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.
- Food lines
- Crappier and crappier food
- High and higher prices for crappier and crappier food
- 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.
- 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.