How the Health Crisis was solved 80 years ago.

[Sirrus_Asura]

Sorry for the delay.. ADD + work + new games + Yanks-Sox series kicked in..

Here's §2791c of the Pulic Health Service Act..


Combined with the text from the currently pending bill, this looks to just be defining what wouldn't qualify for coverage under a public plan. For example, if you're involved in a car accident public medical insurance would not cover it (which is understood already - private medical insurance doesn't cover it either; it's either paid by auto insurance or out-of-pocket). Likewise, something that would be covered by existing insurance coverage, i.e. if someone's on a privately-purchased plan or Medicare, it obviously wouldn't need to be covered under a public plan.

I'd be willing to bet you'd see this kind of restrictive cover-their-bases language in just about any medical insurance contract, private or not.

Well fuck man, if what you say is true, On paper this bill doesn't look bad at all.

[Beckwin]

and now you're falling into the fallacy that once markets become "free enough" (at some magic, unknown point) they will magic leap out of shittiness and provide the paragon of low costs, job creation, and profits to advance mankind and take us to the cosmos. whereas in the real world healthcare, we see a general trend of greater collectivization/socialization resulting in better coverage, better public health, and lower costs... meaning that among developed countries, those with "freer" markets tend to offer a worse service for what people put into it. efficiency out the window... I thought that was the virtue of markets? and on top of that you have to keep in mind that a lot of medical breakthroughs are rooted in universities and are really becoming prominent from foreign countries (and their left wing hippy government universities!).

[Beckwin]

So would you be in favor of a pure free market w/ Insurance? (Not what we're dealing with currently)

no, a "pure free market" for insurance probably turn hospitals into Thunderdomes. I don't even want to think about the misleading salesmanship and then exclusivity for plans that actually cover something.

[Sirrus_Asura]

and now you're falling into the fallacy that once markets become "free enough" (at some magic, unknown point) they will magic leap out of shittiness and provide the paragon of low costs, job creation, and profits to advance mankind and take us to the cosmos.whereas in the real world healthcare, we see a general trend of greater collectivization/socialization resulting in better coverage, better public health, and lower costs... meaning that among developed countries, those with "freer" markets tend to offer a worse service for what people put into it. efficiency out the window... I thought that was the virtue of markets? and on top of that you have to keep in mind that a lot of medical breakthroughs are rooted in universities and are really becoming prominent from foreign countries (and their left wing hippy government universities!).

Better Coverage? Better Public Health? I'm not so sure.

America has a heath problem yea, but I'm not sure it's solely from the lack of health care. We're a pretty unhealthy country as is.

[Sirrus_Asura]

no, a "pure free market" for insurance probably turn hospitals into Thunderdomes. I don't even want to think about the misleading salesmanship and then exclusivity for plans that actually cover something.

Well the free market requires you to be an informed consumer. Is this too much to ask? I mean, this IS your HEALTHCARE we're talking about.

[Beckwin]

Better Coverage? Better Public Health? I'm not so sure.

America has a heath problem yea, but I'm not sure it's solely from the lack of health care. We're a pretty unhealthy country as is.

are 15% of french/british/canadian/german/italian/swedish/japanese/cuban etc people without health insurance, with many of those unable to afford any significant care without going bankrupt? yes, they offer better coverage.

do said nationalities generally rank better for longevity, infant mortality rates, prevalence of diseases, etc? yes, they offer better public health.

[Beckwin]

Well the free market requires you to be an informed consumer. Is this too much to ask? I mean, this IS your HEALTHCARE we're talking about.

you needed help understanding a bill that reads not too dissimilar from an insurance policy. you really underestimate salesmanship and deception; has nothing been learned from the housing crisis? lol. it's simply not realistic to expect everyone to be informed enough on all significant issues they may face in life- taxes, mortgages, health insurance, auto insurance, disaster insurance, all rules and regulations for starting a small business/incorporating, credit card policy, credit ratings, building codes, and so on....

and that only gets more complicated the more you "free" the market by removing centralized/universal standards for professions like doctors and other health workers (as guartz roughly proposes). how the hell can you really expect joe schmoe with a sick kid to properly evaluate proclaimed professionals?

[Olo401]

Better Coverage? Better Public Health? I'm not so sure.

America has a health problem yea, but I'm not sure it's solely from the lack of health care. We're a pretty unhealthy country as is.

