Tuesday, March 23, 2010

Doctoral thesis on health care

So now we’re on the road to health care reform. At the very least, we’re on the map.

Passing this legislation was nothing short of miraculous. The polarized political climate nearly killed it, and even many on the left seemed to want it to die in its current form. Ultimately, deem-and-pass may have saved it and certainly made it less prone to further watering-down.

I do have my quibbles with the bill, mainly that it’s without single-payer universal care or a public option. These are the best two ideas for reforming health care, both in cost and societal obligation, but they are also the most politically loaded. True to what critics say, the health insurance mandate forces everyone to buy into private insurance companies. And even though it’s almost completely forgotten that the poorest Americans and small businesses can get waivers for the cost, it’s still a sore point for most. It’s just too bad that single-payer is such a poisonous concept that a mandate had to be considered in the first place. Even so, the point of the mandate is to create the largest risk pool possible, which in theory drives costs down for everyone. So it isn’t a total wash. Nor do I think it is a total giveaway to the insurance companies and Big Pharma, because while they’re getting more business, it isn’t necessarily more profitable business. There’s a reason they fought this tooth-and-nail, despite conventional wisdom that the Obama administration appeased them.

The real effect of this bill is that its policies will pave the way toward a more widespread acceptance of the need for a public option and/or universal health care. Many critics of the legislation, the ones who object because they’ve been conditioned to split hairs over spending (at least post-2009), will find it to benefit them in the future. And when it comes through in the clutch for them, it will seem less like a Marxist nightmare than an essential part of being a secure citizen. Remember, these same conservatives were dead set against Medicare and Social Security back when those programs were pipe dreams. But just try putting your government hands on their Medicare, and you’ll see just how rugged and individualistic Americans truly are.

What I don’t appreciate is the opposition against the bill, which is growing exponentially juvenile by the minute. Yesterday, I spent much of my free time scouring the comments sections of various online newspapers and message boards, as well as having numerous conversations with friends and acquaintances in person and online. Comments ranged from lucid to ridiculous. Diplomatically speaking.

Whenever I hear anyone use the terms “Obamacare,” “BO,” “communist,” “Marxist,” “fascist” or any of the other common epithets so loosely applied these days, I immediately know what to expect and how fast to dismiss it. And yet, educated adults bandy these words about as if they’re universally accepted currency and not the terms of specific philosophies and/or disrespect that they are.

More intelligent and thoughtful critics speak of long lines, extended waits and an apathetic bureaucracy, as if that isn’t exactly the reality for most as it stands now. At least those are thoughtful points and not like these common criticisms:

“How’s that hopey-changey thing working out for you?/This is what you get for voting for Obama/This is going to lead to an electoral bloodbath in November.” I could say that I enjoy watching Republicans, libertarians and teabaggers self-destruct in their own foam over this bill’s passage. But, really, I don’t. For me, this isn’t about the Democrats scoring a political victory and/or rubbing it in the faces of the snarling GOP. I believe in health care reform. I want it. And while this bill is far from perfect, it’s a tremendous leap in the right direction (right as in correct, not right as in wrong). It’s going to help everyone, not just those in favor of it; that’s why I care about its success. On the other hand, I’ve heard plenty of comments, both from politicians and from friends, suggesting that they want it to fail so that the Democrats run scared. That’s pathetic. I can’t ever recall opposing a Bush policy for the purpose of seeing him squirm; it’s because I don’t like elective war or regressive tax cuts that would (and did) destabilize the economy.

Also, I don’t care if this leads to fewer Democratic seats in November. You aren’t going to scare me with that for three reasons: 1) that’s a historic midterm trend; 2) health care reform is worth the risk; and 3) I’m not all that sure that said bloodbath is a given at this point.

Again, it’s about doing the right thing. And that is the change I voted for.

“Free America died today.” This is a good one. It’s a fascinating mind-set that overlooks all of the very real rollbacks in personal freedom over the past decade, such as the Patriot Act, and decides that helping insure millions of Americans with no other lifeline is the ultimate affront to the Constitution. Never mind that pretty much anyone can point out which specific amendments the Patriot Act violates, while no one has yet given a cogent argument as to what part of the document health care reform dishonors. It seems to me that health care reform promotes the general welfare, which is in the Preamble. But I know how many feel about welfare.

