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Among the things that people can't afford and really need, the most common ones are healthcare and housing. The problem with giving people more money to stimul

Among the things that people can't afford and really need, the most common ones are healthcare and housing. The problem with giving people more money to stimulate demand for those things is that it only solves half of the problem. Healthcare is limited by the supply of doctors so no matter how much government subsidizes it, the amount of people who can be seen by the constant number of doctors will be the same. In practice, this means the price will increase every time you try to give people more money for healthcare. Housing is similar in that even if you give people money for new houses, everyone wants their house to be in a nice location and there are only so many houses that can fit in a constant amount of desirable real estate. Without reforms to medical school and medical residency programs, healthcare might never be affordable. Without reforms to zoning laws, housing might never be affordable. Without at least allowing for an increase to the supply of nice things, increasing the demand of nice things won't be very helpful.

Nokinside 9y ago
US spends significantly more money per capita to healthcare than other countries. US healthcare problem has nothing to do with lack of resources (human or financial resources). US could save money in healthcare while improving it by reorganizing the healthcare. Even wealthy people get worse treatment than they could because the way incentives work. https://www.reddit.com/r/medicine/comments/6addvo/the_wealthy_patient_dilemma/ https://www.reddit.com/r/medicine/comments/6addvo/the_wealth...
- WhoIsSatoshi 9y ago
  healthcare sucks a lot more out of the customer in the US than elsewhere in the world, so the fact that the US spends more is combined with healthcare patients spending more money per capita in the US. Having experienced both, I can tell you that I am terrified of having a motorcycle accident in the US. Or breaking a leg.
  - Nokinside 9y ago
    There is this weirdly strict moral aspect of what someone 'deserves' in the realms of public policy. In private finances, deserving is not an issue at all. If pure cold economic calculation would be applied to public policy, it would become clear that healthcare is not just personal issue, good healthcare provides positive externalizes for all. Your neighbors good teeth are not completely unlike investing in a bridge or other public infrastructure. If someone stays healthy and can work full time 5 years more because he had free healthcare, he pays 5 years more taxes, generates more profits fro employer, and consumes less medical services during his lifetime.
    - saint_fiasco 9y ago
      To be completely fair, we don't actually know that health care pays for itself. The RAND Health Insurance experiment and the Oregon Medicaid experiment found little improvement in health outcomes and a significant increase in medical spending when insurance was expanded. Those studies are hard to make because it's hard to measure medical outcomes. For example, for the Oregon experiment they couldn't look into differences in death rates because death rates were too low even among uninsured people. They had to look at cholesterol, blood sugar and other proxies for health outcomes, instead of the outcomes themselves. This suggests that at some point further spending in health has diminishing returns and we don't actually know if we reached that point yet. https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experiment https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experim... https://en.wikipedia.org/wiki/RAND_Health_Insurance_Experiment https://en.wikipedia.org/wiki/RAND_Health_Insurance_Experime...
- saint_fiasco 9y ago
  This is the sort of thing that happens when there are not enough doctors to go around so rich people use their fortune to hog up a disproportionate amount of qualified medical personnel and resources. With the resources that are used to keep VIP hospitals running, they could probably have dozens of regular hospitals. It's similar to what happens when there aren't enough houses in an affordable nice place so rich people use their fortunes to outbid everyone else and the nice affordable place becomes expensive and gentrified. With the money and labor spent on huge mansions (or hyper-luxurious tiny houses, because land is inelastic), they could have built hundreds of regular houses or apartments.
bubbleRefuge 9y ago
Gr8 points. The healthcare problem is a disconnect in the laws of supply and demand. In economic theory prices are determined by the intersection of supply and demand curves. So when demand shifts up, more supply comes online to meet demand and bring prices back down. In health care this is not happening. Bear in mind that the first and one of the most powerfull lobbying organizations is the AMA.
Chathamization 9y ago
> Without reforms to medical school and medical residency programs, healthcare might never be affordable. That's important, true. But that's not the only thing that would increase the amount of healthcare available to people. Dean Baker, for example, makes the important point that we could greatly increase the supply of doctors simply by allowing qualified foreign doctors to be certified in the U.S.[1] Lower class workers in industries like manufacturing have had to compete with foreign workers because of free trade, but upper class workers benefit from extreme protectionism that shuts out foreign competition. Protectionism is also why drug prices are so high; if people were allowed to import drugs from places like Canada, the cost would be substantially cheaper. [1] http://cepr.net/blogs/beat-the-press/more-of-free-trade-in-doctors-response-to-simon-lester http://cepr.net/blogs/beat-the-press/more-of-free-trade-in-d...
- rainbowmverse 9y ago
  Doctors saw what happened when every factory worker in the US was forced to compete with every factory worker in North America after NAFTA, and later the world. Unlike factory workers, no one's spent decades dismantling doctor unions and organizations, and they actually have the money and influence to resist attempts to break protectionist barriers. This just isn't going to happen. Rapid, careless globalization was an interesting experiment, but it's left a lot of people with no hope for the future. Do we really want to repeat it?
  - saint_fiasco 9y ago
    It worked, didn't it? The price of most manufactured things went way down while the price of healthcare keeps going up. Besides, doctors are service workers. It's not like their jobs will be outsourced or people will start traveling to India to visit a cheaper doctor.
kps 9y ago
The problem isn't money for doctors, it's money for administrators (including insurance). Same as education. In any field x, you have people who specialize in x and people who specialize in extracting money. It's no surprise where the money ends up. (This is independent of particular mechanisms for extracting money that vary across economic and political systems.)
- saint_fiasco 9y ago
  If more money is put into the healthcare system but the amount of new doctors per year does not increase, of course the money is going to go to administration. It has nowhere else to go. That's also why the US spends so much on drugs. Doctors are overworked, so they are forced to depend on prescribing more drugs, the most time-efficient tools for them.
  - kps 9y ago
    Doctors are overwhelmed with paperwork, often with institutionally-mandated EHR systems that are slower and worse than traditional paper notes for medical purposes. They are spending more time on administrative tasks that could otherwise be spent on actual patients, just like professors are spending more time on grant acquisition that could otherwise be spent on teaching and research.
speby 9y ago
> The problem with giving people more money to stimulate demand for those things is that it only solves half of the problem. Healthcare is limited by the supply of doctors so no matter how much government subsidizes it, the amount of people who can be seen by the constant number of doctors will be the same. In practice, this means the price will increase every time you try to give people more money for healthcare. That's true but that's not true. While the # of doctors is constant right now, it is always changing as new doctors are trained and licensed (and also older doctors retiring). Just like computer science, as the demand increases and supply does not grow to catch up, wages will increase, but that doesn't mean there isn't at least some stimulus in the number of new people who decide to get into the profession. While there won't be a glut of new doctors in 48 hours, obviously, but rather over years, it will (hopefully) eventually catch up. Just consider the US population growing at around 0.7% yearly (https://www.nytimes.com/2016/12/22/us/usa-population-growth.html?mcubz=3 https://www.nytimes.com/2016/12/22/us/usa-population-growth....). And if there are about 390 patients, on average, per practicing doctor in the US (http://bigthink.com/strange-maps/185-the-patients-per-doctor-map-of-the-world http://bigthink.com/strange-maps/185-the-patients-per-doctor...), then given that population of the US increases around 2.2 million per year, that means we should be getting around ~5600 new doctors into the field every year. If you believe the stats, we will likely be facing quite a shortage over the next 7-10 years: https://www.washingtonpost.com/news/to-your-health/wp/2015/03/03/u-s-faces-90000-doctor-shortage-by-2025-medical-school-association-warns/ https://www.washingtonpost.com/news/to-your-health/wp/2015/0...
- saint_fiasco 9y ago
  It's not just like computer science because those are cheaper to train, their work can be outsourced if their wage rises too much and immigration is not as restricted as it is for doctors. Computer scientists also don't have to do residencies. More should be done to speed up the supply of new doctors.

