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'[OT]: US healthcare revisited'
2007\10\16@043513 by Vitaliy

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Chris Smolinski wrote:
>>I smell overregulation, government instated monopoly, or unions.
>
> E. All of the above

Care to elaborate? :)

2007\10\16@071609 by Chris Smolinski

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>Chris Smolinski wrote:
>>>I smell overregulation, government instated monopoly, or unions.
>>
>>  E. All of the above
>
>Care to elaborate? :)

Sure, they're all related. You generally need to see a doctor for
even the most basic health care needs, even when a nurse would do
just as well. If you could go to a small (for profit!) walk in clinic
to see a nurse for a sprain or sore throat, you'd likely have cheaper
(and probably faster!) access to health care. This is
over-regulation, mandated by the government (laws), backed by the AMA
(unions) ;-)

--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

2007\10\16@080306 by Gerhard Fiedler

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On 2007-10-15 18:06:29, Vitaliy wrote:

> Are there any countries out there, that have a successful free
> market-based health care system?

I don't think so. I think one of the reasons is that health care is by
definition contrary to the market premises. As it is, "health" care pros
only get paid when you're not healthy -- guess what their economic
incentives are to make you consistently healthy?

Gerhard

2007\10\16@083623 by Chris Smolinski

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>On 2007-10-15 18:06:29, Vitaliy wrote:
>
>>  Are there any countries out there, that have a successful free
>>  market-based health care system?
>
>I don't think so. I think one of the reasons is that health care is by
>definition contrary to the market premises. As it is, "health" care pros
>only get paid when you're not healthy -- guess what their economic
>incentives are to make you consistently healthy?

It's interesting how many pharmaceuticals today are maintenance drugs
you take forever, rather than drugs you take for a short period of
time.

Also, there's one area where I think we need a return to more
government regulation - we should go back to banning direct marketing
of prescription drugs to consumers.

--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

2007\10\16@085037 by SM Ling

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>
> >>I smell overregulation, government instated monopoly, or unions.
> >
> > E. All of the above
>

The Economists reported that the health care cost for GM workers add about
US$1200 - US$1500 per car.  This figure is insane if it is accurate.

Another contributing factor is the over-testing and over-treatment being
performed with no added benefits.  The patients are partly to blame as some
of the unnecessary treatment are demanded than prescribed.

Another undesirable side-effect is the health care industries of other
countries are using the US as an example to justifying their ever-increasing
cost.  It is happening here already.  It is sick but true that there is
"culture" of comparing posh cars among the doctors in some of the private
hospitals here.  Bare in mind that a car here (Singapore) costs 3 time as
much as the same car in the US, and only can be driven for 10 years.

Personally I am trying my best to counter this by trying to support the
traditional health care philosophy of the Eastern medical practitioners, by
providing donation to the free clinic locally, and writing to the government
to try a non-profit based Western medical services.

Cheerful regards,  Ling SM

2007\10\16@120107 by William \Chops\ Westfield

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On Oct 16, 2007, at 5:02 AM, Gerhard Fiedler wrote:

>
>> Are there any countries out there, that have a successful free
>> market-based health care system?
>
Are there any countries out there that have a successful
health care system, period?  There are certainly plenty of
horror stories about public health systems as well as free
market health systems.

I think a fair amount of the blame lies with the "insurance"
concept.  That was fine when your insurance mainly covered
unexpected accidents and statistically unlikely health problems.
That's what insurance IS.  But we replaced that with "health
care" that's supposed to help avoid those unlikely events, and
it 1) doesn't seem to be all that true, 2) adds a layer of cost
and beaurocracy to the health-care system, and 3) the fact that
"the haves" have had their expenses paid has reduced motivation
to reduce costs.

The focus should be on reducing the cost of healthcare (apply
technology, "nurse practitioners", etc) rather than on increasing
the availability of "insurance."  (and "insurance" should go back
to covering unlikely events...)

BillW

2007\10\16@120803 by Chris Smolinski

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>I think a fair amount of the blame lies with the "insurance"
>concept.  That was fine when your insurance mainly covered
>unexpected accidents and statistically unlikely health problems.
>That's what insurance IS.  But we replaced that with "health
>care" that's supposed to help avoid those unlikely events, and
>it 1) doesn't seem to be all that true, 2) adds a layer of cost
>and beaurocracy to the health-care system, and 3) the fact that
>"the haves" have had their expenses paid has reduced motivation
>to reduce costs.
>
>The focus should be on reducing the cost of healthcare (apply
>technology, "nurse practitioners", etc) rather than on increasing
>the availability of "insurance."  (and "insurance" should go back
>to covering unlikely events...)

Give that man a cigar!*  Now try to get the average person to
understand that (let alone the average politician).

(*) use of cigar will void your health insurance policy

--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

2007\10\16@134144 by Nate Duehr

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Alex Harford wrote:

> Then why do health care costs decrease and quality increases with a
> single payer health care system like Canada?

