6 ms·

This really is a study on the political consequences of an underregulated free-market economy and the result of political demands for more libertarian ideals a

This really is a study on the political consequences of an underregulated free-market economy and the result of political demands for more libertarian ideals as applied. The consequence is the poor cannot afford to live.

minikites 7y ago
Lots of people affirmatively believe that the uninsured should die: https://slate.com/news-and-politics/2011/09/let-him-die-a-debate-question-exposes-the-incoherence-and-cowardice-of-the-republican-candidates-opposition-to-obamacare.html https://slate.com/news-and-politics/2011/09/let-him-die-a-de... >What should happen, the moderator asked hypothetically, if a healthy 30-year-old man who can afford insurance chooses not to buy it—and then becomes catastrophically ill and needs intensive care for six months? When Dr. Paul ducked, fondly recalling the good old days before Medicare and saying that we should all take responsibility for ourselves, Blitzer pressed the point. “But, Congressman, are you saying the society should just let him die?” At that point, the rabble erupted in cheers and whoops of “Yeah!”
- ksdale 7y ago
  I feel like these are two vastly different questions though, whether, on the one hand, society should let people who cannot afford healthcare die, and on the other hand, whether society should allow people to choose how their dollars are spent in a way that may lead to bad healthcare outcomes (like dying from something that's preventable given enough dollars). In your quote, they seem to explicity mention that the person can afford insurance but chooses not to buy it. I mean, we don't make it illegal for people to do a ton of extreme sports where they might die. I don't see much of a difference between, say, climbing Mount Everest and a healthy, wealthy person deciding to spend thousands of dollars on something other than health insurance, knowing that they might not be able to pay the piper. Both are instances of someone choosing current enjoyment and weighing it against the chance of a life-threatening outcome. The real problem seems to be when people have no choice. Of course everyone wants to not die, and of course no one wants to pay for healthcare, but we can't have both, so we have to find a middle ground that involves preventing deaths and paying for healthcare, and it doesn't seem horribly immoral to me to allow people to make the choice to trade their future health for money now (or enjoyment, in the case of mountain climbing or sky diving or whatever). Once again, the problem lies in the lack of choice from the get go.
  - lgeorget 7y ago
    I'm not sure the analogy is accurate though. People doing extreme sports are (usually) aware of the risks and take them consciously. Even those who suffer severe injuries usually say it was worth it and they knew it was something that could happen. On the other hand, the uninsured person is just gambling, and regrets not being insured the day they needs hospitalization.
    - RobertoG 7y ago
      Maybe a more accurate analogy would be: somebody fall in the mountain doing something risk of what was totally aware, should we go to rescue her or left her to die?
      - ksdale 7y ago
        But even then, it's not immoral to talk about the very real tradeoffs involving the search and rescue personnel and resources that could be devoted to doing other things, and this indeed comes up when someone is doing something particularly dangerous in the mountains and ends up requiring a spectacular rescue. These rescues are always followed by arguments about who should bear the cost and what should happen if people can't pay. And surely nobody has the obligation to go into the mountains to save someone who was knowingly taking the risk. We live in a world where search and rescue already exists, so it seems natural and obvious to say that they should try and save everyone they can, but are they responsible for a death if they save so many people in a week and decide they can't go out again? In my prior post, I wasn't trying to suggest that we should willy-nilly leave people to die, just that we don't live in a world of infinite resources and that I don't personally believe it's horribly immoral to let people make choices even when those choices can have terrible consequences, assuming they know the risks.