Nokinside 9y ago

US spends significantly more money per capita to healthcare than other countries. US healthcare problem has nothing to do with lack of resources (human or financial resources). US could save money in healthcare while improving it by reorganizing the healthcare. Even wealthy people get worse treatment than they could because the way incentives work. https://www.reddit.com/r/medicine/comments/6addvo/the_wealthy_patient_dilemma/ https://www.reddit.com/r/medicine/comments/6addvo/the_wealth...

WhoIsSatoshi 9y ago
healthcare sucks a lot more out of the customer in the US than elsewhere in the world, so the fact that the US spends more is combined with healthcare patients spending more money per capita in the US. Having experienced both, I can tell you that I am terrified of having a motorcycle accident in the US. Or breaking a leg.
- Nokinside 9y ago
  There is this weirdly strict moral aspect of what someone 'deserves' in the realms of public policy. In private finances, deserving is not an issue at all. If pure cold economic calculation would be applied to public policy, it would become clear that healthcare is not just personal issue, good healthcare provides positive externalizes for all. Your neighbors good teeth are not completely unlike investing in a bridge or other public infrastructure. If someone stays healthy and can work full time 5 years more because he had free healthcare, he pays 5 years more taxes, generates more profits fro employer, and consumes less medical services during his lifetime.
  - saint_fiasco 9y ago
    To be completely fair, we don't actually know that health care pays for itself. The RAND Health Insurance experiment and the Oregon Medicaid experiment found little improvement in health outcomes and a significant increase in medical spending when insurance was expanded. Those studies are hard to make because it's hard to measure medical outcomes. For example, for the Oregon experiment they couldn't look into differences in death rates because death rates were too low even among uninsured people. They had to look at cholesterol, blood sugar and other proxies for health outcomes, instead of the outcomes themselves. This suggests that at some point further spending in health has diminishing returns and we don't actually know if we reached that point yet. https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experiment https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experim... https://en.wikipedia.org/wiki/RAND_Health_Insurance_Experiment https://en.wikipedia.org/wiki/RAND_Health_Insurance_Experime...
saint_fiasco 9y ago
This is the sort of thing that happens when there are not enough doctors to go around so rich people use their fortune to hog up a disproportionate amount of qualified medical personnel and resources. With the resources that are used to keep VIP hospitals running, they could probably have dozens of regular hospitals. It's similar to what happens when there aren't enough houses in an affordable nice place so rich people use their fortunes to outbid everyone else and the nice affordable place becomes expensive and gentrified. With the money and labor spent on huge mansions (or hyper-luxurious tiny houses, because land is inelastic), they could have built hundreds of regular houses or apartments.

