An excellent, well thought out and argued post.Although our opinions differ on more than a few things lol.
I thought you meant shortages as to medicine not in amounts of HCP available. My fault for misunderstanding you.I agree, there is a serious lack of medical personal in Canada that needs to be remedied.
I meant both, actually. It's an irony of the socialized systems elsewhere that the US has such huge drug costs. The price controls in other countries make it barely profitable to still sell the drugs there so long as the US bears the burden of development and taking up the slack of any marginal return not gotten elsewhere. Were the US to implement price controls
a la Canada on drugs
en masse you'd see a serious shortage of meds hit fairly quickly with little to no development taking place as well.
As for the shortage, you can't 'address' it other than to let supply and demand equillibrate. The governemnt may raise the prices doctors can receive and you'll get more of them, but the unerlying problem is you can't play market, you can't replace a genuine price system. You'll likely end up paying more than you should have in that situation.
I do know many families that do not have health coverage in the US. My wifes mothers best friend died because of it. Many can not afford it. Some of her family died because of not being able to make it to the right hospital covered in their HMO.Why isn't there a slew of paperwork available to the public on it? Why isn't it reported far and wide? No one in government or the medical business machine cares about the poor.There is a lot of undocumented things that happen in the world my friend.Ever heard of invisible children?
If they were denied at an ER then that hospital commited a crime. And the HMO act is a government action, not some creation of the private market. It is in fact the beginings of the rationing in the US that was predicted quite some time ago. As for the prices, once more I ask what is magical about health insurance that keeps prices high? In every other industry they tend to go down, at least those industries without major government interventions. And they go down despite high costs for specialized personel and machines. It isn't exactly a simple matter to manufacture a computer chip and bring a whole computer to market. You need multiple engineers working on it earning easily 6 figures each and specialized capital like clean rooms, pure silicon, ultra precise machinery, static free rooms, etc., etc., etc. Investments totally millions if not billions. Yet comuters are dirt cheap despite the massive capital investment needed to produce them. What too many analysts miss is that they are cheap
because of that investment, not despite it.
The reason things are reversed in the medical field is because there are disincentives to increasing supply as well as regulations and mandates galore that interfere with pricing, not the least of which is general inflation and entitlement programs creating more and more dollars to chase the existing supply pool. David Beido has done some great work in this field, specifically looking at the development and subsequent destruction of fraternal organizations and other voluntary, free market approaches to getting health care to people. As the government took on more and more of those functions prices went through the roof with little to no observable effect on availability. That's not a coincidence. Another great book that touches on this issue is The Unraveling of America, which addresses welfare programs in general but does touch on medicare and medicaid specifically as well.
BTW have you EVER been to Cuba? Do you know any Cubans personally?
No and yes respectively. The ones I know would rather die than go back, even if they had breast cancer.
I do. They are very articulate and have an educational understanding far surpassing that of any average Americans that I know(of which I know a lot).
Ever met any Cuban political prisoners? I have. Ever met any that Castro didn't want you to meet or who hadn't spent significant amounts of time in the US? It's easy to educate people with a public system if you kill massive amounts of demand by throwing people in prison and stifling dissent. A socialist system which never has to meet any real demand thanks to routine massacre, deprivation and imprisonment isn't one that's going to have too many problems.
The American school system is a joke. The basic knowledge taught in comparison to Canada is a joke. I can name all your states for instance...I have met few Americans that can.Their main goal is to sluice people in to college as quickly as possible. I am aghast at the lack of common knowledge that people in American schools have. I am not supporting Communism or any political party or Government as I believe they are all useless fyi.
