5 ms·

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or t

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

clarkevans 9y ago
Regarding "violent coersion of the state", by this, I assume you mean.. taxes. At this point in the world's history, we are not individuals who can wander off into the wilderness on our own, to live and die as God might have intended. We are members of a vast, global social fabric. We benefit from it. We pay into it. There's no way to avoid the coersion/evils or really deny the benefits/goods that this society provides. We can only discuss things relatively speaking, on a whole, in balance. I think a productive use of our time is thinking about (and experimenting with) how information technology could better support our emerging social fabric so that we could make the best collective decisions: that is, enable even more personal freedom.
fogzen 9y ago
Law is violent coercion. This isn’t libertarian philosophy class, it’s the real world. In many places in the real world, universal government insurance is already in place. This isn’t some hypothetical.
- Consultant32452 9y ago
  The fact that some people or nations behave in a particular way does not in any way determine whether that behavior is moral.
  - aninhumer 9y ago
    No, but the fact that it results in demonstrably better outcomes in pretty much every case does.
  - ordinaryradical 9y ago
    States in and of themselves aren’t moral under your framework because they can only exist by threat and use of force. But some of us are interested in solutions for the real world instead of the debating the merits of unfeasible utopias. I, too, would enjoy a stateless peaceful utopia of equitable commerce, but that has zero bearing on how we should decide public policy. Foraging for utopias is the same kind of naïveté Marxists trot out again and again and were it ever enacted at scale it would lead to the same kind of human suffering.
    - Consultant32452 9y ago
      Let's bring this back to the topic at hand. We have the entire history of the US up until the 1940s where the government had basically no say in healthcare and there was nothing like the scale of human suffering brought about by Marxists. FWIW I don't support stateless anarchy/utopia, but when we grant someone a monopoly on force, it's rational to keep their power to a bare minimum.
      - RobertoG 9y ago
        Fair enough. What is that minimum? The proposed minimum is always to grant the needed power to cover unlimited property rights, but not universal healthcare.
        Consultant32452 9y ago
        It would be difficult to impossible for me to try to think of every feasible scenario in a HN post, but here's some off the top of my head: national defense, stopping people from physically harming others, enforce voting rights, establish trade agreements with other nations, etc.
deleted 9y ago
[deleted]
throwawayjava 9y ago
The point of this report is that the empirical evidence contradicts your hypothesis. These sorts of broad-strokes, ultra-rationalist arguments should be set aside whenever data is available.
- Consultant32452 9y ago
  Data is available on rapid price inflation that coincides with central planning initiatives in the US. Data also exists showing the systemic risks to nations created by these systems, such as the looming global demographic crisis created by the combination of social welfare systems and the baby boom.
  - moorhosj 9y ago
    We aren't talking about those abstract ideas, we are talking about health care and it's associated access and cost. As such, the data shows us the United States fares worse than similar countries on the measures of access and cost (both to the individual and the state)[1]. The United States also has the most "free market-like" system of comparable countries. How can it be that costs are so high and outcomes are no better if we are closer to a free market than others? [1] https://thumbor.forbes.com/thumbor/960x0/https%3A%2F%2Fblogs-images.forbes.com%2Fdanmunro%2Ffiles%2F2014%2F06%2FTCFchart.jpg https://thumbor.forbes.com/thumbor/960x0/https%3A%2F%2Fblogs...
    - Consultant32452 9y ago
      Causes of price inflation and the looming demographic crisis are not "abstract ideas." For literally decades the US did not open a single medical school due to lobbying from the medical industry. Even though we've tried to reverse the trend since the 90s, there are still fewer medical schools today than there were 100 years ago. When the government decides how many doctors there will be, it may get the number right or it may get the number wrong. But that's nothing akin to "free market-like." And it's a major part of the explanation why US doctors make 2x+ what their counterparts in countries like Germany make. During the New Deal era regulations wage caps were put on workers in the hopes of staving off inflation. Employers, wanting to entice good employees to work for them sought to get around these wage caps by offering health insurance. This then spread like wildfire, coincides with the time healthcare inflation separated from general inflation, and began the trend towards a lack of price transparency. Most of the differences in outcomes between us and other wealthy nations amount to lifestyle/culture much more-so than affordability and availability. Americans are very obese. Not having to pay a copay to visit the doctor is not going to change that. But obesity means we'll have more problems with newborns, lower life expectancy, etc.
Pica_soO 9y ago
