[quote]PRCalDude wrote:
I can’t calculate your patient’s utility curve for him. [/quote]
No shit.
You could not even “calculate” your own, outside of a Neumann-Morgenstern scenario.
I thought this was pretty funny.
[quote]orion wrote:
PRCalDude wrote:
I can’t calculate your patient’s utility curve for him.
No shit.
You could not even “calculate” your own, outside of a Neumann-Morgenstern scenario.
[/quote]
(That Johnny v. sure got around, eh?)
So-called “conparative effectiveness research” (a bureaucratic term if ever there was one) has been around forever, and uses a variety of such formulae; there is a preference for Markov partitions among decision analysts.
I suppose it has some use–very often competing utilities are expressed as “adjusted quality of life years” or some such obscenity–but there is seldom a dollar value put on that year of life.
For PRC, I cannot calculate the utility function for him either. (Today my bone marrow biopsy on him was painless–of course–and,foregoing the VA and other cheaper medical care, he has decided that I will be his doctor.)
But let’s say, on a wild guess, even if I could get inferior or older treatment for him, it would save him only $40,000–and then I have not included the costs of the marginal extra toxicities, mistakes, infertility. Most of us here would spend 40 kilobucks for a 12% better chance of symptom-free survival; who in their right mind would say no?
Now then, what if he doesn’t have the additional $40,000? What kind of “free market” is that? Does consigning him to inferior treatment have adverse risk for him alone, or for society at large?
This abstract speculation might be far from HeavyThrower’s intent, but it ain’t so abstract for me. We, as a society, are about to impose further rationing on all of us, in the cause of serving more of us.
However you might wish it, the egg will not be unscrambled: there will be no ideal free market in medical care. (Maybe, if we are lucky, there will be a competitive market in insurance services.) Some kind of jerry-rigged “plan” will pass, and I guarantee that it will not be rational, socially efficient, or transparent.
So, find your congressmen and e-mail them.
[quote]John S. wrote:
I thought this was pretty funny.[/quote]
And try this one:
[quote]DrSkeptix wrote:
Some kind of jerry-rigged “plan” will pass, and I guarantee that it will not be rational, socially efficient, or transparent.
So, find your congressmen and e-mail them. [/quote]
This is a good point. As there seems to be no consensus, whatever plan passes will be “middle of the road” and piss of people on both sides. I wonder, will it be better than what we have now though? That’s the question, right?
So what should we be e-mailing our congressmen? Should we tell them to vote against anything and everything? Should we tell them to hire DrSkeptix (or his like) to advise how to make the legislation better? IS there a few points that you’d recommend we bring up?
[quote]DrSkeptix wrote:
orion wrote:
PRCalDude wrote:
I can’t calculate your patient’s utility curve for him.
No shit.
You could not even “calculate” your own, outside of a Neumann-Morgenstern scenario.
(That Johnny v. sure got around, eh?)
So-called “conparative effectiveness research” (a bureaucratic term if ever there was one) has been around forever, and uses a variety of such formulae; there is a preference for Markov partitions among decision analysts.
I suppose it has some use–very often competing utilities are expressed as “adjusted quality of life years” or some such obscenity–but there is seldom a dollar value put on that year of life.
For PRC, I cannot calculate the utility function for him either. (Today my bone marrow biopsy on him was painless–of course–and,foregoing the VA and other cheaper medical care, he has decided that I will be his doctor.)
But let’s say, on a wild guess, even if I could get inferior or older treatment for him, it would save him only $40,000–and then I have not included the costs of the marginal extra toxicities, mistakes, infertility. Most of us here would spend 40 kilobucks for a 12% better chance of symptom-free survival; who in their right mind would say no?
Now then, what if he doesn’t have the additional $40,000? What kind of “free market” is that? Does consigning him to inferior treatment have adverse risk for him alone, or for society at large?
This abstract speculation might be far from HeavyThrower’s intent, but it ain’t so abstract for me. We, as a society, are about to impose further rationing on all of us, in the cause of serving more of us.
