4 ms·

I don't mean it as a pejorative at all. I am all for a universal basic health care setup (e.g., Medicare for all) because "we" (the insured and tax payer) are a

I don't mean it as a pejorative at all. I am all for a universal basic health care setup (e.g., Medicare for all) because "we" (the insured and tax payer) are already paying for everyone's healthcare that can't afford it. If you go to the ER instead of PCP, we are paying for it; if you lose out on work because of preventable illness, we are paying for it; if you die early without adding productively to society, we are paying. But we currently don't have this system to pay for this from those who are making money. In other words, everyone is paying for this, but in reality it should be the higher earners that are paying more for this. That is what I see as a wealth transfer. People like you (likely) and me will have higher payroll taxes or income taxes to cover those who cannot afford. Please don't take this the wrong way--I am all for this. But it may entrench this inequality because it removes the "push" from the invisible hand of the market to get people finding ways to improve their lot in life--the whole basis of our current economic system. Again, not saying it is right or wrong, just commenting on how I think things are.

pjc50 7y ago
Healthcare is not a market. There's no price transparency, often no real choice (you can't choose your employer's insurer or what drugs you need), no real ability by consumers to assess the quality, and extremely high barriers to entry. US healthcare functions more like a horrific reverse lottery where occasionally someone is sent a bill that bankrupts them for reasons they don't understand and had no control over.
mnm1 7y ago
So if people aren't faced with chronic illness and the fear of bankruptcy they won't have a drive to succeed and improve ghetto their lot in life? Are you seriously arguing that? That's absolutely absurd. Why would a sick person me motivated to be productive when they can go on Medicaid or to the er for free? I think you have it backwards.
NeedMoreTea 7y ago
The push from the market appears to mainly consist of a) engineering ways of preventing drugs coming out of patent b) absurdly increase margins on basic and necessary items c) insanely increase margins on items with limited competition, e.g. epipens, last but certainly not least, advertising to unbalance healthcare by encouraging the expensive over the appropriate treatment. Pharma prefers to find long term treatments rather than new antibiotics and other treatments that are a week or two then done. Much more money in an ongoing treatment than cure. It's not the market, but far more US liability laws and willingness to sue that brings the US tendency to over investigate, diagnose and treat, is it not? That seems to be the sole advantage of the US approach over others, and even that can be questioned in many areas. All of those market pushes seem to be in the interests of medical CEOs and stockholders, not patients and citizens. I am far happier with a system that tries to remove or limit those for benefit of everyone. That tries (fallibly) to achieve fairness on medical not solely market grounds. I would prefer more openness too, but after the infamous farce of monoclonal antibodies, that's not realistic. Seems more like we need to keep that invisible, and very imperfect hand out of healthcare as much as possible. Then heavily constrain it where we can't keep it out.

pjc50 7y ago

Healthcare is not a market. There's no price transparency, often no real choice (you can't choose your employer's insurer or what drugs you need), no real ability by consumers to assess the quality, and extremely high barriers to entry. US healthcare functions more like a horrific reverse lottery where occasionally someone is sent a bill that bankrupts them for reasons they don't understand and had no control over.

mnm1 7y ago

So if people aren't faced with chronic illness and the fear of bankruptcy they won't have a drive to succeed and improve ghetto their lot in life? Are you seriously arguing that? That's absolutely absurd. Why would a sick person me motivated to be productive when they can go on Medicaid or to the er for free? I think you have it backwards.

NeedMoreTea 7y ago

The push from the market appears to mainly consist of a) engineering ways of preventing drugs coming out of patent b) absurdly increase margins on basic and necessary items c) insanely increase margins on items with limited competition, e.g. epipens, last but certainly not least, advertising to unbalance healthcare by encouraging the expensive over the appropriate treatment. Pharma prefers to find long term treatments rather than new antibiotics and other treatments that are a week or two then done. Much more money in an ongoing treatment than cure. It's not the market, but far more US liability laws and willingness to sue that brings the US tendency to over investigate, diagnose and treat, is it not? That seems to be the sole advantage of the US approach over others, and even that can be questioned in many areas. All of those market pushes seem to be in the interests of medical CEOs and stockholders, not patients and citizens. I am far happier with a system that tries to remove or limit those for benefit of everyone. That tries (fallibly) to achieve fairness on medical not solely market grounds. I would prefer more openness too, but after the infamous farce of monoclonal antibodies, that's not realistic. Seems more like we need to keep that invisible, and very imperfect hand out of healthcare as much as possible. Then heavily constrain it where we can't keep it out.