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Started By
Message
re: The Good People of Switzerland have said no to government healthcare
Posted on 9/30/14 at 6:31 pm to Korkstand
Posted on 9/30/14 at 6:31 pm to Korkstand
quote:Well let's see.
I'm not sure what you mean by the opposite reason.
Let's suppose:
Doctor "A" is the preeminent neurosurgeon in the region.
Doctor "C" is another neurosurgeon in the same region. He does average work.
Doctor "F" is also a neurosurgeon in the region, but his results are awful.
Medicare compensation for all 3 is the same per procedure. Not a hypothetical. It is fact!
Let's repeat that!
Medicare compensation for all 3 is the same per procedure.
Private insurance reimbursement for neurosurgery is based on Medicare rates. e.g., 140%-160% of medicare schedule.
Do you understand the issue?
If consumers were left to their own devices, and if they had access to quality information, they would Pay far more to Doctor "A" than Doctor "C" and far far less to Doctor "F" per procedure. Insurance cares far less about outcome than it does about cost. There is little incentive for carriers to compensate doctors differentially per procedure based on quality. In fact, insurance companies are motivated to make healthcare anything but an actual free market.
1
Posted on 9/30/14 at 9:11 pm to Korkstand
quote:
I'm just saying that many health care treatments do not come close to fitting the definition of "commodities".
All healthcare treatments constitute commodities. You don't understand the concept of demand. Demand doesn't require intent.
Posted on 9/30/14 at 9:27 pm to HailHailtoMichigan!
quote:
The pinkos of Switzerland truly believe that the price of a commodity should be determined by income level. The continent that gave us free enterprise is now populated largely by economic illiterates.
They don't view healthcare as a commodity, they view it as a necessity.
Posted on 9/30/14 at 10:22 pm to Antonio Moss
quote:
All healthcare treatments constitute commodities.
Define commodity for me please. And then morph that definition to include all healthcare treatments. quote:
You don't understand the concept of demand.
I understand it just fine. quote:Demand in a free market requires a relationship with price. Tell me, how will demand for treatment for broken bones react if the price doubles?
Demand doesn't require intent.
Spare me the ideological bullshite, and think about what you're saying.
Posted on 9/30/14 at 10:40 pm to HailHailtoMichigan!
Remains one of the more filthy rich - in control bastard nations.
No wonder they rejected this...the transplant super rich safe harbor nation doesn't want to pay for socialized medicine?
Shock and awe.
This is like the Vatican voting for Catholicism.
No wonder they rejected this...the transplant super rich safe harbor nation doesn't want to pay for socialized medicine?
Shock and awe.
This is like the Vatican voting for Catholicism.
Posted on 9/30/14 at 10:52 pm to Korkstand
quote:did I misspell it?
A cultural choice?
quote:Where we goin'?
Come on, man.
quote:Our wants are always infinite. That doesn't imply much. If I offered a free 1-lb gold bar very few wouldn't take it. That doesn't mean gold ceases to be a commodity, or a marketable good.
It's a choice between living and dying, it's pretty universal.
quote:We should pick more non-fringe examples. Most medical care isn't acute. Veeeery few of us will get shot. The majority of expenses come in the last three years of life.
Take gunshot wounds, for example,
quote:It would matter a whole lot if I lived! I pay my bills. Even if I didn't negotiate the price up front.
If you got shot, would it matter whether it costs $100k, $10k, or $10?
And yes, you can bet your a$$ I'd be negotiating on the back end, and comparing comps and customary charges paid by insurers--esp. MEDI. But I'm tenacious like that.
quote:It isn't the only assertion you've made. I agreed the market is distorted and mostly dysfunctional. But as I said... I think where we disagree is whether that's an existential condition.
So, you agree with the only point I've tried to make in this thread?
You should drink a beer. You seem really wound up.
This post was edited on 9/30/14 at 11:02 pm
Posted on 9/30/14 at 11:02 pm to NC_Tigah
quote:Do you think that, left to their own devices, there would be any consumers "on the fence" about having brain surgery, if only they could find the right price/quality balance? It's not like food, where one can opt for the brain surgery of food, or opt for the flu shot of food, and both will sustain life.
