A Vicious Circle

Spacekiwi wrote:Just an interesting point about the nobel prizes though. in the 28 yeras between 51 and 79, the US won 42 nobels against the worlds 25. In the next time period of 31 years, with a higher popualtion, the Us won the same amount while the worlds total increased by 7. So The US dropped in nobels per capita or per year.

That interpretation would support my point regarding how the US turned away from free markets in health in the 70's. Unfortunately, I don't believe that's the case.

More like the rest of the world finished rebuilding their economies and regained some measure of pre-war infrastructure and stability. They could then compete on a more equal footing to the US. Between the Great Depression and WWII, I suspect there are simply too many variables in play to use in our comparison.

PeterZ wrote:The remaining insinsured or another 22 million people DO NOT WANT IT. They took the gamble that they will not fall sick and so did not purchase healthcare insurance. That is their right in a free society.

How many of them are choosing to take the gamble because insurance is too expensive for them and would choose differently if it was cheaper? As well a people who couldn't get insurance at any affordable cost due to preexisting conditions?

Also, uninured people are only one part of the problem - you also have people who technically have insurance but it's crap, people who are essentially chained to their jobs because their plan is tied to their employer, as well as recission, which can make a good plan worthless.

That interpretation would support my point regarding how the US turned away from free markets in health in the 70's. Unfortunately, I don't believe that's the case.

More like the rest of the world finished rebuilding their economies and regained some measure of pre-war infrastructure and stability. They could then compete on a more equal footing to the US. Between the Great Depression and WWII, I suspect there are simply too many variables in play to use in our comparison.

There are far too many variables involved in Nobel prizes to make it a good measure. For one thing, there's no particular reason that Nobel prizes are specifically due to a pure free market approach in health care supply (how many of those prizes were given to researchers in private companies or hospitals?)

PeterZ, thanks for that and it did confirm my belief that the US has great medical researchers, however I can't resist pointing out that you had 99 winners (Nobel in medicine), and we had 7 which equates to 105 when the 15 to 1 population balance is factored in.
Lies, damn lies, and statistics. I'm sure each of us could cherry pick statistics that "prove" our point.
Personally I can't see how this relates to a medical welfare net, or why anyone would regard unofficial immigrants as being not deserving of full medical assistance. We all should be treated with dignity and respect.

Illegal immigrants to get medical treatment whether they can pay for it or not. Emergency rooms are mandated to treat anyone that shows up and asks for service. That complaint doesn't wash.

As I said the correlation was good enough to illustrate the point I wanted to make. There is likely an English speaking mafia effect in medical research. You might note the extreme over representation of winners from English speaking countries. Does this reflect a bias in nominations? It might. Does it prove to a fare-thee-well a relationship between socialized medicine and a lack of innovation? No.

Bottom line is why change our entire system simply to expand coverage to a very small part of American society? The risk to our innovation engine exists. The disruption to those perfectly content with their medical coverage is being felt now. More and more Obamacare is being seen as a power grab rather than the implementation if good policy.

Tying this back to the original post, the media has been trying to shape public opinion to support this awful law. That is beginning to fray. If the implementation and execution of this awful law continues to achieve similar degrees of success, it might abort US progressives attempts to further consolidate power in the US Federal Government. That is to be hoped for.

Daryl wrote:PeterZ, thanks for that and it did confirm my belief that the US has great medical researchers, however I can't resist pointing out that you had 99 winners (Nobel in medicine), and we had 7 which equates to 105 when the 15 to 1 population balance is factored in.
Lies, damn lies, and statistics. I'm sure each of us could cherry pick statistics that "prove" our point.
Personally I can't see how this relates to a medical welfare net, or why anyone would regard unofficial immigrants as being not deserving of full medical assistance. We all should be treated with dignity and respect.

Cost of insurance had more to do with regulations. For example, companies couldn't sell their insurance across state lines. That means an insurance company had to build a subsidiary to expand into another state. That doesn't make sense. If the original organization could expand more inexpensively in the original state, they couldn't. If the original insurance company could expand withtheir current staff, they couldn't because of that stupid law. The law effectively made the insurance market an oligopoly within each state. That by itself drove prices higher and could addressed with more open competition.

So, while I agree thatinsurance prices could be lowered with better policies. I do not agree that the only way to do it is through MORE government idiocy. Idiocy like the ACA.

