Is healthcare a right? why or why not?

[Listening]

Quite possibly a pure market based system might be the worst possible way to deliver health care.

Quite simply, it depends upon what the goals for the program are.

Once you can agree on goals and objectives....the delivery vehicle becomes pretty evident.

 

[Listening]

One thing that history has shown us is that government pretty much screws up everything it touches.

Kinda like Midas....only it turns to crap.

 

[Sactowndog]

That theory isn't exactly true. It rests on the premise that since no one would sacrifice their life or child's life for cost, there is no diminishing utility. That premise isn't accurate. It isnt' reality. Our medical system isnt' treating only life threatening issues. It isn't even treating mostly life threatening issues. Since for most medical issues people's lives are in fact NOT at stake they would be in a position to shop for care.

Bern, you are correct that portions of the medical field are discretionary and would not be subject to life threatening or other high impact issues. It would be fair to say the premise is not accurate in this case but I have highlighted other market issues that cause people to skip preventative care or prenatal care because the poor linkage between costs and benefits. Really the only portion of the medical field that works well with market dynamics is cosmetic surgury which has an immediate cost and an immediate benefit.

However much of the cost in medicine occurs in the final stages where life threatening issues are at play and where if left to the individual demand curves go vertical. The premise completely holds in this scenario and unfortunately this is where most of the costs reside.

 

[Sactowndog]

Not really.

The left is mistaken in call it a right. But I believe the argument is a misuese of words by many. What I think the left believes is that it is a social responsibility. In that regard, we should be talking.

I agree that everyone agrees we have some social responsibility. The question is which is the most effective use of our money. We can't do it all and talks of death panels is disingenuous

The right believes that market forces will solve the problem. That is true. If the problem is that people don't have access to the health care they are willing to pay for. That is much different than being able to afford it.

For critical care it is not true. Market forces require working supply and demand and demand curves are vertical in this case.

 

[Sactowndog]

Quite possibly a pure market based system might be the worst possible way to deliver health care.

Quite simply, it depends upon what the goals for the program are.

Once you can agree on goals and objectives....the delivery vehicle becomes pretty evident.

Yes but it will fail if you assume you have a functioning demand curve when in fact that is not the case for the part of the health care market where most of the costs lie.

 

[Bern80]

That theory isn't exactly true. It rests on the premise that since no one would sacrifice their life or child's life for cost, there is no diminishing utility. That premise isn't accurate. It isnt' reality. Our medical system isnt' treating only life threatening issues. It isn't even treating mostly life threatening issues. Since for most medical issues people's lives are in fact NOT at stake they would be in a position to shop for care.

Bern, you are correct that portions of the medical field are discretionary and would not be subject to life threatening or other high impact issues. It would be fair to say the premise is not accurate in this case but I have highlighted other market issues that cause people to skip preventative care or prenatal care because the poor linkage between costs and benefits. Really the only portion of the medical field that works well with market dynamics is cosmetic surgury which has an immediate cost and an immediate benefit.

However much of the cost in medicine occurs in the final stages where life threatening issues are at play and where if left to the individual demand curves go vertical. The premise completely holds in this scenario and unfortunately this is where most of the costs reside.

And the problem I have with that theory is what we are being told the problem is. You are contending it seems that costs of goods and services would not change even if the market was free. Yet what are we being told by the proponents of Obamacare. We are being told that the problem essentially is, if not but for cost more people would get the care they needed. Now look at that problem from the hospital side of things. You have a group of people that supposedly want to use your service, but can not because of what it costs. So what does a business have to do. Somehow they have to figure out a way to make their product mroe affordable for people say they can actually buy it. But there isn't any incentive to do that right now, because the money to purchase the service isn't coming from the person consuming it, it's coming from insurance companies or the government, thus there is no incentive for the business to cater to the consumer because it isn't going to change where the money comes from.

 

[Listening]

For critical care it is not true. Market forces require working supply and demand and demand curves are vertical in this case.

I don't fully agree with this either. Even the term critical care is something that can be broken down.

However, in general, I understand where you are going with this. Again, it needs to be part of an overall discussion about the goals of health care.

You won't put an emergency room in a place where the demand won't support it. As you move closer to a place where it will, the demand curve changes. But, just what represents demand is a subject for debate.

 

[Wiseacre]

There is no market in much of health care. If you think there is you should have failed Macro Economics....

Let me spell it out again since you apparently missed it last time....

Markets require supply and demand curves...

Demand Curves are based on the notion of Diminishing Utility. Diminishing Utility is why demand falls as price rises.

