5 ms·

> Why don't you believe in a free market for health insurance? There are two main reasons. First of all, as someone mentioned it in another thread here a few d

> Why don't you believe in a free market for health insurance? There are two main reasons. First of all, as someone mentioned it in another thread here a few days ago, healthcare does not follow the rules of supply and demand, since people would pay anything for survival. You're never going to say that "ah this treatment is a bit overpriced; I think I'll get more value for my money if I'll just die instead". It's ridiculous. Second, there are various domains where the short term interests of various parties do not coincide with the long terms interests of everyone, hence regulation is needed. This is not political theory, it's game theory, it is nothing to do with personal opinion. It's a fact. > Let's say that I have a genetic condition that is certain to kill me rapidly at age 30 You probably don't want to die then at 25 after not receiving a treatment after having car accident. > Why should I be forced to pony up for other people's healthcare, too? It's called compassion and it is a cornerstone of our civilization. > The more insidious thing about universal healthcare is that it really screws over most minorities. I don't know about that. I am not a doctor so I don't know whether such conditions really exist, but my gut feeling is that almost all of the stuff people get treated for are universal across various minorities. > What if those who decide health coverage decide that heterozygous genetic condition X is covered... I think this must be a fundamental, antagonistic difference between our world views. As a European conservative, I truly believe that no life is unnecessary, no life is wasted. > ultimately, going to be a transfer of wealth from the poor (via inflation) to those who have the right genetic predisposition to conditions Most of the things people get treated for have nothing or almost nothing to do with genetic conditions. There is no gene for suffering a car accident. While having unlucky genes could decrease the chances of survival, ultimately everyone can get cancer.

