I love a good debate. It is important to have your ideas challenged. When you engage in an opinionated lifestyle such as mine you will suffer setbacks. When you try and foster new ideas or question the status-quo you will be met by opposition.
When I was younger this could be a hard thing to handle. The idea of losing a debate or not having enough knowledge offhand to rattle ones opponent frightened me. Well, I handle things quite differently today.
I love hearing new ideas and having ideas challenged. This helps me to analyze my ideas and to know if they are valid or if they are weak.
Last September, when the Healthcare debate was raging, I had a lengthy conversation with one of my good friends over this issue. I was arguing for single-payer universal care while my friend was arguing against government.
I wrote an article, actually 3 of them, detailing the healthcare bills and the overhaul.
Here is the 1st one:
The idea of universal health care in the United States has remained the figurative 800 pound gorilla in the room. In the our history there has never been a time that needs universal health care legislation more than we do currently. Our country needs it and we need it now!
Today we are faced with a challenge unique to the United States. We have been led to believe that our private system is the way to go, but now it is failing. We spend more money, in terms of per capita and in total terms, than any other nation of the planet, but yet we have almost 50 million uninsured.
There is a problem with the healthcare system in the United States. There are an estimated 45-50 million uninsured and even more that have substandard insurance. We are facing rising costs of medical procedures, equipment and prescription drugs and it would be great if we could throw more money at the problem, but we already spend the most per capita on healthcare than any other country in the world. “In 2007, health care spending in the United States reached $2.3 trillion, and was projected to reach $3 trillion in 2011. Health care spending is projected to reach $4.2 trillion by 2016”.
The problem seems to be a problem of mismanagement and lack of bureaucratic efficiency. “In 2005, the United States spent 16 percent of its gross domestic product (GDP) on health care. It is projected that the percentage will reach 20 percent by 2016”. The US spends more money on healthcare than any other country but yet it has almost 1/6th of its population without health insurance. Even those without insurance will receive medical care when they need it, but the price of medical care is so outrageous that it often leads to bankruptcy. This will just continue the horrible cycle of poverty that has crippled so many working people in the United States.
The rising costs of maintaining our healthcare system is increasingly burdening employers, hospitals and the people who have the policies. “Premiums for employer-based health insurance rose by 6.1 percent in 2007. Small employers saw their premiums, on average, increase 5.5 percent. Firms with less than 24 workers experienced an increase of 6.8 percent”. The employers are burdened and they pass the expenses on to their employers by finding cheaper policies, canceling insurance or simply making the employees pay for the difference. Since 2000 the costs employees pay for their health insurance rose 143%, rising at an estimated four time faster than the wages of these employees.
Workers who have to support families are asked to contribute even more. An average annual premium for a family of four is $12,200, significantly more than the $10,712 made by a fulltime worker earning a minimum wage salary.
The system of healthcare that is seen in the United States can be described as inefficient, unresponsive and difficult for average people to manage. The current system is a confederation of various Health Maintenance Organizations (HMOs) who control prices and quality of care and manipulate legislation to prevent state run healthcare. HMOs are the service providers of a healthcare plan, they coordinate through regional alliances between clinics, specialists, doctors and hospitals, to get you care. The biggest flaws concerning the practice of HMOs is that they restrict where one can get their care to facilities that are incorporated within the regional network. This makes it so if one wants to see a specialist, or have the freedom to choose between a wide range of doctors they cannot.
There is a lot of news regarding the quality of care received by HMOs, most if it regards them as not fulfilling their quality of care standards. However, studies have shown that patients tend to prefer the care received from an HMO when compared to a fee-for-service or uninsured experience. HMOs operated within the system to provide the best service that they can for the least amount of money. They negotiate, often times with hardball tactics, to lower prices so that they can net a larger profit. A plan for universal healthcare would either eliminate the need for HMOs or it would drastically reduce their influence, profit margins while forcing a number of them out of business.
