My Article about Reducing Health Care Costs

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Scott
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My Article about Reducing Health Care Costs

Post by Scott » October 21st, 2009, 8:11 pm

If you haven't already, please check out my new philosophy of politics article, Ways to Lower Health Care Costs.

In it, I explain 5 general suggestions that I support for lowering health care costs. In the article, there is a link to a thread for each suggestion where that specific one can be discussed.

You can use this thread to comment on the article as a whole and to post other ideas for how to reduce health care costs.

Please note, as explained in the article, the issue is not who to make pay for health care costs but rather how to lower health care costs.

Thanks!
Scott
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Post by Belinda » October 22nd, 2009, 6:57 am

I agree Scott.Your proposals sound like the British National Health Service with the exception of this one:
Nonetheless, let's charge for example a higher insurance premium to someone who voluntarily chooses to smoke cigarettes and a lower premium to someone who does not. The same goes for engaging in overeating, criminal violence, recklessness, drug use, alcohol consumption, consuming carcinogens, not getting medical checkups, etc. (Discuss the idea of basing premiums on habits.)

I am far from saying that the NHS is foolproof. It need continual tweaking into line financially and practically. But then so do any other institutions.
I can see two difficulties about basing premiums on habits.
1. e.g. overeating. This is a psychological and genetic defect in a society in which fattening food is easily got, and cheap to buy. Because it's not a free choice to eat too much over-eaters and obese people need more preventive psychological care with regard to eating healthily.This care costs money from the common pool however preventive care is cheaper than remedial care for those who are already obese and will benefit society that funds the common pool.Much the same may be said about alcoholism, criminal violence, undue risk taking, and so on.Improved education and improved leisure facilities can work towards reducing overall health costs.

E.g. alcoholism. Again , preventive measures such as making it a lot more expensive to buy, and adequately policing outlets with regard to drunks and under age drinkers.



2. The other difficulty about basing premiums on habits is the possible difficulty in administrating the rules. Are people to self report to the insurers? If so how can the insurers investigate whether or not the insured are honest, or balanced in their estimates? Anti-social behaviours with regard to personal health are so various and intricate that I dont see how they can be insured against accurately.The effects on near relatives such as mothers wives husbands and children of anti social persons with regard to personal health also impinge on community health care costs. The varieties of carers, of for instance over eaters,or alcoholics, or schizophrenics who refuse medication, is one of the costs that have to be met somehow from the public purse.I don't see how all this could be self assessed for insurance purposes.

Not that the British NHS has no problems! The governments here do public awareness raising by television etc. Dietary, alcohol, car driving, sports etc.This as you may guess has mixed effects. But there is nothing better available except ploughing money into improvements in education and healthy leisure facilities.Curricula now have to have so many hours of physical exercise per week , for instance.Doctors and their subsidairy staff such as qualified nurses have specialist sessions on diabetic care, dietary advice, asthma, smoker- stopping and so on.
Other than education, heath and safety regulations, and leisure facilities at work and other general preventive measures I think there is no alternative to remedial care for all on demand filtered through the family medic.
Socialist

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Post by whitetrshsoldier » October 22nd, 2009, 2:41 pm

Scott,

Why can't we discuss WHO will pay for these things, when your proposals inherantly demand that the money must come at the expense of CERTAIN PEOPLE? Who is to decide who deserves what and when? Does it matter how expensive health care is when we think that we, as a "society" can determine who is more deserving of health care than the individual who seeks care himself?

And Belinda,

Do you think that anybody is responsible for themselves or their conditions? So the drug addict is just a victim of their psychological state, as is the food addict, and the depressed sedentary obese person. How about the violent sociopath? I'm sure that Hitler, Stalin, and Mao only killed people because their brain chemistry was off a bit, right? And I'm only railing against them because I'm deluded. And anybody who does anything that you consider socially unacceptable is only doing so because they were inproperly "conditioned", right?

