Pondering Socialized Health Care

[Clive At Five]

I've been thinking about Universal Health Care, lately. I've come to the conclusion that of all the things that the government could subsidize entirely, it's quite possibly the least justified.

The market effects of UHC are two-fold: first, it destroys competition amongst pharmaceutical companies and secondly, it entirely eliminates insurance companies. (The latter is a by-product, not a direct component of UHC.) So let's start with the pharms:

Socialized medicine suffers the same drawbacks of any other subsidized market. It lacks incentive to produce. Suppose I was a genius biochemist in a free-market and I had an idea of a drug/process that I thought would revolutionize cancer treatment. I'm going to research/patent it as quickly as possible so I can sell it on the market and make a couple bucks. Under a gov't-controlled model, I would still be a genius biochemist and I'd still work in a lab to develop a cancer treatment, but I'd be funded by the taxpayer. Every month, I would get a pay check regardless of whether I developed a cure or not. So long as I can convince my superiors that I am making an honest effort, I keep getting paid. A similar scheme applies to health services.

Without free-market medicine, insurance companies become irrelevant. While this aspect might send cheers to the jilted (I sense a lot of unjust ire for the insurance companies) it is not a positive outcome at all. Until I studied actuarial courses, I, too, ridiculed the insurance companies for what seemed like consumer exploitation. Those courses completely grew my knowledge and respect for insurance companies. The beauty of individual insurance is that each person pays for their own risk factors. That means that I don't have to pay for my downstairs neighbor's insanely high DUI-insurance, or the incompetence-factor of his idiot teen daughter. Plus, with my own insurance, everyone has an incentive to reduce their own risk factors to lower their premiums.

We could increase competition amongst insurance companies in our current system by disassociating them from workplaces. I see no reason I should have to pay for a plan my employer picks out, which more likely than not, doesn't represent my personal health needs. It ends up in a lot of waste that individuals have to pay for. I prefer the sort of competition we see amongst Geico, esurance, and Progressive. The only negative side-effect would be a billion TV ads about health insurance.

The other controversial aspect is the notion of a "right to health care." As opposed to the Right to Food, Right to Work, and Right to Education, the right to health care cannot be self-fulfilled. Subsequently, it can neither be protected nor guaranteed by government as it depends of the capability of other people to administer it (and the government can't force individuals to pursue careers in health). The supposed right to health care is therefore not a right at all.

A privilege, perhaps, but then, we come back to the notion of whether it's right to A) pay for other people's health problems & bad habits, and B) making other people pay for ours.

The most ideal of solutions is to maintain a safety net which protects the impoverished, and in the meantime, de-collectivize workplace insurance to reduce the burden on companies & workers, and drive down prices on insurance policies so the less-fortunate-but-still-productive can have more affordable health care that's customized to their needs.

Cue the flames.

-Clive

[skunk]

Your post betrays an astounding ignorance about the way in which other universal health care services operate.

[Iscariot]

It lacks incentive to produce. Suppose I was a genius biochemist in a free-market and I had an idea of a drug/process that I thought would revolutionize cancer treatment. I'm going to research/patent it as quickly as possible so I can sell it on the market and make a couple bucks.

Not all socialized medical systems subsidized drugs, and those that do subsidize prescription drugs. Market incentive still exists for over-the-counter drugs. The free market can also be as detrimental to the development of drugs — taking the extremely unrealistic viewpoint that you've presented that biochemists are only interested in money — because repackaging an easy cure as an extensive treatment process would earn significantly more money.
Plus, with my own insurance, everyone has an incentive to reduce their own risk factors to lower their premiums.

Under a socialized system, everyone's premiums go down. I pay less for my healthcare period than you pay just in taxes for healthcare, never mind whatever absurd premiums or fees you also have to pay.
Cue the flames.

Cue an absolutely abysmal understanding of socialized medicine. The bottom line here is really simple Clive; your nation's healthcare ranks absurdly poorly for the richest nation in the world. It's not serving the people, and it's costing you more than a universal system would. You pay more in taxes for less in service.

[MyDesktopBroke]

I had an idea of a drug/process that I thought would revolutionize cancer treatment. I'm going to research/patent it as quickly as possible so I can sell it on the market and make a couple bucks.

Isn't this how we turn the world into zombies?

The cynics will kill this idea I'm sure, but maybe if medical treatment wasn't such a lucrative market, there would be less people in it for the money, and more in it to heal people.

[iJohnHenry]

Your post betrays an astounding ignorance about the way in which other universal health care services operate.

As always, I admire your tenacity. ;)

[chrmjenkins]

Clive is right, socialized medicine is just one of the dangers of a society based on socialism.

Just look here at the horrors of Sweden:

http://ccinsider.comedycentral.com/2009/04/23/wyatt-cenac-on-the-horrors-of-socialism-in-sweden/

[mactastic]

Clive, do you have a solution for those the insurance company deem uninsurable? Say you've had cancer before, and you lose your job. When you get a new job, the insurance company deems you to large of a risk, and refuses to cover you. What do you suggest?

[miloblithe]

The other controversial aspect is the notion of a "right to health care." As opposed to the Right to Food, Right to Work, and Right to Education, the right to health care cannot be self-fulfilled. Subsequently, it can neither be protected nor guaranteed by government as it depends of the capability of other people to administer it (and the government can't force individuals to pursue careers in health). The supposed right to health care is therefore not a right at all.

????

I don't understand how health care cannot be self-fulfilled, but education, food, and work can? Aren't there schools staffed by teachers and administrators just as there are hospitals staffed by doctors, nurses, and administrators? What's the difference here, in the way you conceive this as self-fulfillable?

[Ugg]

Clive is right, socialized medicine is just one of the dangers of a society based on socialism.

Just look here at the horrors of Sweden:

........ and Germany and France and Denmark and Spain and Japan and......

It boggles the mind how when it comes to health care, the rest of the world is irrelevant to Clivian minded people...

[sushi]

Your post betrays an astounding ignorance about the way in which other universal health care services operate.
Would you elaborate on this.

[Ntombi]

I was going to respond, but I'll just quote Iscariot instead. He said it right.

Not all socialized medical systems subsidized drugs, and those that do subsidize prescription drugs. Market incentive still exists for over-the-counter drugs. The free market can also be as detrimental to the development of drugs — taking the extremely unrealistic viewpoint that you've presented that biochemists are only interested in money — because repackaging an easy cure as an extensive treatment process would earn significantly more money.


