5 US Health Care Myths

Interesting article. What do you think?


2. Somebody else is paying for your health insurance.

Nope. Even when your employer offers coverage, he isn't reaching into his own pocket to cover you and your fellow employees; he's reaching into your pocket, paying you lower wages than he would if he didn't have to pay for your health insurance.

Rising health-care costs are partly to blame for stagnant wages. Over the past five years, health insurance premiums have risen 5.5 times faster on average than inflation, 2.3 times faster than business income and four times faster than workers' earnings. Four times. That's why wages have been nearly flat since the 1980s, even as U.S. productivity has been going up. In effect, about half the money you should be earning for being more productive is being sucked up by ever more expensive health-insurance premiums.

If you pay taxes, you're also paying for the health care provided through state and federal programs such as Medicare, Medicaid, the Veterans Administration and the military. All told, the average family of four is coughing up $29,000 a year for health care through taxes, lower wages and out-of-pocket medical expenses.

A pretty good article. Now all that needs to be done is for the will of the American people expressed over many years to be enacted. Seemingly an impossible task.

I find attributing wage stagnation to health care cost a big stretch. Wages are stagnant, and health care costs are skyrocketing, because of naked profiteering. The business press in the 90s ran out of superlatives to describe profit growth, and yet it is a total mystery how that can occur while customers pay more and worker wages and benefits stagnate or decline.

How domesticated must a child be to express no complaint when mum cooks a larger pie each meal and boasts about how enormous her slice is becoming, while theirs remains the same!

Link

Pretty good follow-up to #1 on that list. A woman went to the hospital for a kidney stone removal, got an infection that was not properly treated, and ended up losing both hands, both feet, and sight in one eye.

Wonder what her copay was.

This is why I really don't get the massive hate over European/Canadian style healthcare systems. The US model pricing is spiraling out of control and if it keeps going this way "healthcare for all" is going to be a thing of the past. I don't want to be forced into bankruptcy because I break my leg or have a heart attack.

The main complaints I hear firsthand come from a married couple who are friends of mine. One's a nurse and the other is a gastrointerologist. They say if we adopted "socialized medicine" that healthcare professionals wouldn't get paid jack and all medical innovation would grind to a halt because there would be no financial incentive or funding to research new drugs and procedures. And of course they claim we'd have to wait months on end for simple procedures.

I have a hard time getting behind those arguments. The gastrointerologist currently makes over 500k a year, and this is his first year post residency or whatever it's called, and the nurse makes between 40-60k a year depending on where she's working. They claim under a European system he'd only be making 50-60k a year and she'd be making 20-30k. While I'm guessing any cuts wouldn't be near as severe as they claim maybe, just maybe, many doctors and nurses ARE overpaid. Okay, maybe not the nurses so much but definitely many doctors. A half mill a year? My wife used to work for a couple of cardiologists that were clearing several million a year. While the education needed is staggering and job grueling... are they really worth several million a year? I dunno. And as for waiting several months for procedures? I already have to do that. I had to have knee surgery a few years ago and was told they wouldn't be able to get to me for 3 to 6 months. So for months I'm hobbling around just waiting on my turn. How much would that change?

Kehama wrote:
And of course they claim we'd have to wait months on end for simple procedures.

Which is funny considering I normally have to wait 3-4 weeks just to get an appointment with Primary Care Physician to have him check out a skin rash or incessant watery eyes.

I always cringe a bit at this discussion because I am perplexed as to why the universal health care plan has to be "just like Canada or England."

Why can't we take their model and simply make it better?

Kehama wrote:
This is why I really don't get the massive hate over European/Canadian style healthcare systems. The US model pricing is spiraling out of control and if it keeps going this way "healthcare for all" is going to be a thing of the past. I don't want to be forced into bankruptcy because I break my leg or have a heart attack.

The main complaints I hear firsthand come from a married couple who are friends of mine. One's a nurse and the other is a gastrointerologist. They say if we adopted "socialized medicine" that healthcare professionals wouldn't get paid jack and all medical innovation would grind to a halt because there would be no financial incentive or funding to research new drugs and procedures. And of course they claim we'd have to wait months on end for simple procedures.

