Re: Obamacare

In article <h819dc$101u$1@xxxxxxxxxxxxx>, Alan Mackenzie <acm@xxxxxx> wrote:
Herman Rubin <hrubin@xxxxxxxxxxxxxxxxxxxx> wrote:
In article <h80lfp$2412$1@xxxxxxxxxxxxx>, Alan Mackenzie <acm@xxxxxx>
wrote:
Herman Rubin <hrubin@xxxxxxxxxxxxxxxxxxxx> wrote:
In article <h7rtbb$27me$1@xxxxxxxxxxxxx>, Alan Mackenzie <acm@xxxxxx>
wrote:
scrape <scrapeNOTHANKS@xxxxxxxxxxxxx> wrote:

................

I just read today that, while good treatment of diabetes
reduces the cost of later complications, the cost of the
treatment is comparable, and my own calculations show that
the cost of what I consider reasonable testing is greater
than the figure presented. Some bean counter is going to
use that to defund taxpayer support of good treatment of
diabetes. The same holds for other diseases.

This might well happen, admitted. The supply of test strips on the
Krankenkasse's bill is somewhat restricted here. Nothing however stops
people buying extra strips of their own, if they can afford them. The
best solution of all would be to de-rig the "market" in testing strips
so that firms would compete on price.

This is unlikely to happen. However, I believe that the
method of testing using strips is too inaccurate, too
expensive, and incapable of detecting changes sufficiently.
My readings often change by 100 (5.6 in the molar system)
withing an hour or so.

But how is the scenario you're depicting worse that it is at the moment.
(That's not a rhetorical question.)

The "free health care for all" mantra is hugely misleading. It's
nothing of the sort.

Of course it's not, and it would be mischevous to suggest it was.
However, it should be free (or cheap) AT THE TIME WHEN PATIENT MEETS
DOCTOR. The reason is that people can afford to pay for health care
when they don't need it and vice versa. Health care is needed by
children, old people, and pregnant women. Children and old people don't
earn, and people with young children are skint anyway. Those at the
peak of their earning capacity, say 30 - 60, don't need much medical
care.

Parents pay for children, and those at the peak of their
earning capacity should be saving for their old age instead
of spending and expecting the government to cover it.

People need to buy food, clothes, housing, transport, and a certain
(small) minimum of luxury goods, and to pay the medical bills of their
children, of course. Only if there's anything left over can they save
for their old age.

I think you need to reread the fable of the grasshopper
and the ant.

Many do, and there have been quite a few bankruptcies because
of the lack of real insurance. Few "medical plans" have high
enough limits.

OK, I was speaking in very broad generalities. I think it's accurate
to say that the bulk of people who survive to old age need very little
medical care between 30 and 60. Those same people typically need a lot
of medical care after the age of 60.

So those between 30 and 60 should prepare for the future.

Yes.

Do you want to rely on the ignorant majority for what you
can get in your later years?

I'll have to, because I'll then be incable of producing it myself.

If you save up for themselves, they should be able to
get better care. If the government taxes them so they
cannot save up, the government is totalitarian fascist.

People in Germany and the UK don't suffer bankruptcies from the cost of
medical treatment, since that cost is guaranteed by the respective
governments. People in the USA do. That needs fixing.

But they often cannot get the treatment.

I beg your pardon? That is utterly untrue. Several of my relatives and
friends have had treatment, including expensive emergency treatment, in
the last few years, both in the UK and in Germany, and I know of nobody
who has been denied it for lack of resources or any other reason.

I presume you've uncritically accepted propaganda from organisations
opposed to reform in the USA, that propaganda having used lies to scare
you and people like you. Can you understand me getting angry at some of
the ways freedom of expression can be abused? Can you begin to
understand my point about the exercise of freedom always being at
somebody's expense?

Let me repeat: ill people in both the UK and Germany get treatment when
they need it. I've no reason to doubt that people in other
industrialised countries apart from the USA also get treatment when they
need it.

This cannot be true if a bunch of politicians and
bureaucrats decides who needs it.

I do not expect a financially strapped government supporting treatments
denied by the present insurance companies, which can be, and have been,
sued to compel them.

If every other advanced industrial country can manage it, why can't the
USA?

