[ExI] Medical Costs

Lee Corbin lcorbin at rawbw.com
Wed Feb 20 04:22:50 UTC 2008

Fred writes

> I have yet another small request.

Quite the demanding fellow, eh?  :-)

> If we are going to have a long drawn out debate on medical costs then
> would all of the participants please use some common sense and provide
> the details and background for the various data sets that will almost
> inevitably be tossed around.
> In particular it is useful to document the nature of what you want the
> health care system to do and the nature of the persons involved.

Yes, not only do people probably want, as you point out, systems
to do different things (each participant with his own agenda), but
even what people want out of a discussion can vary. For example,
I'm most interested in understanding economics, mechanisms,
and incentives, while others may be more interested in a factual
comparison of existing systems. Stathis and Damien are perhaps most
interested in the latter---and had good discussions earlier with Rafal
and J. Andrew, without, so far as I know, any consensus being

> Define the inputs, the outputs, all of the relevant parameters
> and the criteria used for making a decision.

What an optimist!

> A small example:  Two people each have the same model (same year) of
> Toyota Corolla.  Person A in takes Car A to Pat's Garage and pays $100
> and leaves with a car that gets 30 MPG.  Person B takes Car B to Chris's
> Garage and pays $200 and leaves with a car that gets 25 MPG.  Which
> garage is getter?  Well it depends on the condition of the cars when
> they came in for one thing.  Both Car A and Car B might have been well
> maintained or Car A might have been well maintained and Car B neglected
> or the reverse or both might have been neglected.

Yes, in many ways it really is hard to compare different countries.
For one thing, there are profound demographic differences. For
another, the differing tax structures of the nations probably plays a
big role: if a small enough percentage of the people pay almost all
the taxes, then I have yet to hear of any mechanism---I repeat,
my interest is in ideas, processes, incentives, etc.---that prevents
a runaway self-immolation of the economy.  Unless, of course,
the rich simply corrupt the process and hire the politicians directly,
running roughshod over the electorate (but doing so covertly).

> So if you are going to do a comparison then it makes sense
> to use inputs as similar as possible and to explicitly list the
> goals.  Is MPG the value we want to track?  What about
> top speed?  My point is that the typical back and forth
> talking past one another is just a waste of bandwidth.
> Note that my request is not meant to favor one position or
> another and if any reads it that way then they have misread it.

Oh darn. Several of us here were all ready to let fly with both
barrels, just as soon as it looked like you were on the other side.


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