Anyway, corporatist in this day and age usually means rule by corporations in collusion with government. Part private, part public. That’s *precisely* what I meant by corporatism. France may indeed have a corporatist system, but it leans more in the direction of public control via the state rather than of private control via the state.

In fact, there IS no such thing as a corporation without government; they are legal fictions chartered by state fiat. To see corporations as mechanisms of the “free market” is a bit of a contradiction on its face. But, I don’t want to blow the Catoids minds all in one fell swoop. :-)

I may be ignorant of the nuanced particulars of health care policy; granted. All I’m saying is that it’s my opinion that, if I have to choose between a socialized system that favors private business interests and a socialized system that favors political power, I’ll at least go with the one that gives me a tiny say every four years over the one that gives me no say whatsoever. In fact, this has nothing to do with health care qua health care, really, but health care as a proxy for politics.

I prefer a free market, free of gov’t intervention of all sorts. Absent that, I have secondary preferences. They are just preferences. But to say that this is a choice between the free market and socialism is wrong. That’s why I criticize Radley even though I greatly admire the work he does.

Matt Moore: my solution is anarchism; getting privilege out of the equation and letting people deal amongst themselves as they will. If I have to deal with some sort of regulatory apparatus and a genuine free market is off the table, I’ll take the one that favors me as a human being over me as a customer. But that’s just my preference.

Do you have any evidence to support that statement?

Free-market economics. Without a market there is no way to assign the correct value to a good, so we end up paying too much or too little for everything and supply never equals demand.

There’s a joke about what would have happened if Communism had succeeded in taking over the world. All the countries in the world are now socialist, with the exception of Japan, which still has completely free markets. Why’d leave one country alone? Because otherwise they wouldn’t no what things should cost.

By the way, +1 on the Swiss system, but it would require something akin to an armed incursion to convince big pharma and big insurance to become not-for-profit, which is a big lynch pin of that system.

The Swiss system isn’t not-for-profit. The “base” insurance, mandated for all, is not-for-profit, and the supplemental insurance is for-profit.

More here:

“How does it work? The Swiss example shows that universal coverage is possible, even in a highly capitalist nation with powerful insurance and pharmaceutical industries. Insurance companies are not allowed to make a profit on basic care and are prohibited from cherry-picking only young and healthy applicants. They can make money on supplemental insurance, however. As in Germany, the insurers negotiate with providers to set standard prices for services, but drug prices are set by the government.

What are the concerns? The Swiss system is the second most expensive in the world — but it’s still far cheaper than U.S. health care. Drug prices are still slightly higher than in other European nations, and even then the discounts may be subsidized by the more expensive U.S. market, where some Swiss drug companies make one-third of their profits. In general, the Swiss do not have gatekeeper doctors, although some insurance plans require them or give a discount to consumers who use them.”

Is it ideal? No (in my humble opinion, a free market is ideal).

But it’s a damned sight better than single-payer, and most of the system allows for profit. Again, it’s a mix of socialized and free market aspects to medicine, that seek to limit the socialized portions as much as possible (while still offering universal coverage).

If it is almost free, then you are paying something. Now maybe in your specific case there was little gain, but where I work a young, reasonably healthy employee, would see some extra money in his/her paycheck every two weeks.

If my employer is willing to buy me 600 dollars of insurance a month, and they only charge me 40, I’d be a fool to turn that down. I tend to think people, even young people, are not fools.

I agree totally with all your AMA talk, btw. Interesting info, too… are there any decent books on the history of managed health care?

You are perfectly clear, what you are failing to realize is that some might decide to carry no insurance at all and keep the money they’d otherwise spend through their company provided health care plan.

No, I do realize that. I just don’t have a problem with it.

Do you have any evidence to support that statement?

Gammon’s Law. In government regulated institutions the as inputs increase output decreases.

Linky

Some years ago, I came across a study by Max Gammon, a British physician who also researches medical care, comparing input and output in the British socialized hospital system. He took the number of employees as his measure of input and the number of hospital beds as his measure of output. He found that input had increased sharply, while output had actually fallen.
He was led to enunciate what he called “the theory of bureaucratic displacement.” In his words, in “a bureaucratic system . . . increase in expenditure will be matched by fall in production. . . . Such systems will act rather like `black holes,’ in the economic universe, simultaneously sucking in resources, and shrinking in terms of `emitted production.’”

Sigh… you’re not reading my posts at all. I’ve had several jobs where I health insurance is almost free and canceling it does not increase my paycheck.

If it is almost free, then you are paying something. Now maybe in your specific case there was little gain, but where I work a young, reasonably healthy employee, would see some extra money in his/her paycheck every two weeks. You can’t make policy recommendations because Matt Moore sees little impact to just Matt Moore.

I’m not sure how much more clear I can be here.

You are perfectly clear, what you are failing to realize is that some might decide to carry no insurance at all and keep the money they’d otherwise spend through their company provided health care plan.

