5 ms·

This is all true, but I am guessing the article skipped it because rising healthcare costs likely impact Gen Z much less than the population overall. Obamacare

by slg 4y ago

This is all true, but I am guessing the article skipped it because rising healthcare costs likely impact Gen Z much less than the population overall. Obamacare has allowed children to stay on their parent's insurance for much longer. All of Gen Z is still young enough to qualify for that, so as a generation they haven't felt the full cost of seeking insurance independently. Plus the overturning of the personal mandate means young people are once again free to simply not get insurance which is often a bad decision overall, but can end up saving a healthy young adult some money. There is still something very wrong with the healthcare system in the US, it just isn't a problem that has hit Gen Z particularly hard yet.

WalterBright 4y ago
> There is still something very wrong with the healthcare system in the US Government interference with the free market.
- notch656a 4y ago
  I would take straight up communism health care or ancap pay-or-die unregulated over our current bastardized system that combines the worst aspects of both.
  - WalterBright 4y ago
    Really? I remember a thread on reddit about the HBO series Chernobyl. A lot of posters who lived through it commented. One I recall said that root canals were free in the USSR, but you didn't get any anesthetic. Another commented that the hospital stay was free, but you had to bribe the nurses to take care of you. Having had a root canal myself, it's "no thanks" to free communist health care.
    - notch656a 4y ago
      Order of preference [not an exhaustive list] 1) Unregulated ancap pay-or-die (or charity) 2) USSR style salute Lenin on the way into the doctor's office 3) Our system
    - wyre 4y ago
      I’d rather suffer through it and live, than die because I couldn’t afford it.
      - WalterBright 4y ago
        A root canal is an attempt to save what's left of the tooth. The alternative is an extraction.
- modriano 4y ago
  I'm not so sure that is a sensible inference to draw. Government "interference" in healthcare in many countries where citizens both have greater access and report more satisfaction with the healthcare service they receive. Also, free markets really don't have much to say for people who don't have the money to trade in that market, and in the healthcare space, denying treatment to people just because they can't afford treatment can cause some massive negative externalities. Just imagine how bad it would be if there was a massive pandemic and only the rich could afford vaccines; there would be so many unvaccinated hosts for that virus that new variants would keep emerging and significantly harm the quality of life for everyone. Also, market efficiencies are largely a product of the ability of the consumer to compare the price and quality of different services. When the government is the consumer, it A) can afford to allocate this task to a few experts (rather than demand the entire population learn how to evaluate the cost and efficacy of medical treatments), B) can use its monopsony power to negotiate prices, and C) can use its treatment and outcome data to identify opportunities to do preventative maintenance rather than the more expensive (in both life and money) emergency care. I'm more sympathetic to free markets than most, but healthcare is arguably the sector where free markets would produce the worst outcomes.
  - WalterBright 4y ago
    The US had a free market in health care in 1968, and there's simply no evidence to support your suspicions.
    - modriano 4y ago
      First off, the US healthcare market wasn't a free market in 1968. State licensing boards regulated the supply of doctors and as Milton Friedman argued in his book "Free to Choose", powerful interest groups used the US court system to impose massive costs on unlicensed healthcare practitioners; "The AMA has engaged in extensive litigation charging chiropractors and osteopathic physicians with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible." [0]. So no, even before Medicare and Medicaid, there wasn't a free market for healthcare in the US. Still, in that time, there was much less government involvement in healthcare and the stats show significant improvement after the implementation of the SSA of 1965 Act. Infant mortality fell from over 2.5% in the early 1960s to just over half a percent now [1], with the decrease accelerating in the late 1960's before tapering in the 1980's. Life expectancy also jolted upward in the late 1960's [1]. Healthcare has increased in cost significantly since the time before Medicare and Medicaid, when the treatment for a heart attack was to lay in a hospital bed and wait to die, whereas now, we have much better treatments that can add decades on to people's lives. [2] And regarding the pandemic hypothesis, there's so much evidence to support my claims. If vaccine shots hadn't been made free to individuals, uptake would have been far slower and life would be far worse as the death rate would be much higher than the (still horrifying) ~500 people per day. [0] https://en.m.wikipedia.org/wiki/American_Medical_Association#Criticism https://en.m.wikipedia.org/wiki/American_Medical_Association... [1] https://datacommons.org/place/country/USA?category=Health#Infant-mortality-rate https://datacommons.org/place/country/USA?category=Health#In... [2] https://www.politifact.com/article/2012/jan/20/was-early-1960s-golden-age-health-care/ https://www.politifact.com/article/2012/jan/20/was-early-196...
- slg 4y ago
  Is there a country you would point to as a good model for free market healthcare? Because healthcare seems like a market prone to be abused by market forces because the demand for it is often inelastic. For example, the free market price for insulin is basically infinite because type 1 diabetics need a constant supply of it or else they die. Judging by the price of insulin in the US compared to our peer nations, it seems like the US's problem is too free of a market rather than it being too restricted.
  - WalterBright 4y ago
    The US before 1968. Insulin is heavily regulated by the FDA, making competition very difficult.
    - slg 4y ago
      So would you say that other countries in which insulin is cheaper have a healthcare industry that is a freer market than the US?
      - WalterBright 4y ago
        Other countries are not controlled by FDA regulations.
        slg 4y ago
        Sure, but they have their own FDA equivalent with their own regulations. Why are the regulations in the US more harmful than the regulations elsewhere?
        WalterBright 4y ago
        Regulatory barriers to competition: https://www.t1international.com/blog/2019/01/20/why-insulin-so-expensive/ https://www.t1international.com/blog/2019/01/20/why-insulin-... https://www.wbur.org/hereandnow/2021/12/10/insulin-drug-prices https://www.wbur.org/hereandnow/2021/12/10/insulin-drug-pric...

