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> 1. Free market is NOT an appropriate solution for healthcare. There are plenty of reasons for this (assymetry of information, natural monopolies etc) Also:

> 1. Free market is NOT an appropriate solution for healthcare. There are plenty of reasons for this (assymetry of information, natural monopolies etc) Also: * The free market distributes goods based on ability to pay; it's wrong to deny people health care based on their wealth. * The free market requires failures of businesses and services; that is not acceptable when people's health is involved. It's ok that the solution to bad casual gaming software vendors is that their customers are screwed and they go out of business. That's not ok for bad doctors, drugs, hospitals, etc.

WalterBright 10y ago
All those arguments also apply to food production. But that's a free market, and does rather well. (Yes, I know there are agricultural subsidies. It's not a perfect free market.)
- Falkon1313 10y ago
  It's true that there's no shortage of food. In fact we're throwing away more than enough food to feed everyone in the country, around half the food that we produce. That's not very efficient. Meanwhile we stigmatize people who need food assistance, make them jump through bureaucratic hoops designed to demoralize and suppress them, demand that they present proof that their children deserve to not starve, even while incentivizing them to remain in need of food assistance. That's not very effective. So food production isn't doing 'rather well' yet, more like 'almost acceptable but needs work'. (Still much better than it was a century or two ago.)
  - WalterBright 10y ago
    It's doing very well indeed if you compare it to any other system tried for producing food. It is still experiencing price declines (unlike health care). For example, steak was a luxury when I was a kid. Now, it's cheap as dirt at $6.99 a pound. I'll take its imperfections any day over the gaping holes and incredible costs in the not-so-free-market health care system.
    - lovich 10y ago
      A lot of the cheapness of food is coming from using natural resources at an unsustainable rate, like draining the Ogallala Aquifer at far beyond its replenishment rate. I'd call that more along the lines of kicking the problems along for someone in the future to deal with all at once and not "doing very well"
      - WalterBright 10y ago
        The spectre of famine ended in the US around 1800 with free market agriculture, long before anyone heard of the Ogallala Aquifer. It also ended for every other country that adopted free market agriculture. Non-free market agriculture, on the other hand, has a pretty sorry historical record with no evidence that it was more sustainable or equitable.
        hackuser 10y ago
        > The spectre of famine ended in the US around 1800 with free market agriculture I'm not sure how you define "famine", but many people have been malnourished since; some are right now AFAIK. Think of the Great Depression, for example, for a much greater scale problem. I would bet some have starved. But most of all, any research you have would be appreciated; I feel like everyone, including me, is a bit naked out here.
        WalterBright 10y ago
        One objective way is to look at average height, which increased throughout the 19th century in the US, and increased in other countries when they adopted free market agriculture. Height is a good proxy for having sufficient nutritious food.
        hackuser 10y ago
        > One objective way is to look at average height, which increased throughout the 19th century in the US, and increased in other countries when they adopted free market agriculture. Height is a good proxy for having sufficient nutritious food. An insightful way to look at it; thanks. However, the question at hand isn't about the average, but the low end: Was there malnutrition or starvation? Yes, there was and is. EDIT: See this post for some numbers: https://news.ycombinator.com/item?id=13298775 https://news.ycombinator.com/item?id=13298775 I'm not debating whether free market food works very well for 90% in wealthy countries (just a guess at a number) and far better than whatever was done in the 18th century, but that doesn't mean we should call it sufficient or the 'best of all possible worlds'. If millions (tens of millions?) of people in wealthy countries and (hundreds of millions? billions?) in other countries are not getting sufficient food, that's failure - just less failure than we experienced before.
- hackuser 10y ago