There are a number of sources of real stories about Canada's system
where people have had to wait for diagnostic tests before being treated,
for periods of time where their health seriously deteriorates while
waiting on the tests.

I wouldn't call that a "quality increase" over being able to pay and
getting the test done immediately so you could move on to treatment.

David Kilgour stated in a recent interview on the Mike Rosen radio talk
show here in Denver, a couple of weeks ago, that Canada has a relief
valve when their system is broken -- anyone who can pay can go to the
U.S. to get healthcare they can't get in Canada.

(Rosen quipped that if the U.S. goes to government-healthcare, then the
U.S.'s relief will be found in what?  Mexico?  And Canadians won't have
it as easy to go somewhere else either.)

[David W. Kilgour (Ottawa, Ontario) has had a distinguished career in
Canadian federal politics as an MP in both the Conservative and Liberal
parties. During over 26 years in parliament, he also served as Secretary
of State for Latin America & Africa, Secretary of State for Asia-Pacific
and Deputy Speaker of the House.]

http://www.850koa.com/pages/mikerosen.html?page=4

Until the page is updated, the interview recording is there.  It'll
change page numbers in the URL as shows are added.

Nate

2007\10\16@134419 by Nate Duehr

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William "Chops" Westfield wrote:

> The focus should be on reducing the cost of healthcare (apply
> technology, "nurse practitioners", etc) rather than on increasing
> the availability of "insurance."  (and "insurance" should go back
> to covering unlikely events...)

Agreed.

Faster to market, lower cost, better quality -- all things you rarely
get by saying, "Let's add more government involvement.", in any industry!

Nate

2007\10\16@152403 by Alex Harford

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On 10/16/07, Nate Duehr <spam_OUTnateTakeThisOuTspamnatetech.com> wrote:
>
> Agreed.
>
> Faster to market, lower cost, better quality -- all things you rarely
> get by saying, "Let's add more government involvement.", in any industry!

Are you a proponent of privatizing the military then?

Alex

2007\10\16@155359 by Nate Duehr
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Alex Harford wrote:
> On 10/16/07, Nate Duehr <.....nateKILLspamspam@spam@natetech.com> wrote:
>> Agreed.
>>
>> Faster to market, lower cost, better quality -- all things you rarely
>> get by saying, "Let's add more government involvement.", in any industry!
>
> Are you a proponent of privatizing the military then?

Much of it already is.

Seen the profit margins of Boeing, LockMart, or Raytheon lately?

:-)

Nate

2007\10\16@215055 by Vitaliy

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Nate Duehr wrote:
>> On 10/16/07, Nate Duehr <natespamKILLspamnatetech.com> wrote:
>>> Agreed.
>>>
>>> Faster to market, lower cost, better quality -- all things you rarely
>>> get by saying, "Let's add more government involvement.", in any
>>> industry!
>>
>> Are you a proponent of privatizing the military then?
>
> Much of it already is.
>
> Seen the profit margins of Boeing, LockMart, or Raytheon lately?

Add to that the fact that it's an all-volunteer (mercenary) army, and the
reliance on private companies to provide what were traditionally "army"
functions: from meals and fuel to security.

Even Russia saw the light, and is transforming its military into an
all-volunteer force (there, it's called "military service on a contract
basis").

Vitaliy

2007\10\16@235723 by Vitaliy

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William "Chops" Westfield wrote:
> The focus should be on reducing the cost of healthcare (apply
> technology, "nurse practitioners", etc) rather than on increasing
> the availability of "insurance."  (and "insurance" should go back
> to covering unlikely events...)

I agree that the focus should be on reducing the cost, but I think Peter P.
is right in saying that doctor's salary is not a significant part of it. And
I don't see how more technology is going to help the problem (which is not
"lack of technology").

I would really like to see a pie chart that shows where the costs come from
(including things like doctor's overhead -- rent, insurance, etc).

Vitaliy

2007\10\17@044916 by William \Chops\ Westfield

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On Oct 16, 2007, at 8:55 PM, Vitaliy wrote:

> And I don't see how more technology is going to help
> the problem (which is not "lack of technology").

Well, for instance it seems to me that a "cat scan" is a
particularly valuable diagnostic tool dependent on computer
technology to generate 3-D x-ray images (more or less) and
should therefore get cheaper with advances in computer and
other high tech, to the point where they're used about like
diagnostic X-rays in dental offices.  Every "urgent care"
facility ought to include one of SOME sort, the way most
dentist offices include one or more X-ray machines, and it
shouldn't take medical heroics, significant travel, or large
amounts of $$ to have a patient with suspicious symptoms get
the appropriate cat scan.

