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Post 0

Saturday, June 9, 2012 - 3:23pmSanction this postReply
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I received this from an old high school classmate today living in Canada who praised the socialized medicine system there:

Canadians have voted to support socialized medicine for many years. Americans have not. It's about that simple, don't you think? Those who live in a society that prefers to have that system, may have it. Those who prefer not to, have another system. My husband's the most Ayn Rand worshipping conservative businessman on the planet. And yet, he votes to support social medicine and public education - in spite of the fact that this costs him over 50K/year in federal personal taxes, plus whatever taxes the company pays. He believes that a well educated community is to his own benefit as a member of the community, and as far as the socialized medicine is concerned, it's simply a matter of math. America is currently paying a great deal more per capita on healthcare - out of the taxpayer pocket - than Canada pays. These numbers are easily available should you choose to inform yourself and do the per capita comparison.

Ugh. I hate arguments like these. I did kindly inform this woman that her husband obviously does not understand Ayn Rand. I have no interest in a protracted argument as it would waste both our times. But I thought I would post it here for anyone who wants to pick it to pieces. I have better things to do.

I admit this might belong in Dissent since it could potentially draw trolls favoring the italicized view, but I will take a chance and post it to the General Forum for a wider audience.

(Edited by Luke Setzer on 6/09, 3:35pm)




Post 1

Saturday, June 9, 2012 - 4:12pmSanction this postReply
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There is only one passage I want to pick tonight:

America is currently paying a great deal more per capita on healthcare - out of the taxpayer pocket - than Canada pays.

Repeal Medicare and Medicaid and watch that number drop drastically.



Post 2

Saturday, June 9, 2012 - 4:28pmSanction this postReply
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We also pay far more per capita on government provided primary education. That doesn't mean it is working at all, much less being better than free choices in a free market.

We also have an out-of-control tort system that is a price driver in medicine that other countries don't have (since they have adopted loser-pays tort systems).

In our country which is an awful mixture of private and public, part of the total cost is funding research through heavy medical costs at a consumer level (and driving the costs still higher with much of the research being required to satisfy FDA regulations - and our resulting medical technology after we pay for it, becomes a nearly free product to other countries.

Canada to America is simply an apples and oranges type of comparison without more specific criteria. I notice the person did not compare outcomes here versus there (like average longevity after cancer diagnosis) or wait times for service.

We should compare America today with America before we socialized much of our health care. We should project what the cost and speed of implementing new technology would be without the burden of too many and too penalizing a regulation.



Post 3

Saturday, June 9, 2012 - 7:07pmSanction this postReply
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Another passage:

Canadians have voted to support socialized medicine for many years. Americans have not. It's about that simple, don't you think? Those who live in a society that prefers to have that system, may have it. Those who prefer not to, have another system.

This is loaded language that makes no mention of natural rights, the proper role of government, the doctor as "The Forgotten Man" of socialized medicine, etc. This is a purely moral argument that carries no weight with pragmatists. But it warrants a mention anyway.



Post 4

Saturday, June 9, 2012 - 8:59pmSanction this postReply
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You are right, Luke. That argument avoids the simple fact that a majority can crush the rights of individuals. If a majority of the residents of a village vote to lynch individuals with black skin, does that make it right?



Post 5

Sunday, June 10, 2012 - 2:23amSanction this postReply
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I shared Post 0 of this thread privately with several local Ayn Rand fans I know who "get it" and this reply deserved a share:

I survived the growth of Socialism in England just after the Second World War, and was very disgusted with the country and its people for voting the Socialists into power, over Winston Churchill who had just won the war against Germany for them. The communistic traits of the Socialists did a good job of trouncing the country's economy until it was straightened out later by Margaret Thatcher. People there still have a tendency to think that Socialism can give everyone something for nothing. So I have little sympathy for the Canadians who deserve what they get, and no patience for people who think the way described in your link. They are not funny, just deranged. They do not realize that Trotsky and his followers mislead them with all those dreams induced by what they think are entitlements. They are full of false hopes, and I do not propose to spend any more brain power thinking about it. It just makes me angry.

I have a rather rude mathematical expression to give to those people:

8/3(pie)(r)cubed

that is not one, but two, gonads, but this computer does not have the choice of font or formatting to create and send the text as I want to express it.


