7 ms·

How the Government Ruined US Healthcare – And What Can Be Done

14 points by clarkmoody 10y ago

hiddencost 10y ago
Fair warning, this is a think tank named after https://en.wikipedia.org/wiki/Ludwig_von_Mises https://en.wikipedia.org/wiki/Ludwig_von_Mises who is basically the founder of Austrian economics, which has by and large become a vehicle for ultra-conservative folks to push through anti-worker policies.
- bkohlmann 10y ago
  It's interesting that you use the term "fair warning," which may dissuade someone from reading the article and coming to their own conclusions. As someone who values hearing the perspectives of all sides, I find it useful to hear pro-market arguments in something like health care. It helps me challenge my assumptions, especially since health care does seem to be increasingly costly and complex...as the amount of government oversight increases every year.
  - savanaly 10y ago
    I don't interpret "fair warning" as meaning "this person is a wrongthinker, stay away!" I interpret it as "you may find this article interesting, but be aware that its source is outside the mainstream and maybe even outside the Overton window."
    - bkohlmann 10y ago
      I guess we just have a difference in interpretations of the term. My recent (admittedly amateur) interest in behavioral economics and persuasion leads me to believe that even sophisticated people are susceptible to the effects of framing. If you prime someone to read something with a bias towards skepticism, they will either avoid it due to confirmation bias, or potentially read it differently than they would have without the prime. That may not even be your intent, but in reality it happens. And as for "outside the mainstream" - whose mainstream or Overton window? My "mainstream" actually takes Mises very seriously. It sounds like yours does not. I suppose under a broad definition, a warning could be warranted for nearly every article depending on the audience.
  - pdabbadabba 10y ago
    I read that as simply a warning about potential bias. If anything, I find that being on the lookout for potential bias actually helps be come to my own conclusions.
    - bkohlmann 10y ago
      Very possible. But a warning about potential bias may induce an (un?)intended bias of its own!
  - frgtpsswrdlame 10y ago
    Hearing the perspectives of all sides is only useful when they're honest. Any article which talks about Nixon's effects on healthcare and laws passed in 1972 and 1974 but skips right over the Health Maintenance Organization Act of 1973 is not being honest.
    - ancap 10y ago
      The article never claimed to provide an exhaustive list of all healthcare related laws and their affects. In exactly what way does omitting that law weaken their argument?
      - frgtpsswrdlame 10y ago
        I don't expect an exhaustive list, but saying that Nixon's laws in 72 and 74 made our current state of healthcare while ignoring the 73 law is a glaring omission. Considering it allowed the rise of for-profit HMOs I would expect a decent article to at least address/dismiss the concern that maybe this law is part of the reason our prices have gone up so much.
- ancap 10y ago
  The Mises Institute eschews the term "think tank" and does not lobby for any government policy. Its founders purposefully put its headquarters far away from Washington DC because they did not want to be viewed as a lobbying organization or a "think tank". They view their mission as an educational organization, and offer tons of ebooks, audio and video lectures free of cost on their website. Whether you agree or disagree with some of the positions espoused, that's another issue. In summary, rather than going for the ad hominem, debate the actual arguments made in the article.
- theabacus 10y ago
  To the contrary: They criticize Paul Ryan and current ACA proposals: https://mises.org/blog/ryancare-failing-%E2%80%94-what-should-happen-next https://mises.org/blog/ryancare-failing-%E2%80%94-what-shoul... Criticize Trump for problematic policies: https://mises.org/blog/donald-trumps-whig-showing https://mises.org/blog/donald-trumps-whig-showing Criticize Rockefeller and are generally anti-war: https://mises.org/library/rockefeller-morgan-and-war https://mises.org/library/rockefeller-morgan-and-war Critical of the CIA historically and today: https://mises.org/blog/when-cia-partied-lsd-taxpayers-dime https://mises.org/blog/when-cia-partied-lsd-taxpayers-dime and these are just articles published in the last two weeks. In general, Mises is pro individual liberty, pro-immigration, anti-war, and generally critical of both the Left and the Right. I fail to see how they are "ultra-conservative". Besides. This comment is just an ad-hominem and fails to address that actual argument of the article.
  - frgtpsswrdlame 10y ago