However you might wish it, the egg will not be unscrambled: there will be no ideal free market in medical care. (Maybe, if we are lucky, there will be a competitive market in insurance services.) Some kind of jerry-rigged “plan” will pass, and I guarantee that it will not be rational, socially efficient, or transparent.
So, find your congressmen and e-mail them. [/quote]
Yeah, what if he does not have them?
What if he does not have the money to drive a Porsche?
It is not that we do not all drive Porsches because mean capitalists wont let us, we don’t because we do not have the resources to do so, and bundling resources and let them be allocated by the government means usually less resources, not more.
So maybe can you save Peter, but you kill Paul by rationing.
It is either the market that at least tends to reward people who work and save or government bureaucrats.
[quote]DrSkeptix wrote:
<<<< This abstract speculation might be far from HeavyThrower’s intent, but it ain’t so abstract for me. We, as a society, are about to impose further rationing on all of us, in the cause of serving more of us.
However you might wish it, the egg will not be unscrambled: there will be no ideal free market in medical care. (Maybe, if we are lucky, there will be a competitive market in insurance services.) Some kind of jerry-rigged “plan” will pass, and I guarantee that it will not be rational, socially efficient, or transparent.
So, find your congressmen and e-mail them. [/quote]
Maybe I’m dense or slow or both. Could you please tell us what you think is the best course of action today? I’m asking in all sincerity.
[quote]DrSkeptix wrote:
orion wrote:
PRCalDude wrote:
I can’t calculate your patient’s utility curve for him.
No shit.
You could not even “calculate” your own, outside of a Neumann-Morgenstern scenario.
(That Johnny v. sure got around, eh?)
So-called “conparative effectiveness research” (a bureaucratic term if ever there was one) has been around forever, and uses a variety of such formulae; there is a preference for Markov partitions among decision analysts.
I suppose it has some use–very often competing utilities are expressed as “adjusted quality of life years” or some such obscenity–but there is seldom a dollar value put on that year of life.
[/quote]
But this is referring to managed care. I believe Utilitarianism is a failed concept altogether, actually. “Utility” means different things to different people. I was just suggesting that the patient have the right to choose based on available information, the money he makes, the money he is likely to make, how much he and his family want him to live, etc.
I actually agree with you here.
My argument (and actually, Ron Paul made this point in his talk on the Google campus) is that what is best for society at large is free markets. Could a bank loan this guy the rest of the money at interest? Of course they could. They could calculate the probability of this guy surviving the treatment and decide that he’s creditworthy and that they could make money off him because (likely) in the future, he’ll have the means to pay back the principle + interest. Moreover, everyone has friends and family members, church members they know, etc. Couldn’t they give him the money?
I think you’re only allowing for 2 scenarios for this guy under a free market scenario: 1) He has the money and pays or 2) he dies. I see alternatives that can make others some money as well.
At this point in time, we can do almost the exact opposite of what we’ve been doing and things will likely turn out better. When my parents were growing up, there was no medical insurance and there was no Medicare, etc. Everyone paid for things out of pocket. If they needed extra money for care, they did what I suggested earlier. Nowadays, we scream to The State for more help. How’s that working for us?
I don’t agree. I keep presenting alternatives and you keep rejecting them without considering them. Doctors apparently think they can run a business in a different way than everyone else, from what I’ve seen. I don’t see how the basic economic laws change just because we’re dealing with the treatment of people.
[quote]Tiribulus wrote:
DrSkeptix wrote:
<<<< This abstract speculation might be far from HeavyThrower’s intent, but it ain’t so abstract for me. We, as a society, are about to impose further rationing on all of us, in the cause of serving more of us.
However you might wish it, the egg will not be unscrambled: there will be no ideal free market in medical care. (Maybe, if we are lucky, there will be a competitive market in insurance services.) Some kind of jerry-rigged “plan” will pass, and I guarantee that it will not be rational, socially efficient, or transparent.
So, find your congressmen and e-mail them.