If consumers were left to their own devices, and if they had access to quality information, they would Pay far more to Doctor "A" than Doctor "C" and far far less to Doctor "F" per procedure.
Some treatments are optional, and people could be on the fence, and left to their own devices patients and providers could participate in a free market with these treatments. Other treatment requirements, not quite.
quote:Can't doctors opt out of a network? They sign contracts, don't they? Different insurance companies offer differently priced plans, which include different networks of providers, don't they?
Insurance cares far less about outcome than it does about cost. There is little incentive for carriers to compensate doctors differentially per procedure based on quality.
quote:Insurance companies are motivated to profit by participating in the free market between them and providers, and by participating in the free market between them and the insured. They create a free market detour around the non-free market between patients and providers.
insurance companies are motivated to make healthcare anything but an actual free market.
Posted on 9/30/14 at 11:37 pm to Taxing Authority
quote:In the case of commodities, yes! In the case of medical treatment, no.
Our wants are always infinite.
quote:Exactly, because price influences quantity demanded. You would not see people lining up for free heart surgery. This is my point.
If I offered a free 1-lb gold bar very few wouldn't take it.
quote:OK, heart issues and cancer should cover a large chunk of people. And many of us will visit an emergency room at some point. How does the quantity demanded for these vary with price, as compared to your bar of gold?
We should pick more non-fringe examples. Most medical care isn't acute. Veeeery few of us will get shot. The majority of expenses come in the last three years of life.
quote:Yeah, the fact that you lived makes the price go way, way up for you!
It would matter a whole lot if I lived! I pay my bills. Even if I didn't negotiate the price up front.
quote:I asked the question in terms of how the cost would affect demand, not whether it "matters" financially. Of course if you owe the hospital $10k, you have a problem. But if you owe them $10million, they have a problem.
And yes, you can bet your a$$ I'd be negotiating on the back end, and comparing comps and customary charges paid by insurers--esp. MEDI. But I'm tenacious like that.
quote:Well, I think that if it was possible for the health care market to be functional as a truly free market, then it would be allowed to function as such, and there would be little reason for governments around the world to interfere with it, and there would probably be little reason for insurance to exist. But governments do interfere, and insurance does exist, and, to me at least, that is strong evidence that health care is not a common commodity, and that dysfunction is inherent.
It isn't the only assertion you've made. I agreed the market is distorted and mostly dysfunctional. But as I said... I think where we disagree is whether that's an existential condition.
quote:Any other risk factors you want me to frick around with? Should I have a couple smokes while I'm at it?
You should drink a beer. You seem really wound up.
Posted on 9/30/14 at 11:52 pm to HailHailtoMichigan!
quote:my my my aren't we defensive. I'm not clicking your link BC IFGAF but I would like you to link to a post of mine where I said I was a supporter of Romneycare.
Before StrawmanTUba, doghead, or Vegas Bengal responds that Swisscare is Obamacare, let me just say that it is still a very positive thing that they rejected government control of the care. THAT is the subject of this thread. If you want to hijack it and use it to glorify messiahcare, then start your own thread.
Posted on 10/1/14 at 7:17 am to SlowFlowPro
quote:
that's still coercion and not control over the care itself
And Medicare/government creates laws that are impossible to follow by design, so the threat of jail because of medicare "fraud" can be used on "undesirables" (those who chose to do what is right for the patients but can lead to expensive care). Always follow the money.
If you don't think control cannot be exerted by coercion I don't know what to tell you. You are probably one of those unicorn believers.
Posted on 10/1/14 at 7:18 am to Korkstand
quote:
In the case of commodities, yes! In the case of medical treatment, no.
this is completely false
Posted on 10/1/14 at 7:25 am to Korkstand
quote:
Define commodity for me please.
Product or service whose distribution is limited by supply and demand.
Posted on 10/1/14 at 7:28 am to Korkstand
quote:
Tell me, how will demand for treatment for broken bones react if the price doubles?
Again, you fundamentally misunderstand the concept of commodities and supply and demand. You are referencing price fixing which doesn't make a commodity any less of a commodity.
The distribution of that service is still subject to supply and demand regardless of the fixed price.
