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Universal Health Care is Not Insurance and Obamacare is Not a Market

Well that was fun: Fuck Obama. Fuck Romney. Fuck Obomney Care

I expected to get a real shit storm of protest over that post. Instead, Twitter lit up and so far, the comment action with just a couple of exceptions is right in line with this whole thing being an Obamanation. Good. I love to have my faith in humanity and good sense restored from time to time—even taking account of the fact that my readers aren't your average moron on the street.

For me it's pretty simple: government has no business in the "health care" market...any more than it does in the food market, clothing market, housing market, job market or any other market. In fact, when government does get involved, it ceases to be a market, anymore. The term "free market" is really a redundancy. The very nature of a market means that it's "governed" by social and economic dynamics (supply & demand), not by govern-ment, an agent of coercive force.

When you are forced to buy something, or a supplier is forced to provide you with something, this is not a market. And, this is why commenter Matt to the last post is wrong:

I can’t speak for other supporters of the ACA, but I don’t see it as furthering some goal of a “risk-free life.” I see it as getting us somewhat closer to a sane and rational market in which each of us participates, like it or not. [...]

I would suggest that you fundamentally do not understand what it means to participate in a market. If you had no insurance, and had a heart attack/stroke/were in a car accident, would you go to the emergency room? Or would you just say: "Meh, this was the risk I took by living. I'll just let myself die." If you would go to the ER, you are participating in the market, regardless of whether you have insurance or whether you can afford to pay your bill.

Wrong. There is no market to participate in, if the participants are forced into behaviors that are coerced and not market driven.

Commenter K. Wilson is right:

Interesting choice of words there “sane and rational market”. Tell me what would happen if no one had insurance. If everyone were forced to pay their own medical costs? Very few people would seek medical services, decreasing the demand for those services. If the demand for the services decrease the providers of those services will do one of two things; they will increase the price to accommodate their overhead costs or they will lower the cost in order to engage more clients and keep their business above water. If they raise costs, fewer and fewer people will seek services. Eventually they will destroy their own market and new entrepreneurs will enter the market at a lower price point to meet the demand for affordable service. If they lower the cost to begin with more people will seek the service. Insurance CREATES a false market. On another note- Do we actually need all the healthcare services that we have? Is there any point at all to having a person locked up in a long term care facility that costs 6-8 thousand dollars per month plus medication fees? What about accepting your fate and dying when nature intends for you to die. Nature should take its course.

My only quibble is that's it's not insurance, per se, that creates a false market (actually, renders it not a market at all, but a government entitlement program), but the false notion that a bumper-to-bumper medical maintenance plan is anything remotely like insurance. Here, I'll let commenter Steve explain:

Well, there is already a definition of insurance, it has been around for awhile. No one ever had any trouble knowing what it meant till recently. Covering for routine care is not insurance, that is a health plan. Covering the unexpected, like cancer or a trauma, is insurance. That is why your car insurance doesn’t pay for oil changes or the dents to be fixed in your newly purchased used car [or new tires when the old ones wear out - Ed]. Calling this insurance starts this debate off on dishonest foot to begin with. [...] I am no healthcare historian, but it seems to me, as more people got insurance, Medicaid and Medicare, and were further removed from paying attention to the actual cost of healthcare, the more cost went up.

That's because it ceased to operate as a market and began to operate as a government entitlement hybrid with all the rent seeking behavior that goes along with it. So, now medical care institutions like insurance companies, HMOs, hospitals and such are primarily concerned with getting a bigger slice of an ever increasing pie—not with markets that would have them competing with one another on cost and quality of service. In fact, it is precisely these institutions that have, for decades been the ones driving the trend to make medical services as far from real markets as possible. Markets are messy, tough, difficult.

You know what I mean. When is the last time you went to a doctor, and prior to each procedure or test, you were given a list of options and costs, or even given the opportunity to shop around? You might be more familiar with that sort of market behavior from a dentist if you don't have a dental plan, or a veterinarian. In fact, it's quite common in both. I recall some years back—in the 90s when I had neither medical or dental—having a dentist try to convince me for years to have a crown put on one of my teeth ($565, as I recall). I eventually did, but paid for it myself.

No; instead, because you are covered by some payer of sorts, the doc just goes about his business, ordering this procedure, test, and that, jotting it all down where later, one of the "medical billing personnel"—that the industry needs a whole separate industry now, just to create bills ought to be a huge clue to the problem—logs on and goes through a complicated process to check this and that in order to eventually get paid and the patient is entirely out of the loop.

This is not a market anymore, in any true sense of the word.

If you really want to understand why medical care is so expensive, consider what would happen if we removed food from the marketplace and enacted The Affordable Food Act. I don't even have to explain it because if people could essentially have unlimited food at a fixed cost, you know very well what would happen.

  1. Food lines
  2. Crappier and crappier food
  3. High and higher prices for crappier and crappier food
  4. When you proceed through the checkout to show your Food card, in addition to everything you already put in your cart, Food Specialists would add things to your cart whether you needed them, wanted them or not.
  5. Grocery outlets and Food Specialists would have to carry expensive malpractice insurance in case they failed to provide the correct or adequate food in #4.

You could go on and on. That is why it's so expensive, and it has nothing whatever to do with purported ER visits by poor folks who don't have insurance and who can't pay—though this is what you'll continually hear as justification for hijacking the entire country.

The bottom line is that the medical industry is not a market anymore, and this is the essential problem.

You want a market? Get what's called "catastrophic insurance" (it really should just be called insurance) where you pay 100% of everything until over some period like a year, you pay more than $X amount, at which point you pay zero for all care and procedures associated with that condition. This is insurance....but never mind. That'll never happen. Cat's outta the bag already, everyone clamoring to live at the expense of everyone else. It's all just cannibal pot-dynamics from here on out: who goes into the pot, and who gets to feast.

...My brother is in Norway on business presently and the other day sent out a pic of a standard pint of Newcastle Ale in a typical pub. It cost him $12.56. Then he and his associates proceeded to have dinner there. The bill for the five of them (beer only, with dinner) was $1,237.

But, hey, at least they have "free" healthcare.

Comments

  1. America already has the affordable food act, it’s been around for decades. It’s called corn.

  2. Depsite the fact I have read many times how you hate nit-picking, I’m going to nit-pick a small part of Karen’s comment.
    My 100 year old grandfather had a stroke roughly a month ago, fell, and busted his head open. He is now in a facility living out the last few hours to maybe a day of his life. The only medicine he’s being given are to make him “comfortable””, but not to prolong his life. My family all wish, for his sake, that he would give up, but he’s tougher than boot leather and keeps on breathing. Would Karen have had us to let him lie after his fall and die there or is she ok with us trying to let him have his last few weeks where he has his dignity at a facility that can handle all the post-death hassle? I think we do need the ability to proivide end-of-life care to folks, but the cost should not be borne by anyone other than the family or the individual if they are able. My Mom is paying 100% of his care and medications. Maybe that’s not at all what Karen was saying, but that was my interpretation of her question of “is there any point?”.
    Otherwise, I agree with her pretty much spot on.
    Sorry for the rant, been a rough few days.
    Thanks for your blog and all the well thought out comments.

    • I don’t know Karen, but “cost should not be borne by anyone other than the family or the individual if they are able” makes perfect fucking sense.

    • That’s why I would like to be able to keep a stockpile of morphine on hand, it’s wonderful stuff. Hospice does a great job but I’m a DIY kind of guy. I guess I would need someone to administer it but I can afford to pay someone to shoot me up.

      But noooo, because some people can’t be trusted with drugs doing that would be highly illegal.

    • WRS

      I think you make an excellent case for being the sort of person in your life that people want to help in unfortunate or emergency situations.

      I think friends and family are competent to make those judgments.

    • The other thing, WRS, is where along the way did we lose the notion of “ask nicely.”

      I’m not anti-charity at all–in fact quite the opposite.

      Part of the problem is that our culture has morphed into this twisted monstrosity where people are afraid to ask nicely either over fear of embarrassment or being told no, so using an agent to force people against their will is just fine and dandy.

      And it is literally destroying the unique American culture before our very eyes. Anyone aware that on a per-capita basis of individual giving, Americans are the most generous on Earth? (I read that a coupla places a few years back but did not fact check it, so anyone interested in repeating it, please do)

    • You said it better than I ever could. I try to be as charitable as I’m able, but I don’t like being forced via mandate, tax…whatever they want to call it.
      Happy Independence Day everyone.

    • K. Wilson -KATE says:

      And your family made that choice, not the government. Which is my point exactly. In the event that a person chose to alienate themselves from their family, choose not to plan for their eventual demise, I do not feel that they should be given an unlimited supply of life extending care. Enough medication to let them pass into the next life without excruciating pain and not a single bit more. They chose that outcome for themselves. We are all responsible for our own choices.

    • Elenor says:

      “Would Karen have had us to let him lie after his fall and die there or is she ok with us trying to let him have his last few weeks where he has his dignity at a facility that can handle all the post-death hassle? I think we do need the ability to proivide end-of-life care to folks, but the cost should not be borne by anyone other than the family or the individual if they are able.”

      Oh my: Total strawman! I’m not Karen, but *I* would have you carry him indoors to his own bed, call his family and friends around, have the local pharmacy deliver pain meds as needed, and y’all hold his hands and reminisce till he shuffles off this mortal coil in his own time. IF your mom had to pay only her usual electricity and mortgage, plus pain meds — would SHE not be better off? And wouldn’t he rather die at home, as so very many folks say they wish to? Instead, he’s in a place surrounded by strangers and ‘things’ that are not his (in a bed designed for the ease of the caregivers NOT the person lying in it!); he’s being interrupted for care and cleaning at their schedule, not his; and I’ll bet they’re keeping OUT family and friends whenever they wish, for their own convenience, rather than letting his own people be with him at all times…

      Oh, and “post-death hassles”?! My dad died at home (in a rented hospital bed, with his family there). The “post death hassle was a phone call to the local hospital coroner, who sent a hearse to pick up his body. END of hassle! You seem like one of so many Americans, who have NO exposure to death and can’t imagine what they’d do.

    • Elenor, you couldn’t be more wrong and fuck you for your insinuations.
      The nurses only came in to deliver the medicine on schedule or when one of us asked for help.
      My Mom & brother were there the entire last 48 hours of his life.
      Don’t go pitying us poor Americans. I don’t know why the fuck you even had to throw that comment in there. You seem like a heartless bitch. I’ve seen my share of death and know perfectly what to do. My mom could have chosen to have her dad at her home, but we don’t live in some small fucking backwoods village where a local pharmacy delivers med.s. Our screwed up healthcare system doesn’t allow such.

    • Wow, Elenor, I am not unique in this, my father recently passed away at home after long illness and emaciated from cancer (81). In the rented hospital bed, Just the way he (we) wanted. Family could come in the room anytime they wanted and see him. After he passed the hospice agency came and retreived all thier implements of death, they were not there for life, however for passing. There are limits to lifespan as well as healthcare.

  3. JohnC says:

    First off I’m a proud Canadian and freely admit this is really none of my business however your post begged for some response just on the grounds of reality alone.

    Affordable food act? Really? A better analogy might be Affordable Highways Act or Affordable Policing Act or Affordable National Defense Act.

    All things that are a universal necessity a common good and provide excellent economies of scale and are much more similar to healthcare.

    Dinner in Norway is expensive? So what? Tell me how much of that was taxes and how much of those taxes go to healthcare and it *might* have some relevance. Right now it’s just an unrelated anecdote that proves nothing whatsoever.

    I’m sure there’s perfectly logical reasons to criticise the Affordable Care Act (perverting it by trying to fit it into the “free” market); that whole food analogy seems very weak to me.

    Only the most determined head in the sand polemicist would not agree that there are at least *some* good things to come out of the ACA, mostly in the areas of stopping corrupt practices by the existing insurance companies. A nice summary can be found here: http://www.motherjones.com/mojo/2012/06/obamacare-supreme-court-regular-americans

    If you really don’t want your society to get better why even be a part of it at all? Taking the personal responsibility to it’s inevitable conclusion where there are zero social safety nets at all might result in you living in a compound and having to defend it daily, who wants to live that way? If you do there are plenty of lawless places in the world that would welcome the opportunity to take a crack at opinionated assholes like us!

    • “Affordable National Defense Act”
      Comparing universal healthcare to the defense agency is a great idea. It’s highly inefficient and has a lot of blood on its hands.

    • @ JohnC
      Are you somewhat familiar with classic liberalism, just a lithe bit? Why do you bring up National Defense and the Police? I happen to think that you know those two (in conjunction with courts) are the only legitimate governmental institutions as they don’t interfere with your rights. (no military draft of course)

      They’re “better” analogies for you, because you subconsciously know they are the most important. That’s why you bring them up.
      But of course, you want to be a good citizen and you continue to promote the “common good”. Because everyone tells you so. After that paragraph you lost me. You don’t speak honest anymore and you refer to bullshit arguments from a journalist. They are so BS, you couldn’t even make it up for yourself.

    • Marnee says:

      Is it so easy to turn a blind eye to opportunity costs.

      These Economic principles are real.

      Even if you do not understand the immorality of forcing others to be responsible for your life, you have to face the laws of Economics. They are clear and unambiguous. You must see the Tragedy of the Commons playing out right in front of you!

    • Sorry, JohnC, those aren’t legitimate comparisons. Roads, defense and policing have always been considered government functions. Roads and defense are actually provided for in the US constitution. Normal people don’t “purchase” roads, defense or police services. Obviously there are some exceptions to this, but the norm is that the “government” provided these services. Structurally, society doesn’t want individuals providing their own defense or police and a shared commodity like roads is best provided by communal payment.

      In the US, prior to Medicare/Medicaid/etc., the government’s involvement in health care was only to regulate the safety/quality of health care and to ensure soldiers and sailors were properly tended. Normal people purchased their health care from private practitioners. The prices were set between the patient and the practitioner, whether doctor, midwife or snake-oil salesman. There is no structural requirement for health care to be provided by the government.

      Food is actually a very good comparison. Everybody needs food, just like everyone needs some amount of health care. Throughout history, people have died of starvation and died through lack of healthcare, even though food and healthcare was available to others with more money. Also, there is a huge difference between minimal food or health care and maximal food or health care. Even people who will gladly provide basic sustenance to the poor, don’t think everyone is entitled to steak and lobster dinners every night. It’s not so different to say that a charitable community would provide for basic first and second level aid, but not pay for kidney transplants and extreme end-0f-life care. Yet, some seem to suggest that, if a treatment is in existence, every citizen should have the same access to that treatment, no matter their ability to pay. And, many will say that anyone who suggests otherwise is just being greedy.

      A market, operating in a community of humans, is better able to make these resource decisions in a sustainable manner, than a government manipulated by corrupt politicians, rent-seeking corporations and special interest groups.