The American school system is virtually controlled by the government. What makes you think our government will do a better job with health care than it has with schooling? In fact our school system is a text book example of what happens when something is nationalized and actual demands are put on the system: quality goes down; cost goes up; costs are forced onto the tax payers who, haven't paid for the 'service' once already are more and more reluctant to pay again for a private alternative; the private industry due to a shrinking market ends up either getting entangled with the public side to get hold of some tax dollars, or ends up getting marginalized and serving a reduced market of only the rich and super rich at prices fewer and fewer people can afford. That is in fact exactly what we can expect over time should the government nationalize or even significantly raise its involvment with our health care system. The poor and increasingly over time the middle and upper middle class will come to rely on the system and not be able to afford the remaining alternatives; the rich will have their choice of whatever they want and everyone will bitch about 'the system' not working and not be willing to accept that it
can't work.
I DO think it is greed when you charge say $2000 for 3 stitches and a sample pack of T3's(which a helper of mine received) or a bill for $1350 just to talk to a doctor, that is BS. No one deserves that. The difference between what I do and a doctor who charges ridiculous amounts is there is not a price competition among doctors. They can and do charge whatever the hell they want to. I have to cut prices when my competitors cut prices so I can stay competitive, they don't.
Greed? Maybe. So you're telling me if we enabled any other profession to charge whatever the hell they wanted, say auto mechanics, that they'd all become altruists and charge barely above cost? No, they'd suck the system for every penny it's worth, just like most any other person would. What you are missing is that they don't have some mystical power that allows them to do this, the system is geared to let that happen. We have laws and mandates that basically allow a doctor to get paid for anything he wants done. We have two massive single payer systems which spend everyone else's money on services demanded by other people. We have a defacto third party payment system in the form of employer provided health plans, again people spending money that largely isn't theirs on themselves. All of these and other factors allow people to essentially rape the system.
As an analogy, do you know a single service that would work today without a computer? Our entire modern lifestyle is based on near instant communication and massive processing power. You would think that would put computer manufacturers in a position where they could charge damn near anything. But they can't, because the market in computers is still relatively free. Of course, should IBM get a law passed saying that all government servers have to be I Series and anyone who wants to interface with them has to use I Series, etc., well then guess what happens to the prices of those servers and IBM products in general? Kind of like getting a law passed saying if you want drug X to cure or treat condition Y, first you have to go to a legally designated drug dealer, otherwise known as a doctor/pharmacist. Or, kind of like getting a law passed which allows a professional association to exercise control over the supply of their service providers, like I don't know, letting the AMA control the supply of doctors for all intents and purposes. Suppose MicroSoft got a law passed controlling the supply of MSCE instructors and a law mandating the use of their and only their software for certain applications. Think their salaries might go up a bit?
There was a time when doctors
couldn't charge what ever they wanted to, it was before the government enabled them to do so. And the answer isn't to go to the opposite extreme in socialization and enact price controls, it's to get rid of the interventions that caused the problem to begin with. Get rid of the AMA's strangle hold on supply. End FDA monopoly on drug control and end doctors' monopoly on RX privileges. Make all health care costs tax deductible so people will be more willing to pay out of pocket. Repeal all laws that force insurance companies to pay for whatever a doctor orders, no matter how unnecessary. Repeal all laws and mandates which screw with insurance pricing. You say you don't support one approach or another, but you write of the US system as if it has somehow up until now escaped any significant government control or intervention. Nothing could further from the truth. When you speak of the problems with the system you pinpoint doctors. Do you honestly think that doctors are any more or less greedy than any other profession on the planet? If not, why does the raw greed present in us all allow us to merely charge ten to twenty times what we normally would for our services? You've got the problem nailed, but you are
way off on identifying cause. If greed caused high prices
nobody would be able to afford
anything. Hell, we all need food to live, so why don't greedy farmers charge a thousand dollars per carrot? Something systemic has to fuel and enable that greed by tipping the bargaining scales in one party's favor. And doctors are in no more inherrently better bargaining position than a body shop for cars or a grocery store selling food.
You don't run around bleeding to death getting quotes from other doctors for the cost of saving your life.
No, you don't. But as with any other situation if you haven't planned ahead for an emergency and one arises, you would expect to pay a premium. This is a completely irrelevant point; people can and do plan ahead. Some choose not to, why the hell should anyone else pick up the tab for their stupidity and/or lack of responsibility? Why should they be immune from the premium that would arise in any such situation?