Maybe I’m dense or slow or both. Could you please tell us what you think is the best course of action today? I’m asking in all sincerity.
[/quote]
You are neither dense nor slow!
I have ideas, but if I post them, they will become the topic of conversation–as you already see–and they will be shot down, on theory, or belief, or some conservative or liberal bona fides. It serves us all better, don’t you think, to offer one’s own insights?
[quote]orion wrote:
DrSkeptix wrote:
orion wrote:
PRCalDude wrote:
I can’t calculate your patient’s utility curve for him.
No shit.
You could not even “calculate” your own, outside of a Neumann-Morgenstern scenario.
(That Johnny v. sure got around, eh?)
So-called “conparative effectiveness research” (a bureaucratic term if ever there was one) has been around forever, and uses a variety of such formulae; there is a preference for Markov partitions among decision analysts.
I suppose it has some use–very often competing utilities are expressed as “adjusted quality of life years” or some such obscenity–but there is seldom a dollar value put on that year of life.
For PRC, I cannot calculate the utility function for him either. (Today my bone marrow biopsy on him was painless–of course–and,foregoing the VA and other cheaper medical care, he has decided that I will be his doctor.)
But let’s say, on a wild guess, even if I could get inferior or older treatment for him, it would save him only $40,000–and then I have not included the costs of the marginal extra toxicities, mistakes, infertility. Most of us here would spend 40 kilobucks for a 12% better chance of symptom-free survival; who in their right mind would say no?
Now then, what if he doesn’t have the additional $40,000? What kind of “free market” is that? Does consigning him to inferior treatment have adverse risk for him alone, or for society at large?
This abstract speculation might be far from HeavyThrower’s intent, but it ain’t so abstract for me. We, as a society, are about to impose further rationing on all of us, in the cause of serving more of us.
However you might wish it, the egg will not be unscrambled: there will be no ideal free market in medical care. (Maybe, if we are lucky, there will be a competitive market in insurance services.) Some kind of jerry-rigged “plan” will pass, and I guarantee that it will not be rational, socially efficient, or transparent.
So, find your congressmen and e-mail them.
Yeah, what if he does not have them?
What if he does not have the money to drive a Porsche?
It is not that we do not all drive Porsches because mean capitalists wont let us, we don’t because we do not have the resources to do so, and bundling resources and let them be allocated by the government means usually less resources, not more.
So maybe can you save Peter, but you kill Paul by rationing.
It is either the market that at least tends to reward people who work and save or government bureaucrats.
[/quote]
People don’t die if they can’t have a Porsche.
I entirely agree that saving is a virtue. My premise is that it is not adequate in our current, practical situation, of personal medical care.
Risk managaement–insurance, both private and perhaps public–may also be a virtue, and not at odds with your ideology at all…
[quote]PRCalDude wrote:
DrSkeptix wrote:
orion wrote:
PRCalDude wrote:
I can’t calculate your patient’s utility curve for him.
No shit.
You could not even “calculate” your own, outside of a Neumann-Morgenstern scenario.
(That Johnny v. sure got around, eh?)
So-called “conparative effectiveness research” (a bureaucratic term if ever there was one) has been around forever, and uses a variety of such formulae; there is a preference for Markov partitions among decision analysts.
I suppose it has some use–very often competing utilities are expressed as “adjusted quality of life years” or some such obscenity–but there is seldom a dollar value put on that year of life.
But this is referring to managed care. I believe Utilitarianism is a failed concept altogether, actually. “Utility” means different things to different people. I was just suggesting that the patient have the right to choose based on available information, the money he makes, the money he is likely to make, how much he and his family want him to live, etc.
For PRC, I cannot calculate the utility function for him either. (Today my bone marrow biopsy on him was painless–of course–and,foregoing the VA and other cheaper medical care, he has decided that I will be his doctor.)
But let’s say, on a wild guess, even if I could get inferior or older treatment for him, it would save him only $40,000–and then I have not included the costs of the marginal extra toxicities, mistakes, infertility. Most of us here would spend 40 kilobucks for a 12% better chance of symptom-free survival; who in their right mind would say no?
