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Why can't free markets provide healthcare?

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The Grim Reaper
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Postby The Grim Reaper » Sun Sep 14, 2014 9:15 pm

Avenio wrote:
Reaganiffic wrote:Why can't we say the same thing for agriculture?


... Agriculture really isn't all that much like the healthcare sector.


I would argue it is, which is why American agriculture is effectively a failed industry. It's subsidised by illegal labour and one of the most protectionist economic policies in history.
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Postby Lalaki » Sun Sep 14, 2014 9:15 pm

Republic of Coldwater wrote:I don't hate America, I want it to improve. I love America, and that is exactly why I am talking about these issues.


And this is where we agree, even if we have different solutions.
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Postby Gauthier » Sun Sep 14, 2014 9:17 pm

Because the free market is inherently about making profit, and in the health care industry profit is achieved by minimizing the draw of assets by consumers the same as it is with any insurance industry. The less your paying customers draw on your resources to take care of their medical conditions, the more profitable you become. Therefore you try to maximize the number of customers paying premiums while minimizing how much they use your benefits.
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Postby Lalaki » Sun Sep 14, 2014 9:18 pm

Gauthier wrote:Because the free market is inherently about making profit, and in the health care industry profit is achieved by minimizing the draw of assets by consumers the same as it is with any insurance industry. The less your paying customers draw on your resources to take care of their medical conditions, the more profitable you become. Therefore you try to maximize the number of customers paying premiums while minimizing how much they use your benefits.


:clap:
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Postby Othelos » Sun Sep 14, 2014 9:22 pm

They can, but only for people fortunate enough to be able to afford it.
Last edited by Othelos on Sun Sep 14, 2014 9:22 pm, edited 1 time in total.
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The Scientific States
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Postby The Scientific States » Sun Sep 14, 2014 9:23 pm

Healthcare shouldn't be for profit. There is a major difference between buying commodities and buying healthcare, which is essential to human survival. If healthcare is privatized it would ultimately have a negative effect on the poor as healthcare companies would be able to set prices and the like as they pleased. It's foolish.
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Postby Gauthier » Sun Sep 14, 2014 9:23 pm

The Scientific States wrote:Healthcare shouldn't be for profit. There is a major difference between buying commodities and buying healthcare, which is essential to human survival. If healthcare is privatized it would ultimately have a negative effect on the poor as healthcare companies would be able to set prices and the like as they pleased. It's foolish.


And before federal laws, they already did that with a wonderful invention called Pre-Existing Conditions.
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Postby Frisbeeteria » Sun Sep 14, 2014 9:24 pm

Gauthier wrote:Therefore you try to maximize the number of customers paying premiums while minimizing how much they use your benefits.

As I already stated, but nobody responded to ...

The simplest way to maximize profits is to refuse to provide insurance to high risk patients (like me). By eliminating the top end of the risk pool entirely, the actuarial value of the smaller pool is lower, and they can charge lower premiums and still make lots of money. However ... people like me still require health services, so we'll stiff the hospitals instead of paying a more balanced premium. You're still going to soak up the costs in the form of higher-priced healthcare.

Lalaki wrote:Health care can be paid for with $15k.

Until the Affordable Care Act, I couldn't buy health insurance for any price. So no, you can't make a generalization like that.

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Postby Lalaki » Sun Sep 14, 2014 9:25 pm

Frisbeeteria wrote:
Gauthier wrote:Therefore you try to maximize the number of customers paying premiums while minimizing how much they use your benefits.

As I already stated, but nobody responded to ...

The simplest way to maximize profits is to refuse to provide insurance to high risk patients (like me). By eliminating the top end of the risk pool entirely, the actuarial value of the smaller pool is lower, and they can charge lower premiums and still make lots of money. However ... people like me still require health services, so we'll stiff the hospitals instead of paying a more balanced premium. You're still going to soak up the costs in the form of higher-priced healthcare.

Lalaki wrote:Health care can be paid for with $15k.

