Miss USA: Health Care Is a Privilege, Not a Right...

[Sparko]

You're not really paying attention. Either way we're using our dollars to make the doctors rich. Maybe if we cut out the insurance distribution system, we save money by not making the administrators and investors rich along the way.

fwiw,
guacamole

but I am not arguing about the current system, but about what happens if we decide Healthcare is a right and government should pay for it. We either go broke making the doctors rich government employees, or we treat them like the slaves that they will be and force them to work for cheap to save tax money. Which will result in fewer doctors and poorer healthcare.

So do we end up paying through the nose to keep doctors rich and happy or do we have a shortage of doctors and lousy healthcare?

[guacamole]

but I am not arguing about the current system, but about what happens if we decide Healthcare is a right and government should pay for it. We either go broke making the doctors rich government employees, or we treat them like the slaves that they will be and force them to work for cheap to save tax money. Which will result in fewer doctors and poorer healthcare.

So do we end up paying through the nose to keep doctors rich and happy or do we have a shortage of doctors and lousy healthcare?

Yes. But, as I noted, we already pay through the nose to keep doctors (and administrators, and investors) rich and happy.

But I think you're proposing a false dichotomy. Even in government and government contract work, there are market forces in play. If salaries aren't high enough for the ambitious, then we will have labor contraction until salaries rise. I would wager that eventually we'd reach a stabilizing point of the number of high quality people willing to do the job for the pay--probably still high by average standards, but not as high as they are now during what feels like a health-care gold rush.

Granted, I haven't studied any of this in any depth so this all comes out of my backside, but it stands to reason that if other countries can have capable systems that do not bankrupt the people, and which routinely give better healthcare results than we get in the states, then there are ways forward. It wouldn't have to look like any one system available now, either. We can borrow as we like.

fwiw,
guacamole

[Mountain Man]

By force do you mean "bribe with high salaries and benefits" because if there were a doctor shortage, I imagine that's what would happen, no?

No, I mean literally force, as in compel them against their will.

If healthcare is a right, and if there are not sufficient services for someone to pursue that right, is the government obligated to force people into the medical profession to ensure adequate services?

Yes or no? If you say "yes" then you have to explain how someone's "right" to healthcare supercedes someone else's right to liberty. If you say "no" then you can not reasonably argue that healthcare is a right.

[guacamole]

No, I mean literally force, as in compel them against their will.

If healthcare is a right, and if there are not sufficient services for someone to pursue that right, is the government obligated to force people into the medical profession to ensure adequate services?

Yes or no? If you say "no" then you can not reasonably argue that healthcare is a right.

Yes. Force people into it if you have no alternative because if you can take care of people, you have a moral obligation to.

fwiw,
guacamole

[Sparko]

Yes. But, as I noted, we already pay through the nose to keep doctors (and administrators, and investors) rich and happy.

but now we have a free market and we don't think the government should pay for healthcare, and we are NOT HAPPY WITH PAYING SO MUCH. In other words the whole discussion is about CHANGING the way things are. So arguing that "well that is the way things are now" is not helpful is it?

But I think you're proposing a false dichotomy. Even in government and government contract work, there are market forces in play. If salaries aren't high enough for the ambitious, then we will have labor contraction until salaries rise. I would wager that eventually we'd reach a stabilizing point of the number of high quality people willing to do the job for the pay--probably still high by average standards, but not as high as they are now during what feels like a health-care gold rush.

Granted, I haven't studied any of this in any depth so this all comes out of my backside, but it stands to reason that if other countries can have capable systems that do not bankrupt the people, and which routinely give better healthcare results than we get in the states, then there are ways forward. It wouldn't have to look like any one system available now, either. We can borrow as we like.

fwiw,
guacamole

A lot of countries that have single payer/ government run systems do NOT have good healthcare. Take Canada for instance. Long waiting periods for tests and doctor visits. Doctors that don't give a fart. No pharmaceutical research because there is no profit in it.

Or look at our own government run healthcare: the VA. Again, long waits and lousy healthcare.

See a pattern?

[guacamole]

but now we have a free market

I don't think we have a free-market system. We have a managed health care system, just a privately managed one. A free-market health care system is one where it is easy to understand what you are going to pay out of pocket up front before the procedure is done, rather than what we currently have.

and we don't think the government should pay for healthcare, and we are NOT HAPPY WITH PAYING SO MUCH. In other words the whole discussion is about CHANGING the way things are. So arguing that "well that is the way things are now" is not helpful is it?

I'm saying "well, that's the way things are now" to point out that objecting that paying doctors is therefore a valid critique of the current system.

A lot of countries that have single payer/ government run systems do NOT have good healthcare. Take Canada for instance. Long waiting periods for tests and doctor visits. Doctors that don't give a fart.

I've often heard that said, but the more I read about it, the more I question that assertion. Here's a comparative site that measures six different "goods" that come out of health care:

http://www.commonwealthfund.org/inte...=1&compare=AUS

The specific interactive comparison I've cued up relates to Australia, but there are a number of given countries there. Canada has some better outcomes (infant mortality, preventable deaths) and some worse (wait times, visits to the ER), etc. Australia seems to be killing it. That's the country Trump praised, by the way.