BillW

2007\10\17@045912 by Dario Greggio

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Alex Harford wrote:

> The free market is working perfectly.  The problem is that the demand
> for health care is inelastic.  Ie how much are you willing to pay to
> avoid death?

Yep, agreed: this is where "free market" has to be somewhat "limited" ;-)

--
Ciao, Dario

2007\10\17@103104 by Alex Harford

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On 10/16/07, Vitaliy <.....spamKILLspamspam.....maksimov.org> wrote:
>
> I agree that the focus should be on reducing the cost, but I think Peter P.
> is right in saying that doctor's salary is not a significant part of it. And
> I don't see how more technology is going to help the problem (which is not
> "lack of technology").
>
> I would really like to see a pie chart that shows where the costs come from
> (including things like doctor's overhead -- rent, insurance, etc).

This:
http://www.google.ca/search?q=hospital+stay+expense+breakdown

got me here:
https://www.answers.google.com/answers/threadview?id=271467

The National Transplant Assistance Fund provides the following
breakdown for charges billed in the first year after a liver
transplant:

Evaluation:  $16,100
Candidacy (per month): $9,600
Organ Procurement:  $26,900
Hospital:  $121,600
Physician:  $32,500
Follow-up:  $48,400
Immunosuppressants:  $12,800
                   ==========
TOTAL:               $267,900

Unfortunately no breakdown of the hospital costs.

I can see why North Americans are starting to go to India:

http://www.worldmedassist.com/
http://www.worldmedassist.com/Medical_Tourism_India_Liver_Transplant_WorldMed_Assist.htm

Alex

2007\10\17@103243 by Alex Harford

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On 10/16/07, Nate Duehr <EraseMEnatespam_OUTspamTakeThisOuTnatetech.com> wrote:
> Alex Harford wrote:
> > On 10/16/07, Nate Duehr <natespamspam_OUTnatetech.com> wrote:
> >> Faster to market, lower cost, better quality -- all things you rarely
> >> get by saying, "Let's add more government involvement.", in any industry!
> >
> > Are you a proponent of privatizing the military then?
>
> Much of it already is.

And the rest of it?  Generals in the Pentagon to grunts on the
ground...  should that be privatized as well?

Alex

2007\10\17@103804 by Alex Harford

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On 10/16/07, Vitaliy <@spam@spamKILLspamspammaksimov.org> wrote:
>
> Add to that the fact that it's an all-volunteer (mercenary) army, and the
> reliance on private companies to provide what were traditionally "army"
> functions: from meals and fuel to security.

An all-volunteer army is not necessarily privatized... we don't draft
doctors here in Canada but we still consider it a public service. :)

Alex

2007\10\17@122137 by Martin

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I don't believe health care costs will ever go down. I'm not going to
voluntarily pay for something that my insurance covers because it is so
expensive, and there are no significantly cheaper alternatives anyway. I
don't believe the problem is in the insurance company, I believe the
problem is that the cost of terminal illness and injury has gone through
the roof, not to mention drugs.

Maybe the answer is to get everyone to live in a climate controlled
bubble where they can't take risks, smoke, drink alcohol, do drugs, or
get injured.
--
Martin K

William "Chops" Westfield wrote:
{Quote hidden}

2007\10\17@192413 by Gerhard Fiedler

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Martin wrote:

> I believe the problem is that the cost of terminal illness and injury has
> gone through the roof, not to mention drugs.

I don't think it's the cost of the illness that has gone through the roof.
To me, it seems to be more our expectation of treatments, together with the
cost of the expected treatments.

> Maybe the answer is to get everyone to live in a climate controlled
> bubble where they can't take risks, smoke, drink alcohol, do drugs, or
> get injured.

This is a complicated matter. People should be allowed to do harm to
themselves, but they shouldn't necessarily expect others to pick up the tab
if they do so. In Germany, mountain rescue has traditionally been a
volunteer job (assisted by some pros from police and the military where
more heavy equipment was needed, like helicopters). This went well for
quite a long time and has a certain tradition. (Search for "Bergwacht" if
you want more info. It's a subdivision of the German Red Cross.)

But since the advent of mobile phones with signal in many mountain ranges
(the Alps are much smaller, in terms of extension, than the Rockies), this
doesn't work anymore. People just get themselves into trouble without the
proper precautions (they may even make fun of the few who do the same
one-day tour that they do with a backpack full of emergency equipment),
then call for help -- and expect that the volunteers go out and help,
sometimes putting their life on the line. And of course that any hospital
cost is taken care of, too.

This is a special case, but the attitude is typical. And it shows rather
clearly (maybe too clearly) why health care costs are going through the
roof.

Gerhard

2007\10\18@023915 by William \Chops\ Westfield

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On Oct 17, 2007, at 9:21 AM, Martin wrote:

> I don't believe the problem is in the insurance company, I
> believe the problem is that the cost of terminal illness and
> injury has gone through the roof, not to mention drugs.