Under a socialized system, everyone's premiums go down. I pay less for my healthcare period than you pay just in taxes for healthcare, never mind whatever absurd premiums or fees you also have to pay.


Cue an absolutely abysmal understanding of socialized medicine. The bottom line here is really simple Clive; your nation's healthcare ranks absurdly poorly for the richest nation in the world. It's not serving the people, and it's costing you more than a universal system would. You pay more in taxes for less in service.

[.Andy]

I've been thinking about Universal Health Care, lately. I've come to the conclusion that of all the things that the government could subsidize entirely
UHC (or socialised healthcare as you've put in the thread title - are they analagous?) does not have to be all or nothing. It can coexist with private health care. In Australia we have a combination of public and private. You have a urgent problem (i.e. emergency, cancer etc) you go straight to surgery or treatment. If you need to go to emergency you get seen depending on the urgency of your presenation (not your bank balance). If you want elective surgery or treatment (non-emergency) you can go on a public waiting list (often long) or get it done sooner under your own private health insurance. If you want to be treated by a specific doctor you can choose to do so under your own private health insurance. It's not a perfect system by all means but better than a system where an insurance company is a third party deciding medical treament. It's certainly not the all or nothing you are presenting in your first sentence.

Besides education I can't think of many other things that rank up there with healthcare as something that a government should concentrate on providing for the citizens that it represents. I'd be interested to hear what else you have on the list that a government should subsidise that rates above healthcare....

[CalBoy]

Socialized medicine suffers the same drawbacks of any other subsidized market. It lacks incentive to produce. Suppose I was a genius biochemist in a free-market and I had an idea of a drug/process that I thought would revolutionize cancer treatment. I'm going to research/patent it as quickly as possible so I can sell it on the market and make a couple bucks. Under a gov't-controlled model, I would still be a genius biochemist and I'd still work in a lab to develop a cancer treatment, but I'd be funded by the taxpayer. Every month, I would get a pay check regardless of whether I developed a cure or not. So long as I can convince my superiors that I am making an honest effort, I keep getting paid. A similar scheme applies to health services.

You do realize that not every nation provides end-user healthcare services right? Most of Western Europe (and other developed nations, along with many developing nations, just to mark how pathetic it is that we're still having this discussion at such a low level of discourse) provides its citizens with a national insurance plan that they can then use to purchase healthcare just like you do today. Most of these nations also allow the individual to not use the government insurance plan and make use of a private insurance plan (you receive a credit towards your selection of a private plan) if they so desire.

Drug companies across the globe are not run by governments. Just recently, the Swiss biotech giant Roche (http://en.wikipedia.org/wiki/Hoffmann-La_Roche) purchased American biotech pioneer Genentech. You'll note that the Swiss have what you conceptualize as "socialist" medicine. I wonder how on earth they managed to have a free-market pharmaceutical company, let alone one that is at the leading edge of the industry. :confused:


Without free-market medicine, insurance companies become irrelevant.

Insurance companies become irrelevant once we realize that pooling risk should not be a profitable enterprise. If you really conceptualize what an insurance company does to earn its profit, you will see that it essentially aggregates risk and then skims a little off the top for itself. This is unacceptable when we are talking about life and death.

An insurance company does not generate new ideas, innovate new medical technologies, etc. Removing its profit incentives would only benefit everyone who needs to pool their risk (which in the case of health insurance, is everyone).


The beauty of individual insurance is that each person pays for their own risk factors. That means that I don't have to pay for my downstairs neighbor's insanely high DUI-insurance, or the incompetence-factor of his idiot teen daughter. Plus, with my own insurance, everyone has an incentive to reduce their own risk factors to lower their premiums.

That's right, after all, all medical problems are the fault of the individual. Predisposition to cancer is clearly the patient's fault right?

Health insurance is not as simple as life insurance or car insurance, where the factors are far more in the individual's control. For those risk factors that are within individual control, you can have "sin" taxes, which serve as a two-pronged solution. On the one hand they reduce use of the dangerous substance, and at the same time they provide additional revenue for our grand risk pool to compensate when someone has a health problem related to that dangerous activity.

We could increase competition amongst insurance companies in our current system by disassociating them from workplaces.

And with that you can also kiss goodbye the benefits of buying in bulk. Employers receive discounts on their insurance plans because they typically purchase large bundles, saving money in administration and making it easier for the insurance company to manage its policy holders. Imagine if that same principle was applied to over 300 million people as opposed to a few thousand. Consider the savings the entire system would generate. Since I'm sure you're very busy, I'll let you in on a little secret: the estimated savings of having a universal insurance plan for the entire nation would save the entire nation $100 billion in administration costs alone. Once you factor in other savings, like reduced usage of the emergency room, and you get a really good picture of how costly our current system is.

The other controversial aspect is the notion of a "right to health care." As opposed to the Right to Food, Right to Work, and Right to Education, the right to health care cannot be self-fulfilled.

You can't really educate yourself either, or else no one would bother paying for school. It's also rather difficult to be employed on your own without at least some assistance from some people. No one is an island, we are all on the same ship and we might as well work together to have a better life.

The supposed right to health care is therefore not a right at all.

In a formal sense, the US has no positive rights (like the right to education). Our Constitution only has negative rights (protections from government intrusions). This doesn't mean we should not treat access to essential services as a right, because as a matter of human dignity, they are a right.

[Clive At Five]

I don't have the time or ability to respond to everyone, but here are a couple responses.

Under a socialized system, everyone's premiums go down. I pay less for my healthcare period than you pay just in taxes for healthcare, never mind whatever absurd premiums or fees you also have to pay.

On a top-level view, yes, initially the sum of all taxes paid will be less than the sum of all premiums paid. There are two problems though...

A) In a perfect world, UHC would cost less in total than premiums, but it's unrealistic to think that a system would remain untainted. Look at what has happened to education, where bureaucrats and unions have abducted the system, made it less efficient and made it cost more. And for what? Our kids haven't performed this poorly in decades. I have a hard time believing that an even more-complicated mess like Health Care wouldn't suffer the same tragedy, if not something even more severe.

B) Let's be honest. Would this really result in every single person paying less in taxes? Really? Even the top 10% who pay 70% of the total Federal income tax? No, of course not. The step tax system would make sure these people were paying "their fair share."

In a system with competition, everyone's prices trend downward over time when new procedures/technologies/medications are invented. The increased quality of care counters the decreasing cost of competing industries. In a socialized system, there's less innovation and an ever-growing bureaucracy which will ensure that the amount of money required to keep it afloat is always increasing.

