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Stossel Solves the Health Crisis with Capitalism

Earthborn said:
What sort of bizarro world insurance company allows such a thing? If there is no medical need to pay for a more expensive device, why would it bother to fund it?

Why doesn't the insurance company pay for the generic?
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I can answer this. There have been studies into why, exactly, HMOs tend to provide brand-name meds instead of generics. There are several reasons:

  • the HMO has a strategic partnership with a pharmaceutical - they have cross-dependencies that synergize, such as owning shares.
  • the HMO can always pass costs to the consumer; this is easier to do than pass costs to taxpayers for reasons that aren't well understood
  • the HMO needs to respond more to consumer expectations, and patients do feel mistreated if they get a generic, as they associate brands with quality; they are inclined to select the supplier that appears to provide a better quality service
  • related to the above point, the branded products can justify a higher markup on a la carte purchases
 
A political discussion programme just came on the TV here. Someone asked a question about NHS funding. Some people who don't know as much as they think they do (Germaine Greer, I'm looking at you....) said some pretty silly things. Then politician whom I really, truly, madly, deeply, HATE, explained that in the USA people losing their jobs in the current recession are also losing their entitlement to healthcare. Thanks to the NHS, we in Britain never have to face that. And he will never sanction any "reforms" that might threaten that.

There was a bit of a stunned silence, then a cracking round of applause.

I'll never vote for the guy before hell freezes over. (The guys I vote for believe the same thing anyway.) But I just started to respect him a helluva lot more.

(Oops, Germaine Greer just said something sensible. Hell must be getting a bit icy....)

Rolfe.
 
Mongrel said:
Sorry, missed that :blush:
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I simplified. First, it was OK because he wasn't forced to contribute. Then, although he was opposed to taking out more than one had contributed to the system, it was OK for him to do that if he had to because the other people in the insurance policy were also in it voluntarily.

He kind of sidestepped the problem that he was actually contributing to other people's healthcare through his insurance, completely avoided addressing the point that some of these people almost certainly eat junk food and drink too much, and ran a mile from the revelation that his premiums were artificially high in order to support the legal duty of the hospitals to treat every emergency presentation even if that person has no means of paying.

Then he revealed that the job he was in didn't give him a choice of insurance plans anyway.

Rolfe.
 
blutoski said:
I believe that the only reasons they don't adopt a single-payer system is that the public is given false information, and also some simply subscribe to ideology over self-interest. See: "What's the Matter With Kansas."

Free-market cranks just can't accepte it, and invent stories or scare tactics to distort the public's ability to make a rational decision....
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There certainly seems to be a lot of false information sloshing around.

I mentioned my Tennessee friend, who has lupus. She had to lie on her job application when she wanted to change jobs, in order to get her healthcare provision continued. She then had to struggle to work while she was having chemotherapy, because there's no concept of sick leave apparently. And even though she was covered by insurance, it was still costing her a fortune.

And she was genuinely, completely, grateful to be American. She had been told that only in America would she have access to the chemotherapy drugs she was getting.

I didn't have the heart to tell her that wasn't true. If she'd known that in Britain she's have got the same drugs free at point of need, with no tie-up to her employment, and that she'd also have been entitled to a reasonable period of sick leave to recover from the chemo and the flare-ups, and that when she finally had to admit defeat and give up work, her entitlement to healthcare would be completely unaffected, I fear that she'd have lost something that was very important to her.

Posters here have told us that we have a second-class system, and that only in America do patients get "the best". I ask them to tell me what more Abigail could have received if she'd been American, and moreover, to assure me that Abigail would undoubtedly have received that treatment even if her father had been an unemployed builder's labourer. Nobody has yet answered that at all.

Posters here have told us that we have no choice, and the government dictates our treatment. I point out that only our doctors dictate our treatment - not an insurance company - that we can choose whichever doctor, hospital or consultant we want, and that we can even choose to go private through insurance or self-pay. I've shown conclusively that we have a far wider range of options to choose from than US citizens, that every single option they have we also have, and more besides. No answer.

Posters here have told us that we have less freedom. I point out not only the freedom of choice, but our freedom to change or leave our jobs without worrying about our healthcare coverage, and so on. No answer.

Posters here have told us that our doctors are coerced and enslaved. I ask just how this guy is enslaved. No answer.

Posters here have said that we are having money "ripped from our wallets" to pay for other people's healthcare. We point out that US taxpayers are having even more money ripped from their wallets for that purpose, and at least we are entitled to benefit from the care our taxes are funding, unlike them. No answer.