But the insurance companies said that "healthcare" rather than
"insurance" would be cheaper in the long-run because people
would be healthier.  The result is that their "insurance" began
to cover normal expected healthcare expenses, which then began
to increase relatively out of control (cause my insurance pays
for it.)  (example: I complained of hayfever, and the instant
reaction was to prescribe Allegra, at a (pre-insurance) cost of
$100/month.  That's ridiculous.  My hayfever isn't worth $100/m
to treat.  With insurance it was only $30/m (brand name drug
with no generic alternative -> less coverage) and I decided that
was too much too, but if it had been the (old) standard co-pay
of $5 or $10 I probably wouldn't have noticed.)

So in theory, while "health care" is keeping people "healthier",
it's spending quite a lot of money to do so (and it isn't clear
whether all that money is well spent.)

Add to that YOUR observation that a significant amount of the
statistical things (accident, serious illness NOT easily preventable)
haven't gone away, and the fact that "terminal illness" includes
"life"...

BillW

2007\10\18@193423 by Vitaliy

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Alex Harford wrote:
> And the rest of it?  Generals in the Pentagon to grunts on the
> ground...  should that be privatized as well?

Alex, what is your point? These questions seem irrelevant to the discussion.
It's like asking, "President and Senate... should that be privatized as
well?"  Non-sequitir.

2007\10\18@221811 by Alex Harford

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On 10/18/07, Vitaliy <KILLspamspamKILLspamspammaksimov.org> wrote:
> Alex Harford wrote:
> > And the rest of it?  Generals in the Pentagon to grunts on the
> > ground...  should that be privatized as well?
>
> Alex, what is your point? These questions seem irrelevant to the discussion.
> It's like asking, "President and Senate... should that be privatized as
> well?"  Non-sequitir.

My thoughts are this:

- is there anything that the government can be trusted to do?
 - many people would argue that running the military, ie national
defense is one of them.  I'm wondering where you and Nate stand on
this.  Contracting out the military is an option that a country could
take.
 - I would argue that policing and emergency services are another
one.  Ever had to negotiate with firemen while your house was burning
down? :-P
 - if government can be trusted to do some things, then there is the
possibility that health care could be one of those things included in
the list

Now comes the rant.

In fact, many countries with single payer systems are showing that it
is indeed possible to have a better[1] healthcare system that the
United States' current one.  So the argument that government can't
handle healthcare is not a valid one in my opinion because it has been
demonstrated in many countries that it can work.

Canadian society has decided that they would rather increase wait
times and risk some people's health rather than have families go
bankrupt from illness.  There definitely is rationing to our health
care system but the overall effect on our society is positive.

Yes, there are Canadians going to the US for medical treatment.
They're also going to India.  But the traffic isn't one way.  There
are also people from the US coming to Canada to fill their
prescriptions.  I read that the estimated spending is in the order of
$1billion, although don't quote me on that as I read it on a blog that
linked to a missing page.

There is a very topical Snopes page on this subject that was posted
this morning:
http://www.snopes.com/politics/medical/canada.asp

Gotta run... baby's crying.  TTYL

[1] Better in my opinion as being defined as less expensive,
accessible to everyone, with similar lifespans and infant mortality.
See the WHO studies / CIA World Factbook studies, with the exception
that I mentioned before re infant mortality.

2007\10\19@072508 by Gerhard Fiedler

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Alex Harford wrote:

> My thoughts are this:
>
> - is there anything that the government can be trusted to do?

I don't think that there is anything any institution (private or public)
can be trusted to do. They all need diligent supervision.

> - many people would argue that running the military, ie national defense
> is one of them.  

In my opinion, anything where a decent competitive situation is not
possible is a candidate. That's mostly infrastructure and things we agree
that everybody should have minimum access to, and of course the use of
violence (which is by definition a government monopoly).

Some of these can be "privatized", but that's in general not a real
privatization; it's either a spotty, marginal thing (like toll roads) or
it's something that's highly regulated and (supposedly) controlled by the
government (like energy and telecom infrastructure).

(FWIW, I basically agree with you on health care. And I'd apply similar
thoughts to education.)

Gerhard

2007\10\20@024209 by Vitaliy

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Gerhard Fiedler wrote:
>> - is there anything that the government can be trusted to do?
>
> I don't think that there is anything any institution (private or public)
> can be trusted to do. They all need diligent supervision.

Even small businesses? There are many restaurants in my neighborhood that
have delicious food and excellent service, seemingly without government
intervention.

>> - many people would argue that running the military, ie national defense
>> is one of them.
>
> In my opinion, anything where a decent competitive situation is not
> possible is a candidate. That's mostly infrastructure and things we agree
> that everybody should have minimum access to, and of course the use of
> violence (which is by definition a government monopoly).

So what makes medicine a good candidate? Decent competitive situation is not
possible? There's no infrastructure? Or is medicine one of the things
everybody should have minimum access to?