        lgeorget 7y ago
        You have a point. Actually, in the case of search-and-rescue that's already a moral decision that is made each time. In case the rescue mission itself is seemed to dangerous for the team, it's not attempted.
ecpottinger 7y ago
You don't even need to be poor, just not have a lot of money saved or expensive insurance and then have a major health problem.
- mrguyorama 7y ago
  You can be genuinely well off, making over $120k a year, and still get medically bankrupted because of an unforeseeable condition and some capricious bullshit by your expensive health plan
Prophasi 7y ago
This perception of the US as having a free-market economy, particularly in the area of healthcare, is curiously persistent. Vast sums of money are spent lobbying to distort the market in favor of particular companies and industries. The FDA has long been accused of preventing key drugs from coming to market that are available in other countries. The patent system alone perpetuates medication monopolies over decades for fabricated reasons, keeping cheap generics out of people's hands. The tax system heavily favors employer-run plans (for reasons rooted in the WWII era) that encourage overspending, tie coverage to your employer, and distort the market in multiple, deep ways. Medicare and Medicaid are huge. The chart in the FEE link below puts US gov per capita expenditures at 4th in the world. The below Vox article, which is otherwise anti-free-market, concedes that generic insulin providers seem too daunted by secondary patents and "extreme regulatory complexity," both of which obviously run counter to a free market. This isn't to say a free-market system would be a panacea of all complaints (systems dealing in scarce resources will never be perfect to all participants), but those complaints would be much different than those about the layers of bureaucracy, high government spending, low competition, high time-to-market for drugs, breathtaking lobbying efforts, and overwhelming tax complexity we have now. Maybe you think you'd prefer single-payer to the present regime, but to characterize the latter as "free-market" sets up a false dichotomy. (Note that it could logically still be "underregulated," as you say, despite not being free - not that I would agree.) Drug patents: https://www.statnews.com/2019/02/11/drug-patent-protection-one-done/ https://www.statnews.com/2019/02/11/drug-patent-protection-o... Tax distortion: https://www.forbes.com/sites/theapothecary/2017/07/30/why-tax-reform-should-address-incomprehensible-and-indefensible-inequities-in-health-subsidies https://www.forbes.com/sites/theapothecary/2017/07/30/why-ta... Insulin prices: https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expensive https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expe... Free market? https://fee.org/articles/the-idea-that-the-us-has-a-free-market-health-care-system-is-pure-fantasy/ https://fee.org/articles/the-idea-that-the-us-has-a-free-mar...
- howard941 7y ago
  We had a free market for drugs. So free and freely abused that it gave birth to modern journalism (muckraking) and the Pure Food and Drug Act of 1906. For good reasons few yearn to return to those truly free times. https://en.wikipedia.org/wiki/Pure_Food_and_Drug_Act https://en.wikipedia.org/wiki/Pure_Food_and_Drug_Act https://www.u-s-history.com/pages/h917.html https://www.u-s-history.com/pages/h917.html

