5 US Health Care Myths

Staats wrote:
OG_slinger wrote:

I'd love to, but virtually every "libertarian" I've come across are angry white men with lots of guns who's vision of political Nirvana involves everyone living on self-sufficient compounds in Montana or Texas.

In the case you cited above, how would I, an individual citizen who was wronged, go after a large company who was dumping the mercury? The company has more money than I do. They can hired more and better lawyers. They can afford to let the case drag out for years. The end result will be that I'm financially ruined and the company continues to pollute.

It's only when the government can step in with the EPA to fine, shut down, and sue the company that the polluting will stop.

Well, I'm not suggesting that. I think Aetius works at IBM, so I'll go ahead and say he's not for that either. If you view someone through the lens of a stereotype, you'll never understand their position.

As for your question, that's an orthogonal issue related to how the law is written and how the judicial system works - clearly if it's not feasible to prosecute some infraction, something is wrong.

My views of libertarians are based on the ones with which I've had discussions. My opinion is that they are essentially Reganite small government types taken to a ridiculous extreme. I'd love to have a rational discussion, but when their opener is effectively "all government sucks and private industry is completely infallable", I find it difficult to continue.

As for my question, do you really think that there would even be a law against dumping mercury without a strong government that has an independent agency concerned with the safety of the environment? The industry lobby would make sure there would be no such thing.

Even your general guideline of "restrict freedom only when necessary to preserve the freedom of others" begs the questions 1) just what exactly is considered a 'freedom', and 2) who determines when one person's freedom trumps someone else's freedom? You might want to drive a big ass SUV that gets eight miles to the gallon. I might want cleaner air and less oil imports. Who's version of freedom reigns supreme? Can a policy that creates a collective good ever merit taking away an individual 'freedom'?

PyromanFO wrote:

My argument isn't that there aren't limits to what we can spend as a society on healthcare. My argument is that there aren't limits to what you will spend on healthcare.

The only system in which there is unlimited spending on the individual level (and by extension, the group level) is the socialized one. In a free market system I am limited to the money I have.

Yeah there's only so many doctors to go around, but if the market can't discover prices, then they can charge whatever the hell they feel like. You will give them everything you own every time you need heart surgery. Hell, you would pay that just to get on a list that they might get around to you.

People are perfectly capable of making rational decisions when it comes to life and death. Soldiers jump on grenades to save their friends. If a doctor wanted everything I had for heart surgery, it would not be rational to give it to him and cause hardship for my family.

In order for the line to be drawn in any sane fashion, you can't depend on market forces to take care of it for you. You have to use bureaucracy. And then it's simply a matter of a private oligarchy or a public monopoly.

I don't know about you, but I save money to make sure I can make good choices when it comes to health care. Only in a free market can I set the line where I want it (within my means), rather than some bureaucrat a thousand miles away. Of course, that entails the ability to set the line too low.

Staats wrote:

When discussing libertarianism, forget the official Libertarian platform and instead focus on the general philosophy of libertarianism. . . . The general guideline of "restrict freedom only when necessary to preserve the freedom of others" does not preclude environmental regulations.

No, but it raises a conflict with other parts of what we've come to expect from libertarian doctrine. If someone complains that the government bureaucracy is always too lazy and incompetent, that taxes must be low as possible, that government should be restricted in its powers- what are we to expect regarding environmental regulations that will require money, government bureaucrats, and less privacy to enforce?

I have to agree. I think the normal formulation is "Restrict freedom when necessary to preserve the *safety* of others."

OG_slinger wrote:

Health insurance companies can't exactly do the same.

Except that they do, every day.

It is in the health insurance company's best interest to pay for the "low-level crap" because its the best way to spot and treat any condition that might grow into a really serious (read costly as all hell) condition. In simplier words, it would be cheaper to pay for preventative treatments than, say quadruple bypass surgery.

That is easily taken care of by reduced premiums for people who can prove that they get preventative care.