In the US, in certain situations it is legal for private citizens and
organizations to use violence (e.g., self-defence, or protecting property).

> Some of these can be "privatized", but that's in general not a real
> privatization; it's either a spotty, marginal thing (like toll roads) or
> it's something that's highly regulated and (supposedly) controlled by the
> government (like energy and telecom infrastructure).

Toll roads are mostly operated by local governments. And it's been shown
that energy and telecom infrastructure can definitely benefit from
privatization. In certain cities, you have a choice of providers for cable
TV.

> (FWIW, I basically agree with you on health care. And I'd apply similar
> thoughts to education.)

Public education and postal service are among the worst government operated
systems in the United States.

European Union have actually made it a requirement for its members to
privatize its post offices. Countries that have privatized their postal
services have seen tremendous increases in efficiency [1].

I can't wait until the public school system in the US is converted to a
voucher system. If the government schools are just as good as private ones,
why not let the parents decide where to take their vouchers?

Vitaliy


[1] Time for the Mail Monopoly to Go
<http://www.fee.org/publications/the-freeman/article.asp?aid=3976>

2007\10\20@032032 by Vitaliy

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Alex Harford wrote:
> - is there anything that the government can be trusted to do?
>  - many people would argue that running the military, ie national
> defense is one of them.  I'm wondering where you and Nate stand on
> this.  Contracting out the military is an option that a country could
> take.

I would support privatization of the army to a large extent. It's already
happening -- and yes, even combat functions can be outsourced.

There are private armies operating in Africa, each consisting of a small
number of professional soldiers. Although they make a lot of people
uncomfortable, so far they have acted in a morally responsible way (more
than can be said of the UN troops). The truth is, there are checks and
balances in place, that provide an incentive for the mercenaries to side
with the good guys.

Machiavelli argued that an army of citizens is inherently better than a
mercenary army -- they're more devoted to the cause, they fight to win, etc.
However, the type of wars that are being fought today, and peacekeeping
operations especially, are prime candidates for outsourcing.

>  - I would argue that policing and emergency services are another
> one.  Ever had to negotiate with firemen while your house was burning
> down? :-P

The premise is flawed, of course no one would be negotiation on a
case-by-case basis. If a city were to outsource emergency services, they
would have companies bidding to provide the services. The same way that
local governments contract out the building of bridges and garbage
collection.

>  - if government can be trusted to do some things, then there is the
> possibility that health care could be one of those things included in
> the list

You already know I disagree. :-)

> In fact, many countries with single payer systems are showing that it
> is indeed possible to have a better[1] healthcare system that the
> United States' current one.

That does not mean that US healthcare system sucks because it isn't
controlled by the government. There seem to be plenty of reasons why it
doesn't work, that has little to do with that.

> So the argument that government can't
> handle healthcare is not a valid one in my opinion because it has been
> demonstrated in many countries that it can work.

Yes, but at what cost?

> Canadian society has decided that they would rather increase wait
> times and risk some people's health rather than have families go
> bankrupt from illness.  There definitely is rationing to our health
> care system but the overall effect on our society is positive.

Woa, hold on. Wasn't it you who said:

> The problem is that the demand
> for health care is inelastic.  Ie how much are you willing to pay to
> avoid death?

So you'd rather take away people's right to choose between their money and
their health (or life)?

In reality, most people have medical insurance. And bankruptcy in the US
isn't all that bad (what's the worst thing that can happen in a bankruptcy?)
The safety net does not allow people to go hungry, and being "low income"
makes one eligible for Medicare (man, I miss the times when I was
eligible!).

> Yes, there are Canadians going to the US for medical treatment.
> They're also going to India.  But the traffic isn't one way.  There
> are also people from the US coming to Canada to fill their
> prescriptions.  I read that the estimated spending is in the order of
> $1billion, although don't quote me on that as I read it on a blog that
> linked to a missing page.

Cheap Canadian medications are financed in large part by US patients (who
are picking up the R&D bill). I mean, wouldn't it be great if the
governments fixed low prices on everything? Oh wait, that did happen here in
the 70s... prior to the worst gas shortage in US history.

Healthcare needs less regulation, not more.

> Gotta run... baby's crying.  TTYL

Enjoy it while it lasts! ;-D

Vitaliy

2007\10\20@042307 by Russell McMahon

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> I would support privatization of the army to a large
> extent. It's already
> happening -- and yes, even combat functions can be
> outsourced.

Blackwater?
:-)
:-(

       Russell

2007\10\20@085757 by Gerhard Fiedler

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Vitaliy wrote:

>>> - is there anything that the government can be trusted to do?
>>
>> I don't think that there is anything any institution (private or public)
>> can be trusted to do. They all need diligent supervision.
>
> Even small businesses? There are many restaurants in my neighborhood that
> have delicious food and excellent service, seemingly without government
> intervention.