    They are critical of the Right because they believe the Right isn't "right" enough. >I fail to see how they are "ultra-conservative". Well let's go through it then, from your first link: >Yet we can’t be blind to the realities of modern politics — Washington is dominated by progressive ideology in both parties. Following that link, we get some real beauties. >•Progressives overwhelmingly control both major political parties in the US; >•Progressives control the federal judiciary, along with all federal departments and agencies; >•Major corporations, both global and domestic, are run by progressives. Their boards are progressives. Their corporate branding and messaging is progressive; >•Wall Street is progressive; >Of course progressivism virtually always means left progressivism. While there are right-wing progressives (neoconservatives) with grandiose ideas about government and human nature, most of them came from and will comfortably return to the Left when it suits them. >Let’s be clear about supposed conservatives like George W. Bush, Mitt Romney, Paul Ryan, Mitch McConnell, & company: they're all progressives. Sheldon Adelson, Rupert Murdoch and Fox News are progressive. >Every realistic, potential, or actual threat to liberty in the western world today results directly from progressives policies. This took me all of two clicks. Let's not pretend the Mises institute is something it's not.
TYPE_FASTER 10y ago
"On average, members of these direct primary care clinics pay as little as $60 per month, with couples paying about $150." Sounds great. Does that include cardiac or oncology specialists? What do you do after your primary care clinician sees you, and says "I can't help you, but I know somebody who can"?
- ancap 10y ago
  I'm always amazed at the quality and cheapness of the options provided from some third world countries' private medical care. It's amazing what can be accomplished when patients and doctors cooperate without the meddling of a third party. Sadly such arrangements are not accessible to all.
  - mkaziz 10y ago
    Yeah but you also have situations there like my old man, who got admitted for a heart attack and the hospital refused to operate without ~ his annual income (and we're middle class there) in cash being deposited first.
samysaadi 10y ago
How does this work when a patient needs surgery? They pay out of pocket? Or do they have insurance for that, alongside their primary care fees?
dustinmoorenet 10y ago
Not Everything can be left to the market to figure out. When government colludes with medical corporations to maximize profits we get what we have here. It isn't governments or corporations that are the problem. When you can profit from the sick, morals have to be thrown out the window.
- theabacus 10y ago
  How can we expect people to be moral when the prevailing philosophy is existential, deconstructionist and postmodern which has no absolute ethic and even eschews ethics from its philosophy? What even is morality in such a society?
  - vedranm 10y ago
    Have you read Atlas Shrugged by Ayn Rand? If yes, you might remember this moment of Hank Rearden's enlightenment: "He lay still, alone in the silence of his office. He knew that the meaning of his mills had ceased to exist, and the fullness of the knowledge left no room for the pain of regretting an illusion. He had seen, in a final image, the soul and essence of his enemies: the mindless face of the thug with the club. It was not the face itself that made him draw back in horror, but the professors, the philosophers, the moralists, the mystics who had released that face upon the world." Ayn Rand firmly believed that philosophy shapes human action. I agree with that and frequently quote her on this one: "The present state of the world is not the proof of philosophy’s impotence, but the proof of philosophy’s power. It is philosophy that has brought men to this state – it is only philosophy that can lead them out."
jlewis7272 10y ago
I feel this is a problem the government created so the government could come up with never ending "solutions". The issue needs to be defined better. The point of health insurance is to prevent me from going bankrupt due to a catastrophic illness. Instead of socialized health care we needed insurance reform and for the collusion between health providers and health insurers to end. No other industry allows this sort of collusion to occur. My doctor and my insurance company should not be talking to each other.
- alphabettsy 10y ago
  In the case of some the healthcare provider and insurer are basically the same. CVS Caremark for example.
alphabettsy 10y ago
This article only really addresses primary care, what about major surgery, emergency care, disease management? That's where the majority of the cost is and how can a person be expected to be able to pay for an operation that costs double or triple their yearly income? As soon as you involve some kind of public assistance for those who can't afford care, you invite regulations and we're back to where we started. Sure starting completely over and removing all regulations sounds nice, but big money in health will always make sure they get policies they like unless we're going to also address imbalanced political influence.
maxerickson 10y ago
I made it to the 6th paragraph before finding something pretty misleading: It wasn’t until 1972 that President Richard Nixon restricted the supply of hospitals by requiring institutions to provide a certificate-of-need. Federal certificate of need laws were repealed in the 1980s, after it was decided that they didn't lower costs. It's pretty misleading to mention that they were put in place and then not mention that they were repealed.