dnautics 16y ago
>It's called compassion and it is a cornerstone of our civilization. compassion does not occur when someone forces you to pay into a system. If you want to be compassionate, pay out of your own pocket. Do not take out of someone else's pocket for charity and pat yourself on the back for being 'compassionate'. That is the opposite of compassion, it is total selfishness.
dnautics 16y ago
"Most of the things people get treated for have nothing or almost nothing to do with genetic conditions." Almost completely incorrect. Got the flu? Well that's because the flu virus latched onto a receptor that let it get into your respiratory cell. That receptor could be mutated in you. Got into a car accident? The surgery is painful. They're going to give you an anaesthetic. Your response to the anaesthetic is going to be governed by genetics. The pharamacokinetics - how much anaesthetic you'll need - governed by genetics. Maybe the current standards of care will kill you. "While having unlucky genes could decrease the chances of survival, ultimately everyone can get cancer." Thanks for making my point for me. Cancer is extremely genetic. Got a mutation in BRCA? You're going to have an elevated (or possibly reduced) risk of breast and prostate cancers. And especially, individual cancers' response to drug treatments is going to be partially stochastic and highly dependent on the underlying genetics. "As a European conservative, I truly believe that no life is unnecessary, no life is wasted." Hypothetical: You see, I'm a biomedical engineer (true). Let's say I build a machine that can keep anyone alive. The machine is great, the quality of life for the user is awesome. And it's such a great machine, it works indefinitely. Here's the catch. To operate the machine takes 400 barrels of crude oil a day. There's no way around this. Now. If health care is a right, and no life should be unnecessary or wasted, then do people have a right to this machine? Just to be clear, I don't think that no life is unnecessary or wasted, I just don't think that health care is a right, and I think that people need to accept the fact that they are going to die someday, and it's not such a horrible tragedy if medicine cannot save them, even if a possible cure existed and the only reason why they couldn't get access to it due to money. Obviously, I am not heartless and I think that situation should be minimized, via charitable actions - and I think that any system that tries to cover everyone will wind up costing everyone more and having rapidly diminishing returns in the face of reality, and will also really screw over corner cases. If such a system has the capacity to appropriate money from people against their will and the authority to make decisions for people, then the costs and the injustices will pile up even faster.
- dnautics 16y ago
  you know what. I know someone is going to criticize me for my hypothetical. So I'm going to just say, this is not far from reality (although it is not the reason why US healthcare costs so damn much). In 2004 Novartis reported that they were making the anticancer drug discodermolide. From scratch. (http://pubs.acs.org/doi/abs/10.1021/op034130e http://pubs.acs.org/doi/abs/10.1021/op034130e) This process started from petrochemical feedstocks and largely used chromatographic purification steps. According to FDA regulations, chromatographic media must be discarded after each use and basically cannot be efficiently recycled. The amount of resources that went into producing 60 grams of this drug is staggering - keep in mind that it is estimated that in the known universe only about 6 milligrams total of the material exists. Unless this was some sort of sick PR stunt, Novartis clearly thought that in the short term it could actually make enough for this drug to be profitable (it failed phase I trials on safety grounds, which gives you an idea of how bad an idea this was in the first place since to fail a safety trial on a cancer drug means your candidate really sucks). But the question of long-term sustainability of medical care is going to become very real in the not too distant future, whether or not this country and others gets the cost of our medical care down due to its structural problems. Whether or not we like it, the issue of health care rationing is going to but up against the problem of limited global resources.
Experimentalist 16y ago
1. Health care does follow the rules of supply and demand. It's erroneous to claim otherwise. 2. Many if not most health care costs are not emergency services, and they include many elective non-emergency procedures, diagnostics, mental health issues, drugs etc. A lot of costs come from behavioral choices and are preventable by responsible individuals. "Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures while covering 120 million people a year." http://www.acep.org/content.aspx?id=25902 http://www.acep.org/content.aspx?id=25902 3. Regarding compassion - Hospitals are not staffed with nurses, doctors, advanced medical services based on compassion -- all that costs money, labor and raw materials, and takes investment, education, specializations and entreneurship- all of which are not achieved through compassion. Economics and finance applies regardless of intention (ie. compassion).
Calamitous 16y ago
While I agree with some of what you say, I take issue with the following: > You're never going to say that "ah this treatment is a bit overpriced; I think I'll get more value for my money if I'll just die instead". No one is rationally arguing this. The free-market point-of-view is that multiple providers will offer you treatment, and you can select, based on quality, price, provider's reputation etc. etc. what best fits your needs. Over and over in this debate I see this fallacy that a free-market system says "You pay this price or you die." If a procedure can be made cheaper or more effective, a variety of providers is going to scramble to provide it. The difficulty we face in the U.S. is that there is no real competition in healthcare. As others have pointed out, the people making the purchasing decisions are not the people with a vested interest in the affordability and quality of healthcare, and price/quality signals are obscure at best, and typically hidden altogether. You, as a consumer, can't make rational healthcare decisions when your insurance is selected by your employer, your doctor is chosen by your insurer, and your treatment is chosen with an eye toward liability rather than effectiveness.

dnautics 16y ago

>It's called compassion and it is a cornerstone of our civilization. compassion does not occur when someone forces you to pay into a system. If you want to be compassionate, pay out of your own pocket. Do not take out of someone else's pocket for charity and pat yourself on the back for being 'compassionate'. That is the opposite of compassion, it is total selfishness.

