Rationing Health Care - it's a lie!

[Architect]

How do you trust a profit driven private insurance company over a not-for-profit democratically (and accountable every four years) government?

One where even the slightest perceived failing the NHS is plastered over the press and on the tv.....where to suggest privatisation is political suicide? Really, buggering up the NHS will lose you an election.

 

[Darat]

One where even the slightest perceived failing the NHS is plastered over the press and on the tv.....where to suggest privatisation is political suicide? Really, buggering up the NHS will lose you an election.

Not quite - if the opposition is so incompetent (and yes I am looking at you "old Labour") that they cannot get the message across that the NHS is bad because it is being underfunded, the likes of Thatcher can get away with undermining the NHS by underfunding it.

Thankfully I don't think that could happen again, at least for a generation.

 

[Ziggurat]

But the government is elected by the people. It's accountable to the people.

An insurance company is accountable to it's shareholders.

And its customers.

How do you trust a profit driven private insurance company over a not-for-profit democratically (and accountable every four years) government?

Easily: I know exactly what motivates someone seeking profit. That makes them very trustworthy: they may not do what I want, but I can predict what they will do, and hence trust them. Politicians have much more slippery motives. They make complex calculations between competing interests, and I cannot predict what those calculations will produce. So I cannot trust them. I trust Walmart more than I trust FEMA.

 

[ddt]

One of the big issues is that government run healthcare can bully corporations that develop medical technology.

Have you ever asked yourself why prescription drugs are so expensive in the US but not in France, the UK, Canada, etc? Those governments told the developers of those drugs that they can only charge a fixed amount for their drugs, this doesn't include massive R&D costs. So who pays for the the R&D? The USA does. What do you think would happen if the USA removed the ban on importing prescription drugs from Canada? Canadian prices would skyrocket and USA prices would go down slightly. It would be more fair, the Canadians would have to pick up more of the R&D costs.

In fact you're strongly arguing for health care reform. What you're saying, in effect, is that the rest of the world does negotiate with pharma companies about the prices of drugs, but the USA is so daft to pay whatever they're asking. To put it even more rhetorically: the USA doesn't understand how capitalism works. That's glaringly apparent in the Medicare part D law, which explicitly specifies that government is not allowed to negotiate over the price of drugs.

I wouldn't agree with your assessment that prices would "skyrocket" in the rest of the world - it's not only about Canada, but also about Europe, Japan, Australia, etc. They might rise a bit. But they'd definitely plummet in the USA.

This same system also applies new imaging technology and all of the other fun gizmos we have. The USA generally gets these things first (since we can afford them) but we also get overcharged compared to socialist health systems.

Do you have evidence for this?

We also have an overmedicated population, which is in part due to drugs marketed directly to people (seriously, wtf???) and doctors practicing medicine defensively so they don't get sued.

So you'd be all in favour of laws regulating this (the direct marketing)? For the record, I agree the idea is repulsive.

 

[uk_dave]

Politicians have much more slippery motives. They make complex calculations between competing interests, and I cannot predict what those calculations will produce. So I cannot trust them. I trust Walmart more than I trust FEMA.

No, actually American politicians (until now) have been extremely canny. They've managed to convince a large section of the electorate that they can't (shouldn't) be trusted with something as vital as health care and so they don't have to be held accountable for it. Great for the politicos. Just what is the US government responsible/accountable for?

The private medical insurer will maximise profits by keeping down expenditure. The sharp end of that expenditure is the policyholder.

Don't like the insurer? Go find another...oh what? No other carrier will cover you? oh dear.

ETA - It's interesting that you bring up WalMart and their efforts after Katrina. The thing is, WalMart weren't required to do what they did. There was no one going to hold them accountable if they didn't help out. It was good that they did, but the government agency has no choice, it has to act and if it fails it should be held accountable.

What if there was no WalMart to pick up the pieces?

 

[Rolfe]

I think enough of the cluster that is the US healthcare "system" is making its way into the news here this summer, to make people pretty grateful for what we have here, and informed enough to start a revolution the next time some idiot suggests adopting any American ideas into the NHS. People are particularly pissed-off by the filthy lies about the NHS that are being told in America, if still a bit incredulous at how awful things are there.

Rolfe.

 

[Francesca R]

And its customers.

Not in the US. Not in the UK either. In some countries such as Germany, a corporation is legally chartered to be accountable to employees, which leads to requirements for executive boards to be represented on by employees, but even they are not accountable to customers.

I don't know what gave you the idea that a corporation is accountable to customers. Nowhere is this the case.

 

[Darat]

Not in the US. Not in the UK either. In some countries such as Germany, a corporation is legally chartered to be accountable to employees, which leads to requirements for executive boards to be represented on by employees, but even they are not accountable to customers.

I don't know what gave you the idea that a corporation is accountable to customers. Nowhere is this the case.

But the corporations like me - why else would they keep telling me that my call is important to them!

 

[Francesca R]

They don't tell you. A computer tells you while they neglect your call.

 

[Rolfe]

Have you ever asked yourself why prescription drugs are so expensive in the US but not in France, the UK, Canada, etc? Those governments told the developers of those drugs that they can only charge a fixed amount for their drugs, this doesn't include massive R&D costs. So who pays for the the R&D? The USA does. What do you think would happen if the USA removed the ban on importing prescription drugs from Canada? Canadian prices would skyrocket and USA prices would go down slightly. It would be more fair, the Canadians would have to pick up more of the R&D costs.

