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What Free Market Health Care Would Actually Look Like


Muda69

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1 hour ago, Muda69 said:

"Tell me Dante, why do insurance companies and government regulations have to insert themselves between myself and a physician for a simple yearly check-up?"

Because health care is more than a yearly check-up. 

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2 minutes ago, DanteEstonia said:

Because health care is more than a yearly check-up. 

?  A yearly check-up is a yearly check up, by definition.    If my physician discovers something during this checkup then subsequent appointments, medications,  a specialist referral, etc. may  come into play.  You still haven't explained why I just can't pay the physician $50-$100 out of my own pocket for this yearly checkup, keeping insurance companies and government out of the equation.

 

 

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1 hour ago, Muda69 said:

If my physician discovers something during this checkup then subsequent appointments, medications,  a specialist referral, etc. may  come into play.  You still haven't explained why I just can't pay the physician $50-$100 out of my own pocket for this yearly checkup, keeping insurance companies and government out of the equation.

 

You explained it for yourself in you own previous sentence. 

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15 hours ago, DanteEstonia said:

Start at sentence two- 

 

Key word in that sentence is "If".   What if during my yearly check up my physician discovers no issues?  Why should government and insurance companies come between that transaction?

 

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Canadian Healthcare: A Half Century of Broken Promises

https://mises.org/wire/canadian-healthcare-half-century-broken-promises

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"People primordially fear illness and death, and physicians, from shaman to modern scientists, have always been perceived as holding a near-talismanic power over both. With the rise of modern wealth came the potential for enormous tax harvesting, and politicians were quick to see that this power over life and death could generate deep feelings of gratitude and loyalty. Could they take this power unto themselves?” – William D. Gairdner, The Trouble with Canada . . . Still! A Citizen Speaks Out

Yes, they could, and in 1966, Canadian politicians took that power unto themselves, then promptly reneged on their promise to provide universally accessible healthcare for everyone.

The Deception

According to Tom Kent (the government’s senior policy wonk at the time), the Medical Care Act of 1966 was needed because “many poorer people just did not get care when it was needed.”

In an imperfect world, it is probably true that some people did not receive care when it was needed. However, as I have written before, it is doubtful that more people lacked access to care under the pre-1966 private system as compared to the government’s socialized system. Furthermore, in the private system, contrary to Kent’s assertion, healthcare was routinely provided to people who could not afford to pay for it.

Charitable impulses and the pursuit of profits are not mutually exclusive concepts, despite what Kent wanted us to believe, and despite what politicians and bureaucrats still want us to believe. That’s the deception.

Broken Promises

Kent said that the government’s objective with the Medical Care Act was “to make sure that people could get care when it was needed without regard to other considerations.” That sounds good, but as Milton Friedman warned, we should judge policies by their results, not their intentions.

At the beginning of each year, budgets for Canadian hospitals are dictated by the government, and if this predetermined tax revenue is depleted before the end of the year, as often happens, new patients are put on a waiting list for the next fiscal year. Thus, the government breaks its promise “to make sure that people [can] get care when it [is] needed without regard to other considerations.”

Moreover, the government breaks its promise every year, usually more so than the previous year, thereby establishing a trend of deteriorating performance over fifty-plus years, with deadly consequences:

In the 2005 Chaoulli decision, Justices of the Supreme Court of Canada noted that patients in Canada die as a result of waiting lists for universally accessible health care.

Our analysis estimates that between 25,456 and 63,090 (with a middle value of 44,273) Canadian women may have died as a result of increased wait times between 1993 and 2009. (emphasis added)

Year after year, “wait times” in Canada tend to increase, not decrease. It seems that politicians and bureaucrats do not embrace the concept of “practice makes perfect,” no matter how much time we give them.

Private Healthcare? How Dare You!

More than a million Canadians are waiting for the healthcare that the government promised to deliver. And, as we have seen, in 2005, the government, through its supreme court, acknowledged the deadly consequences of its broken promises. The logical solution is to return healthcare to the private sector. However, heartless politicians and bureaucrats ignore this solution, and they cruelly forbid patients on their waiting list from accessing private healthcare options in Canada, thereby condemning many of them to death.

Despite the government’s growing incompetence, a more recent court ruling affirmed the government’s position that people must be denied the freedom to pursue private healthcare options in Canada.

Last year, the British Columbia Supreme Court “dismissed a court challenge by Dr. Brian Day, former head of the Canadian Medical Association, whose surgical clinic in Vancouver provided medical services to patients failed by the public system, in violation of BC law. Dr. Day argued that the province’s ostensible ban on this type of privately funded healthcare violates the Charter of Rights and Freedoms. While the court ruling acknowledged the plight of thousands of patients on waiting lists, it simultaneously denied them the right to do anything about it.”

