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Libertarians have been complaining about the USA's complicated health bureaucracy for decades. Hell, they've written dozens of books about it. It doesn't take a

Libertarians have been complaining about the USA's complicated health bureaucracy for decades. Hell, they've written dozens of books about it. It doesn't take a genius to find perverse incentives in US medical pricing schemes. But don't let me get in the way of your 30 seconds of hate...

pyre 13y ago
I've met plenty of people whose political views on health care were along the lines of: Person 1: "You should pay for your own care" Person 2: "What if you are poor and can't?" Person 1: "Sucks to be you." With the possible addendum of: Person 1: "But charity organizations will cover the costs for those that can't pay, because then I can choose of my own will to put money towards the cause." Person 2: "What if not enough people donate?" Person 1: "Well, it sucks to be poor." [I'll note that "sucks to be you" as an answer could probably be translated as, "I have not thought out my position that far, and I don't like you challenging my views, so I'll give you a short and curt answer."]
- rexreed 13y ago
  Can the issue of who pays for healthcare be adequately separated from the issue of its cost? I think so -- given how wide the disparity in health COSTS (put aside the payer) are between not only countries, but even counties in the US [1]. It would be great if we can talk about the origin of these health costs without getting entangled into who should be paying them. But maybe that's an impossible task. The Libertarian-in-Chief Ron Paul himself a Physician who claims that the exhorbitant costs in health care are a more recent phenomenon. He quotes how much his costs were to do house-visits (remarkably small), and compares that with the ballooning in costs more recently. While one can argue that Libertarianism is a Utopic view, the rapidly escalating prices of healthcare are not something that is espoused by Libertarian philosophy. I.e. Low health costs and individual responsibility for health paying are not incompatible. Then again, neither are low health costs and universal health coverage. Right now, we have the worst of both worlds: high health costs and individual responsibility for payment. [1] http://big.assets.huffingtonpost.com/hospital-procedure-costs-map-2.png http://big.assets.huffingtonpost.com/hospital-procedure-cost...
  - pyre 13y ago
    Can (some of) the ballooning costs be attributed to the costs / time investment in medical school? When Ron Paul went to medical school how much did it cost (adjusted for inflation)? How much more knowledge are doctors expected to have now than then?
    - rexreed 13y ago
      Maybe, but not any significant part. As evidenced by this post, only a small portion of the costs are attributable to the work performed by the surgeon. The majority of costs are allocated to facility costs (whose increases in price are not related to tuition costs) and equipment. Indeed, if there was such a direct correlation between the two, the easiest way to control healthcare costs would be to reduce doctoral school tuition rates. Clearly, this is not a viable solution here because the two are not directly correlated. Now, it is true that Tuition Costs have risen at a much higher rate since 1960 than Health Care costs on a percentage basis compared to inflation [1] [2] [3], but in aggregate the actual health care costs on a per-individual basis dwarf total tuition costs as part of household income [4]. [1] https://lh3.ggpht.com/-dqm5PIPoC58/Ti8HKy2jjrI/AAAAAAAAPgU/Wm3iJROU5KQ/s1600/college.jpg https://lh3.ggpht.com/-dqm5PIPoC58/Ti8HKy2jjrI/AAAAAAAAPgU/W... [2] http://chartingtheeconomy.com/wp-content/uploads/2009/04/healthcare309_28214_image012.gif http://chartingtheeconomy.com/wp-content/uploads/2009/04/hea... [3] http://cdn.theatlanticwire.com/img/upload/2011/08/aw-chart-college-tuition-vs-other-price-indices-2/large.png http://cdn.theatlanticwire.com/img/upload/2011/08/aw-chart-c... [4] http://static2.businessinsider.com/image/4d775519ccd1d57115010000/chart.gif http://static2.businessinsider.com/image/4d775519ccd1d571150...
      - pyre 13y ago
        To be fair, comparing the costs of ACL surgery to Ron Paul's costs for 'making house calls' isn't exactly an apples-to-apples comparison either. I'm merely pointing out that this is a complex beast with many contributing factors: - The money/time investment to become a medical professional. - The increase in the number / complexity of procedures over the years. Our medical knowledge keeps increasing we keep getting more and more ways to fix things. - Comparisons without details. For example, people like to compare how cheap MRIs are in Japan, but the MRIs that people get in Japan aren't as powerful/accurate as the ones that are charged for in the US. Does this justify the cost difference? Maybe, but maybe not.
csense 13y ago
Today with the US-based insurance system, there's usually at least one whole employee at every doctor's office whose only job it is to figure out who pays what, and do all the related phone calls and paperwork. For example talking to every patient's insurance company and turning medical procedures into ID numbers. If the doctor sends you to get lab work, the lab has its own person that fills that role. If the doctor sends you to a specialist, ditto. Of course the insurance companies have their own hordes of employees who write all the rules of who pays what under what circumstances, keep the books of all the patients' deductibles and all the providers' bills, etc. None of these employees does anything economically productive. They just move money around. Obamacare requires that people buy health insurance, which protects this bureaucracy with a legal mandate to purchase their services, and creates more bureaucracy, on the government side, to administer the law.