I have a hard time getting behind those arguments. The gastrointerologist currently makes over 500k a year, and this is his first year post residency or whatever it's called, and the nurse makes between 40-60k a year depending on where she's working. They claim under a European system he'd only be making 50-60k a year and she'd be making 20-30k. While I'm guessing any cuts wouldn't be near as severe as they claim maybe, just maybe, many doctors and nurses ARE overpaid. Okay, maybe not the nurses so much but definitely many doctors. A half mill a year? My wife used to work for a couple of cardiologists that were clearing several million a year. While the education needed is staggering and job grueling... are they really worth several million a year? I dunno. And as for waiting several months for procedures? I already have to do that. I had to have knee surgery a few years ago and was told they wouldn't be able to get to me for 3 to 6 months. So for months I'm hobbling around just waiting on my turn. How much would that change?

My wife is a nurse practicioner, so I'm not exactly a neutral observer in this particular argument. That said, I find myself remarkably unsympathetic to this argument that doctors and nurses would be paid less in a functional healthcare system. I imagine a dysfunctional system in just about any vertical can be constructed in such a way that it benefits wages for specialized professionals at the expense of consumers. It would be pretty piss poor behavior in a benign industry. It is simply unconscienable in the field of public health. I suggest you should ask your friends if they would find it acceptable to make an extra $10k/year if it meant strangling a baby once in a while.

Moreover, I don't find any real evidence that this argument is even true. The reason why nurses get paid is because there is an acute nursing shortage, not because the system inherantly favors them. I have run into one doctor who decided that practicing in "medical tourist" destinations like India or Thailand is far more preferrable to doing so in the US just so he doesn't have to deal with the idiocy of slow paying health insurance companies and/or the demands of Medicare/Medicaid. He suggested that it "isn't what you make, it's what you keep". And in the end, he feels the quality of service he provides is better in just about every way.

We had an all employee call in which we went over the increase in health insurance costs for the open enrollment period. It appears rates are going up quite a bit and, as the article mentioned, those costs are being passed on. At least they are honest about it rather than hiding them in wage cuts, hiring freezes, or quota increases.

One point that the CEO did seem to hint at, however, was that the overall healthcare situation was a matter of national debate and was likely to resolve itself now that there seemed to be sufficient political pressure being applied to it. Translation: Obama will overhaul healthcare so there is no point bankrupting the company or robbing employees of real wages to do better than the current market.

I certainly hope he is right. Either that or I hope my wife gets a cushy government job so I can sponge off her benefits.

The primary broken bit in our health care system is pricing. People have no concept of how much their doctor is charging their insurance company, yet complain that their premiums are too high. As long as that persists, prices will keep going up. You can't have a good market without good pricing information.

Aetius wrote:
The primary broken bit in our health care system is pricing. People have no concept of how much their doctor is charging their insurance company, yet complain that their premiums are too high. As long as that persists, prices will keep going up. You can't have a good market without good pricing information.

That is hardly the primary or the only major problem. Heck, in the grand scheme of things, that's a fairly minor one.

The very concept of private health insurance really lies at the heart of what is wrong with our system. As my buddy the hospital administrator put it, every form of insurance depends on the truth of one particular fiscal concept: that the individual policyholder will, on average, pay more in premiums than he/she will receive in benefits over the life of the contract. Health insurance is the sole and spectacular exception to that rule.

In car insurance, you will, on average, pay more in premiums than you will cause in damage. In fire insurance, you will pay more in premiums than you will receive in fire damage. But in health insurance, if the insurance is doing the job of properly preventing and/or treating illness or injury, you will live longer. The longer you llive, the more you will cost your healthcare provider. There are no exceptions to that rule.

The ONLY way that health insurance companies can make money is to push you out of the system once you become costly. They prevent folks from obtaining insurance for expensive pre-existing conditions. They cancel coverage for folks who get expensive conditions. And they restrict treatment for procedures that may benefit health based on cost. As a result, those who are unprofittable to the insurance companies become the responsibility of the taxpayer.