Regarding a “free” market for health care:

The market was also less free with the advent of the AMA and its attempts to restrict entry into the market. This raises prices and its impact on quality is dubious at best. Further, various laws and rules prevent people from going to health care providers other than doctors. That is suppose there is a person who can’t afford to go to the doctor, but could afford to see a nurse if the problem isn’t that severe. This option is precluded and instead they are forced to go to the emergency room when the condition gets really bad. That is the most expensive option there is.

I agree that a free market is not going to result in money growing from trees, everyone becoming beautiful, and cats and dogs living together. However, there is a problem with the sustainability of health care schemes that rely too much on the public sector.

By the way, if anyone wonders how the government will finance universal health care, the answer is simple. They will do it the same way they’ve financed all of their welfare state nightmares. They’ll just charge it to the account of future generations. You want evidence? Just have a gander at the current public debt. At the moment it’s $9,493,175,590,922.86

I’d be glad to discuss government solutions with anyone who writes a check that takes that to zero.

Except that private companies only contribute about 29% of total research funding, and the vast majority of that is for final stage clinical trial work. Virtually all the basic work is publicly funded. So the “profit from medicine” is a small factor in medical research.

“It would be a disaster to further regulate or nationalize the American health care system.”

Do you have any evidence to support that statement?

Moving to employer provided healthcare is not the same thing as moving to a regulated system. The employers at the time were just buying the insurance on the free market. So I don’t think your statement is germaine.

Moving to employer provided insurance under government fiat with a tax break is a step towards a regulated system.

I would like to know why you think virtually all industrialized nations moved from free market to regulated/socialized system in the last century or so.

Several reasons. Health care is one of those things (like education) that everyone thinks should be free and equally provided. Doctors require years of schooling, and a simple mistake on their part can end someone’s life, so it’s easy to justify government regulation/control of their jobs. Ditto for drug regulation. Finally, most of the countries with fully nationalized health care don’t do much (compared to the US) drug and medical research so it doesn’t cause as much harm to remove the profit from medicine.

It would be a disaster to further regulate or nationalize the American health care system.

Thank you for the honest admission. That it would be better was made as a positive assertion above.

Moving to employer provided healthcare is not the same thing as moving to a regulated system. The employers at the time were just buying the insurance on the free market. So I don’t think your statement is germaine.

I would like to know why you think virtually all industrialized nations moved from free market to regulated/socialized system in the last century or so.

And don’t make a positive statement if the real answer is “don’t know” – or I do get complain.

“There are surprisingly few comments about charity here. Back in the days before poverty became a growth industry, the poor were largely helped by charitable organizations, churches, and families.”

Yes, and they also the poor largely died from illness at much higher rates than wealthier people.

A national health insurance program would at least offer some economies of scale. In any event, we don’t have anything approaching a true free-market industry today.

Yes, our non-free-market health care system is failing, so let’s make it even less free!

#67 | perlhaqr | July 11th, 2008 at 1:46 am
Li saith: By the way, +1 on the Swiss system, but it would require something akin to an armed incursion to convince big pharma and big insurance to become not-for-profit, which is a big lynch pin of that system.

Out of curiousity, how much original pharmaceutical research is coming out of Switzerland?

As much as is comning out of the U.S. Have you heard of Roche or Novartis?

For more details, click here.

You also have 52 separate sets of mandated benefits – e.g., insurers have to cover 100% of charges for treatment of phenylketonuria in Minnesota.

The result is a massive bureaucracy within the health insurance industry that exists solely to interact with state governments & the obvious multiplication of effort that goes with that.

A national health insurance program would at least offer some economies of scale. In any event, we don’t have anything approaching a true free-market industry today.

http://libertariannation.org/a/f12l3.html

Out of curiousity, how much original pharmaceutical research is coming out of Switzerland?

BTW, we HAVE tried a free market system in this country, however we moved away from it quite dramatically- because it didn’t seem to be working.

The move away from free market medicine had nothing to do with our health care system not working. During WWII the government subjected corporations to a wage freeze, right when we had a labor shortage because the most desirable workers were drafted into the military. So companies, in an attempt to attract workers without raising salaries, started to offer benefits like medical and dental insurance. Before that most people paid out of pocket for medical care.

No one is answering your question about how a modern free market health care system would look because we just don’t know. It’s never been tried, so quit acting all superior because we’re “dodging” your question.

I’m talking about people who wouldn’t buy insurance to begin with. If you don’t have much in the way of assets, and are reasonably healthy, then yes there is a benefit.

Sigh… you’re not reading my posts at all. I’ve had several jobs where I health insurance is almost free and canceling it does not increase my paycheck. Therefore there would be no economic benefit to rejecting the insurance program. I think many young people who work in middle class careers at large corporations are stuck in the same situation… they’re basically forced to buy insurance they don’t need.

If the company would give me that money in salary I probably would have carried only high deductible/low premium insurance throughout my twenties. But that wasn’t an option.

I’m not sure how much more clear I can be here.