      Keep in mind that the “corrupt practices by the existing insurance companies” are mostly either rent-seeking because the government is in control or defensive measures to protect against a mandated set of requirements that weren’t negotiated between a customer and a vendor. If we weren’t so far along the road to socialized medicine, we wouldn’t need yet more legislation to “fix” the problems caused by the previous legislation.

    • TimA: +1

    • JohnC:

      Well, I’ll defer to the comments others have already posted that pretty much nail it.

      Mother Jones, eh? I love how the article starts out:

      “10 Things You Get…”

      1) Insurance companies can no longer impose lifetime coverage limits on your insurance.

      ===> In other words, you no longer have an option to purchase the policy you want, with the limits acceptable to you, at the price you wish to bargain for.

      2) If you don’t know someone who has run into a lifetime cap, you probably know someone who has run into an annual cap. The use of these will be sharply limited. (They’ll be eliminated entirely in 2014.)

      ===> IOW, by 2014, you no longer have an option to purchase the policy you want, with the limits acceptable to you, at the price you wish to bargain for.

      3) Insurers can no longer tell kids with preexisting conditions that they’ll insure them “except for” the preexisting condition. That’s called preexisting condition exclusion, and it’s out the window.

      ===> IOW, you no longer have an option to purchase the policy you want, with the limits acceptable to you, at the price you wish to bargain for.

      4) A special, temporary program will help adults with preexisting conditions get coverage. It expires in 2014, when the health insurance exchanges—basically big “pools” of businesses and individuals—come on-line. That’s when all insurers will have to cover everyone, preexisting condition or not.

      ===> At whose expense? It’s a safe bet that insurance companies are not going to be taking a loss on this. It’s merely just another in a long line of scams designed to transfer money from citizens to big corporations via coercive mechanisms and not market dynamics—and don’t forget the middleman. That’ll be as efficient and wasteful as they can possibly make it.

      5) Insurance companies can’t drop you when you get sick, either—this plan means the end of “rescissions.”

      ===> In other words, a company no longer has the ability to do business with whom they choose. They no longer have the business option of choosing not to renew a contract they find to be no longer in their interest, once it expires. It’s like rent control, another abomination of government that basically makes chattel of landlords.

      6) You can stay on your parents’ insurance until you’re 26.

      ===> Wonderful. Great way to encourage self-sufficient adulthood. Of course, the socialist 1st world is careening towards infantile status as fast as it possibly can.

      7) Seniors get $250 towards closing the “doughnut hole” in their prescription drug coverage. [...] Eventually, the health care reform bill will close the donut hole entirely.

      ===> I assume that’s monthly. Yay, free money! Doesn’t cost anyone a thing.

      8) Medicare’s preventive benefits now come with a free visit with your primary care doctor every year to plan out your prevention services. And there are no more co-pays for preventative services in Medicare.

      ===> Your doctor is now in part, your slave.

      9) This is a big one: Small businesses get big tax credits—up to 50 percent of premium costs—for offering health insurance to their workers.

      ===> Fabulous! “We’re only going to steal half of what we used to from you.”

      10) Insurers with unusually high administrative costs have to offer rebates to their customers, and every insurance company has to reveal how much it spends on overhead.

      ===> You own a business, so you have no right to keep your business affairs private, from customers, competitors, or the government.

      11) Free birth control and other preventative services for women, unless you work for a faith-based organization that opposes birth control.

      ===> At whose expense?

      So, in summary, it’s all just a bunch bread and circuses so politicians can one again fool you into believing that you’re getting something for nothing, or just like kids at the dinner table, worried that another kid will get a bigger slice of pie than he but who’d perfectly happy to get the largest slice for himself if he can.

      All of this crap is despicable and loathsome, promoting the absolute worst sort of behavior, not to mention deleterious for any culture. American culture is being destroyed from the inside out right in front of our very eyes.

    • JohnC says:

      Paul I’m not at all familiar with or remotely interested in “classic liberalism” whatever the hell that means to you. Your desire to put labels in me tells me a lot more about you than it does about myself.

      I “promote the common good” (if that’s even what I was doing, didn’t occur to me that I was grinding some axe but if you say so) because it is patently *good* on the face of it.

      I gladly pay for social safety nets even though I’m probably (almost certainly) in the top 1% of people who never have used them personally.

      Can they be more efficient or improved upon? Hell yes. Are private businesses the best people to trust the common good to? Hell no.

      That does not mean I don’t benefit from social programs personally despite rarely taking advantage of them. I most certainly do and any thinking human being can easily make that same connection.

      I don’t want to live in a society filled with desperate people with nothing to lose.

    • “the common good”

      Anyone notice the gross presumption in such a phrase?

    • JohnC says:

      Richard I’m a business owner and I believe in the free market and capitalism as much as the next entrepreneur. I’ve been self employed for almost my entire adult life. I sure as hell do not want my government involved in any iota more than they need to be.

      Of course governments are wasteful. Any organization, indeed any organism’s main purpose is to perpetuate themselves and be fruitful. This leads to practices that seem perfectly legitimate on the inside but are wholly corrupt when viewed from the outside.

      This is precisely the same process at work in charities that raise great amounts of money for “awareness” rather than eliminating the problem they exist for in the first place. It’s the same reason why police constantly overreport the value of marijuana busts by a ludicrous factor: it gets them more money.

      It seems to me that there are several ways to go on health care:

      The wholly private health care system: a private organization, responsible to almost no one but their shareholders who will try their damnedest using every method at their disposal to *not* provide health care that their customers pay for. You of course know this because you read about it in the news on a daily basis.

      A wholly government run system: you know there will be inefficiencies and money grabbing in the form of budget padding, pork barrelling etc just like any government run organization, however they are answerable to the electorate and the economy of scale is just incredible. This is pretty much what we have here in Canada. Note that there is nothing stopping me from going to a private clinic and paying if I want more but I need never fear I nor my family will need health care and not get it.

      A bastard system, half private enterprise, half government: This seems to be what you all have now and it’s of course the worst of both worlds since there are so many fingers in the pie and everything is hundreds of times more expensive than it needs to be. I agree it doesn’t seem ideal but it does address the weasels in the private system and ensures fairness to the customers and it eliminates freeloaders on the system that you were previously paying for anyway.

      But most of all it ensures there are many less desperate people around with no options and nothing to lose. I don’t know if you have ever followed some of the stories reported about the truly vile stuff the U.S. health care industry gets up to to avoid honouring their contractual obligations but it’s sickening from my point of view.

      How you see this as a *bad* thing for your culture is mystifying unless what you value are desperate poor people who have had the ladder pulled up in front of them to ensure they will never really have any power in your society or a place at the table.

      I guess what I see and experience is all the benefits of living in a society where desperate people with nothing to lose are extremely rare and turn on the news and see a very different picture in the U.S. and most stupendously a lot of people promoting tea party type stuff that is so clearly and self evidently against their own interests.

      I have the same opportunities (and arguable much more *true* freedom than) you do I just don’t see anyone else having to suffer for it.

      By the way, I didn’t address your rants about the mother jones article because you clearly aren’t up on many of the issues addressed by it.

      One example: rescission doesn’t mean that the insurer chooses not to “renew a contract when it expires” as you say, it means specifically that they rip it up entirely *while* it’s in effect when you go to take advantage of it because it’s cheaper for them to give you your money back than to pay for your treatment.

      In other words you buy insurance where you wish with the terms that seem best to you. You get cancer and start treatment and the insurance company simply cancels your contract and returns your money.

      That is common practice in your golden utopia of private insurance only one of the many things you seem to be utterly blind to, and I can’t imagine anything more indefensible to a business person or true capitalist.

      (And yes I agree that children are too coddled these days and all but useless in society, hell everyone agrees with that but you need look no further than the nearest parent to account for that, not government health care. The kids are not to blame, the parents are. The biggest reported problem for kids these days going to college is no longer the college experience itself but the actual living on their own part which they are wholly unprepared for.)

    • JohnC says:

      Tim, in my world normal people don’t “purchase” health care either. I do spend about 50 bucks a month to insure my family and have no choice in the matter but I’ll gladly take that over a thousand or more a month only to be rejected by rescission when I truly need it.

      That might be a “purchase” in your world but it sure doesn’t feel like one in mine.

      There are many things that an open market does well, unfortunately I would be very hard pressed to find a truly open market in the United States today. Your describing an ideal, an anachronistic fantasy world that simply doesn’t match today’s reality on the ground. The health care industry has everyone by the balls and acts like it and the second the government comes along to rectify the situation people rise up and say “no, I like my balls firmly ensconced in the hand of the insurance company”. Utter madness!

    • JohnC says:

      Marnee those are a lot of buzz words and phrases, what exactly are you trying to say?
      It appears you are taking some kind of Ayn Rand tack on this?

    • “The health care industry has everyone by the balls and acts like it and the second the government comes along to rectify the situation people rise up and say “no, I like my balls firmly ensconced in the hand of the insurance company””

      You pretend that people just started complaining about government’s meddling in medical services just began last week.

      I think we need more government involvement in the food industry. 20 years from now, when food companies have us all by the balls and act like it, we can enact the Affordable Food Act and pretend like government is solving a problem.

    • And as bad as it is to fly now (And why? Anyone?), imagine how much worse it would be if rather than deregulating from required routes and prices back in ’77 or so, they had instead enacted the Affordable Ailine Travel Act.

    • “unfortunately I would be very hard pressed to find a truly open market in the United States today”

      Craig’s list, EBay, garage sales, personal transactions of all sorts, including even money lending (from grandma to loan sharks). I sold my wife’s iPad 1 (only 16 gig, but with 3G) yesterday on Craig’s list in under 2 hours from posting. Guy drove over an hour to get here and grab it. Two years old: $250.

      But yea, in general I have to agree on the reality of the “mixed economy.” There is such an overhead burden in terms of regulations, licensing, taxes, compliance, etc., it’s difficult to know a market when you see one,

      Hell, even illegal drugs are distorted qua market (And why? Anyone?).

    • As Richard mentioned, this situation didn’t start yesterday with the “health care industry” having everyone by the balls and everyone crying out to government to save us. It started many decades ago when a few companies were trying to sell legitimate insurance to individuals. Then, FDR, in his infinite wisdom, implemented wage controls. Since they couldn’t compete with higher wages, companies started offering health insurance to current and prospective employees. Thus was born the third-party payment system where a health care provider not only didn’t negotiate with the patient, the insurance company didn’t negotiate with the patient either. So, rather than third-party payments, we had fourth-party payments. And, the curse of Other People’s Money started controlling the health care industry.

      Since the patients didn’t negotiate with insurance companies or doctors directly, they had no incentive at all to save money or avoid costs. They also had every reason to lobby their congresscritters to make sure the insurance companies “did the right thing.” And, since the patients weren’t paying, everyone with something to sell, whether drug treatment practices or chiropracters or individually-wrapped-syringe manufacturers, were ready to demand that their products were legitimate health care costs that had to be covered by insurance. So congress and the bureaucracies kept adding to the “minimal standards” for an insurance policy. Of course, to pay for all this, the insurance companies had to increase the price to the employers or negotiate lower prices from the health care providers or both. Which then requires congress to come save us from the corrupt insurance companies who don’t want to meet their obligations.

      And, for some reason, minimal attempts to reconnect the customer (patient) with the cost, like copays and HSAs, are considered immoral. So the solution is to completely break the concept of insurance and just make the “insurance” companies publicly controlled healthcare utilities. If you don’t have the concept of pre-existing conditions, coverage caps and actuarial pricing, you don’t have insurance. You have a regulated utility, much like the power company. Except, rather than selling a single, managable product, where they own the production facilities (dams, power plants, wires, etc.) they have to negotiate with thousands upon thousands of individual service providers and, at the same time, try to compete with other “insurance” companies doing the same thing.

      So, you are correct that the current situation isn’t an open market where individuals purchase services from health care providers, and it hasn’t been one for a long time. It’s actually the final stages of a continued attempt by stupid politicians and bureaucrats to control something so they can look like they are giving people something for nothing. And, it’s due to most people’s desire to get something for nothing that they’d always rather believe that Uncle Sam will finally get it right and make the mean ol’ insurance companies give them their due.

      Socialism never works. It always requires more and more reductions to liberty to make the system do what people want it to do. The US is in the last stages of implementing a completely socialistic health care model, which still won’t work when we cross the final threshold. This set of laws won’t fix a competitive market because we don’t have one. This step will just complete the collapse of the pretend market we have so people will demand the government fully socialize it. Then, it will just keep getting worse, because that’s what socialism does. But, politicians will keep their power through the next election and the properly placed people will get a bigger cut of the money flowing around. And the actual patients will still get screwed.

    • And now I need to turn over my whole blog to TimA. Excellent, sir.

    • Thank you. That’s very kind. I’m new to paleo eating and don’t have much useful to add, but I’ve been keeping up with this subject for quite some time. Thanks for keeping such an interesting blog going.

    • Amen

    • “your golden utopia”

      JohnC. Two things everyone should always notice:

      1. I never, ever engage in utopia theorizing. Freedom is really fucking messy and I’m totally fine with that.

      2. I never, ever proscribe anything whatsoever for anyone whatsoever in terms of social organization.

      It’s your long comment that goes to great lengths to try and work out how people and businesses ought to conduct their own private affairs under the force and coercion of the state.

      Understand: I do not give a flying fuck what happens to “society,” anywhere, at any time. Fuck anyone and everyone who attempts to, advocates or otherwise supports the notion of force by government to get them things they want but are otherwise unwilling to pay for themselves.

      No exceptions, ever. I don’t care how many dying baby stories you give me, either. Are we clear?

    • Bushrat says:

      “Medicare’s preventive benefits now come with a free visit with your primary care doctor every year to plan out your prevention services.”

      - WTF? Any remember when you only went to the doctor when you were sick. In fact, how the hell did the majority of humanity ever survive without needing a doctor to tell them how to live? What ever happened to being in charge of your own life?

    • Bushrat says:
    • Bushrat says:

      “I never, ever engage in utopia theorizing.”

      One man’s utopia is another man’s hell

    • “The wholly private health care system: a private organization, responsible to almost no one but their shareholders who will try their damnedest using every method at their disposal to *not* provide health care that their customers pay for. You of course know this because you read about it in the news on a daily basis.”

      That’s not how private businesses work. I’ve worked for a private insurance company, and they compensate their customers according to the rules, which you can and should familiarize yourself before buying insurance from them. I never met a colleague who actively tried to deny customers compensation — but I did run into a lot of people who tried to get compensated even when the insurance policy clearly stated otherwise.

      If you think it’s possible to run an insurance business without ever compensating anyone, maybe you should start one yourself? Sounds like free money to me.

      - JLL

    • Elenor says:

      “2) If you don’t know someone who has run into a lifetime cap, you probably know someone who has run into an annual cap. The use of these will be sharply limited. (They’ll be eliminated entirely in 2014.)”