I don't believe that if people had to pay for doctor visits and pills they'd start making better decisions largely because those decisions will always involve themselves or their loved ones. Are parents really going to make a rational economic decision when little Jimmy is sick? Nope, they're going to pull out all the stops. Crap, I know people who spent thousands of dollars to keep their pet cat alive.

Do you know people who don't have thousands of dollars who do that? Of course people can make rational decisions when it comes to health care, just like everything else.

For most people, the decision will come down to do I eat and pay rent this month or do I get my script for blood pressure pills filled?

Huh? There are very, very few people in first-world countries who make the choice of eating or medicine. Give me a break.

That patch work health care will end up and cost the system more over the long term. That person who only periodically gets their blood pressure pills will develop a very costly vascular problem. It's just like antibiodics in developing countries. They're expensive, so people only take as many as they need to feel better, not the entire 10-day course. The end result? We're seeing the emergence of some pretty nasty antibiodic resistant strains of diseases and bacteria. All courtesy of rational economic decisions.

I would argue that that decision is not very rational. I mean, seriously. You make it sound like the only rational decision is based on price, when clearly many buying decisions have very little to do with price.

OG_slinger wrote:

In the case you cited above, how would I, an individual citizen who was wronged, go after a large company who was dumping the mercury? The company has more money than I do. They can hired more and better lawyers. They can afford to let the case drag out for years. The end result will be that I'm financially ruined and the company continues to pollute.

It's only when the government can step in with the EPA to fine, shut down, and sue the company that the polluting will stop.

I'll leave the rest of these comments alone, but I want to respond to this one.

Can you see yourself as being part of a group besides your family and your country? You're not alone, and you wouldn't be alone in fighting such a company.

Libertarians support freedom, unless you are trying to hurt someone or swindle them. Pollution breaks both of those tenets. How do you think Libertarians would react to that? I don't know of any Libertarians (big or small L) who advocate the dissolution of the EPA; in fact, since some pollution is particularly hard to deal with in relation to things like air rights, the government would have to be involved. Mostly, the Libertarian argument would be that if we got rid of all the stuff the government isn't supposed to do, they might actually be able to focus on the stuff that matters like pollution.

Robear wrote:

I have to agree. I think the normal formulation is "Restrict freedom when necessary to preserve the *safety* of others."

The logical extension of that argument is totalitarianism and total state control, since safety can never be fully guaranteed.

Yeah, we have a pretty good system in Mexico. Only problem is we're kinda poor.

Paleocon wrote:

Even if we are to accept that the problem of cost in the system has to do with folks not knowing the price of their services (a very tenuous argument at best), it still doesn't explain at all why practically every other industrialized country on the planet enjoys vastly superior medical service to ours at prices much lower than ours while, at the same time, making costs to the consumer entirely opaque. .

Man, even Mexico and Cuba have better free health care systems than the USA.

I've got a couple of horror stories from mexican tourists who had to travel to Mexico to get treatment or operations because the cost was ridiculously high in the US.

Something really fishy happened with the US health care system at some point, it went so wrong, wonder what it was. You work just as hard or harder than most other citizens of the world...

Also you guys have lots of popular medical TV shows, I wonder why that is, you seem to love doctors.

Funkenpants wrote:
Staats wrote:

When discussing libertarianism, forget the official Libertarian platform and instead focus on the general philosophy of libertarianism. . . . The general guideline of "restrict freedom only when necessary to preserve the freedom of others" does not preclude environmental regulations.

No, but it raises a conflict with other parts of what we've come to expect from libertarian doctrine. If someone complains that the government bureaucracy is always too lazy and incompetent, that taxes must be low as possible, that government should be restricted in its powers- what are we to expect regarding environmental regulations that will require money, government bureaucrats, and less privacy to enforce?

The libertarian doctrine is that minimal government is optimal. Not none. (Though there is an anarchist strain to libertarianism.) The requirement to prevent or address aggression and to combat fraud is right there, and would completely apply to dealing with polluters and environmental concerns. The government would (and should) encourage these matters to be resolved privately, but where they cannot or will not, the government has to be there. It's not efficient, but it's the only way. You do what you can to make it as efficient and effective as possible - which is a heck of a lot easier when there is a lot less government to deal with.