Eyal wrote:

PeterZ wrote:The remaining insinsured or another 22 million people DO NOT WANT IT. They took the gamble that they will not fall sick and so did not purchase healthcare insurance. That is their right in a free society.

How many of them are choosing to take the gamble because insurance is too expensive for them and would choose differently if it was cheaper? As well a people who couldn't get insurance at any affordable cost due to preexisting conditions?

Also, uninured people are only one part of the problem - you also have people who technically have insurance but it's crap, people who are essentially chained to their jobs because their plan is tied to their employer, as well as recission, which can make a good plan worthless.

That interpretation would support my point regarding how the US turned away from free markets in health in the 70's. Unfortunately, I don't believe that's the case.

More like the rest of the world finished rebuilding their economies and regained some measure of pre-war infrastructure and stability. They could then compete on a more equal footing to the US. Between the Great Depression and WWII, I suspect there are simply too many variables in play to use in our comparison.

There are far too many variables involved in Nobel prizes to make it a good measure. For one thing, there's no particular reason that Nobel prizes are specifically due to a pure free market approach in health care supply (how many of those prizes were given to researchers in private companies or hospitals?)

PeterZ wrote:Illegal immigrants to get medical treatment whether they can pay for it or not. Emergency rooms are mandated to treat anyone that shows up and asks for service. That complaint doesn't wash.

Not the same thing. Yes, emergency rooms are obligated to treat you, but they will only provide short-term care. If you have a long-term problem, they won't help so much. Not to mention that forcing the poor to rely on ERs as medical providers increases costs (as ER care is very expensive, as well as the fact that you generally don't go to the ER until your problem is serius - which usually means expensive to treat - whereas it could have been treated for much less if you'd gone to a doctor earlier), as well as the strain on the ERs.

Bottom line is why change our entire system simply to expand coverage to a very small part of American society? The risk to our innovation engine exists. The disruption to those perfectly content with their medical coverage is being felt now. More and more Obamacare is being seen as a power grab rather than the implementation if good policy.

You're talking about around 1/6 of your population being uninsured, not to mention those who's insurance won't be there when they need it (which a pure free market approach makes more likely, see below). That's hardly a "very small part". And while some people are having their medical coverage disrupted, others have said that they can now afford insurance or that the cost dropped significantly. (I've also seen an article, that claimed that a lot of the disruptions were due to shenanigans by the insurance companies).
And the risk to your innovation is pure conjencture - you have not suggested any mechanism which would cause that.

PeterZ wrote:Cost of insurance had more to do with regulations. For example, companies couldn't sell their insurance across state lines. That means an insurance company had to build a subsidiary to expand into another state. That doesn't make sense. If the original organization could expand more inexpensively in the original state, they couldn't. If the original insurance company could expand withtheir current staff, they couldn't because of that stupid law. The law effectively made the insurance market an oligopoly within each state. That by itself drove prices higher and could addressed with more open competition.

So, while I agree thatinsurance prices could be lowered with better policies. I do not agree that the only way to do it is through MORE government idiocy. Idiocy like the ACA.

Cost is only one factor. Health care is a problematic subject for a pure free market approach because the demand is inelastic - people will pay to stay alive, which means that the suppliers have disproportionate power. And since the free market is profit-driven, it's in the insurance company's interest to accept your premiums but to deny paying out (a company which deny's all claims will not stay in business long, but they have an interest in maximizing their denial rate given that consideration). Furthermore, because of a number of factors, they can get away with that far more easily than, say, an auto insurance company.

Daryl wrote:PeterZ, thanks for that and it did confirm my belief that the US has great medical researchers, however I can't resist pointing out that you had 99 winners (Nobel in medicine), and we had 7 which equates to 105 when the 15 to 1 population balance is factored in.
Lies, damn lies, and statistics. I'm sure each of us could cherry pick statistics that "prove" our point.
Personally I can't see how this relates to a medical welfare net, or why anyone would regard unofficial immigrants as being not deserving of full medical assistance. We all should be treated with dignity and respect.

Your use of vocabulary to spin reality astounds me.

The "unofficial" immigrants knowingly and intentionally entered the US in flagrant violations of our laws. I agree that they need to be treated with dignitynand respect, including emergency medical care, then escorted back to their home country.

