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How do you feel about the East German medical system? Could you design other things that way? The current American system is not an example of free-market med

by moldbug 15y ago

How do you feel about the East German medical system? Could you design other things that way? The current American system is not an example of free-market medicine, it's a strawman of free-market medicine. It's pretty hard to have a free-market system with a central price-fixing committee. Does the term "RVU" mean anything to you? See under: http://en.wikipedia.org/wiki/Specialty_Society_Relative_Value_Scale_Update_Committee http://en.wikipedia.org/wiki/Specialty_Society_Relative_Valu... http://en.wikipedia.org/wiki/Gosplan http://en.wikipedia.org/wiki/Gosplan For a non-strawman, you'd need a system in which fee for service, catastrophic insurance (ie, actual insurance - the correct solution to your "risk pools"), and charity care were all separated. Look at any Anglosphere country before 1940, and add modern technology. The separation of charity and paid care (universal before 1940) is the absolutely essential reform, and it's so politically incorrect that no one on either side can even mention it. (Even the word "charity" is almost illegal.) For instance, the Canadian system is a reasonably good charity health system extended to the entire population. But Canada has to make private medicine illegal, to prevent the middle class from inventing it. As it is they just resort to the United States. And I haven't even mentioned medical innovation, which has ground to a giant flaming fscked-up halt. No, if you were designing something that you didn't want to suck, you wouldn't start with any of the existing solutions.

praxeologist 15y ago
You are so right. Look at the continually improving capabilities and continually decreasing prices of computer chips and notice that this results from market processes. The same can be seen in health care where government is rarely not involved (Lasik). The only fundamental difference between health care and any other good or service is that it is "really, really important" and people are more apt to fall for "We're with the government and we're here to help."

by moldbug 15y ago

praxeologist 15y ago

You are so right. Look at the continually improving capabilities and continually decreasing prices of computer chips and notice that this results from market processes. The same can be seen in health care where government is rarely not involved (Lasik). The only fundamental difference between health care and any other good or service is that it is "really, really important" and people are more apt to fall for "We're with the government and we're here to help."