The only system in which there is unlimited spending on the individual level (and by extension, the group level) is the socialized one. In a free market system I am limited to the money I have.

How could I as an individual have unlimited spending in a socialized system when I do not have control over the individual purchasing decisions?

People are perfectly capable of making rational decisions when it comes to life and death. Soldiers jump on grenades to save their friends. If a doctor wanted everything I had for heart surgery, it would not be rational to give it to him and cause hardship for my family.

Two things here. One, if you don't have a family you're still entirely rational to end up homeless but alive. Two, if you do have a family, there's a good chance they'll just wait till your incapacitated then spend it anyway. You can call it rational or not, but most people would rather spend the rest of their lives with their loved ones alive than spend it with them dead but owning a nice car. And I wouldn't want to set up a system where they're encouraged to let their loved ones die in order to remain financially solvent.

I think it's fair to say at this point we have a fundamental disagreement about human nature.

OG_slinger wrote:

I'd love to have a rational discussion, but when their opener is effectively "all government sucks and private industry is completely infallable", I find it difficult to continue.

Did I say that?

OG_slinger wrote:

As for my question, do you really think that there would even be a law against dumping mercury without a strong government that has an independent agency concerned with the safety of the environment? The industry lobby would make sure there would be no such thing.

Why not? What about a strong government and the EPA discourages industry lobbyists? Regardless of the size of the government, one need only convince 269 legislators to pass or not pass a law. At some point the EPA went from "not existing" to "existing", despite whatever resistance existed, right? The creation of EPA is a much larger jump than simply banning the dumping of mercury.

OG_slinger wrote:

Even your general guideline of "restrict freedom only when necessary to preserve the freedom of others" begs the questions 1) just what exactly is considered a 'freedom', and 2) who determines when one person's freedom trumps someone else's freedom? You might want to drive a big ass SUV that gets eight miles to the gallon. I might want cleaner air and less oil imports. Who's version of freedom reigns supreme? Can a policy that creates a collective good ever merit taking away an individual 'freedom'?

It's a gray area. Can I definitively nail down the definition of "freedom" and algorithmically determine what is and is not acceptable use of government? Of course not - hence the term "guideline". Very few people have political beliefs so rigorously defined. I only have a vague notion of your political beliefs, but I feel confident they're a result your own interpretation of some set of principles. Someone else probably follows a similar set of principles and arrives at a different conclusion. You both probably make an exception for some issue you feel trumps your principles.

That I accept the existence of government as necessary should indicate that, yes, a policy that creates a collective good can merit taking away an individual freedom. The SUV example is a tough one. On the one hand, people are free to waste resources (fattest country in the world!). On the other hand , emissions have been shown to harm others, which is not something you can say about french fries. And on the gripping hand, these emissions are necessary to our day-to-day survival, because without oil society would basically collapse. I personally like the idea of carbon trading or a gas tax; others have different solutions. (Aside: "less oil imports" isn't a freedom under pretty much any definition, that's a goal.)

The version of freedom that reigns supreme is determined by law, but - as I have said in other threads - people should take caution not to abuse that power. Libertarianism appeals to me in part because I have observed that people generally want to ban or regulate things they don't like, and don't want things banned or regulated that they do like - smoking becomes an evil to be stamped out while alcohol goes unmentioned, large vehicles are bad while international flights for vacations are OK, gays are destroying marriage while no-fault divorce is OK, etc. And so I take the position that unless a proposed ban has a large majority (90+%) and clearly prevents some people from harming others, we're all probably better off not trying to force decisions or values on others.

Aetius wrote:
It is in the health insurance company's best interest to pay for the "low-level crap" because its the best way to spot and treat any condition that might grow into a really serious (read costly as all hell) condition. In simplier words, it would be cheaper to pay for preventative treatments than, say quadruple bypass surgery.

