Health Care

Paul A. Keating PKEATING at JCVAXA.JCU.EDU
Thu Sep 7 18:39:54 MDT 1995


|Date: Thu, 07 Sep 1995 12:08:16 -0400
|From: Willaim Thurber - PhD Student <thurber at FMGMT.MGMT.UTORONTO.CA>
|Subject: Re: Health Care
|
|>         The argument is cost control, not justified intervention.  Strawman
|>         not allowed!  The stupid and/or wiley cause costs to soar, to the
|>         taxpayers'/bill payers' lament!
|
|Two sides of the same issue, if the stupid cause prices to increase to
|you, then the government is justified in preventing these people from
|harming you by introducing cost control through its monopoly power.  I do
|not suggest that the monopoly must be government run, but my recent
|experience suggests that private insurers have an incentive to disallow
|claims in the name of profit.  Dr. DJ's story suggests that our govm't
|plan is not exempt from these pressures either.
 
        Government cannot prevent prices rising via cost control.  They
        may be able to delay price increases, but not prevent them.  Read
        about this phenomenon occuring during the early 1970s resulting
        from a government imposed wage & price freeze.  Talk about being
        slapped in the face by the "invisible hand"!
 
        But, then, you said monopoly.  Yes, full control is available
        in a monopoly.  Full control to the extent of pricing services
        out of the consumers ability to pay.  Full control to the extent
        of requiring unrestrained taxation.  My wonder regarding the use
        of a monopoly would center on who will/could control it?
 
        A private monopoly-style health system would be illegal.  Mandated
        payments into the program would be taxes, and only the House of
        Representatives is empowered to appropriate taxes.  Then there are
        all of those nasty anti-monopoly laws and statutes that would have
        to be footnoted with the provisio of "health care excluded"!
 
        To quote Charles Caleb Colton:
 
        "Power will intoxicate the best hearts, as wine the strongest heads.
        No man is wise enough, nor good enough to be entrusted with unlimited
        power."
 
        Our current Social Security program is an example.  Those funds were
        not to be touched by any other agency.  The government had monopolistic
        control of the revenues.  The trust, however, now contains a lot of
        "I.O.U.s"!  The government is just borrowing the money for now.  Sort
        of an interest-free loan to debtors who fail to seek or qualify for
        loans elsewhere!
 
        Private systems, on the other hand, have market and consumers playing
        an integral role.
 
|> |The US system limits costs because the free
|> |market limits the number of people covered.
|>
|>         Then it is a plus for the Us system, no?
|
|Not in my book, good health to me is a right (a subsection of the right
|to life and liberty)
 
        Rights can be guaranteed.  Can the Canadian Government guarantee
        your good health?  (Not the maintenance of health or care for
        those in poor health, but guarantee good health.)  No.
 
        If you are in poor health, who is violating your right?  Good health
        is no more a right than is a full stomach.  You have a right to vote,
        but not a right to a run-free nose nor a free lunch.
 
        The right being impeded here is my right to the pursuit of happiness
        which is violated by my being directed to pay for someone else's
        health care.  The right to liberty is also in peril as my freedom to
        make the choice whether or not to pay for someone else is denied me.
 
        (Note:  I willingly and ably give to charity.  It's a choice that I
        cheefully choose.  Mandated donations, on the other hand, are cause
        for disdain.)
 
|>
|>         Perhaps, without a source of market-based health care to the South,
|>         Canada's program would fail.
|
|You have an interesting point but I am not sure I understand, can you
|elaborate?
 
        When those trapped in the system cannot avail themselves to the
        "pressure release valve-like" effects of a market-based system
        to the South, they would all have to suffer the consequences of
        waiting lists, limits on procedures, unavailability of certain
        procedures, &c.
 
        People being people, I'd suspect that they wouldn't stand for it for
        too long, and would seek remedy.  That would be the end of Canada's
        program as it now stands, replaced by something to be determined.
 
|>         No mention of greed in my argument--profit is not greed, profit is
|>         making at least a penny over cost.  Anyone who doesn't make a profit
|>         should not be in business (unless his/her business is going deeper
|>         into poverty!).
|
|Greed is an ugly word and I knew I would regret using it.  But you
|implied that Cdn Doc's are starving, profitless, dweebs.  In fact they earn
|$100-200K.  True, this is less than US Docs but is a far cry from
|profitless.
 
        Please don't say that I result to ad hominem or implying ad hominem.
        I do not, and did not.  In re-reading my statement above, I cannot
        detect the implication you say I make.
 
        When you only look at income without looking at expenses, then those
        large salaries do seem high.  Education costs and other expenses
        deferred until earning power reaches the $100-200K level take an
        unearthly bite out of income.  A global look at a doctor's economic
        picture is in order.
 
        Then there are the premiums for malpractice insurance.  If we can
        agree that the argument to focus on is one of "cost control" and
        not "identification of administrator," then we should attack the
        litigious society we live in (in the USA) and the sharks that
        insure the environment remains in place--lawyers!
 
        The threat of treble punitive damages plus the high cost to fight a
        case (even when the physician is without guilt or liability) make
        many an innocent doctor settle out of court.  Settlement is handled
        by malpractice insurance.  (Of course, to add fuel to the fire,
        a settlement is either misrepresented or wrongfully thought
        of as a sign of guilt.)  Settlement = higher premiums.  Higher
        premiums = increased cost of medical care.
 
|>         The payroll tax for medicaid that I pay does not pay for my health
|>         care.  My health care is provided by a system of my own choosing.
|>         That is a choice I am free to make and you are not.
|
|As previously noted we pay the same health tax, you get nothing and have
|a reason to be proud of that (because it is a sign of success in the US)
|I on the other hand get cradle to grave coverage.  What's not to compare?
 
        GAO computations show that adopting a government-run health care
        system similar to Canada's is not sustainable on revenues raised
        from present payroll taxes.  Your premise of paying the same
        health tax, therefore, is flawed.
 
        The payroll tax I pay is not intended for my health care, but for
        the Medicare system.  I am not eligible for renumeration from that
        program.  You, on the other hand, are the beneficiary of your health
        tax dollars.  Therefore, the tax we pay are not the same.
 
        Based on the observation of a false premise, your argument is not sound.
 
        The contemptuous statement of pride and sign of success in the US
        is beneath any responsible comment.
 
        Your cradle-to-grave care is born on the backs of those who are
        healthy enough to never use the system.  Seems like incentive to
        smoke, drink, and grow fat!  "Not to worry, the government will
        take care of me."
 
        Require hospitalization after driving into a tree after a six-pack?
        No problem!  Government to the rescue.  No fuss, no muss, no ugly
        responsibility for your own actions to worry about on the health care
        scene.  After all, wouldn't making someone pay for their "mistake" in
        a court of law and in a hospital cashier's office be considered some
        form of double jeopardy?  ;-D  (Argument using "Reductio ad Absurdum")
 
|>         "Why would we want to" is another strawman--the argument is freedom
|>         that we have that you don't!  I've made the point.
|>
|
|Guilty as charged.  A by-product of my enthusiasm for this system, if it
|were perfect "why would I want to" is valid.  I apologize for a) precluding
|a better system and b) incorrectly assuming our system was perfect.
 
        Validity's still not the question.  Admitting to one strawman by
        offering another one!  I'd rather see mention of straying from
        the argument of "freedom that we have that you don't" than the
        two-headed strawman apology!



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