So, in a roundabout way, we already have a socialized health system. We just have the world's most expensive and inefficient one.

Aetius wrote:
The primary broken bit in our health care system is pricing. People have no concept of how much their doctor is charging their insurance company, yet complain that their premiums are too high. As long as that persists, prices will keep going up. You can't have a good market without good pricing information.

That's the absolute truth. We don't even know how much our prescriptions are. And even if we take the time to find out how much we are saving, shopping for a good price does us no good when we use copays.

Paleocon wrote:
The ONLY way that health insurance companies can make money is to push you out of the system once you become costly. They prevent folks from obtaining insurance for expensive pre-existing conditions. They cancel coverage for folks who get expensive conditions. And they restrict treatment for procedures that may benefit health based on cost. As a result, those who are unprofittable to the insurance companies become the responsibility of the taxpayer.

It's not the only way. The other insurances work because they only deal with unlikely events. Does your car insurance pay for gas or an oil change? Of course not. Then why does your health insurance pay for every doctor's visit and pill you take? Remove all the low-level crap, and suddenly you end up with a halfway sensible system. And if people had to pay for those doctor visits and pills, they might actually be able to make economic decisions about health care correctly.

Aetius wrote:
The primary broken bit in our health care system is pricing. People have no concept of how much their doctor is charging their insurance company, yet complain that their premiums are too high. As long as that persists, prices will keep going up. You can't have a good market without good pricing information.

I would think limitless demand and an insistence on low rationing are the primary culprits, but then you'd just remind me that those are because health care is "free".

Fixing it is straightforward, let someone ration. Either let the insurance companies ration, let the government ration it, or make it a true free market and let price ration it. All can be done with a reasonable safety net for the truly incompetent.

Step one, allow insurance companies to really limit access to specialists and cutting edge treatments. They try to do it now, and they get the crap sued out of them. It would put the focus back on the GP (raising their earnings and reestablishing the field), and costs would plummet.

Will some people die? Sure. People will die anyway. At least we can all shut up and move on.

Why, I know what our doctors are charging my insurance. I receive statements.
For a sniffles checkup, I think it works like this -- the doc bills the insurance for $150 of his time with your kid, and the insurance says GTFO and pays the doc $38 instead.

Gorilla.800.lbs wrote:
Why, I know what our doctors are charging my insurance. I receive statements.
For a sniffles checkup, I think it works like this -- the doc bills the insurance for $150 of his time with your kid, and the insurance says GTFO and pays the doc $38 instead. :)

And the entire system pays two or three times that for all the extra people you need to process the paperwork.

The wage argument made by the doctors is partly true. Nurses and Doctors do make more in the U.S compared to Canada. I know a nurse who's been considering re-doing some of her tests to get American certification to get that extra $$$. On the flip side one of my friends dad is a Cardiologist and he chose to stay in Canada over going to the U.S where he was being recruited heavily at a very high salary. When it came down to it he knew he was going to be well off anyways and he preferred to raise his family in Canada.

Someone with some good google fu could probably easy find the average salaries in each country.

Paleocon wrote:
Aetius wrote:
The primary broken bit in our health care system is pricing. People have no concept of how much their doctor is charging their insurance company, yet complain that their premiums are too high. As long as that persists, prices will keep going up. You can't have a good market without good pricing information.

That is hardly the primary or the only major problem. Heck, in the grand scheme of things, that's a fairly minor one.

So, in a roundabout way, we already have a socialized health system. We just have the world's most expensive and inefficient one.

The reason we have the world's most expensive and inefficient health care system (and I would dispute the latter, incidentally) is because the people that consume are too far removed from payment, as Aetius correctly asserts.

Also, I work in healthcare IT, and while every insurance company has their numerous faults, CMS (Medicare/Medicaid) sets the gold standard for nonsensical reimbursement decisions. That's definitely not the direction I want to see my health care going.