That is easily taken care of by reduced premiums for people who can prove that they get preventative care.

Years ago, I went on COBRA, which meant I was paying the full, no employer contribution rate of about $325 a month for my health insurance. If I had to pay for all of my preventative doctor's visits (at, say, $150 a pop, plus lab fees, etc.), you would REALLY have to reduce my premiums to make it worth my while. Cutting my premium down by twenty bones a month isn't going to motivate me to shell a lot out of my pocket now to save the insurance company lots of dough down the road.

Besides, there's still the tricky part about determining exactly what is preventative care and what is the "low-level crap" you don't like. The devil is always in the details.

Aetius wrote:
I don't believe that if people had to pay for doctor visits and pills they'd start making better decisions largely because those decisions will always involve themselves or their loved ones. Are parents really going to make a rational economic decision when little Jimmy is sick? Nope, they're going to pull out all the stops. Crap, I know people who spent thousands of dollars to keep their pet cat alive.

Do you know people who don't have thousands of dollars who do that? Of course people can make rational decisions when it comes to health care, just like everything else.

Yes. The guy in question was a bartender with nary a nickle to rub together. When emotions are involved, comparison shopping goes out the window. Madison Avenue has understood this for decades.

It might be possible for people to make more informed decisions about their health care, but if I was very sick I'd always opt for any treatment that would get me better even if I knew I couldn't afford it. Why? Because I can alway worry about paying off the debt later...when I'm better. I'm certainly not going to say, "Sorry, doctor. It's just not in my budget."

Aetius wrote:
For most people, the decision will come down to do I eat and pay rent this month or do I get my script for blood pressure pills filled?

Huh? There are very, very few people in first-world countries who make the choice of eating or medicine. Give me a break.

That's because we have health insurance. Take that away and you'll see a boat load of people wondering if that Lipitor pill is worth the 60 bucks a month it costs them. God forbid they have a serious disease, like MS, where the drugs to treat it cost $1,900 a month.

Most insurance companies are even boosting the co-pays for these expensive drugs to the point where they cost several hundred dollars a month. I could afford that, but I know that extra cost would crush my sisters and their families because they live on a much tighter budget. For them it really would be a decision about paying the mortgage or getting the drug. This is why the number one cause of bankruptcy is medical bills.

Aetius wrote:
That patch work health care will end up and cost the system more over the long term. That person who only periodically gets their blood pressure pills will develop a very costly vascular problem. It's just like antibiodics in developing countries. They're expensive, so people only take as many as they need to feel better, not the entire 10-day course. The end result? We're seeing the emergence of some pretty nasty antibiodic resistant strains of diseases and bacteria. All courtesy of rational economic decisions.

I would argue that that decision is not very rational. I mean, seriously. You make it sound like the only rational decision is based on price, when clearly many buying decisions have very little to do with price.

It's exceptionally rational. I feel better, so why should I continue to pay for drugs I think I don't need? Again, the proof is in the pudding: the antibiodic resistant diseases just didn't magically appear. They came from lots of people making the same decision, the same trade off.

Aetius, if government is that small, how will it enforce it's decisions? Is it ever realistic to expect that it will *not* have to enforce it's decisions "at the point of a gun"?

Robear wrote:

Aetius, if government is that small, how will it enforce it's decisions? Is it ever realistic to expect that it will *not* have to enforce it's decisions "at the point of a gun"?

No, which is why you minimize its size and power. Minimum use of force to get the jobs done that can't be done any other way.

Aetius wrote:

The libertarian doctrine is that minimal government is optimal. Not none.

Fine. The difficulty is that most government bureaucracies and regs exist for the same reason as anti-pollution bureaucracies do. There's generally some problem that needs to be solved that isn't being addressed through private agreement. It's pretty rare to find more than minimal amounts of government effort in any activity that doesn't present a social problem or protection of some economic right. Budgets aren't that big.

So we always come back to the idea of which activities represent social problems that need intervention and which don't. It's not a question of minimal government, but rather of which social problems are worth attempting to correct.