Clive, do you have a solution for those the insurance company deem uninsurable? Say you've had cancer before, and you lose your job. When you get a new job, the insurance company deems you to large of a risk, and refuses to cover you. What do you suggest?

They are covered by the "safety net" as I said in the original post. Though politicians want you to think you are surrounded by these people, their cases are few, just like other "burdens of the state".

I don't understand how health care cannot be self-fulfilled, but education, food, and work can? Aren't there schools staffed by teachers and administrators just as there are hospitals staffed by doctors, nurses, and administrators? What's the difference here, in the way you conceive this as self-fulfillable?

I can grow my own food, I can teach myself to read, but I can't give myself a life-saving medical treatment. I can't develop medications to cure my biological woes. A government, in my opinion, only has an obligation to see that your natural rights (food and education) are attainable, not to actually ensure that every individual has those things.

UHC (or socialised healthcare as you've put in the thread title - are they analagous?) does not have to be all or nothing. It can coexist with private health care. In Australia we have a combination of public and private. You have a urgent problem (i.e. emergency, cancer etc) you go straight to surgery or treatment. If you need to go to emergency you get seen depending on the urgency of your presenation (not your bank balance). If you want elective surgery or treatment (non-emergency) you can go on a public waiting list (often long) or get it done sooner under your own private health insurance. If you want to be treated by a specific doctor you can choose to do so under your own private health insurance. It's not a perfect system by all means but better than a system where an insurance company is a third party deciding medical treament. It's certainly not the all or nothing you are presenting in your first sentence.

Besides education I can't think of many other things that rank up there with healthcare as something that a government should concentrate on providing for the citizens that it represents. I'd be interested to hear what else you have on the list that a government should subsidise that rates above healthcare....

I'm not saying there isn't a middle ground between all or none (i.e. the safety net), but in terms of each individual paying what he or she truly owes, the only fair way to do it is a non-socialized way.

...unless, of course, you believe that the poor are victims of an evil conspiracy by the rich. If that's the case, I can understand the desire to punish them. I, however, don't believe in that crap.

I think we should focus on making sure everyone has access to wealth, but as far as attaining it goes, they're on their own. We've become obsessed, however, with granting everyone reparations, like they were somehow wronged by every person that earns even a dime more than him or her.

-Clive

[kastenbrust]

The World Health Organization's ranking
of the world's health systems:

1 France - Socialized
2 Italy - Socialized
3 San Marino
4 Andorra
5 Malta - Socialized
6 Singapore - Socialized & a tiny bit Privatised
7 Spain - Socialized
8 Oman
9 Austria - Socialized
10 Japan - Socialized
11 Norway - Socialized & a tiny bit Privatised
12 Portugal
13 Monaco
14 Greece - Socialized
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom - Socialized
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America - Privatised

Enough Said?

[Iscariot]

B) Let's be honest. Would this really result in every single person paying less in taxes? Really? Even the top 10% who pay 70% of the total Federal income tax? No, of course not. The step tax system would make sure these people were paying "their fair share."

Actually, it would. You already pay something like 60% of US healthcare costs out of your taxes. You don't have a private system; what you have is a system wherein the costs are double-dipped into your pocket to extract maximum profit. You already pay more in taxes than I do for healthcare.

[Malfoy]

Actually, it would. You already pay something like 60% of US healthcare costs out of your taxes. You don't have a private system; what you have is a system wherein the costs are double-dipped into your pocket to extract maximum profit. You already pay more in taxes than I do for healthcare.

Ok something about what you italicized and

Under a socialized system, everyone's premiums go down. I pay less for my healthcare period than you pay just in taxes for healthcare, never mind whatever absurd premiums or fees you also have to pay.

isn't adding up or I'm really misunderstanding what you are trying to say.

Im guessing from your location your in Toronto (or from some place that has a very odd name) and I was always under the impression that Canadians paid more in taxes on their income than those in US. I'm referring to middle class(we'll say 50k and up). What is the income tax scale where you live and if you are paying less for healthcare than we are, where does your tax money go?

[.Andy]

I'm not saying there isn't a middle ground between all or none
Well you did. I've put it in bold for you;

I've come to the conclusion that of all the things that the government could subsidize entirely, it's quite possibly the least justified.
That's how you framed your argument with your opening paragraph. It's false.


the only fair way to do it is a non-socialized way.
Fair by what measure? That people needlessly die because they can't afford care? Or by your measure does the perception of economic fairness trump all?

...unless, of course, you believe that the poor are victims of an evil conspiracy by the rich. If that's the case, I can understand the desire to punish them. I, however, don't believe in that crap.
Justifying who receives medical care and who lives and dies based on their bank balance is absolute crap. That is absolutely no way to run an equitable health system.

I think we should focus on making sure everyone has access to wealth
This has nothing to do with an equitable health system. You're mixing up your economic ideology with healthcare. The two are distinct.

but as far as attaining it goes, they're on their own.
Except not really in any modern society. We're all linked. Our quality of life is dependent on the whole of society (healthcare, employment, crime, goods etc). Enhancing the health of the entire community is an investment for everyone.

We've become obsessed, however, with granting everyone reparations, like they were somehow wronged by every person that earns even a dime more than him or her.
This isn't true. You are regurgitating a strawman of a talking point.

[CalBoy]

Ok something about what you italicized and



isn't adding up or I'm really misunderstanding what you are trying to say.

It seems counterintuitive, but forcing everyone to have insurance does indeed lower the cost of insuring each individual.

The reason is quite simply that risk can be pooled far more successfully, and administrative costs can be drastically reduced. In addition, people don't have to use the emergency room like a physical, which saves immense amounts of money.

Im guessing from your location your in Toronto (or from some place that has a very odd name) and I was always under the impression that Canadians paid more in taxes on their income than those in US. I'm referring to middle class(we'll say 50k and up). What is the income tax scale where you live and if you are paying less for healthcare than we are, where does your tax money go?

Americans unequivocally pay more per capita for healthcare than any other group of people, period. We expend over 17% of our GDP towards healthcare, far more than any other industrialized nation.

Ask yourself what we have to show for this very expensive system. We have the highest rates of infant mortality, the highest rates of preventable death, and the most inequitable levels of overall health in the developed world.

In return, we do have some minor advantages over other nations' healthcare. Our terminal cancer patients tend to survive longer and those with other rare and deadly diseases tend to do better in the US when they are nearing death. However, keeping doctors and drug companies in the private sector would continue to generate the innovation that has made this possible. All we really need to do is make everyone insured. Is that really so bad?