Diminishing Utility doesn't exist for much of health care. If a child or parent is seriously sick varying the cost doesn't change the demand for the item. No one will sacrafice the life of their child no matter how you vary the price.

The demand curve is a straight vertical line and the only that constrains prices is the conscious of the suppliers. Lately as health care has gone corporate that conscious is in short supply.


Where demands curves do exist in health care they function poorly.

Demand curves work best where you are buying a product. The benefit is immediately tangible.

Demand curves work less well where the benefit being bought is unclear such as reducing risk in the future. It is even worse when the consumer believes the government will eliminate that risk by forcing Hospitals to accept all patients regardless of ability to pay.

As a result people skip preventative care and neo-natal care they should be getting because of poor market dynamics.

Quite possibly a pure market based system might be the worst possible way to deliver health care.

There used to be a market demand.

Where Sacdog's argument goes off the rails is his misunderstanding of how competition in a free market works. The beauty of the free market for ANY product or service is competition; if you've got a sick kid you're not stuck with one provider, and you are not forced to pay any price. On the contrary, you can shop around for varuous providers and make a choice. CHOICE. That is why he is dead wrong about free market systems.

 

[Cecilie1200]

Of course it's a right.
You can't pursue anything, including hapiness, without it -so why wouldn't it be a right guaranteed by the Constitution?

Because people with health problems are never happy?

Our country tries to guarantee you the right to pursue happiness. Nowhere has it EVER tried to guarantee you the tools to do so. That's up to you. Or, to put it another way, acquiring and securing the tools to pursue happiness is part of the pursuit of happiness.

 

[Cecilie1200]

Isn't this a ridiculously black and white question?

Rush is an idiot and choses to ignore the fact that we already provide free health care for a huge chunck of society and those who have the most ability to be independent in their choices (the elderly) are the least penalized. As long we we mandate emergency rooms take all comers we provide free health care.

It is equally true however, that we can't do everything. So the question isn't do we provide fee healthcare, the question is how do we ration our scarce dollars.

An even better question is how can we keep HC costs down? And for the record I don't think HC is a right, it's a service that you pay for if you want it.

I would agree but I think you have to start by acknowledging (via 5 questions) that health care costs are high because we depend on a market based system where supply and demand doesn't/can't work. If you disagree then tell me how much you childs life is worth because a demand curve requires you to have a number.

Once you acknowlege that truth you can begin to build a system.

No, healthcare is so expensive because we DON'T depend on a market-based system. Instead, we have a system in which the government has interfered and created a giant muddle. The consumers are not the payers, which creates no incentive whatsoever for the consumer to shop for the best deal OR to ration himself, nor any particular incentive for the suppliers to keep costs down. Prices are set according to motivating factors that have nothing to do with the market basics of supply and demand. None of this is "market-based".

 

[Cecilie1200]

Supply and demand could work to hold down costs if the gov't didn't intervene. Unfortunately, that's not the case, we have price controls and we do not allow free and open competition for HC services in most states.

As you no doubt know, a child's life is priceless and you would do well to eschew the theatrics and stick to the reality of the situation.

It is not theatrics at all. The two statements are by definition mutally exclusive for anyone who has spent anytime studying Macro economics...

A childs life (or a parents) is priceless
and
supply and demand could work

Just like it is a big lie that "healthcare is a right" among liberals it is an equally big lie that "the market will work" among conservatives.

The market was working prior to HMO's and comprehensive coverage. It used to be the case that insurance was just that: insurance if something catastrophic happened. People paid for physician office visits, thus prices were affordable due to market forces. Same with drugs. If I didn't like Dr A, I could go to Dr B. This created competition for business.

The market still DOES work in the case of medical care that isn't typically covered by insurance, but is paid for out of the patient's pocket. Look at any procedure or product not normally covered by medical insurance or government programs: cosmetic surgery, laser eye surgery, bariatric surgery, you name it. When they first come out, they're expensive because very few people are qualified to supply them. The niche market rapidly gets filled with suppliers looking to cash in, and the price plunges. And then, frequently, the government mandates that insurance companies have to start covering it, and BOOM! The price takes a small jump up and stays there, unless a new competitor hits the market and makes it obsolete.

 

[Cecilie1200]

When you start talking about a child's life, you're bringing emotionalism into what should be an intellectual discussion. Maybe it's time for you to face reality; which is that no matter which way we go, we cannot save every child's life. We don't have enough providers and we can't afford it. That is the reality dude, we don't have the money and sooner or later we go bankrupt and no amount of increased taxes on rich people can change that.