I do not know how to do that expression in HTML either but perhaps someone here does.

To clarify, the quoted material in Post 0 came from a classmate from my "gifted" high school, the North Carolina School of Science and Mathematics (NCSSM). Among other "privileges" we enjoyed, we studied the "revolutionary breakthrough" American history text (at the time) A People's History of the United States by Howard Zinn. I do not know what texts they use now for American Studies, but a recent graduate said Zinn was not among them, thankfully. The indoctrinating effects of government schools on young minds have effects that last a lifetime.

(Edited by Luke Setzer on 6/10, 2:29am)




Post 6

Sunday, June 10, 2012 - 8:27amSanction this postReply
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Luke,
There is only one passage I want to pick tonight:

America is currently paying a great deal more per capita on healthcare - out of the taxpayer pocket - than Canada pays.
 
...
 
Another passage:

Canadians have voted to support socialized medicine for many years. Americans have not. It's about that simple, don't you think? Those who live in a society that prefers to have that system, may have it. Those who prefer not to, have another system.
In some respects, the Canadian health care system approximates a free market better than does the US health care system. This is not an indictment of a free market system, it is an endorsement of it. For instance, in Canada, health care coverage is portable across the provinces of the country. This is not true in the US, where government has forced monopolies that operate along state lines. Also, if you track health care spending in Canada since the 1980s, more and more of the overall medical costs are getting taken up by private consumers in Canada. This is not true in the US.

Note how this affects the relative proportion of spending taken up by the government. If private consumers start paying more of the bill, this relieves pressure off of the government for footing the bill, even if total medical costs are slowly rising overall. It makes it seem like Canadians are getting more for less.

Also, Steve's points about tort reform and long wait times, and your point about Medicaid/Medicare, are also key. In Canada, if you have a grievance, you appeal the government -- i.e., you "fight City Hall." That keeps costs down because individuals alone propose no financial threat to "City Hall." Also in Canada, both federal and provincial lawmakers point fingers at each other regarding blame for rising health care costs -- any cost rise in health care means that other government programs take a hit. This is market dynamics in a zero-sum domain. You can't have "out-of-control" health care costs in Canada because ... the market for all other government services would have to shrivel up.

The pressure from the "competition" of various government services in Canada partly explains why medical costs are lower there. In the US, our government doesn't care about the cost of things. We just run up a government credit card. This is reflected in the disparity of national debt between Canada and the US. So, in many ways, the apparent superiority of the Canadian system is not because there is more nanny-statism there ...

... it's because there are more active market forces there.

In other words, the reason that medical costs are higher here is not because of market forces, but because we have more unchecked nanny-statism at the precise pressure points that would lead to continually-rising costs.

Ed

Related Links
Health Care Abroad: Canada

HEALTH CARE COST COMPARISON OF THE UNITED STATES AND CANADA

House passes health care cost-control bill

Lowering the Cost of Health Care




Post 7

Sunday, June 10, 2012 - 9:00amSanction this postReply
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This dialogue arose because a mutual classmate has a son with brain cancer and lives in the United States. Some of us made donations to the child's charity fund via Facebook and the Canadian classmate posted some kind of rant there about how they do not have this problem in Canada because of socialized medicine. I did not want to pollute the thread with a debate so I informed her privately that I did not want to ague the matter but simply wanted to let her know that not all of us agree with her viewpoint. Despite my request for no argument, she argued via Post 0 anyway. After my reply noting this and the Ayn Rand misrepresentation, we agreed not to exchange messages again and she "blocked" me on Facebook. Oh, well, no loss there. "Assbook" strikes again!

Thanks for explaining the economics of Canadian medical care, Ed. I think America definitely has some "crony capitalism" at play, too. There are just so many things wrong with all these current systems I hardly know where to begin.

(Edited by Luke Setzer on 6/10, 9:02am)




Post 8

Sunday, June 10, 2012 - 9:17amSanction this postReply
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Imagine this scenario:

****************
Three aliens -- Captlist, Soshlist, and Media -- are sitting at a coffee table at a party. Media says to the other two: "I heard that you two had competing ideas regarding the provision of health care. Please oblige me."

Soshlist responds: "I have an idea that involves portable health care coverage, private hospitals, private physicians, more competition between these private physicians (greater physician/clientele ratio), more competition between this health care coverage with the other provided services, and an increasing rate of private incurrence of cost through time, which partly covers increases in medical costs."