Shockingly, as Justice John Steeves affirmed the illegality of voluntary exchanges between patients and doctors unimpeded by government conditions, he irreverently declared that this does not violate these individuals’ right to liberty under the Charter.

The Charter is part of Canada’s Constitution. Section 7 of the Charter reads:

Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

In his ruling, Steeves wrote: “[L]iberty interests under s. 7 are engaged only where the law or state action interferes with a person’s ability to make fundamental personal choices” (para. 1764, emphasis added).

That sounds good, but then Steeves wrote:

[P]atients are free to spend their money on healthcare services as they deem appropriate (admittedly within the constraints of the MPA [Medicare Protection Act]). Therefore it cannot be said that there is a sufficient causal connection between the impugned provisions and the alleged deprivation…. I conclude that the plaintiffs have not established a deprivation of their right to liberty under s. 7. (paras. 1767, 1768, emphasis added)

To say that this is a deception seems blatantly obvious. Steeves ignores the fact that “the law or state action” necessarily includes the MPA with its acknowledged constraints. Among other things, these constraints include rules about which medical practitioners may offer their services, which services they may offer, and at what prices they may offer these services. This clearly interferes with people’s (patients and doctors) “ability to make fundamental personal choices.” Yet while this deprivation of liberty is beyond dispute, Steeves denies it.

There you have it. Free = Unfree, according to the BC Supreme Court.

The courts will continue to support politicians and bureaucrats. The duplicity of these charlatans is painfully clear. For decades, their bureaucracies have feasted on billions of tax dollars while thousands of dead Canadians wait for the healthcare they were promised. They are dead because the government denied them the right to use their own money to save their own lives by purchasing private healthcare from willing providers in the Canadian marketplace.

The trail of broken promises will grow longer. The inhumane treatment of Canadian patients will become more widespread, and many more will die. Nothing will change until the masses realize that their health and well-being can be greatly enhanced only through the restoration of their freedoms.

Bingo.  Yet socialists like Dante still drool over failed health care systems like Canada's.

 

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3 hours ago, Muda69 said:

In an imperfect world, it is probably true that some people did not receive care when it was needed.

At least he admits he's wrong right from the start. 

Whenever these people cite anything other than the Fraser Institute, we will talk. 

And even then it's a straw man to always focus on Canada. No one ever complains about Australia. 

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15 hours ago, DanteEstonia said:

And even then it's a straw man to always focus on Canada. No one ever complains about Australia. 

Nice attempt at deflection, Dante.  You know socialized medicine at a scale large enough to service a market the size of the USA would be a colossal failure.  Hell, it doesn't work in Canada, a country with about 1/10 our population.

 

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7 minutes ago, DanteEstonia said:

I guess if "achieving it's potential" equals long wait times for simple tests and procedures resulting in death then yes, you and other socialists would consider that a success. After all "everybody" now has access to "health care", right?   

Myself and other free market advocates consider it a failure.

 

 

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More Canadians leaving country for health care: Report

https://torontosun.com/news/national/canadians-continue-to-leave-the-country-for-health-care-says-new-report

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The flight of the sick continues to rise in Canada.

A policy brief — titled Flight of the Sick, by the Calgary-based think tank secondstreet.org — says 217,500 Canadians left the country for health care in 2017, according to Statistics Canada. If those travelling with the patients are included in the count, the total rises to 369,700 people.

“We’ve heard stories in the news for a long time now about Canadians who don’t want to wait for health care … leave the country,” said said Colin Craig, president of secondstreet.org.

 

“We’re trying to look at this through an economic lens because there’s a huge amount of economic activity that’s leaving.”

To that end, secondstreet.org noted Statistics Canada estimates that Canadians spent $690 million on health care abroad in 2017, up from $447 million in 2013. (The federal agency wasn’t able to provide a breakdown of patients seeking medically-necessary procedures and those leaving Canada for cosmetic surgery.)

That worked out to $1.9 million per day in 2017, an increase from $1.2 million per day in 2013.

Of those Canadians seeking health care elsewhere in 2017, the report says the majority were from Ontario, anywhere from as low as 154,000 people to as high as 208,400, based on survey data from Stats Canada.

“One potential solution is for the government to continue to find the publicly available health care system but allow private clinics to provide even more services than what they’re allowed to now,” said Craig.

“So then someone might decide to pay for the service in Canada instead of going abroad. And then if the government did that, more money would stay in the economy here supporting Canadian jobs and those workers and those businesses would pay taxes which could also fund the Canadian health-care system.”

Craig says secondstreet.org’s mandate is to look at “how everyday Canadians are affected by government policies.”

When you have a national socialist healthcare system where hundreds of thousands of individuals every year choose to leave the country to receive medical care elsewhere then your system is a failure. Full stop.