The question boils down to whether the free market can do a better job of holding down HC costs than the gov't can. Which way can provide the best and most care, which one avoids rationing the most. You say gov't, I say free market. You say the free market hasn't done so well up to now, I say fix it then. You say the gov't can do a better job, I say the gov't couldn't effectively run a nickle lemonade stand. You say that price controls will work tohold down costs, I say you're out of your mind, price controls have NEVER worked to do that.

So you just ignore the point and spew your dogma I guess.

There is nothing emotional about it at all. It is purely an factual understanding of demand curves and how they work. I don't give a damm if we save any childs life, the point is those who do have a child at risk will spend any amount. You can't have a market under those conditions.

Also in my post I never said government provide it or provide price controls. I only pointed out those who claim a pure free market is the best approach either never took or should have failed macro economics.

Several problems here. First of all, the vast majority of healthcare is NOT some TV-melodrama race to save a child's life. Most of it is pretty fucking mundane. Second of all, people with children WILL typically spend anything to save the child, and that's fine. THEY should. But the reality, hard and cold, is that they should be spending THEIR money, not the money of people who don't know them or the kid. I'm very sorry that their child is sick, but I have my own children to care for.

And all markets have extreme ends in both directions. The existence of those extremes does not negate the existence of the market itself. A person who is on the verge of starving to death will pay anything for a loaf of bread, but that doesn't mean that food production and distribution is not an economic market.

 

[Cecilie1200]

Health care costs are high because of government intervention in the free market. When congress passed legislation requiring insurance companies to provide comprehensive coverage, regardless of the market demand, and individuals stopped having to pay for their drugs and physician office visits, the cost controls which were formerly provided by market competition were driven out.

There is no market in much of health care. If you think there is you should have failed Macro Economics....

Let me spell it out again since you apparently missed it last time....

Markets require supply and demand curves...

Demand Curves are based on the notion of Diminishing Utility. Diminishing Utility is why demand falls as price rises.

Diminishing Utility doesn't exist for much of health care. If a child or parent is seriously sick varying the cost doesn't change the demand for the item. No one will sacrafice the life of their child no matter how you vary the price.

The demand curve is a straight vertical line and the only that constrains prices is the conscious of the suppliers. Lately as health care has gone corporate that conscious is in short supply.


Where demands curves do exist in health care they function poorly.

Demand curves work best where you are buying a product. The benefit is immediately tangible.

Demand curves work less well where the benefit being bought is unclear such as reducing risk in the future. It is even worse when the consumer believes the government will eliminate that risk by forcing Hospitals to accept all patients regardless of ability to pay.

As a result people skip preventative care and neo-natal care they should be getting because of poor market dynamics.

Quite possibly a pure market based system might be the worst possible way to deliver health care.

That theory isn't exactly true. It rests on the premise that since no one would sacrifice their life or child's life for cost, there is no diminishing utility. That premise isn't accurate. It isnt' reality. Our medical system isnt' treating only life threatening issues. It isn't even treating mostly life threatening issues. Since for most medical issues people's lives are in fact NOT at stake they would be in a position to shop for care.

Also, many people in a situation of life-threatening illness DO decide to just quit trying to fight it off, due to the law of diminishing returns. Like any economic decision, people in those situations DO calculate the costs - and not just the financial ones, but those too - against the likelihood of success, and many of them opt instead to simply enjoy what time they have left.

When you get right down to it, ALL decisions in life are economics. Even medical ones.

 

[Listening]

Also, many people in a situation of life-threatening illness DO decide to just quit trying to fight it off, due to the law of diminishing returns. Like any economic decision, people in those situations DO calculate the costs - and not just the financial ones, but those too - against the likelihood of success, and many of them opt instead to simply enjoy what time they have left.

When you get right down to it, ALL decisions in life are economics. Even medical ones.

Great post !

That is why I like the idea of specific social security accounts where your principle is passed on to others.

One thing we could do in a health care situation like medicare is say "well, you are 85 and have stage 4 lung cancer....we are not paying for your chemo (but we will give you palative care). You could opt to pay for it yourself knowing that the 100 grand you might spend would otherwise go into your childrens SS accounts and either allow them to reduce contributions or give them a bigger balance.

I suggest to liberals and they are aghast at the idea. I agree with you....it pretty much all comes down to econcomics and choice. Why should you and your kids have to pay for my desire to spend a lot of money on a situation with low probability of success ?

 

[Cecilie1200]

Also, many people in a situation of life-threatening illness DO decide to just quit trying to fight it off, due to the law of diminishing returns. Like any economic decision, people in those situations DO calculate the costs - and not just the financial ones, but those too - against the likelihood of success, and many of them opt instead to simply enjoy what time they have left.