I actually agree with you here.
Now then, what if he doesn’t have the additional $40,000? What kind of “free market” is that? Does consigning him to inferior treatment have adverse risk for him alone, or for society at large?
My argument (and actually, Ron Paul made this point in his talk on the Google campus) is that what is best for society at large is free markets. Could a bank loan this guy the rest of the money at interest? Of course they could. They could calculate the probability of this guy surviving the treatment and decide that he’s creditworthy and that they could make money off him because (likely) in the future, he’ll have the means to pay back the principle + interest. Moreover, everyone has friends and family members, church members they know, etc. Couldn’t they give him the money?
I think you’re only allowing for 2 scenarios for this guy under a free market scenario: 1) He has the money and pays or 2) he dies. I see alternatives that can make others some money as well.
This abstract speculation might be far from HeavyThrower’s intent, but it ain’t so abstract for me. We, as a society, are about to impose further rationing on all of us, in the cause of serving more of us.
At this point in time, we can do almost the exact opposite of what we’ve been doing and things will likely turn out better. When my parents were growing up, there was no medical insurance and there was no Medicare, etc. Everyone paid for things out of pocket. If they needed extra money for care, they did what I suggested earlier. Nowadays, we scream to The State for more help. How’s that working for us?
However you might wish it, the egg will not be unscrambled: there will be no ideal free market in medical care.
I don’t agree. I keep presenting alternatives and you keep rejecting them without considering them. Doctors apparently think they can run a business in a different way than everyone else, from what I’ve seen. I don’t see how the basic economic laws change just because we’re dealing with the treatment of people.
[/quote]
Comparative effectiveness research has nothing, per se, to do with managed care. It is a tool that can be misused, but it’s application is in choosing technology without reference to payor class.
Ron Paul? Uh…what medical insurance does he have, again?
When your parents had no insurance, and there was no MediCare, “society” deemed those things necessary, or desirable, or affordable, or rational choices. Your parents may even have wanted it, and may soon use it. Insurance and Medicare were “needed”…they just didn’t fall out of the sky onto Wilbur Cohen’s desk. What happened afterwards–oh, yes, that’s where the argument continues.
As for rejecting your ideas out of hand…ok: please pencil out the consequences of cancelling all Medicare, Medicaid, and private insurance–and malpractice liability if you like–and tell me how that works for people, and why I should keep my office open.
[quote]DrSkeptix wrote:
People don’t die if they can’t have a Porsche.
I entirely agree that saving is a virtue. My premise is that it is not adequate in our current, practical situation, of personal medical care.
Risk managaement–insurance, both private and perhaps public–may also be a virtue, and not at odds with your ideology at all…
[/quote]
No they do not die if they have no Porsche but that is not the point. There are not enough out there and some product will always be of supreme quality. Economic laws do not change just because peoples life depend on the outcome, it is the dismal science after all.
Saving is a wide area. To stop smoking at get a decent insurance counts as saving to me. To skip a few holidays so that your family is insured counts as saving to me.
And I really think that people will start to have to learn that in medicine too, there are different courses of action and that they cost different amounts of money.
[quote]DrSkeptix wrote:
Ron Paul? Uh…what medical insurance does he have, again?
[/quote]
I dunno. Point?
It’s not that they wanted it or do want it, it’s that that is how the game is rigged. I’m sure they’d prefer to keep their $2-3k a month in taxes rather than hand it over to our Betters in DC to redistribute. The fact is, the federal government already pays 2/3 of all medical costs in this country, so it’s not just a private insurance matter.
The other problem you’ve unwittingly illustrated here is that Americans, until the past 12 months, have exactly zero in the savings account. The savings rate has recently crept up to 6% (yay!), but the Chinese save 50% of what they make, so we shouldn’t start congratulating ourselves. Actually, until very recently, most Americans have had a negative savings rate. Having no money in the bank and a stack of debt owed to various creditors makes it very tough to pay medical bills when the time comes.