And I'm rather disappointed Clive At Five; many of the things you brought up in your most recent post I addressed in my previous one. Surely you can muster the time and dexterity to deal with me? ;)

[.Andy]

Surely you can muster the time and dexterity to deal with me? ;)
Perhaps his insurance doesn't cover his required carpal tunnel operation :p;)?

[CalBoy]

Perhaps his insurance doesn't cover his required carpal tunnel operation?

Well they would have, but the keyboard was a preexisting condition.

[.Andy]

Well they would have, but the keyboard was a preexisting condition.
Should have switched to a DVORAK before making a claim :D!

[Malfoy]

It seems counterintuitive, but forcing everyone to have insurance does indeed lower the cost of insuring each individual.

The reason is quite simply that risk can be pooled far more successfully, and administrative costs can be drastically reduced. In addition, people don't have to use the emergency room like a physical, which saves immense amounts of money.


Americans unequivocally pay more per capita for healthcare than any other group of people, period. We expend over 17% of our GDP towards healthcare, far more than any other industrialized nation.

Ask yourself what we have to show for this very expensive system. We have the highest rates of infant mortality, the highest rates of preventable death, and the most inequitable levels of overall health in the developed world.

In return, we do have some minor advantages over other nations' healthcare. Our terminal cancer patients tend to survive longer and those with other rare and deadly diseases tend to do better in the US when they are nearing death. However, keeping doctors and drug companies in the private sector would continue to generate the innovation that has made this possible. All we really need to do is make everyone insured. Is that really so bad?


I understand the math behind the bolded statement My only issue is with the force aspect. Forcing people to pay for a product to subsidize the cost for someone else(this is essentially what is happening since costs only go down when everyones in) doesn't sit well with me.

[CalBoy]

Should have switched to a DVORAK before making a claim :D!

Ahh, well then it's an "experimental procedure." :D

Say, I'm good at this. Maybe I should become an insurance agent; it can't be any worse than being a lawyer! :D

[Malfoy]

Ahh, well then it's an "experimental procedure." :D

Say, I'm good at this. Maybe I should become an insurance agent; it can't be any worse than being a lawyer! :D

I think it can :(

[Iscariot]

Im guessing from your location your in Toronto (or from some place that has a very odd name) and I was always under the impression that Canadians paid more in taxes on their income than those in US. I'm referring to middle class(we'll say 50k and up). What is the income tax scale where you live and if you are paying less for healthcare than we are, where does your tax money go?

Our taxes are indeed higher, but not because of health-care costs. A huge amount of our taxes goes to interest payments for debt, transfers to persons (unemployment, welfare, job training, family support), and education. Ours is a much more socialized nation in many more ways than just healthcare. We also have lower tax rates for lower earners: once you drop below about 28 000, our tax rate is lower than yours.

To use your example of middleclass at 50k, here you're looking at paying about 1 000 more in income tax.

On the flip side, while our taxes are higher, the average Canadian tends to have a higher personal savings rate than the average American (although right now zero and almost zero doesn't represent much of a difference) because healthcare costs, unemployment costs, and disability costs are more readily absorbed by society on behalf of the individual.
Forcing people to pay for a product to subsidize the cost for someone else(this is essentially what is happening since costs only go down when everyones in) doesn't sit well with me.

Even if it lowers your own cost, and leaves you with more money in your pocket?

[.Andy]

Ahh, well then it's an "experimental procedure." :D
Hahaha :D!

Say, I'm good at this. Maybe I should become an insurance agent; it can't be any worse than being a lawyer! :D
It'd be equivalent professional respect by the community :D;):p!

[anjinha]

I understand the math behind the bolded statement My only issue is with the force aspect. Forcing people to pay for a product to subsidize the cost for someone else(this is essentially what is happening since costs only go down when everyones in) doesn't sit well with me.

Isn't that the case with everything that is payed with tax payers money?

[CalBoy]

I understand the math behind the bolded statement My only issue is with the force aspect. Forcing people to pay for a product to subsidize the cost for someone else(this is essentially what is happening since costs only go down when everyones in) doesn't sit well with me.

This isn't a standard product though. We're not forcing you to buy an iPhone so that others can have a cheaper iPhone. You need health insurance, as does your neighbor, your hairdresser, your mechanic, your gardner, your children, and your parents.

If we all participate and we all pay less as a result, why not?

[Malfoy]

Even if it lowers your own cost, and leaves you with more money in your pocket?

See that's a tricky question :D

While I enjoy more money in my pocket, and I'm not saying our healthcare system is perfect because it's not. The idea that there might be people out there who doesn't want a particular plan or any at all and has to be forced into it, I can't support that.

Insurance and I are in a never ending war. I'm ahead against car insurance but behind in health insurance. :(

[Iscariot]

It'd be equivalent professional respect by the community :D;):p!

What is this, connect four?

:D:o:D
:o:o:D
:D:o:D
:D:o:o

You lose, human.

[anjinha]

This isn't a standard product though. We're not forcing you to buy an iPhone so that others can have a cheaper iPhone. You need health insurance, as does your neighbor, your hairdresser, your mechanic, your gardner, your children, and your parents.

If we all participate and we all pay less as a result, why not?

Yeah, since we're all Apple geeks we all NEED iPhones so we make a deal with apple to buy them in bulk so that it's cheaper for everyone. :D Sounds like a deal to me.

EDIT: I'm sorry if I'm not making any sense, I'm kinda sleep deprived... :o

[Gelfin]

What is this, connect four?

:D:o:D
:o:o:D
:D:o:D
:D:o:o

You lose, human.

Pretty sneaky, sis!

[anjinha]

See that's a tricky question :D

While I enjoy more money in my pocket, and I'm not saying our healthcare system is perfect because it's not. The idea that there might be people out there who doesn't want a particular plan or any at all and has to be forced into it, I can't support that.

Insurance and I are in a never ending war. I'm ahead against car insurance but behind in health insurance. :(

Who doesn't want healthcare?

[Malfoy]

This isn't a standard product though. We're not forcing you to buy an iPhone so that others can have a cheaper iPhone. You need health insurance, as does your neighbor, your hairdresser, your mechanic, your gardner, your children, and your parents.

If we all participate and we all pay less as a result, why not?