When you get right down to it, ALL decisions in life are economics. Even medical ones.

Great post !

That is why I like the idea of specific social security accounts where your principle is passed on to others.

One thing we could do in a health care situation like medicare is say "well, you are 85 and have stage 4 lung cancer....we are not paying for your chemo (but we will give you palative care). You could opt to pay for it yourself knowing that the 100 grand you might spend would otherwise go into your childrens SS accounts and either allow them to reduce contributions or give them a bigger balance.

I suggest to liberals and they are aghast at the idea. I agree with you....it pretty much all comes down to econcomics and choice. Why should you and your kids have to pay for my desire to spend a lot of money on a situation with low probability of success ?

Exactly! Many people in that situation DO decide not to spend their money on what is likely a fruitless battle against death, and opt to spend the time and money instead enjoying what's left of their life. And there's nothing wrong with that. "Life at all costs" is only a universal good in the movies.

 

[Rozman]

Let's take it a step further...where does it end...

Is employment a right?
Is housing a right?
Is food to feed oneself a right?
Is clothing a right?

If people want this as a priority and want government tom pick up the tab say so
those that can't get healthcare on their own or through an employer should have to
pay something extra in taxes to the government to get put into some sort of health care system.
Those that have healthcare should not be dragged into this.

 

[Sactowndog]

Where Sacdog's argument goes off the rails is his misunderstanding of how competition in a free market works. The beauty of the free market for ANY product or service is competition; if you've got a sick kid you're not stuck with one provider, and you are not forced to pay any price. On the contrary, you can shop around for varuous providers and make a choice. CHOICE. That is why he is dead wrong about free market systems.

Choice is a fair criticism let me address it. I see two issues in rebuttal:

1) patents: many medical treatments are protected by patents and while you may have choice (to stretch a point to make a point) you aren't going to chose the treatment with 40% of success over the new treatment with 90% chance. Generally in a case like this the whole market moves. It isn't like we are buying cars here

2) knowledge: Choice requires knowledge to make choices. The medical market is famously opaque and outcomes data is hard to come by. Do you know which of your local hospitals have had the highest rate of Mersa? Part of ObamaCare is to improve knowlege so people can make choices. In addition, choice required time to research your options which you often may not have in a critical care situation. Who plans to have a heart attack and tells the ER doc, assuming they can speak, I want that brand of stents.

 

[Sactowndog]

The market still DOES work in the case of medical care that isn't typically covered by insurance, but is paid for out of the patient's pocket. Look at any procedure or product not normally covered by medical insurance or government programs: cosmetic surgery, laser eye surgery, bariatric surgery, you name it. When they first come out, they're expensive because very few people are qualified to supply them. The niche market rapidly gets filled with suppliers looking to cash in, and the price plunges. And then, frequently, the government mandates that insurance companies have to start covering it, and BOOM! The price takes a small jump up and stays there, unless a new competitor hits the market and makes it obsolete.

Your are citing elective procedures and even more to the point I made earlier, discretionary procedures where immediate results are apparent. Yes these work very well with market based rules

You are missing the entire point of the discussion which is for non-elective and more importantly potentially life threatening non-elective procedures the demand curve goes vertical. If you have a vertical demand curve supply and demand doesn't work.

 

[Sactowndog]

Also, many people in a situation of life-threatening illness DO decide to just quit trying to fight it off, due to the law of diminishing returns. Like any economic decision, people in those situations DO calculate the costs - and not just the financial ones, but those too - against the likelihood of success, and many of them opt instead to simply enjoy what time they have left.

When you get right down to it, ALL decisions in life are economics. Even medical ones.

In some cases yes where they make the decision personnally that can be the case. Certainly this is done more so when a person is elderly.

So ALL decisions are economic... Okay do you have kids? If all decisions are economic tell what you childs life is worth? If your statement is true you should be able to name a price.

 

[Listening]

Also, many people in a situation of life-threatening illness DO decide to just quit trying to fight it off, due to the law of diminishing returns. Like any economic decision, people in those situations DO calculate the costs - and not just the financial ones, but those too - against the likelihood of success, and many of them opt instead to simply enjoy what time they have left.

When you get right down to it, ALL decisions in life are economics. Even medical ones.

In some cases yes where they make the decision personnally that can be the case. Certainly this is done more so when a person is elderly.

So ALL decisions are economic... Okay do you have kids? If all decisions are economic tell what you childs life is worth? If your statement is true you should be able to name a price.

$250,000...that is what my insurance will pay.