Socialized Healthcare and the Problem of Calculation

[Autodidact]

Hi Shadow Wolf,
How exactly would the government lower the costs of healthcare?

First, you eliminate an entire industry that provides no care to anyone, and earns enormous profits--the health insurance industry. Second, you provide managed, comprehensive care to everyone, so that instead of people getting expensive emergency room care for conditions that could have been prevented through reasonably priced clinical care, you spend less to get more sooner. Third, you encourage preventative care, which saves money later. Fourth, the government uses its tremendous bargaining power to negotiate lower costs from health insurance providers, especially pharmaceutical companies. Fifth, you reduce administrative costs. (Governmental administrative costs are a fraction of industry costs.) Sixth, you reduce legal costs, especially for defending bad faith claims. Seventh, you reduce administrative duplication, even by medical providers, because there is only one administrative agency, so you don't have to submit or have people review multiple bills and paperwork. Those are the main ways I'm aware of.

Because the fact is, universal health care costs about half as much as the U.S. "system." Is it important enough to you to have private health insurance for all of us to pay twice as much for health care that only some of us get?

 

[Joe_Stocks]

Hi Auto,

In the actual, as opposed to theoretical world, who is spending more per capita on health care, the U.S., Canada, Spain or Australia?

The U.S. spends the most for a number of reasons; 1. The U.S. is the richest country in the world. 2. Countries with socialized healthcare limit how much they spend by rationing the care given to its people.

And in the real world, who has a greater life expectancy, the U.S., Canada, Spain or Australia?

How many factors go into life expectancy? Crime rate, rate of auto accidents, military deaths, eating habits and on and on. These are not directly tied to quality of healthcare but have a direct impact on life expectancy, so that stat is trash.

 

[Valjean]

How is the US different from the rest of the developed world, Joe? Everyone else who's tried it likes it and would never go back. Everywhere else it has improved public health, improved access, and decreased costs.

You're like that news announcer in Baghdad that persisted in broadcasting reports or Iraqi victory and US defeat even as the US troops rolled unapposed into downtown Baghdad.

 

[9-10ths_Penguin]

And exactly how do you measure that in a non-monetary way?

I just told you: effort, time, non-monetary resources. The valuation of each one relative to the others will be different for each person. My Econ 101 prof liked to use the fictional unit of the "util" (short for "utility") to measure cost and benefit for problem examples, but I think that's a bit simplistic for real-world application.

Because there has to be waiting lines or lists, right? There is no way getting around this. This is one of the surefire ways countries with socialized healthcare can control costs; withhold healthcare from people.

Don't put words in my mouth.

There will always be some span of time from when you're first diagnosed with a condition until that condition has been cured or addressed. And there are wait times under private health care systems as well.

Most certainly does the U.S. system have its flaws. Precisely because third parties (be it government or insurance companies) pay for healthcare instead of the actual consumers of healthcare paying for it. Socializing healthcare would only make the problems worse.

Hang on... I thought you said that the free market would yield the best solution; isn't health insurance a product of market demand?

 

[9-10ths_Penguin]

The U.S. spends the most for a number of reasons; 1. The U.S. is the richest country in the world. 2. Countries with socialized healthcare limit how much they spend by rationing the care given to its people.

No, they don't.

If you disagree, please tell me the number of, say, hip replacements that have been rationed for Ontario or the number of kidney stone treatments that have been rationed for Sweden for this year.

 

[Autodidact]

Hi Auto,



The U.S. spends the most for a number of reasons; 1. The U.S. is the richest country in the world. 2. Countries with socialized healthcare limit how much they spend by rationing the care given to its people.

So the answer to my question is that the U.S., which does not have universal health care, spends the most, and all the countries that have it spend about half as much as us. From this, you conclude that universal health care costs more than our non-system? Do you see a problem with that logic at all?

Why would our wealth cause us to spend more? btw, the U.S. is not the richest country in the world. In terms of GDP per capital, Luxembourg, which spends a little more than half (per capita) than we do, is. #2 is a bit right, and is why we need to do exactly that. Universal health care saves money, as you agree.

How many factors go into life expectancy? Crime rate, rate of auto accidents, military deaths, eating habits and on and on. These are not directly tied to quality of healthcare but have a direct impact on life expectancy, so that stat is trash.

Well, there are many factors going into life expectancy. What do you think would be a good measure of a country's health care system. How about satisfaction?

 

[Autodidact]

Hi Seyorni,

Can you provide any real world examples where this occurs?

The United States of America.

 

[Autodidact]

Joe:

What would be some objective measures of how good a health care system is? I suggest:

Cost per capita.
Consumer satisfaction.
Health care statistics, such as infant mortality, life expectancy, and so forth.

What do you suggest?

 

[Autodidact]

Anyway, Joe, my main point is this. I understood the main point of your OP to be that privatized health care is more cost effective than universal health care. However, in reality, our hybrid private/public health care (which is the only relevant one that matters; I don't know if there is any country with a purely private system, and the U.S. certainly isn't going there) is the most expensive system in the world. At the same time, it does not provide the best care. So your OP is wrong.

As for denying medical care to people, what do you think the U.S. does?

 

[TurkeyOnRye]

A free market healthcare system means that healthcare develops in the direction of profit, not whether or not the healthcare actually works. For example, where's the profit in finding cures? Free market healthcare promotes treatment of symptoms, not treatment of the cause of symptoms.

And socialized healthcare is not a theoretical system; most western countries already use socialized healthcare and it works great.

The American healthcare system is absolutely aweful. A few months ago, shortly after I lost my health insurance, I went to the ER for dystonia. Apparently, all I needed was an IV of Atavan. But weeks later, I came to find that I'm stuck with a hospital bill of over $1,400. Had I ridden in the ambulance that came (which I blatantly refused, despite laying on the ground and being at the mercy of people around me.), the bill would have been much, much higher.