bubbleRefuge 9y ago

Gr8 points. The healthcare problem is a disconnect in the laws of supply and demand. In economic theory prices are determined by the intersection of supply and demand curves. So when demand shifts up, more supply comes online to meet demand and bring prices back down. In health care this is not happening. Bear in mind that the first and one of the most powerfull lobbying organizations is the AMA.

Chathamization 9y ago

> Without reforms to medical school and medical residency programs, healthcare might never be affordable. That's important, true. But that's not the only thing that would increase the amount of healthcare available to people. Dean Baker, for example, makes the important point that we could greatly increase the supply of doctors simply by allowing qualified foreign doctors to be certified in the U.S.[1] Lower class workers in industries like manufacturing have had to compete with foreign workers because of free trade, but upper class workers benefit from extreme protectionism that shuts out foreign competition. Protectionism is also why drug prices are so high; if people were allowed to import drugs from places like Canada, the cost would be substantially cheaper. [1] http://cepr.net/blogs/beat-the-press/more-of-free-trade-in-doctors-response-to-simon-lester http://cepr.net/blogs/beat-the-press/more-of-free-trade-in-d...

rainbowmverse 9y ago
Doctors saw what happened when every factory worker in the US was forced to compete with every factory worker in North America after NAFTA, and later the world. Unlike factory workers, no one's spent decades dismantling doctor unions and organizations, and they actually have the money and influence to resist attempts to break protectionist barriers. This just isn't going to happen. Rapid, careless globalization was an interesting experiment, but it's left a lot of people with no hope for the future. Do we really want to repeat it?
- saint_fiasco 9y ago
  It worked, didn't it? The price of most manufactured things went way down while the price of healthcare keeps going up. Besides, doctors are service workers. It's not like their jobs will be outsourced or people will start traveling to India to visit a cheaper doctor.

kps 9y ago

The problem isn't money for doctors, it's money for administrators (including insurance). Same as education. In any field x, you have people who specialize in x and people who specialize in extracting money. It's no surprise where the money ends up. (This is independent of particular mechanisms for extracting money that vary across economic and political systems.)

saint_fiasco 9y ago
If more money is put into the healthcare system but the amount of new doctors per year does not increase, of course the money is going to go to administration. It has nowhere else to go. That's also why the US spends so much on drugs. Doctors are overworked, so they are forced to depend on prescribing more drugs, the most time-efficient tools for them.
- kps 9y ago
  Doctors are overwhelmed with paperwork, often with institutionally-mandated EHR systems that are slower and worse than traditional paper notes for medical purposes. They are spending more time on administrative tasks that could otherwise be spent on actual patients, just like professors are spending more time on grant acquisition that could otherwise be spent on teaching and research.

speby 9y ago

> The problem with giving people more money to stimulate demand for those things is that it only solves half of the problem. Healthcare is limited by the supply of doctors so no matter how much government subsidizes it, the amount of people who can be seen by the constant number of doctors will be the same. In practice, this means the price will increase every time you try to give people more money for healthcare. That's true but that's not true. While the # of doctors is constant right now, it is always changing as new doctors are trained and licensed (and also older doctors retiring). Just like computer science, as the demand increases and supply does not grow to catch up, wages will increase, but that doesn't mean there isn't at least some stimulus in the number of new people who decide to get into the profession. While there won't be a glut of new doctors in 48 hours, obviously, but rather over years, it will (hopefully) eventually catch up. Just consider the US population growing at around 0.7% yearly (https://www.nytimes.com/2016/12/22/us/usa-population-growth.html?mcubz=3 https://www.nytimes.com/2016/12/22/us/usa-population-growth....). And if there are about 390 patients, on average, per practicing doctor in the US (http://bigthink.com/strange-maps/185-the-patients-per-doctor-map-of-the-world http://bigthink.com/strange-maps/185-the-patients-per-doctor...), then given that population of the US increases around 2.2 million per year, that means we should be getting around ~5600 new doctors into the field every year. If you believe the stats, we will likely be facing quite a shortage over the next 7-10 years: https://www.washingtonpost.com/news/to-your-health/wp/2015/03/03/u-s-faces-90000-doctor-shortage-by-2025-medical-school-association-warns/ https://www.washingtonpost.com/news/to-your-health/wp/2015/0...

saint_fiasco 9y ago
It's not just like computer science because those are cheaper to train, their work can be outsourced if their wage rises too much and immigration is not as restricted as it is for doctors. Computer scientists also don't have to do residencies. More should be done to speed up the supply of new doctors.