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There is no serious debate anymore, USSR imploded from impossibility of central planning, even despite attempts to computerize the process. Even if every single
by cat_plus_plus 3y ago
There is no serious debate anymore, USSR imploded from impossibility of central planning, even despite attempts to computerize the process. Even if every single factory manager was honest and knowledgeable and even if every single worker put in 100% effort for no extra reward, modern economy is not centrally computable and contains factors not knowable apriori, such is whether consumers will like a certain style of shoes once they are already made and on the store shelves. These things need to be discovered bit by bit through local knowledge and private assumption of risks, which in turn is only possible through incentive of private enjoyment of rewards.
However, I am also tired of both sides claiming that labor unions, or social safety net, or some amount of government regulation are socialism and therefore either "see you like it, lets have some more" or "if government provides a health insurance scheme, it's Gulags right away". These things are governments or voluntary organizations of workers leveraging productivity of free market to accomplish some additional tasks deemed to remain unaddressed by market forces. Mind you, I am not a fan of lots of government, especially on central level. There are separate arguments about incentives for providers of aid to remain efficient and for recipients to be grateful and responsible. But let's have intelligent conversations about each thing rather than "Medicare is communism and border control is fascism".
There are also objective negative externalities like "if I didn't buy smoke from your factory, you have no right to blow it over my house", where regulation actually advances voluntary free market. Some movements like Georgism have interesting proposals to use mitigation of externalities to fund whatever government is needed while making market more efficient.
- WalterBright 3y ago> if government provides a health insurance scheme, it's Gulags right away The price of health care in the US rose at the same rate as inflation, up until 1968. Then, the price increases tilted upwards, and have not slowed down since. What happened in 1968? Government health insurance.
- ajross 3y agoAlso antibiotics, immune control drugs, transplant technology, hearing aids, prosthetics, computer-assisted tomography, MRI scans, cancer treatments that actually work, mental health drugs and treatments likewise, ... This is just wildly wrong. What you're looking at is the "advent of modern medicine". Prior to the middle of the 20th century, doctors were more or less limited to stitching people up after injury. Since then, we can treat... almost everything, honestly. But that's expensive, in particular in regimes like the US that want to provide all that stuff to everyone in the private markets that have the ability to pay for it. It's got absolutely nothing to do with how the payments are handled. That's just silly.
- dukeyukey 3y agoSpending on healthcare rose faster in the US than pretty much anywhere else, at the same time American life expectancy growth slowed down compared to peer nations. I dunno what went wrong but something did.
- ajross 3y agoSpending everywhere rose much faster than inflation, though it's true more in the US. And life expectancy in the US rose very rapidly through the 60's and 70's, the period under discussion. It wasn't until the late 80's that we started to fall off the curve.[1] Your final sentence is just the same point upthread: you want a simple coincidence[2] to make your argument. [1] There is a ton of analysis and argument to do there too, but suffice it to say that "because medicare" is just as terrible an explanation. [2] It's not even a coincidence! Desire for government-guaranteed health care came about precisely because of and simultaneous to the availability of late-life care that actually worked. No one wanted medicare in the 20's because there wasn't anything to pay for even if you had it. But they damn sure wanted their walkers and hip replacements in the 60's.
- dukeyukey 3y agoNo, I literally do not know what went wrong or when. I'm not trying to make a point about government-provided anything. Although government-provided healthcare began quite a bit earlier than that, as early as the 1880s in Germany, but definitely in the 1940s when the UK NHS started.
- WalterBright 3y ago> This is just wildly wrong. Funny how it coincides with the very year the government started providing health insurance. Funny how the same thing happened when the government started providing education subsidies. Funny how the inflation did not happen with medical procedures not covered by the government, such as Lasik eye surgery. A longish, but good read about this: https://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/ https://www.theatlantic.com/magazine/archive/2009/09/how-ame... P.S. Antibiotics came out in WW2, not 1968.
- escapedmoose 3y agoWhere are you getting this information? I’m unable to verify it.
- WalterBright 3y agogoogle "historical US healthcare costs"
- mhh__ 3y agohttps://fred.stlouisfed.org/series/CPIMEDSL https://fred.stlouisfed.org/series/CPIMEDSL Not sure if I see it. If it's a total expenditure graph, then surely it's obvious that expanding coverage would cost money?
- WalterBright 3y agoSigh. What can I say? Google it, and at the VERY TOP of the results page is a graph that is captioned "Per capita out-of-pocket expenditures 1970-2021". To the right of it is another graph entitled "Total national health expenditures, US $ per capita, 1970-2021". per capita
- mhh__ 3y agoSurely you realize that Google ranks the results differently for different people?