The US single-payer system known as Medicare is often criticized for not utilizing its strength more properly. I like to think of a single-payer system as being similar to Wal-Mart. Wal-Mart negotiates with its vendors to provide their supplies for a much lower rate then they would to other companies. This is due to the fact that Wal-Mart is the largest company in the United States and is capable of selling massive amounts of merchandise. Wal-Mart has a philosophy that if they are not getting a reasonable price then they are not going to sell that product, which will hurt that company a lot more than it will hurt Wal-Mart.
The US single-payer system increases competition amongst the companiesIf the U.S. or Minnesota (for example) were to operate on a single-payer system they would receive the best rates and high quality products. If pharmaceutical companies refused to negotiate or lower prices then the single-payer system could find other sources, such as Canada, to find the necessary prescriptions and supplies.
Since the days of FDR universal health care has been one of the programs that we need the most, but yet it always seems to fail. In the year 2008 the United States is the only developed nation to not offer universal health care. China, Cuba, Costa Rica, Serbia, Russia and many other countries offer health coverage for all of their citizens. Why is the world’s leading democracy refusing to provide health care for all of its citizens?
In this article I made a passionate argument that details the economic reasons for wanting Universal care, but I also made the moral argument as well.
The friend of mine who was advocating for less Government involvement decided it would be a good idea to post this article on the Ludwig von Mises Community Forum. Ludwig Von Mises was an economist of the Austrian school of thought. He hated socialists, taxes and was very vocal about it.
(Ed note. On the Mises Forum my whole article did not appear and I dealt with numerous attempts at censorship and deleting my arguments as you will see below)
At one point von Mises yelled at Milton Friedman (one of the founders of our current economic system) calling him a socialist for suggesting progressive taxation. At least it is good to know that ‘name-calling’ was still as popular 50 years ago.
Anyways, the community at the von Mises website did not agree with many of my findings and they wrote as follows: Please note their careful use of words, ex: “chronically uninsured” or their attempts at discrediting me because I offer Cuba as an example of a country that has universal healthcare. While the US (Rich and Powerful) does not offer Universal healthcare.
David Z replied on Fri, Sep 11 2009 3:42 PM
46 million uninsureds is a huge lie. Actual figures for chronically uninsured is probably less than 15M (still a lot of people) but this market distortion could be traced back to the bad incentives that prevent individuals from buying health care on the same terms as corporations, as a result, health care is inextricably linked to employment, or more precisely, employment at a mid- to large-sized corporation.
Single-payer advocates neglect the fact that a government still has to ration health care.
Nationalizing healthcare will help cement a corporate oligopoly.
Other oft-cited lies suggest that the US has a comparatively high infant mortality rate, and lower life expectancy.
ladyattis replied on Fri, Sep 11 2009 3:42 PM
Here’s some facts for your friend to chew on.
1. Half of all US dollars spent on healthcare come from Medicare (government health program).
2. Medical schools whether by intention or accident restrict the total number of graduates per year (or semester).
3. The pharmaceutical industry derives most of its profits in the US (and not worldwide).
4. State license boards also restrict the number of doctors allowed to practice medicine (whether as a total population or per year license review/acceptance).
5. The HMO Act of ’76 had restricted the means of litigation when a given HMO failed to comply with its obligations [per contract]. (Note: I’m not sure if the so-called Healthcare Bill of Rights law actually removed this particular restriction or not, so I’m assuming it has.)
6. The FDA restricts many medicines that have been proven safe in other countries, and in other trials, especially those related to cancer [tumor] treatment.
Well, that’s about the six I can think of off the top of my head in terms of factors that add to the costs of healthcare in the US. Number 1 has to be the most important because Medicare is a bitch to deal with as a doctor as certain doctors will not accept Medicare covered patients as such (unless they offer cash or private insurance instead). Numbers 2 and 4 are important as when you restrict the supply of anything you automatically can assume a higher price for it (even if it seems nominally unimportant or unvaluable). Number 3 is important because what people don’t grasp is that because most other nations have socialized medicine, they also have restricted the price ranges on medicines. So, in essence, the US market on medicines is paying for the rest of the world’s ‘cheap’ medicine. Numbers 4 and 6 are important too because it shows further supply restrictions (of two distinct kinds). Number 4 in particular restricts the supply of competent HMOs by virtue of the fact that there’s little [civil] legal fear when a given HMO has failed to fulfill its [contractual] obligations. Thus, the flipside of the market where negative feedback leads to better services [through direct change in the failing firm itself or from a competitor] is nonexistent. Number 6 is very important in terms of restrict the supply of the kinds of medicines one can receive. There are many cancer fighting drugs that are accepted worldwide, even in European nations, which are quite effective and cost effective to produce, yet the FDA has categorically restricted their use or prohibited use entirely.