      My local TV news ran a story before the SC decision, and then a follow-up after, about a 6-yr-old child who was born ‘broken” and had a kidney transplant, and is now taking $2,000 a month in meds — and will for life (well, except of course, that the cost of the meds will keep rising). The mother was complaining that the family had hit it’s ONE MILLION DOLLAR lifetime cap for this child — and she was so happy with Obamacare that now the insurance companies would HAVE to pay forever, no matter the cost! (And, of course, the news story did not touch on the father’s *employer* — who is on the hook for all that insurance, and whose business is affected by the change!)

      That’s ONE family, ONE child — and they’ve already spent a million dollars before she reached age seven! Multiply that by the thousands of (just American) children (then add the illegals and “compassion imports” who need organ transplants and meds and ongoing care. Yes, yes, “terrible tragedy, how can we NOT save every single child?” Well, the answer is we can’t AFFORD to save every single child! Take all those kids needing massively expensive care, add the rest of the folks needing massively expensive care — and there isn’t enough money on the GLOBE to cover it!

      But the Obamanation promised it, so open your wallets, those of you (like me!) who can’t actually AFFORD health insurance and can’t go to an ER for care — because the hospitals and doctors WILL come after me for payment! (American (very-)small business owner who co-owns a house with the bank!)

    • Anna K. says:

      Elenor, you bring up a good point, when cost is too much.
      Also, how many children like this are out there? probably not too many.
      Why meds cost 2000 a month?
      Why doctors make so much money?
      What about quality of life?
      What is the cost of human life?
      But nobody wants to talk about it.

      People are too partisan , it’s either all or nothing. either free for all, or pay for all. Either government or no government. But what about something in between? May be pay a little for everybody? May be some government? There needs to be a compromise. You can’t please everybody.

      For example, just hypothetically, If I have to pay 100$ a month so that child and other children can live, sure. If I have to pay 10000 a month, may be not.

  4. re: dinner in Norway,

    Newcastle Brown, I’m tellin you, it can sure smack you down.
    –Steve Marriott, Humble Pie

  5. I’m glad to see someone in the “paleosphere” is talking about Obamacare. Keep up the good work Richard.

    • Kurt Harris once wrote a long personal post about this. What is he up to anyway?

    • Kurt Harris also once suggested paleo folks get together to make their own health insurance pool. Great idea right? People who put some effort into taking care of their bodies, rewarded not only by feeling good and living longer, but reaping a little economic savings for their trouble? Trouble is, it’s illegal in our “free” country. As soon as you reject someone’s 25-year-old kid who eats a diet of crap, you’ve broken the law by not including him in his parents’ insurance.

  6. Ruben says:

    Wow. Catastrophic insurance is not redundant for insurance. Look up the definition of insurance — it’s the transfer of the risk of loss from an uncertain outcome. There are non-catastrophic medical conditions that would not be covered in “catastrophic insurance” and are uncertain to occur. Why is buying protection for those uncertain outcomes not considered insurance?

    Preventative care coverage included in healthcare plans are there to *reduce* the risk of loss from the uncertain outcome. They’re in the interests of those selling the insurance! Same with driving school and security system discounts for driver and home insurance, respectively.

    • “Look up the definition of insurance”

      I don’t need to, but all this will be addressed in a follow-on post on Thursday or Friday: What is Insurance?

    • Ruben says:

      There’s a certainty to your argument structure that sounds self-assured. Shit’s complicated, remember?

    • There’s a certainty to your argument structure that sounds self assured.”

      Which would most certainly be a sin, right? After all, nobody ought be sure in themselves about anything because there are degrees, certifications, licenses, recertificatons, tests, qualifications, degrees, permissions, ordinations, and all manner of of authoritarian chattel designed to make you look like a minion begging what to to be told to do next,

      Fucking pathetic.

    • Ruben says:

      Jesus H, “context MF’er, do you speak it?” Did I appeal to authority anywhere? I’m talking sound arguments with fully-formed premises to support your claim. Do you really think insult-driven ranting where you declare who/what is right without support is good argument? You sound self-assured as in not by reason.

    • “Shit’s complicated, remember? ”

      And you’re complaining about my arguments?

      “I’m talking sound arguments with fully-formed premises to support your claim.”

      No you’re not. You’re talking about complicated shit and incidentally, nothing I wrote in the post in any way contradicts your quite obvious statements about the nature of insurance in terms of risk.

      I’ll be addressing all of that specifically in a subsequent post and then you’ll know why I considered your comment a silly, ho-hum nitpick.

    • Elenor says:

      “Preventative care coverage included in healthcare plans are there to *reduce* the risk of loss from the uncertain outcome. They’re in the interests of those selling the insurance! Same with driving school and security system discounts for driver and home insurance, respectively.”

      The insurance companies do NOT pay for you to go to driving school nor to buy your security system! YOU choose it. YOU pay to buy it and keep it up! And if you show you’re a better risk than someone else (by having paid for school/security) then the insurance company (often-not-always) figures you’re less likely to be in a crash/have a break-in and thus to cost them less, and so they may choose to lower your premium. Why do you think ‘preventive care’ is not ALSO the responsibility of the ‘driver’ (body owner)?

      Your health is your business, not the business of the govt! Catastrophic insurance — which requires the “body owner” to get educated about health (“driving school”) and take care of the ‘system’ (paleo lifestyle/exercise) — covers things that were NOT prevented or were unexpected (cancer, broken leg). That’s the point, that’s why it’s called *catastrophic* — it’s for catastrophes, not regular education and care!

  7. Joseph Fetz says:

    The state is the antithesis of the market. The market is based upon voluntary exchanges, the state is based upon force. How one can mix these two things is beyond me. Well, unless they are entirely ignorant of economics, then I can see it.

    As Mises said, “The issue is always the same: the government or the market. There is no third solution.”

    • Economic arguments are completely worthless as this is a moral battle. Forget Mises. He won’t help you with this.

    • Joseph Fetz says:

      Is theft ethical? Is it ethical to limit supply and increase demand in a world of scarce resources, such that the overall level of care is diminished for everybody? Is it moral to create a bureaucracy, a body that does nothing in itself to increase health, to syphon a portion of the resources that would otherwise go to increasing care? Is it ethical to increase the range of the administration of a good to an entity that cannot rationally calculate costs?

      Sure, morality plays its part, but one cannot make the claim that they are taking the moral high ground while also ensuring less utility for a greater number of people. In fact, that would be immoral, or at the very least amoral.

      Take a listen to former Labor Secretary Robert Reich actually being honest about things in 2007 and tell me that this is about morality- http://www.youtube.com/watch?v=31J4BF9EFAw

    • ““The issue is always the same: the government or the market. There is no third solution.”

      “Economic arguments are completely worthless as this is a moral battle. Forget Mises. He won’t help you with this.”

      If the government is force and the market is defined as voluntarily, then it’s both an ethical and economic discussion. No battle needed here, force is immoral and there’s no need to battle over that fact.

    • Joseph Fetz says:

      I like your thinking, Carlos.

    • Robert Ve says:

      Some people are actually more pragmatic than moral, so don’t discount economics.

  8. Richard, it’s such a good feeling to read your posts. European journalists are ejaculating nonstop over that issue as America gets more “civilized” and such BS. They all superficially justify it with legalistic gibberish.

    • It’s a warning sign! As a American you have to piss of European Intellectuals.

  9. As a Norwegian I find it very hard to believe your brother paid ~$250 for dinner at a typical pub. Must have been a very high-end restaurant?

    I’m not very engaged in politics, but the health care here is of high quality, and most people seem to be happy about it. Whatever that means…

    • JohnC says:

      Yup, seems like a lot of cutting off the nose to spite the face going on here.

    • Andy

      He’s currently en route back home to Texas but I have an email in asking exactly where it was.

    • Andy,

      To close the loop on this, heard back from my brother. I’d assumed they ate in the same pub where he paid over $12 for the beer. But it was nice restaurant in Stravanger.

      By comparison, a Big Mac meal at McDonald’s is $21.00. I think it’s about $4-5 here in CA.

    • Cool, must have been pretty good then!

      It’s lucky that Norwegians earn exponentially more to be able to buy all this “expensive” food :)

  10. Interesting to read, sitting here on the other side of “the pond” (Norway, Northern Europe). We have had free health care for decades, and we just take of for granted I guess.

    My 70 year old mother in law got seriously ill last week, but not lucky enough to have free help at the hospital – she lives in South Africa. Her insurance covers her stay at the hospital to a certain amount, but then no more. To a Norwegian that is a very foreign concept – that they would actually throw you out of the hospital if you cant pay.. (Luckily for her she has family that can help)

    I believe every one is entitled to free medical help, if the government can afford it that is…

    • “We have had free health care for decades”

      Really, so all the doctors, nurses, support staff, hospitals, medical supply companies all work and supply goods for free?

      That’s very charitable of them.

    • Joseph Fetz says:

      Richard, even if they all worked without pay, it still would not be free. Don’t forget opportunity cost.

    • JohnC says:

      Come on man, you’re better than that.
      Hitchens would have taken it as intended.

    • Joseph Fetz says:

      “if the government can afford it that is…”

      You do realize that the government has nothing that it has not first taken from the private sector, right?

    • “You do realize that the government has nothing that it has not first taken from the private sector, right?”

      Well, other than the hidden taxation of inflation (printing one’s self out of debt or, increasing the money supply beyond the demand for debt/credit).

    • Joseph Fetz says:

      Actually, my statement is entirely accurate. Under our current system, the government must borrow the money from the central bank. For each dollar printed, there is a security issued to the Fed which includes principle, plus interest. This is actually taking from the future generations of the private sector.

      However, even under a government issuing system, my statement is correct. The reason being that in order to get the presses, paper, ink, computers, etc; it must first tax the population in order to purchase those items from the market. Further, each note exchanged by the state is done through coercion (i.e. you must accept the note for your wares or be imprisoned).

      Obviously, we could assume a socialist economy, in which case the regression becomes much more complex. However, if you go far enough to the point at which property rights are abolished, then one can reason that the state has unjustly confiscated ALL resources from the private sector.

      I know that many like to call inflation a tax, I am not too fond of that practice. While it is true that inflation is a transfer of wealth from one group to another just like a tax, the difference lies in fact that the government can control who pays a tax, as well as who benefits from the tax. However, with inflation, the government cannot entirely control which group benefits from inflation, nor can it control which groups suffer, because the prices don’t actually increase until well after the money supply has been increased, the increase of those prices is not uniform or proportional, and each unit of currency will change hands many times during the duration of an inflation (i.e. an inflation occurs over a period of time). No doubt, it is an unjust transfer of wealth, it just differs from an actual tax in my mind.

    • Joseph Fetz says:

      Oh, I almost forgot. Printing money doesn’t actually create any resources, it only redirects currently existing resources to paths that they would not have taken without an inflation of the money supply.

    • I guess this is my Joseph Fetz nit-picking day.

      Joseph, you might discern from the length of my comments my desire to be exhaustive.

      Inflation is effectively a tax. It used to be physical, ie, clipping coins. It’s effectively the same thing now, and it matters not one lick the paper shuffled around between central banks and government financial commissars.

    • Joseph Fetz says:

      How about we meet in the middle. It is a form of theft, as is taxation. ;)

    • Printing money does create wealth and resources. Via debt (making a loan in a fractional reserve system is creating–printing–money), which in simplest terms is the selling of one’s own future labor or capital appreciation now.

      Starched collared bankers used to know how to do this (I’m not a fan of tossing babies out with bath water; creating money via making loans was ingenious, potentially the most energetic thing that ever happened to human advancement in terms of accessing future labor and capital appreciation now).

    • Joseph Fetz says:

      Yes, I understand that you’re essentially selling the discounted future value of your labor, but remember that one cannot own another man’s will and the future is always uncertain. One can certainly change one’s mind, or one can simply die, in which case nothing new was created in terms of actual wealth. Also, I do understand what you’re saying regarding how fractional reserve banking can indeed increase wealth (Salmon Khan actually has a pretty good video on his site on this very thing), but that is only true if the venture that such money was borrowed for is successful and the loan payed back (i.e. the balance sheet reconciled). Obviously, the venture could flop and resources be squandered. It still stands that merely printing a paper note does not cause more resources to enter the economy by virtue of the fact that a new note was printed.

    • Well, Joseph, it was George Washngton who said that government is force. My question would be, why?

      People fail to make the obvious, essential connection. Force and correction are always about theft, except in the microcosm of serial killers.

    • “but remember that one cannot own another man’s will and the future is always uncertain. One can certainly change one’s mind, or one can simply die, in which case nothing new was created in terms of actual wealth.”

      Here’s the thing: a banker should go bust and his depositors lose all or a fraction of deposits if he makes too many imprudent loans. That’s just simple market dynamics.

      Back in the day when there were hundreds of private currencies and banks had printing presses in the vault, this is how it operated and it kicked the shit out of warehouse receipts for a deposit that just sat there.

      Banking, per se, is fucking ingenious and I have never given a wit about a gold standard. I prefer a “fall on your ass and explain to your customers how you fucking lost all their money standard.” The gold standard is a sucker’s plea for reigning in government abuse, which can’t be done short of bloodshed.

    • “It still stands that merely printing a paper note does not cause more resources to enter the economy by virtue of the fact that a new note was printed.”

      I believe it was about 1995 or so that I argued against that notion. I must tell you: while I’m vey sympathetic to Rand, Mises, the Austrians and even the Chicago school–and I have had dinner with David Friedman (son of Milton, Autor of “The Machinery of Freedom” and law professor at Santa Calara U here locally, even though he has never taken a law course…)–I hold a different view.

      Focussing on the printing is concrete bound. Rather, we are human beings and printing money to create money for a loan–which is reality a (hopefully) discounted sale on future production–ought to focus on the _promise_ of repayment. This used to be the sock in trade of starched collared banker; they were excellent at sizing up people (in quantitative and qualitative ways) to judge whether they were credit worthy…in which case the bank would make interest on money created by a printing press. But far, far more importantly, they made mone off of a _legitimate promise to repay_ from a human being with pride (which was his job to judge).

      I said it first almost 20 years ago: a promise from a good human being is valuable. You can often bank on it.

    • You know Richard, everyone of your readers knows what Helen meant by free healthcare. Those of us who live in country’s with universal healthcare, would never want it to change. We all understand the extra tax burden. The majority of us don’t mind higher taxes when it comes to health and education. You have to understand how amazing it is, to know that whenever illness strikes us, or our loved ones, we are never, ever be denied treatment.

    • “Those of us who live in country’s with universal healthcare, would never want it to change.”

      Rick, Rick!

      You misunderstand. I want you to go on being the helpless pussy wankers you are who delight at being able to get others to pay your way.

      I was hoping that realization might jar an American or two into realizing why America is in the first place (most of the non-pussies left).