Media: "How do refer to that idea (by name)?"

Soshlist: "I call it Soshlized Medicine."

Media: "Oh, imagine that. A system based on free association, lots of competition, increasing purchasing choice and purchasing power by individuals -- and you call it Soshlized Medicine?"

Soshlist: "Yep, that's my name for it."

Media: "Well, Captlist, tell us about your idea for the provision of health care."

Captlist: "I have an idea that involves less competition among physicians (a low physician/clientele ratio), state-enforced monopolies working against the portability of coverage, over 60% of all medical costs incurred by the federal government specifically, and almost 100% of all costs incurred by a third party generally (rather than by the direct consumer), and loads of bureaucratic red tape (more than the Soshlized system) and never-ending sense-of-entitlement lawsuits."

Media: "And how is it that you have decided to refer to that idea?"

Captlist: "I have decided to refer to it as the Captlist version of health care."

Media: "Really? So, you have an idea that involves less competition among direct providers of concrete health care, proportionately more total 3rd-party payment of health care, less competition among these 3rd-party payers of health care, and burgeoning oversight coupled with a counterproductive means to obtained unearned value from entities caught halfway between full government control and market-based economics -- in other words, a system based on unfree association, little competition, decreasing purchasing choice and purchasing power by individuals -- and you are going to refer to it as the Captlist version of health care?"

Captlist: "Bingo! Ding, ding, ding, diiiiiiinnnnng!"

Media: "Well ... I think I am going to write up a story about these 2 systems. Thank you for your time, gentlemen!"
****************

:-)

Ed

(Edited by Ed Thompson on 6/10, 9:20am)




Post 9

Sunday, June 10, 2012 - 9:30amSanction this postReply
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Ed, would the average Canadian be able to explain this? Post 0 surely did not. All I was left to think was that the Canadians pay huge taxes for a universal health care system that ignores market forces. Your posts suggest otherwise.



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Post 10

Sunday, June 10, 2012 - 12:53pmSanction this postReply
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I've posted this link before.

http://www.health.gov.on.ca/en/public/programs/waittimes/surgery/default.aspx

This is a factual accounting of the wait times in Canada for various procedures. You will note that 6 months is not unusual for things like knee replacements and when you add the times for referrals from the PCP to the specialist to the surgeon, you're talking about a long, long time. I've had a lot of procedures done on me, including a pacemaker/defibrillator, stents, knee replacement, many CAT scans, etc., in the US since I moved from Canada in 1995 and all of them took place within a week of being diagnosed. Absolutely no comparison.

Sam




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Post 11

Sunday, June 10, 2012 - 1:40pmSanction this postReply
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Canadian Armed Forces: about 68,000

NYPD: about 36,000

Canadian defense budget: about 22 billion.

(Much of that for Moose Milk.)

NYPD budget: about 4.5 billion.


Canadian defense: about twice as large and four times as expensive as ... the NYPD.


A sense of scale.






Post 12

Sunday, June 10, 2012 - 1:42pmSanction this postReply
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Thank you, Sam. Every project represents a composite of scope, cost, and schedule, with each vertex of the "iron triangle" influencing the other two to impact the overall quality of the project. Clearly, lower costs create longer schedules and, often, reduced scopes for any medical "project" such as a knee replacement. I was looking for something like this.



Post 13

Sunday, June 10, 2012 - 2:32pmSanction this postReply
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Luke,

The average Canadian has been bombarded with health care propaganda for at least 12 straight years, so I'm not sure what they think about how they fare against us medically, and about whether they think they pay too much for the exact services that they do receive. The issue is far from cut-and-dry. European national health systems are becoming more privatized over time (because of necessity). Canada is pretending that they are not. They are pretending that they have it all under control. Here are some relevant articles:

*****************************************************************
2000
Privatization of the Canadian Health Care System: Not yet and hopefully never
Why is privatization an option in Canada? Two important events in recent years have been responsible for much of the health care privatization or reprivatization around the world. The first is both direct and indirect pressure by the World Bank (1993) to privatize health care delivery and funding. Many nations, particularly those that had become dependent upon the World Bank for funding, reformed their health systems or initiated health systems to conform with the World Bank preferred model of American-style privatized health care. Furthermore, many countries have followed a trend to privatization of health care, social services, education, and government services set in motion by the neoliberal viewpoints of Thatcher and Reagan, a viewpoint backed by pro-business factions (Terris, 1999).