pyre 13y ago

I've met plenty of people whose political views on health care were along the lines of: Person 1: "You should pay for your own care" Person 2: "What if you are poor and can't?" Person 1: "Sucks to be you." With the possible addendum of: Person 1: "But charity organizations will cover the costs for those that can't pay, because then I can choose of my own will to put money towards the cause." Person 2: "What if not enough people donate?" Person 1: "Well, it sucks to be poor." [I'll note that "sucks to be you" as an answer could probably be translated as, "I have not thought out my position that far, and I don't like you challenging my views, so I'll give you a short and curt answer."]

rexreed 13y ago
Can the issue of who pays for healthcare be adequately separated from the issue of its cost? I think so -- given how wide the disparity in health COSTS (put aside the payer) are between not only countries, but even counties in the US [1]. It would be great if we can talk about the origin of these health costs without getting entangled into who should be paying them. But maybe that's an impossible task. The Libertarian-in-Chief Ron Paul himself a Physician who claims that the exhorbitant costs in health care are a more recent phenomenon. He quotes how much his costs were to do house-visits (remarkably small), and compares that with the ballooning in costs more recently. While one can argue that Libertarianism is a Utopic view, the rapidly escalating prices of healthcare are not something that is espoused by Libertarian philosophy. I.e. Low health costs and individual responsibility for health paying are not incompatible. Then again, neither are low health costs and universal health coverage. Right now, we have the worst of both worlds: high health costs and individual responsibility for payment. [1] http://big.assets.huffingtonpost.com/hospital-procedure-costs-map-2.png http://big.assets.huffingtonpost.com/hospital-procedure-cost...
- pyre 13y ago
  Can (some of) the ballooning costs be attributed to the costs / time investment in medical school? When Ron Paul went to medical school how much did it cost (adjusted for inflation)? How much more knowledge are doctors expected to have now than then?
  - rexreed 13y ago
    Maybe, but not any significant part. As evidenced by this post, only a small portion of the costs are attributable to the work performed by the surgeon. The majority of costs are allocated to facility costs (whose increases in price are not related to tuition costs) and equipment. Indeed, if there was such a direct correlation between the two, the easiest way to control healthcare costs would be to reduce doctoral school tuition rates. Clearly, this is not a viable solution here because the two are not directly correlated. Now, it is true that Tuition Costs have risen at a much higher rate since 1960 than Health Care costs on a percentage basis compared to inflation [1] [2] [3], but in aggregate the actual health care costs on a per-individual basis dwarf total tuition costs as part of household income [4]. [1] https://lh3.ggpht.com/-dqm5PIPoC58/Ti8HKy2jjrI/AAAAAAAAPgU/Wm3iJROU5KQ/s1600/college.jpg https://lh3.ggpht.com/-dqm5PIPoC58/Ti8HKy2jjrI/AAAAAAAAPgU/W... [2] http://chartingtheeconomy.com/wp-content/uploads/2009/04/healthcare309_28214_image012.gif http://chartingtheeconomy.com/wp-content/uploads/2009/04/hea... [3] http://cdn.theatlanticwire.com/img/upload/2011/08/aw-chart-college-tuition-vs-other-price-indices-2/large.png http://cdn.theatlanticwire.com/img/upload/2011/08/aw-chart-c... [4] http://static2.businessinsider.com/image/4d775519ccd1d57115010000/chart.gif http://static2.businessinsider.com/image/4d775519ccd1d571150...
    - pyre 13y ago
      To be fair, comparing the costs of ACL surgery to Ron Paul's costs for 'making house calls' isn't exactly an apples-to-apples comparison either. I'm merely pointing out that this is a complex beast with many contributing factors: - The money/time investment to become a medical professional. - The increase in the number / complexity of procedures over the years. Our medical knowledge keeps increasing we keep getting more and more ways to fix things. - Comparisons without details. For example, people like to compare how cheap MRIs are in Japan, but the MRIs that people get in Japan aren't as powerful/accurate as the ones that are charged for in the US. Does this justify the cost difference? Maybe, but maybe not.

csense 13y ago

Today with the US-based insurance system, there's usually at least one whole employee at every doctor's office whose only job it is to figure out who pays what, and do all the related phone calls and paperwork. For example talking to every patient's insurance company and turning medical procedures into ID numbers. If the doctor sends you to get lab work, the lab has its own person that fills that role. If the doctor sends you to a specialist, ditto. Of course the insurance companies have their own hordes of employees who write all the rules of who pays what under what circumstances, keep the books of all the patients' deductibles and all the providers' bills, etc. None of these employees does anything economically productive. They just move money around. Obamacare requires that people buy health insurance, which protects this bureaucracy with a legal mandate to purchase their services, and creates more bureaucracy, on the government side, to administer the law.