Until the Affordable Care Act, I couldn't buy health insurance for any price. So no, you can't make a generalization like that.


I wasn't making that claim in that context. Read the conversation again. I fully support universal health care, and understand that people in poverty cannot afford health care at all.
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Postby Frisbeeteria » Sun Sep 14, 2014 9:31 pm

Lalaki wrote:I fully support universal health care, and understand that people in poverty cannot afford health care at all.

Just to be clear, I'm not poor. I could afford to buy insurance if I wanted to, but no non-governmental source would sell it to me.

I have several chronic conditions (think arthritis) that I don't treat, that don't cause me pain, but will never ever go away. If I treated them, costs would be in excess of $50,000 per year. Since I don't need or want to treat them, my actual costs are around $100/year. Nonetheless, I'm added to a risk pool that's higher than private enterprise will not support. So the initial premise of the OP that healthcare is a completely interchangable economic commodity is quite simply false.
Last edited by Frisbeeteria on Sun Sep 14, 2014 9:32 pm, edited 1 time in total.

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Lalaki
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Postby Lalaki » Sun Sep 14, 2014 9:32 pm

Frisbeeteria wrote:
Lalaki wrote:I fully support universal health care, and understand that people in poverty cannot afford health care at all.

Just to be clear, I'm not poor. I could afford to buy insurance if I wanted to, but no non-governmental source would sell it to me.

I have several chronic conditions (think arthritis) that I don't treat, that don't cause me pain, but will never ever go away. If I treated them, costs would be in excess of $50K per year. Since I don't need or want to treat them, my actual costs are around $100/year. Nonetheless, I'm added to a risk pool that's higher than private enterprise will support. So the initial premise of the OP that healthcare is a completely interchangable economic commodity is quite simply false.


I fully agree.

And I think I was wrong earlier. Thanks for the correction. That was my fault.
Last edited by Lalaki on Sun Sep 14, 2014 9:33 pm, edited 1 time in total.
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Postby Avenio » Sun Sep 14, 2014 9:36 pm

The Grim Reaper wrote:
Avenio wrote:
... Agriculture really isn't all that much like the healthcare sector.


I would argue it is, which is why American agriculture is effectively a failed industry. It's subsidised by illegal labour and one of the most protectionist economic policies in history.


Well that's the thing, though, isn't it? You can't really say that the healthcare industry is being kept afloat by tariffs on imported medicines or cheap foreign-trained doctors smuggled across the Mexican border, can you? Different situation entirely.
Last edited by Avenio on Sun Sep 14, 2014 9:37 pm, edited 1 time in total.

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Postby Gauthier » Sun Sep 14, 2014 9:38 pm

Lalaki wrote:
Frisbeeteria wrote:Just to be clear, I'm not poor. I could afford to buy insurance if I wanted to, but no non-governmental source would sell it to me.

I have several chronic conditions (think arthritis) that I don't treat, that don't cause me pain, but will never ever go away. If I treated them, costs would be in excess of $50K per year. Since I don't need or want to treat them, my actual costs are around $100/year. Nonetheless, I'm added to a risk pool that's higher than private enterprise will support. So the initial premise of the OP that healthcare is a completely interchangable economic commodity is quite simply false.


I fully agree.

And I think I was wrong earlier. Thanks for the correction. That was my fault.


Simply put, if the free market had total reign over healthcare, people who need healthcare the most would simply be left to die quick as Alan Grayson once said because they'd cost more money than they bring to the health care companies.
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Postby Arkiasis » Sun Sep 14, 2014 9:44 pm

You can choose to buy a potato, if one grocery store has too expensive potato's you can go to another one. And potato's are cheap enough that you can afford them even with a minimum wage job. Healthcare does not work like this, you cannot choose to not get into a car accident, you can't choose not to have a heart attack, and you most certainly cannot "shop around" for cheaper hospitals when you're dying. Also healthcare is very very very unaffordable, you can't compare a potato which costs 20 cents to a 1 day hospital stay which in America will cost 10,000-20,000 dollars. And even if you're homeless, food is incredibly easy to make and distribute, most people are willing to maybe give a homeless man $5 so they can get a meal, the same cannot be said for healthcare. Charities will NOT be able to cover the healthcare needs of the millions who cannot afford it.