1st - 'Diligent supervision' has nothing to do with government, a priori.
In your case, I trust that you're doing it by judging the quality of the
food you're buying and not coming back if you find (maybe repeatedly) that
there was a problem. If you haven't been in their kitchen, this may be the
time to do so -- AFAIK it's the law that they have to show it to you on
request (not sure about that though, definitely depends on where you are).

2nd - Restaurants in most places do have quite a bit of government
regulation to deal with, in terms of hygiene, and you probably can be glad
about that. (There is a /lot/ of government intervention behind the scenes,
and all the radical anti-governmentalists should really look quite closely
whether they really want to live without all this.) I don't think that it
is a good idea to really let them handle that without any government
supervision. You'd have to inspect the kitchen (and not only the kitchen,
also the contents of the fridge etc) of any restaurant before you order --
do you do this? I don't. Would you like to have to do this?


>> In my opinion, anything where a decent competitive situation is not
>> possible is a candidate. That's mostly infrastructure and things we
>> agree that everybody should have minimum access to, and of course the
>> use of violence (which is by definition a government monopoly).
>
> So what makes medicine a good candidate? Decent competitive situation is
> not possible? There's no infrastructure? Or is medicine one of the
> things everybody should have minimum access to?

I think there is a strong problem with competitiveness, due to health care
being somewhat outside of the market economy paradigm. (The economic
incentive is not to keep you healthy, it is to make you spend money on
health and sickness.) The ones who actually keep their clients healthy are
probably not the ones who are economically successful. You could say 'tough
luck, the market has spoken' -- but where it's almost proven that the
market doesn't speak my language, it just don't like it :)

I also think that health care is one of the things that everybody should
have a minimum access. Personal preference; no sources :)


> In the US, in certain situations it is legal for private citizens and
> organizations to use violence (e.g., self-defence, or protecting
> property).

Yes, but only when specifically granted by the monopoly holder. It's not as
if there was a basic right to exercise violence that's restricted in
certain cases; it's no right, but in certain cases you get granted an
exception, kind of an extension of the government monopoly.


>> Some of these can be "privatized", but that's in general not a real
>> privatization; it's either a spotty, marginal thing (like toll roads)
>> or it's something that's highly regulated and (supposedly) controlled
>> by the government (like energy and telecom infrastructure).
>
> Toll roads are mostly operated by local governments. And it's been shown
> that energy and telecom infrastructure can definitely benefit from
> privatization. In certain cities, you have a choice of providers for
> cable TV.

You don't seem to get my point. Here in Brazil, toll roads are almost
exclusively run by private enterprises. Not all of the world is like the
USA. Also, this was an example, and as such, there are always situations
that are different -- without harming the point that I want to illustrate:
private toll roads (where they exist) are generally not providing a
complete infrastructure.

And energy and telecom infrastructure definitely qualify for what I call
"highly regulated and controlled by the government". Other than that the
companies are part of the private sector (or should I write that "'private'
sector"? :), there's not much of a market economy in those areas. The fact
that you can choose between different telephone providers is not due to
market economy at work, it's because of government intervention. Without
that intervention, pretty much all of telecom would probably be one company
by now (at least per country).


> Public education [...] are among the worst government operated systems in
> the United States.

Possibly. As far as I am concerned, public education works well in other
countries, so it seems if this is the case, it's not a problem with the
system but rather with a particular implementation. The USA are not the
measuring stick for everything. Something that doesn't work there may work
elsewhere, and just because it doesn't work there doesn't mean that the
idea itself is bad. It may not be adequate for the USA the way it's done
there, but that's possibly all there is to it.

> I can't wait until the public school system in the US is converted to a
> voucher system. If the government schools are just as good as private
> ones, why not let the parents decide where to take their vouchers?

One thing that seems to generally be missing in the voucher discussion is
that I think that any school that admits any student with a voucher has to
admit all students with vouchers that want to attend that school (possibly
with a restriction by residence address). That's the way the government
schools have to operate, and that's the way any school that receives
voucher money should have to operate in order to compete fairly. No
pick-and-choose of the students anymore.

Gerhard

2007\10\20@100049 by peter green

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>> Even small businesses? There are many restaurants in my neighborhood that
>> have delicious food and excellent service, seemingly without government
>> intervention.
>>    
>
> 2nd - Restaurants in most places do have quite a bit of government
> regulation to deal with, in terms of hygiene, and you probably can be glad
> about that.
This is one of the key points, niceness of food is something customers
can easilly judge and doesn't cause too much harm if it is poor. So it
is safe enough to leave up to market forces. Food hygine on the other
hand is something that can only really be determined by either
inspecting the kitchen or looking at people statistically. If you get
food poisoning you have no easy way to tell where you got it. Since
having every customer inspect the kitchen of every place they eat would
be wildly impractical it is an area that is best dealt with through a
regulatory body.

