Is healthcare a right? why or why not?

[Listening]

I can only assume it's already been brought up in this very long thread, but trying to claim a service that someone else provides a political 'right' is incoherent. Essentially the question boils down to: do you have the 'right' to force someone else to provide health care for you? If we accept such a conception of a right (the right to force others to your will) we'll undermine the entire concept of political rights and create government that becomes the bully, rather than protects us from the bully.

Yeah 40 some odd pages pretty much flattent that cat....

Here is the summary... not a right, it is a service and one we can't afford at current rates....

First of all, who's "we", Sparkles? Second of all, what is it about more of the same thing that CAUSED the high prices that's supposed to FIX them?

If you want to debate the cost of health insurance and health care services, that is something else. This thread was about whether or not access to health care (whatever that means) is a fundamental right (as it is according to Dennis "the menace" Kucinich).

Rights are not based on costs. This is a fundamental question that has to be answered because if it is ever established that unfettered access to health care is a right....there will be quite a number of changes to our system. I don't believe people really understand what that means.

And I don't believe Obamacare is Universal Health Care. It is about creating a platform for Universal Health Care in the future.

If it is not a right, and is so established, then you only have the market to look at and at that point the question becomes what it is that you are asking.

 

[Bern80]

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

Also only partially true. Given the medical circumstance certainly it's possible that there may be many choices or very few real choices. The point is choice does or can exist more often than you seem to want to acknowledge.

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.

Also true. Why? Because no one right now has the incentive to obtain the knowledge OR provide it. There is no incentive for the mother to research various doctors and prices because either insurance will cover wherever she goes or her insurance provider limits her choices as to where she can go. Since there's no incentive to seek the information to make an informed choice about which doctor to see there is thus no incentive for hospitals to provide that information to the public. We all know that a business is in business to make money. The simplest way to tell you how a business does that successfully is they do what there customers want. Right now they aren't getting a signal from the customer telling them to provide this tranparent data such as cost of services and quality of care. How do you introduce that into a market. You reduce the use of health insurance, not increase it by adding every more regulations about what they have to cover and you certainly don't mandate that every person must buy their product.

 

[lizzie]

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

There used to be a market demand.

I don't think so.

Health care prices were constrained by a sense of propriety not by market demand. It was also constrained by their was just less you could do to keep someone alive. You couldn't spend $500,000 keeping someone alive not because you didn't want to but because they died long before that point.

Executive compensation used to be reasonable relative to other peoples salaries. Demand for Chief Executives was no less great in the 40's or 50's than now. But the sense of propriety among our business leaders has changed greatly. That difference and your ability to keep people alive longer is what has changed not the shape of the demand curve.

As the Chief said a childs life is priceless. It was no less so in the 50's.

Prior to comprehensive medical insurance which happened with passage of HMO legislation in the 70's, insurance was meant to be coverage for emergencies and catastrophes. At that time, there was market competition for doctors and for drugs. If Doctor A was a jerk to his patients, or if he charged significantly more for his services, the market dictated how much of the market share he got. Patients would take their business elsewhere. It was the same with drugs/pharmaceuticals. In most areas of health care treatment, there are alternatives and cheaper medicines which will accomplish the same things as the new drugs coming out onto the market. There's a huge number of anti-hypertensives, several different medications for management of seizure disorders, several anti-depressants- I'm sure you get the picture. The choice has been taken out of the hands of the consumer, because the consumer doesn't have to pay anymore. Doctors don't have a need to prescribe the most affordable drug for their patients because the patient isn't paying for the drug. The insurance companies are making all the decisions- not the consumers of the product(s). This inflates prices by taking away choice at the consumer level.

As for the life of a child, speaking from an emotional standpoint, you're right. From a monetary standpoint, you're incorrect. Our medical technology has outgrown our ability to pay. I know that is sounds grand and heroic to say that there is no price which can be placed on a human life, but there is when it comes to the point that our society can no longer afford it.

 

[Listening]

If life was invaluable....we would never call of search and rescue missions.

I am afraid that prevention of dying is not seen as warranting unlimited resources.

 

[Sactowndog]

'Cause nothing else in the world comes with patents on it.

This isn't the car market where some people want gas milage and other people want performance and others want towing.

This is healthcare where for non-elective procedures people want a single thing: to be made well. So if someone gains an advantage in this regard they become a defacto monopolist for the life of their patent. Why do you think health care stocks move so widely on the issuance or expiration of a patent? Because you are moving into or out of a monopolistic supplier position where people are not able to decline use of your product.

As to knowledge, the Internet is a wonderful thing.

