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U.S. Healthcare And The Tragedy Of The Commons
Submitted by Charles Hugh-Smith of OfTwoMinds blog,
When the system is set up to encourage maximizing self-interest, accountability for the whole is lost.
The lessons drawn from the U.S. healthcare system's failures can be fruitfully applied to a variety of large-scale problems around the world. Let's start with an insightful look at the fixes that have largely failed to rein in costs and improve actual care/patient health.
Dilemma over Deductibles: Healthcare costs crippling middle class:
"Physician Praveen Arla is witnessing a reversal of health care fortunes: Poor, long-uninsured patients are getting Medicaid through Obamacare and finally coming to his office for care. But middle-class workers are increasingly staying away.
"It's flip-flopped," says Arla, who helps his father run a family practice in Hillview, Ky. Patients with job-based plans, he says, will say: " 'My deductible is so high. I'm trying to come to the doctor as little as possible. … What is the minimum I can get done?' They're really worried about cost."
It's a deep and common concern across the USA, where employer plans cover 60% of working-age Americans, or about 150 million people. Coverage long considered the gold standard of health insurance now often requires workers to pay so much out-of-pocket that many feel they must skip doctor visits, put off medical procedures, avoid filling prescriptions and ration pills — much as the uninsured have done."
The average hourly wage is nearly identical to what it was 50 years ago in today's dollars: $19.18 in 1964 compared with $20.67 in 2014, according to U.S. Bureau of Labor data analyzed by the Pew Research Center. Meanwhile, U.S. health spending ballooned from 5% of gross domestic product in 1960 to 17% in 2013."
While I have often discussed unintended consequences of centralized policies such as ObamaCare, my focus today is how U.S. healthcare perversely reflects the Tragedy of the Commons, the seminal paper by Garrett Hardin which described the failure of the market to value/price communally owned assets, i.e. "the commons."
Here is a basic example of the dynamic: Each individual farmer will graze his cattle/sheep on the communally owned pastures ("the commons") to boost his own profit, since the commons are "free". This exploitation of what the market has determined is "free" leads to overgrazing and the destruction of the commons--a huge loss to the entire community as well as to the farmers who were grazing their animals in the commons.
When everyone sees the commons as "free for the taking," then the commons is soon destroyed for all.
To the degree that Central State (federal) revenue is a form of public commons (since it is collected from taxpayers), the siphoning of that resource to serve individual gain leads to the loss of the commons, as well as the loss of any notion of the "common good."
This dynamic is reflected in the extraordinary expansion of healthcare's share of the national economy, from 5% to 18% (on its way to 20%). While healthcare for practioners is about patients, from the financial point of view, healthcare is focused on increasing revenues and profits by whatever means are necessary.
Financially, the commons (tax revenues) are being stripped by those with the most political power.
Though we don't normally think of the health of a nation's citizens as a commons, I think this makes a lot of sense. After all, the healthier a population is, the more productive and happy it will be, and that serves the interests of the nation and its citizenry.
From this perspective, we have to ask if the enormous expense of healthcare is improving the health and happiness of the populace as much as it could, were it spent more effectively. I think it is fair to say that the overall health of the U.S. populace is actually declining, despite modest advances in longevity and survival rates.
This does not reflect any lack of effort from the often-overworked providers--rather, it seems to reflect a deterioration of the populace's own habits and lifestyles, and the lack of focus and accountability of the entire system.
We can trace this failure to the Tragedy of the Commons: when every participant is driven to seek maximum gain from exploiting the commons for their own interests, no one is accountable for protecting the commons as a whole.
When we ask, who is responsible for improving the overall health and well-being of the citizens, we get an answer that boils down to: everyone and no one.
When the system is set up to encourage maximizing self-interest, accountability for the whole is lost. And once accountability for the effectiveness and health of the whole system is lost, the system will degrade and eventually collapse, for the same reason that unrestricted grazing by individuals eventually destroys the commons.
Put another way: if I concern myself with the health of the commons (or the overall health of the populace), I earn nothing for this work. Even worse, while I devoted myself to the common good, someone else increased his herd grazing the commons. I will eventually be forced to either join in the exploitation or go broke.
That's the Tragedy of the Commons dynamic, and I think it applies to many systems around the globe.
For more on this topic: The Slide to Collapse Is Greased with Self-Interest (August 4, 2014)
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I'm a big proponent of the rights of the insane, being mentally ill myself. To my mind, society does not do a good job of treating mental illness and addcition. Take these pills! I can tell you, the pills do help, but only to a point. Any real treatment of the underlying causes must be done by myself. Other people can guide me, but only I can make the journey.
In a way I'm glad I'm sick. It put my mind just enough out of phase where I had a chance to reject consensus reality and become truly aware. Not there yet, but I can see the path.