No, I am not against immigration. I firmly believe that the US should have more legal immigrants than we now have on a path to citizenship. The farm area that I grew up in hip as been transformed into suburbs with 1/3 the population Asian immigrants. It looks like 1950s America. I also favor a guest worker program that would no doubt require some type of insurance financed by the taxes on their earnings. If the low skilled workers who enter the US legally on guest worker visas learn English, they should have the opportunity to go through the naturalization process. I just oppose granting defacto citizenship to people whose lack of job skills, inability to speak the language, and political heritage insure that they will vote for liberal totalitarianism.

Hey Fly happy Veterans Day:



Ah well quoting himself, "Better to be hanged for a hexapuma than a house cat."

Poker

Eyal wrote:
Cost is only one factor. Health care is a problematic subject for a pure free market approach because the demand is inelastic - people will pay to stay alive, which means that the suppliers have disproportionate power. And since the free market is profit-driven, it's in the insurance company's interest to accept your premiums but to deny paying out (a company which deny's all claims will not stay in business long, but they have an interest in maximizing their denial rate given that consideration). Furthermore, because of a number of factors, they can get away with that far more easily than, say, an auto insurance company.

Sorry Eyal, but the experience here doesn't match your asertion. Truly, the pre-medicaide system we had was very much a free market. No insurance companies to speak of and little regulations limiting how a doctor muight practice. Doctors knew their patients often from childhood. Families stayed with the same doctor and or practice. Those doctors knew their patients and were willing to be very flexible regarding payments. Yes, they also provided care for free or found doctors that could provide that care. There was not hue and cry about people not having access to health care. Doctors found a way to treat people, especially those people they knew.

For those indigents in every city, we had county or city hospitals. These were run by localities and did serve the indigent. My father came to the US to work at such a facility in Chicago. The hospital had a world wide reputation in the 60's that quickly faded after the 1970. Again our system worked because the county hospital was local and under local control. There was only so much graft possible. We are speaking of Chicago here, US capital for graft and corruption. Even so, the system worked.

Federal Government intrusion slowly destroyed that relationship between doctors and their patients. So, while socialized medicine might well be required elsewhere, it was not required here. Yet, here we are blaming insurance companies that came about as a response to increased regulations from the 70's on. Now, the situation has deteriorated so much that those same morons in the US that started our slide into poor healthcare service, now demand the government manage the entire system.

Again, you guys living in other countries might well have developed systems that make socialized healthcare preferrable for your countries. I don't live there and don't really want to. I can say that your assertions that such a government system will provide good healthcare here in the US might be overly optimistic. If for no other reason than our politicians have a much bigger trough to steal from and they appear to be much greedier sods than frequent your bailleywicks. So, this government healthcare system is just another huge pool of funds that politicians will siphon into their campaigns or use to blackmail/bribe people/companies to contributing to their campaigns. No, thank you.

Daryl wrote:PeterZ, thanks for that and it did confirm my belief that the US has great medical researchers, however I can't resist pointing out that you had 99 winners (Nobel in medicine), and we had 7 which equates to 105 when the 15 to 1 population balance is factored in.
Lies, damn lies, and statistics. I'm sure each of us could cherry pick statistics that "prove" our point.
Personally I can't see how this relates to a medical welfare net, or why anyone would regard unofficial immigrants as being not deserving of full medical assistance. We all should be treated with dignity and respect.

Let's go with Patents, then.
http://www.wipo.int/ipstats/en/statistics/patents/wipo_pub_931.html#f1

Please look at the patents by nation and type.

Between 2001-2005 the US has had 54.9% (43,317) of all Pharma patents and 56.8%(32,139) of all Biotech patents. Japan is the closest nation with 9.8%(7,738) and 12.5%(7,094) for Pharma and Biotech. Aussies come in at 1.2%(958) and 1.3%(760) respectively.

I believe that patents might hold a much closer correlation to innovations in medicine than Nobel Prizes. Either way, the US is an innovation engine and changes of such magnitude to this engine is a risk. Nothing anyone has posted or brought forth into the public discourse has suggested that this engine will not be impacted by the changes in Obamacare.

Given the sheer crappyness of this law, why on earth should we willingly accept it? The media can't lie about its praises enough to maintain positive public opinion of the POS.