Originally Posted by Galen

It might interest you to know that price inflation in medical care started to outpace the general price inflation rate in 1966 after Medicare and Medicaid were passed. This effect is easily predictable since you have the combination of government bureaucracy and increasing demand on already scarce resources.

If there was any shortage, it was in physicians because medical schools ensured a shortage of positions for prospective doctors. That was intended to raise the pay of physicians and make med students more willing to take out huge loans. Add to that, Big Pharma arranged a cartel so that American prices for pharmaceuticals to be the highest in the world, ostensibly to promote medical research. (Dirty little secret: the pharmaceutical industry spends more money on marketing than on research, much of which is done by the federal government and by medical schools).

The simple fact of the matter is that there will be rationing of medical care. You can choose to do it by a wait list or by ability to pay. Pick one.

If anything, the inequities of the entire American economic system themselves consign millions to poverty for no purposes other than the enrichment of elites and the ability of economic elites to keep the masses cowed. Wait lists are the norm whenever shortages of staff appear. Pricing people into the grave as a continuing practice is unconscionable.

I am surprised that you didn't mention high income taxes on physicians. Because income taxes have fallen, the effective rewards to physicians have also increased. That itself gives huge incentives to anyone who could be a doctor in the US to become and stay a doctor in the US -- as shown by the large number of immigrant physicians.

What surprises me is the inability of anyone to consider the possibility that government intervention in the provision of medicine is making things much worse.

And the benefit to the customer of charging what the traffic will bear is...

Originally Posted by Deb C

There's already a rationing of care, it's done by the for profit insurance industry. They are continuously denying procedures and life saving diagnostic care. Thousands of people go bankrupt every year for the lack of health insurance, or having been sold junk policies with huge co-pays and out of pocket expenses.

Hospitals, just like people, are held hostage by this industry. If they want an insurance corporation's patients, then that price for their patients are negotiated for the lowest possible payments for care, and that's dictated by the the insurnace giants. ...

There is also evidence that the insurance companies are not the primary problem with our current system:

Health insurance: Clear diagnosis, uncertain remedy | The Economist
http://www.economist.com/node/15545834
..."The biggest factor behind the cost conundrum, however, is that insurers lack market power. Health-care providers hold all the cards. On this argument, the problem with private health insurance is not that market forces do not work: it is that reforms have not gone far enough to allow proper competition to emerge. For example, in Germany and the Netherlands some insurers have started to negotiate special deals with providers that make the management of chronic diseases easier for patients. However, there are strict limits on what they can bargain for. And insurers cannot easily favour only the best hospitals, because politicians will not let inefficient hospitals go bust."...

One clear problem is the excessive administrative costs resulting from multiple insurance company forms. We don't need hundreds or thousands of insurance companies to drive up administrative costs. Single payer is one solution. I would prefer a small number of companies & member organizations( such as Unions) to provide some competetion. This does require Govt oversight.

Originally Posted by TnT

Oversimplification. A simple example ... what did medical imaging consist of in 1966? A simple x-ray exam. That was about it. What does medical imaging consist of today? Well, let's see ... MRI's, PET's, nuclear medicine studies, CT's, Ultra-sound, oh, yeah, and x-rays.

You missed the point. For many years prior to 1965 the price inflation rate of medical care was the same as the rate for the economy as a whole. New medical technology was being created both before and after that year. After that year the price inflation for medical care started to accelerate much faster than the CPI.

Something changed in 1965 and medical prices have been increasing much faster every since.

Here are two articles you might want to read.
http://www.americanthinker.com/2009/...se_of_hea.html
http://mises.org/daily/4434

Have you even considered the possibility that government intervention has caused the problems you are asking it to solve? This is a question the the lefties can not and will not consider.

Originally Posted by Galen

You missed the point. For many years prior to 1965 the price inflation rate of medical care was the same as the rate for the economy as a whole. New medical technology was being created both before and after that year. After that year the price inflation for medical care started to accelerate much faster than the CPI.

Something changed in 1965 and medical prices have been increasing much faster every since.

Here are two articles you might want to read.
http://www.americanthinker.com/2009/...se_of_hea.html
http://mises.org/daily/4434

Have you even considered the possibility that government intervention has caused the problems you are asking it to solve? This is a question the the lefties can not and will not consider.

