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David A. Hyman is an adjunct scholar at the Cato Institute Yes, if you are paid to argue against price caps you argue against price caps.

seibelj 8y ago
Yes, it’s from Cato, but really it’s a whirlwind tour of what’s wrong with the system from a group that has no dog in the fight. But the democrats and republicans are very, very invested. If you are skeptical, read the book, and then make your decision. It has thousands of citations, it is more academic than opinion.
- HarryHirsch 8y ago
  It's the Cato Institute, it's supported by the Koch Foundation, and the Koch Brothers are supporters of economic and individual liberty. Whoever is supported by someone's money is not going to argue against their dearly held viewpoints. An interesting question that a scientist would ask: how does that book argue against price caps and monopsony buyers, considering that that approach works extremely well in the civilized world. Health expenditures in all other OECD countries are about 1/4 of what they are in the US.
  - seibelj 8y ago
    One model suggested is we let people take the money they put into health insurance and instead put it into a health savings account. Given that family plus employer pays about $20k per year for a family of 4, the value adds up quite quickly. Then you let the family take as income any amount they don’t spend. This encourages frugality and price shopping for routine procedures. Additionally, the government should backstop everything with catastrophic insurance as is done in Switzerland, so if cancer hits you don’t go destitute. Also, we should drastically expand retail medical care, with advertised prices, as it has routinely been shown to reduce costs through competition and price shopping (LASIK, Botox, vasectomies, etc. all prove this out). They go in great detail about pharmaceuticals and the suggestion that a prize based system would be better than the current system of the government paying for all the research and then letting a private company gouge the consumers who paid for it with tax dollars. The book is very detailed, if you are interested in this subject I highly recommend it. Keep an open mind, clearly neither the American left or right has solved this issue and this book is very refreshing.
    - HarryHirsch 8y ago
      When it comes to health insurance you want to spread the risk over a group of people. Health savings accounts are very nice, except when you have a chronic illness and need continuous medication and frequent physician visits. Price shopping doesn't work - when you need medical care you need it, and it's the big-ticket items that drive the cost. When you take the kids to the doctor because they have a fever, that kind of visit is a few hundred dollars at most.
      - seibelj 8y ago
        I think you should just read the book. It has a solution for chronic illnesses. Essentially, you have a relatively small group of people with huge one-off bills or longterm chronic illnesses, and the government can help those people. But the problem with American healthcare isn’t those situations - it’s when a hospital charges $500 for a couple Tylenol, because they can. There is no need to moral grandstand. The situation is so beyond messed up and corrupted that we really need to change the entire system from top to bottom.
      - adventured 8y ago
        > Health savings accounts are very nice, except when you have a chronic illness and need continuous medication and frequent physician visits That's covered by the parent's catastrophic scenario, which would be backstopped by the Federal Government. If you have a diagnosed chronic illness, you are no longer operating under any semblance of normal health terms, it's catastrophic. The US could easily segment itself into these two systems (Federal catastrophic program, eliminating most bankruptcies; and a market system, for routine and trivial healthcare items), and it would be a drastic improvement over how the healthcare system works today. Medicaid is 22% of all health coverage today, expand that to 25-30%. Medicare is 15% of the population, expand that to 20%. Use that 50% leverage to aggressively deflate pricing in healthcare (which is a stick the government largely refuses to use). Create a Federal catastrophic program for the other 50% of people. Now to implement this obvious, dramatic improvement, all you have to do is change everything about US politics and remove nearly every politician.
    - mgkimsal 8y ago
ekianjo 8y ago
So you discard a book before reading it, relying on etiquettes? How tribal.
- HarryHirsch 8y ago
  Would you trust a study on the effects of smoking commissioned by the tobacco industry? Competing interests cause bias, that's why you throw out papers on the health effects of wine when they are sponsored by alcohol producers.
  - seibelj 8y ago
    Cato is not a health insurer. They are not advocating a product that they themselves sell, like the tobacco and alcohol industries. They have a libertarian viewpoint but overall they just recommend a pro-market viewpoint. In the situation of American healthcare we should be willing to listen to a variety of viewpoints considering the situation is the worst in the entire developed world by a large margin.
  - vonmoltke 8y ago
    Would I trust it? No. However, I'm also not going to dismiss it out of hand just because of where it comes from or who is funding it. That is anti-intellectual tribalism. All researchers have bias, some much more severe than others. The existence of bias does not invalidate their research. Rather, the manifestation of it does, and that is determined by critically analyzing it and exposing where it has warped the research.
    - HarryHirsch 8y ago
      When Big Tobacco funded its studies they were never interested in the long-term consequences of smoking for health, their goal was to continue in business as always, and the public health folks were bad for business. It was never an honest engagement, the pro-tobacco side engaged in obfuscation. This is now a well-known, documented historical fact: https://www.industrydocumentslibrary.ucsf.edu/tobacco/ https://www.industrydocumentslibrary.ucsf.edu/tobacco/ In the realm of politics it's foolish not to take someone's motivation into account and assume they are interested in an honest debate. Pointing this out isn't "anti-intellectual tribalism".

seibelj 8y ago

Yes, it’s from Cato, but really it’s a whirlwind tour of what’s wrong with the system from a group that has no dog in the fight. But the democrats and republicans are very, very invested. If you are skeptical, read the book, and then make your decision. It has thousands of citations, it is more academic than opinion.