People die in hospitals every day due to error. I challenge you to post one data point on the rankings of hospitals in your area based on frequency of errors or time to diagnosis.

And frankly, neither of these things has anything to do with your assertion that health care is not a market, just like every other product and service out there. Sorry, but customer ignorance doesn't negate the existence of the marketplace, nor does legal protection of intellectual property rights.

And frankly, you might want to reread the posts. I never said a market doesn't exist. I said supply and demand doesn't function well because the demand curves are vertical. There are markets where supply and demand doesn't function.

 

[Cecilie1200]

There used to be a market demand.

I don't think so.

Health care prices were constrained by a sense of propriety not by market demand. It was also constrained by their was just less you could do to keep someone alive. You couldn't spend $500,000 keeping someone alive not because you didn't want to but because they died long before that point.

Executive compensation used to be reasonable relative to other peoples salaries. Demand for Chief Executives was no less great in the 40's or 50's than now. But the sense of propriety among our business leaders has changed greatly. That difference and your ability to keep people alive longer is what has changed not the shape of the demand curve.

As the Chief said a childs life is priceless. It was no less so in the 50's.

Prior to comprehensive medical insurance which happened with passage of HMO legislation in the 70's, insurance was meant to be coverage for emergencies and catastrophes. At that time, there was market competition for doctors and for drugs. If Doctor A was a jerk to his patients, or if he charged significantly more for his services, the market dictated how much of the market share he got. Patients would take their business elsewhere. It was the same with drugs/pharmaceuticals. In most areas of health care treatment, there are alternatives and cheaper medicines which will accomplish the same things as the new drugs coming out onto the market. There's a huge number of anti-hypertensives, several different medications for management of seizure disorders, several anti-depressants- I'm sure you get the picture. The choice has been taken out of the hands of the consumer, because the consumer doesn't have to pay anymore. Doctors don't have a need to prescribe the most affordable drug for their patients because the patient isn't paying for the drug. The insurance companies are making all the decisions- not the consumers of the product(s). This inflates prices by taking away choice at the consumer level.

As for the life of a child, speaking from an emotional standpoint, you're right. From a monetary standpoint, you're incorrect. Our medical technology has outgrown our ability to pay. I know that is sounds grand and heroic to say that there is no price which can be placed on a human life, but there is when it comes to the point that our society can no longer afford it.

Well, let's put it this way. A price WILL be put on a human life. Already happens. Generally, it's placed by whoever has to fork over the cash to protect and preserve that life. So do you want that price being set by total strangers, to whom that human being is just an abstract concept, a statistic that's sucking up their tax money? Or the faceless bureaucrats who work in the system that disburses those tax dollars? Or do you want it to be set by the family and friends who love that person? If you want it to be them, then THEY need to be the ones footing the bill so it can be.

 

[Bern80]

And frankly, you might want to reread the posts. I never said a market doesn't exist. I said supply and demand doesn't function well because the demand curves are vertical. There are markets where supply and demand doesn't function.

And the counter assertion is that simply isn't the case. The demand curves are not vertical. As I stated before what we're being told essentially via Obamacare, that if not but for cost, more people would get the care they need. Therefore there has to be a point on the demand curve where people will purchase services at a certain price and a point at which they won't. That being the case the demand curve can not be vertical and through the introduction of free market principles can be made even less vertical.

 

[Wiseacre]

And frankly, you might want to reread the posts. I never said a market doesn't exist. I said supply and demand doesn't function well because the demand curves are vertical. There are markets where supply and demand doesn't function.

And the counter assertion is that simply isn't the case. The demand curves are not vertical. As I stated before what we're being told essentially via Obamacare, that if not but for cost, more people would get the care they need. That being the case the demand curve can not be vertical and through the introduction of free market principles can be made even less vertical.

Agree, the only way you get a vertical demand line is if you only have one source of supply and no alternatives. Mostly that is not the case, and even if it were the free market system would be no worse than any other alternative.

 

[Cecilie1200]

'Cause nothing else in the world comes with patents on it.

This isn't the car market where some people want gas milage and other people want performance and others want towing.

This is healthcare where for non-elective procedures people want a single thing: to be made well. So if someone gains an advantage in this regard they become a defacto monopolist for the life of their patent. Why do you think health care stocks move so widely on the issuance or expiration of a patent? Because you are moving into or out of a monopolistic supplier position where people are not able to decline use of your product.



People die in hospitals every day due to error. I challenge you to post one data point on the rankings of hospitals in your area based on frequency of errors or time to diagnosis.