      Thanks, Rick, for being the international pussy I expect you to be.

      Ok, I leave you to your extreme comfort.

    • Joseph Fetz says:

      That’s funny, I’m currently engaged in a debate with David Friedman, but it is more related to libertarianism (he and I rarely agree on anything other than anti-statism). I am not too big of a fan of Rand due to her being a statism. I used to be a monetarist (i.e. Chicago School adherent) about 6-7 years ago, today I consider them monetary socialists. I do like Mises, but I am more of a Rothbardian/Hoppeian than anything else, these days (at least regarding political economy).

      Basically, I can care less what people choose to use for exchange, that is between them. I prefer an entirely free market in money, so I am obviously against a gold standard or any other imposed standard. However, I do take issue with fractional reserves, but it has nothing to do with it being paper money, neither is my gripe related to the increase of deposits (i.e. money supply) that is created by fractional reserve banking. In fact, there was a time when I would have considered myself a free banker in the vein of Selgin, White and D. Friedman. That is until I looked at the logical implications that come with a fractional reserve system.

      The fractional reserve system creates a logical impossibility: that two people can have full ownership rights of single good. Obviously, multiple people can have shared ownership rights, but it is a logical impossibility for more than one person to have full ownership over any single good. However, this is the exact situation that the fractional reserve system creates. Obviously, somebody is getting fucked.

      Money is a good like any other, the only difference is that it is more highly valued for its use in exchange rather than for its direct use (consumption). Therefor, it is entirely proper in terms of discussing ownership to compare it to any other good, such as a car. Let’s say that I deposit my car into a John Banker’s warehouse. Obviously, I own the car and am only warehousing it with John. However, he decides to loan it out to Billy at interest. Now, Billy may indeed create much wealth with that borrowed car, however I am the one that is getting pluked in the ass in this deal. There simply is no logical way that it can be said that I own the car while also saying that Billy owns the car (nor John), however this is exactly what is being presented.

      Sure, I may get the car back, but it may have lost some of its value due to its being loaned to and used by Billy (similar to inflation, but in this case we are speaking of the actual use depreciation). Further, my property was used without my knowledge to enrich a third party (John) without my consent, as well as Billy. Last is the opportunity foregone. If my property was to be used to enrich anybody, that should most certainly be the owner: me. Essentially, what took place in the exchange was that my property rights were taken and transferred to somebody else, who then was allowed to make use of that property for his own benefit, only to be returned to me in a lesser state. Indeed, it could have been completely destroyed altogether. Now, it would be fine if this is how it was presented and I agreed to it, but that is not how it is presented and I am not given the opportunity to agree. Remember, I thought that I was merely warehousing my car.

      Anyhow, ever since coming to this understanding I never keep more money on deposit than what is required to clear checks in the same day (bankers hate me). Further, I don’t hold cash for longer than what will be spent in a week (not usually, anyhow). Almost all of my wealth is held in physical commodities, and when bills come due, I sell what is needed to cover. If somebody wants to borrow or rent my property, I am the one getting the interest return. Indeed, I am entirely in the monetary black market.

    • Joseph Fetz says:

      *that should have read, “I am not a big fan of Rand due to her support of statism”. Well, there is also the fact that I’ve found many of her followers to be narcissistic pricks, but that’s a different issue.

    • Joseph

      “However, I do take  issue with fractional reserves”

      Why? It’s rightly just a banking business model. In a sane world, you’d get to compete. You’d likely lose.

      There is nothing wrong and everything brilliant about fractional reserve, so long as anyone who undertakes it can fail (along with his depositors) with crating new money backed by stupid loans.

      I don’t sense you really got the essence of my last comment. It’s is about people. We’re always, forever, about people. Bankers (professional, competent ones, starched collars and all) are potentially the best social scientists of all.

      You really missed the point. What is the value of a human promise? Needless to say, it can be worth nothing. It can also be worth a billion dollars and more. Sorting that all out is the job of a competent banker.

      Your analogy to warehousing a car is just non-sequitur. Anyone who warehouses a car expects it to stay put (otherwise they would rent or lease it out). Unless they’re ignorant, they don’t expect their dollars to sit in a stack in the vault, especially if they are earning interest.

    • Joseph Fetz says:

      Here is Hoppe’s argument against fiduciary media, if you’re interested.
      https://mises.org/journals/qjae/pdf/Q11_2.pdf

    • “am not a big fan of Rand due to her support of statism”

      Agreed.

      As to her followers, I’m often dumbfounded. Literally, some people attempt to “interpret” her as others interpret the bible.

      Creepy.

    • Got about a page into it. That sort of thing was 15-20 years ago for me. Eventually, I began thinking for myself.

      Just in the first page: of course it’s a fuckimg contract, morons, and rothbardian characterization helps not a fuck of a lot. Here’s what helps: is their money safe, secure? Do they earn a market profit in interest and is it paid with uttmost precision on time?

      Yes? Then consider staying.

      No? Then shop around and move your money.

    • To put it in more direct terms, the problem is that banking, far, far before health care, became a contrat arm of the state.

      We would do better as hunter gatherers to determine for ourselves what banking systems suited us best, and which bankers understood us the best,

    • Joseph Fetz says:

      Who owns the property in question? Property can only have a single title, so in the case of FRB, who holds the property title?

      In the case of a loan from person A to person B, it is obvious who owns the title at any given time. A is the original owner and then transfers ownership to B for a definite duration in expectation of the property being returned back to A’s ownership at a later date. However, this is not the case in fractional reserve banking, as what is occurring is that more than one title is being created for a single piece of property (a title for both A and B on the same piece of property). This is inherently fraudulent, because you are misrepresenting reality. There cannot exist more than one title to the same piece of property. Further, if B then lends to another party C, then in order for A to redeem their title, then B then transfer property and title owned by D, or E, and so on. You soon create many more titles to property than there is property that exists.

      You keep acting as if FRB is a loan or a promise, when in fact it is the creation of the impossible. If it were a loan, then it would be obvious who the owner of the property is at any given time because there would exist only one title, same with a promise to pay. If we were discussing loans or promises, then there would be no argument. In the case of contract, still there can only exist one title for any given piece of property. No contract or promise can create two titles unless there exists two separate pieces of property. This is a very basic truth, and you cannot refute it.

      You call the creation of two titles to a single piece of property contract/promise, I call it fraud and misrepresentation of reality. I have no problem with voluntary exchanges/promises/contracts, or what have you; but, I completely reject that you can make the pigs fly and triangles round, which is exactly what you’re attempting to do here.

    • Joseph

      Please stop giving me flashbacks to 15 year old masturbations.

      “Property can only have a single title, so in the case of FRB, who holds the property title?  ”

      You actually don’t even realize how masturbatory that is. Like I told you. 15 years ago.

      I’m going to leave you to figure put why you need to stop listening and reading all this masturbatory bullshit and start thinking for yourself.

    • Who knew what a reaction my post made…. Thanks for all the replies guys! ;)

      I still think – if the basic need are met – food, a roof over their head, and basic medical care if needed – and most important of all – a free education, it provides the opportunity for more people to contribute to society by working and paying their taxes.

      But I also realise that its easier to do this in a country with only 5 million people..

    • Thanks for the support.. Although im fine with alle the comments ;) I do understand when I “step on a sore toe” there will be reactions.. (And I do love a good discussion…) ;)

      But this is the thing – even the super rich dont want to change our health care system. And I have never heard any complaints on taxes used on education and health care – ever. (There are plenty complaints on other types of taxes (road taxes, proterty taxes and so on..), but thats a whole different story..)

      And you can be as healthy as you want – you still might be injured in a car accident, or someone rob and injures you. And if you were so unlucky to be in-between jobs with no insurance you are not supposed to get help?

      But again – I do understand the concerns about where the government will get the funding from.. by all means.

    • (thanks for the support RICK.. my answer ended up far away from your reply….)

    • This comment is beneath you

    • wait why is it here, oh forget it!

    • Joseph,

      Sorry, there’s a fundamental flaw here. You aren’t warehousing your money. You are buying a contract for a future payment of some amount larger than the amount you are paying. That payment may be on demand (checking account) or at a predetermined date (CD). You don’t own the money any more. You own an IOU. You do this with the full knowledge that the banker will turn around and use that money (pooled with money from others) to make the same type of deal with someone else. You also know that he will need to get a larger return on his contract than you get on yours, because he makes his living on the difference between what he gets and what he pays you.

      So, you own a contract, not money. In many situations, you can actually sell this contract for whatever you can get for it. Otherwise, you can transfer ownership of a portion of this contract to someone else (aka write a check). Eventually, when the contract expires (or you demand your deposits back), the banker will pay you the agreed amount. It’s reasonably certain that he won’t give you your original money back, though, even if you actually deposited or paid for your original contract (CD) in cash.

      There is no fraud here and no multiple ownership of money. There is ownership of multiple contracts for repayment, not ownership of money. Obviously, it’s all dependent on everyone making good on their contracts, but that’s where the people thing comes in that Richard mentions.

    • Joseph Fetz says:

      “flashbacks to 15 year old masturbations”

      Ha! That’s kind of like Nietzsche for me. Either way, I am not going to continue to argue to the point, because it isn’t going to get anywhere, and I am not a fan of wasteful behavior. I’ve been on both sides of this issue in the past and have essentially rejected all arguments (including Rothbard’s) except for Hoppe’s, because it relies upon a logical proof, which is something that I always use when dealing with problems of this type (i.e. it is something that I probably would have arrived at anyway). There is, however, something that I must address.

      You act as if thinking for oneself automatically negates learning from others. I reject this. After all, in order to accept or reject an argument, mustn’t one think for oneself? If one *only* thought for oneself– they only accepted theories and arguments that they themselves thought up– then surely there would exist nothing that we could call science or philosophy. After all, we could not even agree on definitions or terms, let alone more complex agreements such as theories, because they would automatically be rejected as not being derived from one’s own thinking. That surely isn’t a world that I would wish to live.

      We got way off topic anyway, so it is probably best that we agree to disagree on the FRB issue. The fact that there are men far more intelligent than you or I debating this issue shows that neither side has presented a bulletproof argument, and a definite conclusion is still there for the taking.

    • Joseph Fetz says:

      TimA, you’re treating this as a loan, which is incorrect. If it were a loan, then no general increase in the money supply would take place. However, in the process of FRB, my deposit is counted as money, as well is the fiduciary media issued to the borrower, thus effectively double-counting the same physical good as being owned by two separate entities. A loan is merely a transfer of title, and doesn’t have any effect on the supply of money. I don’t care what a contract says, but I do know that it cannot create goods out of thin air, which is both physically and logically impossible. Yet, that is exactly was FRB does.

      If I made a contract with you that said that I would make a triangle round, you would automatically reject it as fraudulent. Yet, for some reason you accept an equally ridiculous proposition in terms of money, just because a balance sheet says so. Sorry, but the resources have’t doubled and somebody is getting fucked.

    • “it provides the opportunity for more people to contribute to society”

      Whose society Helen?

      The only “society” I care to contribute to is my own small cadre of friends and family—as well as the greater one represented by my blog.

      Why should I give a single runny shit about anyone else’s “society” anywhere else in the world? In fact, I don’t. They’re on their on their own and should see to their own affairs and I will certainly leave them to that unhindered and I’ll even wish them well with it.

    • “You act as if thinking for oneself automatically negates learning from others. I reject this.”

      No, not at all. It’s simply that once I had the basics down over some 5 years reading stuff I found increasingly that things get masturbatory pretty quickly and there’s no place that happens more than in these intricate discussions over monetary policy, banking systems, etc. Or, to put it in economic terms, the marginal utility of each new theoretical paper approaches zero for me.

    • Joseph Fetz says:

      As you know, I tend to read a lot (usually about 500-1000 pages per week), it is one of my hobbies and is not limited to any single subject. To me, reading (and, presumably learning) is better than sex, friendship, family, drugs, etc. I am also fortunate to have a labor intensive job (one that requires a minimal amount of mental capacity), which allows me the time to think about theoretical questions at least 8 hours a day. It’s what gets me off, so to speak.

      Then again, value is subjective. ;)

    • JohnC says:

      I think what Rick and I and others with healthcare are saying is that we don’t mind contributing to making our society better where it sounds like you just want to see yours burn down into some kind of crazy “mad max” style dystopia.

      It’s ridiculous to think that just because I’m paying into it and not using it and someone else is that I will *never* use it or be the person needing it some day. That’s just unrealistic thinking.

      Would you be against any system? No matter how efficient?

      Isn’t all this financial discussion and “freedom” discussion really just masking a way of saying you’re better than other people and fuck them and their meaningless (to you) lives? Let them die as long as it doesn’t cost you anything you’re happy?

      Where is the line?

    • Anna K. says:

      “Isn’t all this financial discussion and “freedom” discussion really just masking a way of saying you’re better than other people and fuck them and their meaningless (to you) lives? Let them die as long as it doesn’t cost you anything you’re happy?”

      I agree, “fuck them” often what it boils down to.

      On the other hand, we can’t save everybody, so at the end of the day we will have to answer these questions:
      —– what is the price of human life?
      —– at what point have we done enough and each additional treatment has diminishing returns?

    • “it sounds like you just want to see yours burn down into some kind of crazy “mad max” style dystopia.”

      Well, no. I’d prefer that people started minding their own damn business, start seeing to their own affairs and leave others to theirs, and generally get a brain.

      But, whatever it takes. I’m simply a realist. There is no question in the matter that government is way overextended and things are beginning to crumble. It’s only a matter of time and the nature of the human animal is such that people will not change course until there are no other options left.

      “Would you be against any system? No matter how efficient? ”

      I love euphemisms. Here, let me help.

      “Would you be against any theft? No matter how efficient?

      I am against all initiatory force, all theft, no matter the justification, including dead babies. As such, I am against all forms of government at all levels, no exceptions, no qualifications.

      “Isn’t all this financial discussion and “freedom” discussion really just masking a way of saying you’re better than other people and fuck them and their meaningless (to you) lives? Let them die as long as it doesn’t cost you anything you’re happy?”

      No, I never said that. I wish everyone well. But here’s what’s funny. I’m the bad guy and meany because I advocate that YOU, JohnC, should never be forced to pay a single penny in taxes. Never, not under any circumstances. Same goes for your wife, kids, all your friends and relatives. I could be dying on the street, and still nobody should ever be forced to do a single thing to help me. I’ll have charity—and give it when I can—but I will not have theft on my behalf. But I’m the meany. You openly, gratuitously celebrate outright stealing from people and jailing them if the refuse, in order to pay for your machinations. And you’re the good guy. You really care.

      “Where is the line? ”

      Force. Theft.

    • Anna K. says:

      Richard, I may be dull, so help me understand. I’m not for government interfering into every aspect of your life and it does go overboard, but zero taxes? zero government? no police? no any kind of law? no exceptions? is that what you really mean?

      and isn’t it utopian?