All in all, if your friend has any background in healthcare, he wouldn’t be so naive as to assume it has to be the evils of so-called big business as the primary culprit of the US healthcare’s high costs. Rather, it’s in itself a perfect text book example of cartelization meets government intervention. And just like with oil, you will pay the piper his due as he owns the bureaucrats and the doctors too.
raykeller replied on Sat, Sep 12 2009 6:04 PM
A word about buying in bulk and being large. First, how is Target or Aldi in business? There are things other than price that matter when making a decision to purchase goods (including healthcare). Second, if size was what mattered insurance companies would have already lobbied for being able to cross state lines. Maybe the stupid laws that restrict selling insurance should be lifted. Then the insurance companies can grow nice and big like Walmart. A little less government intervention rather than more. On another note, remember Walmart didn’t even offer health insurance for a wile. The thing is, people still went to work there knowing there was no health insurance. If people refused to work for companies that did not offer health insurance, they would go out of business. It is apparent that some people do not value health insurance like others do. A value should not be assigned by the government.
Capital Pumper replied on Sat, Sep 12 2009 6:14 PM
Why did he list Cuba?
liberty student replied on Sat, Sep 12 2009 6:30 PM
“and lack of bureaucratic efficiency”
Now that made me laugh.
It pretty much ended here, for now. I replied and, not surprisingly, I had my whole argument and my point of view completely removed from their site. I originally posted a lengthy rebuttal to their points and detailed my sources and what not. This is the reply as follows:
DavidBrooks replied on Fri, Oct 16 2009 5:22 PM (me)
Well, thank you Joe. I appreciate the posting of my article. I am the friend that wrote this.
[note: giant socialist spamspew removed--a simple link to the article will suffice]
First off, it should be noted the first article was written about two months ago and the second one about a month ago or so. So, the first article is referencing the idea of universal healthcare in general while the second is referring to HR 3200.
DavidBrooks replied on Fri, May 14 2010 3:16 PM (notice the date)
Well, I am saddened that you would need to resort to calling my thoughtful argument for universal health care, “giant socialist spamspew.” It is clear that you do not understand what I am saying, I am guess you most likely did not read it. But, I have patiently waited for a reply for quite some time and yet still nothing.
I am guessing that none of you felt comfortable enough with debating me, is that correct?
Let me know. BTW, here is the link to my site, www.politablog.com
We can meet in person too if you wish, I live in Minneapolis, MN. Let me know!
OR,
You can also resort to calling me socialist or whatever you feel that you need to, I honestly don’t really mind. But, that is far from the truth.
limitgov replied on Fri, May 14 2010 3:28 PM
First, your friend seems to think the high prices and problems we face in our healthcare system were caused by the free market. In truth, they were caused by government intervention.
Complete government takeover will only amplify the existing problems…
Hard Rain replied on Fri, May 14 2010 3:29 PM
It’s been almost a year, dude. Refute the retorts put forth or get over it?
DD5 replied on Fri, May 14 2010 3:34 PM
You complain about “rising costs”, which is the result of nothing more then the process of bringing the reality of scarcity in line with demand, and you go on to propose to relieve this scarcity by abolishing or severely hampering the market even further. Now how is you being a socialist far from the truth?
ViennaSausage replied on Fri, May 14 2010 3:45 PM
We need to go back to the days where the choice of healthcare and payment where up to the doctor and the patient. Get the middleman of politicans and insurers (protected by government), out of the way. Let people make their own decisions.