And so it goes on. One drive-by poster after another, making the same completely fallacious arguments. And Dan, clinging to his mutually exclusive positions and his cognitive dissonance.

It's a bit like the homoeopaths. One continues the discussion as much to try to understand how anyone can possibly hold such views as to explore the actual topic.

Rolfe.
 
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Darat said:
I think Policenaut does have a point. Why is Medicare and the other current communist socialist fascist non-universal but here's a band-aid of something not quite totally unlike universal health care so expensive?
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There have been investigations into this, and there is more than one contributor.

Largely, the Medicare system in the US is a different demographic. The HMOs make an effort to reject applicants who are likely to make claims, ie: unhealthy people can't get insurance. These uninsurable people will need to rely on Medicare.

Additionally, there is an expensive overhead administrative cost in the US Medicare system that is not borne by nationalized systems in other countries that have a universal coverage: verification of qualifications such as means tests.

Having said that, the independent comparisons are that Medicare has about a 5% administrative overhead, Canadian health ministries have about a 1% administrative overhead, and US HMOs have about a 40% administrative overhead.
 
Tim Moen said:
My problem with UHC is primarily ethical and results from my lack of belief in positive rights (the notion that I must be coerced to provide some service or resource to someone else):

1) Money should not be extorted from one individual and given to another.
2) Physicians, or anyone who provides any service really, should not be compelled to work against their will, or charge prices against their will. Coercion is unethical and counterproductive in the long run.
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Just to come back to this: I appreciate the frankness and insight in recognizing that the reasoning is associated with a philosophical outlook rather than an interest in utilitarian benefits. I am reminded of my youth, where so many of my colleagues explained that they would be quite satisfied if everybody in the world was killed in a nuclear exchange, so long as it meant the Soviets didn't gain another hectare of Europe. It's a choice.




Tim Moen said:
As a Canadian healthcare worker for the past 16 years, I've seen what I consider to be a steady decline in healthcare in general. I attribute this to the increasing socialization.
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I'm revisiting this, because I'm not sure why you said it. The Canadian healthcare system, from what I can tell, has been becoming more privatized, although obviously in small increments and in particular ways. Mostly subcontracting operations.




Tim Moen said:
When you work for the state your incentive is not the same as when you work for the person you are trying to cure. The result is a growing bureaucracy, increased health spending, increased hospital wait times (the University of Alberta hospital recently found a guy with rigor mortis waiting in a chair... for real).
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I'm familiar with this story. It wasn't caused by wait-times: the patient was overlooked - didn't even check in with the clerk. This happens quite often, unfortunately. Surrey Memorial in BC has a terrible reputation for not noticing patients in the lobby, mistaking them for relatives or the indigent. Edmonton is particularly challenged becuase in winter, the homeless do park themselves in public buildings, including hospitals.

Just as a comparison: my friend who is a surgical nurse just moved here from LA, and she actually worked at a hospital that almost lost its license to operate because so many patients died in the lobby during a probationary period. (the probation was triggered by their habit of putting patients who had no means of payment into taxis and dumping them at a shelter - yup: my friend worked at the same hospital made famous by Moore, and she can verify that they learned nothing from the bad PR)





Tim Moen said:
For at least the last 6 years political rhetoric about the looming healthcare crisis has been on the increase. The average wait time in ER in Quebec is something like 13 hours, and in one Montreal hospital its 29 hours.
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I find that doubtful. I'd appreciate a reference. I read the CMAJ waitlist monitoring surveys quarterly, and this is not what they are reporting.





Tim Moen said:
Rolfe, you aptly point out that healthcare is not an abundant resource. Its scarce, and with our population aging its only getting more scarce. Is it your contention that Marxist principles are the best way of dealing with a scarce resource? I'm more convinced by the Austrian school of economics. It seems much more plausible that individuals can determine the value of a scarce resource much more efficiently than some central bureaucracy, since its the individual themself who has to buy it or produce it.
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I don't think we have to deal with hypotheticals, here. Austrian School... Marxism... academic.

Bottom line: the US system provides worse care, covers fewer people, costs twice as much, and the tax burden paying their public fraction is paradoxically higher than it is for Canadians, covering everybody. No theory required.

Ethical objections are understandable.

But there is no credible objection for those who value results.
 
And the rest?
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The rest would benefit from lower prices for health care.