Two books endorsing privatization, one by Douglass (1993) and another by Osborne and Gaebler (1993), have been particularly instrumental for making privatization appear beneficial in Canada. Douglass's book contains both his aim and his method for converting the public health care system of New Zealand into a system whereby "responsibility means providing for yourself and your family to the extend you can afford" (p. 1). Osborne and Gaebler, two American business consultants, also endorsed small government and entrepreneurialism. Contracting out or decentralization was one of the main thrusts of their book.

Although many provinces have considered downsizing their governments and other changes to reduce government expenditure during the fiscally challenged 1980s and early to mid 1990s, Albertans have lived through many attempts to initiate health care privatization (Harrison & Laxer, 1995; Taft, 1997). Much of this ongoing privatization initiative can be pinned on Alberta's Premier, Ralph Klein, and his majority government for repeatedly endorsing various forms of privatization and for showing support for the individuals and groups intent upon initiating private health care businesses across Alberta (Harrison & Laxer, 1995; Taft, 1997). Since 1993, many privatization initiatives have been endorsed by this long-standing conservative government in Alberta, but few have come to pass as a result of much political action by nursing and other groups for raising public awareness and concern. However, in November of 1999, Ralph Klein personally and publicly indicated that his government will pass legislation in the year 2000 to allow private, for-profit hospitals to open and being collecting public funding when providing medically-necessary health care services to Albertans. It does not seem to matter to the Klein government that virtually no legislation exists in Canada to control private health care profiteering ...

2001
Privatized Health Care: US System is Not the Way To Go
Americans are more likely to buy over-the-counter medications than seek medical help. This is true even when a fever is present, which is the medical ``red flag'' that something is wrong. Pop a couple of acetaminophen tablets, cross the fingers, and hope for the best. An expensive trip to the emergency room was made only if the illness persisted.

Eventually, insurance companies developed the managed care concept to control the spiralling cost of medical treatment that resulted from this practice. Under managed care, Americans could seek treatment without being stuck with a bill afterward. Unfortunately, the price they paid was costly insurance premiums and a rigid set of rules to follow. If a rule was broken, the patient got stuck with the bill.

My experience with managed care was not better than the old insurance system. My share of the premiums, after my employer's contribution, was an annual $4,000 for a family of three. Worse yet, some of the rules that patients had to follow were simply unrealistic. For instance, unless it's a life-threatening condition, you are supposed to call the hospital before seeking treatment.

I once got stuck with a bill that amounted to several hundred dollars when an anxiety attack put me in a hospital without contacting my primary care centre in advance. Never mind that I thought I was having a heart attack or that deaf people rarely have an accessible phone handy while in public places. The important issue was the call was not made.

Although these stories are worst case scenarios, they provide a contrast to the picture that proponents of privatization wish to paint. What they would like Canadians to believe is that allowing the medical system to chase dual goals of providing optimum care and realizing a profit will not hurt the system.

They seem to believe that allowing private medicine into our system will somehow improve services and reduce costs.

2006
Public vs. private health care
Canada spent an estimated $142 billion on health care in 2005, or $4,411 per person, according to Health Care in Canada 2006, a report released by the Canadian Institute for Health Information. After taking inflation into account, this amounts to almost three times what was spent in 1975.

Of that, just over $98.8 billion was spent by governments delivering public health care. About $43.2 billion was spent on private health care. ...

For instance, should you have to spend some time in the hospital, the public system will cover the cost of your bed in a ward, which usually has three other patients. If you want a private room, the extra charge will come out of your pocket, unless you have extended health coverage either through your employer or through a policy you have bought yourself.

Need an ambulance ride? Expect to receive a bill. If you have extended health care coverage, your insurance company will likely pick up the tab.

Dr. Albert Schumacher, former president of the Canadian Medical Association estimates that 75 per cent of health-care services are delivered privately, but funded publicly.

"Frontline practitioners whether they're GPs or specialists by and large are not salaried. They're small hardware stores. Same thing with labs and radiology clinics …The situation we are seeing now are more services around not being funded publicly but people having to pay for them, or their insurance companies. We have sort of a passive privatization." ...