It's not so much a lack of health care as it is lack of access to affordable health care. Health problems are merely an after-effect of people being turned/forced away and being afraid of seeking treatment out of fear of financial ruin when an insurance company, HMO or PPO creates an excuse not to pay for something.

[Sirrus_Asura]

you needed help understanding a bill that reads not too dissimilar from an insurance policy. you really underestimate salesmanship and deception; has nothing been learned from the housing crisis? lol. it's simply not realistic to expect everyone to be informed enough on all significant issues they may face in life- taxes, mortgages, health insurance, auto insurance, disaster insurance, all rules and regulations for starting a small business/incorporating, credit card policy, credit ratings, building codes, and so on....

and that only gets more complicated the more you "free" the market by removing centralized/universal standards for professions like doctors and other health workers (as guartz roughly proposes). how the hell can you really expect joe schmoe with a sick kid to properly evaluate proclaimed professionals?

Honestly, I do. I expect people to be very informed about something that is going to effect their life like that. Its a big fucking deal.

[Sirrus_Asura]

It's not so much a lack of health care as it is lack of access to affordable health care. Health problems are merely an after-effect of people being turned/forced away and being afraid of seeking treatment out of fear of financial ruin when an insurance company, HMO or PPO creates an excuse not to pay for something.

I was kinda hitting on America having unhealthy habits in general.

[Olo401]

I was kinda hitting on America having unhealthy habits in general.

The only thing I can think of that we do or don't do individually on an equivalent scale to other countries is exercise, especially since the smoking population percentages have come into line with Europe through increase regulations.

On a collective scale, you need to look to the average American diet as compared to other countries (we have a MUCH larger emphasis on heavily processed foods, use of corn syrup, preservatives, etc. than Europe) and, again, people who have isolated themselves from regular medical treatment (until it is almost too late) because of lack of insurance or that their insurance will find a reason not to cover them.

[Not not Mattaru]

Despite the glaring fact that medicine 80 years ago (the article was written in the early 90s...so it would have actually been talking about ~1914) is so radically different than today that it really does call into question the point of comparing the way it is managed across the span of a century. Even so, I'm sure the author would argue that Libertarian ideology, like many, ought not be constrained by something like time. In other words, it worked then it can work now. Which is just silly and completely ignores vast variation across humanity and even modern history.

For some context, 80 years ago from the time of the article...there was no Penicillin, X-ray's were not widely used, blood transfusion was not used (until WWI really got into motion), even arcane things like lobotomies were around during the time most of our parents were growing up or starting families. Needless to say the type of medical care and demand for it has changed drastically.

I think most importantly is that it is not as if these type of societies are outlawed or banned, many still exist today in a variety of forms. Simply, the government and other organizations decided to take on their roles and that is continued because people's faith in said organizations. In other words, freedom of choice isn't gone - another agent simply offered another choice and people went with it.

For some reason many Libertarians tend to cry out to protect the free market and have faith in its panacea-like caress. Like some force of nature, it will always win, you can't fight it. Like the mystical Tao if you fight against it you will only be drowned like fighting a raging river. But the moment some agent like the government tries to "impede" or "intervene" in the market socialism is at the front gates, the timid virgin of capitalism is so easily motivated to give it up after imbibing a wine cooler. The more nuanced view is obviously that things are more intertwined, the boundaries between entities is not so clear and the government is one of the many actors inside of the economy and as long as the government is somewhat representative it is under similar forces of persuasion.

As far as the case of uniqueness of this article to the current situation it is hard to grasp. Simply because the real argument is hard to grasp. Is it - look the government fucked something up or we should all get back to the good old days of friendly societies and lodges. I'm not really sure and either way there are more compelling arguments to this end besides healthcare. Moreover I am pretty sure I can find examples of private sector major fuck ups etc. Fucking up is not unique to the government.

Moreover, the health plan in the works isn't imposed on anyone who already has a health care provider they like unless their employer decides to use the government one...which if people act rationally we can assume they would do so because they find it to be better than their current one and if that is in the power of the person in charge rather than employees they could change to any number of insurance providers that employees may have a problem with anyway. So the argument is not unique to the status quo. All that is changing is another choice is being made available - hit the deck sounds like competition a tenet of capitalism. Luckily we all here believe Adam Smith to a T so this government healthcare thing should disappear like an out of season Elmo doll.