Stop eating poisonous food (GMO, glyphosate, hydrogenated, modified protein excitotoxins, HFCS, SUGAR, soy, etc) and you might get better.
This is an unpopular idea in some circles, but the root of the problem is society's decision to make health care a social, as opposed to a market good. Once a system is created that allows people to avoid having to choose between the (for example) new car and the knee replacement, people stop taking enough care of themselves, while the cost of all this high-tech service is socialized.
The truth of the matter is that most of the gains in life span and quality of life in the last few hundred years have occurred because of public health initiatives (sewer systems, fresh water distribution, trash removal, food chain protections, refrigeration, etc.), not medical (with a few exceptions like antibiotics and trauma innovations) care.
As a society, the ROI of our healthcare system is way past the point of diminishing marginal returns. We are not getting a tenth of the value we are paying for.
<< Take these pills! >>
Can you share those names with me? I'd like to give them a try.
I take geodon and lithium. Ones an antipsychotic and the other a mood stabilizer.
I really do much better on them. It's kind if hard to describe, but I feel happier and more level. Far from stumbling around in a daze, I'm more awake than ever.
I take geodon and lithium. Ones an antipsychotic and the other a mood stabilizer.
I really do much better on them. It's kind if hard to describe, but I feel happier and more level. Far from stumbling around in a daze, I'm more awake than ever.
And stop eating grains. I.e. grass seeds. We are not ruminants.
You don't need to be insane to see the insanity. I think most people do see it. They either:
a) Don't give a fuck
b) Don't know what to do about it
c) Don't want to do what is necessary
d) Enjoy the entertainment value
e) Are profiting from it
f) All of the above
doompaul.jpg
Told you imbeciles, just wait till its...Farrreeee!
Free including my job that I will not have as of March 31 because of it. I cannot believe the electorate is this stupid
They are, they really are that stupid.
However its also an opportunity too, you have some time to think without the drudgery & expectations now. What have you always wanted to do (I mean besides Pelosi saying just paint a picture or make some pottery...lol) work wise?
Chase that, you never know ;-)
Losing my job and the identity that went with it, about four years back, was the most liberating thing that ever happened to me. I woke up to the fucking nightmare that America has become. Yeah, I almost died of shock, but I'm better for it, I think.....
It takes a little getting used to. I was a "mercenary" (contractor) before I hired on where I'm at. The one thing I miss is the freedom, exchanged for "security" I suppose...which is never as secure as one thinks going in.
In my case I guess its all good, kids are almost grown so its close enough.
I can go full-kracken again at anytime, I know how to read their contracts, I helped write them ;-)
The progressives who did this to you had such good intentions though, that they are now and always be heroes for it.
To get the country back unfortunately we have to influence some feckless people in the middle to see them for what they are, delusional narciccists ruining are hard won Republic piece by piece, to make themselves feel even better about themselves.
And yet, for that, there is no pill nor will there ever be. Odd.
'Tragedy of the Commons' ? What a fool.
The author and several commenting here seem to be under the impression that o 'care' is about health. This is despite massive evidence to the contrary which is readily available.
In actuality it is about theft, impoverishing the middle class, control using intrusive record keeping, and killing off as many 'useless eaters' as possible.
Americans are some of the stupidest and weakest muther fukkers on the planet to allow this shit.
Hell, they 'voted' in politicians to stop this - and got completely shafted again. " Land of the Free, Home of the Brave" ? . . . what a pathetic joke.
You can both be correct. To me it seems that they are taking care of the most worthless useless eaters while stripping the money from the ones who saved a little bit of money.
What about Canada, Germany, France, UK etc. All have a socialized health care system but way more effecient (lifespan divided by cost).
There is something different about the US system, in that there is a much higher for-profit component. And when you have a for-profit component the natural direction is higher profits which means higher costs, both for care and for drugs.
Canada system is under attack from conservatives, who want a 2-tier system. naturally this will result in the degradation of the poor people's part of the system, as the wealthy influential people wonder why they need to sponsor a system they don't use and gets paid out their taxes.
There are a lot of Canadian doctors who head south for more $$ only to return to canada and take a pay cut because the system is so anti-social.
Infrastructure costs money, and is not always efficient. But when you introduce the "invisible hand" of the market (i.e. profit) the corporations will win for sure. People's needs are always secondary. You can't suck and blow.
Agreed.
The problem the nutty free marketers do not understand i that health care is not a good like others. Very few people choose to get an extra colonoscopy or an extra course of chemo or a heart bypass. AND if you need them to stay alive most people will pay anything they have. Like I said not your average consumer good.
The solution is single payer. The cost for the population is relatively fixed (X people get sick each year) so why not spread the cost over everyone and in the process we save all the admin and price gouging and have a little more power as a consumer (the government as the large scale buyer can squeeze discounts etc.)
