payer functionally the same thing, at least in that by socializing medicine you are not eliminating the root cause of the problem: When someone else pays for something, it kills consumer price sensitivity, resulting in spikes in demand, causing the market to respond with higher prices in order to slow down the demand thus preserving that scarce resource? The problem is, these higher prices will not result in a decrease in demand to any great degree because someone else is still paying for the medicine. Price sensitivity has not changed in any substantive way. So, if anything, socializing medicine will only compound the problem, because you are just adding that many more people to the pool of 'free' users."

His reply: "I agree that the existence of a third party or single payer will have the same effect in that there will be massive inefficiency in the allocation of resources, but I think there will be a few differences. For one, american's need to stop viewing medicine as a traditional market or a market at all."

Me: "woah, ok, it doesnt matter what you want to call it, be it a market or a dildo. the fact is that medicine is a good because it is compromised of many, many scarce resources. These have to be allocated somehow, be it through the market or through some state-scheme. Lets be clear about that first."

Him: Well, yeah, but ok, let me get back to the real differences. In a socialized healthcare system, you are wrong. Costs would not go up as much as the current system because if the state is responsible for allocating the care, two things will be massively different. First, doctors will be paid a flat salary - this will decrease or totally eliminate their incentive to perform marginally unproductive tests. This will not only result in lower prices, but also will preserve scarce resources like drugs and usage of things like MRI machines and other tests because of this disincentive to offer and prescribe them just because they know the patient will accept them. I have seen Vanderbilt hospital voluntarily switch to a salary system for their doctors and I can tell the prices there are more reasonable" This didn't make a lot of sense to me, considering one hospital switching to a salary system wouldn’t affect over-all prices much.

Basically his argument here is "the government will be sensitive to price because they have to be, but insurance companies aren't" He did make the comment that sometimes insurance companies are, like when they refuse to pay for a test or procedure…after it has been performed. This assertion led to his saying that, "because of this, the people get fucked even harder because they think, and expect, that their insurance will pay for all this, then they get stuck with the bill after the test or procedure has been performed. so, essentially, he is that that we can rely on the government to always pay, but clearly not the insurers."

I asked him: "perhaps in theory these changes might lower costs, but only if they are actually followed. Corruption will abound, much as it does now, but probably more so, and once you hand over that much more power to the politicians, they have that much more power with which different factions will vie for influence over." He admitted this could be true, and accepted his nirvana fallacy. I also added that “when public schools were first started in this country, it was believed by many that, one, education should be a right, and, two, that this would reduce prices because of economies of scale. Of course, it didn’t work out this way because we know today that public schools are vastly incapable of educating children well compared to private schools and the average cost to educate one kid in a public school is ten times that of the private school cost. This will apply in medicine as well, because they are, after all, both scarce goods.”

There is perhaps more I could have said but at the moment I couldn't think of anything. Let me know how you all would have responded to this claim.

He also claimed, "At least in a socialized system, the poor can expect some treatment, even if there is a slight line. Right now, if you don't have health insurance in this country, you are just fucked. And, even if you do, you might be. If Lisa (his wife) and I were to get in a car accident, and the medical bill was a total of $200,000, we have to pay the first 20%. This debt of $40,000 would ruin us financially. Living in Poland, under its socialized healthcare system, I knew pretty certainly that if that same accident occurred, I would be taken care of and that debt would be non-existent."

I replied, "That is, of course, if there is an emergency room to accept you when you need it."

Him: "There are no real lines, at least not near the kind that American's fear."

He would later recant this claim when I rhetorically backed him into a corner, and his argument necessitated that he admit it. I will get to that in a bit. This happened because for pretty much the rest of the argument, I tried to make the calculation problem argument. He admitted to the argument's validity, but claimed the same argument could be applied to the current system. I admitted this was true to some extent, but kept harping on the point that socializing medicine would simply compound the third-party payer problem to a greater degree, and we went in circles.

His main line of defense was that prices of medicine in other countries with socialized medicine are not nearly as high as they are here, and that their systems appear to work better than ours.

I replied that there is really no way to know that because in a socialized market, there are no prices, which is the problem.

Him: "What do you mean there are no prices? Someone produces the medicine or services and they are paid by the state. whatever the state pays, that is the price."

Me: "yes, but what I mean is that because no one in the market directly pays these prices, we dont know what they are, and even the government has no rational price because they either tax, borrow, or print the money to pay them. There are no rational prices because there is no coherent, systematic, rational price system"

Finally, as I stated earlier, I got him to admit that there are lines for care because he said, "Look, the Polish system works great because we don’t have this exorbitant use of resources like we do here. This is because Polish people know that they better not get sick or hurt themselves or they will be waiting while."

I laughed and said, that kind of like saying, "no one goes to that bar anymore because its so damn crowded." he didn't entirely understand, but then said, "Now, our emergency room never has lines. You can always bet that you will get in there in a reasonable time-frame, easily comparable to the US."

A lot of his comebacks essentially were, "you don't know what you are talking about. I've lived under both systems, and socialization is better than fascism." Argument form authority, but not totally with any merit; I have only second hand accounts of the lines, I have never personally experienced them. However, to this, I tried to explain that he could still not answer the main logical points against SM, and that his evidence was largely empirical. I tried to tell him that you can compare our system to Poland's or Canada's but there are literally billions of variables other than the healthcare system that will effect over all health, and that is if we assume we can objectively define what the picture of god health is. When you compare two countries, such other variables are dietary, exercise, smoking, and lifestyle habits, as well as cultural and environmental factors. I don't think he totally bought this argument either.

In the end, I did admit that, “for a time, socialized medicine may improve the lot of the lives of a sizeable portion of the American population. The real question then might be, ‘how long can this last?’. If we want to talk about empirical evidence, just look at the sheer dollar figures associated with the unfunded liabilities of social security, medicare, and Medicaid alone. They are roughly standing at $122 trillion. These are essentially aspects and minor experiments in socialized healthcare (barring perhaps SS), and what these programs pertain to comprise a very small portion of what our healthcare industry treats and covers. Imagine if the entire system were put in the care of the government, given these numbers. We simply cannot afford to do this. Other countries have money to some degree.”

Him: “we have money, we are one of the wealthiest countries in the world.”

Me: “Man, I know that you know that is an illusion of our fiscal policies and inflationary practices in hoisting up our industries. I know this because we talk about it all the time, and for you to say otherwise is intellectually dishonest. Compared to our debts, and liabilities, we are broke as hell.”

He admitted this to be true

I said, “Clearly our government has shown severe ineptitude in its ability to budget for these programs with a relatively small reach into the medical industry. Imagine if they had their hands in the entire thing.”

Him: “Well, we could just continue our inflationary practices to pay for this stuff. I can think of many worst projects we spend our money on, like the military industrial complex. That is much more wasteful. We could cut from those programs.”

Me: “that doesn’t work on me because you know I think that is just as wasteful. And if you wanna talk about reality, do you really believe they will cut from these programs? No way. So, since you admit that the only way we could pay for this stuff is through more borrowing, inflation and Ponzi scheming, then you must admit that in the long run it would make things much worst for everybody, screwing hardest those who rely on the SM the most. Question is, are you willing to take a short-lived minor improvement in over-all health care availability for a few people, and maybe even you, at the cost of totally ruining the economy once and for all, if not for yourself, then for your children and grandchildren?”

Finally, he admitted I had a god point, but kept on. I don’t know how I could have handled it much better…I just don’t get it. He still claimed prices would fall, compensating for the hikes in taxes or inflation. I also think his ER assertion is dubious, but I don’t have the evidence to back this up.