Lastly, an oft-used critique on Libertarian thought is it over-emphasizes the individual. That you put the individual before the group, individuals acting selfishly somehow equates to the world we have today. I would say this lingers in the grey zone between true and false, but when you make it into an ideology and political platform such leeway isn't allowed and that becomes dangerous. Putting all the emphasis on the individual is damaging to such social safety groups that the author mentions. Social safety nets don't exist in a fully libertarian world because society is by virtue of libertarian values atomized.

[Rhinox]

So tell me guys. How does it feel to have to pay almost double the costs in healthcare and still be ranked 46th in the world in Infant mortality rate? Must be embarrasing. It is to me.

[guartz]

so now, back to healthcare and how greater degrees of collectivization drive down costs,

greater degree of collectivization, such as, I don't know, insurance?!

I hope you appreciate the irony here. One is voluntary, the other is forced upon people. One has to compete for service and quality, the other does not. One is liable for lawsuits, the other is not.

[Olo401]

greater degree of collectivization, such as, I don't know, insurance?!

I hope you appreciate the irony here. One is voluntary, the other is forced upon people. One has to compete for service and quality, the other does not. One is liable for lawsuits, the other is not.

No, health care is a fact of life - it is both voluntary AND forced upon you, because if you fail to address it you die too young.

No, one has to compete with its own customers and the purpose of its existence against its bottom line, which means that service and quality are sacrificed. The other puts service and quality first by mandate.

No, one uses its profits to buy legislation to protect it from lawsuits and hire lawyers to twist the arms of its customers AND doctors. The other holds everyone accountable, including the patient/customer.

I hope you appreciate the irony that every single reason you give to not have a public health care system is counteracted by the fact that all your own reasons are why the existing private for-profit system is broken.

[Olo401]

Some stories of demented and completely misinformed people from town hall meetings around the country.. Names of those who wrote these experiences have been withheld.

At Ed Perlmutter's town hall in Brighton, CO, I was locked in conversation with a little old lady who claimed the government would send an agent to everyone's house to tell them how to speak with their kids and if we didn't comply, the government would take our kids away from us and put them into the foster care system. I told her she had better not let her insurance company know she had gone senile, because they would drop her policy or declare it a pre-existing condition.

One lady I spoke to told me I didn't know about the euthanasia portion of the bill because I hadn't read the bill. I told her I actually had read it, and Section 45 had no mention of euthanasia or any mandatory panels. She told me, well of course not, it's not *in* there, but everyone knows it's "understood" from back-room deals in Congress. It was ... surreal.

(I) got a little freaked out at the health care rally this morning after a sweet, kindly older lady vehemently tried to convince me Obama was sending people to my house to force me to have an abortion. She didn't even back down when I explained I wasn't even pregnant.

[guartz]

Olo, the irony I was referring to was that insurance or "collectivization of healthcare" is a creation of a free market.

"No, health care is a fact of life "
Again I was talking about insurance, no harm done though.

"The other puts service and quality first by mandate"
That's so easy, to just stamp a mandate and pretend it will happen. How will you motivate millions of doctors, nurses, administrators and other persons to this goal remains a mystery.

"No, one uses its profits to buy legislation to protect it from lawsuits and hire lawyers to twist the arms of its customers AND doctors"

Ah yes, well THAT particular service is provided by none other then the people whom you cry for salvation. Logic would mandate that you'd want to steer away from government interferences, not draw it in further.

"for-profit system is broken."

lol. Actually it works just as intended. Besides, you can't take that equation out of humanity. Been tried, doesn't work. The question is always, for-profit to whom?

[Olo401]

"The other puts service and quality first by mandate"
That's so easy, to just stamp a mandate and pretend it will happen. How will you motivate millions of doctors, nurses, administrators and other persons to this goal remains a mystery.

No way.. Are you SERIOUSLY this fucking brain dead? The motivation is the same as always - to keep people healthy and alive. And the distraction from this motivation is having to deal with the insurance companies and their manipulation of everything involved in health care to gain a profit.

"No, one uses its profits to buy legislation to protect it from lawsuits and hire lawyers to twist the arms of its customers AND doctors"

Ah yes, well THAT particular service is provided by none other then the people whom you cry for salvation. Logic would mandate that you'd want to steer away from government interferences, not draw it in further.

No, logic would dictate a system that keeps people healthy instead of KILLING THEM FOR MATERIAL GAIN.

"for-profit system is broken."

lol. Actually it works just as intended. Besides, you can't take that equation out of humanity. Been tried, doesn't work. The question is always, for-profit to whom?

That's the problem - it should be for no one's financial profit. A system of health care should do EXACTLY that. When financial profit is introduced into such a system, so is harm to the patient, and that harm is a violation of the very oath that medical professionals take before they can even gain license.

