Economics Questions

Re: Once and for all: the waiting room question for soc. Health care

Graham Wright — Tue, 25 Sep 2012 22:17:46 GMT

The Texas Trigger:
It is often asserted by Americans who oppose universal healthcare that the lines are atrocious in countries with universal healthcare. In the tradition of Misesian Praxeology, this assertion makes sense to me; it seems valid and logical no matter what empirical proof one may offer to the contrary.

This is an error. Praxeology tells us a free market in healthcare - and everything else - will more efficiently satisfy consumer demands than a regulated market or socialised market in healthcare. It doesn't tell us waiting lines will necessarily be longer with socialised healthcare. Imagine if government spent it's whole budget on healthcare - they may be able to lower waiting times practically to zero. The question you should ask anyone claiming low waiting lines under socialised healthcare make socialised healthcare preferable is: at what cost?

The UK government spent £119bn ($192bn) - 18% of it's budget - on healthcare in 2009. That is about £1919 ($3111) per person per year. Out of curiosity, how does that compare to the American regulated market? (See Jack Roberts' post describing what we get for that.)

Re: Once and for all: the waiting room question for soc. Health care

Fool on the Hill — Sat, 22 Sep 2012 20:50:49 GMT

You mean like for an ebook reader (excuse my technological ignorance)? This site has a lot of them as online html, and this site has some available for download. I'm not sure what the format is of the latter. At least some of them do appear to be in the public domain.

Re: Once and for all: the waiting room question for soc. Health care

xahrx — Sat, 22 Sep 2012 19:44:45 GMT

@Fool on the Hill

Do you know of a convenient spot that offers Illich's books in eformat for free? I'm not sure of their copyright status and Amazon charges for them, but I've seen them charge for works not under copyright and I'm just making sure before I order. Obviously this one seems to be free at the site you linked to but it's just listed as out of print, not public domain.

Re: Once and for all: the waiting room question for soc. Health care

Fool on the Hill — Sat, 22 Sep 2012 18:25:49 GMT

This article might interest you :

Is It the Epidemiologists’ Elusive “Fundamental Cause” of Social Class Inequalities in Health ?

That does look interesting, thanks.

I've also been wanting to read this book.

Re: Once and for all: the waiting room question for soc. Health care

xahrx — Sat, 22 Sep 2012 16:37:19 GMT

Finally, we actually get an answer. Am I right that you are basically saying that there is no clear or definitive evidence to turn to to say that lines and waiting times are much (if any) worst in universal countries than they are compared to the Current U.S. system.

No idea. Every 'free market' think tank who has looked at it says the socialized lines are longer, every left wing think tank says they are comparable or shorter. It seems to be an issue where depending on how you look at the info, you can get the answer you want. And again, it's irrelevant.

The reason I feel this is important is because (I WILL SAY IT ONE MORE TIME) many on this forum seem to imply (and many neocons explicitly state) that lines and waiting times in universal systems are longer than they are here in the U.S. currently.

So because some people mistakenly argue over irrelevanies, so should I?

Re: Once and for all: the waiting room question for soc. Health care

Rodolphe Topffer — Sat, 22 Sep 2012 15:04:21 GMT

Fool on the Hill,

This article might interest you :

Is It the Epidemiologists’ Elusive “Fundamental Cause” of Social Class Inequalities in Health ?

The introduction of Medicaid and Medicare in the United States during the 1960s soon led to the poor making as many physician visits per year as the non-poor, but large class differentials in health remained — even when the poor began to visit physicians at a higher rate than the non-poor (Rundall & Wheeler, 1979, p. 397). Great Britain and other countries that had expected to break the link between class and health by providing universal health care were dismayed when the disparities in health not only failed to shrink but even grew (see The Black Report by Townsend & Davidson, 1982; also Link & Phelan, 1995, p. 86; Marmot, Kogevinas, & Elston, 1987, p. 132; Susser, Watson, & Hopper, 1985, p. 237).

… equalizing the availability of health care does not equalize its use. Perhaps most importantly, less educated and lower income individuals seek preventive health care (as distinct from curative care) less often than do better educated or higher income persons, even when care is free (Adler, Boyce, Chesney, Folkman, & Syme, 1993; Goldenberg, Patterson, & Freese, 1992; Rundall & Wheeler, 1979; Susser et al., 1985, p. 253; Townsend & Davidson, 1982, ch. 4).

Second, greater use of medical care does not necessarily improve health (Marmot et al., 1987, p. 132; Valdez, Rogers, Keeler, Lohr, & Newhouse, 1985). To illustrate, when a large federally-funded RAND-conducted randomized controlled experiment tested the effects of subsidizing health care costs at different levels in six cities across the United States, participants with free care used more medical care than those with only partly subsidized care, but their health was no better after two years. Participants with free care had indiscriminately increased their use of inappropriate as well as appropriate care (Lohr et al., 1986, p. 72).

Re: Once and for all: the waiting room question for soc. Health care

Kelvin Silva — Sat, 22 Sep 2012 04:19:41 GMT

I think the biggest problem is that people think our fascist healthcare system is "free market".

Re: Once and for all: the waiting room question for soc. Health care

Fool on the Hill — Sat, 22 Sep 2012 03:49:18 GMT

You really don't see any hole in such a statement? The coffee in your office has sufficiently limited demand and abundant supply that it's effectively like water or air. But only because its demand is limited to those allowed into your office. If you opened yourselves up to the general public for coffee, supply would no longer be sufficient and you'd certainly have lines.