 

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  • 2 weeks later...

Why Progressives Will Never Accept Market-Based Medical Care

https://mises.org/wire/why-progressives-will-never-accept-market-based-medical-care

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A recent article on this page highlighted a stunning situation in which a surgery clinic in Oklahoma City was able to offer outpatient procedures at less than one-tenth of what local hospitals were charging to third-party payment systems such as insurance companies and Medicare. This was a significant article in many ways, in that it presented what truly is a shocking picture of what really happens in the medical care systems in this country.

At the same time, I was not surprised that Dr. G. Keith Smith’s clinic was able both to offer high-quality services at prices that are within the reach of most Americans and do it in an economical and convenient manner. After all, a free market economy has done the same with nearly all other privately offered goods and services for centuries and medical care should be no exception.

First, and most important, medical care is a scarce good, which means that it is subject to all of the immutable laws of economics. Second, when entrepreneurs are permitted the opportunities to improve goods and services in a free market setting, the results are predictable: better and less costly goods and services become the norm.

The facts that Dr. Smith presented seem to be indisputable. One can pull up the material online and see the prices, and it seems that everything else there is in order. Furthermore, they have pulled off what economists like Paul Krugman have claimed was impossible: lowering real medical care costs over time. To quote Krugman:

Why do health care costs keep on rising? It’s not because doctors and hospitals are greedy; it’s because of medical progress. More and more conditions that once lay beyond doctors’ reach can now be treated, adding years to the lives of patients and greatly increasing the quality of those years—but at ever greater expense. A triple coronary bypass does a lot more for you than a nice bedside manner, but it costs a lot more, too.

What this Oklahoma City clinic has done should be catching on everywhere and it should be celebrated in our body politic. Instead, as Dr. Smith points out, the medical establishment has done everything possible to shut it down and, if those in charge of other clinics and hospitals had their way, the Surgery Center of Oklahoma would meet the same fate as Tom Smith’s “Incredible Bread Machine.”

Some of the rejection certainly falls into the “capture theory” category of regulatory economics. Other medical entities don’t like the competition and they use the apparatus of government to hamstring competing firms—all while using the “we’re protecting the consumer” rhetoric, which is textbook theory. Likewise, we also can see the “Baptists and bootleggers” theory of regulation at work. (Both Baptists and bootleggers want the liquor stores closed, but for very different reasons. The Baptists provide the high-sounding, “public interest” rhetoric, while the bootleggers don’t want the competition from legal entities.)

No matter what theory we use to describe the opposition to free market medical care, we easily can characterize it by the following statement: medical care should not be inexpensive; it should be free. Anything less than “free” is morally and politically unacceptable. Whether one reads statements by Paul Krugman, Bernie Sanders, Elizabeth Warren, Alexandria Ocasio-Cortez, or anyone else in the current pantheon of American progressivism, “free” medical care is at the heart of all their demands.

I point out that no one—not even Krugman—believes that medical care is a “free” or nonscarce service. To state otherwise would be claiming that every single factor of production that goes into the development and delivery of medical care also would have to be nonscarce, from labor to every single component of every medical device used. Even people that claim that medical care is ”different” from other goods and services and does not adhere to standard laws of economics are not going to claim that every input that goes into medical care also should be free.

Since progressives believe that “free” medical care actually is not free in the economic sense, we are left with their central doctrine: all medical care should be administered free of charge to recipients and all payments that go to providers of medical care and producers of goods used in medical services should come from sources other than the direct recipients of medical services. This is not so much an economic statement as it is a religious one. If there is one central religious belief that all progressives share it is the belief that no one who receives medical services should have to pay directly for them. The amount of the fee is irrelevant; anything more than zero is prima facie immoral.

This doctrine is so central to American progressive beliefs that progressives will go to extraordinary lengths to defend any political regime that offers free medical care. All one needs to do is to find progressive support for every single Communist regime from the twentieth century—and that includes the madly genocidal regime of Pol Pot in Cambodia in the mid-1970s—because they have free healthcare.

Even after the collapse of most Communist regimes thirty years ago, the lone holdouts like Cuba and North Korea have their amen corners. Nikole Hannah-Jones, before she came to the New York Times, wrote this for readers of her former employer, the Portland Oregonian, after a visit to Cuba in 2008:

While there, I found a Cuba you may not know. A Cuba with a 99.8 percent literacy rate, the lowest HIV infection rate in the Western Hemisphere, free college and health care.

She continues:

Cuba's universal health care system is seen by many as a world model. Neighborhood clinics and municipal hospitals provide free treatment, including laser vision correction and cosmetic surgery to fix deformities. HIV and AIDS drugs cost nothing. Most clinics make do with outdated equipment and a shortage of supplies. Yet the country has a higher ratio of doctors to patients than the U.S., and Cubans live longer than we do.

