Good Luck With That Retirement!

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Posted By: Young Libertarian @ 05/28/2009 3:19:21 PM

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  Posted By: jarcher1 @ 05/28/2009 9:20:57 PM

  Inventive, but you're example of elective surgery is rather weak. It is elective surgery after all. I really don't see how you can link that to surgery for cancer or cardio-vascular conditions in any form, shape, or fashion. You might as well be comparing life sustaining medication to recreation drug use. About the only thing they have in common is the term medical.
  
  I fail to see how health savings accounts and minimal insurance would enhance consumers ability to make rational choices. The same factors that mitigate against rational choice would be in play no matter what the source of the money might be. We are talking, after all, about the real world, not some ideal never-never land where competition trumps greed. Doctors in a particular region know what other doctors in that region get for such and such a procedure, doctors are bright people. Do you honestly believe that given a constant number of physicians in an area and a constant or rising demand, Dr A will offer to do the procedure for less than what Dr B gets? The AMA takes care of holding the number of MD's constant, its the worlds best union. It controls all aspects of medical education, and in a practical sense decides who gets a medical license. No help with increasing competition from that source. Then on the demand side, demand is probably increasing due to the demographics of an aging population. No sir, a free market in medicine is not in the cards in the foreseeable future, no matter where the payments come from.
  
  Finally, I'll leave you with a little food for thought. What free markets actually exist? Economists invented the "free market" as a theoretical construct. Unfortunately, some economists and a lot of lay persons have reified the concept. They don't exist in the real world. Why, one of your examples, food, is about as far from a free market model as can be found in a capitalist economy. The government heavily subsidizes and regulates agriculture. That's why the Department of Agriculture is a cabinet level department. That's why Congress has an agricultural bill to finance myriad crop, land use,and agricultural research subsidies. No food is a long, long way from being a classical free market. I'll leave the exercise of working through your other example to you for personal enrichment.

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    Posted By: Young Libertarian @ 05/29/2009 1:57:45 AM

    Let me address your assertions in turn, bear with me as there is plenty to comment on.
    
    My "inventive" example is not some brain game that I imagined; it's free market economics at work in a very real way. You call it weak because the example dealt with elective surgery but that comment just demonstrates a very limited view of how workers, even physicians, earn their salaries. They provide a service. Whether is a coronary bypass, external beam radiation therapy, or making your face pretty, physicians provide a service to patients for a fee. Some do it to save lives, some do it to make wrinkles disappear. From an economic standpoint the distinction is moot.
    
    Your statement expressing doubt regarding health savings accounts and minimial insurance again overlooks very simple and accepted economic trends. Supply and demand. Patients in control of their own funds that are allowed to make choices about from whom they receive their health care create an environment of price competition even among physicians and health providers. Your continued assertions that patients would be unable to act as rational actors on the demand side is nothing less than mind-boggling. We see patients being rational about their health care options when they seek second opinions from multiple institutions before making a decision. By your own theory no consumer would be able to make rational decisions regarding how he or she decides to spend their income, whether its health care or what kind of bread they buy at the store. You say doctors are bright people and so Dr. A would never charge less than Dr. B. By that logic absolutely no product or service in the world would ever exhibit a price drop since their providers would never charge less than their competitors. Clearly that is not the case at all in a market economy.
    

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      Posted By: Young Libertarian @ 05/29/2009 2:00:45 AM

      Finally, your comment regarding government subsidies in agriculture is correct. I simply used that sector as an example of free market economics in the sense that consumers are able to bargain shop at different grocery stores and markets to get the most for their money. This same mentality can and would be available in a private health care system that is free of governement and employer interference. Dr. A would most certainly charge less than Dr. B if his small price drop brought in larger profits through higher patient throughput; higher patient throughput that would be possible if patients truly controlled their funds and how they were used. In a universal health care system physicans decisions are no longer based on their medical intuition but some care-limiting, cost-efficiency protocol. Your congressmen begin to play doctor. Much like you, they try, fallaciously, to blame the free market for our current health care woes; calling it a "failure" or a "theoretical construct" and implying the government is an all-knowing, all-caring entity with only our interests in mind. Universal health care is the equivalent of the government opening a grocery store and giving you food for free, in exchange for them dictating what kinds and how much food you can feed your family. Thanks but no thanks. I've seen our form of universal health care in this nation; the absolutely horrific, government-controlled VA hospital system. Do an hour of research on this system, the Canadian system, and the UK system and tell me this is what our citizens deserve.
      