The American system is pure stupidity. But hey, land of the free to die with no health care.
Your poor life decisions are not my responsibility. If your choice in school was to piss off and you are making $7.45 flipping burgers are the age of 40 why should I help provide the best care to you? Just my opinion
Straw man argument. The burger flippers have better options than your typical middle class guy even with insurance (unless you don't get sick). There are endless stories about families who earned low six figures and who have insurance who went bankrupt when a family member got seriously sick. That's fucked up in any society in which I want to live.
The UK system stinks to high heaven. I worked there one summer during college in St Something Big Hospital and they kept running out of blood, their one GI scope kept breaking down and they often had power failures in parts of the hospital. Not to mention patients waited 2-4 years for hip/knee replacements.
Cheap --- yes. But you get what you pay for in this case.
I agree with you to a point, but it's never going to happen. You can't just ask doctors who make mid-six figures and up, hospital administrators who make more, insurance companies who make more, etc., to start earning a fraction as much or go out of business entirely, which would be required for a single payor system.
Yes you can. Eliminate the high cost administrators and Insrance costs -eliminate extraaordinary costs of doctors to get their medical degrees- start letting qualified Americans go to med school instead of importing doctors from India, pakistan and Nigeria who can barely speak English.
Heard on the newzzz Florida's gonna need 7,000 doctors in five years. Yeah, forcing qualified doctors to make less pay always works out for all involved, you get what you pay for.
Maybe all those debt laden poli-sci majors can switch over and make a killing ;-)
I often wonder just how much of this industry is designed specifically around fleecing the Baby Boomers of their last few pennies.....
if the Oncology specialist don't get ya the Assisted Living Center will...
Prolly best just to get yourself a Government cheese job of some kind....get yer snout in the taxdolla trough too
Moronic, Rand. Business paradigms shift all the time. Remember? That's what we used to tell the manufacturing sector, when we had one. Single Payer is the only viable solution for large populations. As for the "UK patients have to wait 4-years for a hip replacement" argument, it is a canard. No one said Single Payer systems bar private insurance. People who can afford it simply buy supplemental coverage, and private healthcare networks for profit are alive and well in the UK, Australia and Canada. The premiums are much, much lower because basic care is provided by the government. Incidentally, the whole thing is elegantly financed with a VAT or national sales tax. The U.S. healthcare problem is one of ignorance, including the ignorance of government.
How many people know the medical profession is exempt from anti trust and consumer protection laws that apply to every other business?
Do away with these special monopoly privileges and costs would drop by more than half overnight.
How does this get down-voted? You are citing indisputable facts. There are some statist trolls lurking on this thread tonight.
One of the special protections is tort reform. Physicians and hospitals can put profit ahead of patient care and have virtually no consequences. There's your free market at work.
@BuckarooBanzai - the down votes of facts likely come from the naive who believe socialist med care is nirvana - though they likely were never victims of it. And, are likely from those who benefit from the current system.
Lay out the facts about the harm that the 'education' system inflicts on children to teachers, and also see how many down votes you get.
Always the same answer from you centralized folks, isn't it? "Common man too stupid to be able to comprehend what is good for him. Thus, we must replace the judgement of the common man with the dictates of the experts, because only they know what is good for you. You, the common man, will always take the short term gain at the expense of long term loss, so we must take over your ability to make decisions for your own good."
So. Turn that logic around and apply it to voting. Same principle applies, no? So, why the hell do you want to let people vote? They will just choose short term gain at long term loss. Can't be trusted with that either, right?
What you want is King Obama with his executive order power. It's the only answer that fits your view of the world.
Although I don't count myself as a conservative by any definition used in the US, I'm all for a two-tier system. There is nothing wrong with people of better means (not just the insanely wealthy) having better options than poorer and middle-income people. Why not? If you have a few million to spend for the best care and want to spend it, spend it. But in the US, we have a three-tier system. Great health care for the wealthy, decent health care for the poor and elderly (Medicaid/Medicare), and bankrupt-you-if-you-get-sick-even-if-you-have-insurance health care for the majority middle class.
I know two people who are dog ass poor, one got a brain tumor removed and the other got a liver transplant, both via Medicaid free of charge. Both will have lifelong medical needs associated with their surgeries, totaling millions. I'm in that middle gap where getting a broken leg set might be impossible......
Two tier system?? Fùck that. How about a cash-for-services, free market system? It worked great up until world war 2, when defense contractors were forced to create "health care benefits" as a way to compete for workers because the salaries they paid were subject to government-imposed ceilings.