 

[rojse]

The most definable characteristic of free market capitalism is the price system. The price system allocates scarce resources in the most efficient uses.

In theory, yes. In a real-world sense, this is extremely debatable - there are trade tarrifs, restrictions on imports and exports, government grants, and so forth.

And the price system goes along the profit and loss system. Enterprises that produce something or provide a service are rewarded for providing it in an efficient manner. Those that operate inefficiently record losses and are punished. This spurs innovation and ingenuity as industries compete at being the most efficient at their given task.

Again, only in theory - we also reward businesses with our custom for other reasons - to shop locally, for example, because we know the owners, and so forth.

Socialism does away with the price system which then means that socialism does away with the profit and loss system.

So, the question invariably arises; how will the best types of healthcare be rewarded under socialized healthcare? Under socialism there is no incentive to be more efficient because there is no calculation system.

The incentive comes from the fact that people work in healthcare because they are passionate about saving lives.

Incentive might also come from other places - poor health care practices might be an election issue, for example.

For example, under socialized healthcare how would treatment X be regarded as more efficient than treatment Y?

Under the free market system the treatment that produced the best results at the cheapest cost would be rewarded with profits whereas the treatment that was less efficient would be punished with losses.

Again, this only occurs in theory. In a more practical sense, other considerations come to mind - the amount of money a family is willing to spend, for example.

The same scenario could be posed in regard to doctors. Will poor doctors be punished under socialized healthcare and will good doctors be rewarded with more pay under socialized healthcare? And under socialized healthcare how could there be a system to determine this?

If a doctor has poor performance record, the staff might be able to make complaints to the health care system about said doctor.

 

[Shadow Wolf]

How exactly would the government lower the costs of healthcare?

I never claimed it would. Myself, I have carpel tunnel in both wrists, advanced osteoarthritis in my left knee, pinched nerves in both knees, and my ever step is a painful one. And I can't afford to get medical help. I would first have to go to a doctor to get a referral, and probably some pain meds, then I would go to a specialist, and probably some stronger pain meds, steroid shots, and surgery. Even if I had to wait a year, or even two or more to get help, at least it would be coming, and I would probably be able to sleep better at night knowing I might not have to be put on disabilities in my thirties.

 

[ThuggishSplicer]

Her's what you do:
Be a socialist, get a good(and i mean really good) job .
Do well in your career, care for others
Once you've attained success, be a capitalist like Andrew Ryan.
Guide the Great Chain

 

[methylatedghosts]

Most certainly does the U.S. system have its flaws. Precisely because third parties (be it government or insurance companies) pay for healthcare instead of the actual consumers of healthcare paying for it. Socializing healthcare would only make the problems worse.

So... you'd rather have NO third parties...

And just let the poor people die...?

 

[methylatedghosts]

I would prefer to pay an extra cent in my dollar so that I know my neighbours will be taken care of if something befalls them, knowing that they won't get pushed down the waiting list because they can't afford to pay for it and not getting second-rate care because they can't afford a better doctor... while also understanding that they are doing the same for me.

 

[methylatedghosts]

The U.S. spends the most for a number of reasons; 1. The U.S. is the richest country in the world. 2. Countries with socialized healthcare limit how much they spend by rationing the care given to its people.

As opposed to forcing people to mortgage their house so that they can have a life-saving operation? No thank you.

I honestly don't believe you know what you're talking about.

 

[Reverend Rick]

Joe:

In the actual, as opposed to theoretical world, who is spending more per capita on health care, who has a greater life expectancy,

If you live longer, would you not see the doctor more times in your life?

 

[Reverend Rick]

First, you eliminate an entire industry that provides no care to anyone, and earns enormous profits--the health insurance industry. Second, you provide managed, comprehensive care to everyone

So you abolish one group of people and replace them with government run folks. Insurance people are less efficient than government run programs?

the government uses its tremendous bargaining power to negotiate lower costs from health insurance providers

Which means doctors will work harder and longer for less. Great deal for them huh?

you reduce administrative costs. (Governmental administrative costs are a fraction of industry costs.)

You really believe the government is going to do a better job than the private sector can?

you reduce administrative duplication, even by medical providers, because there is only one administrative agency, so you don't have to submit or have people review multiple bills and paperwork.

no checks and balances? Sounds like a run away system to me. How do you check for fraud and abuse?

 

[Autodidact]

If you live longer, would you not see the doctor more times in your life?

And yet these countries spend about half as much as we do on health care. Go figure!

 

[Autodidact]

So you abolish one group of people and replace them with government run folks. Insurance people are less efficient than government run programs?

Yes, much. The medical insurance with the lowest administrative costs is Medicare. Also, we already have these government workers; we're now duplicating costs.

Which means doctors will work harder and longer for less.

I don't think our current high costs come from doctors; I think they come from hospitals and pharmaceutical companies (as well as health insurance companies.) In fact, doctors are earning less (in adjusted dollars) than they used to, in large part because of our current system of private/public funding. Among other things, the paperwork is overwhelming.

Great deal for them huh?

I haven't seen the research (but am willing to look for it) but I think that doctors in other countries are on the average more satisfied with their jobs than here. I think that's because they get to just practice medicine, and not have to master a labyrinthine bureaucracy of conflicting payers.

You really believe the government is going to do a better job than the private sector can?

That's what the evidence shows. I think it will do a much better job of providing care, not as good a job at making a profit, but then the government isn't in the business of making a profit.

no checks and balances? Sounds like a run away system to me. How do you check for fraud and abuse?

what makes you think the government can't have checks and balances?

Rick: Why do you think the entire world that has universal health care spends about half as much as we do, and gets better care?