Ok I think I need some more math explained to me to make sure we're all on the same page. Let's assume that all the rich people have insurance and all the upper middle class have insurance. So lower class people don't and some middle class don't. You want everyone to have it, but the some middle/lower class doesn't have it because they can't afford it. Where is the money coming from that they can now afford it?

I'm imagining it is that one if not both of these groups are now paying more so the lower class can pay for it (which I have a big problem with).

[.Andy]

What is this, connect four?

:D:o:D
:o:o:D
:D:o:D
:D:o:o

You lose, human.
I should have gone for the diagonals :mad:.

[Malfoy]

I should have gone for the diagonals :mad:.

LOL


Why did I find that post so funny? :o

[Malfoy]

I need you guys to stop posting so I can sleep.

[Iscariot]

While I enjoy more money in my pocket, and I'm not saying our healthcare system is perfect because it's not. The idea that there might be people out there who doesn't want a particular plan or any at all and has to be forced into it, I can't support that.

Well, you're already "forced into" paying for a number of things that you may personally not see a lot of use out of, but that benefits all of society. National defense (be it militarily or diplomatically), national infrastructure and healthcare. Let's not forget; you're already paying for it.
Ok I think I need some more math explained to me to make sure we're all on the same page. Let's assume that all the rich people have insurance and all the upper middle class have insurance. So lower class people don't and some middle class don't. You want everyone to have it, but the some middle/lower class doesn't have it because they can't afford it. Where is the money coming from that they can now afford it?

I'm imagining it is that one if not both of these groups are now paying more so the lower class can pay for it (which I have a big problem with).

Improved efficiency and a lower reliance on emergency services lowers the per capita cost of healthcare so dramatically that correctly implemented the current tax revenue can absorb the costs of healthcare for everyone. That's why less of my tax money goes to healthcare even though I'm paying for everyone to have it.
Pretty sneaky, sis!
The Dougler! The Dougler! The… Dougler?
I should have gone for the diagonals :mad:.

This particular illustration does not supply enough horizontal spaces for a diagonal score.

…human.

[CalBoy]

Ok I think I need some more math explained to me to make sure we're all on the same page. Let's assume that all the rich people have insurance and all the upper middle class have insurance. So lower class people don't and some middle class don't. You want everyone to have it, but the some middle/lower class doesn't have it because they can't afford it. Where is the money coming from that they can now afford it?

I'm imaging it is that one if not both of these groups are now paying more so the lower class can pay for it (which I have a big problem with).

The additional money comes from a variety of sources. The first major source of savings is administrative costs. As I mentioned earlier in the thread, $100 billion would be saved per year if we had one single insurance plan for the entire country with Medicare's overhead expenses.

Let's assume that insuring someone costs $7,500 per year (that's slightly higher than our current per capita spending rate). This means that the savings generated would be able to insure 13.3 million people, or more than one quarter of those who currently don't have insurance.

After that, we can expect major savings from reduced use of the emergency room, as those without insurance commonly use that as a means of having their problems diagnosed when the same can be done for far less with a simple office visit. I don't know the precise figure on this, but rest assured that it is quite enormous.

The remainder we can all pay for as good neighbors and citizens, just as we do with education, fire services, police services, regulations, etc.

[Malfoy]

The additional money comes from a variety of sources. The first major source of savings is administrative costs. As I mentioned earlier in the thread, $100 billion would be saved per year if we had one single insurance plan for the entire country with Medicare's overhead expenses.

Let's assume that insuring someone costs $7,500 per year (that's slightly higher than our current per capita spending rate). This means that the savings generated would be able to insure 13.3 million people, or more than one quarter of those who currently don't have insurance.

After that, we can expect major savings from reduced use of the emergency room, as those without insurance commonly use that as a means of having their problems diagnosed when the same can be done for far less with a simple office visit. I don't know the precise figure on this, but rest assured that it is quite enormous.

The remainder we can all pay for as good neighbors and citizens, just as we do with education, fire services, police services, regulations, etc.



Ok, I have a few more questions, but its 2 am where I am and this convo has the potential to go on for days. So I'm going to sleep now and if there is activity tomorrow in this thread, I'll jump back in. :) Good night everyone

[skunk]

Would you elaborate on this.I think others have elaborated splendidly.

[mactastic]

A) In a perfect world, UHC would cost less in total than premiums, but it's unrealistic to think that a system would remain untainted. Look at what has happened to education, where bureaucrats and unions have abducted the system, made it less efficient and made it cost more. And for what? Our kids haven't performed this poorly in decades. I have a hard time believing that an even more-complicated mess like Health Care wouldn't suffer the same tragedy, if not something even more severe.
In case you haven't noticed, health care costs in your supposedly "more efficient than government" system have risen far faster than either wages or inflation with no corresponsing increase in quality of care. In fact, from all accounts, quality of care has gone down as the cost has increased. Fewer nurses take care of a greater number of patients, for example. To paraphrase you, hospitals haven't performed this poorly in decades.

Why is a system you claim is more efficient that a government-run system having these kinds of problems?

B) Let's be honest. Would this really result in every single person paying less in taxes? Really? Even the top 10% who pay 70% of the total Federal income tax? No, of course not. The step tax system would make sure these people were paying "their fair share."
Of course you'll end up paying more in taxes. But you'll also pay no health insurance premiums. But it sounds like many would rather pay more in health insurance premiums than pay a cent more in taxes.

Let's say your taxes went up by $X, but your out-of-pocket costs for insurance, co-pays, etc. went down by $1.05X. Would you still complain about the increase in taxes, even though you wind up with more money in your pocket?

In a system with competition, everyone's prices trend downward over time when new procedures/technologies/medications are invented. The increased quality of care counters the decreasing cost of competing industries. In a socialized system, there's less innovation and an ever-growing bureaucracy which will ensure that the amount of money required to keep it afloat is always increasing.
Riddle me this then... we have a system with competition right now, yet costs have been increasing -- as I noted above -- at rates well beyond inflation or wage growth. Yet you claim that in a system with competition, everyone's prices trend downward over time.

When was the last time your insurance company told you they would be charging you less this year than last year?

They are covered by the "safety net" as I said in the original post. Though politicians want you to think you are surrounded by these people, their cases are few, just like other "burdens of the state".
So you're in favor of "lemon socialism" then? You would allow the corporate profiteers to reap the benefits of insuring the healthy and force the government to shoulder the burden of insuring the sick?

Do you not see the potential for abuse here, not to mention the burden you inadvertently shift to the taxpayer, if you allow these for-profit companies to decide who they feel like covering and shunting all the others over to the government? That's the worst of both worlds. The only people who benefit from that solution are the shareholders of the insurance companies.