So maybe we should just happily indoctrinate everybody to act according to the dictates we feel appropriate? Sounds great! Call George Orwell! 1984 Has arrived!!!
"I'm sorry if I hurt your feelings! I'm obviously just insecure with the ineptitudes of my logic and rational faculties. Forgive me - I'm a "lost soul", blinded by my "ignorant belief" that there's such a thing as reality and truth in the world"

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Re: My Article about Reducing Health Care Costs

Post by ThomasHobbes » July 29th, 2018, 5:13 am

Reduce health care costs.
Move to the UK!

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Re: My Article about Reducing Health Care Costs

Post by LuckyR » July 31st, 2018, 3:01 am

Before we decide how to reduce expenditures, there should be a consensus that expenditures are too high.
"As usual... it depends."

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Re: My Article about Reducing Health Care Costs

Post by Steve3007 » July 31st, 2018, 4:33 am

This topic seems to be mostly about the cost of healthcare specifically in the US. From what I've read, the average cost there does appear to be very high. But, as you'd probably expect, opinions in the US about why that is vary greatly. Some people on the more "libertarian" end of the political spectrum think it stems from the expansion of the welfare system under FDR and the subsequent introduction of Medicare. They think that a truly free-market healthcare system would be more efficient. See, for example, G E Morton's posts:

viewtopic.php?p=296931#p296931


Others think that healthcare is an example of one of those collective resources that can't simply be left to the free market to provide and that it's not always true that free markets = greater efficiency. Anecdotally, an American colleague of mine thinks that in the US system there is massively wasteful due to such things as duplication of effort and the need to hire lawyers to check whether people have the means to pay before allowing them to use taxpayer funded healthcare services.

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Re: My Article about Reducing Health Care Costs

Post by ThomasHobbes » July 31st, 2018, 4:42 am

Free markets lead to monopoly and litigiousness.
This means spiralling costs.

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Re: My Article about Reducing Health Care Costs

Post by GE Morton » July 31st, 2018, 8:48 pm

ThomasHobbes wrote:
July 31st, 2018, 4:42 am
Free markets lead to monopoly and litigiousness.
This means spiralling costs.
No, they don't. Indeed, they assure that any monopolies that form will not survive. Socialism, on the other hand, is a monopoly by definition.

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Re: My Article about Reducing Health Care Costs

Post by GE Morton » July 31st, 2018, 8:54 pm

The spiraling costs of health care in the US since WWII, BTW, are not due to free markets, which always work to reduce costs (due to the pressures of competition). Health care costs in the US have spiraled for two reasons: 1) the ever-growing burden of government overhead on medical services and products, and 2) the destruction of the nexus between supply and demand by the shift to 3rd-party payers.

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Re: My Article about Reducing Health Care Costs

Post by Greta » July 31st, 2018, 10:50 pm

Funny thing that the US has less public health coverage yet also suffers much higher medical costs than other western nations.

Logically, if government involvement was anything more than just an excuse then the opposite would be the case.

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ThomasHobbes
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Re: My Article about Reducing Health Care Costs

Post by ThomasHobbes » August 1st, 2018, 5:07 am

GE Morton wrote:
July 31st, 2018, 8:48 pm
ThomasHobbes wrote:
July 31st, 2018, 4:42 am
Free markets lead to monopoly and litigiousness.
This means spiralling costs.
No, they don't. Indeed, they assure that any monopolies that form will not survive. Socialism, on the other hand, is a monopoly by definition.
Total nonsense.
Socialism splits up monopolies. You need government control to prevent monopolies.
You are living in a dream world of naivete.

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ThomasHobbes
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Re: My Article about Reducing Health Care Costs

Post by ThomasHobbes » August 1st, 2018, 5:10 am

GE Morton wrote:
July 31st, 2018, 8:54 pm
The spiraling costs of health care in the US since WWII, BTW, are not due to free markets, which always work to reduce costs (due to the pressures of competition). Health care costs in the US have spiraled for two reasons: 1) the ever-growing burden of government overhead on medical services and products, and 2) the destruction of the nexus between supply and demand by the shift to 3rd-party payers.
Health care should decrease, as it has in the UK.
The USA's problem is that private medicine and insurance acts like a parasite on the government which is in any event made up of the same individuals that benefit from cheating the system.
American business is cheating the people.