Once "health care benefits" became a routine part of the compensation system, the "health care insurance" industry was born. Of course, "health care" is a completely uninsurable risk, because the costs cannot be properly measured or allocated. But we had already started down this road of clusterfuckery, which has led us to the abomination that is Obamacare.
Back in "olden times"-- that is to say, 50+ years ago-- people paid cash for their medical treatments. If people couldn't pay, they negotiated in-kind payment with their doctor. If the poor needed hospitalization, there was a broad network of Catholic hospitals that provided care for the indigent as part of the Church's mission.
Unfortunately, the Catholic Church-- which was infiltrated by homosexuals and Marxists at roughly the same time that "health insurance" and "socialized medicine" was sweeping the westernized world in the mid-20th century-- began to abandon its charitable healthcare mission in direct defiance of the commandments of Jesus, in favor of letting The State take over...with disastrous results.
This is a crisis of spiritual, economic, and political dimensions. It is sickening and disgusting to watch it unfold.
+1 Million for incorporating Marxists, homos, socialists, Catholics, Jesus, and clusterfuckery in a single post about why poor people shouldn't have access to health care unless they can pay out of pocket or have homo Catholics help them. And an extra 1 for saying it is a spiritual crisis in the same breath. You have serious issues, my friend.
As an aside, health care wasn't quite as expensive before WWII. You know, before they invented 90% of what we consider modern medicine today. Health care was even cheaper in the 1800's. If you could afford a saw and a bullet to bite down on, you were set.
Your ignorance of economics is matched only by your lack of reading comprehension skills, your spiritual vacancy, and your absence of a definable moral center.
Superb.
Concise, yet thorough.
Oh fuck off Randy you piece of shit.
My in-laws have tried for years to do what was "right" and stay away from the government feed-trough. One of the last holdouts, as poor as they are, and this is the straw that's broken their back. They simple can't afford ObongoCare, so now it's time for Medicaid. At least we'll all have shitty health-care while we hold hands into the blast furnace.
"Obamacare is not some communist, left-wing, socialist plot.
It's a Republican plot.
Back in 1971, then President Richard Nixon was extremely concerned that he would have to face then Sen. Ted Kennedy in the 1972 presidential election.
At that time, Senator Kennedy was pushing a proposal for a national single-payer health care plan that would extend coverage to all Americans.
Nixon knew that Kennedy's proposal would be popular with the American people, and could threaten his re-election chances, so he came up with a health care proposal of his own.
Nixon's proposal for health care in the US included different plans for four categories of Americans.
Under Nixon's plan, employers would have been required to buy health insurance providing a basic package of benefits for 150 million working US residents and their families.
For 20 million people who were considered the working poor at the time and their families, Nixon's plan would have replaced Medicaid services with private health insurance plans fully paid for by the government for the poorest, with a sliding scale of contributions for families earning over $3,000 (roughly $17,300 in today's dollars).
Nixon's plan also dropped Medicare premiums for 21 million "aging" Americans, and instead adjusted Social Security taxes to make up for the costs.
Finally, Nixon's plan lowered health care costs for 30 million self-employed Americans by allowing them to buy health care policies at lower group rates through insurance pools.
Now, what does all of that sound like to you? It sounds an awful lot like Obamacare, right?
That's because most of the tenets of Obamacare were introduced way back in 1971 by Richard Nixon, a Republican president.
But Nixon wasn't the only Republican to get behind a health care plan that sounds a lot like Obamacare.
Back in 1993, then-President Bill Clinton tried desperately to reform healthcare in the US. He created a special health care task force that was charged with finding solutions to rising healthcare costs and an increasing number of uninsured Americans.
While that task force was trying to find solutions, Republicans in Congress were trying to create a health care reform alternative of their own.
They came up with the Health Equity and Access Reform Today bill, or HEART.
That bill was spearheaded by then Republican Sen. John Chafee of Rhode Island, and co-sponsored by 18 other Republican senators, including current Republican Senators Orrin Hatch and Chuck Grassley, both of whom are now opposed to Obamacare.
It was also supported by the conservative-leaning Heritage Foundation, which at the time was pushing particularly heavily for an individual mandate.
Among other things, the HEART bill proposed by Republican senators included an individual mandate (to appease the folks over at the Heritage Foundation), the creation of insurance purchasing pools, standardized benefits, vouchers for poor Americans to buy insurance and a ban on insurance companies denying coverage based on preexisting conditions.
Again, what does that sound like?
Speaking about the HEART bill, Sheila Burke, former chief of staff for former Sen. Bob Dole told PolitiFact's PunditFact that,
So, yet again, you have Republicans introducing a national health care reform plan that contained a lot of the key tenets of today's Obamacare.