Posted on 10/1/14 at 9:39 am to Antonio Moss
quote:I'm not referencing price fixing, I'm asking how the quantity demanded of emergency services might change in response to a change in price. How can a market work if price does not matter?
You are referencing price fixing which doesn't make a commodity any less of a commodity.
quote:This isn't a standard inelastic demand curve like housing and food. With emergency services, you have to buy this particular house or that particular meal. The buyer can't choose to get a mobile home instead of the mansion, or eat ramen instead of steak. He can't even go to the next town where steaks are cheaper. He has to have this steak right now at this price.
The distribution of that service is still subject to supply and demand regardless of the fixed price.
How healthy can a market be if the law of demand isn't even on the books?
Posted on 10/1/14 at 9:42 am to Korkstand
quote:
How healthy can a market be if the law of demand isn't even on the books?
It is there on a macro level. You're mistaking what the commodity is - the availability pool of fire, police, first responder, E/R services is the commodity, not the individual visit.
Why is this true? Because (someone) pays for them whether they're used or not. Now, the point is valid in that the government provides fire and police, but private entities provide first responder and E/R services.
But, other than that, they're the same. They're part of a municipal budget on the one hand, and the operating costs of a medical corporation on the other.
Posted on 10/1/14 at 10:40 am to Ace Midnight
quote:No, I understand what the commodity is.
You're mistaking what the commodity is - the availability pool of fire, police, first responder, E/R services is the commodity, not the individual visit.
quote:This is all supply, which, for the most part, probably would react to price changes in a free market.
Why is this true? Because (someone) pays for them whether they're used or not. Now, the point is valid in that the government provides fire and police, but private entities provide first responder and E/R services.
But, other than that, they're the same. They're part of a municipal budget on the one hand, and the operating costs of a medical corporation on the other.
But the demand for emergency services is not just inelastic, but inelastic with caveats.
I honestly thought I was stating the obvious here, that emergency services do not work in a free market. If they did, we wouldn't even be having a discussion about it. We would just buy and sell them like we do food, clothes, housing, etc.
Posted on 10/1/14 at 11:02 am to Korkstand
quote:
I'm asking how the quantity demanded of emergency services might change in response to a change in price.
Depends on the severity of the emergency and its occurrence in a population.
Posted on 10/1/14 at 11:04 am to Korkstand
quote:
I honestly thought I was stating the obvious here, that emergency services do not work in a free market.
Sure they do. And because of the elasticity of issues requiring emergency services, insurance has become the market adjustment.
It's no different than homeowners or car insurance.
Posted on 10/1/14 at 11:31 am to Antonio Moss
quote:It is hugely different, with the main differences being time and competition. Competition is pretty critical in order for a free market to work, isn't it?
It's no different than homeowners or car insurance.
With homeowners or car insurance, time elapses between the incident and the rendering of services. Estimates can be compared and decisions can be made before any work is done and before anybody is owed any money. The insured/insurer chooses the provider. In the case of emergencies, the provider "chooses" you. This flip-flop of roles is a huge difference, and is a huge impediment to the proper function of a free market.
Yes, insurance is the adjustment the market has made to overcome most of the obstacles that create "dysfunction" in the health care market, but it doesn't solve every problem. And no, I don't have a solution. I am just pointing out that there is a reason that there is always a discussion about it, because it is not simply a commodity like any other.
Posted on 10/1/14 at 12:06 pm to Korkstand
quote:
But the demand for emergency services is not just inelastic, but inelastic with caveats.
This is demonstrably not true. People call 9/11 to bring them a drink of water. If this is not discouraged, it continues. People go to the emergency room to get refills of their anti-seizure medication. Why? No upfront costs to them.
Emergency services are elastic, precisely because there are incentives for their utilization for "non-emergency" purposes. Just as E/Rs have adjusted to being the de facto pain management clinics by declining to provide the prescription drugs of abuse, their utilization for these purposes have dropped.
Human behavior is also not "inelastic", as it responds in relation to the market. In a small community with 1 fire truck, perhaps Joe Average doesn't call them for a small trash fire and puts it out himself. While in a large city, a small trash fire near a medium-sized apartment complex might generate a reasonable fire response.
While it is far more complex than the supply and demand laws for Coca-cola, for example, market forces exist for almost anything you can imagine.
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