No pharmaceutical research because there is no profit in it.

This is another of my personal issues. We Americans basically subsidize cheaper meds for people around the world because their governments negotiate for the entire system whereas we get charged a higher price because insurance companies negotiate individually. Again, we can institute economic incentives to drive research and development if we want to. We do so in other areas and are effective at doing so.

Or look at our own government run healthcare: the VA. Again, long waits and lousy healthcare.

No argument there. Much about the VA is a crime.

See a pattern?

Not really.

fwiw,
guacamole

[Sparko]

This is another of my personal issues. We Americans basically subsidize cheaper meds for people around the world because their governments negotiate for the entire system whereas we get charged a higher price because insurance companies negotiate individually. Again, we can institute economic incentives to drive research and development if we want to. We do so in other areas and are effective at doing so.

More than that. Drug companies charge outrageous prices here because they can. That basically funds the research for new drugs. Other countries benefit from the new drugs but don't get charged those outrageous prices because they won't pay them. So what happens when WE won't pay them because of government run healthcare? Will the drug companies be driven out of business? Will they stop doing research into new drugs? That is something to think about.

[guacamole]

More than that. Drug companies charge outrageous prices here because they can. That basically funds the research for new drugs. Other countries benefit from the new drugs but don't get charged those outrageous prices because they won't pay them. So what happens when WE won't pay them because of government run healthcare? Will the drug companies be driven out of business? Will they stop doing research into new drugs? That is something to think about.

I agree with the futurists who argue that pharmaceuticals would be essentially weaponized. Your allies would get them. Your enemies would steal them through espionage.

fwiw,
guacamole

[Carrikature]

More than that. Drug companies charge outrageous prices here because they can. That basically funds the research for new drugs. Other countries benefit from the new drugs but don't get charged those outrageous prices because they won't pay them. So what happens when WE won't pay them because of government run healthcare? Will the drug companies be driven out of business? Will they stop doing research into new drugs? That is something to think about.

More like the focus will be on research for drugs we need not drugs we want. Potentially they could receive funding to research treatments for relatively rare (but curable) diseases that don't currently pass the cost/profit margins.

[Mountain Man]

Yes. Force people into it if you have no alternative because if you can take care of people, you have a moral obligation to.

Really? That's your argument?

You might have a moral obligation to help someone, but you do not have a moral obligation to force someone else to help them. In fact, that would be arguably immoral.

This is where the whole liberal notion of "charity through government" goes off the rails.

[Carrikature]

Other countries benefit from the new drugs but don't get charged those outrageous prices because they won't pay them.

I think it's worth pointing out that some countries require drug manufacturers to demonstrate increased efficacy and/or cost reduction before accepting new medications into their system. There are A LOT of drugs that can't show increased efficacy AT ALL.

[Sparko]

I think it's worth pointing out that some countries require drug manufacturers to demonstrate increased efficacy and/or cost reduction before accepting new medications into their system. There are A LOT of drugs that can't show increased efficacy AT ALL.

they all also just seem to copy each other on what happens to be popular at the time. Take all those new drugs for managing diabetes. Seems like there are dozens of commercials out there now for basically the same types of drugs: long term, once daily insulins like Tuojeo, or Tresiba, etc. They all do the same thing. Why research and develop all these similar drugs when the money could be used to develop new drugs?

[Carrikature]

they all also just seem to copy each other on what happens to be popular at the time. Take all those new drugs for managing diabetes. Seems like there are dozens of commercials out there now for basically the same types of drugs: long term, once daily insulins like Tuojeo, or Tresiba, etc. They all do the same thing. Why research and develop all these similar drugs when the money could be used to develop new drugs?

I'm going to guess that most 'new' drugs are really just improvements on existing treatments that are fairly well understood. The R&D costs would be low, so profit can be higher.



I don't buy the story that higher US prices pays for everyone else. I think they can just get more here, so they do. Check out this article on antivenom costs.

[Sparko]

I'm going to guess that most 'new' drugs are really just improvements on existing treatments that are fairly well understood. The R&D costs would be low, so profit can be higher.



I don't buy the story that higher US prices pays for everyone else. I think they can just get more here, so they do. Check out this article on antivenom costs.

true. Especially when it comes to Insulin. Diabetes is big business because it is pretty common. I have to take insulin. I take a long term insulin called Humilin, that comes in a pen and lasts 10 days (the pen lasts 10 days, I take one shot per day). Comes in a box of 5 pens (so about 2 months worth, a bit less)
This is a drug that has been out for YEARS. It is not a new one like Tuejeo. Guess how much it costs? nearly $500. about $10/ shot

[guacamole]

Really? That's your argument?

You might have a moral obligation to help someone, but you do not have a moral obligation to force someone else to help them. In fact, that would be arguably immoral.

This is where the whole liberal notion of "charity through government" goes off the rails.

If someone else also has a moral obligation to help someone then you aren't doing anything immoral by holding them to moral obligations.

fwiw,
guacamole