The facts speak for themselves. Republicans have been pushing Obamacare-like health-care principles for more than 40 years!..."
http://bit.ly/1LP4777
Your slogan poor people's "access to health care" is just the same old meaningless political bullshit
As the article pointed out - whatever medicaid crap a few more "poor" get - is taken away in multiples from the middle-class.
And through the unfolding of this crisis, you have thusfar managed to survive, despite the patent fact that your brain hardly produces enough electricity to sustain the ambulation of your limbs. Banzai.
The U.K is sending some of their doctors overseas to raise money to fun their "free" healthcare.
Non-profits are vehicles for socialism and communism.
Where in hell did you get the idea we have a free market? Medicare/Medicaid is the problem. They pay out over 50% of healthcare dollars. A lot to medical fraudsters. The death (cancer) industry combined with the Cardio fraudsters (bypass surgery on 80+ year olds) have made healthcare too expensive for the working middle class. There hasn't been a free market since LBJ started Medicare!
You must learn that the medical system is a predator that feeds on pure ignorance. That is why it should not be socialised. To socialise it, means that I must pay for other people's ignorance.
When someone decides to binge drink and needs an ambulance to take them to hospital to get their stomach pumped, I pay.
When someone sticks a bowling ball up their arse and wonders why it won't come back out, I pay for them to get it removed.
When a woman drinks alcohol while pregnant and her kid is born with various physical and mental deformities, I pay for the medical system to perform futile treatments on that child.
When a 30yr old man buys a motorbike with more horsepower than his brain and rams it into a tree, I pay to have his shattered body put back together and the months/years of rehab that go with it.
do you see the point? No amount of efficiency makes a socialised medical system efficient. Because there is no limit to how low the human ignorance will go.
True. And now that the AMA and CDC have declared 'fatness' a disease instead of a 'life style choice,' we get to pay for all their diabetes, heart disease, stroke, etc. And now with Obamacare, there is little incentive to stay healthy for many people cause they know OPM will pay for it.
I'll let you in on a secret... you're paying for that anyways. If they have no insurance, the hospital may raise rates to compensate which is reflected in your insurance rates. If they have insurance, those numbers are used to raise your rates next year. And if they don't get treated at all... guess what, you'll be paying the cost in one way or another eventually as long as you are in the same society.
So, seeing as this is going to happen anyways, it almost makes sense to spread out this cost to as many as possible to lessen it, while at the same time ensuring that rates are controlled and not set on a whim to extract maximum profit.
Hey, that's single payer, you're welcome. Oh no, new taxes! Well, considering that healthcare spending is already hitting 17% and on the way to 20%... what if they just replaced it with a 7% tax? It would still be the best funded healthcare system on the planet.
You are already paying for it, imbecile. Single Payer would at least present the opportunity for cost control.
Where do the terms 'cost control' and 'government' go together ?
Undoubtedly another product of the government 'schools' which turn out naive morons.
Goes a lot further than that, buddy. You must learn that government itself is a predator that feeds on pure ignorance. That is why societal control should not be socialized. If you socialize it, it means that we all must pay for other people's ignorance.
When idiotic do gooders who don't know jack shit about physiology decide that they are going to "Fix everyone's teeth" by putting toxic fluoride waste in all the water, we must all pay for the cascade of long term health effects that stems from this ignorant boondoggle.
When sanitation experts conclude that constant exposure to small amounts of toxic free chlorine in all the drinking water certainly can't be bad for bowel flora or healthy skin bacteria and certainly does no damage when inhaled in the shower, we all pay for the cascade of long term health effects that stems from this ignorance of physiology.
When the solution to teaching the immune system through exposure to mostly benign childhood diseases is to replace this learning process with intravenous rather than mucosal exposure to antigens, we all must pay for the cascade of long term health effects.
Just apply this ad infinitum and you will begin to sense the scope of the real problem. Fake food that's all chemicals and all dead, considered superior because we can stuff it in our faces at a greater and greater pace because it is cheaper and cheaper than real food. Recommendations by the "experts" to avoid life giving sunlight and smearing toxic chemicals on the skin to block life giving UV. Fuckin fireproof chemicals in every single pair of children's jammies by mandate. Piling more and more layers of homework and sitting at a desk on children that desperately need to run and move, all in order to make up for the fact that they are steadily getting more and more stupid as we constantly knock every single leg out from under their physiologic table. And on and on and on.
And yet, it would appear that an endless string of bad outcomes can't dissuade us from chasing the mirage of achieving better outcomes through mis-applying industrial revolution manufacturing principles to all sorts of systems to which it doesn't apply.
If your only tool is a hammer, then lo and behold, if you are king, then every solution involves you hammering something. Similarly, if your only tool is assembly line processes, then if you are king, every solution involves making something into an assembly line.
It is time for us to move past the industrial revolution. But, it will take a revolution of its own to accomplish that.