https://www.health-tourism.com/medical-tourism/usa-research/ https://www.health-tourism.com/medical-tourism/usa-research/ The ultimate market victory - completely avoiding the destroyed free market healthcare system and travel abroad to parasite on universal healthcare.
frgtpsswrdlame 9y ago
I don't see how you can define the state taking money from the wealthy to buy healthcare for the poor as violently coercive but not also define a corporation withholding necessary care from a poor person as violently coercive.
- Consultant32452 9y ago
  Doing nothing is not violent or coercive. It may be morally wrong for a person to do nothing, but it's not violent or coercive.
  - frgtpsswrdlame 9y ago
    I disagree with the asymmetry. Withholding care isn't actually 'doing nothing' and has the ability to be violent or coercive. Take a life-saving but expensive pill. 'Doing nothing' in the case of someone who needs but can't afford the pill would be actually doing nothing - that person could waltz in, walk behind the counter, take the pill, swallow and walk out. Bada-bing bada boom, problem solved no violence or coercion. Healthcare providers don't actually do that though, someone who tried to walk in and take the pill would be met with violence in order to prevent them from accessing the pill until they had paid. That violence is coercive. ---------------- Since the mods are rate-limiting me, here's my reply to your post below: >Otherwise every person in every situation who demands to be paid for their work, including doctors who demand to be paid by the state in a universal healthcare system are all being coercive. I agree that this is coercion. >When taken to that level, the word coerce ceases to have a useful meaning. Well no, when taken to that level coerce retains it's meaning perfectly, it just happens to illustrate that the market system has coercion baked into almost every aspect. Here, this guy says it better than I can: But there is no neutral construction of “coercion” that would ever support such a distinction. As Hale aptly demonstrates, coercion occurs when there are “background constraints on the universe of socially available choices from which an individual might ‘freely’ choose.” In a world of scarcity, all economic rules–including rules that create private property ownership, contract laws, and so on–impose background constraints on the universe of choices individuals can make (e.g. the choice to move into a building and sleep in it without paying anyone anything). When we talk about the economy, we are not arguing about whether we want coercion. We are arguing about what coercion we’d like. http://www.demos.org/blog/10/28/13/libertarians-are-huge-fans-economic-coercion http://www.demos.org/blog/10/28/13/libertarians-are-huge-fan...
ska 9y ago
The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that... Talking about free market efficiencies is a bit like talking about the effect of Newtonian forces on a spherical cow. Very useful to learn from in an undergrad setting but rarely sufficient to capture real world systems. What you actually want from policy is something like a trajectory toward the best expected result in existing markets over reasonable times. This is much more practical than a provably optimal result in an oversimplified model. Models can be very useful, but the map is not the territory.
- Consultant32452 9y ago
  >What you actually want from policy is something like a trajectory toward the best expected result in existing markets over reasonable times. What I don't want from policy is you* deciding for me what results should be aimed for and then forcing me to maximize your personal pet project. If you have good arguments that something should be funded, you don't need to force me to do it. *: The you here is proverbial. Feel free to insert Donald Trump as an example of the type of person who would have a say in my healthcare options.
  - ska 9y ago
    I suspect this comment is largely mistargeted, policy is in no way equivalent to force, though some policies may engage it. Unless you are arguing for a fairly pure form of anarchism (good luck with that, if so) you have policy work and the desire to improve it. It is a reasonable expectation that doing so empirically will vastly outperform doing so ideologically in any scenario like healthcare reform.
deleted 9y ago
[deleted]
Frondo 9y ago
Taxation is not violent coercion by the state and it is disingenuous to describe the former as the latter.
- aninhumer 9y ago
  I would argue it is coercive, but so is the property system underpinning the market in the first place. Adding a redistribution element to a system of private property doesn't introduce violent coercion, it merely changes how it is being used to allocate resources.
  - ebalit 9y ago
    As Adam Smith wrote: "Civil government, in so far as it is instituted for the security of property, is in reality instituted for the defense of the rich against the poor, or of those who have some property against those who have none at all."
    - Consultant32452 9y ago
      That quote doesn't mean what you think it means. Taken in context, that quote is talking about the origins of civil government and how it is often corrupted as stated in that quote. It is used as an argument for why there must be a separation of powers to ensure fair judgement and protect the property rights of both the poor and the wealthy.
kitd 9y ago
I assume you are also pushing for multiple roads between 2 towns, all competing on toll price.
- conanbatt 9y ago
  The competition is before the road is built..