Aetius wrote:
Paleocon wrote:
The ONLY way that health insurance companies can make money is to push you out of the system once you become costly. They prevent folks from obtaining insurance for expensive pre-existing conditions. They cancel coverage for folks who get expensive conditions. And they restrict treatment for procedures that may benefit health based on cost. As a result, those who are unprofittable to the insurance companies become the responsibility of the taxpayer.

It's not the only way. The other insurances work because they only deal with unlikely events. Does your car insurance pay for gas or an oil change? Of course not. Then why does your health insurance pay for every doctor's visit and pill you take? Remove all the low-level crap, and suddenly you end up with a halfway sensible system. And if people had to pay for those doctor visits and pills, they might actually be able to make economic decisions about health care correctly.

This is exactly what needs to be done to get 80% of our healthcare costs in line. Of course, I still think the rest would be better managed by the government than a profit minded insurance company. So that is where we diverge.

But this is the first step that would need to take place if a nationalized healthcare plan were to be implemented. This is where it could cut costs and become possible.

Aetius wrote:
Gorilla.800.lbs wrote:
Why, I know what our doctors are charging my insurance. I receive statements.
For a sniffles checkup, I think it works like this -- the doc bills the insurance for $150 of his time with your kid, and the insurance says GTFO and pays the doc $38 instead. :)

And the entire system pays two or three times that for all the extra people you need to process the paperwork.

Hardly. I will check their published administrative overhead figures. I don't expect the costs factor to be as outrageous as 2x or 3x times of worth of services delivered. More likely, the major dough goes to, well, "the shareholders". And perhaps, the executive compensation is a factor as well.

jowner wrote:
The wage argument made by the doctors is partly true. Nurses and Doctors do make more in the U.S compared to Canada. I know a nurse who's been considering re-doing some of her tests to get American certification to get that extra $$$. On the flip side one of my friends dad is a Cardiologist and he chose to stay in Canada over going to the U.S where he was being recruited heavily at a very high salary. When it came down to it he knew he was going to be well off anyways and he preferred to raise his family in Canada.

Someone with some good google fu could probably easy find the average salaries in each country.

I did a service call a while ago for my family doctor. He lives in an expensive part of town in a very nice house and his wife is a stay-at-home-Mom. He makes at least low 6 figures. And this is in the "socialized" Canadian system. I doubt he makes half a million but he does very well.

Jayhawker wrote:
Aetius wrote:
Paleocon wrote:
The ONLY way that health insurance companies can make money is to push you out of the system once you become costly. They prevent folks from obtaining insurance for expensive pre-existing conditions. They cancel coverage for folks who get expensive conditions. And they restrict treatment for procedures that may benefit health based on cost. As a result, those who are unprofittable to the insurance companies become the responsibility of the taxpayer.

It's not the only way. The other insurances work because they only deal with unlikely events. Does your car insurance pay for gas or an oil change? Of course not. Then why does your health insurance pay for every doctor's visit and pill you take? Remove all the low-level crap, and suddenly you end up with a halfway sensible system. And if people had to pay for those doctor visits and pills, they might actually be able to make economic decisions about health care correctly.

This is exactly what needs to be done to get 80% of our healthcare costs in line. Of course, I still think the rest would be better managed by the government than a profit minded insurance company. So that is where we diverge.

But this is the first step that would need to take place if a nationalized healthcare plan were to be implemented. This is where it could cut costs and become possible.

If you have medication that prevents you from having a heart attack, and the company has a patent on it (i.e. it's not generic yet), what happens when you think they're charging too much? What are you going to do about it? Have a heart attack?

Let's face it, for minor problems the whole pricing transparency thing sounds great. But there's a very fine line in health care between a minor problem and a major one. Sometimes it's just a matter of time, perhaps minutes even. Are you going to be at some cheap 24-hour convenient store clinic then go into shock? Are they going to teleport you to the hospital at that point? If you go to the hospital for both minor and major issues, why would the hospital even bother with the cheap stuff?

Health care is a special case, like the military. The only thing more valuable than your money is your life. And anytime you have a health issue, no matter how minor, there's a chance it could become something more serious without proper treatment. So you can never say no, which is one of the first requirements of a free market, being able to walk away from the transaction. So prices are always going to be inflated and not reflecting reality, because price negotiation can't take place.