I recall reading the same worshipful language directed at Mao’s regime in China even during the disastrous Cultural Revolution and praise directed to the former USSR and its Eastern European satellites for their alleged “free” medical care for all. No matter how violent, how murderous, and how genocidal a political regime might be, if it offers “free” and universal medical care then nothing else matters. “Free” and universal medical care legitimizes all other excesses. The left-leaning Guardian provides a recent example of this principle.

Given that progressives are willing to excuse political mass murder if the regime in question claims to offer “free” medical care to everyone, then they hardly will be convinced that a medical model like that of the Surgery Center of Oklahoma (SCO) is morally legitimate even when it provides quality services at a fraction of the cost of medical care under third-party payments. For example, even after acknowledging the success of the SCO, a self-described “libertarian” recently challenged its legitimacy, employing Kenneth Arrow’s famous 1963 paper in American Economic Review that claimed medical care was “different” than other goods and services and needed to be removed from the market system.

For all of the praise heaped upon the paper, and for all of its positive acceptance by the elites of academic economics, the Arrow paper is a poster child for the informal fallacy of “begging the question.” Arrow begins with a conclusion and then “proves” his point—without proving anything at all. Likewise, progressives begin with the declaration that the only morally legitimate system of medical care is one in which no recipient of medical services pays directly, so even if the SCO were able to bring their prices down to a nickel per procedure, progressives still would object.

Briefly put, the Arrow theme is that because there is much uncertainty in the field of medical care, markets in that field cannot be competitive, which means that by definition they are not optimal. He writes: “[W]hen the market fails to reach an optimal state, society will, to some extent at least, recognize the gap and nonmarket social institutions will rise attempting to bridge it.” There is much to criticize here and not enough space to do it, but suffice it to say that Arrow’s analysis, as faulty as it may be, provides the fig leaf for economists like Krugman to make his antimarket claims:

There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence.

The fact that the SCO can profitably perform surgeries at less than a tenth of what nearby hospitals would charge insurers is irrelevant to economists like Krugman, who forcefully dismiss such information on its face. Not only clinics like the SCO but also outfits like Epiphany Health Direct Primary Care in North Port, Florida, are able to provide quality healthcare at affordable prices, but mainstream economists simply can deny their existence—and get away with it. In fact, there are more than fourteen hundred such cash-only practices across the country, giving lie to Krugman’s claim that free markets make healthcare more expensive and less available. (Remember, in Krugman’s world, only the wealthy have access to medical care in a free market system. That most patients taking part in the medical version of free markets are not wealthy people does not change Krugman’s narrative.)

In his 1963 paper, Arrow spoke for progressives when he conducted a flawed analysis meant to reach conclusions “proving” that the free market and healthcare were incompatible. He wrote: “It is the general consensus, clearly, that the laissez-faire solution for medicine is intolerable.” However, there is plenty of evidence today that laissez-faire medical care is not intolerable and that most medical procedures performed in a free market setting are well within the financial means of most people in this country.

Medical care that truly is affordable certainly is not given a fair and honest hearing in this country. For politicians, the media, such a situation is anathema. They would rather see a contrived, high-cost system that wastes trillions of dollars in misallocated resources but is subsidized on the back end to give the appearance of being “affordable” and, more important, “equitable.” High-cost “free” medical care is morally superior to low-cost free market medical care, because, well, because it is.

When such ground rules for debate exist, it is hard to be able to make a public argument. Economists like Krugman, who are able to martial media resources to shout down opposing arguments, will appear to carry the day, at least where the supposed debate is concerned, as will his allies in academe and in Congress and the legislatures.

But economics is not based upon rhetoric but rather the real world of resources, production, and consumption. Just because Paul Krugman claims that by definition free market medical clinics cannot exist does not mean that thousands of people are not receiving the kind of care that Krugman, Arrow, and most of the economics profession claim to be impossible. Free market care does exist, and it provides, frankly, a moral choice against the lies the established elites are telling us.

 

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On 7/31/2021 at 10:49 AM, DanteEstonia said:

...because market-based medical care doesn't work. 

This fits you to a T, my socialist friend:

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Since progressives believe that “free” medical care actually is not free in the economic sense, we are left with their central doctrine: all medical care should be administered free of charge to recipients and all payments that go to providers of medical care and producers of goods used in medical services should come from sources other than the direct recipients of medical services. This is not so much an economic statement as it is a religious one. If there is one central religious belief that all progressives share it is the belief that no one who receives medical services should have to pay directly for them. The amount of the fee is irrelevant; anything more than zero is prima facie immoral.

 

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