You really think health care is like any other "consumer service"? When consumers are purchasing just about any other product, whether its a TV, a car, basically anything, they have a good sense as to what the market for that product is and what a fair price is. No one has any clue what constitutes a fair price when it comes to health care. An appendectomy in one state might cost you $8,000. In other state it can be $30,000. Such a wide gap in any other consumer service would be evidence of collusion or price manipulation.
You're actually agreeing with me about the cause, but possibly not the solution. That's one thing about the healthcare debates that makes me sad, so many people seem to talk past each other without seeing there's some agreement too (not an accusation I'm aiming at anyone here).
But on point, the only reason you have this problem is the fact we have an insurance system, and we only have the insurance system we do because insurance programs have to be structured in particular ways because that's the law.
Now we've gone and made it worse by requiring everyone be insured. This hampers people thinking creatively to solve the problem. That's really my main beef with well meaning efforts to politicize health care, there's no provision to opt out of what others think is best regardless of whether it may actually be or not.
I wouldn't let someone decide what books I was allowed to read, what kind of car I could buy, etc. Why should I let someone tell me what health care I need to buy?
But that's essentially what we've been doing for decades, and ideas like letting nurse pracicioners provide services without an MD authorizing them or letting pharmacists sell "behind the counter" medicines just get pushed by the wayside.
The best price, the fair price, for healthcare can only be achieved by giving the total consumer base total power to "negotiate" the price with the providers via the market. Instead in the interest of making sure some people have better healthcare access than others (which is all the ACA does), we have let, or rather forced, the providers cut the customer base up into discrete portions so they can exercise price discrimination.
You get the a fair price, and a fairly uniform price, for television sets because the providers have to "negotiate" with the entire consumer base, not just parts of it, some of whom pay $1000 for a TV and some of whom pay $500, etc.
I am confident if we had to buy television sets via television insurance, where individual people had no clue what they were actually paying, we'd have the exact same clusterscrew just for a different good.
Also, there is the fundamental moral issue surrounding health care and profit. At some point, your life depends on this particular "consumer service". Just how much profit should the doctors, insurance company, etc. be able to reap off of your predicament? Obviously, the incentive of the insurance company is to collect as much money in insurance premiums as possible, while paying out as little amount of money as it can in benefits. Call me crazy, but in the absence of government regulation that seems like a recipe to simply deny a bunch of people health care coverage, or make them pay out of pocket for a ton of their costs (costs that we don't want to control, because FREEDOM!)
So, i for one, would like the government to continue to intrude in this particular area and drag us into modernity, along with every other developed country on the planet.
How much profit is "fair" is honestly a question best decided by as many people as possible, because we all have different ideas. I would argue that different profit margins are necessary in different kinds of businesses, and have noticed that the only way we seem to have a clue what those margins should be is just by letting those businesses run through their cycles and figure it out by trial and error.
That issue aside, I actually do have sympathy for the sentiment behind this argument, and were I a wizard I would wave my hands and make all the pain and suffering of chronic conditions and disease go away. Truth is I think the vast majority of people would.
Lacking that power, the best we can do is try to make it as inexpensive and widely available as possible. The best way to do that is to make, or rather let, medicine have to compete in the general market like everyone else.
The problem is, you can make this exact same argument for any service or good, and we don't try to filter most of those through some government provision. Socialized healthcare is one of those instances where people think with their feelings too much sometimes and get their desire to see other people healthy and well muddled with what cold hard reality will allow for.
How exactly is the government over regulating healthcare? It seems if anybody's doing that, it's the insurance companies. What does "small" government even mean? Fewer employees? Fewer agencies/departments? Smaller budgets? You don't see how healthcare is different than buying a car or iPad?
Again the insurance system we have is that way because the government has made it that way. You have to cover certain things for certain people even when it doesn't make sense.
It's only different from buying a car or Ipad because statute or tradition makes it so. And it's not just federal or state laws either, it can be things like medical licensing, the billing practices of hospitals, and so on. The only way to clear it up is to tear it down.
As far as small government, yes you are exactly right. We should be focusing on elegance of design, keeping only those parts of the government that we have good reason to believe are highly effective and necessary. A great deal of it can go. You can draw a parrallel to engineering and optimization principles.
The very existence of successful cash practices, that they're viable at all, should give pause maybe we aren't really using our brains here.
I only found out they exist when someone I knew cut his hand badly on some glass. He went to an all cash doctor and got it disinfected, stitched, etc. for $75.
Had he gone to a conventional hospital emergency room, well I can't even imagine the cost but what do you want to bet it'd be a four digit number, or at least a large three digit number.
Now can a cash only doctor handle a problem like terminal cancer? I'm thinking probably not in the current system we have, but the fact that this model works for at least some services is yet another reason to rethink our central approach.
The problem I see so often in arguments like this is that people think that opponents of socialized medicine argue against it from an ideology that values freedom for its own sake without consideration for reason.
That's backward, reason and the desire to see others do well leads one to value freedom. Only freedom gives human beings the ability to be awesome and solve problems that were previously grave and dire problems.
The worst part about the ACA is we can't at least have a middle ground, what if instead of subsidizing other people's health insurance, I want to spend the money on more cancer research instead. What makes a bunch of lawyers in Congress who are no more qualified than I am better than me at making that decision on how to spend my money? Why not allow people to do things like that instead of having to buy insurance?
To bring this back around, I really truly don't blame people who are using the ACA to retire earlier or accomplish other things. Those are the rules we have in place, whether they are good rules or not doesn't really matter, but there will be unintended consequences, putting us on a regulatory treadmill.