      Finally, your tongue-in-cheek language implying you are some how dispelling my economic misgivings and replacing them with your expert knowledge is mildly entertaining. None of your arguments, other than your reference to agriculture, have no backing and ring hollow. Your statements amount to nothing more than a conspiracy theory between physicians and the AMA. Spend a few weeks researching your arguments before slapping them in a reply as if they were fact. You seem like a very intelligent and capable individual and I encourage you to think outside what the media tells you is correct and make the decisions for yourself. Free markets do exist and provide the ONLY reasonable way for consumers and providers to interact in the fairest equilibrium; through the fair, unrestricted transfer of money between purchaser and supplier, regardless of the industry. Consumers, even patients, are more than capable of handling their own funds. In fact they are the BEST managers of their own money since they EARNED it in the first place. Don't sit and wait for the goverment to hand you everything. Take the intiative. Learn as much as possible. Think uniquely. I look forward to your response and thank you for your engaging discussion.

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        Posted By: jarcher1 @ 05/29/2009 11:01:48 AM

        Um no, they are not the same economically. To go back to the beginning. Free market models require a demand side capable of making a rational choice. Duress and lack of information preclude, to a large extent, making rational choices. Your example is weak because it picks perhaps the lowest levels of duress of any area in medicine. Elective surgery also has minimal time pressure so there is time to "shop around." That would make your example the best possible case for the possibility of a free market model in health care, but it doesn't address the problems with rational choice in all or even a substantial portion of the health care market. That's why I call it weak, it plainly doesn't support your contention that health care can operate on a free market model.
        
        I don't think my statement overlooks simple and accepted economic trends. I simply asked how it was that changing the source of funds from a business financed insurance source to medical savings accounts and minimal insurance allows medical consumers to make more rational choices with every thing else remaining constant. I address medical supply and demand and you want to allude to supposed conspiracy theories. I said the AMA basically holds the level of practitioners relatively constant through its control of medical education and state licensing procedures. Is the AMA's working to economically benefit it's dues paying members a conspiracy? I would have thought it evident. Thus no increase in the relative number of competitors. Demand holding constant and probably trending higher. Physicians possessing expert pricing knowledge of the market. I don't know for the life of me what simple and accepted economic trends are violated when I say that under those conditions Dr A has no incentive to undercut Dr B. In fact under those conditions it is irrational for A to undercut B, both in the short term and the long run.

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        Posted By: jarcher1 @ 05/29/2009 10:58:18 AM

        I really do wish you would not overgeneralize what I said. Except toward the end of my reply, I was only talking about the health care market. Do try to remain on topic, rather than make statements that are overly broad. Do try to refrain from binomial logic. I never asserted that all medical consumers fail to make rational choices, just that reality is stacked against rational choice, and most apparently do not. I also dispute your representation that patients don't exercise control over their finances, except for experimental procedures, doctors and patients are pretty much free to spend the insurance companies money as they choose, in the case a substantiated benefit. Of course there are numerous gray areas in the preceding statement, a lot of insurance will disallow chiropractors for example. Of course there are places where the insurance company does triage. Does that hip replacement really make sense for a 99 year old patient?
        
        No both of us started out by agreeing the health care market was not a free market model. I never referred to free market models as evil, that's your imputation of other poster's thoughts. Evil is a value judgment and really doesn't mix well with rational examination, unless you've found a rational system of values. If you have all the world's Axiologists will celebrate you for millenia. I never said free market models were a failure. Please refrain from putting words in my mouth. I did say the free market model was a theoretical construct. If you understand that term, you'll understand my claim that pure free markets don't exist in the real world. Nor, do I see any implication in my reply that I regard the government as all knowing or having only our interests in mind. Again please quit putting words in my mouth or imputing thoughts to me that are not mine.
        
        In closing, your little flight of fantasy into what Universal Health Care would look like is just that, fantasy. Neither you or I could say with any authority what the final product will look like.

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    Posted By: Young Libertarian @ 05/29/2009 1:58:52 AM

    Let me address your assertions in turn, bear with me as there is plenty to comment on.
    
    My "inventive" example is not some brain game that I imagined; it's free market economics at work in a very real way. You call it weak because the example dealt with elective surgery but that comment just demonstrates a very limited view of how workers, even physicians, earn their salaries. They provide a service. Whether is a coronary bypass, external beam radiation therapy, or making your face pretty, physicians provide a service to patients for a fee. Some do it to save lives, some do it to make wrinkles disappear. From an economic standpoint the distinction is moot.
    
    Your statement expressing doubt regarding health savings accounts and minimial insurance again overlooks very simple and accepted economic trends. Supply and demand. Patients in control of their own funds that are allowed to make choices about from whom they receive their health care create an environment of price competition even among physicians and health providers. Your continued assertions that patients would be unable to act as rational actors on the demand side is nothing less than mind-boggling. We see patients being rational about their health care options when they seek second opinions from multiple institutions before making a decision. By your own theory no consumer would be able to make rational decisions regarding how he or she decides to spend their income, whether its health care or what kind of bread they buy at the store. You say doctors are bright people and so Dr. A would never charge less than Dr. B. By that logic absolutely no product or service in the world would ever exhibit a price drop since their providers would never charge less than their competitors. Even a fifth grader knows this is simply untrue.