Staats wrote:
OG_slinger wrote:

I'd love to have a rational discussion, but when their opener is effectively "all government sucks and private industry is completely infallable", I find it difficult to continue.

Did I say that?

No you did not. Nor did I say you did.

Staats wrote:
OG_slinger wrote:

As for my question, do you really think that there would even be a law against dumping mercury without a strong government that has an independent agency concerned with the safety of the environment? The industry lobby would make sure there would be no such thing.

Why not? What about a strong government and the EPA discourages industry lobbyists? Regardless of the size of the government, one need only convince 269 legislators to pass or not pass a law. At some point the EPA went from "not existing" to "existing", despite whatever resistance existed, right? The creation of EPA is a much larger jump than simply banning the dumping of mercury.

The EPA functions as an industry watchdog. It provides an independent, scientific assessment of the risks, dangers, and costs of pollution and is empowered to regulate said industries. If there were no EPA, then that function would either, a) not exist, or b) be handled by an ineffective patchwork of conflicting state and local regulations (see current economic crisis for how well that works).

In the example you cited, law makers would consult the EPA about the proposed new law to dump mercury and they'd say "heck no." Without the EPA, who would be able to counter the industry lobbyists who would certainly pull out ten reports about how dumping mercury will do no harm and create thousands of jobs.

There really wasn't any public resistance to the creation of the EPA in 1970. That's because rivers were literally burning and the Great Lakes could barely support life because of pollution.

If the EPA did not exist, I'm sure a majority of libertarians would be against creating a $7.2 billion agency that employs 17,000 bureaucrats and that creates and enforces regulations. They'd be against it on principle alone.

Staats wrote:

That I accept the existence of government as necessary should indicate that, yes, a policy that creates a collective good can merit taking away an individual freedom. The SUV example is a tough one. On the one hand, people are free to waste resources (fattest country in the world!). On the other hand , emissions have been shown to harm others, which is not something you can say about french fries. And on the gripping hand, these emissions are necessary to our day-to-day survival, because without oil society would basically collapse. I personally like the idea of carbon trading or a gas tax; others have different solutions. (Aside: "less oil imports" isn't a freedom under pretty much any definition, that's a goal.)

This is where the "grayness" of libertarianism become like fighting smoke.

In the case of the SUV, the trump can't be that emissions are necessary to our day-to-day survival, because they simply aren't. Humans have lived in societies for thousands of years before the invention of the internal combustion engine.

The issue is how much emissions are too much? You might be free to waste resources all you want, but a certain point you driving that SUV is going to put out enough CO2 and pollutants that it affects my freedom. Again, how is this point determined? How are these competing 'freedoms' valued?

I guess I really dislike the petty use of 'freedom' like it was describing an inalienable right. Does someone really have the freedom to waste resources or are they just being an ass?

Funkenpants wrote:
Aetius wrote:

The libertarian doctrine is that minimal government is optimal. Not none.

So we always come back to the idea of which activities represent social problems that need intervention and which don't. It's not a question of minimal government, but rather of which social problems are worth attempting to correct.

Since the current government stance is that every problem needs intervention, I think we've got some room to cut.

Robear wrote:

I have to agree. I think the normal formulation is "Restrict freedom when necessary to preserve the *safety* of others."

I generally consider freedom to live to be #1 on the list. Though as Aetius points out, it's easy to go way too far. Anyways, I think I like your phrasing better.

OG_slinger wrote:

The EPA functions as an industry watchdog. It provides an independent, scientific assessment of the risks, dangers, and costs of pollution and is empowered to regulate said industries. If there were no EPA, then that function would either, a) not exist, or b) be handled by an ineffective patchwork of conflicting state and local regulations (see current economic crisis for how well that works).

In the example you cited, law makers would consult the EPA about the proposed new law to dump mercury and they'd say "heck no." Without the EPA, who would be able to counter the industry lobbyists who would certainly pull out ten reports about how dumping mercury will do no harm and create thousands of jobs.

