Megan McArdle on the morality -- not the economics -- of a single-payer healthcare system:
As a class, are the young and healthy more responsible for the bad health of the old and sick? Quite the reverse. Many people in the old and sick category did nothing at all to deserve their fate; they just aged or were victims of fate. But some members of the "old and sick" class contributed to their fate. Contra many of my interlocutors, there are a lot of very expensive diseases that have a substantial lifestyle component: high blood pressure, coronary artery disease, diabetes, lung cancer, emphysema/COPD, congestive heart failure . . . many of our nation's biggest killers, and consumers of health care dollars. So as a class, the old and sick are somewhat responsible for their poor healthcare outcomes, although I will leave it up to the doctors to argue exactly how much responsibility they bear.
Niall Ferguson in the New Yorker reviews a book on the Marshall Plan by Greg Behrman:
This positive reassessment echoes the argument advanced in the early nineties by Brad DeLong and Barry Eichengreen (in an article that is absent from Behrman's bibliography). Marshall Aid was indeed vital, but more in terms of political economy than macroeconomics. It helped get the European economies through a balance-of-payments crisis, to be sure. More important, though, it helped European governments balance budgets and reduce inflation. It forced them to shift from wartime controls to free-market mechanisms. And it played an important part in moving Europe from a dysfunctional system of labor relations based on strike action and class conflict to one based on wage restraint and productivity growth. In all of this, the Marshall Plan resembled the "structural adjustment programs" the International Monetary Fund imposed on borrowers in the developing world during the nineties, but on a larger scale and with much better public relations. As Marshall had foreseen, tackling the food bottleneck was beneficial both materially and psychologically. One Dutch baker displayed a sign that read, "More than half of your daily bread is baked with Marshall wheat." Wherever the red-white-and-blue Marshall shield could be seen, its motto resonated: "For European Recovery: Supplied by the United States of America." The most important strings attached to such supplies were the ones tying Europe to the new American model of managerial capitalism.
The Peter's elephantnose fish sees with an electrical organ on its nose. It can even distinguish dead from living food with it:
Originating in Central Africa, Peters' elephantnose fish (Gnathonemus petersii), finds its bearings by means of weak electrical fields...The fish, which is as long as a cigar, hovers with its head inclined, close to the gravel-covered bed. While it swims forward slowly, its trunk-like elongated chin sweeps steadily from right to left, always at a distance of a few millimetres from the bottom. This way the fish behaves like treasure hunters searching for buried gold coins on the beach with their metal detector. Basically, this is precisely what the fish is doing. Hidden in the sediment there are large numbers of dead nematocera larvae waiting for it, its favourite food...The chin of Peters' elephantnose fish is basically its eye. In its tail is the corresponding torch. Via mutated muscle cells it produces regular electrical pulses of a few volts with it. 80 times per second the fish switches this little battery on and off for the blink of an eye...Nearby objects distort the field, so that the fish obtains an image of its surroundings, which is a surprisingly complex one.
The article published in the Journal of Experimental Biology is here. Zooillogix has more.
A uranium leak in 2006 was hidden by the Nuclear Regulatory Commission. Hat-tip: Slashdot:
Some 35 liters, or just over 9 gallons, of highly enriched uranium solution leaked from a transfer line into a protected glovebox and spilled onto the floor. The leak was discovered when a supervisor saw a yellow liquid "running into a hallway" from under a door, according to one document.
The commission said there were two areas, the glovebox and an old elevator shaft, where the solution potentially could have collected in such a way to cause an uncontrolled nuclear reaction.
"It is likely that at least one worker would have received an exposure high enough to cause acute health effects or death," the agency wrote.
GrrlScientist shows how grounds squirrels wave and heat their tails to scare away rattlesnakes. Rattlesnakes have an organ below their eye that can detect infrared, and it makes the squirrels appear bigger than they are.
The post has this really cool video.
Read the whole thing.
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God, please don't tell me you pointed to Megan's article approvingly. It's top to bottom crap.
In a mature single payer system, the old have been paying into the system THEIR ENTIRE LIVES, and the young will benefit from the exact same benefits once they grow old, as well as the wonders of new technology available to them. And then she whines that the young, who have been paying into the system for only a few years, are being unfairly hit by the redistribution of wealth? Laughable.
Second, if the state walked into her hospital room, and fined her $5000 for breaking her leg while skiing, she would be screaming bloody murder for restricting the freedoms of the individual. But if a for-profit hospital does the same thing, she seems to be fine with that as an example of "personal responsibility".
