GOVERNMENT CAN’T FIX HEALTH CARE

In my last post, ADVERSARIES OR JUST DIFFERENT SOLUTIONS?, I asked a bunch of questions.  The post was popular, but nobody tried to answer my questions. Why not? I suppose I could be just preaching to the choir. Maybe Liberal Democrats just hate having their good intentions questioned. Not sure. Only got one response from someone who disagreed. Is what Doug (FPS/DougLite.com) said representative of other advocates for a single payer healthcare system think => https://citizentom.com/2018/04/24/adversaries-or-just-different-solutions/#comment-80568? If it is, why do these people want the government to run our healthcare? With so much evidence to the contrary (even according to him), what makes think politicians are competent to run our healthcare?

Frankly, people often leave me head scratching. I don’t think I have all the answers. I don’t personally know anyone who thinks they have all the answers. Yet many of us will vote for someone like Barack Obama, and he made the most preposterous claims. Why would they believe anyone who says he can lower the sea levels and provide everyone healthcare as a “right”?

Even when Jesus performed miracles, most would not believe Him. Yet because of his grand claims and promises, the Norwegian Nobel Committee awarded Barack Obama the Nobel Peace Prize before he had done anything.

Well, I can’t read minds. So I doubt I can figure out why we do all the stupid things we do. I just know government-run healthcare is a fundamentally impractical idea. Why? Here is something for my fellow choir members. It is a short video that even those of us who sing poorly can sing along with. It is also a video that will delight those of you who sing well.

Please enjoy.

22 thoughts on “GOVERNMENT CAN’T FIX HEALTH CARE

  1. @Tom
    [ Completely off-topic food for thought. I’d be interested to learn your take on this, perhaps it’s something for you to blog about. Feel free to delete. ]

    https://www.forbes.com/sites/trevornace/2018/04/24/epa-chief-scott-pruitt-delete-decades-of-science-in-the-name-of-transparency/

    This is a strong attack on science based decision making, masked as a call for transparency. An example is the Six-Cities Study by Douglas Dockery, et. al.,, which established that particulate air pollution increases mortality. It was based on following up on the health development of about 8000 adults. As questionares asked for the detailed medical history of the participants, hence they were covered by confidentiality agreements, that the data may only be used in anonymized form. Pruitts proposed rule would thus exclude this milestone study (among the most cited in environmental matters) from consideration in EPA rulings. Basically the EPA would no longer (or only to a lesser extent) “know”, that smog is bad for you, and would be limited in what measures it could take to improve air quality.

    Like

    1. I don’t see the problem with demanding transparency for studies that cost us billions of dollars. This isn’t a privacy issue.
      The Lancet (along with all other medical journals on the planet) publishes studies all the time based on personal information. Revealing that personal information isn’t required to make a study public. They just leave it out.

      Liked by 1 person

      1. I think you are falling for the intended lingual trap. Yes, transparency is important, to an extent. However, reasonable transparency as you and I probably have in mind, is not what the Republican congressmen have in mind.

        Let’s have a look at the past. Republican congressmen early on tried to get access to the Six-Cities study raw data. As a compromise, where Havard trusted a specific third-party to safeguard the data and Congress trusted the same third-party to do a proper analysis, the Health Effects Institute reanalysed the data and confirmed the findings of the Six-Cities study back in 2000. Nonetheless Lamar Smith and the Republican part of the Science committee tried to subpoena the RAW data in 2013, to share the data with “various reputable entities and organizations” while “deidentifying” the data. How do you do “deidentify” a person with date of birth and death (you cannot tamper with these crucial data w/o compromising the value of the dataset) and additional data in a town of 20,000?

        http://www.scientificintegrityinstitute.org/Science080913.pdf

        They did not get the data back then, the new strategy is to make the data inadmissable to be part of the science available to EPA to base rulings on.

        Like

    2. @marmoewp

      Thanks for the comment. I had heard about this, but I had yet to give it much attention.

      Scott Pruitt has been the usual subject of personal attacks by Democrats and news media, and I just don’t believe them anymore. The Russian collusion thing has been inexcusably hypocritical, and too many of them participated in it.

      The issue here, however, is whether the EPA was hiding research data that prevented other researchers from trying to duplicate their results. Since we are actually talking about whether what Pruitt actually did makes sense, an actual public policy, I guess that that is worth considering.

      I don’t know how profound I will be, but i will try to post something by next week. I suspect there will be some articles written by people more informed than i that I can borrow from.

      Wish Keith was still posting. This would have been right up his alley.

      Like

  2. If buying a TV were like buying healthcare insurance in a free market:
    I’d like that TV – Fine, that’s $999.
    I’d like that TV – Fine, that’s $999.
    I’d like that TV – Fine, that’ll be $999,999,999, as you have a preexisting condition. – But I only make $3,000 a month – Not my problem.

    Like

    1. @marmoewp

      Look up the definition of insurance. It is what it is.