I can grow my own food, I can teach myself to read, but I can't give myself a life-saving medical treatment. I can't develop medications to cure my biological woes. A government, in my opinion, only has an obligation to see that your natural rights (food and education) are attainable, not to actually ensure that every individual has those things.
How is education a natural right? :confused:

I'm not saying there isn't a middle ground between all or none (i.e. the safety net), but in terms of each individual paying what he or she truly owes, the only fair way to do it is a non-socialized way.

...unless, of course, you believe that the poor are victims of an evil conspiracy by the rich. If that's the case, I can understand the desire to punish them. I, however, don't believe in that crap.
Why is it that conservatives only want things to be "fair" when it comes to money?

...unless of course you believe that the poor are worthless leeches on society. If that's the case, I can understand the desire to punish them. I, however, don't believe in that crap.

Even if it lowers your own cost, and leaves you with more money in your pocket?
It appears that many of our conservative friends would rather pay more out-of-pocket just so long as you don't "force" them to pay more in taxes. Doesn't matter what the fees and co-pays are, just so long as you don't call them "taxes". :cool:

[nick9191]

The World Health Organization's ranking
of the world's health systems:

1 France - Socialized
2 Italy - Socialized
3 San Marino
4 Andorra
5 Malta - Socialized
6 Singapore - Socialized & a tiny bit Privatised
7 Spain - Socialized
8 Oman
9 Austria - Socialized
10 Japan - Socialized
11 Norway - Socialized & a tiny bit Privatised
12 Portugal
13 Monaco
14 Greece - Socialized
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom - Socialized
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America - Privatised

Enough Said?
This post pretty much counters any argument anyone could possibly provide on the negatives of universal healthcare.

[Desertrat]

Medical treatment costs, which drive health insurance costs, have risen faster than inflation for several reasons. One is the relatively low payment of Medicare/Medicaid reimbursement, which leads to "overcharging" of those with alternative insurance plans.

Example: My cancer treatment had a total billing including surgery and radiation of some $40,000. I regularly got billings of, say, $1,000 with "adjustment" of maybe $400; Medicare paid maybe $400, and I paid $200. I have to assume that had I had other insurance coverage, there would not have been an adjustment.

Another factor is the amount of paperwork and record keeping which has arisen since the early 1980s, mandated in large part by various laws. That leads to more overhead in the form of larger office space for the additional clerical personel: More rent, more salaries. Doctors' incomes must support more people.

I had one doctor comment to me that when he got to his office on Monday morning, he was $1,000 in the hole: His weekly allocated malpractice insurance.

So you wind up with an assembly-line style, with minor problems dealt with by a PA instead of an MD. Oops, another salary and an office.

Regardless, there are only so many patients who can be dealt with in five days. So, some allocated $$$ of overhead per patient. Add the doctor's "profit" on his deal. So, there is no way that costs can be held down.

Okay, so we have national health insurance. Question: Are private insurors still allowed to do business?

At the moment, just under 40% of US doctors won't take new Medicare patients due to a reduction in payments. Private insurors and personal billfolds only.

I'm in an "I don't know, and I'm suspicious" mode about this. I read articles from English newspapers which claim that a goodly percentage of English healthcare professionals go outside the system for treatment. I have Canadian tourist tell me that the waiting periods are inordinately long for various treatments.

IOW, the US has excellent medical treatment; the argument is how it should be paid for. Further, there are legitimate questions as to what inefficiencies are likely within a very large governmental system.

I first got a lesson at GM in 1962/1963; it was reinforced by eleven years working for the state of Texas, and then further reinforced by four years of working as a consultant with state and federal agencies: Very large systems are damned inefficient and there is a lot of wasted time and money.

'Rat

[iCantwait]

socialism is the biggest failure of all time.

[leekohler]

socialism is the biggest failure of all time.

Yep- those fire and police departments sure do suck. :rolleyes:

[chrmjenkins]

Rat, you touched on one of the things that bothers me for our country- its size. We have 300 million people, and we're also one of the unhealthiest modernized nations. I wonder how well we could follow the model of other socialized systems. I think the right to health care should win out, but I'm apprehensive about how well it will work for us.

[leekohler]

Rat, you touched on one of the things that bothers me for our country- its size. We have 300 million people, and we're also one of the unhealthiest modernized nations. I wonder how well we could follow the model of other socialized systems. I think the right to health care should win out, but I'm apprehensive about how well it will work for us.

Seems to work for everyone else. Or are you saying Americans are too stupid and corrupt to figure it out?

[NT1440]

Seems to work for everyone else. Or are you saying Americans are too stupid and corrupt to figure it out?

Apparently having more people to be able to chip in negatively affects the situation......

:rolleyes:

[leekohler]

Apparently having more people to be able to chip in negatively affects the situation......

:rolleyes:

So why try, right? :rolleyes:

[chrmjenkins]

Seems to work for everyone else. Or are you saying Americans are too stupid and corrupt to figure it out?

I just err on the side of cynicism when it comes to government infrastructure :D

I'd love to be proven wrong here.

[SactoGuy18]

By the way, the French system is NOT the British NHS, which even the French laugh at all the time. And you wonder why British citizens who need surgery often go to France to have that surgery at times (or go to the USA to do if if they can afford it).

I think President Obama will base his health care plan on the French system, not the system used in Canada and the UK.

[skunk]

By the way, the French system is NOT the British NHS, which even the French laugh at all the time. And you wonder why British citizens who need surgery often go to France to have that surgeryDo you have a link for that?

[Desertrat]

It seems to me that the idea of the US as an unhealthy place derives from skewed data. For instance, we have many millions of people who were unhealthy when they came here, and have not the income or education to improve themselves. We have other sub-cuiltures whose very lifestyles lead to health problems.

It's not an issue of availability or cost, for many millions.

Not saying it's any sort of "the" problem, but a couch potato living on Twinkies and pizza is gonna have health problems.

We are regularly told that obesity is a national health problem. We are also told by the demographic analyses that a higher percentage of poverty-level people are obese than are the more well-off. Sorry; I have no answer, but nationalized health care can't help that problem--it's a function of lifestyle.

Overall, it doesn't really matter. The U.S. government is broke and going broker. The debt burden of SS, Medicare and Medicaid are already above what we can afford. Add in the current level of deficit spending and all we can do is make an unholy situation far worse.