DavidBrooks replied on Fri, May 14 2010 4:29 PM
Thank you for the response! Those are all very legitimate and well thought-out arguments. I do appreciate it.
Clayton replied on Fri, May 14 2010 4:54 PM
@OP: Why does the government want to provide healthcare? Unless you believe in angels, then those in government act in their own, rational, self-interest as much as the next guy. What do those who are agitating for universal healthcare stand to benefit; cui bono?
The government already universalizes a lot of goods (the basket varies depending where you live): roads, postal service, telephones, electrical power, education, and if you live in Britain or some other countries, health care. In every case, the prices of such services (as measured in real outlays) skyrockets and the quality is diminished.
The government gives business owners myriad tax-breaks. Why? For the simple reason that employers help the government collect taxes (through payroll tax withholding). It may appear that business tax breaks represent some sort of beneficence on the part of government toward businessmen but that’s silly. Every action the government takes is calculated to maximize its revenue.
So how does providing health care help the government maximize its revenue? Government schools play an integral role in conditioning youngsters to pay their taxes when they graduate. More or less, that’s why government provides universal education. But why universal health care? The only reasonable explanation is that universal health care will somehow help the government reduce its outlays. But how? Well, there is a glut of baby-boomers coming down the pipe who are going to be eligible for $60 trillion dollars in unfunded liabilities – Social Security, Medicare and Medicaid. By universalizing health care, the State can take control of the health care apparatus and decide what services to deny – and to whom – in order to bring this number down to a manageable size.
Universal health care has nothing to do with any soft-heartedness on the part of Democrats or any other members of our government. It has everything to do with bringing the promised medical care outlays of the State under control before things get out of control. Ultimately, this means choosing who will live and who will die, who will receive treatment and who will not… but in the absence of a competitive health market, these decisions will be made in an increasingly lethargic and unproductive medical sector. Once doctor’s incomes are capped, up-and-coming talent will flee medicine to other fields, driving down the available quality of service no matter how loud the democratic mob screams at the ballot box. No amount of “throw the bums out” will attract new, talented individuals to medicine.
I cannot understand why people want the organization that gave us the IRS, ATF, TSA, DMV, CIA, etc. to run our health care system. You really want your hospital visit to be more like a visit to the DMV?!?
Clayton -
LeeO replied on Fri, May 14 2010 5:10 PM
Here is something I posted earlier on a different thread, but it fits into this discussion:
Like most other industries, the food and medical industries in America have been severely distorted by government intervention, and more importantly by the partnership between government and big business. For example, large phameceutical companies spend millions of dollars lobbying the government at the expense of natural and alternative medicine. Think about it: the FDA will never approve a food, herb, or other natural substance for the treatment of disease, because it’s much more difficult to make a profit on something from nature. Instead, drug companies take a natural substance with health benefits, figure out how to make a synthetic replica, patent the replica, and then market the result as a “miracle pill” that will prevent heart disease, lower cholesterol, fight obesity, etc. Not only is the drug less effective than the original natural medicine, but it can cause more harm than good in the form of side effects (just listen to the end of any Viagra commerical).
In the arena of food and nutrition, the partnership between government and big agriculture has equally harmful effects. For example, corn subsidies ensure that corn finds it’s way into every food imaginable in the standard American diet – think of all the places you see “high fructose corn syrup.” Not only does corn syrup promote weight gain more than say, sugar cane, it is also a highly allergic food. Many people develop chronic allergies to common foods like corn, wheat, dairy, soy, and eggs without even realizing it, because they eat these foods every day and are in a sense “addicted” to them as one might be addicted to nicotine. This chronic allergy promotes obesity, arthritis, chronic headaches, depression, and a myriad of other “unexplained” systems. So what happens? Doctors say “it’s all in your head,” and send the difficult patient to a psychiatrist, where he will be convinced to take more drugs.
I believe the answer to America’s health problems is simply to take the Austrian approach: respect freedom-of-choice, let the market work, and GET THE GOVERNMENT OUT OF HEALTH CARE. If natural medicine was actually allowed to compete with “mainstream” medicine, our medical system would be turned upside down and the “quacks” would be those who think that synthetic drugs promote health and that diet and nutrition do not matter.
