4 ms·

I think you hit the nail on the head in 2 ways. First, s completely free market might work in healthcare, but what we have in America is so far from that, that

by mchusma 13y ago

I think you hit the nail on the head in 2 ways. First, s completely free market might work in healthcare, but what we have in America is so far from that, that most people don't even know what they are fighting for. Second, you do have much more freedom to move for tax purposes. The US demands its citizens everywhere to pay income tax, globally, even for 2 years after renouncing citizenship. A potential downside to the world (maybe good for Americans) would be if changes in American healthcare reduces funding overall for drug research and development. I've always heard we fund most of R&D.

marvin 13y ago
A completely free market in healthcare will absolutely not work. Insurance companies will drop everyone who has shown any form of uncommon illness - this is their natural incentive in the absence of regulation. Many serious and expensive illnesses are so rare that most insurance companies would severely curtail support towards these illnesses, with cheaper premiums and more customers as a result. Libertarians are suffering from the same delusion that the communists did: In a world where humans are perfectly ethical towards each other and always put the public good ahead of their own interests, it will work perfectly. In the real world, it won't.
- codehotter 13y ago
  Would it be possible for charities to fund the medical costs of people with uncommon illnesses?
  - marvin 13y ago
    Of course, but then you're right back at where you started: Taxation. Charities are much more common in the US than in Europe, because they cover services and treatments which are provided by the public sector in European countries. In the US, many of these services are based on voluntary donations and volunteering. Of course, if the state is as corrupt as it is in the US, I understand the reluctance to pay more taxes. But in effect, charities do the same thing, except veiled by the fact that contributions are voluntary.
- philh 13y ago
  I'm having difficulty parsing your prediction. Are you saying that in a free market, nobody would offer insurance against the possibility of developing a rare, expensive medical problem? Or that once you've developed an expensive medical condition, you'll no longer be able to get insurance against it? Or something else?
  - ThomPete 13y ago
    Its not just that. The problem is that for the insurance to work optimally everyone have to chip in so that those that are healthy offset the cost of those that aren't. In the US the young aren't getting insurance which is one of the reasons for the Offordable Healthcare Act. To force everyone to have an insurance so that economics become better. Of course in reality the best possible system would be a single payer (tax based) healthcare system with some payment for usage but where no one can go bankrupt or be dropped or fall under the deadly pre-existing conditions clause. Or a mandated private insurance like in Germany & Switzerland. Obamacare is one step of that way but it's so alien to US culture and have been so poorly implemented that on could fear for its future.
    - virtualritz 13y ago
      > Or a mandated private insurance like in Germany [...] There is no mandated /private/ health insurance, there is just mandated health insurance in Germany. See e.g. http://www.slowtravelberlin.com/guide-health-insurance-germany/ http://www.slowtravelberlin.com/guide-health-insurance-germa...
      - ThomPete 13y ago
        Thats true but I don't think that is as important for the point I am making, but sure.
  - michaelt 13y ago
    Assume you were an insurance company executive and you wanted to maximize profit and you were indifferent to the plight of your customers. What would you do? I'd release new products regularly, while increasing the insurance premiums of old products. Healthy people would just switch to the new product to avoid the price increase, but people with pre-existing conditions wouldn't be eligible so I could price-gouge them. So you could get insurance against expensive medical conditions - but if you had to claim on that insurance, suddenly your premiums would start rising by 30% a year, and you would have no alternative because of your pre-existing condition. The companies that didn't engage in this would then look expensive to healthy people and attractive to unhealthy people. And if the healthy (profitable) people leave and unhealthy (subsidized) people join, meaning premiums have to go up further, you could get a chain reaction putting them out of business.
- 001sky 13y ago
  A completely free market in healthcare will absolutely not work. It doesn't work because of other reasons. And libertarianism is quite irrelevant. A good economist can point out the flaws in economic markets...using economics. A marxist alternative is clearly from the wrong century and is irrelevant. The important point that govermnet semi-intervention is part of the problem is perfectly plausible. That is a different point than no co-operation is needed for a viable solution. People co-operate all of the time without the need for a "government solution". Try staring at people in the elevator or invading the personal space of someone on the NYC subway if you want to prove this point to yourself.

