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NeoNotes — Health care funding

Which raises the question why should care be publicly funded? Among other things, that keeps prices artificially high and the availability of care subject to an ever changing maze of eligibility regulations. Most importantly, the existence of an "all inclusive" (HAH!) government option drives most private alternatives out of business.

And yes, I've gone through this. My stepfather spent years confined to bed and with dementia. And for the last couple of years I've been my mother's caretaker after she rolled her car.



"Public funding" means that politicos and technocrats set the prices. It also means that certain companies and certain products/services receive preferential treatment by government and are often protected from competition. You should try web-searching "certificate of necessity" in the news for some real horror stories.

We know that the one thing that brings prices down, improves products and services, and increases availability is competition. It doesn't matter the product, it doesn't matter the service, competition makes it better, cheaper, and more available.

But don't take my word for it. Look at groceries, Look at computers. Look at smart phones. Look at toothpaste. Look at shoes. Every single time there is competition, prices drop, quality increases, and it gets more widespread.

How's that for a moral position?

Government has messed with medical care and medical insurance since the Great Depression. It's not getting less complicated. We know what works, but we have politicos telling us that Government Can Manage It For Our Own Good. How many times has that worked out for us?



Pardon, but competition can't co-exist with government funding. At least, not for very long. Look at history. When government gets involved, it acts to make competition harder often using the excuse of "fairness."

Competition will make health care cheaper, provided we make sure government is not involved. Look at how the price of lasik surgery has dropped. Look at how the cost of eyeglasses have dropped.

This is not an accident. To keep customers, businesses have to improve what they offer because that is what the competition is doing.

Government doesn't do that. Government declares what will be offered and at what price, not to mention all the specifications. There is no incentive to make it better if government pays the bills.



I'm not a Republican. I'm a free market libertarian, small "L," not associated with the party.

If people are paid to provide a service, then it is a commodity. And yes, I know how expensive it is. We had to put my stepfather in a home for the last years of his life. Even before that it was just plain silly. This coverage was for thirty days at a time unless something happened. This other coverage was for forty-five days. This other coverage was for sixty days. What would reset one wouldn't reset the others.

Socialized medicine is a relatively young concept and hasn't worked out terribly well anywhere it has been tried. At best it has produced shortages and long waiting lines for essential services.

I'm pretty sure that medical care as it exists now won't survive. But I am not sure it has to. Every one of the things you listed drives prices up and availability down.



Service does equal commodity, at least as long as you are paying people.

Overproduction still has to be paid for. Once the excess capability exists, it has to be profitable or it can't be maintained. People want money for their labor. If there is a surplus, capacity will be cut. With less capacity, prices go up.

There are no free alternatives. There are alternatives that are paid for by someone else, usually government.

The thing with government services and subsidies is that choice is removed from the equation. Senator Fixit may think that ten million widgets are a great idea, but he doesn't know if anyone wants a widget.

Price isn't just an arbitrary number. It's actually part of a sophisticated feedback mechanism. Subsidize something and you shifting costs (and other various governmental and administrative costs) to something that isn't as obvious.

Price fixing messes with the signals, which means the cost of producing something can get distorted. This can lead to widespread shortages. The best known example in American history was the gas shortage. It would have fixed itself, but thanks to government interference it took much longer.

One of the immediate measurable effects of Obamacare is that there are fewer insurance companies willing to sell medical insurance. One not so obvious effect is that there are fewer new doctors and nurses. Since Obamacare regulates prices, there are limited ways that doctors can make back the money that their education cost.

With time and competition (and without government meddling with prices), costs do drop, services get better, and availability spreads. This happens with every single product or service. The worst thing you can do is make it entirely government controlled. The second worst thing you can do it make it mixed. Most of the reasons boil down to this, government doesn't like or trust the free market. Politicos want problems they can stage manage, it's what keeps them in office.



"Obamacare basically solidified insurance monopolies, meaning insurance is now more expensive since insurance companies can extort people more easily."

You're right, it did. It led to record profits for those companies participating. And it could not have happened without government action.

""Public funding" means that politicos and technocrats set the prices. It also means that certain companies and certain products/services receive preferential treatment by government and are often protected from competition."

From my second post on this thread, with emphasis added. Long story short, monopolies can't last without government help.