TnT is right. The mid-60s is the beginning of technological medicine. Since we were both alive at the time and actually remember what occurred and how it occurred, then we'll tend to trust "our lying eyes". On one point you are right. Prior to Medicare and the growth of public care in Europe and Japan, there was insufficient money in the medical care pipeline to justify the development of all this technology. So credit or blame where its due. Without those increases, we would have a much more primitive medical system today, and shorter life times to show for it.

Originally Posted by The Rani

Maybe, if it weren't for rising liability insurance premiums. And don't forget Canada:


Again, all I can say is make sure your own ass is covered if we head down the single-payer yellow brick road. There's no place like home.

That said, profits-first medical care might be rough on a conscience.

Originally Posted by Marx & Lennon

TnT is right. The mid-60s is the beginning of technological medicine. Since we were both alive at the time and actually remember what occurred and how it occurred, then we'll tend to trust "our lying eyes". On one point you are right. Prior to Medicare and the growth of public care in Europe and Japan, there was insufficient money in the medical care pipeline to justify the development of all this technology. So credit or blame where its due. Without those increases, we would have a much more primitive medical system today, and shorter life times to show for it.

So what you are saying is that medical technology would stagnate with out government intervention? Then where did X-Ray imaging come from? That was invented long before the government started pumping money into medical care. Electrocardiogram was first invented in 1911 and was very expensive but became very cheap due to advances in electronics. Again invented before the government started subsidizing medical care.

In every other industry technology has increased productivity or created completely new industries. In your view health care is not subject to the same economic laws that govern every other business.

Consider what would happen to any other industry subject to the same level of regulation and system third party payers as medical care. That industry would suffer from the same cost increases as medicine now does.

Thank you for demonstrating so clearly how far progressives and modern liberals will go to avoid asking if the government has made the situation worse. The evangelical conservatives worship God and the modern liberals worship the state in the same way. If they should question their god then their whole world view falls apart.

Originally Posted by Galen

So what you are saying is that medical technology would stagnate with out government intervention? Then where did X-Ray imaging come from? That was invented long before the government started pumping money into medical care. Electrocardiogram was first invented in 1911 and was very expensive but became very cheap due to advances in electronics. Again invented before the government started subsidizing medical care.

Yes, most of the early stuff was expensive in its day, but the development cost was orders of magnitude less intensive than the modern stuff. For GE or Siemens to commit $100 Million to developing modern imaging technology, they had to know that there was a funding source that could sustain it. This is not good or bad. It just is.

Originally Posted by Galen

In every other industry technology has increased productivity or created completely new industries. In your view health care is not subject to the same economic laws that govern every other business.

No it isn't. Note the difference between a demand based and a need based market, for lack of a better term. No one can put off heart surgery if they need it, like you can put off buying a new car. To make matters worse, the people who need the most expensive health care are typically in a state that they are not healthy earners. The same can be said for police and fire protection. They should all be essential services. Why healthcare is not addressed that way in this country is a mystery. It is elsewhere.

Originally Posted by Galen

Consider what would happen to any other industry subject to the same level of regulation and system third party payers as medical care. That industry would suffer from the same cost increases as medicine now does.

Hogwash! We used to regulate public utilities intensively, and they performed better then than they do now.

Originally Posted by Galen

Thank you for demonstrating so clearly how far progressives and modern liberals will go to avoid asking if the government has made the situation worse. The evangelical conservatives worship God and the modern liberals worship the state in the same way. If they should question their god then their whole world view falls apart.

Thank you for showing your magical thinking on the miracle of the markets. Do you folks have data to support your assertions? I haven't seen any. So who are guilty of making their beliefs into a faux religion?

Mr. Galen,

Convince us that you deserve your namesake and send us some data and analysis with other than superficial, bald partisan statements.

Convince us that you have even a nodding acquaintance with the field of medicine and how it is practiced in the U.S.

Same thing has been happening with college tuition after the Higher Education Act of 1965.

Maybe it is an effect of lots of government money chasing a fixed product, maybe it is a true sign of domestic inflation since we can't just import cheap, foreign hospitals & college classrooms.

Originally Posted by JohnMc82

Same thing has been happening with college tuition after the Higher Education Act of 1965.

Maybe it is an effect of lots of government money chasing a fixed product, maybe it is a true sign of domestic inflation since we can't just import cheap, foreign hospitals & college classrooms.

You might have something here.

Originally Posted by JohnMc82

Same thing has been happening with college tuition after the Higher Education Act of 1965.