minikites 7y ago

Lots of people affirmatively believe that the uninsured should die: https://slate.com/news-and-politics/2011/09/let-him-die-a-debate-question-exposes-the-incoherence-and-cowardice-of-the-republican-candidates-opposition-to-obamacare.html https://slate.com/news-and-politics/2011/09/let-him-die-a-de... >What should happen, the moderator asked hypothetically, if a healthy 30-year-old man who can afford insurance chooses not to buy it—and then becomes catastrophically ill and needs intensive care for six months? When Dr. Paul ducked, fondly recalling the good old days before Medicare and saying that we should all take responsibility for ourselves, Blitzer pressed the point. “But, Congressman, are you saying the society should just let him die?” At that point, the rabble erupted in cheers and whoops of “Yeah!”

ksdale 7y ago
I feel like these are two vastly different questions though, whether, on the one hand, society should let people who cannot afford healthcare die, and on the other hand, whether society should allow people to choose how their dollars are spent in a way that may lead to bad healthcare outcomes (like dying from something that's preventable given enough dollars). In your quote, they seem to explicity mention that the person can afford insurance but chooses not to buy it. I mean, we don't make it illegal for people to do a ton of extreme sports where they might die. I don't see much of a difference between, say, climbing Mount Everest and a healthy, wealthy person deciding to spend thousands of dollars on something other than health insurance, knowing that they might not be able to pay the piper. Both are instances of someone choosing current enjoyment and weighing it against the chance of a life-threatening outcome. The real problem seems to be when people have no choice. Of course everyone wants to not die, and of course no one wants to pay for healthcare, but we can't have both, so we have to find a middle ground that involves preventing deaths and paying for healthcare, and it doesn't seem horribly immoral to me to allow people to make the choice to trade their future health for money now (or enjoyment, in the case of mountain climbing or sky diving or whatever). Once again, the problem lies in the lack of choice from the get go.
- lgeorget 7y ago
  I'm not sure the analogy is accurate though. People doing extreme sports are (usually) aware of the risks and take them consciously. Even those who suffer severe injuries usually say it was worth it and they knew it was something that could happen. On the other hand, the uninsured person is just gambling, and regrets not being insured the day they needs hospitalization.
  - RobertoG 7y ago
    Maybe a more accurate analogy would be: somebody fall in the mountain doing something risk of what was totally aware, should we go to rescue her or left her to die?
    - ksdale 7y ago
      But even then, it's not immoral to talk about the very real tradeoffs involving the search and rescue personnel and resources that could be devoted to doing other things, and this indeed comes up when someone is doing something particularly dangerous in the mountains and ends up requiring a spectacular rescue. These rescues are always followed by arguments about who should bear the cost and what should happen if people can't pay. And surely nobody has the obligation to go into the mountains to save someone who was knowingly taking the risk. We live in a world where search and rescue already exists, so it seems natural and obvious to say that they should try and save everyone they can, but are they responsible for a death if they save so many people in a week and decide they can't go out again? In my prior post, I wasn't trying to suggest that we should willy-nilly leave people to die, just that we don't live in a world of infinite resources and that I don't personally believe it's horribly immoral to let people make choices even when those choices can have terrible consequences, assuming they know the risks.
      - lgeorget 7y ago
        You have a point. Actually, in the case of search-and-rescue that's already a moral decision that is made each time. In case the rescue mission itself is seemed to dangerous for the team, it's not attempted.

ecpottinger 7y ago

You don't even need to be poor, just not have a lot of money saved or expensive insurance and then have a major health problem.

mrguyorama 7y ago
You can be genuinely well off, making over $120k a year, and still get medically bankrupted because of an unforeseeable condition and some capricious bullshit by your expensive health plan

Prophasi 7y ago

This perception of the US as having a free-market economy, particularly in the area of healthcare, is curiously persistent. Vast sums of money are spent lobbying to distort the market in favor of particular companies and industries. The FDA has long been accused of preventing key drugs from coming to market that are available in other countries. The patent system alone perpetuates medication monopolies over decades for fabricated reasons, keeping cheap generics out of people's hands. The tax system heavily favors employer-run plans (for reasons rooted in the WWII era) that encourage overspending, tie coverage to your employer, and distort the market in multiple, deep ways. Medicare and Medicaid are huge. The chart in the FEE link below puts US gov per capita expenditures at 4th in the world. The below Vox article, which is otherwise anti-free-market, concedes that generic insulin providers seem too daunted by secondary patents and "extreme regulatory complexity," both of which obviously run counter to a free market. This isn't to say a free-market system would be a panacea of all complaints (systems dealing in scarce resources will never be perfect to all participants), but those complaints would be much different than those about the layers of bureaucracy, high government spending, low competition, high time-to-market for drugs, breathtaking lobbying efforts, and overwhelming tax complexity we have now. Maybe you think you'd prefer single-payer to the present regime, but to characterize the latter as "free-market" sets up a false dichotomy. (Note that it could logically still be "underregulated," as you say, despite not being free - not that I would agree.) Drug patents: https://www.statnews.com/2019/02/11/drug-patent-protection-one-done/ https://www.statnews.com/2019/02/11/drug-patent-protection-o... Tax distortion: https://www.forbes.com/sites/theapothecary/2017/07/30/why-tax-reform-should-address-incomprehensible-and-indefensible-inequities-in-health-subsidies https://www.forbes.com/sites/theapothecary/2017/07/30/why-ta... Insulin prices: https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expensive https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expe... Free market? https://fee.org/articles/the-idea-that-the-us-has-a-free-market-health-care-system-is-pure-fantasy/ https://fee.org/articles/the-idea-that-the-us-has-a-free-mar...

howard941 7y ago
We had a free market for drugs. So free and freely abused that it gave birth to modern journalism (muckraking) and the Pure Food and Drug Act of 1906. For good reasons few yearn to return to those truly free times. https://en.wikipedia.org/wiki/Pure_Food_and_Drug_Act https://en.wikipedia.org/wiki/Pure_Food_and_Drug_Act https://www.u-s-history.com/pages/h917.html https://www.u-s-history.com/pages/h917.html