Poor health is it's own punishment. Pain, disability, reduced mobility, reduced energy, the spectre of imminent mortality... but because they don't have relative dollar signs, we have to talk about the economics of moral hazard? I fear this is the problem when reducing the argument of human social interaction to purely economic discussion.
She is almost about one thing:
Most advocates of single payer, I think, care most about this justice claim. They may also think that they can make the system more efficient, but if one could somehow prove scientifically that a private system would be cheaper and better, they would still favor a public system as long as a substantial population remained uninsured.
That's absolutely correct. But the fact that multiple nations have shown that universal healthcare IS cheaper and more efficient than the US for profit model, AND manages to cover all people equally and result in better measure of health throughout the population. Because of this the only reason for the point is to portray critics as mushy-headed emotionalists, and to ignore facts in favor of economic models to base her theory on.
I suppose it would be futile to argue that our "free market" health system is so heavily regulated that it is the regulations themselves that keep the system from operating optimally . . .
I suppose it would be futile to argue that our "free market" health system is so heavily regulated that it is the regulations themselves that keep the system from operating optimally . . .
Pretty much. Unless you can show evidence of a nation in the world where the least regulated private medical systems are the most effective.
We were, for a while. Our system has gotten progressively worse as government has become more involved.
Unfortunately when it comes to developed nations, free markets and health care, there isn't much to go on. Government-run health care is all the rage. If I run into something useful I'll post it here, I don't have anything offhand.
We were, for a while. Our system has gotten progressively worse as government has become more involved.
Before continuing with that thought, remember that before the era of the HMO, healthcare was run by non-protit organizations in the United states, not for-profit businesses.
http://www.slate.com/id/2161736/
"The Blues were essentially nonprofit health insurers who served local community organizations like the Elks. In exchange for a tax break, Blue Cross organizations kept premiums reasonably low.
The success of the Blues persuaded commercial insurers, who initially considered medicine an unpromising market, to enter the field. Private insurers accelerated these efforts in the 1940s when businesses, seeking ways to get around wartime wage controls, began to compete for labor by offering health insurance. If government regulators had thought to freeze fringe benefits along with wages, we might have avoided making the workplace primarily responsible for supplying health insurance, a role that most people now agree was ill-advised. Instead, the government jumped on the bandwagon by exempting from the income tax company expenses associated with health care."
Notice how the story more or less starts with a tax exemption, wandered into wage controls, then concluded with another tax break. Of course, once government started to get really savvy about the power of the purse it's not that far a leap from there to here.
But, of course, more government is the solution, not the problem . . .
Um... the paragraph right above the one you quoted reads as follows:
I don't know whether to thank you for making my argument for me, or weep at the willful blindness on display.
I see, so a handful of anecdotes and a conclusive statement that private markets can't deliver health care and that's enough for you. Wow.
No need to read any following paragraphs that describe essentially government involvement and intervention from the beginning, meddling with the market.
Yah, if only government had frozen fringe benefits along with wages, yah! Capitalizm suX0rz!!
Talk about blindness, not being able to see the deterioration of the system with the further and further intervention of government. Back to the executive summary, I guess.
Whatever.
Jim, I asked for data regarding the superiority of a free market system over a socialist one. As in, of the top 30 countries in health statistics, which of those are provided by laissez faire market solutions, as opposed to socialist insurance/hospital systems?
Instead, you take a paragraph out of a book review, apply your own logic to it, and then expect me to accept that over the reviewer's conclusions? You've done nothing to disprove the conclusion in favor of your summary: I.e. that the free market utopia was spoiled by government intervention, as opposed to government intervention being an insufficient fix to the fundamental flaw of an unregulated market running health care. So don't get snippy at me for taking the author's conclusions over yours.
And no, I do not base my beliefs on a book review. My beliefs come from reading up on the relative costs of health care compared to coverage, satisfaction, and key health markers (such as infant fatality rates and life expectancy).
And frankly, I find it hard to believe tat the market is somehow an agile, responsive versatile and highly efficient system, which somehow breaks down the second limitations are placed on the market by government.
So unless there's a nation out there that has managed superior results from a purely capitalist system, I'll have to say the theory of market superiority in this instance is unsupported by evidence.
The fact of living longer as a cause of the healthcare crisis is an interesting viewpoint, especially coming from erstwhile scientists. Disease has it's social causes, some institutional some individual. Some of those causes are immutable such as age and gender. Arguing about old as a cause of the problem is like saying life only has value if one is old and healthy. The healthcare solution will include hardship for everyone, even the healthy--because they too will someday age and become infirm.