[quote]
As for rejecting your ideas out of hand…ok: please pencil out the consequences of cancelling all Medicare, Medicaid, and private insurance–and malpractice liability if you like–and tell me how that works for people, and why I should keep my office open.[/quote]
I really don’t need to. We have $15 trillion in national debt, the Chinese are pushing for a world reserve currency so we can no longer just inflate our way out of things or try to, and the first Boomers just started collected Medicare and SS last year. The system is on its way out, like it or not. Oh, and we’ve spent our GDP through 2019 because of the bailouts.
The malpractice issue is regrettable, but it goes to show you how much better attorneys are at making money than doctors (or engineers for that matter). You could probably all get together and threaten to stop treating politicians unless there’s some sort of malpractice damage cap, though. That’d probably get their attention. LOL.
[quote]PRCalDude wrote:
DrSkeptix wrote:
Ron Paul? Uh…what medical insurance does he have, again?
I dunno. Point?
When your parents had no insurance, and there was no MediCare, “society” deemed those things necessary, or desirable, or affordable, or rational choices. Your parents may even have wanted it, and may soon use it. Insurance and Medicare were “needed”…they just didn’t fall out of the sky onto Wilbur Cohen’s desk. What happened afterwards–oh, yes, that’s where the argument continues.
It’s not that they wanted it or do want it, it’s that that is how the game is rigged. I’m sure they’d prefer to keep their $2-3k a month in taxes rather than hand it over to our Betters in DC to redistribute. The fact is, the federal government already pays 2/3 of all medical costs in this country, so it’s not just a private insurance matter.
The other problem you’ve unwittingly illustrated here is that Americans, until the past 12 months, have exactly zero in the savings account. The savings rate has recently crept up to 6% (yay!), but the Chinese save 50% of what they make, so we shouldn’t start congratulating ourselves. Actually, until very recently, most Americans have had a negative savings rate. Having no money in the bank and a stack of debt owed to various creditors makes it very tough to pay medical bills when the time comes.
As for rejecting your ideas out of hand…ok: please pencil out the consequences of cancelling all Medicare, Medicaid, and private insurance–and malpractice liability if you like–and tell me how that works for people, and why I should keep my office open.
I really don’t need to. We have $15 trillion in national debt, the Chinese are pushing for a world reserve currency so we can no longer just inflate our way out of things or try to, and the first Boomers just started collected Medicare and SS last year. The system is on its way out, like it or not. Oh, and we’ve spent our GDP through 2019 because of the bailouts.
The malpractice issue is regrettable, but it goes to show you how much better attorneys are at making money than doctors (or engineers for that matter). You could probably all get together and threaten to stop treating politicians unless there’s some sort of malpractice damage cap, though. That’d probably get their attention. LOL.
[/quote]
RE: Ron Paul, MD…he has MediCare. And if he does not use it, he an d his family have Congressional insurance and pension…for life. Sauce for goose…?
If he believed so fervently in the Free Market, he will pay for his and his family’s care in gold coins, of which I understand he has quite a store.
And yes, since you are proposing doing away with insurance altogether, you DO have to think of the consequences. No fair proposing without disposing.
So, I will take your ideas seriously when you show me the consequences. FOor example, let’s imagine that my drug costs are $4.5 million per year. The average charge per encounter (just last week) was $1800; I have well patients,too, so for complex problems, my per visit charge, with drugs, is $5-12 kilobucks. Some of these folks have curable diseases but will need treatment 6 times over the next 4 months.
Now tell me again, how are you and orion going to fix this by eliminating insurance?
Don’t tell me that in the long run, prices will fall, because in the long run, we are all dead.
[quote]DrSkeptix wrote:
RE: Ron Paul, MD…he has MediCare. And if he does not use it, he an d his family have Congressional insurance and pension…for life. Sauce for goose…?
If he believed so fervently in the Free Market, he will pay for his and his family’s care in gold coins, of which I understand he has quite a store.