      I don’t even know where to begin …

    • Joseph Fetz says:

      Anna, why would you assume that what Richard means is zero government, no police, no law, etc?

      Obviously, I cannot speak for Richard, but I would imagine that he certainly supports governance, the rule of law and police, only that he doesn’t think that the best means of achieving this is through a monopoly state. Cannot police be provided by private entities? Also, one should not conflate government with the state. Certainly, private organizations can serve as arbitrators of disputes and apply the law. Is this not governance?

      I think what Richard supports is very much what I support: Privatize EVERYTHING! Allow competition of every service, including security, courts, and education. Why is it that one should accept that monopoly is bad regarding everything *but* governance?

      This isn’t utopian at all, for if it were there would be no need for such services as police and courts.

    • “but zero taxes? zero government? no police? no any kind of law? no exceptions? is that what you really mean?”

      Yes.

      “and isn’t it utopian? ”

      No. It’s not utopian to hold out against theft and institutionalized force. I’m not proscribing anything, you all are. You all are the utopians. Just one more law, just one more election. Just a little more theft. Just a few more imprisoned.

      “I don’t even know where to begin … ”

      Modest suggestion: stop sanctioning theft and institutionalized force.

    • “Obviously, I cannot speak for Richard, but I would imagine that he certainly supports governance, the rule of law and police, only that he doesn’t think that the best means of achieving this is through a monopoly state.”

      I prescribe nothing, ever. I have no idea how various values such as security, protection, defense, dispute resolution would work out on the market but I presume it would work out like a lot of values on the market people pay for.

      I no more wring hands or worry about any of these issues than I do about how the 7 billion people of the Earth are going to eat every day, clothe or shelter themselves. The vast majority somehow find a way to get it done, every day.

    • Anna K. says:

      joseph fetz, why there would be no need for police???

    • Joseph Fetz says:

      I don’t know, either. However, I assume that in the absence of a monopoly power-center (aka. a state) that people would engage into private contracts in order to provide for protection from criminals and the like. One thing that I do know is that one cannot assume all humans to be rational or ethical, because it would be a revolt against our nature to do so. I can state that a voluntary society is probably the most just. The state is the antithesis of this, because the state relies upon force and violence to reach its aims, thus one can assume that a voluntary society would include a market for the needs and wants of such a society. How that market provides the services and goods can only be determined by the market itself.

    • Joseph Fetz says:

      Anna, I never said that there would be no need for police (I used the word security, which includes both police and military). However, I do think that police services should be funded through voluntary means (i.e. the market) rather than through theft (i.e. taxation).

    • Anna K. says:

      So Richard, you have no solution but the abolition of everything. And it will magically resolve itself. Great!

      don’t you think we are were we are because people chose to have government?

      ” I have no idea how various values such as security, protection, defense, dispute resolution would work out on the market but I presume it would work out like a lot of values on the market people pay for.”

      Government – this is how it worked out at the end.
      People have chosen. The market has spoken.
      We have evolved from anarchy to government because the majority prefers what we have now to the wild west.

      The solution is to evolve and improve, not to devolve.

    • Joseph,

      It’s irrelevant to me what the government calls it. M1, M2, M6, whatever. They call it “money” and “money supply” because it’s a useful measure of total spending capacity in the economy. The only “real” money is bills and coin. But, acting like that’s the only available liquid asset is silly. And, making arguments based on terms of convenience is pedantic and not useful.

      We all say the sun rises. Yet, other than little children, we all know that the sun is stationary and our position on a rotating planet changes our perspective such that our view of the sun changes throughout the day. Our saying “sunrise” doesn’t change that fact any more than the government calling demand deposit contracts “money” means there is actually more money available.

      Fractional reserve banking adds significantly more spending power to the economy than available hard currency. It has been doing this for many centuries. People have been working with this system for centuries, full knowing that if all the promises collapse the “money” will disappear. That’s why we have the occasional bank run. But, arguing about whether it should be called “money” or “contracts” is a waste of time. It’s clearly a contract because there isn’t any currency in a vault anywhere. Admitting that doesn’t change the risk/value proposition of working with a long-established system that efficiently manages measurable money and money-like assets in a manner that increases utility for all involved.

      If your risk/value position leads you to believe it’s better for you to hold your assets in hard currency, more power to you. But, many (including myself) find that the value of using a dependable payment clearing system, along with some interest earned on monetary assets, is worth the risk that the promisory-based system might collapse. I consider the risk fairly low and the value higher. I’m completely aware that the cash I gave them isn’t sitting in their vaults. (Visions of old Beverly Hillbillies episodes come to mind.)

    • Anna K. says:

      Voluntary police could only work in small villages. how about NYC? it’s absurd.

      the main problem of all you here is that you bash the existing system yet, have no solution, just hope it will our work out at the end. Well, it did. We have government. this is how it worked out.

    • Joseph Fetz says:

      So violence and force is to evolve, whereas voluntary association is to devolve?

      Further, you didn’t choose the government in which you live under, you were born into it. The fact that one doesn’t rise up and abolish a system is not proof that one supports such a system, especially when such a system is capable of murdering or imprisoning you without checks to its power.

      Markets are an arena of voluntary exchanges, thus one cannot then conclude that the state was spawned from the market, because the state is force (the opposite of voluntary exchange). The state was spawned from force and violence, and it begets force and violence.

      Once again, I have no qualms with government. My issue is with the monopoly state. I prefer what I call the “emergent governance”, that is to say that I prefer governance through voluntary means (i.e. market governance).

      Anarchy is a clunky word, as it assumes no law or order. Obviously, that is not what I am condoning. I merely prefer a system without monopoly centers of power and force.

      According to your reasoning, anarchy already exists. After all, there is no central world government. Your position means that you must support a single world government. Do you?

    • Joseph Fetz says:

      “Voluntary police could only work in small villages. how about NYC? it’s absurd.”

      Something like NYC would only exist if the property owners who reside in that area contracted to create such a large city. Since this is not the case, it is clear that such a thing as NYC was imposed upon them, not created by them. That something does exist doesn’t mean that it is just, correct, or ethical.

      “the main problem of all you here is that you bash the existing system yet, have no solution, just hope it will our work out at the end.”

      I bash the means of the current system: violence and force. I do not pretend to know what a stateless society would look like, because I do not wish to impose my values upon others, to do so would be unjust. However, I do state that in order for whatever does emerge to be just, it must be by voluntary means. Violence and force is objectively unjust, thus the state is unjust. Just because you like it, that does not mean that you should impose your will upon others.

    • Anna K. says:

      Joseph Fetz, criticizing without proposing a solution is useless in my book. It’s just theoretical masturbation, as somebody put it.

      NYC already exists and you have to deal with it.

      Violence and force will always exist. How else do you deal with criminals? you have to use force against them, government or private police. No criminal is going to voluntarily kill himself.

      Let me give you a simplistic example that shows your model is utopian. Let’s say a village wants to have a private police force and one house on the block refuses to contribute. What do you do? Make him pay? or let it go? if you let it go, how many more people will refuse to pay? or you are going to evict the person using violence? it’s not an easy solution. What do you do if a family member of a house who is not paying for police gets hurt? Do you not investigate this assalt and let the criminal walk?

      And that’s why we are where we are. Government is where we evolved to. It’s not perfect, but it’s the better of 2 evils.

      I’m not sure about the single government, if we eventually evolve to it, sure, look at Europe. May be they will unite eventually, may be not.

    • “So Richard, you have no solution but the abolition of everything. And it will magically resolve itself. Great!”

      Shorter Ana: tell me how it’ll be just as good as stealing.

      I don’t do that. And theft is not a “market”

    • TimA

      You lay out pretty much exactly why, about 15 years ago I ultimately eye rolled at most of the Austrain/Chicago monetary stuff I was reading, and many others.

      In the end, money is whatever medium of exchange people mutually agree upon.

    • “Voluntary police could only work in small villages. how about NYC? it’s absurd.”

      Work for whom?

      And again, euphemism. I’m arguing against force in general, theft in particular (a form of force). ….What you and others like to call a “system.” You demand a solution. I have already provided one: you don’t get to live by means of the values others produce through force and threats of violence and the only reason you do is because you have an institution that does your dirty work for you.

      If you had to go and hold people up yourself and steal their values to get what you want, you’d probably look for alternatives. Those alternatives are going to vary by individual and group, just like diet does and which is why I don’t prescribe.

    • Anna K. says:

      Richard, how could you ever have any discussion if all you are ever saying – let’s just remove the government and see what happens. You don’t want to predict the future and see what could possible work or happen. It’s just a very week argument, or rather no argument at all. It’s childish, really. Like a 10 years old running away from home thinking it will all work out. And then it doesn’t and you come home. Come home Richard.

    • Elenor says:

      “In the case of a loan from person A to person B, it is obvious who owns the title at any given time. A is the original owner and then transfers ownership to B for a definite duration in expectation of the property being returned back to A’s ownership at a later date.”

      Disagree: A transfers to B the USE, not the ownership! The title remains A’s — or B has no onus to give “back” what B now *owns*! Anymore than me lending my car to someone means they “own” it for the duration of their borrowing! Fuzzy language leads to fuzzy concepts!

    • “You don’t want to predict the future and see what could possible work or happen.”

      I can’t predict the future. Thus, I don’t try, and neither do I blow smoke up people’s asses pretending I can.

      At the same time, your prediction is that everyone will be worse off if everyone stopped stealing from everyone else through government coercion. I’m skeptical.

    • “Violence and force will always exist.”

      Indeed. And criminality is a pimple on a gnat’s ass compared to the hundreds and hundreds of millions maimed, killed, stolen from and otherwise harmed by government force.

      http://freetheanimal.com/2012/07/fuck-obama-fuck-romney-fuck-obomney-care.html#comment-160549

      “It’s not perfect, but it’s the better of 2 evils. ”

      Bullshit. See the above link. Government, the state, is the most destructive perpetrator of evil upon human beings ever devised. In absolute and real terms.

    • OUR society Richard! :) And – I dont believe that you care so little about other people (that is not in your close sircle of friends). I think you are pretending.. No one is that selfish – really.. (Well, maybe |some people..). But anyways – there will always be people that needs help- everyone can not at all time take care of them selves. Handicaped people, (mentally or physically), old people, orphans and so on.. In South Africa (where my husband comes from) the family often need to take care of their own, because there is no government help to get – then what if you dont have any family? Leave them to die on the street?

      But there is one good thing abt the way its been in the States – there is LOADS of voluntaires doing great work for the people in need. There are less of that here since there at not that many people in need..

    • “OUR society”

      That’s absolutely meaningless. I’m party to a culture, not a “society,” except the small cardre of friends and family in _my_ society.

      “I dont believe that you care so little about other people”

      More meaninglessness. You’re essentially asserting that unless I advocate and/or participate in coercion and/or theft to “help” strangers that I don’t care about the human condition.

      I do care about the human condition—passionately so—which is one reason I put so much time and effort into this blog and it is precisely my unequivocal, no-exceptions-ever stand against institutionalized, force, violence and theft that in my book I care far more than all you advocating theft to solve problems you perceive.

    • Anna K. says:

      Richard, it’s not about predicting future, but about planning for it. Other wise as another blogger pointed out:
      ‘ what’s the value in even discussing it or thinking about it? For me, thoughts are only worthwhile if they’re intrinsically enjoyable or they lead me to take action. No sense in just bitching,it meets neither of those qualifications.’

      And you seem to suggest nothing, just bitching how it all sucks.

      even your solution of “no government” of any sort comes with no prescription of how to get there, no action plan. What good is it then?

    • “Richard, it’s not about predicting future, but about planning for it.”

      I have no right to presume to plan anyone else’s future, save for a dependent child to the point where they become self-sufficient.

      My authority in such matters extends to offering helpful suggestions. Not force. Not theft. Never, under any circumstances, no exceptions.

      “even your solution of “no government” of any sort”

      Now you’re putting words in my mouth. I have offered zero “solutions” for one, and I never will because I have no authority, if by “offer,” you mean how force can be used differently. Second, I don’t care what you call it.

      For the mutherfucking 100th time with you: I oppose all initiation of force, all theft. That is _all_. I don’t give a runny shit that anyone won’t be able to have what they want because nobody is going to steal it for them. And I don’t care how anyone does or doesn’t arrange their own affairs. And I’m happy to see any and all thieves get what’s coming to them on the spot.

    • Anna K. says:

      Ok Richard, I got it, you have no predictions, no solutions! Congratulations!
      so “For the mutherfucking 100th time with you” : what’s the point of just talking???

      We got it, you “oppose all initiation of force”, so what now??? Who cares that you don’t like it if you don’t even sugest an alternative? I don’t like many applications of force too, so my alternative to force is government. you have nothing to do, nothing to change, you offer nothing actionable.

      The government with its force is still here as we speak and not going anywhere. Do you see how your anger is just so futile? useless bitching?

      All you do is complain like an old lady in a supermarket that persimmons are out of stock in the spring.
      Get some fucking apples instead.

      No goals produce no results.

      I expect you will tell me to fuck off now, that what people usually resort to when they run out of arguments.

    • Anna K. says:

      “Indeed. And criminality is a pimple on a gnat’s ass compared to the hundreds and hundreds of millions maimed, killed, stolen from and otherwise harmed by government force.”

      Ok Richard, I keep repeating myself, so I better stop posting soon.

      People created government, government is not some woody doll. Is it perfect? no

      BUT even early tribes with primitive government systems had wars for food, territory, some 3d generation back vendettas. So people always die, just like animals fight and die too. We are not that different. We are trying to be better, failing sometimes, but hopefully improving. It’s not a liner process, but hopefully an improvement overall. But if it’s not, it doesn’t matter, because you should fight for it to get better, not just be saying I don’t like it and that’s that. And by fighting I mean anything you want, moving to a different country, state where drugs are legal and there is no state income tax, organizing your own community, whatever, but do something other then bitching.

      Sure we put to prison way too many people. Some are for victimless crimes like drug use and we need to legalize them, but many others are legit. The reason is that rape and mild violence, as examples, are often not persecuted in 3d world counties, so their prison population is lower because of that.

    • “No goals”

      That’s what you think.

  11. Robert Ve says:

    We have “free” health care in Holland. Meaning for a fixed price you get most procedures paid for you.(less and less though) The problem the cost are growing alarmingly fast, and the solution is – according to the government – to raise prices for everyone. This puts an unreasonable burden on young people who are now paying for elderly people who have never and will never pay the actual costs of their health care. The price of free benefits is almost entirely placed on new generations, it’s just a big pyramid scheme.

    It’s ultimately a system that self destructs. It’s only common sense that people should pay the actual price for services they use, but the government distorts the real price. People who should pay more pay less, people who should pay less pay more and everyone pays to much.