2007\10\20@101816 by Chris Smolinski

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>  >> Even small businesses? There are many restaurants in my neighborhood that
>>>  have delicious food and excellent service, seemingly without government
>>>  intervention.
>>>    
>>
>>  2nd - Restaurants in most places do have quite a bit of government
>>  regulation to deal with, in terms of hygiene, and you probably can be glad
>>  about that.
>This is one of the key points, niceness of food is something customers
>can easilly judge and doesn't cause too much harm if it is poor. So it
>is safe enough to leave up to market forces. Food hygine on the other
>hand is something that can only really be determined by either
>inspecting the kitchen or looking at people statistically. If you get
>food poisoning you have no easy way to tell where you got it. Since
>having every customer inspect the kitchen of every place they eat would
>be wildly impractical it is an area that is best dealt with through a
>regulatory body.

Health reports here are public information, you
can usually find them published in the newspaper
or online, at least the violations. Some states
(North Carolina comes to mind) grade restaurants,
and they have to post the results, usually at the
entrance.

IMHO there's an easy way to guesstimate what your
chances are of getting sick eating there - take
15 seconds to visit the bathroom, and see how
dirty it is.

FWIW, some professional chefs have complained
about the food safety laws here in the USA as
being too strict, vs Europe. Certain foods (types
of cheeses for example) or preparation methods
are simply not allowed here. Anthony Bourdain has
complained about this. Alton Brown (not a chef
but he plays one on TV ;-) often pokes fun at FDA
regulations on his Good Eats show.

Speaking of Bourdain, read his book Kitchen
Confidential sometime, if you haven't. You may
eat out less often. Or at least change your
eating habits. Don't eat seafood on a Tuesday.
--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

2007\10\20@150038 by Gerhard Fiedler

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Chris Smolinski wrote:

> Health reports here are public information, you can usually find them
> published in the newspaper or online, at least the violations.

But only because it is regulated. Otherwise, there would be no public
information, nor any violations, to be published.

It's still possible to say that the market forces would come up with some
mechanism -- but I doubt that.

Gerhard

2007\10\20@192138 by Cedric Chang

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>
> On Oct 20, 2007, at 1:00 PM, Gerhard Fiedler wrote:
>
> Chris Smolinski wrote:
>
>> Health reports here are public information, you can usually find them
>> published in the newspaper or online, at least the violations.
>
> But only because it is regulated. Otherwise, there would be no public
> information, nor any violations, to be published.
>
> It's still possible to say that the market forces would come up  
> with some
> mechanism -- but I doubt that.
>
> Gerhard


Isn't this another religion ?  Belief in government solutions or
market solutions ?
Most of these arguments congeal down to " I believe this or I doubt  
that " .
Not much in the way of research results since there is little free  
market activity
to examine.  Almost all so called "free market" processes are very  
tainted by
government intervention.   Some would call U.S. healthcare a free market
process.  I would not.  For example: medicare, regulated insurance,  
physician
monopolies, FDA, prescription drugs, etc.

Omni padme

Cedric


2007\10\20@205025 by Gerhard Fiedler

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Cedric Chang wrote:

>>> Health reports here are public information, you can usually find them
>>> published in the newspaper or online, at least the violations.
>>
>> But only because it is regulated. Otherwise, there would be no public
>> information, nor any violations, to be published.
>>
>> It's still possible to say that the market forces would come up with
>> some mechanism -- but I doubt that.
>
> Isn't this another religion ?  Belief in government solutions or
> market solutions ?

Where did you see here belief? I think I offered doubt rather than belief.
And possibility.

Besides, a belief doesn't make a religion. "I believe it will rain
tomorrow" doesn't create the Tomorrow-Rain religion.

Gerhard

2007\10\20@213100 by Cedric Chang

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{Quote hidden}

I guess I missed the point.  If market forces cannot come up with a  
mechanism,
are you saying you would not go with the government either ?

If you say you believe it will rain tomorrow, and you have no  
supporting reasoning
other than sheer belief, then, yes, it is indeed a Tomorrow-Rain  
religion.  Especially
if you live in Colorado as I do.

May the rain-god perch over your house,
Cedric




2007\10\21@081432 by Gerhard Fiedler

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Cedric Chang wrote:

{Quote hidden}

I think ('believe' :) that a reasonable dose of either, and applied where
it makes the most sense, is the way to go. A pure market economy is not
possible, and neither is a pure government controlled one. The real thing
will always contain elements of both. The thing is to determine (and
re-determine) what and how of each to which -- and this is not a scientific
question, it is a question of community consensus (aka politics). I believe
there is no right or wrong answer.


> If you say you believe it will rain tomorrow, and you have no supporting
> reasoning other than sheer belief, then, yes, it is indeed a
> Tomorrow-Rain religion.  