dnautics 16y ago

"Most of the things people get treated for have nothing or almost nothing to do with genetic conditions." Almost completely incorrect. Got the flu? Well that's because the flu virus latched onto a receptor that let it get into your respiratory cell. That receptor could be mutated in you. Got into a car accident? The surgery is painful. They're going to give you an anaesthetic. Your response to the anaesthetic is going to be governed by genetics. The pharamacokinetics - how much anaesthetic you'll need - governed by genetics. Maybe the current standards of care will kill you. "While having unlucky genes could decrease the chances of survival, ultimately everyone can get cancer." Thanks for making my point for me. Cancer is extremely genetic. Got a mutation in BRCA? You're going to have an elevated (or possibly reduced) risk of breast and prostate cancers. And especially, individual cancers' response to drug treatments is going to be partially stochastic and highly dependent on the underlying genetics. "As a European conservative, I truly believe that no life is unnecessary, no life is wasted." Hypothetical: You see, I'm a biomedical engineer (true). Let's say I build a machine that can keep anyone alive. The machine is great, the quality of life for the user is awesome. And it's such a great machine, it works indefinitely. Here's the catch. To operate the machine takes 400 barrels of crude oil a day. There's no way around this. Now. If health care is a right, and no life should be unnecessary or wasted, then do people have a right to this machine? Just to be clear, I don't think that no life is unnecessary or wasted, I just don't think that health care is a right, and I think that people need to accept the fact that they are going to die someday, and it's not such a horrible tragedy if medicine cannot save them, even if a possible cure existed and the only reason why they couldn't get access to it due to money. Obviously, I am not heartless and I think that situation should be minimized, via charitable actions - and I think that any system that tries to cover everyone will wind up costing everyone more and having rapidly diminishing returns in the face of reality, and will also really screw over corner cases. If such a system has the capacity to appropriate money from people against their will and the authority to make decisions for people, then the costs and the injustices will pile up even faster.

dnautics 16y ago
you know what. I know someone is going to criticize me for my hypothetical. So I'm going to just say, this is not far from reality (although it is not the reason why US healthcare costs so damn much). In 2004 Novartis reported that they were making the anticancer drug discodermolide. From scratch. (http://pubs.acs.org/doi/abs/10.1021/op034130e http://pubs.acs.org/doi/abs/10.1021/op034130e) This process started from petrochemical feedstocks and largely used chromatographic purification steps. According to FDA regulations, chromatographic media must be discarded after each use and basically cannot be efficiently recycled. The amount of resources that went into producing 60 grams of this drug is staggering - keep in mind that it is estimated that in the known universe only about 6 milligrams total of the material exists. Unless this was some sort of sick PR stunt, Novartis clearly thought that in the short term it could actually make enough for this drug to be profitable (it failed phase I trials on safety grounds, which gives you an idea of how bad an idea this was in the first place since to fail a safety trial on a cancer drug means your candidate really sucks). But the question of long-term sustainability of medical care is going to become very real in the not too distant future, whether or not this country and others gets the cost of our medical care down due to its structural problems. Whether or not we like it, the issue of health care rationing is going to but up against the problem of limited global resources.

Experimentalist 16y ago

1. Health care does follow the rules of supply and demand. It's erroneous to claim otherwise. 2. Many if not most health care costs are not emergency services, and they include many elective non-emergency procedures, diagnostics, mental health issues, drugs etc. A lot of costs come from behavioral choices and are preventable by responsible individuals. "Emergency care represents less than 3 percent of the nation’s $2.1 trillion in health care expenditures while covering 120 million people a year." http://www.acep.org/content.aspx?id=25902 http://www.acep.org/content.aspx?id=25902 3. Regarding compassion - Hospitals are not staffed with nurses, doctors, advanced medical services based on compassion -- all that costs money, labor and raw materials, and takes investment, education, specializations and entreneurship- all of which are not achieved through compassion. Economics and finance applies regardless of intention (ie. compassion).

Calamitous 16y ago

While I agree with some of what you say, I take issue with the following: > You're never going to say that "ah this treatment is a bit overpriced; I think I'll get more value for my money if I'll just die instead". No one is rationally arguing this. The free-market point-of-view is that multiple providers will offer you treatment, and you can select, based on quality, price, provider's reputation etc. etc. what best fits your needs. Over and over in this debate I see this fallacy that a free-market system says "You pay this price or you die." If a procedure can be made cheaper or more effective, a variety of providers is going to scramble to provide it. The difficulty we face in the U.S. is that there is no real competition in healthcare. As others have pointed out, the people making the purchasing decisions are not the people with a vested interest in the affordability and quality of healthcare, and price/quality signals are obscure at best, and typically hidden altogether. You, as a consumer, can't make rational healthcare decisions when your insurance is selected by your employer, your doctor is chosen by your insurer, and your treatment is chosen with an eye toward liability rather than effectiveness.