'Rat

[skunk]

It seems to me that the idea of the US as an unhealthy place derives from skewed data. For instance, we have many millions of people who were unhealthy when they came here, and have not the income or education to improve themselves. We have other sub-cuiltures whose very lifestyles lead to health problems.And in what way is this different from other countries?

[Ugg]

It seems to me that the idea of the US as an unhealthy place derives from skewed data. For instance, we have many millions of people who were unhealthy when they came here, and have not the income or education to improve themselves. We have other sub-cuiltures whose very lifestyles lead to health problems.

It's not an issue of availability or cost, for many millions.

Not saying it's any sort of "the" problem, but a couch potato living on Twinkies and pizza is gonna have health problems.

We are regularly told that obesity is a national health problem. We are also told by the demographic analyses that a higher percentage of poverty-level people are obese than are the more well-off. Sorry; I have no answer, but nationalized health care can't help that problem--it's a function of lifestyle.

Overall, it doesn't really matter. The U.S. government is broke and going broker. The debt burden of SS, Medicare and Medicaid are already above what we can afford. Add in the current level of deficit spending and all we can do is make an unholy situation far worse.

'Rat

That's actually one of those fallacies that won't die. There are plenty of studies that show that Native born Americans of American parents are shorter and less healthier than their grandparents were.

Sure, there are refugees from war torn countries who have serious health issues, but they make up a tiny minority of the population. I believe also that generally, women from south of the border have fewer problems during pregnancy than do those north of the border. Once they cross over and are assaulted by the American lifestyle, that quickly changes.

The only real thing that's going to change America's waistlines is to adopt a less car centric lifestyle.

[leekohler]

I just err on the side of cynicism when it comes to corporate ethics in regards to health care. :D

I'd love to be proven wrong here.

Fixed that for you. We already know the private sector is incapable of handling health care. Why not try something we haven't tried- especially when it seems ot be working fairly well for other countries? It's not as if we'd be the first.

[miloblithe]

TThere are plenty of studies that show that Native born Americans of American parents are shorter and less healthier than their grandparents were.

Could you point us to one of these studies? That seems to be distinctly unlikely, depending on your metrics.

[Desertrat]

"There are plenty of studies that show that Native born Americans of American parents are shorter and less healthier than their grandparents were."

Again, look at the demographics regarding birth rates. Which groups are growing the fastest? The poorest and least educated. Which groups are regularly commented about as to health problems? The poorest and least educated. And which groups are noted for a decline in general physical living conditions compared to forty or fifty years ago? The poorest and least educated. This ain't rocket science. It's regularly reported upon in the news.

IOW, it has nothing to do with health care. No health care system anywhere can affect the lifestyle behavior within one's home. Aside from anything else, it's against the law.

So, yeah, it's fair to say that there has been a decline in healthiness in the US, overall. But it has nothing to do with our healthcare system.

In other healthcare news, I saw where Jumpin' Joe Biden sez that healthcare for Olde Pharts is gonna have to be rationed. I'm sure that he'll call for a fair cutoff age-date on that. How old is he? Good starting point, seems like to me.

[miloblithe]

Again, look at the demographics regarding birth rates. Which groups are growing the fastest? The poorest and least educated. Which groups are regularly commented about as to health problems? The poorest and least educated. And which groups are noted for a decline in general physical living conditions compared to forty or fifty years ago? The poorest and least educated. This ain't rocket science. It's regularly reported upon in the news.

IOW, it has nothing to do with health care. No health care system anywhere can affect the lifestyle behavior within one's home. Aside from anything else, it's against the law.

So, yeah, it's fair to say that there has been a decline in healthiness in the US, overall. But it has nothing to do with our healthcare system.

I'm trying to find the study, but you're wrong. Upper middle class white Americans still fare worse than do their European counterparts.

Also, I think your comment that there's nothing you can do about promoting healthy lifestyles buys too much into the myth of American-style self responsibility. There is such a thing as public health, it is NOT against the law, and it has made strides in promoting healthy lifestyles and affecting health outcomes. Health communications and prevention are certainly difficult, and often are ineffective. But, fortunately, they also often are effective.

Here's a case study about a behavior change communication effort that helped raise consistent condom use among clients of commercial sex workers from 63% to 81%.

http://www.gwumc.edu/sphhs/departments/pch/phcm/casesjournal/volume2/peer-reviewed/cases_2_07.cfm


Here's another tidbit for you:

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

http://graphs.gapminder.org/world/index.php#$majorMode=chart$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=30;stl=t;st=t;nsl=t;se=t$wst;tts=C$ts ;sp=6;ti=1952$zpv;v=0$inc_x;mmid=XCOORDS;iid=phAwcNAVuyj0TAlJeCEzcGQ;by=ind$inc_y;mmid=YCOORDS;iid=p hAwcNAVuyj2tPLxKvvnNPA;by=ind$inc_s;uniValue=8.21;iid=phAwcNAVuyj0XOoBL_n5tAQ;by=ind$inc_c;uniValue= 255;gid=CATID0;by=grp$map_x;scale=lin;dataMin=0.842;dataMax=8.7$map_y;scale=lin;dataMin=23;dataMax=8 6$map_s;sma=49;smi=2.65$cd;bd=0$inds=

Currently, the U.S. ranks #50 in the world in life expectancy, 78.11 years at birth. In 1950, we were tied with Canada for 10th, with a life expectancy of 68. In the 59 years since 1950, we've managed to add 12 years to the lifespan of the average American. Meanwhile, Canada added 15 years, bringing their life expectancy to 81.23 years. France went from 66 to 80.98, also adding 15 years. Japan went from 63 to 82. What is the U.S. doing wrong?

[Iscariot]

I'm trying to find the study, but you're wrong. Upper middle class white Americans still fare worse than do their European counterparts.

Also, I think your comment that there's nothing you can do about promoting healthy lifestyles buys too much into the myth of American-style self responsibility. There is such a thing as public health, it is NOT against the law, and it has made strides in promoting healthy lifestyles and affecting health outcomes. Health communications and prevention are certainly difficult, and often are ineffective. But, fortunately, they also often are effective.