HarryHirsch 8y ago
It's the Cato Institute, it's supported by the Koch Foundation, and the Koch Brothers are supporters of economic and individual liberty. Whoever is supported by someone's money is not going to argue against their dearly held viewpoints. An interesting question that a scientist would ask: how does that book argue against price caps and monopsony buyers, considering that that approach works extremely well in the civilized world. Health expenditures in all other OECD countries are about 1/4 of what they are in the US.
- seibelj 8y ago
  One model suggested is we let people take the money they put into health insurance and instead put it into a health savings account. Given that family plus employer pays about $20k per year for a family of 4, the value adds up quite quickly. Then you let the family take as income any amount they don’t spend. This encourages frugality and price shopping for routine procedures. Additionally, the government should backstop everything with catastrophic insurance as is done in Switzerland, so if cancer hits you don’t go destitute. Also, we should drastically expand retail medical care, with advertised prices, as it has routinely been shown to reduce costs through competition and price shopping (LASIK, Botox, vasectomies, etc. all prove this out). They go in great detail about pharmaceuticals and the suggestion that a prize based system would be better than the current system of the government paying for all the research and then letting a private company gouge the consumers who paid for it with tax dollars. The book is very detailed, if you are interested in this subject I highly recommend it. Keep an open mind, clearly neither the American left or right has solved this issue and this book is very refreshing.
  - HarryHirsch 8y ago
    When it comes to health insurance you want to spread the risk over a group of people. Health savings accounts are very nice, except when you have a chronic illness and need continuous medication and frequent physician visits. Price shopping doesn't work - when you need medical care you need it, and it's the big-ticket items that drive the cost. When you take the kids to the doctor because they have a fever, that kind of visit is a few hundred dollars at most.
    - seibelj 8y ago
      I think you should just read the book. It has a solution for chronic illnesses. Essentially, you have a relatively small group of people with huge one-off bills or longterm chronic illnesses, and the government can help those people. But the problem with American healthcare isn’t those situations - it’s when a hospital charges $500 for a couple Tylenol, because they can. There is no need to moral grandstand. The situation is so beyond messed up and corrupted that we really need to change the entire system from top to bottom.
    - adventured 8y ago
      > Health savings accounts are very nice, except when you have a chronic illness and need continuous medication and frequent physician visits That's covered by the parent's catastrophic scenario, which would be backstopped by the Federal Government. If you have a diagnosed chronic illness, you are no longer operating under any semblance of normal health terms, it's catastrophic. The US could easily segment itself into these two systems (Federal catastrophic program, eliminating most bankruptcies; and a market system, for routine and trivial healthcare items), and it would be a drastic improvement over how the healthcare system works today. Medicaid is 22% of all health coverage today, expand that to 25-30%. Medicare is 15% of the population, expand that to 20%. Use that 50% leverage to aggressively deflate pricing in healthcare (which is a stick the government largely refuses to use). Create a Federal catastrophic program for the other 50% of people. Now to implement this obvious, dramatic improvement, all you have to do is change everything about US politics and remove nearly every politician.
  - mgkimsal 8y ago

ekianjo 8y ago

So you discard a book before reading it, relying on etiquettes? How tribal.

HarryHirsch 8y ago
Would you trust a study on the effects of smoking commissioned by the tobacco industry? Competing interests cause bias, that's why you throw out papers on the health effects of wine when they are sponsored by alcohol producers.
- seibelj 8y ago
  Cato is not a health insurer. They are not advocating a product that they themselves sell, like the tobacco and alcohol industries. They have a libertarian viewpoint but overall they just recommend a pro-market viewpoint. In the situation of American healthcare we should be willing to listen to a variety of viewpoints considering the situation is the worst in the entire developed world by a large margin.
- vonmoltke 8y ago
  Would I trust it? No. However, I'm also not going to dismiss it out of hand just because of where it comes from or who is funding it. That is anti-intellectual tribalism. All researchers have bias, some much more severe than others. The existence of bias does not invalidate their research. Rather, the manifestation of it does, and that is determined by critically analyzing it and exposing where it has warped the research.
  - HarryHirsch 8y ago
    When Big Tobacco funded its studies they were never interested in the long-term consequences of smoking for health, their goal was to continue in business as always, and the public health folks were bad for business. It was never an honest engagement, the pro-tobacco side engaged in obfuscation. This is now a well-known, documented historical fact: https://www.industrydocumentslibrary.ucsf.edu/tobacco/ https://www.industrydocumentslibrary.ucsf.edu/tobacco/ In the realm of politics it's foolish not to take someone's motivation into account and assume they are interested in an honest debate. Pointing this out isn't "anti-intellectual tribalism".