And frankly, neither of these things has anything to do with your assertion that health care is not a market, just like every other product and service out there. Sorry, but customer ignorance doesn't negate the existence of the marketplace, nor does legal protection of intellectual property rights.

And frankly, you might want to reread the posts. I never said a market doesn't exist. I said supply and demand doesn't function well because the demand curves are vertical. There are markets where supply and demand doesn't function.

No, there aren't. As I've already pointed out, not everything - or even most things - healthcare are that dire and many markets have that same extreme edge. Doesn't mean supply and demand don't function in that market, or that they aren't still functioning on that edge.

 

[Sactowndog]

Also only partially true. Given the medical circumstance certainly it's possible that there may be many choices or very few real choices. The point is choice does or can exist more often than you seem to want to acknowledge.

Of course it is only partially true. I am not making absolutist statements that in all medical cases the demand curve goes flat or producers achieve a defacto monopolistic position. But sadly in non-discretionary medical care it is true more often than not. Of course in discretionary care and certainly in cosmetic care it is more true that choice exists but that major expenses in health care reside in non-discretionary end of life care.

Also true. Why? Because no one right now has the incentive to obtain the knowledge OR provide it. There is no incentive for the mother to research various doctors and prices because either insurance will cover wherever she goes or her insurance provider limits her choices as to where she can go.

Not the case. Every year we have a choice of insurance plans and I guarentee you the data does not exist because I look for it. People want the data but doctors to date have not provided it. Outcomes research is almost impossible to find even with the internet.

Why make it hypothetical? Look for it yourself and see what you find.

 

[Sactowndog]

In most areas of health care treatment, there are alternatives and cheaper medicines which will accomplish the same things as the new drugs coming out onto the market. There's a huge number of anti-hypertensives, several different medications for management of seizure disorders, several anti-depressants- I'm sure you get the picture. The choice has been taken out of the hands of the consumer, because the consumer doesn't have to pay anymore.

Yes and no. Certainly there are drugs who have had their patents expire and for whom thier is generic competition. And if you plan is like mine you have financial incentives to pick the less expensive generic drugs. And as long as the effectiveness of one is more or less the same as the other..... yes supply and demand come into play.

As for the life of a child, speaking from an emotional standpoint, you're right. From a monetary standpoint, you're incorrect. Our medical technology has outgrown our ability to pay. I know that is sounds grand and heroic to say that there is no price which can be placed on a human life, but there is when it comes to the point that our society can no longer afford it.

Look I am not using a child to evoke emotion. The point is for demand curves to work people have to be willing to forgo an offering at a range of prices. In some cases of medicine people are emotionally unable to specify a price where they will forgoe the service. Without that willingness you don't have a demand curve. I can't be right from an emotional standpoint and wrong about the demand curve. Perhaps you can make the case that it is really a bankrauptcy curve but even then the costs often get shifted to others.

I agree their comes a point society can no longer afford it but that doesn't mean a demand curve magically appears.

 

[Sactowndog]

If life was invaluable....we would never call of search and rescue missions.

I am afraid that prevention of dying is not seen as warranting unlimited resources.

You are mixing the ability of an unemotional societal policy to make a decision and an individual to make a decision.

I would argue that yes as a society we can form a rational demand curve and make cost effective medical choices if we aren't attacked for creating death panels. I would argue as a society we need to make this choice. However, the choices we make today are based on who votes not what is the best decision for the society.

That however is different than an individaul who is emotionally tied in being able to make the same decision and operate in "rational" market context. Remember an underlying assumption of supply and demand is that markets are rational which clearly goes out the window in the case of a sick loved one. Especially if that loved one has not "lived a full life"

 

[Sactowndog]

Well, let's put it this way. A price WILL be put on a human life. Already happens. Generally, it's placed by whoever has to fork over the cash to protect and preserve that life. So do you want that price being set by total strangers, to whom that human being is just an abstract concept, a statistic that's sucking up their tax money? Or the faceless bureaucrats who work in the system that disburses those tax dollars? Or do you want it to be set by the family and friends who love that person? If you want it to be them, then THEY need to be the ones footing the bill so it can be.

To an earlier point the best argument you can make is a bankrauptcy curve exists. That in these cases everyone pays everything they have and the curve is formed by the levels at which people go bankraupt.

 

[Sactowndog]

And the counter assertion is that simply isn't the case. The demand curves are not vertical. As I stated before what we're being told essentially via Obamacare, that if not but for cost, more people would get the care they need. Therefore there has to be a point on the demand curve where people will purchase services at a certain price and a point at which they won't. That being the case the demand curve can not be vertical and through the introduction of free market principles can be made even less vertical.

