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HURRAH! Well spoken!

Agreed. Sounds like the perfect argument for getting .gov out of the medical business.

Nope, it's not. Those two things are mutually exclusive, and people advocating that route (and the state of Taxachusetts) are wrong.

If you're referring to the fact that private enterprise screwed themselves to the point of bankruptcy, then I suppose you're aguing in favor of a pre-iron curtain Soviet manufacturing system? Rather, if you're referrencing it's death to the fact that Government Motors has now taken over, how is it that 100% Government Medical will be any different than those two situations?



I mean, come on, everyone needs a car! Everyone needs their health! Everyone needs groceries! And clothing! Without government we would all be nude, and we can't have that.


I propose Government Motors, GoverMayo Clinic, GoverRainbow Grocery, And Govercrombie and Fitch. What a paradise we would have! No one would have to pay outrageous costs for anything!

Yaaaaaay! Utopia at last!

What screwed up the system was WWII wage controls, and the decision to allow companies to offer health benefits in lieu of increased wages.


The fundamental principles of economics don't change.


Exactly. Government interference has resulted in significant distortion to market signals, and the result has been soaring costs. The solution is not greater government interference, and the complete elimination of market signals.


Who, exactly, is that?


No one I know is defending the system as it is. We're arguing that the only fix is to restore market signals.

As for the plan, a return to where health care "insurance" is actually insurance - a hedge against rare, catastrophic events, and not a way of paying for entirely predictable, routine expenditures would be a nice start.

What the fiscal libertarians are arguing for is:

1. Break the employer-provided health care link. Remove the tax benefit for employer-provided health care, and give it to the individual. Let individuals buy their own plans, and/or joing in any group plan of their choice. If their employer establishes a group plan, they should be free to join it, but there should be no economic penalty for joining some other group. (As for who would be offering group plans, other than the employers, I can buy life insurance through the NRA, why should I not be able to buy medical insurance?)

2. Allow greater variation in the plans. Individuals should be able to choose plans that they think best suit their circumstances. Inexpensive, high-deductible plans should be available. Tax-free health-savings accounts should be available for routine medical expenses.

3. Allow actual competition in health care. That is, allow people to buy health care plans from anyone they choose, not simply the three provides that their state government has seen fit to authorize.

4. Remove mandates on coverage. There is no reason whatsoever that someone should be forced to pay extra for risks that he does not face.



The American automotive industry is dying because of government efforts to protect it from having to adapt to market realities. Our current health care system suffers from much of the same problem. The difference is that their is a health international automotive industry eager to take up the slack. There is no such replacement with health care. Canada has managed, because they've been able to come to the US, when the problems in their system get too severe. Where will we go?

In a government rationed system, how do we continue to incentivize pharmaceutical and device manufacturing innovation?

We don't. We'll just mandate technological advances, like we're doing with fuel economy standards.

"You! Invent something! Now!"

Well, it is rationed NOW. By your insurnce company. I think it may be actually easier to get the government to approve expensive new lifesavers than to get the insurance company to do so. Like, a lot easier.

I'm willing to take chances with change, because health care will shortly bankrupt our country. We don't have time to plan for every cotingency. Do the math. Economy grows 2% per year. 25% of economy is healthcare, and THAT sector is "growing" about 20% per year. What will the ratio be in 4 years? In 8 years?

I think the last thing we have to worry about is "incentives" for unaffordable treatments. How about incentives for folks trying to sort out the big problem, which is how to deliver and pay for basic services. When your health card is rejected because your employer missed a premium, you won't worry about a new stent that costs 5 times as much as your last one, which is no longer available.

America will probably get universal health care rather suddenly. Sort of like we got into banks and car companies this year.

In the meantime, any suggestions or discussion of the health care crisis will serve as subjects for talk radio jocks to bitch about.

We have never had an industry quite like the current medical/insurance/government conglomerate. So, our past experience and private enterprise experience are really not relevant. We can bitch about the rest of the world but at some point we have to either come up with a better plan, or we'll hiring them to set up our plan.

By what evidence? Where in the world has that ever been the case?


Do you think that's open-ended growth?

It's not the approval process I am worried about, it's the incentives. The truly smart people will not develop expensive new products that ultimately become cheap, efficient lifesavers because there will be not enough incentive.

The best talent will go to higher paying industries.

Nah. That's just industry hype. Health care advances are happening all over the world. The US is a small part of the whole thing. And the government is the a better sucker fo new lifesaving technology than an insurance company.

The "talent" now goes to the marketing end of health care technolog,y not the quality end. It's get government approval, get rich, and have a new product ready to replace it whenever people discover it's not as good as they sold it.

I don't buy that at all. I personally know three engineers right here in town in the medical device field who will bolt to computer science or another technology field if they can't get paid what they are earning now.

Well, anyone who's willing to "bolt" for more money doesn't have their heart in their job anyway. There are plenty of research doctors who do have their heart in their work. And it's not like these guys are not paid very well. We don't have the resources to cover our health care bills, and yeah, there'll be cuts. When Mom's can't afford pre-natal care, nobody will worry about these Twin City engineers, i think.

Yep. In any other area, I'd argue about how much of an improvement having multiple providers each making their own decisions is, over having a single provider, in a monopoly position, making the decision. If we were talking higher education, for example, I'd argue that there is a huge difference between having the government deciding whether you qualify to go to college, vs. having thousands of independent colleges each deciding on its own whether you'll be accepted there. Auto or homeowners insurance is the same. Each provider has its own policies, and we routinely compare prices and coverage and reputation.

But we're talking health care, and few of us have a choice. Our employers pick our insurers, and our plans, and we have little choice, and little remedy. And even if we did have the choice, in most states there are only a handful of companies legally authorized to offer health insurance.

Most of the problems we're having are due to people having too little choice and too little control. The solution is increase choice and to restore control, not to eliminate all choice and control.

Well, that may be how you feel, but it doesn't reflect reality. Their skills are interchangeable and they will move on. If somebody offered me more money for essentially the same job, I would take it for my family's sake. If I didn't, I'd be a selfish bastard.

It's elementary economics, if you want less of something, make it more expensive or reduce the reward.

Ah yes, in America fascism was never done quite right, because people recognized the value of economic liberty and freedom of choice. Now that those values are no longer held by the majority, and your description of the current medical/insurance/government conglomerate is progressing into it's more perfect form, people are starting to realize just how crappy of a system it is, even if they don't know it's fascism.

So, your solution is to replace the developing medical fascism in this country with a communized one, because the fully functioning experience of the past under a freedom-based private enterprise health system are... too old?

Huh?

As in: "it used to work, but that doesn't matter, because it's no longer relevant. The expriation date for freedom is 200 years, and we're past that due date, we need something beside freedom and private enterprise to fix our problem."

That sounds glaringly to me like Bush's argument of "911 changed everything". The thought process is always the same: "Freedom and presumed innocence used to work, but that was in the old days. Now we just play lip service to how great freedom is, while we tap your phones, and humiliate you at airports, remove your due process, etc."

After all, it's to keep you safe.
After all, it's to keep you healthy.

Someone tell me why liberty is never the solution to anything anymore?

According to some people, liberty is too expensive these day, therefore, you need government to control costs.....because they are so good doing that.