Today’s conservatives have a twisted definition of “freedom” anyway. Whereas they were just fine with trading basic civil liberties for security (or at least the illusion of it) in the Bush years, suddenly freedom is sacred. And what freedoms of ours are under fire? Why, the right to go bankrupt over a hospital visit! The right to not have any health insurance if you don’t want it (those who can’t afford it, by definition, don’t want it because if they did, they’d try harder to get richer). The right to have the free, private market to be your one-stop shop for every service you ever need. Sick? Let’s cross some state lines! How dare anyone tread on those priceless rights!

“Obama and the Democrats want nothing less than total takeover, so that the people of America are fully dependent on the government for all their needs.” As far as complete government takeovers go, requiring health insurance through private insurance companies and having no public option is a pretty lame start.

Anyway, why would this be a laudable goal, even if it was what Democrats wanted? What’s the gain? And if you say power, well, I’d love to hear how that’s anything but Republican projection. After all, color-coded terrorist alert systems, being told to “watch what you say” and repeatedly making the case that we need more government surveillance absolutely everywhere is a form of government control in itself. A very real and tangible one proposed by a president revered by many of the health care critics.

Conservative pundits often chastise Democrats for what they see as pandering for votes with their social programs. The idea that such programs actually help people rarely seems to enter the discussion. Nor does the idiocy of complaining that people vote for those who pledge to help them. Duh.

“This will just give health care to lazy people and other euphemisms I use to describe poor minorities because I can’t say the words I really want to use.” Well, I’m employed and have good health insurance that I intend to keep, but I also support reform. Why? Because it’s not all about me. For all the talk about how America coddles the poor, there’s a frustrating lack of proof for that. Would any rich/middle-class person in America trade places with a poor “lucky ducky” for some government subsidy? Thought not.

Am I wrong to bring up the racism angle? Given that I uniformly run into talk about “incompetent bureaucrats,” “lazy people,” “welfare cheats” and pretty much any descriptor of Obama, I think it’s a valid concern. When people consider the effects the legislation would have on their suffering friends, neighbors and relatives, they might be amiable to change. Make it about an abstract thug, however, and it becomes all about the bootstraps. It’s an old rhetorical trick, and not a particularly imaginative one.

“Liberals own it now.” That’s right, we do. Republicans have absolutely no claim for any success this legislation will provide, and never will. Because every one of them — along with several moderate Democrats — put political gamesmanship above all else. They whipped their constituents into a frenzy over “death panels” and “government takeovers,” which even they knew was irresponsible, but the Party of No decided long ago that Obama’s failure trumps all other goals.

Still, give it a few years, and everyone will wonder how we ever got by without health care reform. The best thought I can have about it is that, in a generation’s time, no one will even give it a second thought.

40 comments:

Ben Langer said...

my god, it's full of strawmen..

Ian McGibboney said...

Name one and tell me why it's wrong. Much of these are directly from people. Lots of people.

Ben Langer said...

“This will just give health care to lazy people and other euphemisms I use to describe poor minorities because I can’t say the words I really want to use.” Would be a pretty glaring one.

It's also interesting how you excoriate people for using epithets like Obamacare and socialist, yet have no problem calling people "teabaggers". Hyprocrite much?

Robert Taylor said...

Mr. McGibboney, foreseer of the future tells us that "in a generation's time, no one will even give it a second thought". I agree, they'll be too concerned with simply finding a roof to sleep under to care about obamacare.

Ian McGibboney said...

Well, Ben, you can look at any newspaper thread in America and find those racial euphemisms. And that isn't limited to health care either. You can say you don't use them, but others are. Nothing I've written is a straw man; I've seen or heard all of those expressions multiple times, which is why I felt the need to address them.

As for "teabaggers," well, they called themselves that first.

Robert, I also hear a lot of the kinds of comments you're saying. Given that the cost of insurance rises every year and was expected to double in 10, I'd like to know exactly why we shouldn't do anything about it (and yes, I know that's what you're driving at).

To both of you: what would you do about health care?

Robert Taylor said...

The obvious step for me would be to not only eliminate Obamacare, but all socialized health care programs. Then, remove restrictions stopping millions of qualified medical professionals from being able to practice medicine today.

The myriad required to pass through to become a practicing doctor in the US is one set up by the bureaucracies in bed with the big lobbies to line the pockets of the doctor and big Pharma.