Stossel set up a complete straw-man idea that instead of shopping to a budget, everyone would be filling their trolleys with caviare and smoked salmon. And the supermarkets would hike their prices to astronomical levels because the shoppers wouldn't care. It was ludicrous.
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What makes it a straw man, because you say so? Because you don't recognize the common sense within it?

It might be a reasonably workable solution for people in work, with secure employment, and no chronic health problems. But as a panacea to deliver healthcare to everyone, it's a non-starter
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Now that is a straw man. It wasn't presented as a panacea to deliver health care to everyone. It was presented as a way to introduce free market forces into a system that essentially doesn't have any now.
 
Yes, because providing vaccinations and antibiotics is entirely the same thing as "buying steak". :rolleyes:
 
Now somebody is going to start screaming about "loss of our precious Freeeeeedomsssss!", any minute now.
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Do citizens in your country have the option to opt-out of paying a percentage of tax for UHC?
 
Hittman said:
What makes it a straw man, because you say so? Because you don't recognize the common sense within it?
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OK, maybe I need to explain why Stossel's "food insurance" was a straw man. I thought it was obvious, but maybe not. Forgive me if I sound as if I'm explaining this to a small child, but really!

He portrayed consumers running round a supermarket filling their trolleys with the most expensive produce with no care for the price. He also interviewed a store owner who (in response to a couple of leading questions) indicated that he would happily raise his prices to the stratosphere in that situation.

How you can imagine that this is realistic I have literally no idea.

Insurance is a means of spreading risk. Not everybody is going to have their house burgled. But for those who are, it can turn out expensive. I don't know in advance whether I'm going to be one of the unlucky ones or not. So I choose to join a club, as it were, where everybody pays a contribution, then that pot of money is used to pay for the damage of whichever member has the misfortune to be robbed in this way.

The entire premise of the setup is that not everybody in the club is going to be burgled. Most people won't be. So most people will be paying out more than they get back. They just think it's a good deal because they like knowing that if they do happen to be the unlucky one, then they won't be stuck with an enormous bill.

Now supposing that every member in the "club" was going to have their house stripped bare. Inevitably. (And also, going with Stossel's analogy, that they were then entitled to refurnish with the absolute best of everything. And that furniture dealers at the same time doubled their prices.) How would that work?

The cost of the premiums would soar. Enormously. Given that premiums have to cover not just the cost of replacing the household goods, but administration of the scheme, individual premiums would be well over what it would cost the members simply to go out and buy new furniture.

Forget it. It's not even that such a scheme would collapse, because everybody would be a loser. It's that nobody would be crazy enough to set it up in the first place, because it's perfectly obvious that food supply is not an area where the concept of spreading risk is applicable. Unless you're John Stossel, apparently.

Now consider health insurance. It's not exactly the same as home contents insurance, because most people will have some healthcare requirements in their lifetimes. However, like the burglaries, some people are going to be faced with very big-ticket items, and some won't. So again, you join a club. This time, the premiums are a bit more, because you recognise that everybody is going to take something out and you ensure that you can cover this demand. However, the same basic principle applies. Those members who have the misfortune to need the big-ticket items are not faced with an enormous bill they have no hope of paying, and the majority, who pay in more than they get out, are content in the knowledge that if they do happen to be unlucky, then they will be looked after.

Explain to me again how that "food insurance" analogy is in any way comparable?

Rolfe.
 
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Darat said:
And those that still can't afford the now (apparently by magic) cheaper health-care?
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Don't you remember that everyone in America can afford a car, Darat? There are no poor people in the US!
 
Hittman said:
Now that is a straw man. It wasn't presented as a panacea to deliver health care to everyone. It was presented as a way to introduce free market forces into a system that essentially doesn't have any now.
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Possibly. It was a nice example of Stossel's shifting of the agenda during the programme.

Remember the beginning of the programme. The woman with breast cancer who was stranded with no healthcare entitlement, because of sheer bad timing. There were other examples, but that was the most striking and the most clear cut. Now when a programme begins by showing an obvious victim of a broken system, there is an assumption that somewhere in there, some sort of remedy for this person, or those like her, is going to be suggested.

Nope. A better insurance policy is still an insurance policy. Exactly the same problems with lack of entitlement, lack of ability to afford the premiums and exclusion of those deemed to be bad risks are going to apply.

There's no possibility that a better insurance policy is going to "solve the healthcare crisis", which is how this was presented to us.

Rolfe.
 
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