  > All those arguments also apply to food production. But that's a free market, and does rather well. I disagree; it does poorly: Poor people in the U.S., the richest country in the history of the world, need subsidies (such as food stamps) to have enough to eat, and even then often can't afford healthy food. I read awhile ago that over 50% of children in U.S. public schools needed subsidized lunches (but my memory is hazy, so it might be that over 50% came from families that used food stamps or something similar; sorry I'm too lazy to look it up). Despite there being enough food and money in the world to feed everyone, people still starve and others are malnourished in many places. At least some researchers attribute the Arab Spring to increased food prices, as a proxy indicator of the impact (again, too busy to look up the data). > Yes, I know there are agricultural subsidies. It's not a perfect free market. Agreed, and there are other distortions besides agricultural subsidies, esp. when it comes to international trade. I don't know enough about that market to characterize it.
  - WalterBright 10y ago
    Food could be free and there'd still be malnourishment. It's necessary to look at a bigger picture when looking at the overall performance.
    - hackuser 10y ago
      > Food could be free and there'd still be malnourishment. It's necessary to look at a bigger picture when looking at the overall performance. Hmmm ... I'm talking about the whole economic system of production and distribution, the 'free market' (or whatever it is), so I agree with the second statement - I wouldn't throw the whole thing out, but it needs to be supplemented. It doesn't seem like much defense of the current system that radically changing one element of it, the price, won't achieve a perfect outcome (and I frankly doubt you mean it that way but I don't want to speak for you). You seem strongly attached to the free market concept - what if another system worked better? What's more important, the people or the economic system which feeds them? To be fair: I strongly support a 'free market' as a great tool for a great many use cases, but it's not a universal tool or panacea and it's not the goal; it's merely the means - my favorite one in the toolbox. ---- Happy New Year Walter!
tzmudzin 10y ago
I agree with both, but these are normative statements, expressing what one expects to be right or moral. As these are based on belief systems, they may not be convincing to some of us in the forum. There's plenty of positive reasons explaining why free market is NOT the right solution for health care, essentially boiling down to distorted incentives which lead to sub-optimal solutions.
- hackuser 10y ago
  I see the distinction, but as an important aside ... > these are normative statements, expressing what one expects to be right or moral. As these are based on belief systems, they may not be convincing to some of us in the forum. While I respect that people have varying moral beliefs, many much different than mine, I don't believe that morals are infinitely relative and any belief is possible or acceptable. It's sort of the new political correctness, never to discuss morality, assume it, or argue for it. I think there are some pretty universal, natural morals; morals aren't artificial constructs and amoral people aren't normal or common, they are ill and called sociopaths. Yes, there are among our 7 billion fellow humans some that believe people should be left to die at the hospital door because they can't afford care, but it's so few that I don't have to take them into account. More might argue it theoretically, but if someone was dying in front of them they would be horrified and help.
  - jimmywanger 10y ago
    > Yes, there are among our 7 billion fellow humans some that believe people should be left to die at the hospital door because they can't afford care, Wow, strawman argument much? What if they're dying of an acute cancer that requires a million dollar treament? A treatment that could provide food or medical treatment for thousands of other people? What if they were dying of some incurable disease and would simply take up a hospital bed for no use? You seem to think of costs as floating in a vaccum, rather than a redistributive method for limited resources.
- facetube 10y ago
  Complete inelasticity of demand and lack of the ability for consumers to inform themselves (read: I will never understand the finer points of organ transplantation or be able to assess value for money) are two very factual ECON101 reasons.
jimmywanger 10y ago
> it's wrong to deny people health care based on their wealth. Why? There are certain heroic attempts that are not economically feasible to attempt unless you're incredibly wealthy. Is the government responsible for funding extremely expensive treatments at the cost of denying health care/food subsidies for many other people who happen to be in need? Once you start making absolute statements like that, you can justify any atrocity on the altar of your absolute right.