by slg 4y ago

WalterBright 4y ago

> There is still something very wrong with the healthcare system in the US Government interference with the free market.

notch656a 4y ago
I would take straight up communism health care or ancap pay-or-die unregulated over our current bastardized system that combines the worst aspects of both.
- WalterBright 4y ago
  Really? I remember a thread on reddit about the HBO series Chernobyl. A lot of posters who lived through it commented. One I recall said that root canals were free in the USSR, but you didn't get any anesthetic. Another commented that the hospital stay was free, but you had to bribe the nurses to take care of you. Having had a root canal myself, it's "no thanks" to free communist health care.
  - notch656a 4y ago
    Order of preference [not an exhaustive list] 1) Unregulated ancap pay-or-die (or charity) 2) USSR style salute Lenin on the way into the doctor's office 3) Our system
  - wyre 4y ago
    I’d rather suffer through it and live, than die because I couldn’t afford it.
    - WalterBright 4y ago
      A root canal is an attempt to save what's left of the tooth. The alternative is an extraction.
modriano 4y ago
I'm not so sure that is a sensible inference to draw. Government "interference" in healthcare in many countries where citizens both have greater access and report more satisfaction with the healthcare service they receive. Also, free markets really don't have much to say for people who don't have the money to trade in that market, and in the healthcare space, denying treatment to people just because they can't afford treatment can cause some massive negative externalities. Just imagine how bad it would be if there was a massive pandemic and only the rich could afford vaccines; there would be so many unvaccinated hosts for that virus that new variants would keep emerging and significantly harm the quality of life for everyone. Also, market efficiencies are largely a product of the ability of the consumer to compare the price and quality of different services. When the government is the consumer, it A) can afford to allocate this task to a few experts (rather than demand the entire population learn how to evaluate the cost and efficacy of medical treatments), B) can use its monopsony power to negotiate prices, and C) can use its treatment and outcome data to identify opportunities to do preventative maintenance rather than the more expensive (in both life and money) emergency care. I'm more sympathetic to free markets than most, but healthcare is arguably the sector where free markets would produce the worst outcomes.
- WalterBright 4y ago
  The US had a free market in health care in 1968, and there's simply no evidence to support your suspicions.
  - modriano 4y ago
    First off, the US healthcare market wasn't a free market in 1968. State licensing boards regulated the supply of doctors and as Milton Friedman argued in his book "Free to Choose", powerful interest groups used the US court system to impose massive costs on unlicensed healthcare practitioners; "The AMA has engaged in extensive litigation charging chiropractors and osteopathic physicians with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible." [0]. So no, even before Medicare and Medicaid, there wasn't a free market for healthcare in the US. Still, in that time, there was much less government involvement in healthcare and the stats show significant improvement after the implementation of the SSA of 1965 Act. Infant mortality fell from over 2.5% in the early 1960s to just over half a percent now [1], with the decrease accelerating in the late 1960's before tapering in the 1980's. Life expectancy also jolted upward in the late 1960's [1]. Healthcare has increased in cost significantly since the time before Medicare and Medicaid, when the treatment for a heart attack was to lay in a hospital bed and wait to die, whereas now, we have much better treatments that can add decades on to people's lives. [2] And regarding the pandemic hypothesis, there's so much evidence to support my claims. If vaccine shots hadn't been made free to individuals, uptake would have been far slower and life would be far worse as the death rate would be much higher than the (still horrifying) ~500 people per day. [0] https://en.m.wikipedia.org/wiki/American_Medical_Association#Criticism https://en.m.wikipedia.org/wiki/American_Medical_Association... [1] https://datacommons.org/place/country/USA?category=Health#Infant-mortality-rate https://datacommons.org/place/country/USA?category=Health#In... [2] https://www.politifact.com/article/2012/jan/20/was-early-1960s-golden-age-health-care/ https://www.politifact.com/article/2012/jan/20/was-early-196...
slg 4y ago
Is there a country you would point to as a good model for free market healthcare? Because healthcare seems like a market prone to be abused by market forces because the demand for it is often inelastic. For example, the free market price for insulin is basically infinite because type 1 diabetics need a constant supply of it or else they die. Judging by the price of insulin in the US compared to our peer nations, it seems like the US's problem is too free of a market rather than it being too restricted.
- WalterBright 4y ago
  The US before 1968. Insulin is heavily regulated by the FDA, making competition very difficult.
  - slg 4y ago
    So would you say that other countries in which insulin is cheaper have a healthcare industry that is a freer market than the US?
    - WalterBright 4y ago
      Other countries are not controlled by FDA regulations.
      - slg 4y ago
        Sure, but they have their own FDA equivalent with their own regulations. Why are the regulations in the US more harmful than the regulations elsewhere?
        WalterBright 4y ago
        Regulatory barriers to competition: https://www.t1international.com/blog/2019/01/20/why-insulin-so-expensive/ https://www.t1international.com/blog/2019/01/20/why-insulin-... https://www.wbur.org/hereandnow/2021/12/10/insulin-drug-prices https://www.wbur.org/hereandnow/2021/12/10/insulin-drug-pric...