1- I'm not sure we speak the same language. Being not a native speaker, I
probably rely more on dictionaries than one:

<http://en.wikipedia.org/wiki/Religion>
<http://en.wiktionary.org/wiki/religion>
<www.m-w.com/cgi-bin/netdict?Religion>
<http://dictionary.reference.com/browse/religion>

These dictionaries seem to have a different understanding of the concept of
religion than you.

2- Where did the "no supporting reasoning" come in here? For pretty much
all of what I believe I have some supporting reasoning. You may not know it
or you may not agree with it, but that doesn't take it away.

Note that "my gut tells me so" /is/ supporting reasoning, IMO. We all use
that quite often, being aware of it or not. Our 'gut' is a quite powerful
and valid device, if used properly. How do you decide when to stop
searching for the best possible part for an application? Exactly when your
gut tells you that the chances you might find a better suited one than you
already have are too small to make it worthwhile.

3- Is there anything that isn't in the end "sheer belief"? Try the "why"
game, for any affirmation, and the last answer will be "because I believe".

Gerhard

2007\10\21@092202 by Chris Smolinski

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>Cedric Chang wrote:
>
>>>>>>  Health reports here are public information, you can usually find them
>>>>>>  published in the newspaper or online, at least the violations.
>>>>>
>>>>>  But only because it is regulated. Otherwise, there would be no public
>>>>>  information, nor any violations, to be published.
>>>>>
>>>>>  It's still possible to say that the market forces would come up with
>>>>>  some mechanism -- but I doubt that.

Sure they could. We need to look no further than our own field,
engineering, to see a perfect example - Underwriters Laboratories
(UL) here in the USA. There's no reason an organization or non-profit
company couldn't be created by restaurants to offer inspections,
guidance, etc.

--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

2007\10\21@104917 by Tony Smith

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{Quote hidden}

In Oz (or the bit where I am), food outlets are inspected by the Government.
Recently however, they've decided they wouldn't publish the results anymore.
Huh?

I once had someone get upset with me because I chopped up some vegetables
using the same board I'd just cut up some chicken on.  They'd had 'different
boards! contamination!' drummed into their head, but apparently the logic
behind it hadn't made it.  Sure, if I was making salad that's a fair point,
but since both chicken & vegies were going straight into the same pot...

Tony

2007\10\21@112720 by Nate Duehr

face
flavicon
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On Oct 17, 2007, at 8:32 AM, Alex Harford wrote:

> On 10/16/07, Nate Duehr <RemoveMEnateTakeThisOuTspamnatetech.com> wrote:
>> Alex Harford wrote:
>>> On 10/16/07, Nate Duehr <spamBeGonenatespamBeGonespamnatetech.com> wrote:
>>>> Faster to market, lower cost, better quality -- all things you  
>>>> rarely
>>>> get by saying, "Let's add more government involvement.", in any  
>>>> industry!
>>>
>>> Are you a proponent of privatizing the military then?
>>
>> Much of it already is.
>
> And the rest of it?  Generals in the Pentagon to grunts on the
> ground...  should that be privatized as well?

Nope.  For various psychological reasons, militaries are better run  
by governments.  People paid to be mercenaries tend toward very bad  
behavior without heavy oversight.

Not sure why you're asking -- the discussion is about civilians and  
healthcare, not people that fight wars for their country.

--
Nate Duehr
TakeThisOuTnateEraseMEspamspam_OUTnatetech.com



2007\10\21@174147 by Gerhard Fiedler

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Chris Smolinski wrote:

>>>>>> It's still possible to say that the market forces would come up with
>>>>>> some mechanism -- but I doubt that.
>
> Sure they could.

If I read my words correctly, I said they could -- I just doubt they would
(small -- just one letter -- but significant difference :)

> We need to look no further than our own field, engineering, to see a
> perfect example - Underwriters Laboratories (UL) here in the USA.
> There's no reason an organization or non-profit company couldn't be
> created by restaurants to offer inspections, guidance, etc.

You're sure there would be an UL without anything regulated? With no UL
seals required?

Besides, this is just a straw man. What's the difference between a
government regulation and a UL regulation?

Gerhard

2007\10\21@180405 by Chris Smolinski

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>
>>  We need to look no further than our own field, engineering, to see a
>>  perfect example - Underwriters Laboratories (UL) here in the USA.
>>  There's no reason an organization or non-profit company couldn't be
>>  created by restaurants to offer inspections, guidance, etc.
>
>You're sure there would be an UL without anything regulated? With no UL
>seals required?
>
>Besides, this is just a straw man. What's the difference between a
>government regulation and a UL regulation?

UL came about before government regulations with electrical devices,
and isn't mandated by the government. it isn't a regulation, it is
voluntary.

--

---
Chris Smolinski
Black Cat Systems
http://www.blackcatsystems.com

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