Go back and read your economics. A demand curve is formed by the willingness of society to forgo a specified service at a specified price. In the case of non-discretionary critical care society provides it whether the person can afford it our not.

 

[Sactowndog]

First of all, who's "we", Sparkles? Second of all, what is it about more of the same thing that CAUSED the high prices that's supposed to FIX them?

BTW completely tangential but do you use our sig pic to try to disarm your male debaters?

Just curiuos

 

[Sactowndog]

Agree, the only way you get a vertical demand line is if you only have one source of supply and no alternatives. Mostly that is not the case, and even if it were the free market system would be no worse than any other alternative.

That is absolutlely wrong. You would get an F in Freshman Macro economics. You can create a demand curve independent of supply. Having a supply only causes a market price to be specified.

What creates a demand curve is solely the different willingness among market players to forgo a service based on its price. End of Story. It has nothing to do with supply.

 

[Wiseacre]

Agree, the only way you get a vertical demand line is if you only have one source of supply and no alternatives. Mostly that is not the case, and even if it were the free market system would be no worse than any other alternative.

That is absolutlely wrong. You would get an F in Freshman Macro economics. You can create a demand curve independent of supply. Having a supply only causes a market price to be specified.

What creates a demand curve is solely the different willingness among market players to forgo a service based on its price. End of Story. It has nothing to do with supply.

In real life demand curves do not exist independently of the supply curve. That is how the price is determined, no? AND, the alternatives a consumer might choose in place of the product or service has an influence too. That is why a drug company cannot charge a million bucks a pop for a unique drug treatment, few could aford it. I really don't think there are any cases where a purely vertical demand curve exists for anything, certainly not in the medical services field.

 

[Greenbeard]

The simplest way to tell you how a business does that successfully is they do what there customers want.

What do customers in the health industry want? What are they seeking when they look to buy health services?

Outcomes research is almost impossible to find even with the internet.

In part that's because validated outcomes measures are still comparatively rare. If you look at one of the most popular measurement tools used across most health plans in the country, the National Committee for Quality Assurance's HEDIS measure set, they're virtually all process measures. They measure whether physicians provided medically-indicated interventions to certain populations in certain circumstances, but they don't probe the outcomes of those interventions across those populations.

The same is true if you look at the list of National Quality Forum-endorsed measures--they're heavily tilted toward process measures and surveys of patient experience. The goal is to move toward more outcomes-based measurement and with the spread of electronic health records there's potential for measurements that simply weren't possible before but it's still pretty early in that process.

Prior to comprehensive medical insurance which happened with passage of HMO legislation in the 70's, insurance was meant to be coverage for emergencies and catastrophes. At that time, there was market competition for doctors and for drugs. If Doctor A was a jerk to his patients, or if he charged significantly more for his services, the market dictated how much of the market share he got. Patients would take their business elsewhere. It was the same with drugs/pharmaceuticals. In most areas of health care treatment, there are alternatives and cheaper medicines which will accomplish the same things as the new drugs coming out onto the market. There's a huge number of anti-hypertensives, several different medications for management of seizure disorders, several anti-depressants- I'm sure you get the picture. The choice has been taken out of the hands of the consumer, because the consumer doesn't have to pay anymore. Doctors don't have a need to prescribe the most affordable drug for their patients because the patient isn't paying for the drug. The insurance companies are making all the decisions- not the consumers of the product(s). This inflates prices by taking away choice at the consumer level.

The irony here is that the only period in the past half century in which health care cost growth was under control for a sustained period of time was the mid-to-late 1990s, a time characterized by a marked lack of patient choice. This was the era of widespread managed care, in which provider networks were constricted and decision-making was heavily tilted toward the health plan and away from the individual.

That said, we do have more appealing options in the future than going back to that, particularly if we make the right investments right now (which, thankfully, we've started to do over the past few years).

 

[dblack]

What do customers in the health industry want? What are they seeking when they look to buy health services?

The best that someone else's money can buy.

 

[Bern80]

And the counter assertion is that simply isn't the case. The demand curves are not vertical. As I stated before what we're being told essentially via Obamacare, that if not but for cost, more people would get the care they need. Therefore there has to be a point on the demand curve where people will purchase services at a certain price and a point at which they won't. That being the case the demand curve can not be vertical and through the introduction of free market principles can be made even less vertical.

Go back and read your economics. A demand curve is formed by the willingness of society to forgo a specified service at a specified price. In the case of non-discretionary critical care society provides it whether the person can afford it our not.

Then you're back to the same point. Now you're saying society provides the service regarldess of what the consumer can pay. Again a position that is in defiance of the notion that there is cost problem in American where health care is concerned.