Hang on, let me get that right. You are happy to pay twice as much as anybody else for your drugs, so that you can subsidise pharmaceutical research for the rest of the world? Really?

I mean, the idea that you should join everyone else in negotiating the best deal you can cut, so that the overheads were equitably split among all consumers wouldn't do for you?

As I said in another thread, this is like going to buy a new car, armed with the copy of What Car? that tells you the achievable discount is $4,000, and you know this is true because you have a couple of friends who bought the same model from the same dealer and they got that discount. But you refuse even to ask for the discount, because you believe that unless you pay full list price, Ford won't be able to develop the next new model.

Good grief, nobody can be that naive. And in this respect, the pharmaceutical industry isn't so different from the motor industry.

This same system also applies new imaging technology and all of the other fun gizmos we have. The USA generally gets these things first (since we can afford them) but we also get overcharged compared to socialist health systems.

Evidence? That US hospitals get new imaging technology significantly earlier than say French or Japanese?

We also have an overmedicated population, which is in part due to drugs marketed directly to people (seriously, wtf???) and doctors practicing medicine defensively so they don't get sued.

And do you wonder why direct marketing of prescription drugs is allowed in America but not anywhere else? Because your politicos have been bought and sold for American gold, that's why. The same reason as you are the only mugs on the planet paying list price for your new Focus.

And does it not occur to you that the answer to your dilemma is right in your own post? Pharmaceutical companies' advertising budgets are significantly larger than their R&D budgets. They're so competitive that they will never self-regulate to reduce marketing. All you guys have to do is to ban direct-to-patient marketing of prescription drugs, and hey presto, you've probably saved the drug companies enough money to cure death.

I never met anything so unworldly as an American trying to defend US healthcare pricing policies.

Rolfe.

 

[Darat]

They don't tell you. A computer tells you while they neglect your call.

Oh pull the other one - the nice lady doesn't sound anything like Stephen Hawking.

 

[Francesca R]

I've not heard Rolfe speak but that comment is a little south of the border.

 

[Darat]

 

[Ziggurat]

No, actually American politicians (until now) have been extremely canny.

"Canny" is not a synonym for "trustworthy".

They've managed to convince a large section of the electorate that they can't (shouldn't) be trusted with something as vital as health care and so they don't have to be held accountable for it.

Uh, no. Some politicians are trying to convince people of this. Some politicians are trying to convince people of exactly the opposite. And some of the politicians trying to convince me that they are trustworthy enough to run healthcare are ones who have demonstrated that they cannot be trusted (Barney Frank, I'm looking at you). To portray them as a monolithic, Machiavellianly cunning group is just silly.

Just what is the US government responsible/accountable for?

Spending taxpayer money. And many of us aren't happy with how they've been doing.

The private medical insurer will maximise profits by keeping down expenditure.

And enrollments up.

Don't like the insurer? Go find another...oh what? No other carrier will cover you? oh dear.

Welcome to the perverse non-market mechanics of employer-funded health insurance. Thank you, FDR wage freezes!

 

[ddt]

I've not heard Rolfe speak but that comment is a little south of the border.

Let's not bring the West-Lothian question into this thread.

 

[Ziggurat]

Not in the US. Not in the UK either. In some countries such as Germany, a corporation is legally chartered to be accountable to employees, which leads to requirements for executive boards to be represented on by employees, but even they are not accountable to customers.

I don't know what gave you the idea that a corporation is accountable to customers. Nowhere is this the case.

I didn't say they were legally accountable. They are financially accountable. If they don't provide what their customers want, the customers stop giving them money. That's a rather important accountability for anyone whose goal is to make money.

 

[Ziggurat]

ETA - It's interesting that you bring up WalMart and their efforts after Katrina. The thing is, WalMart weren't required to do what they did. There was no one going to hold them accountable if they didn't help out. It was good that they did, but the government agency has no choice, it has to act and if it fails it should be held accountable.

And yet, who performed better? That FEMA is in principle more accountable than Walmart somehow didn't produce the expected result. Maybe this in principle accountability isn't all it's cracked up to be. Maybe customer accountability, despite (because of?) the fact that it's financial and not legal, can work pretty damned well.

 

[uk_dave]

Maybe customer accountability, despite (because of?) the fact that it's financial and not legal, can work pretty damned well.

So WalMart didn't decide to help through altruism but rather because it felt it's customers would demand that it helped?

What did say... Proctor & Gamble volunteer to do in the immediate aftermath of Katrina?

If private enterprise was rushing in from all over the US how could FEMA have failed? They'd have had bugger all to do!

You want to leave such things to the vagaries of the market place or individual altruistic intent? What if no one steps up to the plate?

 

[Rolfe]

Sigh. One more thread disappears into the sand of the pissup in the brewery argument.

Anyone who hasn't seen the discussion about the (non)effect of ensuring that everyone in the population has access to affordable healthcare, could start about here.

http://www.internationalskeptics.com/forums/showthread.php?postid=4990232#post4990232

Rolfe.

 

[GreyICE]

And yet, who performed better? That FEMA is in principle more accountable than Walmart somehow didn't produce the expected result. Maybe this in principle accountability isn't all it's cracked up to be. Maybe customer accountability, despite (because of?) the fact that it's financial and not legal, can work pretty damned well.

Uh, FEMA spent several billion in aid. Wal-Mart, although admirable, probably gave out at most $100-$200 million in cash ($20 mil) and goods.

I'd suggest when the private institution giving out $100-$200 million is praised while the public institution spending billions in aid is criticized, that says everything we need to about whether people think that the generous corporations will really save them.