See the above. These other countries "manage" it by
deciding who gets treated.

As one who has saved up for his old age, I do not have too
much sympathy for those who have not.

What about those who couldn't save up, because they didn't have enough
in the first place?

Are you a Marxist? You are sounding like one.

No, I'm not a Marxist. I'm a socialist. Primarily, I'm a pragmatist.
I like things things that work, dislike things that don't.

Marx was a socialist, and the founder of socialism.

Now, how about some sympathy from you for people who've been unable to
save up for their old age due to never having had enough money?

If there is adequate private charity, we can provide
for them. If not, we are not rich enough to do so.

In fact, I would go further; those who have spent rather than saved
have put themselves in this position, and I see no reason why those
who have saved should give them their savings.

Let's get a little bit abstract. In your old age, you will be entirely
unproductive.

I happen to be quite productive.

It is only the labours of younger folk that will give
your savings any value at all. Your savings are meaningless outside the
context of a stable regulated society. Therefore it is only just that
part of your savings is diverted to mainaining this society.

Other than providing the necessary police force to safeguard
property, I do not see any elements of a regulated society
involved.

This is utter nonsense, or straight Marxist ideology.

Have a think about what money is, and what society is.

Cash is usually invested.


Are you implying that those without insurance and without money can
get free medical care in an emergency room? If that is the case, it
shows how broken the system is. It would surely be better to provide
for these people openly through taxation.

Not quite, but medical care is available. I would rather
have it done by non-profit charitable institutions than by
a government, where the bureaucratic types will be involved.

Who, then is to guarantee the adequacy of those charitable institutions?
I expect your answer to be "nobody", and that should they not be up to
providing adequate health care, people dependent upon them will just
have to do without.

If we cannot get enough charitable institutions to cover what
is wanted, there are not enough resources to go around.

Or there are too many tight-fisted bastards around.

No; there is not enough to go around. As someone once put
the world conditions, it is as if there are lifeboats with
a maximum capacity of 60 floating in a dangerous sea, with
high waves so that a full lifeboat will have people knocked
off, and there are lots of people swimming around for their
lives. Your only alternative, if you are on a lifeboat, is
to fend them off, unless the individuals are useful to you.

This is the case anyhow.

If the USA's spending (per person) on health services has been so much
higher than any other country, how come it's so short of resources when
other countries are doing just fine?

I have been arguing that the other countries are not doing
just fine. There are reasons for the higher US spending,
a good part of it being that there is little government
support of quality higher education for the bright. Someone
in a "disadvantaged" group with a high school diploma can
go to a top college more easily than a genius from a middle
class family.

We will have to face that the world cannot survive and progress by
providing equal resources to all; the former Soviet Union showed that
people will work much harder and better for themselves than for the
state. Socialism does not work.

-isms in general don't work. Capitalism doesn't work, either. Sensible
policies do though, regardless of whether they're categorised as
"capitalist" or "socialist" or "somethingelseist".

However, health services provided by governments work, and work well. I
suspect that the scheme you've sketched out for the USA (personal
medical insurance for the rich, charitable institutions for the poor)
would work badly, scarcely better than what there is at the moment. If
you could point to any examples where it has been tried out and found to
work well, I might change my mind.

They are, alas, a necessary burden, but I would not trust
more than a small proportion to be other than "go by the book"
or "it is my job to save the world according to my values".
That latter type is extremely dangerous, but the former is
not that great.

Herman, your contributions in this thread suggest you yourself are one
of the "latter" type. You wish to impose your values on your
compatriots.

No; those who wish can join a voluntary cooperative, which
can tax them, and only them, to form a medical pool. Libertarians
do not object to people becoming serfs voluntarily.

No, libertarians think their "philosopy" gives them some magic
entitlement to freeload on others, that they needn't pay their way.
That they should only pay as much tax as they feel like. That they
should enjoy the benefits of their society without having to contribute
to its upkeep. Sorry, chum, but you'll find yourself behind bars or at
the sharp end of a gun if you try seriously to exercise any of that
stuff. But do feel free to carry on moaning about it.

Libertarians believe nothing of the sort. People like you do.

...............
--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
hrubin@xxxxxxxxxxxxxxx Phone: (765)494-6054 FAX: (765)494-0558
.

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