Increasing the supply of doctors would be a clear and quick solution of bringing health care costs down. The next obvious solution would be to alleviate the big problems aside from supply of what makes health care so expensive: mainly the cost of malpractice insurance. With a simple contract certain underprivileged, or people looking to save money could go to doctors who enter agreements so that their patients cannot sue them, hence no need for malpractice insurance on the part of the doctor and reduced medical fees!

Free market solutions. Like computers, we could get used to prices consistently going down, and not up.

Ian McGibboney said...

Yeah, Robert, I'd be inclined to believe that if the free market weren't the cause of our problems in the first place.

Explain to me how deregulating the medical profession is in any way constructive. I'd like to see more doctors too, but how do you do that without lowering the standards? I'd think that's where you'd want your standards to be highest.

Also, malpractice reform is but one problem that needs to be addressed, and not in a way that limits patients' rights. And only as part of a comprehensive change.

Ben Langer said...

Really, you've actually heard people say a phrase that included the line "and other euphemisms I use to describe poor minorities because I can’t say the words I really want to use." Really? I highly doubt it. What you're doing is constructing a narrative that is easy for you to knock down. That is called a strawman.

Ian McGibboney said...

Ben, you can try to dodge the issue all day long, but eventually you're going to have to offer some actual input. If I didn't know any better, I'd say you're another account from a certain troll I banned because he wanted to make every conversation about me. Or maybe you just all think alike. I don't know.

I seriously doubt anyone reading this actually thinks that's an exact quote, Ben (and I never said it was, just that these quotes represent very common sentiments with my own rhetorical touch). And while I'm sure it's much easier for you to focus on the supposed flaws in my writing than the obvious points I'm making, eventually you'll have to answer my question about health care. Robert did it. Why can't you?

Ben Langer said...

Well when you put something in quotes it usually means it's a quote of what someone said. Since it's not an actual quote and is just a made up phrase used to easily knock down opponents then it's obviously a strawman. You can kick your feet and try to change the subject all day long, but it is what it is.

As for what I think we should do with Health Care, Paul Ryan said it best at that ridiculous health care summit a few weeks ago, I'm sure it's on Youtube somwhere.

Ian McGibboney said...

Well, Ben, I'm not going to hold your hand through my writing. I've done this for years and people seem to know exactly how to take it. If I were quoting someone verbatim, I would do so and attribute it. I could write the same thing with actual quotes, and I'm sure you'd find some other irrelevant way to dismiss my work without touching on any of the points.

I want to hear your own words, Ben. You thought it was worthwhile to accuse me of straw man; why not channel that energy into something productive?

NOLA Progressive said...

I find it curious that a healthcare discussion denigrates into some ridiculous dialogue about whether or not people want to use racial slurs but don't.

That is one point of a rather full post. I'd say "Paging Dr. Freud" personally.

Ian, InsideNOla did a piece yesterday about all of this that I though was very interesting in a disturbing kind of way. It was basically how this bill has become the universal Facebook divide, and everyone is having their own little civil war in the comments section. Almost all of the snippets you included in this post have been on my wall or friends'. Pretty crazy really

I do agree with you that in a little bit of time the douchebag fest will subside, and I don't think it will take as long as you suggest. Their was a Gallup poll conducted yesterday and released today that showed a favaorable response to passage of this bill by 9 points. Now, I think we both are not big advocates of polls, but as this is supposedly not what the American people want, I find it interesting.

There was much the same stuff going on in and around Medicare and Social Security, and only if you're Glen Beck do you take it seriously for long.

Robert Taylor said...

I just listed you a number of REGULATIONS that are raising the price of health care. I haven't addressed quality yet. So first let's get something straight. A patient has no "rights" when it comes to an exchange.

Health Care is just that: a business, guaranteeing certain services in exchange for money, and should be treated as such. Simply because it is so important for people to get good health care, I can't fathom people supporting a business that ran below standards.

If it's cheap and doesn't cure you, it's not like buying a semi-defective bicycle that can "sort of" ride in a straight line. The free market would weed out substandard doctors. A simple google search for your doctor's name before going to see him on a website like Yelp could yield tons of reviews.

On the other hand you have government workers. If you take all other socialized programs in the US like for an easy example let's say the Postal Service, you can see how things will look in the future.

NOLA Progressive said...