Maybe it is an effect of lots of government money chasing a fixed product, maybe it is a true sign of domestic inflation since we can't just import cheap, foreign hospitals & college classrooms.

In fact, higher education has proved anything but a fixed commodity. Existing land-grant universities expanded, community colleges came into being, large universities set up branches that developed lives of their own, and -- regrettably -- many bad colleges came into existence.

Such schools as secretarial schools and religious academies redefined themselves as colleges so that they could attract students that before the 1960s weren't considered "college material". Such schools couldn't attract good professors, but they could put someone behind a lectern to "teach" people who would have flunked out of Ohio State, let alone not gotten into Harvard except perhaps as a janitor. School administrators duly passed students who matriculated through those second-rate schools where students learned little so long as they kept paying or borrowing for tuition. Even worse, many vocational schools turned into profitable rip-offs.

First-rate education expanded to the extent that kids who used to be rejected for ethnicity, class, or religion could get college education. Ivy League colleges used to have strict quotas against Jews but let in marginal students whose WASP parents were alumni (George W. Bush is a prime example) But those colleges and the ones analogous to them (Rice, Vanderbilt, Stanford, Williams, Pomona, Case Western Reserve, Johns Hopkins, the University of Chicago) didn't expand; they started admitting people who used to be rejected for lack of funds or lack of desired genealogy. Ancestors traveled to America on a slave ship or in steerage on a steamer instead of the Mayflower? Tough!

There are only so many first-rate university professors to go around, and there are only so many people who have the intellectual qualifications to get something out of a first-rate college education. People who wanted to become accountants and didn't give a d@mn about English literature or Renaissance art used to attend business colleges that trained them to be bookkeepers. We would be better off with far fewer diploma mills and far more formal apprenticeships.

Originally Posted by princeofcats67

And to further the Idea, if I may, any failings of The State is reasoned to be caused by manipulation from Corporate Interest ie: Corporatocracy(annoyingly mis-labeled as Corporatism). While that may or may not be true, it is an all too common retort bordering on a Monopoly of Thought ie: Group-Think

This is a very good point. You are describing a phenomenon known as Regulatory Capture. (See http://en.wikipedia.org/wiki/Regulatory_capture) In this way a business can protect its profit margin from the rigour of the free market by shutting out new-comers that would compete on the basis of price.

The liberals and progressive ignore this because they don't have answer for this problem other than more coercion. My answer is that utopia can not be created by coercion.

Originally Posted by Marx & Lennon

Yes, most of the early stuff was expensive in its day, but the development cost was orders of magnitude less intensive than the modern stuff. For GE or Siemens to commit $100 Million to developing modern imaging technology, they had to know that there was a funding source that could sustain it. This is not good or bad. It just is.

You are not taking into account that the value of the dollar has fallen since 1913 when the Federal Reserve was created. For example ten million dollars in 2010 has the same buying power as $452,461.80 in 1913 according to the Bureau of Labor and Statistics. I assure you that current imaging technology would look just as simple to a person living a century from now.

Originally Posted by Marx & Lennon

No it isn't. Note the difference between a demand based and a need based market, for lack of a better term. No one can put off heart surgery if they need it, like you can put off buying a new car. To make matters worse, the people who need the most expensive health care are typically in a state that they are not healthy earners. The same can be said for police and fire protection. They should all be essential services. Why healthcare is not addressed that way in this country is a mystery. It is elsewhere.

This is a totally screwed up statement. Simple truth of the universe is that people have infinite needs and wants and there is a finite pool of resources. There is not magic wand that can change this and given past performance it is a certainty that government is the magic wand that you desire.

Originally Posted by Marx & Lennon

Thank you for showing your magical thinking on the miracle of the markets. Do you folks have data to support your assertions? I haven't seen any. So who are guilty of making their beliefs into a faux religion?

There is nothing magic about a market economy except maybe in the Arthur C. Clarke sense of the word. Given what the liberals and progressives seem to know about economics this is a definite possibility. To help you understand this I suggest you look up the Socialist Calculation problem which tells you why Mises could predict in 1920 that the Soviet Union would collapse which caused the socialist economist Robert Heilbroner to admit that Mises was right.

I do not claim that a market economy will create utopia since that really isn't an option. I do say that every other economic system is worse and will tend to create more suffering.

Originally Posted by TnT

Mr. Galen,
Convince us that you deserve your namesake and send us some data and analysis with other than superficial, bald partisan statements.

