During a recent discussion with Biff, a pro-ObamaCare friend, I suggested that in a health care market untouched by the government, one’s health insurance and employment would most likely not be inter-twined; they’d be completely separate matters. I asked, Does your neighbor lose his auto insurance if he loses his job?
Biff said, “Huh” so I continued the quiz: Do you know the history of employees’ buying health insurance from/thru their employer? Answer: Government wage controls in WWII made health insurance the coin of the realm for recruiters.
Then, as is typical in such a discussion, Biff criticizes and mocks our (not) free-market health care system, as though that’s the only model we’ve ever had. Unfortunately, I aver, that hasn’t been the case for decades. Nonetheless, Biff suggests that the current system is an abysmal failure. I reply, ‘not the most abysmal, but definitely in the ‘Top 10 Most Abysmal.’ He continues by saying that nothing short of a government take-over (but he denies he’d ever propose a government take-over) will solve the problems that the market, he says, has caused.
It’s damn near impossible to defeat that illogical logic. So I continue channelling Socrates. I ask few more questions:
Do you, Biff, really believe that Republicans are so daft and evil that they want their fellow citizens to die of preventable disease? Do you honestly think that the Republicans and their financial supporters want to watch over a sea of poor men and women on their way to being dead bodies? Don’t you suspect they’ll ask ‘EGADS, who will scrub the bottom of the yacht?’ before they let them ALL die?
Really? Please, get a grip, Biff; and a real name, please.
If you think that it is true that Republicans, if you think that anyone opposed to ObamaCare, has a death wish for his fellow man, then you’re an irresponsible and immoral person for not killing me, on the spot, with a bullet shot squarely between my pensive brown eyes (well, yeah, only if I let you borrow my Charlton Heston autographed Smith & Wesson, which I offered to him).
Then, after my gun is removed from Biff’s trembling hand, I ask: Biff and Barack, since neither of you really think such a bad thing about me or any of your Republican friends, please stop saying that you do. It’s irresponsible to fuel that kind of vitriol [Biff hates it when I use that word without a reference to Glenn Beck or Sarah Palin]. Please find something to say about government’s role in the delivery of health care that is interesting, productive or original and that does not impugn my love of sick people or insinuate that I wish them continued sickness and suffering.
Or, be quiet and let the adults take care of making the laws. And delivering health care in an open market.
America's CURE - by Jeff Neal 
You make exactly the same mistake as Biff does. The delivery of health services is one of the most highly regulated businesses in the country – has been for decades. There is no way to define that industry’s ills as a ‘market failure’ because the industry has been smothered by government controls. Do you know how large the FDA is? Do you know that health insurance can’t be sold across state lines? Do you know how many malpractice suits are pending at any given time? Do you know how many bogus lawsuits pharma companies fight? Market failure?
Notwithstanding that, no nation has a health care industry that comes close to the USA’s. What drugs do you think those other countries buy? Drugs created and made in the USA. If I as you to tell me why drugs are cheap in Canada, you’ll say something like “cuz the government uses its muscle to negotiate better prices.” Wrong. It’s because the drug companies cover their fixed costs (research & development) by selling those drugs at fair prices in the US. On the margin, next 5 Viagras don’t cost very much to make so their willing to sell them for whatever Canada offers to pay them. But without a market to pay the right/fair price (the one that takes into account the billions of dollars it takes to develop new drugs, etc) for the pills, they’d never exist to begin with.
The technological advances are happening in all industries. I’m not sure why you seem to think that I was equating pre-technological advances industry to Post-tech, so your point is lost on me.
I think that using health insurance as a form of compensation is part of the problem. It skews decisions and removes the customer/patient from the negotiation over price. It has led to “insurance” being more like pre-paid health care – insurance doesn’t cover gas or oil for your car, does it? Health insurance should be in place for major sickness, not check-ups. In a market where individuals could shop for the exact policy they want instead of taking the one their employer decided was good for the other 5000 people in the company.
Of course health care is an important economic concern. That’s why we should let the market bring its forces to bear to deliver that critical product/service in abundance, just like it does hoola hoops, bottled water, pornography and all other things from the most trivial to the most important. (see http://wp.me/p1jTK0-5X)
No condescending – Biff’s a good listener and learned a great deal from our exchange because he is smart and very secure in his beliefs, so he is not afraid to have them challenged – broadens his mind and he likes that
My main question is how do you think an open market would function with such varied and polarized values in this country? An open market sounds great–in a perfect world, where everyone acts rationally, holds similar values, and responds similarly to the same incentives. But that certainly isn’t the case in this country. I’m not trying to argue that Obamacare is the solution. I’m merely suggesting that an “open market” wouldn’t solve the problem any better. I have the suspicion that a truly “open market” would function very similarly to how congress functions currently, in that it wouldn’t function at all, and for exactly the same reasons.
Ryan – the open market does not depend on 100% rational behavior, but it does minimize the harmful impact of irrational behavior. Without seeming to insult you, study ‘open market’ a little bit and you’ll understand its benefits without expecting it to deliver perfection. Failure is part of life and is a necessary component of a functioning market. I recommend Frederik Hayek (The Constitution of Liberty and The Road to Serfdom) or the writings of Ludwig von Mises as good places to start if you haven’t read those. By the way, congress hardly functions as a marketplace and none of its participants is subject in any sense to the kinds of forces that would be at work in an open market.
My my apologies, the example of congress wasn’t meant to serve as an example of a marketplace, but rather as an example of the irrationality and intractability of people. I don’t expect a free market to deliver perfection, just as I don’t expect regulation to offer perfection either. I’ll have to check out the reading list you’ve provided, but I have a hard time believing that any amount of theory will ever convince me that people are either entirely capable of acting without self-interest or that the self-interest of one person will always be of benefit to others, which is where I see the biggest problem with what I understand of free market thinking (aside from the irrationality of people). Personally, I believe that answer to most of these problems lies somewhere in a gray zone, but I’ll reserve final judgment until I research the material you have listed. Cheers.
self-interest is not evil. self-interest brought you the telephone, running water, Lipitor, canned goods, fresh apples, . . . . everything you consume is available to you because of self interest. The gray zone is the zone between food and poison. You pick how much poison you want in your life – I choose none.
Well, that’s exactly my point. Like most things, self interest is a double edged sword. I’m glad that there are people who wouldn’t cheat or swindle others, but those people certainly do exist. It all goes back to rationality for me. Thankfully most people act rationally most of the time, but there are certainly times when people act irrationally, and not everyone is capable of consistent altruism. And I tend to believe the old axiom that absolute power corrupts absolutely. I suppose I’m cynical.