I guess I should probably point out I have no major problem with the EPA's existence; in general, funding science pays enormous dividends and doling out grants is a great way to get answers to question and problems. That said, hopefully anyone proposing to ban something has contracted for or performed a scientific study showing it is harmful. There are always numerous highly skilled academics that would relish the chance to express their opinion.

(I don't see someone proposing laws to dump mercury; that implies that it is already illegal and thus someone already showed it was harmful.)

OG_slinger wrote:

This is where the "grayness" of libertarianism become like fighting smoke.

In the case of the SUV, the trump can't be that emissions are necessary to our day-to-day survival, because they simply aren't. Humans have lived in societies for thousands of years before the invention of the internal combustion engine.

The issue is how much emissions are too much? You might be free to waste resources all you want, but a certain point you driving that SUV is going to put out enough CO2 and pollutants that it affects my freedom. Again, how is this point determined? How are these competing 'freedoms' valued?

I guess I really dislike the petty use of 'freedom' like it was describing an inalienable right. Does someone really have the freedom to waste resources or are they just being an ass?

Of course emissions are necessary - our society would collapse. Suppose we stop burning coal and gasoline. What happens? Most electricity disappears. Food production would drop to almost nothing. Nearly all transportation would halt. We could shift to different forms of energy, but in their current forms they'd be an incomplete substitute. Tens of millions would die, maybe hundreds of millions. Countries we export agriculture products to would follow.

More to the point: I don't really view "freedoms" as inalienable rights. That's naive - freedoms come and go based on the whims of society. They're more "things you're allowed to do." Valuing them is never easy, which seems pretty self-evident. If it were, government would be much simpler.

In situations like what you've described, where something is both necessary and harmful, the simplest and probably most effective way is to monetarily deincentivize it through taxes. The problem with "wasting resources" is determining when someone is wasting resources. Almost everyone does something that can be considered wasteful - maybe you have an air conditioner, or buy food that is costly to produce, or traded your apartment and subway pass for a half hour commute by car and a two bedroom house. No matter how you draw these lines, personal value systems will come into play and someone will be unhappy. Much easier to "unhide" the hidden costs of gasoline.

You seem frustrated that libertarianism doesn't fit into a neat little box. Does any political ideology? For any goal, conflicts and tradeoffs will always emerge.

Mex wrote:

Yeah, we have a pretty good system in Mexico. Only problem is we're kinda poor.

Paleocon wrote:

Even if we are to accept that the problem of cost in the system has to do with folks not knowing the price of their services (a very tenuous argument at best), it still doesn't explain at all why practically every other industrialized country on the planet enjoys vastly superior medical service to ours at prices much lower than ours while, at the same time, making costs to the consumer entirely opaque. .

Man, even Mexico and Cuba have better free health care systems than the USA.

I've got a couple of horror stories from mexican tourists who had to travel to Mexico to get treatment or operations because the cost was ridiculously high in the US.

Something really fishy happened with the US health care system at some point, it went so wrong, wonder what it was. You work just as hard or harder than most other citizens of the world...

Also you guys have lots of popular medical TV shows, I wonder why that is, you seem to love doctors.

Yup. One month into my moving to Taiwan, I got a wicked case of appendicitis that landed me in the emergency room at National Taiwan University hospital. Seven days and one surgery later, I was discharged with a bagfull of pills, instructions for a follow up appointment to remove stitches, and a warm handshake from the surgeon who stitched me up. The pricetag? $0.

Taiwan is a country in which the market mechanism runs pretty freaking rampant. Construction companies build low income housing for military veterans with irradiated rebar from decommissioned nuclear power plant cores. Expired dog food ends up in New Years moon cakes pretty much annually. For profit private bus services run dilapidated diesel vehicles that flood the passenger compartments with enough exhaust to asphyxiate folks wearing respirators. If there is a way to make a buck, no matter how ethically reprehensible, trust me, the Taiwanese have thought of it, implemented it, and moved on once every little bit of profit was wrung out of it with a hydraulic press.