I am familiar with the Galen of antiquity but that is not why I chose that name. It is the name of a fictional character that I rather like.

You can not imagine how little use I have for either the Democrats and Republicans. As near as I can tell all they want is to pick my pocket and micromanage my life.

Originally Posted by TnT

Convince us that you have even a nodding acquaintance with the field of medicine and how it is practiced in the U.S.

If the opinion of someone in the medical field is what you require then you might want to consider what Dr. Ron Paul has to say about government run medical care since he has had to deal with it. I believe that he has delivered a rather large number of babies over the years.

What I have is a background in technology, one degree in electronics and about to get one in computer science. I have been studying history as well as economics for a couple of decades. Come to think of it, I have been experiencing the fuck ups of government for the better part of half a century.

I also have the experiences of one Lost Generation great-grandmother who got to watch the government grow since the Progressive Era of the early twentieth century. She lived until 1993 and did not approve of how expensive or intrusive government got. Now that I think of it my GI era grandmother said much the same thing and she lived until 2005.

Originally Posted by Galen

If the opinion of someone in the medical field is what you require then you might want to consider what Dr. Ron Paul has to say about government run medical care since he has had to deal with it. I believe that he has delivered a rather large number of babies over the years.

What I have is a background in technology, one degree in electronics and about to get one in computer science. I have been studying history as well as economics for a couple of decades. Come to think of it, I have been experiencing the fuck ups of government for the better part of half a century.

I also have the experiences of one Lost Generation great-grandmother who got to watch the government grow since the Progressive Era of the early twentieth century. She lived until 1993 and did not approve of how expensive or intrusive government got. Now that I think of it my GI era grandmother said much the same thing and she lived until 2005.

Blah, blah, blah.

Originally Posted by TnT

Blah, blah, blah.

Someone's sure feeling their oats today.

Originally Posted by Galen

Originally Posted by Marx & Lennon

Yes, most of the early stuff was expensive in its day, but the development cost was orders of magnitude less intensive than the modern stuff. For GE or Siemens to commit $100 Million to developing modern imaging technology, they had to know that there was a funding source that could sustain it. This is not good or bad. It just is.

You are not taking into account that the value of the dollar has fallen since 1913 when the Federal Reserve was created. For example ten million dollars in 2010 has the same buying power as $452,461.80 in 1913 according to the Bureau of Labor and Statistics. I assure you that current imaging technology would look just as simple to a person living a century from now.

Forget money for a minute, and consider the human capital required. The number of researchers, developers and the cost of producing these devices is vastly disproportionate ... in human terms. The x-ray is pretty simplistic.

Originally Posted by Galen ...

Originally Posted by M&L ...

No it isn't. Note the difference between a demand based and a need based market, for lack of a better term. No one can put off heart surgery if they need it, like you can put off buying a new car. To make matters worse, the people who need the most expensive health care are typically in a state that they are not healthy earners. The same can be said for police and fire protection. They should all be essential services. Why healthcare is not addressed that way in this country is a mystery. It is elsewhere.

This is a totally screwed up statement. Simple truth of the universe is that people have infinite needs and wants and there is a finite pool of resources. There is not magic wand that can change this and given past performance it is a certainty that government is the magic wand that you desire.

Health is a need that doesn't meet market requirements. Food, on the other hand, does fit the market. The need for food is predictable. The need for heart surgery, police protection or a response form the fire department is not. We provide for common needs that are not well distributed and fall on those least able to pay for them at the time they need them through public entities. Health care certainly falls into that model. As a profit making endeavor, it has the potential to be used for extortion built-in; pay me what I demand or die! That's why hospitals can't turn away anyone needing emergency care.

Originally Posted by Galen ...

Originally Posted by M&L ...

Thank you for showing your magical thinking on the miracle of the markets. Do you folks have data to support your assertions? I haven't seen any. So who are guilty of making their beliefs into a faux religion?

There is nothing magic about a market economy except maybe in the Arthur C. Clarke sense of the word. Given what the liberals and progressives seem to know about economics this is a definite possibility. To help you understand this I suggest you look up the Socialist Calculation problem which tells you why Mises could predict in 1920 that the Soviet Union would collapse which caused the socialist economist Robert Heilbroner to admit that Mises was right.

I do not claim that a market economy will create utopia since that really isn't an option. I do say that every other economic system is worse and will tend to create more suffering.