- runarberg 3y agoAlright: First is a graph that shows healthcare costs increase steadily slightly above inflate rate over time from 1970 https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/#Total%20national%20health%20expenditures,%20US%20$%20Billions,%201970-2021 https://www.healthsystemtracker.org/chart-collection/u-s-spe... Seconds are a bunch of numbers in a CSV indicating that there is nothing special about 1968, healthcare costs rose just like any other years. 1965 is in fact a pivotal years, costs rose more then previous years when medicare and medicate were rolled out (more on that later). But also noting that between 1960 and 1965 prices still rose above inflation, just not as much as in the late 1960s, while still much more than in the 1990s. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... Third is an article explaining the trends (using same number as in nr. 2) in terms of historic events. > Between 1961 and 1965, health care spending increased by an average of 8.9% a year. That's because health insurance expanded. As it covered more people, the demand for health care services rose. By 1965, households paid out-of-pocket for 44% of all medical expenses. Health insurance paid for 24%. > From 1966 to 1973, health care spending rose by an average of 11.9% a year. Medicare and Medicaid covered more people and allowed them to use more health care services. Medicaid allowed senior citizens to move into expensive nursing home facilities. https://www.thebalancemoney.com/causes-of-rising-healthcare-costs-4064878 https://www.thebalancemoney.com/causes-of-rising-healthcare-... So when you say stuff like: “The price of health care in the US rose at the same rate as inflation, up until 1968.” first check if your data and your dates are correct, but also consider nuances. Like, what does it mean thate prices go up (explained in source nr. 2) Does it mean that individually your average out of pocket costs are higher, does larger funds go from government to the health care industry? Are hospital operations more expensive? etc. But also note that if nobody gets health care, health care costs are 0 USD, while treating more people will make costs go up as more people are getting more technologically challenging and expensive treatments (explained in source nr. 3). Taking costs going up when more people get healthcare to automatically mean that socialism is bad, that is kind of a simplistic take to say the least.
- danaris 3y agoAre you sure it was 1968? And not, say, 1973? The year Nixon signed the HMO Act into law, and brought about a massive expansion of for-profit health insurance?
- WillPostForFood 3y agoThe HMO act created in response to rising health care costs, Whether it helped or hurt, the problem was already existent.
- WalterBright 3y agoMedicare and Medicaid started up in 1968.
- deleted 3y ago[deleted]
- Manuel_D 3y agoIt also coincided with lower birth rates, and a greater percentage of elderly population. People seem to forget that retirees account for the significant majority of healthcare costs, but a relatively small percentage of healthcare revenue. Increase the share of elderly, and you get higher effective healthcare costs.
- specialist 3y agoRaising the floor without increasing the supply enabled the suppliers to charge more.
- testrun 3y agoNot quite. Since 1968 four things happened in healthcare: 1. A wider range of healthcare issues can be cured or repressed due to advances in medicines. This directly lead to more doctor appointments. 2. People life expectancy increased, but older people need more healthcare. 3. Mental healthcare stigmatization went away (mostly), and therefore more doctor appointments. 4. Due to the higher demand in healthcare and the control over supply, the provider cost is higher than inflation.
- umeshunni 3y ago> whether consumers will like a certain style of shoes once they are already made and on the store shelves The key is to reduce the kind of shoes available. Everyone shall wear the state issued formal shoes and when they need to engage in the required daily sporting activity, shall wear the state issued canvas shoes.
- spamlettuce 3y agoAhhh yes reduce everyone into indistinguishable blobs of society
- prottog 3y ago> movements like Georgism have interesting proposals to use mitigation of externalities to fund whatever government is needed I, too, would very much like to see this play out in practice. But I don't think it'll ever actually happen in real life, because it would likely dramatically reduce the size of government (which politicians are loathe to do) and economically hurt wealthy landowners the most.
- local_crmdgeon 3y agoTexas is arguably the most Georgist state, and it seems to be going quite well for them.
- prottog 3y agoI'm curious, in what way does Texas have Georgist policies? As I understand it, all taxing jurisdictions within Texas that levy a tax on real estate do so on the appraised fair market value of the whole property, with no specific focus on just the unimproved value of the land, which is the linchpin of Georgist taxation.
- mempko 3y agoAnd yet the largest, most successful organizations in the world are centrally planned. The 'markets' don't explain China despite what many those in the west try to believe.