14 points by clarkmoody 10y ago

Fair warning, this is a think tank named after https://en.wikipedia.org/wiki/Ludwig_von_Mises https://en.wikipedia.org/wiki/Ludwig_von_Mises who is basically the founder of Austrian economics, which has by and large become a vehicle for ultra-conservative folks to push through anti-worker policies.

bkohlmann 10y ago
It's interesting that you use the term "fair warning," which may dissuade someone from reading the article and coming to their own conclusions. As someone who values hearing the perspectives of all sides, I find it useful to hear pro-market arguments in something like health care. It helps me challenge my assumptions, especially since health care does seem to be increasingly costly and complex...as the amount of government oversight increases every year.
- savanaly 10y ago
  I don't interpret "fair warning" as meaning "this person is a wrongthinker, stay away!" I interpret it as "you may find this article interesting, but be aware that its source is outside the mainstream and maybe even outside the Overton window."
  - bkohlmann 10y ago
    I guess we just have a difference in interpretations of the term. My recent (admittedly amateur) interest in behavioral economics and persuasion leads me to believe that even sophisticated people are susceptible to the effects of framing. If you prime someone to read something with a bias towards skepticism, they will either avoid it due to confirmation bias, or potentially read it differently than they would have without the prime. That may not even be your intent, but in reality it happens. And as for "outside the mainstream" - whose mainstream or Overton window? My "mainstream" actually takes Mises very seriously. It sounds like yours does not. I suppose under a broad definition, a warning could be warranted for nearly every article depending on the audience.
- pdabbadabba 10y ago
  I read that as simply a warning about potential bias. If anything, I find that being on the lookout for potential bias actually helps be come to my own conclusions.
  - bkohlmann 10y ago
    Very possible. But a warning about potential bias may induce an (un?)intended bias of its own!
- frgtpsswrdlame 10y ago
  Hearing the perspectives of all sides is only useful when they're honest. Any article which talks about Nixon's effects on healthcare and laws passed in 1972 and 1974 but skips right over the Health Maintenance Organization Act of 1973 is not being honest.
  - ancap 10y ago
    The article never claimed to provide an exhaustive list of all healthcare related laws and their affects. In exactly what way does omitting that law weaken their argument?
    - frgtpsswrdlame 10y ago
      I don't expect an exhaustive list, but saying that Nixon's laws in 72 and 74 made our current state of healthcare while ignoring the 73 law is a glaring omission. Considering it allowed the rise of for-profit HMOs I would expect a decent article to at least address/dismiss the concern that maybe this law is part of the reason our prices have gone up so much.
ancap 10y ago
The Mises Institute eschews the term "think tank" and does not lobby for any government policy. Its founders purposefully put its headquarters far away from Washington DC because they did not want to be viewed as a lobbying organization or a "think tank". They view their mission as an educational organization, and offer tons of ebooks, audio and video lectures free of cost on their website. Whether you agree or disagree with some of the positions espoused, that's another issue. In summary, rather than going for the ad hominem, debate the actual arguments made in the article.
theabacus 10y ago
To the contrary: They criticize Paul Ryan and current ACA proposals: https://mises.org/blog/ryancare-failing-%E2%80%94-what-should-happen-next https://mises.org/blog/ryancare-failing-%E2%80%94-what-shoul... Criticize Trump for problematic policies: https://mises.org/blog/donald-trumps-whig-showing https://mises.org/blog/donald-trumps-whig-showing Criticize Rockefeller and are generally anti-war: https://mises.org/library/rockefeller-morgan-and-war https://mises.org/library/rockefeller-morgan-and-war Critical of the CIA historically and today: https://mises.org/blog/when-cia-partied-lsd-taxpayers-dime https://mises.org/blog/when-cia-partied-lsd-taxpayers-dime and these are just articles published in the last two weeks. In general, Mises is pro individual liberty, pro-immigration, anti-war, and generally critical of both the Left and the Right. I fail to see how they are "ultra-conservative". Besides. This comment is just an ad-hominem and fails to address that actual argument of the article.
- frgtpsswrdlame 10y ago
  They are critical of the Right because they believe the Right isn't "right" enough. >I fail to see how they are "ultra-conservative". Well let's go through it then, from your first link: >Yet we can’t be blind to the realities of modern politics — Washington is dominated by progressive ideology in both parties. Following that link, we get some real beauties. >•Progressives overwhelmingly control both major political parties in the US; >•Progressives control the federal judiciary, along with all federal departments and agencies; >•Major corporations, both global and domestic, are run by progressives. Their boards are progressives. Their corporate branding and messaging is progressive; >•Wall Street is progressive; >Of course progressivism virtually always means left progressivism. While there are right-wing progressives (neoconservatives) with grandiose ideas about government and human nature, most of them came from and will comfortably return to the Left when it suits them. >Let’s be clear about supposed conservatives like George W. Bush, Mitt Romney, Paul Ryan, Mitch McConnell, & company: they're all progressives. Sheldon Adelson, Rupert Murdoch and Fox News are progressive. >Every realistic, potential, or actual threat to liberty in the western world today results directly from progressives policies. This took me all of two clicks. Let's not pretend the Mises institute is something it's not.