Krugman put it best. Raw capitalism is the worst form of social Darwinism and absolute socialism is stagnation and failure. The most successful system is capitalism with a robust social safety net. This is demonstrated by the history of the last several centuries, which has examples of all three cases.

On January 1st our new crappy insurance kicked in. This is the new insurance that has been forced on us by my husband's employer. $1000 deductible per person with no co-pay for doctor's visit. I'm still unclear as to whether or not prescriptions are subject to the deductible, but I have never seen anything in the plan which addresses co-pays on prescriptions, so I assuming they are subject for deductible also.

It is now 11 days into the new year and I will find out this afternoon exactly how much it is going to cost every time I have to take a kid to the doctor. My youngest son woke up this morning complaining of an earache. Upon further questioning, it sounds like it began last night after he was hit in the ear with a snowball. My medical opinion as a mother...sounds like a version of swimmer's of ear to me since he doesn't have a cold and isn't running a fever. I called the nurse at the doctors to inquire if it is in fact swimmer's ear, if it will go away on it's own. I received her standard answer, "Well, we don't know if that's what it is, so he needs to see the doctor. Could be something else going on." I don't think she did answer my initial question.

I knew would have to cross this bridge sooner or later, since kids are constantly getting sick. I was just hoping we would make through the first month of the year without having to shell out big bucks to see the doctor and get a prescription.

Originally Posted by Deb C

Someone's sure feeling their oats today.

Yeah, I know. Sometimes I just lose it.

There is just SO much about healthcare to talk about and so many different and creative ways to look for solutions.

This one-note Charlie thingy ... this "all problems are caused by government" bs gets to me, especially when combined with a refusal, or inability to reach below anything but superficial talking points.

For example, George Lundberg, M.D. who was once editor of the JAMA, wrote a book, Severed Trust: Why American Medicine Hasn't Been Fixed . In it he points out how medical care has evolved and how we have quit "caring" for patients, and only "treat" some patients ... Ignoring evidence-based medicine, spending most of our money making dying people miserable instead of caring for them. And, for that matter, there are dozens of other analyses in books about healthcare that could be discussed and debated.

I just don't get it ... do conservatives really think that the current system works? That it's even a system? That a "free market" can even possibly exist in something like healthcare?

I'm baffled.

Originally Posted by Marx & Lennon

..."Health is a need that doesn't meet market requirements. Food, on the other hand, does fit the market. The need for food is predictable. The need for heart surgery, police protection or a response form the fire department is not. We provide for common needs that are not well distributed and fall on those least able to pay for them at the time they need them through public entities. Health care certainly falls into that model. As a profit making endeavor, it has the potential to be used for extortion built-in;"...

Originally Posted by Marx & Lennon

This is a key area where I part company with most Republicans and many conservatives. The Health care 'system' does not work well in the market. As an independent, I also have other issues with the Democrats, but the health care system needs a more systematic way to deal with the common problems.

Originally Posted by TnT

Yeah, I know. Sometimes I just lose it.

There is just SO much about healthcare to talk about and so many different and creative ways to look for solutions.

This one-note Charlie thingy ... this "all problems are caused by government" bs gets to me, especially when combined with a refusal, or inability to reach below anything but superficial talking points.

For example, George Lundberg, M.D. who was once editor of the JAMA, wrote a book, Severed Trust: Why American Medicine Hasn't Been Fixed . In it he points out how medical care has evolved and how we have quit "caring" for patients, and only "treat" some patients ... Ignoring evidence-based medicine, spending most of our money making dying people miserable instead of caring for them. And, for that matter, there are dozens of other analyses in books about healthcare that could be discussed and debated.

I just don't get it ... do conservatives really think that the current system works? That it's even a system? That a "free market" can even possibly exist in something like healthcare?

I'm baffled.

I have a lot of coservative friends and on this issue( like many others), the emotional attachment to a position becomes almost like a religious stand. The discussion breaks down because the facts become irrelevant. To be fair , the same thing occurs from the liberal side on other issues. It is frequently difficult to establish a rational dialog.

Originally Posted by Marx & Lennon

Raw capitalism is the worst form of social Darwinism and absolute socialism is stagnation and failure. The most successful system is capitalism with a robust social safety net. This is demonstrated by the history of the last several centuries, which has examples of all three cases.