clarkevans 9y ago

Regarding "violent coersion of the state", by this, I assume you mean.. taxes. At this point in the world's history, we are not individuals who can wander off into the wilderness on our own, to live and die as God might have intended. We are members of a vast, global social fabric. We benefit from it. We pay into it. There's no way to avoid the coersion/evils or really deny the benefits/goods that this society provides. We can only discuss things relatively speaking, on a whole, in balance. I think a productive use of our time is thinking about (and experimenting with) how information technology could better support our emerging social fabric so that we could make the best collective decisions: that is, enable even more personal freedom.

fogzen 9y ago

Law is violent coercion. This isn’t libertarian philosophy class, it’s the real world. In many places in the real world, universal government insurance is already in place. This isn’t some hypothetical.

Consultant32452 9y ago
The fact that some people or nations behave in a particular way does not in any way determine whether that behavior is moral.
- aninhumer 9y ago
  No, but the fact that it results in demonstrably better outcomes in pretty much every case does.
- ordinaryradical 9y ago
  States in and of themselves aren’t moral under your framework because they can only exist by threat and use of force. But some of us are interested in solutions for the real world instead of the debating the merits of unfeasible utopias. I, too, would enjoy a stateless peaceful utopia of equitable commerce, but that has zero bearing on how we should decide public policy. Foraging for utopias is the same kind of naïveté Marxists trot out again and again and were it ever enacted at scale it would lead to the same kind of human suffering.
  - Consultant32452 9y ago
    Let's bring this back to the topic at hand. We have the entire history of the US up until the 1940s where the government had basically no say in healthcare and there was nothing like the scale of human suffering brought about by Marxists. FWIW I don't support stateless anarchy/utopia, but when we grant someone a monopoly on force, it's rational to keep their power to a bare minimum.
    - RobertoG 9y ago
      Fair enough. What is that minimum? The proposed minimum is always to grant the needed power to cover unlimited property rights, but not universal healthcare.
      - Consultant32452 9y ago
        It would be difficult to impossible for me to try to think of every feasible scenario in a HN post, but here's some off the top of my head: national defense, stopping people from physically harming others, enforce voting rights, establish trade agreements with other nations, etc.

deleted 9y ago

[deleted]

throwawayjava 9y ago

The point of this report is that the empirical evidence contradicts your hypothesis. These sorts of broad-strokes, ultra-rationalist arguments should be set aside whenever data is available.

Consultant32452 9y ago
Data is available on rapid price inflation that coincides with central planning initiatives in the US. Data also exists showing the systemic risks to nations created by these systems, such as the looming global demographic crisis created by the combination of social welfare systems and the baby boom.
- moorhosj 9y ago
  We aren't talking about those abstract ideas, we are talking about health care and it's associated access and cost. As such, the data shows us the United States fares worse than similar countries on the measures of access and cost (both to the individual and the state)[1]. The United States also has the most "free market-like" system of comparable countries. How can it be that costs are so high and outcomes are no better if we are closer to a free market than others? [1] https://thumbor.forbes.com/thumbor/960x0/https%3A%2F%2Fblogs-images.forbes.com%2Fdanmunro%2Ffiles%2F2014%2F06%2FTCFchart.jpg https://thumbor.forbes.com/thumbor/960x0/https%3A%2F%2Fblogs...
  - Consultant32452 9y ago
    Causes of price inflation and the looming demographic crisis are not "abstract ideas." For literally decades the US did not open a single medical school due to lobbying from the medical industry. Even though we've tried to reverse the trend since the 90s, there are still fewer medical schools today than there were 100 years ago. When the government decides how many doctors there will be, it may get the number right or it may get the number wrong. But that's nothing akin to "free market-like." And it's a major part of the explanation why US doctors make 2x+ what their counterparts in countries like Germany make. During the New Deal era regulations wage caps were put on workers in the hopes of staving off inflation. Employers, wanting to entice good employees to work for them sought to get around these wage caps by offering health insurance. This then spread like wildfire, coincides with the time healthcare inflation separated from general inflation, and began the trend towards a lack of price transparency. Most of the differences in outcomes between us and other wealthy nations amount to lifestyle/culture much more-so than affordability and availability. Americans are very obese. Not having to pay a copay to visit the doctor is not going to change that. But obesity means we'll have more problems with newborns, lower life expectancy, etc.