by mchusma 13y ago

marvin 13y ago

A completely free market in healthcare will absolutely not work. Insurance companies will drop everyone who has shown any form of uncommon illness - this is their natural incentive in the absence of regulation. Many serious and expensive illnesses are so rare that most insurance companies would severely curtail support towards these illnesses, with cheaper premiums and more customers as a result. Libertarians are suffering from the same delusion that the communists did: In a world where humans are perfectly ethical towards each other and always put the public good ahead of their own interests, it will work perfectly. In the real world, it won't.

codehotter 13y ago
Would it be possible for charities to fund the medical costs of people with uncommon illnesses?
- marvin 13y ago
  Of course, but then you're right back at where you started: Taxation. Charities are much more common in the US than in Europe, because they cover services and treatments which are provided by the public sector in European countries. In the US, many of these services are based on voluntary donations and volunteering. Of course, if the state is as corrupt as it is in the US, I understand the reluctance to pay more taxes. But in effect, charities do the same thing, except veiled by the fact that contributions are voluntary.
philh 13y ago
I'm having difficulty parsing your prediction. Are you saying that in a free market, nobody would offer insurance against the possibility of developing a rare, expensive medical problem? Or that once you've developed an expensive medical condition, you'll no longer be able to get insurance against it? Or something else?
- ThomPete 13y ago
  Its not just that. The problem is that for the insurance to work optimally everyone have to chip in so that those that are healthy offset the cost of those that aren't. In the US the young aren't getting insurance which is one of the reasons for the Offordable Healthcare Act. To force everyone to have an insurance so that economics become better. Of course in reality the best possible system would be a single payer (tax based) healthcare system with some payment for usage but where no one can go bankrupt or be dropped or fall under the deadly pre-existing conditions clause. Or a mandated private insurance like in Germany & Switzerland. Obamacare is one step of that way but it's so alien to US culture and have been so poorly implemented that on could fear for its future.
  - virtualritz 13y ago
    > Or a mandated private insurance like in Germany [...] There is no mandated /private/ health insurance, there is just mandated health insurance in Germany. See e.g. http://www.slowtravelberlin.com/guide-health-insurance-germany/ http://www.slowtravelberlin.com/guide-health-insurance-germa...
    - ThomPete 13y ago
      Thats true but I don't think that is as important for the point I am making, but sure.
- michaelt 13y ago
  Assume you were an insurance company executive and you wanted to maximize profit and you were indifferent to the plight of your customers. What would you do? I'd release new products regularly, while increasing the insurance premiums of old products. Healthy people would just switch to the new product to avoid the price increase, but people with pre-existing conditions wouldn't be eligible so I could price-gouge them. So you could get insurance against expensive medical conditions - but if you had to claim on that insurance, suddenly your premiums would start rising by 30% a year, and you would have no alternative because of your pre-existing condition. The companies that didn't engage in this would then look expensive to healthy people and attractive to unhealthy people. And if the healthy (profitable) people leave and unhealthy (subsidized) people join, meaning premiums have to go up further, you could get a chain reaction putting them out of business.
001sky 13y ago
A completely free market in healthcare will absolutely not work. It doesn't work because of other reasons. And libertarianism is quite irrelevant. A good economist can point out the flaws in economic markets...using economics. A marxist alternative is clearly from the wrong century and is irrelevant. The important point that govermnet semi-intervention is part of the problem is perfectly plausible. That is a different point than no co-operation is needed for a viable solution. People co-operate all of the time without the need for a "government solution". Try staring at people in the elevator or invading the personal space of someone on the NYC subway if you want to prove this point to yourself.