Also we've given the American way a chance, and its been proven to suck. It's horribly expensive, yet its quality is lacking compared to other countries which provide equitable care at much cheaper costs.
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Postby Zavea » Sun Sep 14, 2014 9:48 pm

Arkiasis wrote: Charities will NOT be able to cover the healthcare needs of the millions who cannot afford it.


on the topic of charity it's worth adding that most charities in the US, canada, etc. are subsidized with government money typically in the form of block grants. because many of these charities are already stretched to their limits, reducing or killing these subsidies often pushes them past their financial breaking point (happened in new york and elsewhere rather recently)
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The Grim Reaper
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Postby The Grim Reaper » Sun Sep 14, 2014 9:52 pm

Avenio wrote:
The Grim Reaper wrote:
I would argue it is, which is why American agriculture is effectively a failed industry. It's subsidised by illegal labour and one of the most protectionist economic policies in history.


Well that's the thing, though, isn't it? You can't really say that the healthcare industry is being kept afloat by tariffs on imported medicines or cheap foreign-trained doctors smuggled across the Mexican border, can you? Different situation entirely.


Ah, OK, fair point.
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Postby SaintB » Sun Sep 14, 2014 10:06 pm

Gauthier wrote:Because the free market is inherently about making profit, and in the health care industry profit is achieved by minimizing the draw of assets by consumers the same as it is with any insurance industry. The less your paying customers draw on your resources to take care of their medical conditions, the more profitable you become. Therefore you try to maximize the number of customers paying premiums while minimizing how much they use your benefits.

Yes, exactly.
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Postby SaintB » Sun Sep 14, 2014 10:13 pm

Rebellious Fishermen wrote:
SaintB wrote:It might actually lead to a decrease, the fed spends billions subsidizing hospitals whose customers are not paying for emergency room treatment - if emergency treatment was already from a public pool there would be more standards in pricing. If you make basic preventative medicine available to the public as well then you decrease the amount of people needing emergency treatment and could in fact actually save money.


I'm always down for a plan that actually lowers costs while maintaining effectiveness.

In the State of Utah they cut down on their emergency room costs, crime rates, and prison budget by providing cost free housing for the homeless until they can afford to pay their own way. That makes me optimistic about cutting medical costs by giving people medical care. It's also been demonstrated to cost less in Hawaii when they made medicine a public utility but Hawaii is a relatively small state.
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Postby Alyakia » Sun Sep 14, 2014 10:14 pm

Reaganiffic wrote:Too often I hear the arguments from liberals that healthcare is somehow different than buying potatoes or an ipod, that the free market cannot work. I think these arguments are a load of rubbish.

Information asymmetry exists in all markets, you don't know where your potatoes come from or how much pollution making them costs. There are various concentrations in various industries, many of them successfully run by the free market. If you buy a parachute and you choose wrong you still die, but the free market runs the parachute industry with success. So why not free markets?

Could it be that liberals don't want to give the American way a chance before they go around making things more socialist? I sense some bias at work here.


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Postby The Joseon Dynasty » Sun Sep 14, 2014 10:20 pm

Gauthier wrote:Because the free market is inherently about making profit, and in the health care industry profit is achieved by minimizing the draw of assets by consumers the same as it is with any insurance industry. The less your paying customers draw on your resources to take care of their medical conditions, the more profitable you become. Therefore you try to maximize the number of customers paying premiums while minimizing how much they use your benefits.