    As some people may know I was a real socialist. I didn’t come easy to these libertarian views, but the more I understand about government to more it becomes clear how inefficient central government is for almost everything. And it makes people weak and dependent. I see it in myself, you get used to the government taking care of you and it’s not easy to reverse this process. Maybe it can never be reversed completely, especially for people who have been dependent on government their entire life.

    And if the common good is so good, people will choose for it freely. If not, well, it wasn’t so good after all.

    • Robert VE drops nuggets:

      “It’s ultimately a system that self destructs. It’s only common sense that people should pay the actual price for services they use, but the government distorts the real price. People who should pay more pay less, people who should pay less pay more and everyone pays to much.”

      Now pay attention folks because beyond the first two phrases of that last sentence.

      Those phrases, on the surface makes it look like the third phrase is a contradiction, but it’s not. It’s perceptive. It’s true understanding and given the reality of the fist two phrases is something everyone should chew on (And why? Anyone?)

    • Paul C says:

      People who should pay more vote for distortion, people who should pay less are a sea of morons, and the distortion layer needs cash flow for hookers and coke.

    • PaulC

      I can’t even begin to sort out the predictable social dynamics that might result and your comment is far worse. You have no idea either,

      Of course, this is the left and right Achilles heal, eventually. They really don’t know what values individuals hold.

    • AndrewS says:

      I think you missed PaulC’s point. “People who should pay more” (meaning low-income individuals, the beneficiaries of handouts) vote for the distortion, because they think they benefit from it. The vast middle class that is too caught up in their own perceived morality are actually morons — because they vote for the handouts; and they “should pay less”, ie they’re the ones paying higher taxes to support the handouts.

      The distortion layer — the bureaucrats and career specialists whose jobs were created by inefficient regulations — well, they vote for it to continue, too, because they are too afraid to get a job creating wealth. The bureaucrats, specifically, spend their income on hookers and blow.

  12. I just don’t understand your healthcare system in the US?

    I’m from the UK where everything is “free” on the NHS – people expect it and to an extent abuse it. Patients are a hassle, and often there isn’t the patient-doctor respect there should be.

    I now live in Australia where there is a medicare system – but it only partially covers medical expenses – so you need medical insurance (from your choice of providers) for big things and cover a lot yourself. This means when I go to see my doctor for example it costs about $80 of which I cover half and medicare (the goverment) the other half. I much prefer this – the cost is a deterent to timewasters (who in the UK would go to the doctor every week), but the payment creates a different relationship between doctor and patient and I find they are more respectful and thorough.

    • Thanks, Suz.

      So you mean to tell me that free can be expensive?

    • I do agree it can be abused – in Norway there is actually a small fee everytime you visit your doctor (exept for pregnant related things and its free for children up till the age of 16), so that prevents the “once a week patients”. Expensive things are all free.

      But I do find the doctors to be very caring – even if most of their salary comes from the government. (there is also private clinics).

  13. traderpaul says:

    @JohnC

    You state that you are a private business owner and entrepreneur.

    Do you really make your money by using every method at your disposal to not provide service to your customers?

    If not, why would private business owners in the health care field do so?

  14. Funny, the US wants “free” health care while Canada is slowly implementing more and more private health care options as the free health care system slowly erodes to a under serviced – over priced joke.

    • mark:

      Heh, it really is quite funny. As Europe crumbles under the weight of their massive social programs (healthcare, pensions) to the point where entire countries need bailouts and “austerity” measures, and a number of states here in the US are on the road to bankruptcy because like in CA, the pension load is now like 60% of the entire state budget, now, people think the answer is more government programs.

      I literally will be laughing my ass off should this whole thing crumble to ruin in my lifetime. Laughing my ass off. I won’t be satisfied until I see worn Armani shoes and suits standing in soup lines. And you know what? I don’t even care how it affects me. Might do me some good to have to scrounge around for a living like my grandparents did.

  15. Richard,

    I have not read all of the comments, but your post shows more understanding of the situation of any that I have read. As an emergency physician I am subject to EMTALA which mandates that I evaluate everyone regardless of ability to pay. As a consequence, I provide 77 percent of my services for NO compensation. Knowing this equation, specialists will not take hospital call any longer because it is not financially feasible. The end result is a law made to benefit the poor ends up hurting them.

    Every day when I go to work there is a poster on the dressing room door to update the critical drug shortages. These are common drugs critical to emergency care. These shortages began after the Medicare drug benefit kicked in and has accelerated since the ACA passed. So if you think that covering everyone is the answer, it is not. It can only be done by compensating the producers less than their costs of production. The end result will be a shortage of that which you seek to guarantee. This is not an opinion. It is natural economic law.

    • Hey Doug.

      Thanks for adding a little reality for all the utopian dreamers out there whose parents evidently didn’t teach them that there’s no free lunch and you can’t get something for nothing. Oh, and that you can’t have your cake and eat it too.

      “It is natural economic law. ”

      I thought Obama and Krugman repealed all of those? :)

      See you in Austin in a few week’s time.

    • “These are common drugs critical to emergency care. These shortages began after the Medicare drug benefit kicked in and has accelerated since the ACA passed. ”

      OK, is this a cause or an association? Most of “Obamacare” hasn’t even take effect yet.

    • James says:

      How are there drug shortages when pharmaceutical companies are raking in record profits every year?

    • Obee,

      This is a classic argument from those not in the belly of the beast. Do you really think a switch gets flipped in 2014 and we all seamlessly start operating under ACA? Do you not realize that markets operate looking well ahead? Ever heard of futures markets?

      Right now ther is an entire cottage industry of experts “helping” hospitals and doctors to gear up for compliance with ACA. Almost all hospitals are already in full ACA mode. They are working in a worst case scenario, even if it gets overturned or repealed something as bad or worse will replace it.

      Every day I work with “Case Managers” staring over my shoulder and pre-approving everything I do. They are basically wet nurses for the government who enforce the government’s moving goalposts for payment. In addition, they are also enforcing ACA regulations, even though it does not take full effect until 2014.

      Any hospital or doctor’s office that did not gear up in this way would be dead in the water come 2014.

      It is truly amazing to me how I can try to give a report from the front lines and someone who has no idea what it is like chooses to argue with me and point out how little they understand even the most basic concepts of economics. It really does matter who is lighting the fire and who is in the pot.

    • Well, thanks for the insult. No, I don’t think a switch comes on in 2012. But how exactly does this all translate into shortages right now? Maybe you could provide a “Drug Futures for Idiots” explanation or something like that.

    • Geez Obee

      ya fuckin poke the bear and the bear pokes back with first hand knowledge and you cry about it.
      Fuckin grow up!

  16. Right on, Richard! Get the government out of healthcare..

    There are some pretty cool free market hospitals out there. The one that comes to mind is the Surgery Center of Oklahoma, they put their prices online, don’t accept medicare & medicaid and if you can’t afford the super low fee, they do it free.

    The doctor who runs it has an awesome blog here, http://surgerycenterofoklahoma.tumblr.com/

    He reads bastiat ;)

    • Nikhil,
      Thanks for turning me on to this blog. It is eye-opening. Every entry is excellent, but scroll down to the piece on children in the Canadian government’s “guaranteed” health care system.

    • Nikhil:

      Cool. I’ll maybe have to blog about that as an example.

  17. Richard,

    Thanks for your commentary, I always enjoy your posts on current issues. I also speak my mind to friends and on FB, and I’m not a scared little pussy about it. I agree with you that American culture is fading into the black.

  18. When I went in to a walk-in clinic with a burn wound a few years back it was almost embarrassing how well they treated me when I said I was paying cash, I had both a doctor and an RN working on me (doc had to scrape the wound), they gave me bandages and ointment and $100 worth of free antibiotics, then seemed guilty about having to charge me $280. Looking back on it I should have left them a generous tip or sent them a box of fruit.

    • Elenor says:

      When I had a kidney stone (and wasted a first-class airline seat from LAX to ATL: I spent the flight lying on the floor under a blanket, but at least it was a first-class floor {eye roll}!), the North Georgia hospital was happy to see me, even (especially?) as an uninsured patient: They ran me through an MRI and charged $8,000 for it!! When I objected (weeks later when the bill came), they dropped the MRI price without comment to $4,000. (Plus the ER visit, plus the drugs, plus the radiologist (? or whoever) who read the MRI, plus plus plus $$$$). Someone WITH insurance, same MRI, pays maybe (probably not) a co-pay of $20-40… and the insurance company pays $1,000 for the MRI — because they have made a deal for cheaper MRIs. Contrary to Rob’s nice bill, I was (WAY) overcharged because the hospital has to make up for them undercharging the insurance companies.

  19. Anna K. says:

    I know it all sounds great in theory, but in reality can somebody help me out answering this:

    Let’s say any of you (anti-universal health care folks), or better yet, your kids, god – forbid, got cancer.
    No, make it a car crash where the other driver has no car insurance.
    Radiation and surgery costs 750 000$ A very reasonable amount (on the low end actually)
    you have no health insurance because you were in between jobs or having a small business or whatever and to buy it on your own was 1500/month for you and your family. You simply don’t have this money.
    your family and friends don’t have such money and you don’t go to temple/church so you can’t ask your parish

    I assume you will try to save your kid somehow, so how are you going to get the money?

    I can tell you the most likely scenario is that:
    – medicaid will pay you bills

    thoughts?

    • I got a better one. You and your wife are having your first child and looking forward to her birth with great excitement. You are planning to be with your wife while she gives birth but you notice the medical people conferring in hushed tones after which they usher you out of the room and ask you to sit in a waiting area. Hours later you learn that your daughter was born with all of her organs ON THE OUTSIDE. It will cost $45,000 a week just to keep her alive. Consumed with grief you go back to work on Monday and notice that the FBI has raided your employer’s offices. Turns out he was running a gigantic ponzi scheme and, despite your innocence, you are also now a target of the U.S. Attorneys office through guilt by association. So now you have no job and no health insurance, and you are facing a federal prosecution. You figure “What the hell I’ll have my doctor check me out before he finds out my health insurance has been cancelled, truth be told I’ve felt like crap lately.” Your doctor insists on putting you through a bunch of tests and then informs you that you have cancers in your colon, your testicles and your prostate.

      What do you do in a situation like that?

    • in a free market, insurance to cover lifesaving care in a catastrophic event should be nowhere near $1500, and most surgery should be nowhere near a million dollars.

      but, recognizing that no matter where you set the price some people could not afford it, there will be situations where people dont get the medical service that could save their lives. dont you realize that those situations already exist? the fact is that they’re controlled by “availability” and government regulations which somehow you people find to be comforting. I’d rather be left alone and take my chances. everybody will still die, some folks will still die younger than we’d like. give me back the last two decades of garnished wages the government took, and I’d take that risk for me and my family in a heartbeat.

    • Anna K. says:

      Jonw, sure you would take the risk, until you don’t and end up in the emergency room facing a life and death situation. We will see how brave you will be then.

      again, it’s all great if you are healthy, but…

    • Anna,

      First, I have to reject a number of your premises. If we didn’t already have a mostly socialized health care system, the assumptions would be totally different. First, why do you think $75ok for radiation and surgery is reasonable. If you strip away decades of third-party payments and rent-seeking and legal/malpractice tort corruption and such, those figures would be much lower. The cost load of a highly regulated, government-controlled, third-party payment-based system is incalculable. But, I suspect a system based on actual human patients working with actual doctors and hospitals would be vastly less expensive.

      Also, if I could purchase an insurance policy in a legitmate market, I wouldn’t have to pay $1,500 a month for me and my family. If I was down on my luck, I could purchase a catastrophic plan with a high deductable for minimal money. The cost would be low both because there would be little risk to the insurance company that I would need to collect and, if I did collect, the insurance company would be paying the reasonable costs established in an actual market.

      If I didn’t even have catastophic coverage, I could either go into debt to cover it or fall back on charity. Many of the greatest hospitals in the country began as charity hospitals. The Catholic Church has run charity hospitals for centuries and other religious and non-religious organizations have operated hospitals and such. Shriner’s Hospital comes to mind.

      And, if none of that was available, my child would likely die. That happens. I would obviously do everything possible to avoid that, but even having top medical care doesn’t ensure my child would get better. Of course, that’s one of the reasons I’ve worked hard to stay employed and went to college and keep my bills paid and purchase insurance and all sorts of stuff that reduces my risk of being in that position. It’s my responsibility to take care of my children, not the rest of the world’s.

      It’s when we decide it’s the community’s job to take care of me and mine that we get $750k surgeries.

    • “First, why do you think $75ok for radiation and surgery is reasonable.”

      Check out the pricing on dozens of surgical procedures and The Surgery Center of Oklahoma. Dozens of them, all inclusive, with only a single one being over $10,000 (a penile prosthesis, of all things) and most are under $5,000.

    • Anna K. says:

      TimA

      1. Charitable hospitals never had any advanced surgical equipment and cancer treatments. they only provided basic care. So forget that.
      2. 750 000 is reasonable in the world we live in. Sure it’s too much money, but it is what it is. We can only operate within the reality. you can complain as much as you want that you don’t like it, but it is still reality, even long before Obama care. How to change that reality is a different point, just repealing the obamacare is not going to solve the fundamental issues.
      3. One of the reasons cancer treatments are so expensive is because of the money put into the research of them and patents. And the same with surgical equipment.
      4. My sister in law was cured for free from cancer in the NIH – national institute of health. It was a very expensive treatment because it was experimental. Tell me that if you had this option for your child you would say no because it’s government ran?
      5. Sh0w me one country where you can purchase this hypothetical insurance for so cheap? does it exist? Basically show me example of what you think is ideal. what is this legitimate theoretical market everybody is talking about? what country. And if you can’t, think why?
      6. Why do you think the bank is going to lend you money for cancer treatment?
      7. What often happens is that people still get all the procedures done at the hospitals and government pays for it anyway via medicaid if you have no money. So mandatory payment for insurance will prevent free riding from people who, when shit hits the fan, change their mind and run for help.

      Instead of bitching about obamacare and how it ruined our lives, let’s face reality – the healthcare was already way too expensive and bloated even before.

      Instead, how about trying to minimize the health care costs:
      1. capping malpractice lawsuits to some reasonable number
      2. canceling or lowering the length of all medical patents will reduce prescription drugs costs? are patents even free market???
      3. finding ways to reduce last year of life costs – this is one of the major issues. Medicare is one of the biggest expenses now. We need to limit what medicare covers.
      4. allowing for assisted suicide
      5. I”m sure there are many others.
      6. educating people on primal diet

    • Anna K. says:

      Richard, the cost you are saying is for simple surgery, I’m talking about cancer treatment with multiple tests, MRI, extended hospital stay, chemotherapy, surgeries that are much more complex then a knee replacement.

      Or a car crash with a brain and spinal surgery need.

      big difference.