Here's a case study about a behavior change communication effort that helped raise consistent condom use among clients of commercial sex workers from 63% to 81%.

http://www.gwumc.edu/sphhs/departments/pch/phcm/casesjournal/volume2/peer-reviewed/cases_2_07.cfm


Here's another tidbit for you:

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

http://graphs.gapminder.org/world/index.php#$majorMode=chart$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=30;stl=t;st=t;nsl=t;se=t$wst;tts=C$ts ;sp=6;ti=1952$zpv;v=0$inc_x;mmid=XCOORDS;iid=phAwcNAVuyj0TAlJeCEzcGQ;by=ind$inc_y;mmid=YCOORDS;iid=p hAwcNAVuyj2tPLxKvvnNPA;by=ind$inc_s;uniValue=8.21;iid=phAwcNAVuyj0XOoBL_n5tAQ;by=ind$inc_c;uniValue= 255;gid=CATID0;by=grp$map_x;scale=lin;dataMin=0.842;dataMax=8.7$map_y;scale=lin;dataMin=23;dataMax=8 6$map_s;sma=49;smi=2.65$cd;bd=0$inds=

Currently, the U.S. ranks #50 in the world in life expectancy, 78.11 years at birth. In 1950, we were tied with Canada for 10th, with a life expectancy of 68. In the 59 years since 1950, we've managed to add 12 years to the lifespan of the average American. Meanwhile, Canada added 15 years, bringing their life expectancy to 81.23 years. France went from 66 to 80.98, also adding 15 years. Japan went from 63 to 82. What is the U.S. doing wrong?

Additionally: "More Nutrition Info Leads to Better Food Choices (http://www.iptv.org/mtom/archivedbazaar.cfm?Bid=614)"

[Peterkro]

"There are plenty of studies that show that Native born Americans of American parents are shorter and less healthier than their grandparents were."

Again, look at the demographics regarding birth rates. Which groups are growing the fastest? The poorest and least educated. Which groups are regularly commented about as to health problems? The poorest and least educated. And which groups are noted for a decline in general physical living conditions compared to forty or fifty years ago? The poorest and least educated. This ain't rocket science. It's regularly reported upon in the news.

IOW, it has nothing to do with health care. No health care system anywhere can affect the lifestyle behavior within one's home. Aside from anything else, it's against the law.

So, yeah, it's fair to say that there has been a decline in healthiness in the US, overall. But it has nothing to do with our healthcare system.

In other healthcare news, I saw where Jumpin' Joe Biden sez that healthcare for Olde Pharts is gonna have to be rationed. I'm sure that he'll call for a fair cutoff age-date on that. How old is he? Good starting point, seems like to me.

Nice, blame the victims. Who incidentally does the majority of the work in the US? I'm not sure what your getting at here but it sounds a bit close to Malthusian bollocks for my liking.

[miloblithe]

So, yeah, it's fair to say that there has been a decline in healthiness in the US, overall. But it has nothing to do with our healthcare system.

I think it's worth concentrating on this statement alone. How can a decline in health have nothing to do with the healthcare system?

[SactoGuy18]

I think the biggest problem with health care right now is dealing with at least two generation of people that were heavy smokers of cigarettes in their adult lives. As such, there's a need for a lot of care of older people with heart diseases and lung-related diseases right now.

With the anti-smoking mantra nowadays, I think within 25-30 years smoking-related diseases will be far less of a problem.

[Iscariot]

With the anti-smoking mantra nowadays, I think within 25-30 years smoking-related diseases will be far less of a problem.

But obesity-related problems will be.

[Iscariot]

Interestingly, while watching CNN in the weight room, the anchor stated that the US won't have adequate influenza vaccinations in the event of a pandemic because there's "no profit" in developing a more effective method for cultivating vaccinations. Meanwhile in Europe, the report continued, they were more prepared.

Makes you think.

[NT1440]

Makes me tired of our pathetic stalling in the name of big business. Peoples health should not be an economics game.

[Gelfin]

Interestingly, while watching CNN in the weight room, the anchor stated that the US won't have adequate influenza vaccinations in the event of a pandemic because there's "no profit" in developing a more effective method for cultivating vaccinations. Meanwhile in Europe, the report continued, they were more prepared.

Makes you think.

No it doesn't!

*sticks fingers in ears*

LA LA LA THE MARKET SOLVES EVERYTHING LA LA LA!

[kastenbrust]

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

Looking at that I personally find it disgusting we're even discussing the US case for having a Socialized health care system in this thread, especially while countries where the average life expectancy is 31.8 years such as Swaziland or 38 years for Angola dont even have real Health Care systems, perhaps its just me but i dont value human life differently depending on location.

[mactastic]

I think it's worth concentrating on this statement alone. How can a decline in health have nothing to do with the healthcare system?
Because the Free Market solves all!

Interestingly, while watching CNN in the weight room, the anchor stated that the US won't have adequate influenza vaccinations in the event of a pandemic because there's "no profit" in developing a more effective method for cultivating vaccinations. Meanwhile in Europe, the report continued, they were more prepared.

Makes you think.
Exactly. In the free market, there is more incentive to develop drugs for erectile disfunction than for pandemic preparedness. Which is precisely why there are certain aspects of the market that cannot be left to be entirely free. That means that in the supposedly "more efficient" US system, "unprofitable" vaccines and cures will always be shunted aside in favor of more profitable treatments -- particularly if such treatments can be ongoing rather than a one-time deal. Far more profitable to hook someone on a cholesterol drug for life than to provide incentives to improve the lifestyle that leads to high cholesterol.

[miloblithe]

Exactly. In the free market, there is more incentive to develop drugs for erectile disfunction than for pandemic preparedness. Which is precisely why there are certain aspects of the market that cannot be left to be entirely free. That means that in the supposedly "more efficient" US system, "unprofitable" vaccines and cures will always be shunted aside in favor of more profitable treatments -- particularly if such treatments can be ongoing rather than a one-time deal. Far more profitable to hook someone on a cholesterol drug for life than to provide incentives to improve the lifestyle that leads to high cholesterol.

I was listening to some podcast, I think the Economist or CSIS or something, and someone was suggesting that there be two tracks for drugs: essentially a patent track like the current track, where companies can profit off of selling ED drugs and hair loss medication to rich people, and a sort of global impact fund track, where companies are paid out of a general fund (contributed to by donor nations) based on some calculation from quality-adjusted life years. On that track, high-impact drugs for as many people as possible (which would tend to be poorer people) would the way to make money. And in the patent track, targeting the rich would be the way to make money. Companies could choose whichever track they prefer for any medication they are developing. On the non-patent track, they would lose control over the drug and generics could be made worldwide, but that would only benefit them as that would increase the impact of the drug and thereby their payment.

It seemed like a really interesting idea to me. Obviously the real mechanics and incentive systems are vastly more complicated than the paragraph above.