Shouldice Hospital in Toronto opened in 1945 – before Canadians were covered by universal health care. Dr. Edward Earle Shouldice developed a unique method of repairing hernias and demand for the services of his staff quickly spread beyond Canada's borders. The hospital remains private today. Residents of Ontario who have a valid health card are covered by the provincial health-care system for the cost of surgery. If you're from outside Ontario, you will probably need extended – private – health coverage to get reimbursed.

Several privately-run clinics have opened across the country as well, offering CT scans and MRI services. Most have contracts with their provincial governments. The idea was to take pressure off the limited resources of hospitals. The clinics are paid by the province to provide their services.

Several clinics opened in Ontario after the then former Conservative government signed contracts with four companies. The companies were allowed to provide 40 hours of testing per machine per week. Physicians associated with the clinics are paid on a fee-for-service basis by the Ontario Health Insurance Plan to read the test results for OHIP-covered patients. While the clinics are allowed to take private customers after hours, they cannot sell MRI or CT scans to anyone who walks in off the street.

2008
Dr. Jacques Chaoulli takes stand against private health-care restrictions
Chaoulli started reacting against the health-care system in 1994 when he was employed as a house-call doctor in Montreal. He was fined by the government for charging his patients directly, which led him to go on a four-week hunger strike in 1996 to protest the restrictions against private health care.

“My goal at that time was to stay in medicare and do my best to help patients who cannot leave their houses ... The medical union didn’t like it and I took the side of the patient since that time,” said Chaoulli.

Countries like Australia, New Zealand and France have private health-care businesses that run alongside the public health-care sector, which is what Chaoulli has been lobbying the provincial and federal governments to consider since 1992.

“I suggest that not only it is moral but a moral obligation to help that person who has money in their pocket to use his money and to get fast access to health care as long as it doesn’t bother another person,” said Chaoulli.

2009
Privatized, For-Profit Health Care: Pay More and Get Less [main page]
Canadians are being told that public health care financing is not ’sustainable’, and that the solution is a shift to more private health insurance and private delivery of services. According to Canada’s leading health care economist, “bluntly, this is a lie.”

2009
Privatized, For-Profit Health Care: Pay More and Get Less
The privatizers also say that health care in Europe can provide a fix for our health care. They call it the European Model.

In fact, there is no “European Model.” It’s a myth promoted by those who will benefit from selling for-profit health services. There are many different systems in Europe, each with their own problems and benefits

2009
In Canada, a move toward a private healthcare option
"I don't have insurance. We're not allowed to have private health insurance in Canada," Woodkey said. ...

Hoping to capitalize on patients who might otherwise go to the U.S. for speedier care, a network of technically illegal private clinics and surgical centers has sprung up in British Columbia, echoing a trend in Quebec. In October, the courts will be asked to decide whether the budding system should be sanctioned.

More than 70 private health providers in British Columbia now schedule simple surgeries and tests such as MRIs with waits as short as a week or two, compared with the months it takes for a public surgical suite to become available for nonessential operations.

"What we have in Canada is access to a government, state-mandated wait list," said Brian Day, a former Canadian Medical Assn. director who runs a private surgical center in Vancouver. "You cannot force a citizen in a free and democratic society to simply wait for healthcare, and outlaw their ability to extricate themselves from a wait list."

Yet the move into privatized care threatens to make the delays -- already long from the perennial shortage of doctors and rationing of facilities -- even longer, public healthcare advocates say. There will be fewer skilled healthcare workers in government hospitals as doctors and nurses are lured into better-paying private jobs, they say.

"What it means is that people who have no money, who are chronically ill, disabled, who require medical attention frequently, are going to suffer dramatically," said Leslie Dickout of the B.C. Health Coalition, which is involved in the lawsuit to determine whether the Canadian Constitution guarantees citizens the right to choose their own care.

"There's so much money to be made by the insurance industry," she said. "If this [legal] case succeeds, what we would have is a system of U.S.-style healthcare -- along with a public system that is decimated."
*****************************************************************

Luke, as you can tell from the above, it's a mess in Canada. The state-run system has all the tax dollars to create propaganda. The independent doctors "fight the system" to get privatized care out to the people who desperately need and want it. It's not paradise there. I'm just saying that it's not fair to compare the US to Canada as if you are comparing a free-market system to a socialized one. Neither country is actually what it claims to be.