Bad science, backed by the government and big pharma, is rampant in the field of medicine. For some good science, check out the work of Linus Pauling, the father of orthomolecular medicine. In the 1960s, he discovered that high doses of certain vitamins could correct brain imbalances and cure schizophrenia. Today, orthomolecular doctors treat everything from cancer to infectious disease by using natural substances (food, vitamins, minerals, amino acids, fatty acids) to correct individual body chemistry imbalances.
Sorry for the rant, but I am very passionate about health freedom!
Orthomolecular medicine: http://www.orthomed.org/
Environmental medicine: http://www.aaemonline.org/
Natural medicine: http://www.naturalnews.com/ and http://www.mercola.com/
This Mises daily article is also a great overview of the history of medicine in America: http://mises.org/daily/4276
enndub replied on Wed, May 19 2010 4:18 PM
The huge percentage of our GDP that we spend on healthcare is more a result of the third-party payer system we have, not so much a result of administrative costs as your friend suggests. Replacing the current system with a single-payer third-party payer system won’t reduce the cost of healthcare, though it might reduce the percentage of our GDP spent on healthcare if they just straight up restrict consumers from buying tests/procedures that they otherwise would.
Chris Pacia replied on Wed, May 19 2010 7:20 PM
Hoppe had a pretty good mises daily on this…..http://mises.org/daily/3643
NewLiberty replied on Wed, May 19 2010 10:02 PM
My favorite links on the subject of health care are as follows:
http://mises.org/daily/3613 (comprehensive)
http://libertariannation.org/a/f12l3.html (Originally, government solved the health care crisis. The time was about 90 years ago, and the problem was health care costs were TOO LOW. Boy, did government solve this problem.)
http://www.youtube.com/watch?v=Nt0tKl0J-S4 (Stefan Molyneaux two part power point series, the FDA stats starting at 14:20 are important)
http://www.npr.org/templates/story/story.php?storyId=124544505 (Modern day mutual aid societies)
Here’s a quick list of government interventions into the free marketplace.
- Medicare, Medicaid, SCHIP, COBRA and all entitlements. (Also, price controls are in these programs, ruins pricing mechanism)
- Intellectual Property (patents on drugs and devices; also leads to patenting of genes, GMO foods, etc.)
- Licensing of doctors and devices (government transfers licensing power to AMA)
- FDA drug testing (1962 law started the problems; see Mary Ruwart’s stats on the FDA in the youtube video by Stefan Molyneaux)
- Rules preventing hospitals from being built (existing hospitals lobby to keep new hospitals out; laws are called “Con laws” http://stossel.blogs.foxbusiness.com/2010/02/09/the-con-of-american-hospitals/). Most hospitals operated by government. (http://mises.org/daily/3586) Also, heavy regulation on the few private hospitals.
- Regulations on insurance. No interstate or out-of-country competition! Insurers are required to cover various conditions no matter what. Etc. Doctors cannot come up with innovative insurance programs (lodge practice type things http://abclocal.go.com/wabc/story?section=news/local&id=6690656). Regulations that cause insurers to have to take sick people embed a social welfare program into a nominally private industry.
- Government prohibition of organ markets. Thousands killed every year.
- Emergency rooms have to take patients no matter what.
- Tax system causes insurance to be embedded into employment system, rather than an individual purchase. (legacy of WW2 era wage controls)
NewLiberty replied on Wed, May 19 2010 10:14 PM
Dilorenzo addresses the “monopolies are good cuz they have economies of scale” fallacy that is in the health care analysis:
http://www.youtube.com/watch?v=z2HXyfe_tCE#t=3m25s
Wibee replied on Wed, Jun 2 2010 5:05 PM
I just breezed through the post, but I got caught up with the first sentence. Insurance is not the problem, affordable healthcare is. I would rather have no insurance, and find a do-able way to take out loans.
