[ExI] Warren Buffett is worried too and thinks Republicans are "asinine"

Omar Rahman rahmans at me.com
Tue Nov 26 14:09:06 UTC 2013


> Date: Tue, 26 Nov 2013 03:44:10 -0500
> From: Rafal Smigrodzki <rafal.smigrodzki at gmail.com>
> To: ExI chat list <extropy-chat at lists.extropy.org>
> Subject: Re: [ExI] Warren Buffett is worried too and thinks
> 	Republicans are	"asinine"
> 
> On Fri, Oct 25, 2013 at 3:53 AM, Omar Rahman <rahmans at me.com> wrote:
> 
> 
>> I would prefer the Federal government to implement an insurance policy that
>> MUST be accepted at all hospitals and only pays a FIXED cost for procedures.
>> Comparison shopping doesn't work well in health care because there is a too
>> much time pressure and you don't have time to move to Arizona/Hawaii/etc
>> where procedure X is covered and/or cheaper than where you live in a 'State
>> Model' situation as you have proposed.
> 
> ### Omar, you are repeating standard leftist boilerplate on medical
> care (at least what they say when they don't talk about the single
> payer). You hit all the points, even the notion of impossibility of
> patient informed decision making in medical care. Just think about the
> following sentence for five minutes: "It is generally impossible for
> an individual to reasonably choose a doctor/hospital/insurance plan".
> Cogitate on the details, try to imagine how a human might go about
> this task. Only a propaganda-elicited learned helplessness can stop
> you from reducing it to an absurdity. Or think about this one: "Fear
> of the police is a good way of making sure there are enough surgeons
> healing patients everywhere".
> 
> Rafal


Rafal,

I actually took the five minutes you suggested.

Conclusions:

1) these statements are yours but you seem to be proposing them as 'my position'
2) these statements are falsifiable on first reading
3) this is an invalid form of argumentation known as 'Straw Man' see https://yourlogicalfallacyis.com/strawman

Of your two statements the first is closer to something I might say, except that I wouldn't want to speak in absolutes. 

Rafal, as a doctor it would seem that you are in a better position to make an informed choice about health care than the vast majority of people. But are you really? With the multitude of 'competing' plans out there how can you be sure unless you read and compare them all. Here's a new reason to need radical life extension: there is no way in hell that anyone could read all the fine print in all the plans in what is a current 'human lifespan'. Especially as armies of lawyers keep changing the details more or less unilaterally. Maybe someone could create an AI to read legalese: the Turing's Lawyer Test perhaps?

We almost never have complete information when we make our decisions so I wouldn't worry too much about the fact that we can't read all the plans except...except.....except....

Insurance is a form of gambling.		(You are betting you are going to get sick, the insurance company bets that you will not get 'sick'.)
You are not 'the house'.				(The rules are different for each side, with one side having a statistical advantage.)
'The house' makes the rules.			(The house decides what 'sick' is and what, if any, treatment applies.)
'The house' always wins in the end.	(The house always makes a profit from cheating you at the most helpless and miserable points in your life.)

The argument I make for 'socialised medicine' is that I want to be 'the house'. If there was ever a case for Keynesian spending, it would be in education, infrastructure, and health care, things that demonstrably grow the tax base and productivity of a nation.

Well, I want to be 'the house' in a collective society, with my fellow citizens and workers, with whom I shall unite to form a glorious republic of the people, for the people, and by the people. See all those very positive words in the previous sentence? How is it that when I string them together like that some list readers will be 'seeing red' in more ways than one?

The argument for private health care is also very compelling. It goes like this: I, or my family member, is ill/hurt. We are rich, there is no damn way I'm going to wait while the situation might deteriorate. Take my money, get me the top specialist, and a latte.

Rafal, as you may know, I live in Poland. If you ever pass through Warsaw we can meet up for coffee and discuss 'extropian' things. Would you agree that Poland has a dysfunctional health care system? I certainly think so. There are, at least, three causes in my opinion.

1) poor management of public systems
2) poor funding of public systems
3) the existence of private hospitals which exist mainly, in my opinion, to allow 'rich' people to jump the queue and get prioritised care in public health care institutions

I'm not 'rich', not by a long shot, but when my family members or myself are ill I don't wait to see the doctor in the public hospital I generally go to see them in their private practice. I'll pay out of pocket if I have to. Seems all well and good, yes? Sometimes the doctor says that the situation isn't as serious as I thought and that's the end of it, but sometimes there is a real problem that must be addressed. In that case the doctor tells you to go to public hospital X at time Y and see Doctor Z. In the current situation in which I live it is in my interest to do this. 

In effect health care here in Poland, and in many other places, is prioritised on the ability to pay.  It should be prioritised on a triage basis.

How do we account for the undeniable human need to receive the best health care possible? Isn't the right to the best health care in fact the right to self preservation? I think that it is.

My best case solution would be to have:

1) a single payer solution (which meets some agreed upon minimum standard of care) that everyone must pay into
2) a private system that is entirely separate (does not function as a queue jumper to the public system)

Sometimes people talk about 'positive rights' and 'negative rights', sometimes paraphrasing this into 'freedom to' and 'freedom from'.

I believe we have a right to health care in society to whatever level we collectively agree to fund it. That's the freedom from disease, and it has, for example, the social benefit of preventing the spread of disease and increasing the productivity of those who would otherwise die or be ill.

I also believe we have a right to get the best health care we can afford. That for me is the freedom to, for example, cryopreserve yourself, make some radical body modifications, try unproven therapies, etc. etc. This is where I see possibility for loosening regulations, as it is an optional system and could function under the rule of caveat emptor. With the removal of much regulation, and patients acting under informed consent, I see the possibility for medical advances to move faster.

Currently, the US should move in the 'Canadian' direction re health care. The rich can, and do, fly to Switzerland anyways. If you can't afford to fly to Switzerland and pay out of pocket there you're probably better off in a 'Canadian' system.

Best regards,

Omar Rahman

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