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Re: My Article about Reducing Health Care Costs

Post by GE Morton » August 1st, 2018, 11:54 am

ThomasHobbes wrote:
August 1st, 2018, 5:07 am

Socialism splits up monopolies. You need government control to prevent monopolies.
In a free market you don't need government to split up monopolies. They self-destruct. If a firm acquires a monopoly it raises prices until reaching the point of diminishing returns. Profits soar. Those high profits, however, immediately attract other investors into that market, who proceed to compete with the dominant firm, while other entrepreneurs develop alternatives to the monopolized product. Thus the monopoly ends, the competition forces prices back down, and technology advances.

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Re: My Article about Reducing Health Care Costs

Post by GE Morton » August 1st, 2018, 12:07 pm

ThomasHobbes wrote:
August 1st, 2018, 5:10 am

The USA's problem is that private medicine and insurance acts like a parasite on the government which is in any event made up of the same individuals that benefit from cheating the system.
Well, that is a classic example of Newspeak. A parasite is an organism that subsists by appropriating, by force or stealth, nutrients produced by others, or the products of others' labor. In health care the products are medicines, various types of instruments, and provider services, most of which are produced or delivered by "private medicine." The only social institution that appropriates those products and services, or the earnings therefrom, by force, that I know of, is government. Who, exactly, is the parasite here?

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Re: My Article about Reducing Health Care Costs

Post by GE Morton » August 1st, 2018, 1:26 pm

Greta wrote:
July 31st, 2018, 10:50 pm
Funny thing that the US has less public health coverage yet also suffers much higher medical costs than other western nations.

Logically, if government involvement was anything more than just an excuse then the opposite would be the case.
The amount of "public health coverage" is not the determinant. It is the total fraction of health care paid by 3rd-party payers, of which the government is only one.

Health care costs in the US are high because prices for everything involved are high --- from drugs to laboratory tests to CT and MRI scans to physicians', nurses', and technicians' salaries to bedpans and bandages.

https://jamanetwork.com/journals/jama/a ... ct/2674671

Why are those prices high? For two reasons --- because of government-imposed restrictions on entry, such as "certificate of need" laws" and licensing requirements for providers, and mandated charity-care laws (such as the federal EMTLA law, which requires emergency rooms to treat all patients regardless of their ability to pay) and state laws which demand hospitals provide certain levels of charity care.

https://www.vox.com/policy-and-politics ... na-lawsuit

The 2nd reason is more fundamental: When a third party is paying the bill the consumer does not care what a product or services costs, and hence does not inform himself of the costs or shop around for a better price. In the US most health care consumers do not even pay for their insurance; the premiums are paid by employers (or the government). Hence the consumer is totally insulated from the costs of his health care (and of the lifestyle choices that lead to health problems). Private insurers try to control costs, but they, too, are subjected to government mandates which force them to include coverages many of their the customers don't need or want, extend insurance to high-risk customers without proportionate premiums (which forces those costs onto other customers), and restrictions on entry into a market, which limits competition.

Imagine that the government instituted a "universal food insurance" scheme, whereby anyone could visit a supermarket, fill his shopping cart with whatever he wanted, and the government or perhaps some private insurer would get the bill. Do you think that cart would be full of hamburger, or filet mignons? What would a pound of hamburger cost in a year?

We've seen a similar spiral in the costs of higher education. Why? Because most college tuition bills (about 60%) are now paid by 3rd party payers, primarily the government. The rise in tuitions over the last few decades precisely tracks the availability of student loans and grants.

https://www.newyorkfed.org/medialibrary ... .pdf?la=en

In both cases the law of supply and demand has ceased to operate; competition is restricted or eliminated and consumers are indifferent to costs. Hence prices can rise with no checks or limits.

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