[/quote]
Point taken, but if those things weren’t available, he also has the money to pay outright. He’s simply financially incentivized,for the time being, to take money from a system he’s already paid into. If he can get free congressional insurance, why wouldn’t he take it? It’s other people’s money that pays for it.
I think the consequences will be that Latinas will start using birth control so that I don’t have to pay for their OB/GYN and ER care through Medi-cal when they show up in labor. I see illegal immigrants pooling resources to go see a real doctor rather than showing up at the ER and making taxpayers pay for it.
I think people will start taking better care of themselves through life rather than eating themselves into early dialysis.
In short, I see more moral hazard being placed back into the system, which will drive costs down.
I also see doctors looking for cheaper equipment/methods for care.
Why are other people obligated to pay this person’s $5 million dollar bill? I don’t get it.
[quote]
Now tell me again, how are you and orion going to fix this by eliminating insurance?
Don’t tell me that in the long run, prices will fall, because in the long run, we are all dead.[/quote]
People will start saving money, there will be greater moral hazard for bad behavior, doctors will figure out how to do things cheaper, etc.
I don’t see why I carry any more burden of proof than you. How will keeping things as they are be feasible in the future, with 100% of our GDP spent through 2019? Like I said, we can do the exact opposite of what we’re doing now and at least do no worse.
[quote]orion wrote:
DrSkeptix wrote:
People don’t die if they can’t have a Porsche.
[/quote]
I should have said, “People don’t die if they can’t have a Porsche…just ex-wives.”
Already done, figured in, and accounted for.
I know the response: “the market will always find something cheaper,” “different cheaper products will be found.” You will find this hard to believe, but my experience tells me that even so, aggregate costs would rise and not reduce.
[quote]PRCalDude wrote:
DrSkeptix wrote:
RE: Ron Paul, MD…he has MediCare. And if he does not use it, he an d his family have Congressional insurance and pension…for life. Sauce for goose…?
If he believed so fervently in the Free Market, he will pay for his and his family’s care in gold coins, of which I understand he has quite a store.
Point taken, but if those things weren’t available, he also has the money to pay outright. He’s simply financially incentivized,for the time being, to take money from a system he’s already paid into. If he can get free congressional insurance, why wouldn’t he take it? It’s other people’s money that pays for it.
And yes, since you are proposing doing away with insurance altogether, you DO have to think of the consequences. No fair proposing without disposing.
I think the consequences will be that Latinas will start using birth control so that I don’t have to pay for their OB/GYN and ER care through Medi-cal when they show up in labor. I see illegal immigrants pooling resources to go see a real doctor rather than showing up at the ER and making taxpayers pay for it.
I think people will start taking better care of themselves through life rather than eating themselves into early dialysis.
In short, I see more moral hazard being placed back into the system, which will drive costs down.
I also see doctors looking for cheaper equipment/methods for care.
So, I will take your ideas seriously when you show me the consequences. FOor example, let’s imagine that my drug costs are $4.5 million per year. The average charge per encounter (just last week) was $1800; I have well patients,too, so for complex problems, my per visit charge, with drugs, is $5-12 kilobucks. Some of these folks have curable diseases but will need treatment 6 times over the next 4 months.
Why are other people obligated to pay this person’s $5 million dollar bill? I don’t get it.
Now tell me again, how are you and orion going to fix this by eliminating insurance?
Don’t tell me that in the long run, prices will fall, because in the long run, we are all dead.
People will start saving money, there will be greater moral hazard for bad behavior, doctors will figure out how to do things cheaper, etc.
I don’t see why I carry any more burden of proof than you. How will keeping things as they are be feasible in the future, with 100% of our GDP spent through 2019? Like I said, we can do the exact opposite of what we’re doing now and at least do no worse. [/quote]
You misunderstood me. My drug costs are $5 million per year; I am conservative in the extreme, and this is my cost for drugs given to my patients.