TYPE_FASTER 10y ago

"On average, members of these direct primary care clinics pay as little as $60 per month, with couples paying about $150." Sounds great. Does that include cardiac or oncology specialists? What do you do after your primary care clinician sees you, and says "I can't help you, but I know somebody who can"?

ancap 10y ago
I'm always amazed at the quality and cheapness of the options provided from some third world countries' private medical care. It's amazing what can be accomplished when patients and doctors cooperate without the meddling of a third party. Sadly such arrangements are not accessible to all.
- mkaziz 10y ago
  Yeah but you also have situations there like my old man, who got admitted for a heart attack and the hospital refused to operate without ~ his annual income (and we're middle class there) in cash being deposited first.

samysaadi 10y ago

How does this work when a patient needs surgery? They pay out of pocket? Or do they have insurance for that, alongside their primary care fees?

dustinmoorenet 10y ago

Not Everything can be left to the market to figure out. When government colludes with medical corporations to maximize profits we get what we have here. It isn't governments or corporations that are the problem. When you can profit from the sick, morals have to be thrown out the window.

theabacus 10y ago
How can we expect people to be moral when the prevailing philosophy is existential, deconstructionist and postmodern which has no absolute ethic and even eschews ethics from its philosophy? What even is morality in such a society?
- vedranm 10y ago
  Have you read Atlas Shrugged by Ayn Rand? If yes, you might remember this moment of Hank Rearden's enlightenment: "He lay still, alone in the silence of his office. He knew that the meaning of his mills had ceased to exist, and the fullness of the knowledge left no room for the pain of regretting an illusion. He had seen, in a final image, the soul and essence of his enemies: the mindless face of the thug with the club. It was not the face itself that made him draw back in horror, but the professors, the philosophers, the moralists, the mystics who had released that face upon the world." Ayn Rand firmly believed that philosophy shapes human action. I agree with that and frequently quote her on this one: "The present state of the world is not the proof of philosophy’s impotence, but the proof of philosophy’s power. It is philosophy that has brought men to this state – it is only philosophy that can lead them out."

jlewis7272 10y ago

I feel this is a problem the government created so the government could come up with never ending "solutions". The issue needs to be defined better. The point of health insurance is to prevent me from going bankrupt due to a catastrophic illness. Instead of socialized health care we needed insurance reform and for the collusion between health providers and health insurers to end. No other industry allows this sort of collusion to occur. My doctor and my insurance company should not be talking to each other.

alphabettsy 10y ago
In the case of some the healthcare provider and insurer are basically the same. CVS Caremark for example.

alphabettsy 10y ago

This article only really addresses primary care, what about major surgery, emergency care, disease management? That's where the majority of the cost is and how can a person be expected to be able to pay for an operation that costs double or triple their yearly income? As soon as you involve some kind of public assistance for those who can't afford care, you invite regulations and we're back to where we started. Sure starting completely over and removing all regulations sounds nice, but big money in health will always make sure they get policies they like unless we're going to also address imbalanced political influence.

maxerickson 10y ago

I made it to the 6th paragraph before finding something pretty misleading: It wasn’t until 1972 that President Richard Nixon restricted the supply of hospitals by requiring institutions to provide a certificate-of-need. Federal certificate of need laws were repealed in the 1980s, after it was decided that they didn't lower costs. It's pretty misleading to mention that they were put in place and then not mention that they were repealed.