PyromanFO wrote:
If you have medication that prevents you from having a heart attack, and the company has a patent on it (i.e. it's not generic yet), what happens when you think they're charging too much? What are you going to do about it? Have a heart attack?

In short, yes. By your measure, everyone should get the latest and greatest technology and all efforts should be made to prolong everyone's life. There's only one problem with that scenario: it can't be done. Health care costs are essentially unlimited - you can spend millions trying to keep someone alive. We must draw the line somewhere. Better than line be drawn by you (or your family) than by some person in a cubicle a thousand miles away who doesn't know you, or a harried doctor who is making snap decisions on 4 hours of sleep in the last three days.

Health care is not a special case. It must be paid for, one way or another. Someone has to make those decisions.

Also, there are plenty of optional healthcare decisions that can be made every day - there are numerous normal choices that can easily be made. That realm is also where a lot of insurance costs are - tests that don't need to be done, things like that.

Kehama wrote:
I have a hard time getting behind those arguments. The gastrointerologist currently makes over 500k a year, and this is his first year post residency or whatever it's called, and the nurse makes between 40-60k a year depending on where she's working. They claim under a European system he'd only be making 50-60k a year and she'd be making 20-30k.

Your friends might want to check their figures. They're variable (depending on hours, services offered, night shifts etc.), but a general family doctor in the UK National Health Service earns £80,000-£120,000 ($120k-$180k), consultants go up to $240k or so (Source). The nurse salary figures are fairly similar, I think, assuming she's reasonably senior. Plus, you don't have to ask "do you have insurance?" before choosing a treatment.

In short, yes. By your measure, everyone should get the latest and greatest technology and all efforts should be made to prolong everyone's life. There's only one problem with that scenario: it can't be done. Health care costs are essentially unlimited - you can spend millions trying to keep someone alive. We must draw the line somewhere. Better than line be drawn by you (or your family) than by some person in a cubicle a thousand miles away who doesn't know you, or a harried doctor who is making snap decisions on 4 hours of sleep in the last three days.
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.

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.

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.

Aetius wrote:
Paleocon wrote:
The ONLY way that health insurance companies can make money is to push you out of the system once you become costly. They prevent folks from obtaining insurance for expensive pre-existing conditions. They cancel coverage for folks who get expensive conditions. And they restrict treatment for procedures that may benefit health based on cost. As a result, those who are unprofittable to the insurance companies become the responsibility of the taxpayer.

It's not the only way. The other insurances work because they only deal with unlikely events. Does your car insurance pay for gas or an oil change? Of course not. Then why does your health insurance pay for every doctor's visit and pill you take? Remove all the low-level crap, and suddenly you end up with a halfway sensible system. And if people had to pay for those doctor visits and pills, they might actually be able to make economic decisions about health care correctly.

Comparing health insurance and car insurance really doesn't work. Does my car insurance pay for oil changes? Absolutely not. But, then again, if I get into a serious enough wreck, they just simply write off my car, give me a check for its Blue Book price, and raise my rates.

Health insurance companies can't exactly do the same.

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.

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.

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?

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.

OG_slinger 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.

What's worse is that Libertarians will fight tooth and nail for your individual rights to make those very decisions that will negatively affect our collective health. Mandating vaccination is an unlawful intrusion, policing the distribution of antibiotics is fascism, capping a company's carbon emissions is totalitarian.

The very idea that individual consumers, through their buying decisions, should be primarily responsible for the policing of corporate business practices is ludicrous. If one battery costs half the price of another and lasts just as long because it was made in a factory that dumps mercury into the local water supply, the *rational* purchasing decision is to buy the cheaper one. Chances are that you're never going to go to China anyway. If you can purchase $20,000 worth of hardwood flooring for $5000 because it came from an Indonesian rain forest, the rational individual purchasing decision is to do so irrespective of the incremental effect it will have on global climate change.