Although I'm sure that incentive misalignment is a component - as it is in all forms of private insurance -, I think it's much more to do with how differently public and private sectors price their services. It's clearly better for high-income people to have private insurance as the norm. Note that since they're client-oriented, private firms can only justify pricing their insurance on a per-client risk basis (i.e. according to the expected cost of each individual client's claims). If a private firm were - for some reason - to go beyond this risk-orientation and subsidise low-income clients by upping the premiums for high-income clients, those high-income clients would transfer to a firm that does not discriminate in that way. Each attempt to subsidise poorer clients would result in the loss of all clients above the median-income client, and so taken to the limit, the firm would lose all their clients. The public sector removes this problem by incorporting premiums straight into taxes; they can and do easily subsidise low-income clients and effectively ignore each individual client's risk because taxes are mandatory. The public sector has that flexibity to base healthcare on a very different principle than in private insurance; where private firms are necessarily concerned with risk, the public sector can be concerned with access and instead smooth risk over all clients in the aggregate (making expected losses on some and expected profit on others), rather than on an individual basis.
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Postby 4years » Sun Sep 14, 2014 10:20 pm

Reaganiffic wrote:
Pandeeria wrote:
How the fuck did you get that out of what Grim said?

What are you even proposing in this thread?

1. Every argument that can be said for socializing healthcare can be said for any other product. 2. We know that a command economy is bad, 3. therefore arguments for socializing healthcare are wrong. It's that simple, and it's the truth.


1. Incorrect. I don't die for lack of access to IPods.
2. Historically command economies outperform market economies in compatible circumstances.
3. Even if your previous assumption was correct (it isn't), you fail to note that the healthcare industry is different from other sectors in that profit maximization in health directly leads to sacrificing human lives on the alter of capitalism.
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Shilya
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Postby Shilya » Sun Sep 14, 2014 10:58 pm

A free market requires that I get to know the price upfront. You can't have competition when everyone just charges whatever the hell they want after the fact.

A free market also requires that I'm actually free to decline the service offered, but when I get healthcare, I do so because declining is not an option.
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Postby Trotskylvania » Sun Sep 14, 2014 11:12 pm

Republic of Coldwater wrote:
Lalaki wrote:

http://www.washingtonpost.com/blogs/won ... _blog.html

Most countries with universal health care have shorter waiting periods than the United States. Canada happens to be an exception.

How about countries such as Hong Kong and Singapore with true, not phony free market healthcare?

There are four times as many publicly owned hospitals in Hong Kong as private ones, the cost of which is entirely supported by the government of Hong Kong.

In Singapore, the government has established a universal health care system that uses a public health insurance system, compulsory savings, price controls and subsidies to ensure affordability and access for its citizens.

So basically, you're completely wrong about the basic, easily verifiable facts about the crux of your argument. Facts you could have learned by consulting wikipedia, or either country's own English language government web sites.
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Republic of Coldwater
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Postby Republic of Coldwater » Mon Sep 15, 2014 12:04 am

Lalaki wrote:
Republic of Coldwater wrote:Food doesn't cost much, HealthCare I already covered and we can move towards vouchers, while housing can also be paid for without aid (cheap housing is perfectly payable with $15k-$20k)


Again, take everything in combination. Food can be a lot for American families, especially if you are trying to maintain a healthy diet.

Health care can be paid for with $15k. Food can. Shelter can. Transpiration can. Schooling can.

But $15k won't pay for all of that in total.

It can pay all of that in total, transportation doesn't have to be a car, you don't have to get the most expensive food or pay the most expensive rent, and it should be fine.

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Republic of Coldwater
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Postby Republic of Coldwater » Mon Sep 15, 2014 12:05 am

Costa Fierro wrote:
Republic of Coldwater wrote:Food doesn't cost much, HealthCare I already covered and we can move towards vouchers, while housing can also be paid for without aid (cheap housing is perfectly payable with $15k-$20k)


Cheap doesn't necessarily mean quality. A house may cost $15,000 but it could be made out of substandard materials, badly maintained and bhave a whole load off issues with it such as poor heat retention or moisture retention.

What I meant was that an annual wage of $15-20k can pay for rent, healthcare and basic necessities.

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