Even THAT country has a better health system than ours precisely because it understands that the limitations of the market make it impossible to provide medical care without a centralized infrastructure.

Paleocon wrote:
Mex wrote:

Yeah, we have a pretty good system in Mexico. Only problem is we're kinda poor.

Paleocon wrote:

Even if we are to accept that the problem of cost in the system has to do with folks not knowing the price of their services (a very tenuous argument at best), it still doesn't explain at all why practically every other industrialized country on the planet enjoys vastly superior medical service to ours at prices much lower than ours while, at the same time, making costs to the consumer entirely opaque. .

Man, even Mexico and Cuba have better free health care systems than the USA.

I've got a couple of horror stories from mexican tourists who had to travel to Mexico to get treatment or operations because the cost was ridiculously high in the US.

Something really fishy happened with the US health care system at some point, it went so wrong, wonder what it was. You work just as hard or harder than most other citizens of the world...

Also you guys have lots of popular medical TV shows, I wonder why that is, you seem to love doctors.

Yup. One month into my moving to Taiwan, I got a wicked case of appendicitis that landed me in the emergency room at National Taiwan University hospital. Seven days and one surgery later, I was discharged with a bagfull of pills, instructions for a follow up appointment to remove stitches, and a warm handshake from the surgeon who stitched me up. The pricetag? $0.

Taiwan is a country in which the market mechanism runs pretty freaking rampant. Construction companies build low income housing for military veterans with irradiated rebar from decommissioned nuclear power plant cores. Expired dog food ends up in New Years moon cakes pretty much annually. For profit private bus services run dilapidated diesel vehicles that flood the passenger compartments with enough exhaust to asphyxiate folks wearing respirators. If there is a way to make a buck, no matter how ethically reprehensible, trust me, the Taiwanese have thought of it, implemented it, and moved on once every little bit of profit was wrung out of it with a hydraulic press.

Even THAT country has a better health system than ours precisely because it understands that the limitations of the market make it impossible to provide medical care without a centralized infrastructure.

Well put.

First of all, let me say that threads like these are generally my favorite thing (these days) about GWJ. I always come out of them feeling like I've learned something. Thank you.

Also, I consider myself fairly unqualified to post in them. That being said...

Aetius wrote:

There are very, very few people in first-world countries who make the choice of eating or medicine.

And in this country, you can thank Medicaid/Medicare for this fact. I suspect you're opposed to its existence (but I could be wrong).

(In many (most?) other first-world countries, the reason people don't have to make that choice is because of actual "socialized medicine".)

Through volunteer opportunities, as well as personal knowledge of at least two family-units in my extended family tree, I can assure you that, were it not for government assistance, there would be many more than a "very, very few" people who would have to choose between eating (or housing) and medicine.

Paleocon wrote:

Even THAT country has a better health system than ours precisely because it understands that the limitations of the market make it impossible to provide medical care without a centralized infrastructure.

So a good health system consists of someone else paying your bills? Sounds nice, except for that other person.

Grumpicus wrote:
Aetius wrote:

There are very, very few people in first-world countries who make the choice of eating or medicine.

And in this country, you can thank Medicaid/Medicare for this fact. I suspect you're opposed to its existence (but I could be wrong).

You're not wrong - and prices through those systems have gotten higher, not lower.

Through volunteer opportunities, as well as personal knowledge of at least two family-units in my extended family tree, I can assure you that, were it not for government assistance, there would be many more than a "very, very few" people who would have to choose between eating (or housing) and medicine.

Sorry, I disagree. I know a family that survives on the income of a waitressing job. It's a mother and a small child. She not only gets by, but she is saving money, and is thinking about starting a business. On a waitress income. (And before you ask, yes, she lives with her extended family, nine people, in a small Habitat for Humanity house. Child care is provided by her family.) I have a very hard time believing that other people simply are unable to be truly frugal. We as a country have trouble with this because reductions in our standard of living are very hard to accept.

