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I think it's pretty hard to argue that private companies are good and ethical at operating natural monopolies. History and all evidence is not on your side. I'l

by cultus 6y ago

I think it's pretty hard to argue that private companies are good and ethical at operating natural monopolies. History and all evidence is not on your side. I'll list a few examples: the California blackouts after electrical deregulation, the Bolivian water crisis after water supplies were privatized, the abuses of companies like Comcast in the US, etc. Even Adam Smith warned of natural monopolies. Nearly any economist will tell you letting them be private and under-regulated is nuts. The same with healthcare. Why is every other first world country able to get objectively better health outcomes for less money with universal healthcare? How is our system better?

LaEc 6y ago
Are healthcare outcomes worse in the US than other first world countries? Life expectancy is endogenous to variables like diet and exercise. Looking at cancer survival rates, the US is best at some and mediocre at others but other countries are not "objectively better"[0]. Is health expenditure in the US higher than in other countries? Yes, but that is because the US is rich, really rich. If we plot US Real Household Income against healthcare consumption, the US is perfectly inline with global trends[1]. [0] https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.... [1] https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/ https://randomcriticalanalysis.com/2018/11/19/why-everything...
- Ididntdothis 6y ago
  The US is obviously not rich enough to cover all or even most citizens. And a lot of people are not rich enough to avoid bankruptcy because of medical bills.
- orwin 6y ago
  At least in France, the liberalisation of our healthcare system from 2005 to today came with a huge drop in efficiency and increase in price (subsidized ofc, as it is still universal healthcare, but still)[0][1]. Act tarification and the bureaucratic ocntrol of the hospital mean that more time is needed for service chiefs to do paperwork instead of... curing people, and the huge increas in private care use is an indicator of the public health service. Also as more and more acts were driven off universal healthcare to private insurance (that your employer have to get for you if you don't have one, but that is paid on your salary) was in fact an increase in cost for everyone. Public healthcare administration cost in France is 18% of their budget [2]. Care to guess what private insurance company administration cost is? 27% for swisslife (i don't know if this account for privatised profits or not sadly). Also nurses and other low-level health workers have low pay compared to the rest of the first world as their salaries did not increase as much as other wokers. [0] https://www.who.int/whr/2000/en/whr00_en.pdf https://www.who.int/whr/2000/en/whr00_en.pdf [1] https://www.commonwealthfund.org/chart/2017/health-care-system-performance-rankings https://www.commonwealthfund.org/chart/2017/health-care-syst... [2] (doing the math myself i found 13% but i think that's because they are also paying the retirement pensions)

by cultus 6y ago

LaEc 6y ago

Are healthcare outcomes worse in the US than other first world countries? Life expectancy is endogenous to variables like diet and exercise. Looking at cancer survival rates, the US is best at some and mediocre at others but other countries are not "objectively better"[0]. Is health expenditure in the US higher than in other countries? Yes, but that is because the US is rich, really rich. If we plot US Real Household Income against healthcare consumption, the US is perfectly inline with global trends[1]. [0] https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.... [1] https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/ https://randomcriticalanalysis.com/2018/11/19/why-everything...

Ididntdothis 6y ago
The US is obviously not rich enough to cover all or even most citizens. And a lot of people are not rich enough to avoid bankruptcy because of medical bills.
orwin 6y ago
At least in France, the liberalisation of our healthcare system from 2005 to today came with a huge drop in efficiency and increase in price (subsidized ofc, as it is still universal healthcare, but still)[0][1]. Act tarification and the bureaucratic ocntrol of the hospital mean that more time is needed for service chiefs to do paperwork instead of... curing people, and the huge increas in private care use is an indicator of the public health service. Also as more and more acts were driven off universal healthcare to private insurance (that your employer have to get for you if you don't have one, but that is paid on your salary) was in fact an increase in cost for everyone. Public healthcare administration cost in France is 18% of their budget [2]. Care to guess what private insurance company administration cost is? 27% for swisslife (i don't know if this account for privatised profits or not sadly). Also nurses and other low-level health workers have low pay compared to the rest of the first world as their salaries did not increase as much as other wokers. [0] https://www.who.int/whr/2000/en/whr00_en.pdf https://www.who.int/whr/2000/en/whr00_en.pdf [1] https://www.commonwealthfund.org/chart/2017/health-care-system-performance-rankings https://www.commonwealthfund.org/chart/2017/health-care-syst... [2] (doing the math myself i found 13% but i think that's because they are also paying the retirement pensions)