Yeah the unfettered free market has done a remarkable job of weeding out deadbeat corporations and private industry types over the last 30 years or so.

Your proposal has merit on allowing for a more fair and open process for doctors to get licensed in the US. Other than that though, it sounds like McDonalds does healthcare. No thanks.

Robert Taylor said...

@NOLA on the contrary, starting with Roosevelt through Eisenhower and all the way to Obama the extent of government's role in health care has been increasing leaps and bounds.

The free market is not what has been raising prices in this subject. I would argue it's precisely the marriage between big business and big government that has not allowed the free market to weed out the nasty corporations. Your beloved Obama bailed out the same companies that screwed the American people with their own tax dollars. All of this sans free market.

Ian McGibboney said...

NOLA - Can you link to the article? I'd be interested in reading it. And yes, I had so much heat on facebook that I actually preserved some of it for posterity.

Robert - I don't see health care as a business venture. No one chooses to be sick, so the market idea is disingenuous. I understand that resources are not infinite, and bloat is bad, but to treat it as any other business is a bad idea.

Also, it assumes that only those who can afford to do so deserve care, which is about the most brutally inhuman stance you can take, and one that the U.S. does not share.

I fail to see letting these corporations do whatever they want can lead to anything but big profits and dead people. As it is, people who pay diligently often see their coverage bounced come crunch time, which is the very kind of bad business that reform aims to curb.

NOLA Progressive said...

I'm not sure how you apply the term "beloved Obama" to our discourse unless of course Ian's earlier supposition proves true. That being said I will admit that "too big to fail" shouldn't exist.

It does seem to me that a little revisionist history is taking place on your part. Clear up for me which president heralded in the Troubled Asset Relief Program?

Also clear up for me, government's marriage is responsible for 100 percent plus rate hikes and dropping patient's mid chemo? You do realize that health care and health care insurance are not the same thing?

NOLA Progressive said...

Here ya go Ian http://www.nola.com/entertainment/index.ssf/2010/03/health_care_reform_is_the_grea.html

Robert Taylor said...

@Ian No one chooses to be hungry, but they get hungry. So food should not be a business either, Ian? You could say this about anything. All human action is about exchange and choices. The only way to economize large tasks is for their to be a group of suppliers that can support the needs of the market (buyers).

It seems you fail to see how "corporations [that] do whatever they want can lead to anything but big profits and dead people" because you think dead people can pay for things. How do big corporations get their money from dead people? I don't get it. In a free market, the only way to receive money is from a voluntary exchange. An exchange a customer can choose to conduct elsewhere if a company is not up to their standards or worse yet disingenuous in which case they can sue for being lied to.

NOT SO in the system you want.

Ian McGibboney said...

Robert, the dead people would be the ones who could not afford health care in the first place. What would you do? Let them die? Do they deserve that fate because they didn't or couldn't accumulate wealth in your precious system?

I understand what you're asking about food. I thought of that same point when I was writing my previous comment. But here's the thing: people shouldn't starve to death. What would you do?

Robert Taylor said...

@Ian well clearly since we are both nice guys Ian, we would personally sacrifice our larger incomes (this is assuming our taxes were significantly lower if not non-existant) that we have since we converted that money which was never made into taxes into a prosperous blogging business, and donate a giant portion to helping those starving and sickly people.

In fact, it wouldn't just be you and me that would be so charitable, it would be each and every person including NOLAProgressive that would help out. AND, what would be so COOL!! is that it would all be voluntary. Jesus is happy because no one is forced to do anything against their will. We all win.

Ian McGibboney said...

I favor charity (in fact, I just spent $150 on a charity dinner ticket today), but it's never enough. We need a safety net that's always with us. I don't mind paying taxes to know that people aren't left with nowhere to go. It's a complex issue that can't be reduced to all-voluntary contributions.

I will say, though, that a blog business sounds awesome.

Robert Taylor said...

@Ian well email me and let's start some brainstorming. I'm in.

As for charity... charity alone would not solve the problem. The free market bringing down prices for the reasons I listed above included with the charity would "solve" the problem as much as it can be "solved".

NOLA Progressive said...

I have to say kudos to Robert. I don't agree with him. Our outlook on government involvement is vastly different but god knows my opinion is worth not a whole hell of a lot in the grand scheme of things. I'm just tickled to have a reasonably civil discourse that discusses actual ethos and not ad hominem and insults.