    • Anna,

      First, I agree with most of your suggestions, other than the one about patents. I actually believe patents are a good thing because they allow someone to monetize a good idea, which encourages more good ideas.

      Regarding the rest of it, you are right that, given the current situation, we aren’t going to magically go back to pre-mostly-socialized medicine. As a friend and I often say, that horse is glue. It’s long out of the barn, lived a good life and has died. There is no politically plausible way, short of possibly an actual revolution, to return to a true market-based health care system.

      That’s why above I actually said that we are on the threshold of a completely socialized health care system. We can possibly stave it off for a while longer, but eventually it will occur. The voting public (or evil corporate masters if you prefer) will never give up their “free” healthcare and have to actually face the realities of responsibility-based life. At some point after we’ve gone to a completely socialist model, it will collapse. Socialism always fails. The only question is how long it will take.

      I could respond point by point to your questions, but the answer would always come back to discussing how it might be if we hadn’t already screwed up the system so badly. There’s not a lot of point to that, though. The system is screwed up. What it could have been is mostly academic and arguing about the details is what Richard would call mastubatory. It might be fun, but it wouldn’t produce anything useful.

      However, in addition to your suggestions I’d love for the US government to implement some market-based improvements, like HSAs and portable insurance and cross-state-line markets. These might help some and stave off socialism for a while. Unfortunately, the US government “system” (federal, states, bureaucracy, special interest, etc.) is so broken, it probably can’t fix anything. So, I’m not counting on much. But, I do want the current Obamacare law repealed. We may be heading for the cliff, but we don’t have to put bricks on the accelerator pedal. Or, since this is a paleo site, I guess we would use rocks. :-)

    • Anna K. says:

      TimA, I’m glad we mostly agree. I don’t like academic arguments either. Healthcare reality is not pretty now.

      And just to add one point – people on medicare already have a socialized healthcare system. And it has existed for a while propelling our debt out of control. I just don’t see t0o many retied people complaining about it. Most want to preserve the status quo. Keep their socialed medicare and fuck the young people who can’t afford health care. So I’m for obama care. We either fail together or reform it all and survive together, I don’t see why there should be part of the society on “socialized” system and part not. And the retired people are not the one producing anything in this economy, they will not be paying for the debts they are piling on….
      Sometimes it needs to get worse to get better.

    • James says:

      There hasn’t been a truly free market for over a hundred years.

      “First, I agree with most of your suggestions, other than the one about patents. I actually believe patents are a good thing because they allow someone to monetize a good idea, which encourages more good ideas.”

      I don’t understand, I keep reading all these posts and a lot of people are making it seem like money is the only incentive to do anything in this country. Haven’t you ever done anything productive without the notion that you would get paid for it?

      “Socialism always fails.”

      So has democracy so far! The French Republic has rebuilt itself numerous times, Yugoslavia was a democratic republic for a time, Chile, Guatamala, Haiti, Czechoslovakia were democracies at one time, ROME, Greece (failing now), The Spanish Republic, Germany was a democracy until they elected Hitler, and the list goes on…..

    • I’ve done plenty of things productive that I didn’t get paid for. Charitable contributions, volunteer work for church and community groups, helping friends and family. As long as they are voluntary and I get to choose who I am helping, I will continue to do so. But, the minute the state or some state-like group starts demanding that I do something, upon penalty of fine, imprisonment or death if I don’t, it stops being volunteer and starts being forced labor or payment. I’m not interested in being compelled to do something that someone with a police force feels is the charitable thing for me to do.

      Not to be too pendantic, but democracy is a political system and socialism is an economic system. And, for more pedantry, there is a big difference between a democracy and a true democratic republic. A democratic republic that’s adhering to a socialist economic system will always cease to be democratic and become a tyranny, because true socialism can only be maintained through autocracy. Humans will never maintain a socialistic system without being forced. People will always take care of themselves, their family and their tribe to the exclusion of others.

      A democratic republic based on capitalism, however, allows people to work through a market to take care of them and theirs in reasonable negotiation with others. Will it work forever? Likely not. There are always people who want greater power or money than they can get working within such a system. In the US (and from what I can tell much of Europe), those people are steering us towards socialism so they can be the pigs who are more equal than others. Once we get there, we will fail, just like all other socialistic systems. The more we can move it back to true capitalism, the longer we can hope to last.

      Unfortunately, political leadership will always strive for socialism, whether overt or covert. It’s the easiest way to control people and milk the system for unearned wealth. The US Founders tried to create a system that would prevent this. So far, it’s lasted about 230 years, but it’s been badly damaged. Who knows how long it can go on.

    • Anna, sorry, I can’t go with you there. I’m well aware of the issues with elderly care, having had a father and mother-in-law die in the last three months and had my father-in-law move in with us. Medicare and its related issues are a real problem. I’m not sure how they can be unwound and I don’t think we’ll ever have politicians with the stones to fix them.

      But, arguing that since someone is getting socialized medicine means we should all get it is an argument from fairness, not logic. Fairness is a false concept used to guilt someone into giving you something that isn’t right. If a system doesn’t work, adding more people to it doesn’t make it work better, no matter how fair the new people think they are being treated.

      You say “sometimes it needs to get worse to get better.” I’m not sure you know how bad “worse” can be. Think Wiemar Germany where the wheel barrow is worth more than the cash it carries. Socializing one seventh of the world’s largest economy is a great way to bring the whole edifice down.

      The Obamacare law is truly a horrible set of rules whose unintended consequences will be catastrophic. It wouldn’t work even if people reacted the way the politicians want them to. And, people won’t react that way because they are humans, not simplistic automatons. In addition, the recent Supreme Court ruling makes it worse. The ruling changed two things. It said people don’t have to purchase insurance as long as they pay the minimal tax/penalty. And, this tax/penalty can never be increased to the point that it makes the “mandate” anything more than an option. The ruling also said the states do not have to participate, as long as they don’t want the additional funding provided by the law. Many states will immediately choose not to participate. Once the others figure out how difficult it is to implement the insurance markets and how much the Medicaid expansions will cost in the long term, a bunch more will opt out.

      The only fix to this will be more mandates and spending and complicated rules to make people do what’s not in their nature to do. As always, socialism will lead to tyranny. That’s how socialism always works. Like I said, we may be heading that way already, but we don’t need to put rocks on the accelerator.

    • “big difference.”

      Meaning: this is something we have to steal to get.

    • “I’m for obama care.”

      Euphemism. You’re for government stealing from others and giving it to you when you can’t or won’t pay for a value you seek to obtain.

  20. Anna K. says:

    theoretical ideas sounds great, but reality is often different.

  21. Awesome, awesome. Good work!! I am a nutritional therapist working in my mom’s small family medical practice. We are actually pretty worried about the future of our small business. We are one of the few 1-doctor only practices left in this country. The new system will probably wipe us out unless we get creative business-wise. We will probably start a cash-only section, with gov’t covered care only available on certain days. We want to offer REAL care to people who are REALLY SICK. We know, based on our experience with HMO patients- which is more like Obamacare than PPO- that with Obamacare our office will flood with people who aren’t sick and only want a prescription for something they don’t need. I also believe that when this gets implemented (IF us Americans take back control), then people will generally stop trying so hard to keep themselves healthy. If everyone is grated the cushy pillow of healthcare, then who cares if I ignore my health…it is taken care of. Lastly, when we eliminate the free market of healthcare, we lose those great doctors that are a cut above the rest because if they aren’t getting paid any differently than another doctor, then what is the point of trying so hard to be the “better” doctor? Oh, this whole thing is SO frustrating! I’m glad there are people like you on the same as me. :)

    • Interesting.

      I have pretty good health insurance, and I work like crazy to stay healthy. Never thought that I ought to quit trying because my insurance will take care of everything.

  22. Geoff says:

    My experience of public and private ‘healthcare’ in UK has left me skeptical of both.
    My health was exceptional until a training injury was misdiagnosed in the public system, I was misprescribed drugs which caused a severe reaction, stopped me from working for five months and eighteen months on has left me possibly irreversibly damaged so that I may never return to the athletic life I pursued with a passion before.

    The private medics, orthodox and alternative offered little to no advice or help, one who worked in both public and private practice took equivalent of $300 for forty minutes in which he googled concepts/terms I raised and agreed with me with no suggestions or advice.

    The cause of the original problem turned out to be a benign bone lesion which a public orthopedic surgeon wanted to fix with toxic bisphosphenate drugs and a intermedullary nail. I declined and was warned of dire consequences if/when my bone broke. Over a year on post xray he admitted he was wrong in his diagnosis and suggested I go back to the training I was doing before.

    Orthodox medicine public and private is a dangerous business, the profit motive and the tax and spend motive both fail us. Iatrogenic damage I ve learnt is widespread and under researched.

    This is as big an issue as the public/private debate

  23. Rachel says:

    It is an interesting debate… In Australia we have public healthcare as well as private and I have been though both systems without a problem. Public heathcare does have negitives like there are waiting lists for some proceedures.
    Sure the idea that my tax is paying for unheathy people annoys me but on the other hand if I have a car accident or break my leg or get cancer or anything else I will not have to morgage my house and borrow money to pay for the treatment.
    Australias debt isn’t out of control it is low compared to most countries sure the system costs alot but the peace of mind that I pay tax and if I need it I will have access to specialists and hospitals brings peace of mind. Private heathcare on the other hand is quite expensive here, it is much cheeper to join a gym and eat well…

    • “Sure the idea that my tax is paying for unheathy people annoys me but on the other hand if I have a car accident or break my leg or get cancer or anything else I will not have to morgage my house and borrow money to pay for the treatment.”

      That’s only because the values to pay for it have been stolen from others through threat of force.

  24. Better public knowledge of the field of medicine, meaning general knowledge of medicine and better personal reflection of the field, would resolve many of these problems. With a better knowledge base people can defend themselves because then they will know they are getting fucked. All the political debate and moral outrage (interchangeable phrases apparently) in the world isn’t going to change a thing.

  25. Women seek security, it’s the way they are wired.

    There’s no point in debating it, they will come up with “What if aliens invaded your home and held you at gunpoint and injected your children with an alien virus, where would you be then?”

    You could argue the odds of that happening until the cows come home but at the end of the day you are stuck with “Women seek security.”

  26. James says:

    I’m still on the fence about the whole thing, but let me ask you this: How are there drug shortages when the pharmaceutical companies are raking in hundreds of millions of dollars of profits every year. Also, I don’t see a problem with the insurance companies taking a hit when their CEOs are making 10 Million and up a year. And one more thing, Roz, the last time I checked, money isn’t the only reason people strive to excel in their fields, and people aren’t going to purposely get sick because they suddenly have health insurance. That’s pure insanity.

    • James, there are drug shortages because the Federal Government, in trying to make things “fair” has artificially set the prices for certain drugs below what a free provider wishes to sell at. Drug companies make lots of money because their highly-paid management knows it’s better to produce profitable products than products where they lose money. Every company has a limited amount of money to invest, even if those limits stretch into the billions. Intelligent companies direct those investments to those products that will bring the best return. Just because someone wants to purchase a product at a given price doesn’t mean someone else wants to sell at that price. That’s what the laws of supply and demand are all about.

      I’m sure all those drug CEOs appreciate that you are willing for them to take a hit. I suspect, though, that the investors who give them their money and approve their salaries aren’t quite as willing to lose their actual money.

      Of course, that’s what socialism is usually about–One person being willing for some other schmuk to take a hit for the betterment of all.

    • AndrewS says:

      People don’t intentionally catch cancer, or give themselves a stroke.

      Instead, they don’t even look at the consequences of downing a Big Gulp or a pint of ice cream. Maybe, some day, twenty years from now, they’ll be obese — but so what? Medical care will be free, and medicine will be better, so maybe they’ll just pop a pill and the problem will go away.

      Free care also communicates that your own health ISNT your own responsibility.

      Anyone that’s had to face paying for their own treatment, or had a close friend or relative that has, will quickly realize how financially worrisome that is. People might react one of two ways: either take control of their own health, or start chanting ever louder for someone else to pay for it.

    • Anna K. says:

      “Free care also communicates that your own health ISNT your own responsibility”

      no it doesn’t, education does, media does, your family values do, etc. There is practically no healthcare in russia, yet people do the same as here in terms of bad eating habits. They just don’t know or don’t want to know any better.

      So why can’t we do both – educate people and have healthcare to treat people.

  27. James says:

    Anna K, check this out: http://www.usgovernmentspending.com/year2011_0.html

    In 2011 government spending on healthcare was $20 Billion less than defense funding.

    http://thinkprogress.org/security/2011/08/05/289395/u-s-defense-expenditures-dwarf-china-iran-north-korea/?mobile=nc

    U.S Spends six times more than China, Iran and North Korea combined, and we haven’t been attacked by a foreign country since 1941. Maybe we could cut back a little and take care of our people? Just a thought.

    • Anna K. says:

      James, sure, agree , we need to cut down our defense spending. But medicare is out of control as well. We can and need to do both.

  28. Felix says:

    The term free market is not a redundancy, but a contradiction in terms. Without someone to ENFORCE property rights, you have no market. And those with enough money bend those “rights” to their liking. Medicare has to be fought as anti-free-market, but going against bank bailouts is deemed socialist.

    With all that “freedom” American people are supposed to have, they seem to have freely chosen a rise of working time to 60-hour workweek and 2 weeks of vacation a year for a complete stagnation of real wages for 40 years as opposed to the less indebted France, for example. Quite some freedom you have there. I think it was Leonardo daVinci, who said that people are the easiest to enslave when they think they are free.

    I also must have missed all those lines and empty isles in pharmacies here in Germany where we have had medicare for ages … and still have lower average medical costs than the US where it’s privatized. There’s something wrong with the advertising, I think.

    • James says:

      How’s Germany’s economy doing, anyway?

    • how’s America’s?

      the strongest and fastest growing economies right now are not “free market” economies. In fact, some of them are almost entirely govt controlled.

    • you seem to have leapt to the assumption that high growth and strength of an “economy” (however you might define that) is something that everybody else values as much as you do.

    • “the strongest and fastest growing economies right now are not “free market” economies. In fact, some of them are almost entirely govt controlled. ”

      Goes to show how badly America has slipped.

    • “you seem to have leapt to the assumption that high growth and strength of an “economy” (however you might define that) is something that everybody else values as much as you do. ”

      jonw also makes a good point, one I often express as: whose economy?

      I personally prefer to have myself a “strong economy.” Some don’t.

  29. one thing I’d like to point out to people talking about the “tragedy of the commons” is that there is also “tragedy of markets” that happens quite regularly.

    The free market didn’t help the white Rhino. In fact, it drove it to certain extinction. That wasn’t govt interference (govt interference is the only think keeping them alive), it was supply and demand.

    The point is that there are things beyond the ability of a market to self-regulate.