      When we want someone else to give us what we cannot afford, we want charity, not what is our “right”.

      What is socialized medicine? Does it exist because market solutions will not work? No. It exists because busybodies want to tell the “rich” how to spend their money.

      Redistributing the wealth does not work well. It is amazing how many Liberal Democrats in this country are billionaires. Billionaires don’t get soaked with high taxes. People with large salaries do.

      Anyway, everyone wants to live forever, but no one of us can pay the bill required to help someone live forever. So what are talking about is how to help people who are poor. Is that government’s job? No. If you want to help someone who needs help, reach into your own pocket. We don’t have the right to steal from the “rich” to give to the poor. When we try that nonsense, demagogues rule.

      Like

      1. The underlying problem (elephant in the room) is, there’s no free market equation in the US healthcare industry. It’s kind of like the education industry (unsurprisingly, the costs of both are rising at the speed of stink).

        One small example, I think I mentioned before (but maybe it was elsewhere?) I have a former flight doctor friend who went to pathology school and is now a pathologist. He wanted to start his own practice and found it impossible to do so. He explained the problem to me:

        The insurance companies are buying out the clinics and creating an ipso-facto monopoly. This is inherently anti-competition…the private practices can’t even get set up, let alone compete.
        In the very short term that might lower cost a small percentage, but they do it by controlling the primary care providers who make the referrals.
        The goal is to turn physicians into employees, beholden to their employers
        (employers who are also the insurance companies…and they count up the number of referrals they make, too many and their employment is in jeopardy).
        It’s pretty easy to see where that one goes:
        “Came in with blood in your stool? Meh, probably a hemorrhoid…some back next month.”

        My friend was eventually able to set up a practice, but ONLY by joining a physician conglomerate that had already paid many many millions and spent years in court for the chance to set up a practice and compete with the insurance companies.
        Think about the impact that has on the price of services.

        Liked by 1 person

  3. You could try and have a look at the German healthcare system. Social healthcare has a long history in Germany, starting back in 1883 when Bismarck made healthcare insurance for workers mandatory. Via wikipedia

    The turnover of the health sector was about US$368.78 billion (€287.3 billion) in 2010, equivalent to 11.6 percent of gross domestic product (GDP) and about US$4,505 (€3,510) per capita.[7] According to the World Health Organization, Germany’s health care system was 77% government-funded and 23% privately funded as of 2004.[8] In 2004 Germany ranked thirtieth in the world in life expectancy (78 years for men). It had a very low infant mortality rate (4.7 per 1,000 live births), and it was tied for eighth place in the number of practicing physicians, at 3.3 per 1,000 persons. In 2001 total spending on health amounted to 10.8 percent of gross domestic product.[9]

    As with any complex problem, the system needs tweaking from time to time.

    Like

    1. @marmoewp

      A large proportion of America’s healthcare has been socialized for decades, but a large proportion remains private. That is why it is so costly. Folks on Medicare and Medicaid look at what people who are paying for their own healthcare get, and they insist upon the same quality. In Germany the government spends what it wants to spend. Your politicians don’t experience quite the same pressures.

      I liken the spending pressures in socialized medicine to the spending pressures for road construction in this country. In a socialist state — before tyranny sets in — politicians spend money to buy votes. To get money for their election campaigns, they first respond to donors. To get the votes they need, they give away money directly to voters in welfare programs. When do they spend money on roads that drivers actually want? When the drivers complain loudly enough.

      The people who complain most loudly about socialized medicine are waiting in line for treatment. If you are very old or your treatment is costly, government is inclined to let you die. To make the metrics look good, the money is better spent elsewhere.

      Still, Liberal Democrats in this country make a practice out of holding up Socialism in Europe as an example. Conservatives respond primarily in one of two ways: (1) they point out what is not working in Europe, or (2) they observe that our way is better. I have a third alternative. Liberal Democrat have been trying to bring the glories of Socialism to the United States for a hundred years. Every time they make an “improvement” they use they their failures to justify demanding more power to make more “improvements”. So I don’t believe it is the improvements they want. I think what they want is power.

      Look at what happened after Trump replaced Obama. Instead of stagnating, our economy is growing again. Instead of busying himself trying to gain greater control over the lives of his countrymen, Trump is trying to reduce the footprint of government. Trump is focusing on his constitutional responsibilities, not dragging every shred of power he can grasp to our nation’s capital.

      We have fifty different State governments, and some of our states are quite large. California, our largest has more land than Germany and about half the population. So if our left coast wants to adopt the German health care model that is where the experiment belongs. We don’t need to damn our whole country with it.

      Any serious effort to find text in our Constitution that gives our Congress the powers to establish health, education, and welfare programs will fail. Frankly, our Supreme Court has just turned a blind eye to this power grab, and that worries me much more than the quality of our health care. Before Obamacare, most people were happy. Nothing is ever perfect, and Obamacare was not actually an improvement.