Unfortunately, the United States is the beacon of the developed world in "free market" health care, which is a complete joke.
What I can point to is areas where the market is trying to find ways to provide low income individuals with basic services at costs available to them, and they are being frustrated by government regulators and those that stand to lose their government-supported incomes:
http://www.tothepeople.com/2007/08/minute-clinics-are-poised-to-make.ht…
http://www.tothepeople.com/2007/05/damn-wal-mart.html
It's easy to claim that you always win the argument because of a lack of evidence for the effectiveness of free market health care, because such a thing in the developed world does not exist. A cheap way to "win" an argument, IMO.
Where am I missing here--if your argument is that socialized medicine wins because there is no demonstrated national success story of free market medicine, where is the evidence that modern free market health care in a developed country is a failure? You sure as hell can't use the United States as a point of evidence, all you have is maybe an argument that some purely socialized systems have the advantage over "hybrid" systems.
Are you just holding comments for moderation now before letting them through, or is this a subtle hint that my conversation with LWF is terminated?
Well, that one came up right away, is the one I submitted yesterday still in the system somewhere?
Jim: A couple of my replies got eaten by moderation in the last thread as well. I think I dropped too many links in it.
Well, the gist of my comment (in which I did include two links) was that it's kind of cheap to use the "no evidence" argument because there is also no evidence that free market medicine doesn't work--not in a modern, developed nation. The US, often pointed to as the reference point for market-based health care compared to the rest of the world, has had progressively increasing amounts of government intervention for decades. So while I don't have a shining example of the wonders of free market medicine per your request, I similarly don't think there is a good counter-example under the same restrictions.
The links I posted to referenced some efforts by large corporations to provide low-cost health care to lower income individuals for routine medical problems--a free market-style approach to the prohibitive cost of health care. The primary problem is that the government, and the doctors who don't want to lose their heavily government-subsidized business, are going to Hell and back to either prevent them outright or burden them with so much regulation that people might as well spend the money to go to the doctor's office or emergency room.
Just to be clear, when I said there isn't a good counter-example under the same restrictions, I did not mean the effectiveness of a fully socialized system such as Italy vs. a hybrid system in the U.S., but rather an example of a failed free market system in a modern, developed country (since your request for for a successful free market health care system in a modern, developed country).
Just to be clear, when I said there isn't a good counter-example under the same restrictions, I did not mean the effectiveness of a fully socialized system such as Italy vs. a hybrid system in the U.S., but rather an example of a failed free market system in a modern, developed country (since your request for for a successful free market health care system in a modern, developed country).
But isn't that setting the bar pretty low? If you're arguing the merits of a free-market medical system, shouldn't that system be superior to the socialist systems?
The problem is I simply don't see a mechanism for a market solution to universal coverage. What economic incentive is there to provide a service to someone who can't afford it?
It is difficult to hypothesize what form a market solution might take. One theory is that once freed from a majority of the bureaucracy and red tape, hospitals and private organizations might have the resources to undertake more charitable work, and with people not having to pay as much in taxes you might also see a boost in donations and private gifts. That's probably not going to get too many destitute people top-flight medical treatment, but it could go a long way towards getting people's basic medical needs covered.
You free up companies to start offering basic, low-cost services, such as Wal-Mart's proposals, and you lower the overall cost for providing basic services for most people.
And insurance companies aren't going to go away. Again, the theory goes that the cost savings that would accompany eliminating a lot of the bureaucracy could go a ways towards making insurance more affordable, so more people are insured and less people have to rely on health care services provided pro bono. That helps close the charity gap.
Part of the nature of the market, though, is that it's hard to tell what form solutions will take. Look at how markets are evolving on the Internet. Look at how traditional music distribution is being turned on its head. No one can pretend to tell you what the market solution will be or will look like in 5 or 10 years or beyond.
And at the end of the day, you're right, none of this guarantees universal coverage. As a matter of fact, it pretty much guarantees that coverage won't be universal. But it is a sustainable system over time, which is one critique I have of the creeping socialized medicine in this country--eventually the cost and the bureaucracy of the system itself makes it unsustainable in the long-run, especially when you are talking about universal prescription coverage, a social security system where no politician has the guts to make the hard choices to make that system sustainable (if it ever could be), on top of all our other expenditures, including, for example, this ridiculous "war". We're going to go broke just as surely as the U.S.S.R. did in the 80's, it's just taken us a little bit longer to get there.