"There is something different about the US system, in that there is a much higher for-profit component. And when you have a for-profit component the natural direction is higher profits which means higher costs, both for care and for drugs."
Competition lowers costs. The natural direction is not higher profits, which means higher costs. The Blu Ray player started at $1,000 dollars. As more companies produced players, the cost dropped dramatically, despite being for profit companies.
The medical industrial complex has anti trust exemption, which keeps prices artificially high.
Bingo. Look at those health care practices which insurance won't pay for-- LASIK eye surgery or cosmetic surgery, for example. Costs have dropped steadily over the last twenty years and quality has gone up.
And yet during the same time frame the insurable healthcare costs have skyrocketed. It doesn't take a genius to figure out why.
Problem is that you can't presume to make value judgments for other people. Because we are all incapable of understanding the value system of anyone but ourselves, any time we step in to make value judgments for other people, we have to substitute quantity for quality.
Take ice cream. Let's suppose that I decide that I am going to choose your flavor of ice cream because you are too stupid and ignorant to choose it yourself. But, I have a mandate to make sure that you enjoy your ice cream. So, my solution will be to give you every flavor. And, of course, charge you for it eventually, but in a round about way that takes a long time, such that you forget exactly what all the cost was for.
Tell this crap to my father-in-law who has been waiting 14 months for a hip replacement in Canada.
No worries. He should should take his millions and have the surgery done in America. They would get him in within a week. What's the problem? You bitching because he can't afford to do that? Oh, right.
People act like dogs fighting for table scraps.
Arguing over the cost of medical care and your prospects for a decent retirement ?
How about the 98% devaluation of the value your dollar over the last 100 years ? Might you and your family have more for their needs & wants today if that wealth hadn't been stolen ?
But go back fighting among yourselves, dogs. Your masters love it & know youre too dumb to do otherwise.
Uhmmm, that would only be correct in a system with no competition. Which is, of course, a big part of the problem with U.S. health care, but it has nothing to do with the for-profit motive, per se. Otherwise, everything would become progressively more expensive on a real basis in the U.S., which obviously isn't true.
The author makes a lot of good points, but the important point is not that "self-interest" causes the problem... it's the commons. People don't overgraze the land *they* own. That certainly involves "self-interest" as much as the other scenario.
Give me a break! The life expectancy should be compared between Norway's all white population and our white population. Including blacks and hispanics in the statistics means you get a totally distorted picutre of health-and you know which way it goes don't you. Same is true of crime, imprisionment rates, gun homicides etc. And IQ of course. Norway's IQ is significantly higher than ours except when only caucasians are compared-then we do very well indeed. You have to compare apples to applies in statistics otherwise you draw false conclusions and false solutions (such as state sponsponed health care).
Who benefits most from good health? You do. I give a flying fuck about general health of people I don't even know (like you for example) and so does anyone who isn't a socialist hypocrite. Those who benefit should pay for the benefit. Competition and profit are the only viable economic drivers. Thanks to government subsidies and insurance we don't have either in health care or education. That's why the inflation is so high! And of course, both are worse than ever!
I agree if you are FIRST going to "abolish" insurance of all types. In TX, it is REQUIRED. Right after they instituted deregulation and tort reform which protected the asset holders and performers of sickcare/treatment from their own abuses and frauds.
Canadas health care has major flaws. Just ask about foot care in New Brunswick. I wish everyone would remember INSURANCE IS NOT HEALTH CARE! and INSURANCE DOES NOT PROVIDE ACCESS TO GOOD HEALTH CARE, If the US wanted to provide low or no cost health care it would have opened clinics and used younb docs in debt to staff them. 1.5 years of work for every year of school debt.
Trying to explain that to my liberal friends, no matter how intelligent they may be, is a waste of breath. How is it that anyone with even a smidgen of brains doesn't understand this? Is it because they want human nature to be better than this? It's the real world baby, and a lotta people are selfish assholes.
Liberals live in a fantasy world, completely disconnected with reality. You might as well be talking to a geranium for all the good it will do you.
before you are 25 if you are not a Socialist you have no heart and after you’re 25 if you are a Socialist you have no head.
The problem is that an overcrowded environment tends to delay the natural progression of our maturation, such that many of us remain in a perpetually juvenile mindset. This is why cities reliably vote Blue while rural areas reliably vote Red.
Overcrowding creates in man a form of mental illness. We inherently need our space, and if deprived of real space, we create virtual space, called anonymity. But, this is not the same as real space, and because it is a virtual space, it is devoid of the cause/effect learning process that nature would normally impose. Thus, the more we all retreat into the virtual space of anonymity, the more distorted our thought processes become, the more we display mal-adaptive behaviors because of these distorted thought processes, and the more dysfunctional society becomes.
