Nope, Healthcare doesn't need to be reformed. Not at all.

[Berkut]

I'm not totally convinced health care is a service best provided by the free market. Convincing people to buy things they don't really need is good business.

Agreed.  The problelm is that free market requires perfect information, and perfect ability to interpret that information.  Obviously this ideal is never satisfied in practice, but in case of medicine the practice is much farther away from ideal than in most other fields.

I don't think that is remotely true. In fact, there are plenty of fields where it is much harder to get reliable or expert information than healthcare.

For most healthcare decisions, the average person has an incredible amount of access to cometeing information about their health.

There is nothing "special" about healthcare, and the problems with it are more because we keep snsiting that there IS something special about it and refusing to let the market actually price it in anything approaching a sane manner.

[Neil]

Health care is 'special'.  It is an essential service.  Do we let the market price police protection?

[Berkut]

This thread is a great example of why I am so skeptical of the idea that the "solution" is to put the government in charge.

the entire argument put forth by Seedy is that since there are people willing to commit fraud, we should "reform" healthcare - and said reform will likely end up making fraud in healthcare much MORE common, not less so - after all, don't they estimate that something like 20% of medicare costs (or some attrocious amount like that) are fraudulent?

How is putting the government in charge going to stop crap like what this article is talking about? Seems to me it will become more common, not less.

Seems to me like the impetus for healthcare reform is just a way to get the governments hands on the gigantic and growing out of control healthcare trough, so that various politicians can direct that money where they like, rather than any real idea that by controlling the system the costs can be controlled as well. And it is the costs of the system (or rather the ridiculously high growth rate of those costs) that are the true problem - not that some doctors somewhere are committing fraud.

[DontSayBanana]

Agreed.  The problelm is that free market requires perfect information, and perfect ability to interpret that information.  Obviously this ideal is never satisfied in practice, but in case of medicine the practice is much farther away from ideal than in most other fields.

I don't think that is remotely true. In fact, there are plenty of fields where it is much harder to get reliable or expert information than healthcare.

For most healthcare decisions, the average person has an incredible amount of access to cometeing information about their health.

There is nothing "special" about healthcare, and the problems with it are more because we keep snsiting that there IS something special about it and refusing to let the market actually price it in anything approaching a sane manner.

Actually, it strikes me that you're both right.  There are many consumer fields where expert information is hard to come by.  Cell phones, for example.  Computers: most consumers wouldn't know the difference between AND, OR, and XOR gates if each successively bit them on the ass.

The difference is that in healthcare, the expert information is necessary.  It's fine if you want to scrape by with subpar electronics to fit into a budget (see my string of crappy digital cameras), but healthcare is the one field where you need to know that the product you're purchasing is absolutely above a minimum quality level.

[Berkut]

Health care is 'special'.  It is an essential service.  Do we let the market price police protection?

Of course. You can hire a security guard, you can buy alarm systems, you can do all kinds of things on your own to increase your personal security.

Nobody is trying to argue that we should get rid of companies that provide supplemental security, are we? Why not, if in fact security was "essential"?

Why should rich people be allowed to be more secure than the poor, if in fact this service is so "essential"?

[Berkut]

Agreed.  The problelm is that free market requires perfect information, and perfect ability to interpret that information.  Obviously this ideal is never satisfied in practice, but in case of medicine the practice is much farther away from ideal than in most other fields.

I don't think that is remotely true. In fact, there are plenty of fields where it is much harder to get reliable or expert information than healthcare.

For most healthcare decisions, the average person has an incredible amount of access to cometeing information about their health.

There is nothing "special" about healthcare, and the problems with it are more because we keep snsiting that there IS something special about it and refusing to let the market actually price it in anything approaching a sane manner.

Actually, it strikes me that you're both right.  There are many consumer fields where expert information is hard to come by.  Cell phones, for example.  Computers: most consumers wouldn't know the difference between AND, OR, and XOR gates if each successively bit them on the ass.

The difference is that in healthcare, the expert information is necessary.  It's fine if you want to scrape by with subpar electronics to fit into a budget (see my string of crappy digital cameras), but healthcare is the one field where you need to know that the product you're purchasing is absolutely above a minimum quality level.

I would argue that there is anything special about healthcare in that regards that is not shared by dozens of other products and services.

But it isn't really the point anyway - the problems with healthcare in the US today have nothing to do with the lack of perfect information, and everything to do with how it is priced and paid for, IMO.

That is where reform should be targetted, and yet it seems like it is completely ignored.

