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There is very little about the health care industry, at any level, that is "free market". The government funds much of the basic research that generates new med

There is very little about the health care industry, at any level, that is "free market". The government funds much of the basic research that generates new medicines and medical devices and then regulates which ones can be sold. It works hand in hand with medical professional associations to determine who can practice medicine and in what capacity; it also funds residencies, the crucial gateway to becoming a physician. It pays for a hefty portion of medical care (for the young, the old, the very poor, and veterans) directly and regulates how the rest is paid for (out of pocket, through employer-provided insurance, or privately purchased insurance). There are a few islands of private industry in healthcare, but between the regulation and the direct payments, it's a government sea. Barring the most radical dissolution of the current system, the question isn't whether the government should be involved, but how.

wtbob 12y ago
You're right that the current healthcare industry is far from a free market, but javert too is right that the golden age of American healthcare was when it was far closer to a free market. Interestingly, the golden age for physicians' personal wealth was during the socialisation phase, as they were able to pocket fees increasingly paid by insurers, leading to a quintupling in income. They went from lower-middle class at $50,000/year in 2010 terms to $250,000 in 2010 terms. Doors anyone seriously suspect that we'll ever get back to $50,000/yr physicians? This illustrates why industries are often keen to socialise: they can guarantee outsize personal success. What our system absolutely rewrites is radical dissolution.
- vacri 12y ago
  When were doctors ever 'lower-middle class' in any western society?
  - jasonisalive 12y ago
    Any time right up until the 1950s I would say. I don't know what you'd call the status of mid-19th century doctors in Britain, for example, but they definitely weren't upper class.
    - vacri 12y ago
      'lower-middle class' is the lower part of the middle class. It's not "lower or middle class". Lower-middle, middle-middle, upper-middle. If it was 'lower or middle', that'd make even less sense - university-educated professionals being part of the working class demographic, at a time when university was an oddity rather than the norm?
  - MaysonL 12y ago
    When I was a kid in the '50s, our family doctor lived and had his office in a house little larger than ours, in much the same neighborhood as ours: definitely middle class.
    - vacri 12y ago
      I didn't say not middle class, I said not lower-middle class. Doctors as a demographic have never been lower-middle class.
  - wtbob 12y ago
    From the article physicians averaged $50,000/year in 2010 dollars back in the 30s or 40s. $50,000/year in 2010 was lower middle class. It's enough to live on, but certainly not enough to be comfortable, especially with a family, not is it enough to save much.

wtbob 12y ago

You're right that the current healthcare industry is far from a free market, but javert too is right that the golden age of American healthcare was when it was far closer to a free market. Interestingly, the golden age for physicians' personal wealth was during the socialisation phase, as they were able to pocket fees increasingly paid by insurers, leading to a quintupling in income. They went from lower-middle class at $50,000/year in 2010 terms to $250,000 in 2010 terms. Doors anyone seriously suspect that we'll ever get back to $50,000/yr physicians? This illustrates why industries are often keen to socialise: they can guarantee outsize personal success. What our system absolutely rewrites is radical dissolution.

vacri 12y ago
When were doctors ever 'lower-middle class' in any western society?
- jasonisalive 12y ago
  Any time right up until the 1950s I would say. I don't know what you'd call the status of mid-19th century doctors in Britain, for example, but they definitely weren't upper class.
  - vacri 12y ago
    'lower-middle class' is the lower part of the middle class. It's not "lower or middle class". Lower-middle, middle-middle, upper-middle. If it was 'lower or middle', that'd make even less sense - university-educated professionals being part of the working class demographic, at a time when university was an oddity rather than the norm?
- MaysonL 12y ago
  When I was a kid in the '50s, our family doctor lived and had his office in a house little larger than ours, in much the same neighborhood as ours: definitely middle class.
  - vacri 12y ago
    I didn't say not middle class, I said not lower-middle class. Doctors as a demographic have never been lower-middle class.
- wtbob 12y ago
  From the article physicians averaged $50,000/year in 2010 dollars back in the 30s or 40s. $50,000/year in 2010 was lower middle class. It's enough to live on, but certainly not enough to be comfortable, especially with a family, not is it enough to save much.