The ideal system of healthcare would be free market capitalism approach

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11 W$ Invested 3w 18h ago
The “healthcare” policy should not be mandated as a right by government, and “healthcare” policy should be decentralized. What is healthcare ? Nobody consumes it, nor is it a right of a mankind, because it is not homogeneous. There has never existed a unit of healthcare. I believe healthcare is a clear set of commodities, goods, and services. These commodities, goods, and services should be decided upon by the individual who seeks them. For instance, laser eye surgery is a service you could purchase on the market that will improve your overall health, and so are pain relievers. Strictly speaking, there is no such thing as “healthcare”. There is only a bundle of various goods and services individuals will want to consume at varying levels due to health concern. The ideal system of healthcare would be free market capitalism approach. A system that has no interference from government subsidies and regulations, but still has great standards and abundant reach for those who require it. In theory, this system would lower cost of goods and services. Similarly, to other good and services provided in cooperative markets where subsidization, government force, and monopoly control are less prevalent( i.e. computers, software, and automobiles).
Moderators: Henryk A. Kowalczyk
Last Edit: 3w 17h ago by Henryk A. Kowalczyk. Reason: Correction asked by the challenge author

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2w 15h ago
Valid arguments were presented by both sides. The core of the difference of opinion reaches beyond health care. The major disagreement is in how much government intervention in economy and in major social affairs as healthcare we need. On one side, it is a conviction that the free market can better resolve our problems than even best crafted government regulations can. This is the position of Cameron L. Williams. The strongest opposing arguments are by Fred V. Carstensen, who brings historic argument that government licensing and other regulations arrive out of necessity to address problems not resolved by the free market.
I decide to resolve this challenge as true, agreeing with the challenger, Fred V. Cameron. The main reason for this decision is that opposite side did not present sufficient opposing arguments to the claim made by Fred V. Cameron, and supported by Ron F. White, as well as by Jazmin Cortes that the free market lowers the prices and improves quality, and thus gives more people access to affordable health care.
This challenge is about one of the major disagreements among Americans. It would be unreasonable to expect that we can have it resolved in one short debate. I encourage everyone seeing shortcomings of the arguments presented here, or disagreeing with my decision, to post a new challenge addressing the same problem. Sometimes rephrasing, or narrowing the subject, can help a challenge to win.
Last Edit: 2w 15h ago by Henryk A. Kowalczyk.

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2 W$ Invested 2w 5d ago
Because of the way this conversation works, I can not build off of comments others have made. For example, a very important point emerges in another comment: the issue of professional expertise. The author seems to think that malpractice suits as well as insurance--which was not put on the table as part of this discussion--can control this. But of course those very points involve government--because we have define in law what constitutes malpractice and what evidence must come forward to support such a conclusion, and I assume the author understands that insurance companies are typically regulated/audited because they sell something that they don't actually have to deliver. There is a long history of insurance companies both refusing to pay claims or just absconding with the accumulated premiums.

We began adopting professional licensure laws in the late 1800s precisely because as a society we recognized that consumers could not assess the professional qualifications of doctors, lawyers, engineers, architects, etc. [We have gone overboard on professional licensure: in some states more than a quarter of all jobs require state licensing. It is very attractive as a device for limiting competition and thus raising prices/incomes.] And especially in the case of medicine where malpractice left you dead, a suit was hardly a remedy.

So the reality is that the market for health care services inherently involves the government (as in fact do all markets because of the need to define property rights, contract, procedure, tort, etc); the only question on the table is the nature and extent of government involvement. The proposal here is for a limited role, leaving individuals/households to make their own choices in purchasing services. It does not contemplate (as my previous comment made clear) the role of insurance. And as the author's response to my first comment showed, the response was cast in terms of whether the cost of an airline ticket was excessive relative to the importance of attending to a dying relative--it ignores the question of the scale of medical costs that relative was incurring and their capacity to make a decision about that care.

The consensus literally in every other country in the world is that provision of health care can not, in general, be left to open competitive markets; it doesn't work. And that is why, from Bismarck"s introduction of universal health care almost 150 years ago, every other country in the world has adopted (in principle if not fully in fact) universal health care. Only America is a holdout, where medical costs are absurdly high and market incentives in large measure perverse. Both history and logic argue strongly against reliance exclusively on market mechanisms in the case of healthcare.

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2 W$ Invested 2w 5d ago
I think the way this is framed makes it impossible to discuss coherently. It focuses on buying health care services discreetly as if we are filling our shopping cart in the grocery store while ignoring the role of insurance. But precisely because the cost of health care services is often very high relative to income and savings, because the need for them is unpredictable, and because the length of time needed for such services is indeterminate ex ante, there is a strong preference for purchasing insurance if it is affordable. Prior to the ACA, the single largest driver of personal bankruptcy was uncovered medical costs; as a society we were facing rapidly growing costs for uncompensated care, and overall the total cost of healthcare was eating the American economy alive--17.4% of GDP.. If the question is reframed as whether we ought to have some form of universal insurance as the most efficient and effective way to providing access to healthcare, in recognition of the healthcare cost and access crisis we had pre-ACA, then we have a rather different discussion.

In the absence of insurance (or inadequate insurance), and in the absence of the 1985 Reagan Rule requiring hospitals to provide care regardless of the ability to pay, people literally died. Only some hospitals provided emergency care for anyone regardless (we used to have "charity" hospitals for the uninsured); increasingly hospitals were refusing to take those who did not have sufficient insurance or private money, insisting they be taken to another hospital. Precisely because people were dying as a result, Congress enacted and Reagan both supported and signed the new mandate.