Now be practical for a moment:
I cannot wait a few years for drug costs, and other services, to deflate. If insurance and MediCare were to disappear on Monday, I close my doors on Tuesday, along with about 200,000 other doctors.
Does this help you understand my skepticism about your plans?
[quote]DrSkeptix wrote:
Now tell me again, how are you and orion going to fix this by eliminating insurance?
Don’t tell me that in the long run, prices will fall, because in the long run, we are all dead.[/quote]
Yes, that is what Keynes said.
And you know what, he died and we are still around to deal with his shit, plus (compound) interest.
And so people living decades from will have to live with our inability to accept that in medical professions too, the profit motive rules supreme when it comes to competition, innovation and, dare I say it, fairness.
But that is just the deeply human flaw that we prefer someone else to pay for our mistakes. Not good economics and not good for the soul.
[quote]DrSkeptix wrote:
You misunderstood me. My drug costs are $5 million per year; I am conservative in the extreme, and this is my cost for drugs given to my patients.
Now be practical for a moment:
I cannot wait a few years for drug costs, and other services, to deflate. If insurance and MediCare were to disappear on Monday, I close my doors on Tuesday, along with about 200,000 other doctors.
Does this help you understand my skepticism about your plans?
[/quote]
I’m not familiar enough with how BigPharma gets their money, but I strongly suspect they’re doing things with a big taxpayer subsidy. The prescription drug benefit that Bush pushed through is a guaranteed profit to the pharmaceutical companies that is taken directly out of the pockets of you and me.
I also know, from personal experience, that a lot of what they turn out for a product either a) doesn’t work or b) works, but ignores far cheaper alternatives. I know this from personal experience.
I also know that, like it or not, cheaper alternatives DO exist in the form of Indian knock-offs, which vary in quality and potency. And I frankly believe that BigPharma deserves to be ripped-off after all they’ve ripped-off from us.
I’m not saying there would be a pleasant transition off of socialism, but I’m saying that it’s inevitable at this point. The whole thing is a big ponzi scheme relying on ever-growing, ever-more wealthy future generations in order to work. Considering there hasn’t been any real GDP growth in the US in 10 years, I’d say the scheme is due to collapse. It would be a definite “creative destruction,” as economists call it. Those 200,000 doctors who would be put out of business would be forced to come up with new business models, and patients would be forced to come up with ways of paying for it other than government theft.
The biggest outrage, by far, is the attempt to eliminate moral hazard and make everyone else pay for bad behavior. I remember watching this Gangland episode on the History channel where this guy gets shot, ends up in the hospital, and then recovers to kill the 3 people who shot him. I remember thinking, “Since there’s obviously no ‘4 Corner Hustler’ insurance plan, the People of Illinois paid for this guy’s care, only to have him go out and kill more people and to perhaps move into their neighborhoods later under a section 8 housing voucher.” Taxpayers should pay for that? I mean, really? Perhaps if there were greater moral hazard, guys like this would say to themselves, “Gee, if I get shot ‘hustling’, I’m likely to die since there’s no care for deadbeats like me. Maybe I’ll get out of the ‘hustling’ business altogether into something less hazardous.” Naw, couldn’t have that, could we?
[quote]orion wrote:
DrSkeptix wrote:
Now tell me again, how are you and orion going to fix this by eliminating insurance?
Don’t tell me that in the long run, prices will fall, because in the long run, we are all dead.
Yes, that is what Keynes said.
And you know what, he died and we are still around to deal with his shit, plus (compound) interest.
…
But that is just the deeply human flaw that we prefer someone else to pay for our mistakes. Not good economics and not good for the soul.
[/quote]
“Paying for mistakes…”
No, not mistakes. Opportunity; my premise is that insurance can be rational. An individual should be able to find a premium and coverage that fits his personal risk assessment. Shared risk can be efficient; aggregate costs can be lower with insurance, in theory, yes?
“In theory.”
Yogi Berra, every bit the wordsmith that Keynes was, opined, “In theory, there should be no difference between theory and practice. But in practice, there is.”