Aetius wrote:

Sorry, I disagree. I know a family that survives on the income of a waitressing job. It's a mother and a small child. She not only gets by, but she is saving money, and is thinking about starting a business. On a waitress income. (And before you ask, yes, she lives with her extended family, nine people, in a small Habitat for Humanity house. Child care is provided by her family.) I have a very hard time believing that other people simply are unable to be truly frugal. We as a country have trouble with this because reductions in our standard of living are very hard to accept.

I don't really want to get involved here, but don't you think that the extended family part of that might have a rather large effect on her conditions. That's got to cut her main outgoings (rent and child care) massively compared to people who don't have family or can't live anywhere near them.

Zelos wrote:
Aetius wrote:

Sorry, I disagree. I know a family that survives on the income of a waitressing job. It's a mother and a small child. She not only gets by, but she is saving money, and is thinking about starting a business. On a waitress income. (And before you ask, yes, she lives with her extended family, nine people, in a small Habitat for Humanity house. Child care is provided by her family.) I have a very hard time believing that other people simply are unable to be truly frugal. We as a country have trouble with this because reductions in our standard of living are very hard to accept.

I don't really want to get involved here, but don't you think that the extended family part of that might have a rather large effect on her conditions. That's got to cut her main outgoings (rent and child care) massively compared to people who don't have family or can't live anywhere near them.

So? Find some people you can live with. Roommates, you know. It's how college students do it. It's not that people can't, it's that they don't want to.

Aetius wrote:

So? Find some people you can live with. Roommates, you know. It's how college students do it. It's not that people can't, it's that they don't want to.

Roommates tend not to want to look after your kids, though. It's just you're extrapolating from one person in a reasonably stable situation to all people.

Zelos wrote:
Aetius wrote:

So? Find some people you can live with. Roommates, you know. It's how college students do it. It's not that people can't, it's that they don't want to.

Roommates tend not to want to look after your kids, though. It's just you're extrapolating from one person in a reasonably stable situation to all people.

No, but having enough (paying) roommates can free up the money you need for child care - or perhaps one of the roommates can make a living handling the kids. You're reaching.

Aetius wrote:
Zelos wrote:
Aetius wrote:

So? Find some people you can live with. Roommates, you know. It's how college students do it. It's not that people can't, it's that they don't want to.

Roommates tend not to want to look after your kids, though. It's just you're extrapolating from one person in a reasonably stable situation to all people.

No, but having enough (paying) roommates can free up the money you need for child care - or perhaps one of the roommates can make a living handling the kids. You're reaching. :)

I don't know about you Aetius, but thinking back to all the roommates I've had, I don't want to raise my kids living with any of them. Yes, there are always situations that break the norm and "solutions" to the problem, but some of them just are not realistic. How many people are going to want to be roommates with a single mother and young child?

It's not as obvious and feasible as you present.

kaostheory wrote:

I don't know about you Aetius, but thinking back to all the roommates I've had, I don't want to raise my kids living with any of them. Yes, there are always situations that break the norm and "solutions" to the problem, but some of them just are not realistic. How many people are going to want to be roommates with a single mother and young child?

lol, yeah this is the first thing I thought. I don't have kids but I wouldn't trust a goldfish to any of my friends.

The average guy (including me) is just really irresponsible.

kaostheory wrote:
Aetius wrote:
Zelos wrote:
Aetius wrote:

So? Find some people you can live with. Roommates, you know. It's how college students do it. It's not that people can't, it's that they don't want to.

Roommates tend not to want to look after your kids, though. It's just you're extrapolating from one person in a reasonably stable situation to all people.

No, but having enough (paying) roommates can free up the money you need for child care - or perhaps one of the roommates can make a living handling the kids. You're reaching. :)

I don't know about you Aetius, but thinking back to all the roommates I've had, I don't want to raise my kids living with any of them. Yes, there are always situations that break the norm and "solutions" to the problem, but some of them just are not realistic. How many people are going to want to be roommates with a single mother and young child?

It's not as obvious and feasible as you present.

Well, remember we're talking about the choice between getting drugs you need to live, and your living arrangements.