What the statement above simply ignores are the historical dynamics involved here and the role of insurance since the introduction of employer-based insurance during WWII. If the system were as the author suggests--an open, competitive market for the provision of health care services--it is absolutely clear from historical experience that many people would die unnecessarily and prematurely. As a society, we decided that was unacceptable.

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6 W$ Invested 2w 4d ago
Fred,

Insurance is traditionally for things you don’t expect to happen. This is the role of insurance and that is why my original statement on “healthcare” being something that is non existent is so vital. I believe you are very aware of this, and pointing out that prior to the ACA uncovered medical cost and healthcare cost were killing the economy is affirming what I stated. The reason medical cost and healthcare is destroying the GDP is essentially the price fixing (medicaid and medicare) by government programs to treat insurance as a set of homogeneous goods and services that American can lay claim to. This is inherently wrong, and explains why government should not play any role in insurance or health of any Americans. I agree we do need governance, but not from government. Governance needs to come from free market interactions, where it is governed by the people whom are consuming the goods and services. People are over insured and have been for decades years prior to ACA. The employee-based insurance during WWII seems to begin when government price and wage controls made it illegal for employers to raise wages to attract additional labor. However, employers could offer benefits such as paid health care per-tax, and then going forward this became a demand of labor unions and now we are stuck in this system because it has prevailed. If we go back further in 1965 people were not dying in the street. Medicare and Medicaid were the main culprits of doubling and tripling the cost of medical services. Let's keep this focused. What do you want me to respond to ? What do you want me to be more clear about?

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10 W$ Invested 2w 5d ago
Everything else for which we enjoy higher quality, lower prices, and the freedom to choose is free market based. Therefore, if we want the same for our health care then we need to take a free market capitalism approach.

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2 W$ Invested 2w 5d ago
You pick one of the few instances where market competition can work in provision of a health service: laser eye surgery. For markets to work, as Milton Friedman noted, you have to have "informed, non-coercive" choices. In a few cases you can meet those standards--where the procedure is discretionary, there is good information about providers, and there is adequate time for investigation, assessment, and decision-making. But many health services don't meet either standard. Unless you have had serious medical training, you may simply be unable to understand either the nature of the disease or the appropriate therapies. That is a principal reason, in fact, that we require doctors to be licensed and to have clearly defined specialties. And in many cases the need is not discretionary: having been run over by an eighteen wheeler, you are in no condition to google for the best provider or negotiate the treatment.

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10 W$ Invested 2w 5d ago
The fact that one has to make an emergency decision doesn't mean that one is being misinformed or coerced. For emergency situations we always pay a higher price, we accept that and make quick decisions based on the information available, just look at overnight shipping versus 10 to 15 days shipping. That will not change no matter the situation, no matter the market. My grandmother was put on life support over the weekend and I needed to flight out of town to see her before she dies. The ticket price was $1,200. However, I got message on a pop-up window saying that I could save about 70% if I fly one week later; not an option given the situation. So I paid 70% more than otherwise would if I had the time to wait for a better price. I was not coerced I was not misinformed, it was just a choice that I had to make with little time to think about the cost. Why should our health care be any different. When companies compete for our money, quality goes up and prices go down across markets. Why is it that we enjoy the freedom of free market capitalism when we are shopping for clothes, for cell phones, for cars, and for pretty much everything else but not for health care?

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10 W$ Invested 3w 15h ago
Is your approach to people that cannot afford free market health care simply to say that they should go die. Because I think that's the problem we are trying to solve. The Haves think the Havenots should just go die because it is the Havenots' own fault that the cannot afford. Under an obvious system of institutionalized oppression for many specific groups, the denial of healthcare to those groups further oppresses them and keeps them from growing out of there desparation.

It's practically calling for an uprising or revolution, becaue what is the reponse to people that receive the threat - "go die"? It's "go die yourself"/"kill the rich".

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2 W$ Invested 3w 5h ago
The real question is: "If we went to a free market system, would the price of health care decline precipitously, thus leaving only a few who can't afford it? Then could private charitable institutions afford to take up the slack?"

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2 W$ Invested 3w 14h ago
Hello Mark,

First, I want to thank you for your response. I understand your concern for a greater approach to the current system, and I want to help you. However, I need some clarification on some of your language. Would you please explain to me what area "have nots" and "haves"(person, income)? I do not want to assume we are talking about a static group of people unless it is clear. Also, could you give me a example of "institutionalized oppression"? If you would like me to clarify my previous statement, please let me know. I want to make this conversation one of understanding.

Thank you,

Cameron Williams

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2 W$ Invested 3w 17h ago
So you don't think that there should be any government regulations to protect people from malpractice? Let the courts decide after the fact on each case of harm? I think that would invite a lot of harm.

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2 W$ Invested 3w 13h ago
First, I want to thank you for your response. I am also concerned with standards, and government does not have the ability to predict what may happen in the future. Therefore, I believe if we look around us now we can see that to be true, and the market of insurance and contract law would be able to prevent malpractice far greater than a central power of distant unaffected bureaucrats. As far as it inviting harm it would be counterproductive to a system lead by cooperation and voluntary exchange to harm its consumers, because this encourages more effective entrepreneurs to cooperate with harmed consumers. Thus, eliminating inefficient entrepreneurs, so this is vastly better than a system where government can monopolize on force which consumers can not opt out of monopoly power of government. Could you please show me a source on private malpractice ? I am certain I can show you how interference of government regulation or special provision caused the event ( The Charlie Gard Case).

Thank you,

Cameron Williams

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3w 17h ago
Cameroon, thank you for opening this provoking challenge. Let us hear opinions for and against it.

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Challenge Total Investment
Agree:42 W$
Disagree:20 W$
Challenge resolved as TRUE