Rational analysis as always, Mr. H. I would add that there seems to be plenty of historical evidence pointing to how capital left to it's own devices leads to a closed system that itself will have structural problems. Money will eventually concentrate and the system will cease to be robust -- concentrated money doesn't "spend" well, and the system closes -- just as Krugman and Reich point out concerning circa 1929 and circa now. Socialism as such is obvious an equally poor solution/outcome.

The government is going to get involved one way or another eventually. If not "progressively", as it were, then crony-style. Our own monopolies at the turn of the century (with the Senate in their pockets) and Russia in the 1990's are good examples. Citizens United v. FEC does not bode well for our current direction.

Originally Posted by The Rani

Liberals are no better, thinking that throwing more money at the problem will help. If the industry has more money to spend, they will sure find new and creative ways to waste it.

Agreed. That's why a combined approach is best.

Originally Posted by radind

This is a key area where I part company with most Republicans and many conservatives. The Health care 'system' does not work well in the market. As an independent, I also have other issues with the Democrats, but the health care system needs a more systematic way to deal with the common problems . . .

I have a lot of coservative friends and on this issue( like many others), the emotional attachment to a position becomes almost like a religious stand. The discussion breaks down because the facts become irrelevant. To be fair , the same thing occurs from the liberal side on other issues. It is frequently difficult to establish a rational dialog.

Bingo! Take this recent event. Oversimply, the Left says that the use of targets and "hit lists" and such caused this young schizo to attack the congresswoman. It has all the signs of becoming a sacred belief. Likewise the Right seems equally determined to deny any connection and sees any attempt to do so as a thinly veiled assualt on the 2nd amendment and/or a craven attempt to score political points. Again, holy writ in the making.

Could it be that the schizo might or might not have done something crazy eventually anyway? Could it be that the use of targets and hit lists is unwise, or at least tasteless?

I think you have really hit the nail on the head. Many liberals I know think anyone who wants to scale back immigration, particulary illegal immigration, is automatically a racist. BTW, in that context I am apparently a racist. Many conservatives I know think Obama is a socialist bent on undermining this country both at home and abroad --that his election is probably illegal -- and that those who support him to any significant degree are ignorant at best, and very possibly traitors to this country. In that context I am apparently an ignorant traitor.

We seem to have somewhat diluted aspects of c. 1773, c. 1860, and c. 1929 all roled up into one. We have people convinced that an oppressive power is holding them down (the Tea Party's Washington DC, the Coffee Party's Money Power), people believing that core beliefs are irreconcilable (North/South then, Blue/Red now), and a concentration of wealth and an economic downturn the likes of which is apparently structural (Great Depression, Great Recession).

The "fact are irrelevant" issue you brought up will determine how this all plays out.

Interesting article from the Economist:

When socialism and libertarianism collide: Who's to blame for American health care? | The Economist
http://www.economist.com/blogs/democ...ianism_collide
Who's to blame for American health care? Jan 10th 2011,

"MOUNTING toward his conclusion in a much-discussed post attempting fairly and precisely to pinpoint the ways in which libertarians have and have not made the world lousy, Ezra Klein says this:

That libertarian dreams of a privatized (or completely dismantled) Medicare system haven't come to pass is no more relevant than dreams of minarchy. What has come to pass is an aggressive and successful effort to stop America from following other countries' paths to national health-care systems. And the result can be seen here: If our costs had followed their costs, we'd have no budget deficit to speak of. Libertarians shouldn't have to answer for minarchy. But they do have to answer for that....Of course, the story can go the other way 'round. If not for the vast and lavishly subsidised conspiracy that has enabled ideologues of social democracy to dominate America's premier opinion-shaping institutions, America would now enjoy the abundant blessings of thoroughly free and competitive markets in insurance and health services. After all, efficient and free markets are the natural and just condition of a free people. This story is at least as compelling as Mr Klein's, and I'll admit I once believed something like it. As it is, libertarianism and social democracy are rival ideologies, and their proponents have fought bitterly to shape public opinion and America's public institutions. ...

In my preferred version of the story, the woeful American health-care system is the wreckage of a collision between between the left's intense desire to put the finishing touch on the so-called "Second Bill of Rights" and the American majority's vaguely libertarianish hostility to socialist institutions. Liberals have tossed up one legislative Hail Mary after another only to get slapped down by public opinion and settle for half-measures which have led cumulatively to the patchwork absurdity of the status quo. To liberals who wanted a single-payer system, and if not that, a public option, Mr Obama's legislative score was more a field goal than a touchdown. And now, according to Gallup, more Americans want to repeal "Obamacare" than want to keep it. The new Republican House majority has taken the cue and is pressing forward with efforts to rescind elements of the Democrats' reforms. However this plays out, the resulting health-care system will be a different but not-necessarily better mess.