There will certainly be a few martyrs that will sacrifice their individual benefit in order to benefit the collective, but they will be in the statistical noise and largely only of the economic class that can afford the luxury of such ethics. Real collective protection must come from governmental action.

Paleocon wrote:

What's worse is that Libertarians will fight tooth and nail for your individual rights to make those very decisions that will negatively affect our collective health. Mandating vaccination is an unlawful intrusion, policing the distribution of antibiotics is fascism, capping a company's carbon emissions is totalitarian.

The very idea that individual consumers, through their buying decisions, should be primarily responsible for the policing of corporate business practices is ludicrous. If one battery costs half the price of another and lasts just as long because it was made in a factory that dumps mercury into the local water supply, the *rational* purchasing decision is to buy the cheaper one. Chances are that you're never going to go to China anyway. If you can purchase $20,000 worth of hardwood flooring for $5000 because it came from an Indonesian rain forest, the rational individual purchasing decision is to do so irrespective of the incremental effect it will have on global climate change.

Either start posting links or stop saying things like this. As far as I can tell, no one is clamoring for the right to poison the water supply. Regulations related to the environment do not run contrary to libertarian thought, particularly ones that clearly prevent others from directly harming others.

How's this? From the Libertarian Party Platform, 2008 (emphasis mine):


We support a clean and healthy environment and sensible use of our natural resources. Private landowners and conservation groups have a vested interest in maintaining natural resources. Pollution and misuse of resources cause damage to our ecosystem. Governments, unlike private businesses, are unaccountable for such damage done to our environment and have a terrible track record when it comes to environmental protection. Protecting the environment requires a clear definition and enforcement of individual rights in resources like land, water, air, and wildlife. Free markets and property rights stimulate the technological innovations and behavioral changes required to protect our environment and ecosystems. We realize that our planet's climate is constantly changing, but environmental advocates and social pressure are the most effective means of changing public behavior.


We favor restoring and reviving a free market health care system. We recognize the freedom of individuals to determine the level of health insurance they want, the level of health care they want, the care providers they want, the medicines and treatments they will use and all other aspects of their medical care, including end-of-life decisions.

When discussing libertarianism, forget the official Libertarian platform and instead focus on the general philosophy of libertarianism. I realize it's a bit more vague, but like "conservatism" or "liberalism" or "progressive" it's a term that encompasses a variety of people who do not necessarily agree with each other.

The general guideline of "restrict freedom only when necessary to preserve the freedom of others" does not preclude environmental regulations. Poisoning the water supply (and dumping mercury in general) harms others almost as directly as punching them in the face. If it were possible to dump mercury and realistically state "no, it will never leave my property" things would be different, but that's just not the case. Similar thought can (carefully) be applied to other environmental concerns (and in many cases can be coupled with market-based solutions, such as carbon trading).

Staats wrote:
When discussing libertarianism, forget the official Libertarian platform and instead focus on the general philosophy of libertarianism. I realize it's a bit more vague, but like "conservatism" or "liberalism" or "progressive" it's a term that encompasses a variety of people who do not necessarily agree with each other.

The general guideline of "restrict freedom only when necessary to preserve the freedom of others" does not preclude environmental regulations. Poisoning the water supply (and dumping mercury in general) harms others almost as directly as punching them in the face. If it were possible to dump mercury and realistically state "no, it will never leave my property" things would be different, but that's just not the case. Similar thought can (carefully) be applied to other environmental concerns (and in many cases can be coupled with market-based solutions, such as carbon trading).

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.

I have lots of guns and would love to have an off-the-grid place out in rural nowhere, but I don't think it's any real substitute for a modern government. I mean, who DOESN'T, want a cool medieval mot and bailey on a hill in Appalachia and a walk in vault full of machineguns? No friend of mine I say.

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.

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.

Ask a German how much an appendectomy costs and he will be entirely unable to tell you. Ask the same question of a Dane or Norwegian and you'll probably get similarly puzzled looks. They aren't involved in any purchasing decisions and yet their systems are many times more efficient than ours, provide better medical service than ours, and have the added advantage of not being an automatic point of anxiety and animosity between worker and employer.