    The other aspect of free markets are that they are a farce. There is and will be no such thing as a completely free market. Freedom can typically means one of 2 things: absence of constraint or absence of coercion. A market without constraint has a lot of coercion, and vise versa. Libertarians tend to want less constraint, whereas liberals want less coercion (especially in the form of private interests).

    So, what exactly is a free market? One where you are allowed to steal from banks or one that allows banks to steal from you?

    • “The point is that there are things beyond the ability of a market to self-regulate.”

      Regulate for whom, and for what?

      As jonw points out below, if a market doesn’t magically “regulate” your values just as you want it to, whether you jump in, get your hands dirty or wallet emptied to do some “regulating” for yourself, then it’s a “market failure” regardless what other values of others might be being served.

    • “There is and will be no such thing as a completely free market.”

      Bullshit. Have you ever bartered with anyone? How about sold something on Craig’s List or eBay? Ever mowed a lawn for money as a kid. Lemonade stand?

      You can go on and on. In fact, there are millions of free market transactions going on all the time—totally anarchist, people trading values with one-another because each presumes they’ll be better off because of it.

    • Anna K. says:

      Richard, you are missing the point is the these so called “free market” transactions can only occur because there is police that enforces the laws of property rights. How secure would you feel bartering if the fruits of your labor could easily be taken away by some band of criminals? You need some basic stability and security for “free market” to function.

      “Capitalism is an economic system that is based on private ownership of the means of production and the creation of goods or services for profit.”

      Also, didn’t government existed before capitalism?
      First government – Primitive Communism among hunters and gathers. Everyone contributed to the survival of the tribe.
      And then we evolved to capitalism, but having government of some sorts seems to be a prerequisite to having capitalism.

      In any society (group of people) there is always tension between private and collective interests, between security and freedom. The solution is not abolition of everything, but finding the compromise that maximizes collective happiness, to put it very simplistically.

    • you bet I have, and those types of transactions are full of coercion and even constraint. You are coercing someone to engage with you.

      It’s a total myth, you can’t be free from coercion and constraint. That’s part of life dealing with other people.

    • “Richard, you are missing the point is the these so called “free market” transactions can only occur because there is police that enforces the laws of property rights.”

      Nonsense. Humans have been trading for eons. And they’ve been protecting themselves for eons as well, including property.

      Question: what entity throughout modern history has been the greatest usurper of property?

      “Capitalism”

      I don’t care about capitalism. I don’t make prescriptions. I oppose force.

      “Primitive Communism”

      Notice the scale of the thing. But like I said, I make no prescription. If people want to get together and be a collective commune with rules for membership I have no qualms, provided anyone is free to leave the commune any time they wish, if the rules for participation no longer suit them.

    • “you bet I have, and those types of transactions are full of coercion and even constraint. You are coercing someone to engage with you.”

      Alright. Done with you. I might as well try to carry on a conversation with a chimpanzee.

    • Anna K. says:

      “If people want to get together and be a collective commune with rules for membership I have no qualms, provided anyone is free to leave the commune any time they wish, if the rules for participation no longer suit them.”

      Richard, who do you think invented government??? People! People GOT TOGETHER and created government! Government is not some magic evil snake, it IS people.

      Sometimes government runs amok and then there is a revolution, or war, or some sort of change that brings the balance of force to the level acceptable to the majority of PEOPLE.

      And you can always leave! Go live off the grid, don’t pay any taxes because you have no money, no income, buy a gun, create your own barter system. Who is stopping you? Buy a very large plot of land in the middle of nothing somewhere in the middle of the country and grow your own food, cows, solar panels if you wish. And BARTER!

      Barter your website access for shipments of food to you.
      Or barter your writing skills for food.
      Better yet create your own currency, or bonds, or just use gold if you wish.
      The world is your oyster.

      Take your anti-government friends and buy multiple plots of land together and start a new system! Show the world how it should be done! If it works, the world will follow!

      Do what you preach! Be inventive! Change starts with you!

      I’m sure you will come up with a slew of excuses why it can’t be done. I’m sure it’s not easy, but I’m sure if you actually try, you can greatly minimize government interference in your life to the point very close to zero.

    • Anna K. says:

      “Humans have been trading for eons. And they’ve been protecting themselves for eons as well, including property.”

      and for eons humans had government and used force to uphold the law of the tribe. Whether it’s the elders, or the strongest, or the smartest, or the shamans, or whatever, there was somebody in charge, always. Even most herds of the animals have the head of the pack. And if somebody doesn’t follow the laws of this group, the force is applied. And the tribe’s youngest hunters/producers always supported the elderlies, the weak. The degree of this was obviously different in different tribes, but the point is that taxation is as old as humanity.

      “Taxes undoubtedly originated with the earliest clans. Some things were done for common benefit, such as group meals or building communal lodgings. Its a pretty obvious idea that everyone should contribute what they can to things done for the group; and those were the first taxes.

      If you are going to organize a community, it becomes pretty clear that certain things are needed for the group — such as a common meeting lodge. Thus, whole clans were called on to contribute to whatever was being done to serve the common interest.

      That would pretty obviously include everyone contributing food and clothing items to the chieftan who was overseeing the community — hence unable to hunt or to farm, and provide for himeself.”

    • the truth is that human history is dominated by our years as hunter gatherers, living in bands of a hundred or so and usually migratory. there is no evidence or rational explanation for your depiction of early humans spontaneously electing leaders to manage their hunting and gathering, voluntarily paying taxes to build a “meeting lodge” … and sharing the bounty of a good hunt with neighbors is a far cry from taxation at the point of a gun (or spear).

      “there was always somebody in charge, always”
      nope. have a quick look at http://en.wikipedia.org/wiki/Hunter-gatherer#Social_and_economic_structure “Full-time leaders, bureaucrats, or artisans are rarely supported by these societies.”

    • Anna K. says:

      well jonw,
      1. we are not longer living in hunter-gatherer society, it’s just a bit more complex now, we have cable and internet and stores and high-rises. But who is stopping you from living off the grid? search for my post about it here.
      2. really, no evidence and explanation? no leader? how about this simple one – which way do we go tomorrow? who decides? random? they throw a coin?
      3. voluntarily paying taxes to build a “meeting lodge” ? and if a few people didn’t pay, what would happen to them? it’s not so voluntary after all.
      4. the bigger the tribe, the more “full-time leaders” it needs, obviously. And obviously, the size produces more inefficiencies. If you tribe is you, your wife and kids, sure you don’t need a leader, how about 1000 people moving together? or 10000? or…1 mil? or do you suggest we all go live 1 person per square mile or land?
      5. you are arguing semantics, not the general premis of taxation, which is as old as people.
      6. Again, we are where wer are because we have evolved here.

    • I didn’t intend to answer this thread anymore, but from your assertion that this is only about semantics I worry I haven’t been clear. People have been around for a half million years, taxation not nearly so long. You are trying to equate voluntary cooperation with involuntary taxation, and ignoring the huge difference. To answer your questions, for most of human history in small bands EVERYONE decided what to do, ON THEIR OWN. Then they did it and faced the consequences. Is it so inconceivable? This is one reason why bands stayed small, because everybody always had the right to split up. And as far as a meeting lodge, the concept is too ridiculous. A group of a few migratory families just has zero need for such a thing. Read more about any culture from bushmen to inuit to plains Indians to get a better idea how our ancestors might have lived.

    • “People GOT TOGETHER and created government!”

      They most certainly did not. Some (a tiny minority) imposed government on everyone else via a combination of fraud, lying, cheating, theft, and force.

      You don’t even have the slightest clue how government actually cam about originally, do you?

      Back at the advent of agriculture when people began acquiring assets (cleared fields, livestock, farming tools, stored food, buildings, etc) there rose up bands of marauders who lived by riding from outposts and villages to the next, looting as they went. But there was a problem with this strategy. No one could be sure that the next village would not have already been looted by another band. The solution was simple. Stick around, impose rule by force, protect the village from other marauders, and of course siphon off taxes.

      Quite literally, government began as a band of thieves and nothing has ever, ever changed.

    • “but the point is that taxation is as old as humanity”

      Patently false.

    • Anna K. says:

      I’m glad Richard that you have a clue about how the government came about – from bands of “marauders”! Wow! And of course “fraud, lying, cheating, theft, and force”

      So why did it really happen? Are you saying that people are so stupid and week that a little “fraud, lying, cheating, theft, and force” made people around the world create governments?

      Well then, according to you there can be no other way, because we do have lots of assets now so if we dismantle all of the government, the “marauders” will impose it anyway, so why bother?

      LOL

    • “So why did it really happen?”

      You can read. Read it again.

      And think. It’s actually far more plausible than everybody getting together. Government is force, it’s imposition (you of all people ought to know that). It’s not everybody getting together, singing Kumbaya with all good intentions and something goes wrong. It’s force and imposition by the few over the many—with “democracy throwing you the got bone—that differs only in degree.

      “Well then, according to you there can be no other way, because we do have lots of assets now so if we dismantle all of the government, the “marauders” will impose it anyway, so why bother?”

      Not everything exists in the static vacuum of your mind.

      We now have the benefit of knowledge, history, technology and weapons. Me? I’d want to be in an alliance with other heavily armed people like myself, decent marksmen like myself. One reason it was so easy, back then, is that it cost looters nothing. Nobody saw it coming, they were helpless, had no prior experience.

      Weaponry, good weaponry, in the hands of everyday people was a huge game changer (geopolitical history—understanding how things like the stirrup, gunpowder, guns changed balances of power in huge ways). America is pretty much the last stand on that issue (with a few exceptions).

    • Anna K. says:

      I did think about it, Richard, and it still doesn’t make sense.

      I”m sure they had weapons then too. Bow and arrow, throw a rock, fire balls… Not sure how having gun powder solves the issues of having a government… Now, nuclear weapons, may be.
      And if “gun powder” is responsible for having a government, why don’t we just have one??? One world-wide government run by people who invented gun powder?

      “One reason it was so easy, back then, is that it cost looters nothing.”
      Really? why?
      Why didn’t people organize to protect themselves? Like you are suggesting doing “I’d want to be in an alliance with other heavily armed people like myself, decent marksmen like myself.”

      “Nobody saw it coming, they were helpless, had no prior experience.”
      and I’m sure they had history as well, it didn’t happen overnight all over the world and all of the villages. After a few hit and runs, don’t you think people would learn? And they did – they created government to protect themselves ,to make their lives easier. People created government, it wasn’t imposed by the “marauders”.

      Nothing is perfect, things don’t always work out, everybody makes mistakes, so government is not perfect, but most of them are better then the alternative of chaos.

      But I think at this point you are arguing from believe, not logic. That’s why you have no solutions, don’t want to have any solutions. It’s a good old adage: It’s much easier to destroy than to create

    • “I did think about it, Richard, and it still doesn’t make sense.”

      Then do the study.

      “I”m sure they had weapons then too. Bow and arrow, throw a rock, fire balls… Not sure how having gun powder solves the issues of having a government… Now, nuclear weapons, may be.
      And if “gun powder” is responsible for having a government, why don’t we just have one??? One world-wide government run by people who invented gun powder?”

      This is just too muddled for me to respond to. Study how various inventions along the way shifted the “balance of power” from individuals and small groups to larger organizations and back again, from centralization of power to decentralization of power.

      “at this point you are arguing from believe, not logic.”

      So, you are unaware of how the simple horse stirrup changed the world, and how. Or gunpowder. Or the firearm.

      So did nukes. You don’t see them being used in Afghanistan now, do you? Hell, even with drone attacks, centralized behemoths like us have one hell of a time with simply armed, poor peasants.

    • Anna K. says:

      Richard, or course any invention changes the world, but what does it have to do with not having a government???

      Firearms do change the balance of power, but they don’t cancel our the need for government. “centralization of power to decentralization of power.” But the power still exists. Somebody has to wield it, wether a gang or government. I prefer government to some gang with wire-arms.

      and you do bring out a good example – Afghanistan. They pretty much didn’t have a government, wild west of sorts, tribal and so? Is that a great model of existence? I dont’ think so, I will have to choose Europe with it’s socialism.

      Explain still why you think that People didn’t created government, but it was imposed by the “marauders”

  30. this is horse shit. the term “tragedy of the commons” comes from a 1968 ecology paper by garrett hardin discussing unsustainable exploitation of a biological resource. you’ve cleverly substituted white rhinos for hardin’s grass, then invented a new name for it as if you had come up with something original. and of course there are things beyond the ability of a market to self-regulate. but if the individuals whose behavior comprises “the market” does not regulate them, they must not be that important. do you suffer in some way because there are no more trilobites in the world? velociraptors? dodo birds? I would suggest that none of us reading this web page has a well-being that hinges on the continued survival of the ~18000 white rhinos living today. on the other hand, there are probably some folks out there in africa for whom killing a white rhino could make the difference in survival or starvation for their family. you have the arrogance to presume that your values are more important than theirs, yet you dont care enough to put your own life savings into white rhino preservation. that’s the basic difference at the root of this whole discussion.

    • Where is the market adjusting for the extinction of the resource? It doesn’t. In fact, the more scarce it gets, the stronger the market demand. That doesn’t work so well when it comes to natural resources or species. The fact remains that it was supply and demand in an unregulated free market that leaves us with less than 10 wild white rhino’s today. Ownership of the rhinos has not limited the market or the demand.

      The importance of things is relative. What we think is important today completely depends on our knowledge of it. So, the many things that are beyond a free market’s ability to self-regulate may not seem important to the market, but only because the market has limited knowledge of the importance.

      Large herbivores have significant importance to an environment, and removing them often has disastrous impacts. This may not be important to the market of the white rhino products, mainly because they 1. don’t know, 2. don’t live there, 3. don’t care. But, that does not diminish the importance of that species, just because the people buying horn powders don’t give a shit about an ecosystem collapse in Africa. The free market answer is to get all the money from the people who 1. do know, 2. do live there, 3. do care. But that amount of market influence is miniscule, because of the extreme demand caused by the market. So, the market fails to self-regulate, Africa looses an large herbivore, and then the importance is realized, maybe, but sorry, it’s too late.

      But what I hear from you is that if a total exploitation of a resource benefits at least one starving family in Africa, it’s worth it.

      So, is it ok to steal from banks or from others? Wouldn’t that be a free market? Why are your values that “stealing” more important than someone who needs something. Talk about arrogance. Quit limiting their freedom!

    • “Where is the market adjusting for the extinction of the resource? It doesn’t. In fact, the more scarce it gets, the stronger the market demand.”

      This demonstrates a profound ignorance of what markets do, their very raison d’etre.

      “So, is it ok to steal from banks or from others? Wouldn’t that be a free market? Why are your values that “stealing” more important than someone who needs something. Talk about arrogance. Quit limiting their freedom! ”

      Yep, discussion with you is absolutely pointless.

  31. I’ m not agree with policy that the country is in controlled by the government.

  32. Quality of care in many states with universal healthcare is not substandard.

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