The story that there is no villain here, only the complex, dynamic interaction of largely irreconcilable interests and ideologies, doesn't move units. So try this. If I had to lay blame for this mess on any single conviction, it would be the left's insistence that positive rights, such as the putative right of access to decent health-care, are best secured by a comprehensive system of government guarantees and regulatory supervision. This is the belief that, when Democrats try to put it into practice, wrecks repeatedly against the shoals of American public opinion. The problem is not so much the notion that access to health care is a human right—a notion I think most Americans endorse in some form or other—but the distinctively progressive vision of government's maximally extensive role in managing the provision of the entitlement. That is to say, our stupid health-care system cannot be attributed to the influence of the likes of Friedrich Hayek and Milton Friedman, neither of whom opposed a universal entitlement to health care. On the contrary, we would have long ago achieved the dream of universal access to decent care had liberals let go of their dream of big government's supervisory role and paid more attention to the likes of Messrs Hayek and Friedmen when they talked about about how to get this sort of thing done. Health-care pundit, heal thyself.

Originally Posted by TnT

Yeah, I know. Sometimes I just lose it.

There is just SO much about healthcare to talk about and so many different and creative ways to look for solutions.

This one-note Charlie thingy ... this "all problems are caused by government" bs gets to me, especially when combined with a refusal, or inability to reach below anything but superficial talking points.

For example, George Lundberg, M.D. who was once editor of the JAMA, wrote a book, Severed Trust: Why American Medicine Hasn't Been Fixed . In it he points out how medical care has evolved and how we have quit "caring" for patients, and only "treat" some patients ... Ignoring evidence-based medicine, spending most of our money making dying people miserable instead of caring for them. And, for that matter, there are dozens of other analyses in books about healthcare that could be discussed and debated.

I just don't get it ... do conservatives really think that the current system works? That it's even a system? That a "free market" can even possibly exist in something like healthcare?

I'm baffled.

I've been working on this issue for a few years now and I'm also baffled at times. Perhaps not understanding the financial savings with a healthcare for all, and that people, not profits, are most important, has something to do with stages of development.

Originally Posted by Marx & Lennon

Forget money for a minute, and consider the human capital required. The number of researchers, developers and the cost of producing these devices is vastly disproportionate ... in human terms. The x-ray is pretty simplistic.

You are forgetting that before there could be the X-Ray there had to be photographic film and then someone had to invent the electron tube in order to make it work. Looks simplistic now from the vantage point of a century but it was leading edge.

The human capital is factored in through the cost of the labor used in design and manufacture of the devices. In short the human capital costs are what the employer and the employee agree to in the employment contract.

This is all part of the process of economic calculation.

Originally Posted by Marx & Lennon

Health is a need that doesn't meet market requirements. Food, on the other hand, does fit the market. The need for food is predictable. The need for heart surgery, police protection or a response form the fire department is not. We provide for common needs that are not well distributed and fall on those least able to pay for them at the time they need them through public entities. Health care certainly falls into that model. As a profit making endeavor, it has the potential to be used for extortion built-in; pay me what I demand or die! That's why hospitals can't turn away anyone needing emergency care.

Most health care is routine. The rest you can buy insurance for much as you would fire or auto insurance. Just in case you think this is unreasonable it is what I did after I was laid off at the end of 2008.

As for the extortion potential, I wish for you to consider the following question: What did people do before the Feds got involved in health care? I assure you the everyone did not drop dead. Wrong Assumption Number One is that all hospitals were for profit. WAN 2 is that doctors did not provide services at reduced prices or for free.

Originally Posted by Marx & Lennon

Krugman put it best. Raw capitalism is the worst form of social Darwinism and absolute socialism is stagnation and failure. The most successful system is capitalism with a robust social safety net. This is demonstrated by the history of the last several centuries, which has examples of all three cases.

I disagree with this. So far all the Great Society had managed to do is subsidize dysfunction. In an earlier time it was religious organizations, private charities and of course families. It did work with out creating the dysfunction that has become so prevalent.

Given the huge financial disaster that the Silent and Boomer generations have been working on for about the last half century an there are limited options. The Millies unfortunately will pay a very heavy price for a disaster that was not of their making.