WalterBright 10y ago

All those arguments also apply to food production. But that's a free market, and does rather well. (Yes, I know there are agricultural subsidies. It's not a perfect free market.)

Falkon1313 10y ago
It's true that there's no shortage of food. In fact we're throwing away more than enough food to feed everyone in the country, around half the food that we produce. That's not very efficient. Meanwhile we stigmatize people who need food assistance, make them jump through bureaucratic hoops designed to demoralize and suppress them, demand that they present proof that their children deserve to not starve, even while incentivizing them to remain in need of food assistance. That's not very effective. So food production isn't doing 'rather well' yet, more like 'almost acceptable but needs work'. (Still much better than it was a century or two ago.)
- WalterBright 10y ago
  It's doing very well indeed if you compare it to any other system tried for producing food. It is still experiencing price declines (unlike health care). For example, steak was a luxury when I was a kid. Now, it's cheap as dirt at $6.99 a pound. I'll take its imperfections any day over the gaping holes and incredible costs in the not-so-free-market health care system.
  - lovich 10y ago
    A lot of the cheapness of food is coming from using natural resources at an unsustainable rate, like draining the Ogallala Aquifer at far beyond its replenishment rate. I'd call that more along the lines of kicking the problems along for someone in the future to deal with all at once and not "doing very well"
    - WalterBright 10y ago
      The spectre of famine ended in the US around 1800 with free market agriculture, long before anyone heard of the Ogallala Aquifer. It also ended for every other country that adopted free market agriculture. Non-free market agriculture, on the other hand, has a pretty sorry historical record with no evidence that it was more sustainable or equitable.
      - hackuser 10y ago
        > The spectre of famine ended in the US around 1800 with free market agriculture I'm not sure how you define "famine", but many people have been malnourished since; some are right now AFAIK. Think of the Great Depression, for example, for a much greater scale problem. I would bet some have starved. But most of all, any research you have would be appreciated; I feel like everyone, including me, is a bit naked out here.
        WalterBright 10y ago
        One objective way is to look at average height, which increased throughout the 19th century in the US, and increased in other countries when they adopted free market agriculture. Height is a good proxy for having sufficient nutritious food.
        hackuser 10y ago
        > One objective way is to look at average height, which increased throughout the 19th century in the US, and increased in other countries when they adopted free market agriculture. Height is a good proxy for having sufficient nutritious food. An insightful way to look at it; thanks. However, the question at hand isn't about the average, but the low end: Was there malnutrition or starvation? Yes, there was and is. EDIT: See this post for some numbers: https://news.ycombinator.com/item?id=13298775 https://news.ycombinator.com/item?id=13298775 I'm not debating whether free market food works very well for 90% in wealthy countries (just a guess at a number) and far better than whatever was done in the 18th century, but that doesn't mean we should call it sufficient or the 'best of all possible worlds'. If millions (tens of millions?) of people in wealthy countries and (hundreds of millions? billions?) in other countries are not getting sufficient food, that's failure - just less failure than we experienced before.
hackuser 10y ago
> All those arguments also apply to food production. But that's a free market, and does rather well. I disagree; it does poorly: Poor people in the U.S., the richest country in the history of the world, need subsidies (such as food stamps) to have enough to eat, and even then often can't afford healthy food. I read awhile ago that over 50% of children in U.S. public schools needed subsidized lunches (but my memory is hazy, so it might be that over 50% came from families that used food stamps or something similar; sorry I'm too lazy to look it up). Despite there being enough food and money in the world to feed everyone, people still starve and others are malnourished in many places. At least some researchers attribute the Arab Spring to increased food prices, as a proxy indicator of the impact (again, too busy to look up the data). > Yes, I know there are agricultural subsidies. It's not a perfect free market. Agreed, and there are other distortions besides agricultural subsidies, esp. when it comes to international trade. I don't know enough about that market to characterize it.
- WalterBright 10y ago
  Food could be free and there'd still be malnourishment. It's necessary to look at a bigger picture when looking at the overall performance.
  - hackuser 10y ago
    > Food could be free and there'd still be malnourishment. It's necessary to look at a bigger picture when looking at the overall performance. Hmmm ... I'm talking about the whole economic system of production and distribution, the 'free market' (or whatever it is), so I agree with the second statement - I wouldn't throw the whole thing out, but it needs to be supplemented. It doesn't seem like much defense of the current system that radically changing one element of it, the price, won't achieve a perfect outcome (and I frankly doubt you mean it that way but I don't want to speak for you). You seem strongly attached to the free market concept - what if another system worked better? What's more important, the people or the economic system which feeds them? To be fair: I strongly support a 'free market' as a great tool for a great many use cases, but it's not a universal tool or panacea and it's not the goal; it's merely the means - my favorite one in the toolbox. ---- Happy New Year Walter!

tzmudzin 10y ago

I agree with both, but these are normative statements, expressing what one expects to be right or moral. As these are based on belief systems, they may not be convincing to some of us in the forum. There's plenty of positive reasons explaining why free market is NOT the right solution for health care, essentially boiling down to distorted incentives which lead to sub-optimal solutions.

hackuser 10y ago
I see the distinction, but as an important aside ... > these are normative statements, expressing what one expects to be right or moral. As these are based on belief systems, they may not be convincing to some of us in the forum. While I respect that people have varying moral beliefs, many much different than mine, I don't believe that morals are infinitely relative and any belief is possible or acceptable. It's sort of the new political correctness, never to discuss morality, assume it, or argue for it. I think there are some pretty universal, natural morals; morals aren't artificial constructs and amoral people aren't normal or common, they are ill and called sociopaths. Yes, there are among our 7 billion fellow humans some that believe people should be left to die at the hospital door because they can't afford care, but it's so few that I don't have to take them into account. More might argue it theoretically, but if someone was dying in front of them they would be horrified and help.
- jimmywanger 10y ago
  > Yes, there are among our 7 billion fellow humans some that believe people should be left to die at the hospital door because they can't afford care, Wow, strawman argument much? What if they're dying of an acute cancer that requires a million dollar treament? A treatment that could provide food or medical treatment for thousands of other people? What if they were dying of some incurable disease and would simply take up a hospital bed for no use? You seem to think of costs as floating in a vaccum, rather than a redistributive method for limited resources.
facetube 10y ago
Complete inelasticity of demand and lack of the ability for consumers to inform themselves (read: I will never understand the finer points of organ transplantation or be able to assess value for money) are two very factual ECON101 reasons.

jimmywanger 10y ago

> it's wrong to deny people health care based on their wealth. Why? There are certain heroic attempts that are not economically feasible to attempt unless you're incredibly wealthy. Is the government responsible for funding extremely expensive treatments at the cost of denying health care/food subsidies for many other people who happen to be in need? Once you start making absolute statements like that, you can justify any atrocity on the altar of your absolute right.