I don't get to set my own prices for my work because its not a life and death situation.
This is, once more, irrelevant. People can plan ahead. That is what insurance is for. And it would be a hell of a lot cheaper if the government would step out of the game and allow proper risk tiering, a la carte pricing, end mandates for forced coverage esepcially when it's for things which aren't strictly insurable risks, and either end the employer tax deductible status of payments or extend it to all health care costs including those made by individuals. In other words the instrument by which to tame these life and death situations exists and would be open to all and affordable for almost everyone if the government would stop interfering and jacking prices up.
Several examples: Why the hell should I pay for drug/alcohol counseling coverage? I don't want it or need it, it's not a strictly insurable risk to begin with which means the cost of 'coverage' will necessarily be higher, but my insurance company is forced to include it in my policy. I don't want it, I have to pay for it. Why should high risk people not have to pay higher premiums? Connecticut used to have and for all I know does still have a law that prohibits charging higher premiums to breast cancer surviors. There are similar mandates throughout the country in all the states and some on the federal level as well I believe. A higher risk person should pay a higher price. Why the hell should I be forced to pick up the tab for someone else's risk? Why the hell should they be forced to pick up the tab for my family's history of heart disease? Why should every fat slob's extra risk be put on the bill of those who remain fit? Why should whites have to pay for the higher blood pressure of blacks? Why should blacks have to pay for the risk of dipshit whites who have a greater tendency to smear themselves across highways in sports cars they shouldn't be driving?
Insurance companies are not the devil, they are like any other business. Give them the enablement and they'll rape the system. Let them alone and they'll serve the customer to get their business. Right now they are hobbled in many ways and enabled in others, and all of it adds up to higher prices for the consumer.
You should want to do it to help people plain and simple. I don't know any poor doctors in any country do you?
I call bullshit. Everyone deserves to make whatever living they can. Doctors are not saints. We don't expect car mechanics to enter their trade for the sheer love of grease and tire tread. You're talking complete nonsense. All people enter into whatever trades they feel drawn to and which they think will earn them a living by putting their talents to the best use. Doctors are no different. If you have a problem with thier pricing I suggest you look into the many ways in which the system is rigged to enable them.
I agree that it is possible.Not that it will.It won't.The governments across the world could put down their arms and devote themselves to feeding clothing and healing the poor of the world..will they do that? No they won't.They could though.
No, they couldn't. That's what's underlying what you're missing in this whole argument. The government is not the perfect cure for the imperfect market, it's just a bunch of people with the power to make laws, levy taxes, and kill dissenters. The problems we're dealing with are not problems of obedience, you can't wave the magic wand of legislation and make them go away. They are in fact due to too many attempts to wave that very wand and the morass of **** that's been left in the wake of such interventions.
They spend tax $$ on such utter useless crap. Like a a load of cash in Canada to cover a statues penis...I mean come on.
I agree, if we could take the politics out of politics, then political systems would fuction perfectly. However, you may as well try to get rid of the friction and subsequent heat and all the problems it causes in internal combustion engines. It's not going to happen.
As for insurance I agree they could do well..but why would they want to change what works for them or for politicians?
They won't. So what makes you think politicians will change that too? More controls will be passed off as being in the interest of the people or the poor, it will end up being another enablement of the doctors and corporations at the expense of the people in the end. The answer isn't more government or putting 'the right people' in charge. It's ending the existing enablements and thus forcing the doctors and the insurance companies to deal directly with the consumers that are their customers. Making them deal directly with the people that are supposed to be their customers, the income they are willing to devote to their services, and the expectations they have and want met.
I think medical school should be free in order to increase supply. There also needs to be more schools. It won't happen but it should.
There is no such thing as free, there is only 'on someone else's dime'. And it shouldn't happen. We'd get a glut and end up with unemployed med school graduates. The supply of doctors like everything else should be dictated by the demand for such. That is something that can only be discovered, not known in advance and planned for.