The large proportion of liberals is actually a by product of an environment that prevents maturation of our species. It cannot be fixed through logic. You can't force someone to mature except by exposing them to cause and effect, but the juvenile solution is to retreat and try to protect themselves more and more from cause and effect. The end result is of course societal collapse, such that the problem is inherently self correcting, but only over the long term.
It's reverse social engineering. The people least capable of supporting children can have them via free healthcare, people who can support themselves are too intelligent to have children because it is too expensive. It's de-evolution, government style. They have the roto rooter touch... Whatever government touches always turns to shit. http://thecivillibertarian.blogspot.com/2015/02/the-obamacare-reality-is...
All we need is some Brawndo and all will be awesome again.
No...you need water...like from a toilet
people who can support themselves are too intelligent to have children because it is too expensive.
An utterly moronic statement.
If you think like that move to a better country. You've totally lost hope.
Anyone not having kids is actually just too weak to move to fertile ground.
Children are a blessing. these folks are brainwashed by a government that funds programs to educate us to not breed
I believe they are called 'eunuchs'. It's more 'civilised' to psychologically castrate them than to physically do it.
is there anything that's not going in the shitter?
Because non-judgmentalism, cowardly political correctness and corrupt Communism (apologies for the redundancy) is now the dominant political and societal mode, the answer is of course, NO.
There are so many things wrong with healthcare it's hard to point to any one thing. IMO, the most distorting part of the system is that it's employer-based.
The problem with your logic is that the implied "solution" is single-payer, which is just as fucked up.
The REAL problem is the whole idea of health "insurance". It is trying to insure something that is uninsurable.
That, combined with the antitrust exemptions that the healthcare industry enjoys, adds up to a complete clusterfuck.
I posted years ago here the AntiTrust Exemptions to Sherman & Clayton AntiTrust Legislation taht the "SickCare" Cabal enjoys is the BIGGEST Issue. Look no furhter than what our parents paid for baby deliveries. They paid it from their savings or in a couple installments......at +-$700. Scrips were nothing.
That would still be the case if our Pols did not bow to industry payoffs to setup laws making it illegal to drive 50 miles across TexMex Border and pay $20 for Snake AntiVenom where it is produced instead of paying $60,000 per vial of same crap at US Hospital.
Stop the thefts and fraud and insurance is not needed. Prices for services and hospital stays will drop 80%.
My "Primary Care" Physician has, over the past 10 years, turned himself into a simile of government bureaucrat.
The wait to get into his office is long, even if you come before appointed. He hurries through patients..I see his PA for 15 minutes, and him for about 5. He's installed some NY-state approved health care web-portal system which is supposed to manage all incoming dox, but documents to and from specialists I see are never there.
Sick Care is the American system. The system produces more profits the sicker people are. This is insane by any definition.
Insurance providers strip 25% of every health care dollar for overhead like profits and marketing.
Over treatment due to fee for service, rather than fee for health.
Incentive to seek cheap and effective treatments, and the best medical care for health maintenance is not there.
I've personal experience with health care in Britain, Sweden, Australia, New Zealand and the United States.
I have no doubt which of these systems is best. BUT, for Americans none of these systems will work. Only the present system will work in America. The culture of America demands the present US system. There is no demand for rational health care, because we Americans are not rational. We want it all, we want it now, and we want a third party payer.
Take Canada, my near neighbor. Health Care is not free, but it is universal and state tax funded. This means you pay for your health care via province taxes. So when you go in, there is no bill, you arrive at your doctor as a payed up customer. You paid when you paid taxes, once you have done that, you have the health care at reasonable and in most cases sufficent quantity and quality. Sweden is the same, you are a paid customer, they treat you fully because you paid for your care already. No bills.
This works great in nations with a sense of social responsibility, we all pay, we all get. Sweden is not the USA, Americans don't want that type of care, they want the insurance company and fee for service system.
It is just different cultures. Their systems are not shit, just because you don't like them. And America's sick care is not better because it costs more than double for worse outcomes.
I'm on the blow my head off if it gets too bad plan.......
dont do it.
Federal Regs require that you have a Bloodborne Pathogens disposal permit.... you are warned!
"This works great in nations with a sense of social responsibility, we all pay, we all get. Sweden is not the USA"
When a Great Depression comes, everything gets thrown out the window.
The global debt bubble is 200 trillion. Sweden will not be immune.
"So when you go in, there is no bill, you arrive at your doctor as a payed up customer."
So, in other words, you've paid in advance, without knowing exactly what the product is, or the quality of service you are getting? And with no say whatsoever as to who will be delivering that product or service?
That is just about the stupidest way there is to buy anything.
Jack, I know you are smarter than this.
