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People seem to think that without ACA, the US healthcare market is free, which is why it has so many problems. This could not be further from reality. We have
by lend000 10y ago
People seem to think that without ACA, the US healthcare market is free, which is why it has so many problems.
This could not be further from reality. We have more government distortions in our healthcare market than countries with completely socialized healthcare. For example:
Medicare: socialized medicare for the elderly, which alone creates more distortion than a universal program would cause by inflating demand/prices for non-qualifying citizens.
Medicaid: socialized healthcare for specially qualifying poor people, which creates the same distortion as Medicare.
An oppressive FDA: which, coupled with overly-powered IP laws, grants de-facto monopolies in the medical product industry. We have an incredibly expensive and subjective medical equipment pre-approval process (as compared to a less-terrible FDA that would just be in charge of labeling, preventing fraud, and maintaining accountability in the event of incidents). Then there's the length and flexibility of patent protections in our current system (maybe we could cut those protection times in half, and patent trolling would not be a lucrative industry).
Oppressive occupational licensing: It's way too hard to become a doctor of any kind, even the kinds that don't manually put things into your heart. This will be a major battle as AI comes to the point where it can better diagnose conditions and largely replace generic/non-specialized pediatrics. Of course, the government will not make this easy.
Plus a slew of more minor things like malpractice regulation, and now the ACA (which is not so minor).
If we cleaned up/removed all of the problems in the above and replaced it with single payer, it would be OK and we would have something similar to Canada/other countries with long wait times, not much access to specialists, and a system where the government gets to decide who gets the last liver transplant and who dies.
Or we could try going the free-ish market approach and try to find a much freer balance with the FDA/USDA/occupational-licensing/scrap Medicare/Medicaid,etc., which we do not currently have AT ALL.
- nodamage 10y ago> Or we could try going the free-ish market approach and try to find a much freer balance with the FDA/USDA/occupational-licensing/scrap Medicare/Medicaid,etc., which we do not currently have AT ALL. Is there any country that has implemented this successfully?
- lend000 10y agoUnfortunately not, but I'd love for our country to be the first.
- mikeyouse 10y agoIf it were truly the lowest-cost, best-outcome method to deliver care to an entire population, don't you think one of the hundreds of countries would have proven that by now?
- lend000 10y ago> If it were truly the lowest-cost, best-outcome method to deliver care to an entire population, don't you think one of the hundreds of countries would have proven that by now? So, do you think everything's already been solved? There have been 100 billion people in Earth's history. Wouldn't you think one of them would have proved P vs NP by now? If you have a legitimate argument against a cleaner, free(r), less corrupt health-care system, feel free to bring it forward. But no, in modern medicine's one century of existence, the problem of finding the best health-care implementation has almost certainly not been solved. In fact, only a dozen or so countries have had the economic capability to sustain modern medical practice on a large scale for more than a couple decades. The others constitute the "second/third worlds."
- nodamage 10y agoWhy do you believe such an approach would work? Is there any evidence behind this position?
- lend000 10y agoIs this so radical? There's ample evidence that our healthcare bureaucracies are NOT working. And there's ample evidence that free markets are more efficient at providing value, when held to a legal framework that maximizes freedom (for everyone, consumers and proprietors alike). I'm not even suggesting a fully 'free' market -- just reducing the size and scope of our bureaucracies which have gotten out of control, and see how much prices drop/ health-care improves before we commit ourselves to eternal government-quality care with minimal innovation. Just ask any veterans relying on the VA how satisfied they are. On a tangent, universal health care is not 'great' anywhere, and the bigger the country, the less compelling the evidence (diseconomies of scale -- see Canada/England vs. Switzerland for example). And our country benefits from another order of magnitude of diseconomies of scale/bureaucratic bloat in trying to institute such a program. So, moral of the story is that if it somehow did not end up making our healthcare system significantly better than universal healthcare countries, then we could still let states that lean a certain direction handle the bureaucracy of a universal healthcare system with slightly more efficiency.