Ed

(Edited by Ed Thompson on 6/10, 2:36pm)




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Post 14

Sunday, June 17, 2012 - 12:14pmSanction this postReply
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What most irritated me about the quoted passage in Post 0 was the concrete-bound thinking involved. Snide statements like, "These numbers are easily available should you choose to inform yourself and do the per capita comparison," refuse to look more deeply at the meanings behind those numbers. This methodology resembles that of a certain poster in the Dissent forum of this site who uses concrete numbers to justify racism. The same "liberal freethinkers" who accuse religious conservatives of "concrete-bound dogma" basically do the same in their own secular way for the sake of their own "sacred cows." As usual, such sophists have their "facts straight" but either misintegrate along false common denominators or disintegrate along non-essential common denominators. Truth suffers at the hands of "facts" wrongly used and abused.

(Edited by Luke Setzer on 6/17, 12:20pm)




Post 15

Sunday, June 17, 2012 - 12:51pmSanction this postReply
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Luke,
The same "liberal freethinkers" who accuse religious conservatives of "concrete-bound dogma" basically do the same in their own secular way for the sake of their own "sacred cows." As usual, such sophists have their "facts straight" but either misintegrate along false common denominators or disintegrate along non-essential common denominators. Truth suffers at the hands of "facts" wrongly used and abused.
What a great point and how extremely well put!

Ed




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Post 16

Sunday, October 13 - 6:45pmSanction this postReply
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Ugh. The comments to this Forbes article continue the fallacies. Of course the current United States health care system is broken. It broke long ago with government meddling. What really angers me is how practically no one in mainstream politics is stepping to the plate to any noticeable degree to show this. All the arguing concerns ACA versus the previous system. I have no wonder why so many so ensnared in a perpetually and deeply flawed patchwork of American bureaucratic nonsense want a way out of it.

Meanwhile, another Forbes writer argues that the 1798 Act for the Relief of Sick and Disabled Seamen shows that the Founders supported socialized medicine, engaging in the begging of numerous questions which comments seek to answer.

Forbes has numerous articles on the topic of socialized medicine including some by ARI authors.

I lay most of the blame at the feet of the crony capitalists who lobbied for the current system.

Sadly, per this article, the conservative Heritage Foundation bears its share of the blame for this mess.

(Edited by Luke Setzer on 10/14, 5:40am)




Post 17

Monday, October 14 - 3:55pmSanction this postReply
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Didn't Ted Cruz have around 25 hours to go over it, and didn't?

I know exactly what you mean, Luke.



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Post 18

Monday, October 14 - 7:28pmSanction this postReply
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Luke,

It appears that the 1798 Act for the Relief of Sick and Disabled Seamen was an early regulation of commerce, specifically foreign commerce (navigators returning from foreign soil) via a payroll tax that was treated as a user fee -- taxes collected from one port had to be turned around and put into the service of healthcare for that port. This was an extremely watered-down (forgive the pun) version of Medicare. Here is my opinion of these 3 key differences:

----------------------------------
Medicare: Everyone pays

1798 Act: Only those engaged in foreign commerce pay


Medicare: Many (but not all) benefit from a common pool of resources, and not in proportion to what they pay into the system

1798 Act: Only those engaged in foreign commerce benefit, and only in direct proportion to what they pay into the system
----------------------------------

Imagine if another kind of a government protection scheme was devised, not for those engaged in foreign commerce, but for those engaged in vehicular operation. Let's say that the government goes ahead a makes a decree that anyone driving on the roads has to spend their personal time, energy, and attention to engage in a safety/prevention class to obtain a driver's license. It is considered a public safety issue. To be clear, the government isn't forcing you to obtain a driver's license, it is saying that if you want to drive on the roads then you have to get one. The same could be said for a pilot's license.

That is like what happened in 1798. Sailors who wanted to sail to foreign lands (where they could pick up nasty tropical diseases and whatnot), were forced to fund a healthcare scheme that affected them and only them. It is much different from Medicare, which makes everyone pay for everyone in any proportion, regardless of who you are. To show the absurdity, if Medicare were equivalent to licensing, then one person's driver's license might end up covering another person's driving habits. In fact, everyone everywhere would have access to a license (regardless of age or experience), because everyone everywhere would be paying for it -- and it is not something that is directed back to the payer in proportion to their contribution.