I know that when I have a heart attack, I'm going to do some serious research into the available doctors at the local hospitals on call at that moment before I get treatment.
sorry but the decision will be made for you.
Another 10 years of socialized medicine and when you have a heart attack, you won't go anywhere, because no one will have made the investments in new clinics and hospitals, and doctors won't be there.
Have a heart-attack in Cuba and see what your options are.
Over 5 year wait in New Brunsswick for foot care. No wait for transgender surgery! Yea Canadian health care!
1 in 10 Swedes still buy private insurance to surpass the state run system. As with all systems, the more strained, the performance suffers.
http://www.thelocal.se/20140117/hospital-queues-tied-to-insurance-trend
Getting sick in merika will bankrupt you for sure. You can usually negotiate with the doctor but the hospitals will slit your throat for a dollar.
Also watcht he big insurers ahere with care...United Healthcare just announced today, big scrutinization on hysterectomy procedures...must be vaginal and not enough MDs know how to do it in the US, otherwise UHC has to approve and MDs submit groves of paperwork.
I see this savings are more money for stock buy backs and dividends...they have both going in size too.. United is right in there with the S&P 500 that spends 95% of their profits on stock buy backs, according to Bloomberg.
http://ducknetweb.blogspot.com/2015/02/united-healthcare-to-now-require-prior.html
I keep telling everyone insurers are hiring those Quants from hedge funds and high frequency traders to model the policies we buy. The actuaries get the long while the quant model comes in to get the short and they can now see the impact on stock of the policies they model..don't laugh..it's happening. As a human you have to almost pretend you are data swimming through a stock exchange except we can't move that fast and keep changing doctors and hospitals based on what the algos tell us to do.
http://ducknetweb.blogspot.com/2014/10/data-scientistsquants-in-health.html
In addition those same quants really know how to risk fiddle CMS and bilk them out of $70 billion too with their models and CMS is kind of stuck now on this one.
http://ducknetweb.blogspot.com/2014/08/cms-discovers-that-insurers-offer...
All I know is that it worked well before Gov't got involved. Let's stop wasting time figuring out how bad the .Gov program is and just let it go fully private.
Does it dawn on anyone that the most significant elements of the US Economy are UNREGULATED or REGULATED BY BOUGHT DOLTS?!
INSURANCE COMPANIES= NOT REGULATED!
DERIVATIVES--$700 T =CRIMINAL ENTERPRISE--UNREGULATED!
COMMODITIES MARKETS= MANIPULATED & unregulated since '90's!
ENERGY MARKETS= MANIPULATED & UNREGULATED
CURRENCY MARKETS= MANIPULATED & UNREGULATED
LIBOR SETTING= CRIMINALLY MANIPULATED & UNREGULATED
BOND MARKETS= CRIMINALLY MANIPULATED & UNREGULATED
CHICAGO MERC.EXCHANGE= MANIPULATED & UNREGULATED
US BANKS= MANIPULATED, UNREGULATED! LOOTED & BANKRUPT BY THE SAME FOLKS RUNNING THE NATION!
Americans don't deserve to live for letting their nation just FLY DOWN THE TOILET in just 15yrs.!
Crestor, (rosuvastatin sodium) a lipid controlling medication, IMHO, a good one at that:
Price at CVS/Brooks = $170 per month
Price at offshorecheapmeds.com (where I buy mine) = $19.15 (+ $10 shipping per order)
The difference, again IMHO is that the stuff shipped from India, made by one of the world's largest pharma manufacturers is that the CVS product comes loosely counted in a non-hermetically sealed plastic container while the stuff from India comes in foil sealed packets. I would not be surprised if the same factory makes the branded Crestor.
Our pharmacy system is seriously into plunder.
Why does the same med cost Americans 800% more than what much of the rest of the world pays?
BTW, I know it's real. It's not fake. I have acces to my own Cholestek device, and switching from branded, bought in America to bought via a Canadian pharmacy has not changed my lipid profile one bit.
Predatory pricing = America's dirty secret.
Hmm...does "tragedy of the commons" also apply to our military? the DHS? NSA? CIA? IRS? TBTF bank and insurance co bailouts, the derivatives market, the FED, ET fucking C...
Solving US Healthcare crisis..
In Argentina..
you can buy penicillin for 7$ 10 tablets..Viagra for 2.5$ us...Go straight to Farmacy and if you know your problem, or can ask a pharmacist and intelligent question..you can get your medicine for 8$, no doctor necessary..There is a 10$us community-doctor-center 5 blocks from where i live..I had an xray done with a 1960s era xray machine for 15$ on my wrist..these machines were given, or bought on the cheap from US and sent to ARgentina..
In USA, 18k hip replacements, cash only..
http://www.surgerycenterok.com/
Eat well, exercise for physical and mental health, and pray for mercy on thine liver.