[ExI] Health system, again

Samantha Atkins sjatkins at mac.com
Sun Apr 13 03:51:14 UTC 2008

Lee Corbin wrote:
> Kevin wrote
>> Personally I think that the concept of health insurance is
>> what has caused the skyrocketing costs in the first place.
>> People no longer saw nor cared what they were being
>> charged because someone else was paying the bill so
>> the market forces controlling costs were removed.
>> It's the cost of BS we all pay. 
> YES!  And do you know how in the United States all
> that BS came about?  
> In World War II the U.S. government in its wisdom
> decided that it could do better than the free market
> in distributing various good, e.g. gasoline. So instead
> of (via tax monies) simply bidding up the price of
> gas so as to keep the troops sufficiently provisioned,
> an idiotic rationing system was employed, which was
> not nearly so efficient.
It was also in WW II that they came up with that other "temporary" 
'efficiency' of having all employers contribute free labor to withhold 
taxes on pay day and send them to the government.  The government has 
been growing tremendously ever since.

> At the same time, the government passed laws decreeing
> certain wage and price controls.  (The last time our
> ingenious government tried that was the 1973 "oil
> embargo" event, so miscalled by people who fail
> to realize that the higher prices necessitated by the
> times would have rationed the gas infinitely better
> than the "gas lines" and shortages that inevitably
> occurred.
Now they do wage and price controls by more indirect means like 
inflating the money supply and juggling tax 'loopholes'.  :-)

> Naturally, such meddling in the market has unforeseen
> consequences. Companies (especially those working in
> the war-related industries) still had to reward success
> and reward those employees who contributed the most.
> But thanks to the new government regulations, they
> couldn't simply be *paid* more.

Or in the case of unions, paid less for less than stellar performance.
>   So loopholes were
> created---for example, the company could provide
> "company funded insurance". These loopholes did
> provide a sneaky way to attract and reward employees,
> but at the sacrifice of some market inefficiency.
> Far worse were the long term consequences. From then
> on, medical "insurance" (which soon took on very un-
> insurance type attributes) and other fringe benefits were
> abetted by the government, which didn't tax those benefits.
> And that's how it all started.
So not taking money from the company and its workers amounts to 
'abetting' or interference with free enterprise?   Hmm.

> Then, seeing the spiraling medical costs (as the final consumers,
> the end users, were separated from those who actually paid,
> that is the insurance companies), and seeing what damage had
> been done, do you suppose that a rollback of the extremely
> damaging government regulations was considered?
Actually more harm was when government got into the act more directly 
with Medicare, Medicaid and the attendant heavy regulations applied to 
the practice of medicine.    When government starts telling doctors how 
to practice and relate to their patients and when government promises so 
much that it will bankrupt generations to pay for it all then all sanity 
is gone.

>   NOT 
> FOR A MOMENT!  It was indeed thought that the answer
> was *more regulation*, more artificial ways to disengage
> the end users of services from those who paid for them.
> So the HMOs were invented. And each such step since has
> resulted in a bigger mess, and more and more outrageous
> and ridiculous medical prices and charges.
>> For example - four years ago I took my 9 yr old daughter to
>> the ER at 3 am because she had a nosebleed that started at
>> 9pm and hadn't stopped. We waited 3 hours, then saw
>> a Dr for 10 minutes who crammed what looked like a small
>> tampon up her nose and sent her home. My cost was $75 for
>> the ER visit. When I later looked up the detailed billing out
>> of curiosity, I saw that the Dr charge was $440 for the
>> 15 minutes and the "tampon" cost $1200! Plus there was
>> another $300 worth of supplies and such.

> That is predictably what will happen without the discipline
> of the market place.  How could the American government
> as late as 1971 (!) have believed in price controls?  How
> in the world as late as 2008 can people still reflexively 
> reject market mechanisms and price signals?

>> I called and asked the hospital about this obvious error
>> and they said that yes, the bill was correct, the "medical
>> device" they put in her nose was "medicated". I was
>> supposed to return in 3 days to have it removed which
>> would have been a $25 co-pay office visit ($120 in
>> insurance), but just to spite the system, I pulled the
>> thing out myself with no trouble at all and the bleeding
>> was obviously gone.
> If you told them later what you had done, they would have
> been speechless with astonishment.  Why, they would
> wonder, had you tried doing that?  After all, they would
> have done it *for free*!
>> I have no idea why nobody wants to address this issue.
>> If Drs are in such short supply, maybe allowing more
>> into medical school
> It's enough to make me gag.  *Allowing* more into whatever.
> And this in a supposedly free country.
The AMA has consistently acted to limit the number of doctors officially 
licensed and allowed to practice medicine.     This country is not 
remotely free in so very many ways and becoming less so all the time.

>> or  allowing  practicing nurses to  do more would be in
>> order and help to drive some of these costs down.
> Why?  To whose benefit (beside the remote tax payer, of
> course) would such accrue?
To everyone's benefit.  Doctors could concentrate more on cases that 
actually require their expertise.  Nurses could practice more of what 
they know.  Costs would be lower regardless of direct and indirect 
arrangement of payers.  Visits would be more timely and brief.  What's 
not to like?

>> I think that the free market isn't working because the
>> market is not free.
> Exactly right.

More information about the extropy-chat mailing list