If the 1798 Act supports universal health insurance, then driver's licenses -- because the same dynamics are employed -- would also support universal health insurance (in roughly the same degree). But this is absurd. I'm assuming that Medicare is not like Social Security, where you are forced to invest in your future (having the government hold your money), but you get benefits in some proportion to what you have paid into the system. If I'm wrong about that, please correct me.

Ed




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Post 19

Monday, October 14 - 8:33pmSanction this postReply
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Luke,

I think a good part of the problem -- and perhaps all of the problem -- stems from the unwillingness or inability to imagine what free market health care would look like. People had just assumed we have a free market, but negative effects of corruptively-lucrative, burgeoning government intervention (all burgeoning intervention into commerce, taken as a "shake-down", affords corrupt people with unearned "profit") started showing up about the time that they killed Kennedy.(1) 

Now, I'm not saying that the same people who killed Kennedy also wanted to make illegitimate (mob-style) profit from shaking-down the medical industry (which caused skyrocketing health care costs in the US) -- that would be wacky conspiracy theory -- I'm just saying that the events coincided. It could be nothing other than a coincidence that this country started to go-to-hell-in-a-hand-basket in the early-to-mid 1960s. I'm just saying that it started back then, and has been getting worse over time. In the 30 years from 1975 to 2005, for instance, the cost to get a drug approved by the FDA increased 13-fold in inflation-adjusted dollars, from $100 million to $1300 million.(2) There are two broad ways to look at something like that:

a) we are 13 times less efficient at researching and developing drugs
b) the FDA, holding the keys to the safe (so to speak), has a captive audience and can charge as much as it likes. Take note that you can "buy" yourself out of some of the trouble that the FDA is proposing to put you through -- by applying for a sort of "speedy trial" or fast-track status and then paying the exorbitant fee which, I think, is a half-billion dollars. That sum of a half-billion dollars is, ironically, about how much it costs to develop a new drug from inception to approval.(3)

Don't quote me on this because it is merely bold conjecture, but I'm pretty sure that in no other country besides the US, does it take a half of a billion dollars in order to invent a new drug.

Now, if we accept the strawman/dichotomy argument as I have laid it out -- that we're either (a) 13 times less efficient (more stupid) than we were back in 1962, or (b) that the FDA is the mob [and they likely killed Kennedy because he had integrity (and would have stopped them from fleecing the industrialists)] -- then you would come to the conclusion that (b) is the case, because (a) is absurd on its face. I mean, think about it. How can we become 13 times less efficient at something! And, if (b) is indeed the case, then you would find some corruption/collusion/extortion going on between government and industry and innocent consumers. What you will find is one party scratching the other's back, in order to extract the kickback bribe that comes from such a thing.

How this will show up is the formation of certain monopolies (federally-refused or federally-withdrawn entries of members of a class or field of competitive things, such as rival drugs or policies or whatever). For instance, if there is a cheap drug that works and helps a lot of people, then the FDA can pull it off the market, in order to help a drug company pocket a steep windfall from a mere knock-off product that was put through the "official" hoops of regulation. In the whole history of medicine, there is at least one instance of something like this happening, wherein innocent people will -- by nothing other than bureaucratic fiat -- instantly have to pay 10 times more for the same molecule that they have been purchasing for decades.(4)

Of course, this doesn't prove that the FDA is getting kickbacks from drug companies whenever and wherever they remove all rival competitors from the market by executive fiat -- it is not direct evidence for corruption -- but is the laying of the seedbed for corruption (followed by the rising costs that would be associated with the corrupt behavior of politico-economic actors).

The answer, as always, is not to get better people at the FDA. No burgeoning government entity was ever made innocuous by putting "good people" in charge. Instead, the answer is to reduce the size, scope, and power of central authority in this arena, if not in all arenas. It is the unjustifiable asymmetry of power -- the enterprise of "surrogate decision making" -- that is, in-and-of-itself, the seedbed of corruption.

Ed

Reference:

(1) FDAReview website [see Figure 2]
(2) Manhattan Institute website [see Figure 1]
(3) fastcompany website
(4) kaiserhealthnews website

(Edited by Ed Thompson on 10/14, 8:51pm)




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