Pica_soO 9y ago

https://www.health-tourism.com/medical-tourism/usa-research/ https://www.health-tourism.com/medical-tourism/usa-research/ The ultimate market victory - completely avoiding the destroyed free market healthcare system and travel abroad to parasite on universal healthcare.

frgtpsswrdlame 9y ago

I don't see how you can define the state taking money from the wealthy to buy healthcare for the poor as violently coercive but not also define a corporation withholding necessary care from a poor person as violently coercive.

Consultant32452 9y ago
Doing nothing is not violent or coercive. It may be morally wrong for a person to do nothing, but it's not violent or coercive.
- frgtpsswrdlame 9y ago
  I disagree with the asymmetry. Withholding care isn't actually 'doing nothing' and has the ability to be violent or coercive. Take a life-saving but expensive pill. 'Doing nothing' in the case of someone who needs but can't afford the pill would be actually doing nothing - that person could waltz in, walk behind the counter, take the pill, swallow and walk out. Bada-bing bada boom, problem solved no violence or coercion. Healthcare providers don't actually do that though, someone who tried to walk in and take the pill would be met with violence in order to prevent them from accessing the pill until they had paid. That violence is coercive. ---------------- Since the mods are rate-limiting me, here's my reply to your post below: >Otherwise every person in every situation who demands to be paid for their work, including doctors who demand to be paid by the state in a universal healthcare system are all being coercive. I agree that this is coercion. >When taken to that level, the word coerce ceases to have a useful meaning. Well no, when taken to that level coerce retains it's meaning perfectly, it just happens to illustrate that the market system has coercion baked into almost every aspect. Here, this guy says it better than I can: But there is no neutral construction of “coercion” that would ever support such a distinction. As Hale aptly demonstrates, coercion occurs when there are “background constraints on the universe of socially available choices from which an individual might ‘freely’ choose.” In a world of scarcity, all economic rules–including rules that create private property ownership, contract laws, and so on–impose background constraints on the universe of choices individuals can make (e.g. the choice to move into a building and sleep in it without paying anyone anything). When we talk about the economy, we are not arguing about whether we want coercion. We are arguing about what coercion we’d like. http://www.demos.org/blog/10/28/13/libertarians-are-huge-fans-economic-coercion http://www.demos.org/blog/10/28/13/libertarians-are-huge-fan...

ska 9y ago

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that... Talking about free market efficiencies is a bit like talking about the effect of Newtonian forces on a spherical cow. Very useful to learn from in an undergrad setting but rarely sufficient to capture real world systems. What you actually want from policy is something like a trajectory toward the best expected result in existing markets over reasonable times. This is much more practical than a provably optimal result in an oversimplified model. Models can be very useful, but the map is not the territory.

Consultant32452 9y ago
>What you actually want from policy is something like a trajectory toward the best expected result in existing markets over reasonable times. What I don't want from policy is you* deciding for me what results should be aimed for and then forcing me to maximize your personal pet project. If you have good arguments that something should be funded, you don't need to force me to do it. *: The you here is proverbial. Feel free to insert Donald Trump as an example of the type of person who would have a say in my healthcare options.
- ska 9y ago
  I suspect this comment is largely mistargeted, policy is in no way equivalent to force, though some policies may engage it. Unless you are arguing for a fairly pure form of anarchism (good luck with that, if so) you have policy work and the desire to improve it. It is a reasonable expectation that doing so empirically will vastly outperform doing so ideologically in any scenario like healthcare reform.

deleted 9y ago

[deleted]

Frondo 9y ago

Taxation is not violent coercion by the state and it is disingenuous to describe the former as the latter.

aninhumer 9y ago
I would argue it is coercive, but so is the property system underpinning the market in the first place. Adding a redistribution element to a system of private property doesn't introduce violent coercion, it merely changes how it is being used to allocate resources.
- ebalit 9y ago
  As Adam Smith wrote: "Civil government, in so far as it is instituted for the security of property, is in reality instituted for the defense of the rich against the poor, or of those who have some property against those who have none at all."
  - Consultant32452 9y ago
    That quote doesn't mean what you think it means. Taken in context, that quote is talking about the origins of civil government and how it is often corrupted as stated in that quote. It is used as an argument for why there must be a separation of powers to ensure fair judgement and protect the property rights of both the poor and the wealthy.

kitd 9y ago

I assume you are also pushing for multiple roads between 2 towns, all competing on toll price.

conanbatt 9y ago
The competition is before the road is built..