The law of supply and demand would take your coffee scenario and say that demand isn't elastic as the price drops but static. Thus, free coffee in your office doesn't result in massively more coffee consumption such that the company paying for it limits supply.

However, with health-care, the costs are virtually limitless. You could spend millions on a single person. And healthcare generally can be consumed in far greater amounts than currently were it 'free.' Which is to say demand is most likely quite elastic. The result can only be lines. This is why other countries have waiting times and mandatory tracks to procedures that the US does not have. And why there's no lines for your in-house coffee.

Well, that's my point. You can't simply say that since the price goes down, demand must go up. You have to look at the particulars of the situation. It's quite possible that in the case of healthcare the lines could increase. But we can't simply dismiss any empirical evidence that lines aren't longer. The empirical evidence tells us whether there are limits to demand in each particular case. In the case of the coffee, the empirical evidence tells us that there are limits. In the case of healthcare, it sounds like it is a bit more debatable.

Re: Once and for all: the waiting room question for soc. Health care

Anenome — Sat, 22 Sep 2012 03:14:28 GMT

Fool on the Hill:

For me, going to the doctor is a relatively unpleasant activity. Free isn't enough. You would have to pay me to go more.

That's fine, but it just indicates that you value personal comfort over the good called medical service. Some people are lactose intolerant enough to turn down free ice-cream as well. I'm not saying that you personally would use more medical service necessarily, but your original argument contained an implied universal statement of how all people might act should healthcare be free.

You're right that even were it free, the annoyance of it will still drive many off. But when it does in fact become free, the medical institutionas will probably seek to make it many times more annoying, out of sheer defense of being overwhelmed.

Fool on the Hill:

Anen: "If the perceived cost is zero, demand will rise concomitantly. This is why any 'free' scheme contains 'cost controls' which are a polite way of saying price controls and supply controls."

Not necessarily true. The coffee in my office is free but there's never a line, and there are no price controls. Yet the Starbucks outside always has a huge line in the morning.

You really don't see any hole in such a statement? The coffee in your office has sufficiently limited demand and abundant supply that it's effectively like water or air. But only because its demand is limited to those allowed into your office. If you opened yourselves up to the general public for coffee, supply would no longer be sufficient and you'd certainly have lines.

The law of supply and demand would take your coffee scenario and say that demand isn't elastic as the price drops but static. Thus, free coffee in your office doesn't result in massively more coffee consumption such that the company paying for it limits supply.

However, with health-care, the costs are virtually limitless. You could spend millions on a single person. And healthcare generally can be consumed in far greater amounts than currently were it 'free.' Which is to say demand is most likely quite elastic. The result can only be lines. This is why other countries have waiting times and mandatory tracks to procedures that the US does not have. And why there's no lines for your in-house coffee.

Re: Once and for all: the waiting room question for soc. Health care

Kelvin Silva — Sat, 22 Sep 2012 03:14:25 GMT

people often ignore that the us population is bigger than that of sweden, norway, finland, the places with government healthcare.

Re: Once and for all: the waiting room question for soc. Health care

Fool on the Hill — Sat, 22 Sep 2012 02:40:09 GMT

For me, going to the doctor is a relatively unpleasant activity. Free isn't enough. You would have to pay me to go more.

If the perceived cost is zero, demand will rise concomitantly. This is why any 'free' scheme contains 'cost controls' which are a polite way of saying price controls and supply controls.

Not necessarily true. The coffee in my office is free but there's never a line, and there are no price controls. Yet the Starbucks outside always has a huge line in the morning.

Re: Once and for all: the waiting room question for soc. Health care

Anenome — Sat, 22 Sep 2012 02:23:07 GMT

Fool on the Hill:

I don't think its logically necessary that universal healthcare would have longer lines. If healthcare were free, I probably wouldn't go any more than I do now.

Law of supply and demand says otherwise.

If the perceived cost is zero, demand will rise concomitantly. This is why any 'free' scheme contains 'cost controls' which are a polite way of saying price controls and supply controls.

Re: Once and for all: the waiting room question for soc. Health care

Fool on the Hill — Sat, 22 Sep 2012 02:17:17 GMT

I don't think its logically necessary that universal healthcare would have longer lines. If healthcare were free, I probably wouldn't go any more than I do now.

Re: Once and for all: the waiting room question for soc. Health care

Esuric — Fri, 21 Sep 2012 22:47:54 GMT

This from someone who can properly define neither "slave" nor pure, organic "capitalism" in a coherent, meaningful form.

Prove it.

Re: Once and for all: the waiting room question for soc. Health care

Anenome — Fri, 21 Sep 2012 20:44:08 GMT

It's not just wait times, there's hidden "waiting" you could say.

Like, there are rules and regs that certain procedures can't be done until you've done x, y, and z. And that only the absolutely neediest can have X done.

So, ultimately it's gov making decisions for doctors and patients, and actually removing control from patients by disallowing what doctors can offer to patients and when.

So, often the patients won't even realize they're receiving substandard care because the doctors are responding to incentives and force applied to them by the gov, thus hiding the coercion from the patient.

In terms of market distortions, it's exactly that, and directly impacts care.