      Better is the enemy of good.

      Like

    1. @Catherine

      You answered my questions? Well, I suppose you did, but I did not lie. When you used a certain four letter word, your comment went into the trash. When your comment did not post, what do you think happened to it? Why do you think you last comment posted? Do you think I am just sitting here at the keyboard eagerly waiting to trash your comments?

      Anyway, I dragged your comment out the trash, edited that four letter word, and approved it (=> https://citizentom.com/2018/04/24/adversaries-or-just-different-solutions/comment-page-1/#comment-80578). My readers are welcome to read it and comment on it.

      Now is time for me to eat my breakfast. Will reply to your comment this evening, Lord willing.

      Like

  4. Tom

    I will give suggestions in my post on incentives. I kinda doubt anything will one of if in the near future because it is a very simple fix.

    Sadly, Governing has become very complicated. Something simple may confuse our legislators.

    Regards and good will. Blogging

    Liked by 1 person

  5. Well, I’m in both agreement and disagreement with the Prager video.
    I do not think laser eye surgery is a reasonable comparison as no one actually needs it.
    Laser eye surgery is a luxury item.
    By contrast, when the paramedic is aspirating your throat you aren’t really in a situation where you can comparison shop. If they’re aspirating your child’s throat, you’ll do pretty much anything to ensure your child lives.
    Wyldkat gave a very pertinent example of the “end state” of socialized medicine on the last thread.
    Very true. The state decides who lives and dies in this type of situation.
    I think it would be reasonable to discuss the end state for exactly the same scenario in a government- free healthcare system. It is very very expensive to keep a child “alive” indefinitely by artificial means.

    Liked by 1 person

    1. @anon

      The problem of comparison shopping is real, but the market, not the government, has provided a solution. One of the major reasons we buy health insurance, into an HMO, or some kind of healthcare plan is that the plan provider does the shopping for us before we get sick or hurt. As you observed, It is not practical to shop for health care when you are sick or hurt.

      What if you don’t purchase some kind of healthcare plan in advance? Well, if you could have afforded one, you are going to pay if you need healthcare. Of course, government now says preexisting conditions don’t matter. So maybe that is not true. So the taxpayers will pay instead.

      What if you cannot afford to buy a healthcare plan? What if this was before Obamacare and preexisting conditions were not covered, before the government had offered up other people’s money to pay for healthcare as a right? If we did not have big government healthcare, some charity would most likely help. Would the care be as good as if you had paid for it? No. Why should it be? Still, unlike government-run healthcare a charity would probably treat your condition instead of insisting you wait in line until “perfect healthcare” was available.

      What is the problem with promises made by politicians? It is highly unlikely that a politician will keep his or her promise.

      Like

  6. Interesting video. IMO, gov can’t fix healthcare because gov is the problem.

    What worked the best for us long ago was direct pay. I’m in a rural area and literally people would pay cash, even trade and barter with docs and dentists who were part of the community. Sometimes we took up a collection for other people who had medical bills. Even if you didn’t go to the doctor that month, often you would send him 30 bucks anyway. It was called “paying in advance.” Kind of a rough form of insurance. We had money on the books. People used to do that with gas and groceries too, pay in advance. So there was no middleman, no interest rates, and no debt. Take those things away and everything is now very cheap. I’m not very old but I still remember when it cost 22 dollars to go to the doctor. That’s good for poor people, that’s called “affordable care.”

    Liked by 1 person

    1. The video does not talk about what the government is supposed to do. It is supposed to regulate transactions. That just means keeping everyone honest. What crafty politicians have done is turn regulation into making our decisions for us. No doubt their donors like this, but it makes healthcare expensive, mostly because we pay for things we don’t need and don’t want.

      Liked by 1 person

  7. Love Prager U videos! Healthcare is complicated because so many of us get insurance through our employers. I have excellent coverage through mine, but it’s nearly impossible to shop for medical services because nobody can tell you with any certainty what things will cost. Plus I’m not paying the providers directly, my health insurance company is who is in turn being paid by my company.

    The ObamaCare answer to this was to mandate that MORE employers provide healthcare and increase the government mandates on services covered, which was already distorting the market. In short it took everything that was wrong about the system pre ObamaCare and put them on steroids.

    You did not have to be an economist, as Doug stated in your previous post, to figure out what a disaster this would end up to be.

    We should start breaking the link of employee covered healthcare by offering the same tax benefit to consumers who buy it privately, who should be allowed to purchase whatever coverage they want from any state they want . Increase the Health Savings Account amounts and enforce real tort reform and we’d have a much healthier system.

    Liked by 1 person

    1. Agreed.

      One of the major reasons we buy health insurance, into an HMO, or some kind of healthcare plan is that the plan provider does the shopping for us before we get sick or hurt. It is not practical to shop for health care when you are sick or hurt, but the market, not government has provided a solution.

      Liked by 1 person

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