[guartz]

Despite the glaring fact that medicine 80 years ago (the article was written in the early 90s...so it would have actually been talking about ~1914) is so radically different than today that it really does call into question the point of comparing the way it is managed across the span of a century. Even so, I'm sure the author would argue that Libertarian ideology, like many, ought not be constrained by something like time. In other words, it worked then it can work now. Which is just silly and completely ignores vast variation across humanity and even modern history.

For some context, 80 years ago from the time of the article...there was no Penicillin, X-ray's were not widely used, blood transfusion was not used (until WWI really got into motion), even arcane things like lobotomies were around during the time most of our parents were growing up or starting families. Needless to say the type of medical care and demand for it has changed drastically.

I think most importantly is that it is not as if these type of societies are outlawed or banned, many still exist today in a variety of forms. Simply, the government and other organizations decided to take on their roles and that is continued because people's faith in said organizations. In other words, freedom of choice isn't gone - another agent simply offered another choice and people went with it.

For some reason many Libertarians tend to cry out to protect the free market and have faith in its panacea-like caress. Like some force of nature, it will always win, you can't fight it. Like the mystical Tao if you fight against it you will only be drowned like fighting a raging river. But the moment some agent like the government tries to "impede" or "intervene" in the market socialism is at the front gates, the timid virgin of capitalism is so easily motivated to give it up after imbibing a wine cooler. The more nuanced view is obviously that things are more intertwined, the boundaries between entities is not so clear and the government is one of the many actors inside of the economy and as long as the government is somewhat representative it is under similar forces of persuasion.

As far as the case of uniqueness of this article to the current situation it is hard to grasp. Simply because the real argument is hard to grasp. Is it - look the government fucked something up or we should all get back to the good old days of friendly societies and lodges. I'm not really sure and either way there are more compelling arguments to this end besides healthcare. Moreover I am pretty sure I can find examples of private sector major fuck ups etc. Fucking up is not unique to the government.

Moreover, the health plan in the works isn't imposed on anyone who already has a health care provider they like unless their employer decides to use the government one...which if people act rationally we can assume they would do so because they find it to be better than their current one and if that is in the power of the person in charge rather than employees they could change to any number of insurance providers that employees may have a problem with anyway. So the argument is not unique to the status quo. All that is changing is another choice is being made available - hit the deck sounds like competition a tenet of capitalism. Luckily we all here believe Adam Smith to a T so this government healthcare thing should disappear like an out of season Elmo doll.

Lastly, an oft-used critique on Libertarian thought is it over-emphasizes the individual. That you put the individual before the group, individuals acting selfishly somehow equates to the world we have today. I would say this lingers in the grey zone between true and false, but when you make it into an ideology and political platform such leeway isn't allowed and that becomes dangerous. Putting all the emphasis on the individual is damaging to such social safety groups that the author mentions. Social safety nets don't exist in a fully libertarian world because society is by virtue of libertarian values atomized.

Well this is refreshing.

Mattaru, I'd like to challenge you on some of the critiques made in your response. I'll begin by saying that no insurance company in America has the ability to issue currency, so your reference to competition is a bit obtuse. Neither can any insurance company unilaterally assign tax to individuals, whether they, as you say, choose to participate or not. I guess that's not precisely true, a insurance company could attempt to tax everyone, but said bills would be largely laughed at all the way to the trash bins.

So when you say, that choice isn't really gone, and that people seemed to have chosen a different agent, what type of choice are you talking about? The one between paying or spending a century in a rape room? But it's just the same, as you say, if people act rationally, they will just pay for this other choice provided for them, whether they utilize it or not, especially considering the consequences.

Also I'm a little worried that you might be confusing Clinton's plan with the current one. Yes they are virtually similar, but unlike Clinton's plan, no such discussion was taken place regarding lowering the standard of employer's offered plan to ease payroll costs. That took place in 1994-5.

Now I couldn't agree more in regards to the time difference, what worked century ago should be taken with a grain of salt. However my appreciation for your account of historic relevance seems to be misplaced. Looking back at the past 100 years of this countries history would show you how government programs start out rather well, but within a few generations begin to stagnate.

[guartz]

No way.. Are you SERIOUSLY this fucking brain dead? The motivation is the same as always - to keep people healthy and alive.

By god man, you are right! How could I have ever doubted the altruism of my own species?!

What fool am I?! What fool!