I knew someone who had a bill of $10,000 in dental bills. They offered a no interest loan for a whole year. inexpensive loans is something i would prefer.
Benjamin replied on Wed, Jun 2 2010 6:39 PM
Funny how all of the best health care systems in the world aren’t market or profit driven.
Feel free to dispute this with evidence; theories about hypothetical markets in utopias are so boring.
nirgrahamUK replied on Wed, Jun 2 2010 7:01 PM
>>Funny how all of the best health care systems in the world aren’t market or profit driven.
>>Feel free to dispute this with evidence; theories about hypothetical markets in utopias are so boring.
why offer well evidenced critiques against a position that was based on no evidence……?
Sieben replied on Wed, Jun 2 2010 7:06 PM
Actually india’s healthcare is doing pretty good with being market driven.
raykeller replied on Thu, Jun 3 2010 9:00 AM
What evidence do you base your “best healthcare systems” in the world on? If I was a doctor I would certainly be motivated by profit. I also gladly give doctors profit to encourage him to treat me well.
A small side note… My general practicioner charges me $85 for a full physical and blood work. I think that is very reasonable. That gets me about an hour and fifteen minutes to an hour and a half with him. Very thorough indeed. The catch: he doesn’t take insurance. Cash or check at the door. No medical billers, no fighting insurance for every penny. Great care, great price. O yea, and no wait. He is located in Toms River, NJ. +%50 on the Medicare RBRVU scale.
Rob Heusdens replied on Thu, Aug 12 2010 1:00 PM
<<< Why did he list Cuba? >>>
Coz Cuba has universal healthcare at no cost.
Mises Pieces replied on Thu, Aug 12 2010 1:01 PM
Coz Cuba has universal healthcare at no cost.
…except your freedom
Giant_Joe replied on Thu, Aug 12 2010 2:22 PM
Singapore has a pretty good system: http://en.wikipedia.org/wiki/Healthcare_in_Singapore
It’s one of the “most free market” out there.
pentahedron replied on Thu, Aug 12 2010 2:26 PM
I was reading about that the other day. We should have adopted a system more like theirs instead of going in the corporate-right direction we did with ours earlier this year.
Caley McKibbin replied on Thu, Aug 12 2010 6:00 PM
I think we should send Rob to one of these Cuban hospitals, don’t you agree?
Enjoy a high protein diet during your stay:
Grayson Lilburne replied on Thu, Aug 12 2010 9:52 PM
Coz Cuba has universal healthcare at no cost.
Someone always pays: just not necessarily voluntarily.
Curtis Zwick replied on Thu, Aug 12 2010 10:19 PM
“<<< Why did he list Cuba? >>>
Coz Cuba has universal healthcare at no cost.”
Wow so much wrong with this short, simple statement. On the other hand it is very useful for pointing out the socialist delusion that one can get something for nothing (no cost). Too bad we don’t live in a world with no scarcity. That would be sweet. Until such a time, it’s an epic fail my man.
WOW
That is a lot to read. Pretty much, their argument is that Universal Healthcare would lead to higher taxes, more government involvement and a decrease in quality of care. Under my plan for Universal, single-payer care, this would not happen.
I obviously addressed all of these issues in my articles and in my rebuttal. Unfortunately, that was replaced by the moderators at the Ludwig von Mises community with “[note: giant socialist spamspew removed--a simple link to the article will suffice]”
Ed Note: no link appeared to my argument in the von Mises “note.”
So, what have we learned from this?
People will argue about things that they do not understand and from different perspectives that do not relate. My argument, Universal Health Care (single payer) for the United States not only makes sense economically, but it is obviously the moral choice as well. I wrote hundreds of pages about this and spent countless hours doing research from credible and unbiased sources.
The difference between me and the people who run the Ludwig von Mises site?
I would never delete (censor) a person’s comments just because I disagree with them. I encourage people to share their views even if I do not agree with them. That is what forms a Democracy, the sharing of ideas. (I am honestly not sure if they are pro-democracy or not)
One other major difference?
I believe that Humans are NOT utile objects or measurements of productivity. They are much more than that.
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