[DontSayBanana]

Of course. You can hire a security guard, you can buy alarm systems, you can do all kinds of things on your own to increase your personal security.

Nobody is trying to argue that we should get rid of companies that provide supplemental security, are we? Why not, if in fact security was "essential"?

Why should rich people be allowed to be more secure than the poor, if in fact this service is so "essential"?

It's a minimum level of security that's essential, and that minimum level is provided by the municipality, the state, and the federal government in the form of public law enforcement agencies.  The supplemental security provided by private security systems and forces is a luxury and the extent is dictated by how much the client can/will pay.

[Admiral Yi]

Health care is 'special'.  It is an essential service.  Do we let the market price police protection?

Food and shelter are essential but priced by the market.  The argument against private police services is the positive externality and free rider problem, not that it is essential.

[Neil]

Of course. You can hire a security guard, you can buy alarm systems, you can do all kinds of things on your own to increase your personal security.

Nobody is trying to argue that we should get rid of companies that provide supplemental security, are we? Why not, if in fact security was "essential"?

Why should rich people be allowed to be more secure than the poor, if in fact this service is so "essential"?

None of those things are police.

It's funny how you get off on these ridiculous asides.

[grumbler]

Seems to me like the impetus for healthcare reform is just a way to get the governments hands on the gigantic and growing out of control healthcare trough, so that various politicians can direct that money where they like, rather than any real idea that by controlling the system the costs can be controlled as well. And it is the costs of the system (or rather the ridiculously high growth rate of those costs) that are the true problem - not that some doctors somewhere are committing fraud.

It always surprises me when I see another example of someone who has drunk the kool-aid and yet thinks him/herself objective on the topic.

The government is heavily and inextricably involved in healthcare right now.  In the US government pays out as much per capita (citizens, not beneficiaries) as the government of Germany, but covers less than half as great a percentage of the population.  Why?  Because the government also spends money ensuring that labor shortages and monopolies are maintained that keep the prices it pays for doctors and drugs far higher than what the German government pays.  The market doesn't work where monopolies intervene.  Only those with a near-monopoly on demand can successfully negotiate with those with a monopoly on supply.

Government-run health care sucks.  Not as much as the current US system sucks, though.

[Berkut]

Seems to me like the impetus for healthcare reform is just a way to get the governments hands on the gigantic and growing out of control healthcare trough, so that various politicians can direct that money where they like, rather than any real idea that by controlling the system the costs can be controlled as well. And it is the costs of the system (or rather the ridiculously high growth rate of those costs) that are the true problem - not that some doctors somewhere are committing fraud.

It always surprises me when I see another example of someone who has drunk the kool-aid and yet thinks him/herself objective on the topic.

Nice opening.

[derspiess]

Health care is 'special'.  It is an essential service.  Do we let the market price police protection?

Yes.  It would be nice if we were able to try that, at least.

[KRonn]

This thread is a great example of why I am so skeptical of the idea that the "solution" is to put the government in charge.

the entire argument put forth by Seedy is that since there are people willing to commit fraud, we should "reform" healthcare - and said reform will likely end up making fraud in healthcare much MORE common, not less so - after all, don't they estimate that something like 20% of medicare costs (or some attrocious amount like that) are fraudulent?

How is putting the government in charge going to stop crap like what this article is talking about? Seems to me it will become more common, not less.

Seems to me like the impetus for healthcare reform is just a way to get the governments hands on the gigantic and growing out of control healthcare trough, so that various politicians can direct that money where they like, rather than any real idea that by controlling the system the costs can be controlled as well. And it is the costs of the system (or rather the ridiculously high growth rate of those costs) that are the true problem - not that some doctors somewhere are committing fraud.

Plus the obvious, that the government already runs medicare and medicaid which are rapidly going broke, and for years have only paid a portion of the bill anyway. Of course they now need the rest of health care. But then, some other nations seem to do a decent job of health care, but the track of the US is pretty poor. And this latest attempt at a health scare bill did nothing to allay my fears.

[grumbler]

And this latest attempt at a health scare bill did nothing to allay my fears.

That's a point I have made way too many times; the choice isn't between the current FAILoriffic democratic plan and the EPIC FAIL of no reform, it is between the EPIC FAIL of no reform, the current FAILoriffic democratic plan, and a reasonable plan that uses the experience of other countries to inform the choices made in this country.

No one is interested in the third choice, seemingly.

[DGuller]

No one is interested in the third choice, seemingly.

It's not that no one is interested in the third choice, but rather it's considered a non-starter (most likely justifiably so).  Too many special interests to ran afoul of, too many regular people to scare with radical changes, etc.