There are private sector solutions. One of the most promising is called direct primary care. Basically the patient pays the clinic and doctor directly instead of going through insurance companies.

Competition in a free market does address your point. There's always going to be someone who thinks "I can do better than that!" Most won't try. Of those who try, most will fail. But there will be someone who can do it better. And when they do, to compete existing companies will have to do it better too. That's when all the customers benefit.



You're making one huge assumption, government is better and more capable than the alternatives.

You want to see how government can screw up medical care even before Obamacare? Try the VA. Or the Indian Health Service. Or as the article above indicates, pretty much any form of long term health care.

Regulations didn't save that. And even after the problems are Officially Acknowledged, government regulation doesn't fix it.

You don't like your gas station, you try another. But what do you do when government screws you?



It may be a blunt instrument, but it is also the only one free of political interference.

Do you honestly want politicos making "compassionate" decisions about health care and health insurance?



That's because politics is about controlling someone.

Democrats are saying now they want a revolution, but where were they a few years ago when Obama was trampling over people's rights? Your concern is about who is in the driver's seat, not about freedom, despite all you say that Trump has done.

You want a real solution? One so Trump and the next thirteen or so Republican politicos don't screw up your life?

Make government smaller than absolutely necessary. Let people choose for themselves and make sure they are responsible for those choices.

Everything else is just shuffling the forms and switching the lines.



We could start with letting people choose who to marry.

We could move to letting people choose what schools teach their kids.

We could even move to affordable health care.

It should be your choice and responsibility.



BTW: "Care should be publicly funded so it will be available to everyone without impoverishing them…"

Only if you live in metropolitan areas. Often only in certain cities and then only in certain neighborhoods. The ones that can make the biggest difference in elections.



It's a fact. I live in one of the most rural states in the union. While there is some good care in Flagstaff, mostly you have to go to Phoenix or Tucson. For me, it's more than five hours to Phoenix. Colorado and New Mexico have similar problems. Utah is better. I'm not familiar with the situation in Nevada or rural California.



No, I disagree.

Based on decades of observation and experience, I can say that Democrats will "pay attention" just long enough to get elected, and then will find excuses to put off any possible solutions.



Exactly.

Better to not allow them. Take back your government.



Small clinics can be profitable, just not as they are currently organized. I don't think that everyone who goes to the doctor necessarily needs a MD. Or even a person.

Granted, I haven't studied it. But one of the things than has fascinated me has been the use of 3D printing for artificial limbs, especially for children who will outgrow whatever they are first fitted with.

In the film Slingshot, one thing that contributed was the company's work on dialysis machines and a method of making medically pure water easily so it wouldn't have to be transported.

There are cheaper ways, but when government puts a decades long approval process in place and won't allow new technologies, we get stuck.



Actually, making medically pure water on a small scale was a major problem. Meanwhile the dialysis machine company was stuck with the expense of shipping water. I really do recommend the film Slingshot, clean water is a major global problem and this is an original solution.

I'm not advocating overthrowing the government, just reducing what we expect it to do. If every problem requires a government solution, isn't that tyranny?



Government is tyranny. Which is why it should be kept small and restrained. Government can't give anything without taking from someone.

Unfortunately violent revolutions tend to put even more tyrannical governments in place.

I really think you should take a look at the movie before dismissing it out of hand.



Actually Kamen deals with some social, political, and economic issues in an unusual way.

According to Milton Friedman, government has three jobs. To defend the country. To enforce contracts between individuals. And to protect citizens from crimes against themselves or their property. All this is boilerplate and pretty much any libertarian (and many conservatives) would tell you the same thing. If government stuck to this, I'd have fewer issues and would have to find something else to complain about.

The second part of the quote is more interesting.

“When government-- in pursuit of good intentions tries to rearrange the economy, legislate morality, or help special interests, the cost come in inefficiency, lack of motivation, and loss of freedom. Government should be a referee, not an active player.”

Or as I like to put it, government is not your friend. No matter how much the politicos tell you it is. It should be watched, carefully, as if it can destroy you and all you hold dear. It is useful on occasion, but always dangerous.

NeoNotes are the selected comments that I made on other boards, in email, or in response to articles where I could not respond directly.

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