I have no problem agreeing to disagree.

Robert Taylor said...

@NOLA thanks I appreciate it and I just want to post a visual representation of the system Ian supports: http://bit.ly/aa0hD4

And the system I support: http://bit.ly/aKf2iL

Ian McGibboney said...

My chart looks like a circuit board, while Robert's looks like the providers are literally anally raping the consumers.

Simpler is not always better.

In all seriousness, though, this has been a strong discussion.

Kinmin said...

Just so everyone knows, "ObamaCare" is not an insult. Liberals are using it, too. The difference is that we (i.e. liberals) will still be using it in the years to come, but the Republicans will stop using it because they won't want to be reminded of how Obama helped them get insurance and medical coverage that is currently unavailable, too restrictive, or too expensive.

Also, the author is correct to question what alternatives the Republicans are suggesting. Just saying "no" all the time doesn't work by itself. You also need to offer an alternative to which people can say "yes." So far, that has not happened.

heykelley said...

Just came across this discussion and wanted to add some insight from my perspective as an intensive care nurse who along with being an American and living and working here for several years has also worked and lived in Canada, England, The Netherlands, and a few African countries. Here in the States,
what happens if a person DOESNT freely protect himself/herself or family from a medical disaster by purchasing health insurance either because they cant afford to or decide not to?
I will tell you....we(including myself) end up paying for them.
Americans do not expect supermarkets to provide food for the hungry, department stores to provide clothing to the poor, or hotels to provide shelter to the homeless......they do, however, expect a hospital to provide medical care to everyone, regardless of whether or not the person can prove he/she can pay for the services. We see this everyday, every hour in the emergency rooms and intensive care units across this country. Can you imagine the uproar in this country if I walked through my unit and literally "unplugged" the 2 or 3 people at any given time out of 14 beds without any health coverage ,saying sorry Dude....no cash......no services. I am guessing I would be tried and found guilty of murder for simply not providing something for free. Yah....I think Americans think the provision of health care is a Right...(food, shelter, clothing...No...but health care....at least to some degree...Yes) and therefore we as a society together have to come up with a way to provide it for everyone and make everyone responsible for it.
Charity alone was probably feasible years ago but with our very advanced life saving surgical procedures like open heart surgery which was first performed in the mid 60's and is now done routinely(though continues to require enormous resources, specialists, expertise, and time)...and therefore money...the elderly patient whose life expectancy was 70 in the 60's and is now 78 is routinely having these surgeries and benefitting greatly and only possible through medicare....another "socialized" system. I would like to put all the money I am and have been dumping into health insurance companies(which I have very rarely used) and which will dump me when I retire and can no longer afford it and put it into a one payer system supported by all of us citizens so that I can dip into this money when I actually will need it......when I am old!
Quite frankly....I found the Canadian system excellent both as a worker and a user in the system.....and by the way, Canadians dont consider themselves socialists......so everyone wins.

Robert Taylor said...

@heykelley I like that. You just tell yourself you're not Socialist and everything's alright.

Ian McGibboney said...

I couldn't care less if people call themselves socialists or not. Though it is amusing that you think we'd find that to be as evil a term as you do. Kind of like how conservative trolls tell me, "Admit it! you're a liberal!" As if that's some kind of ownage.

What I see here boils down to two arguments:

1) Universal/socialized health care has shown to work very well and save money in the long run; also, we can't afford, either financially or morally, to keep people sick.

Versus

2) Tough shit if you can't pay for it.

One of these is more compelling than the other.

Robert Taylor said...

@Ian look I'm not saying being a Socialist is a bad thing necessarily. I just think it's interesting that you would ever deny that Socialism is exactly what all these tax-supported programs are.

I can't however allow you to simplify the arguments for and against Obamacare the way you just did because you do a disservice to the multitude of arguments out there, and moreover you have not proven that Socialized health care is a proven way to save money.

Lastly, I wouldn't really call you a liberal Ian. I mean if we were to lay down your views on a chart, I'd say while you're clearly a leftist, you'd fall under a quite authoritarian-leaning philosophical position given your views on state-imposed collectivism.

Ian McGibboney said...

I could only seem like an authoritarian to an anarchist.

The government is us. Yes, it's corrupt with lobbyists and corporate influence, but ultimately, it's not there to rule us; it's there for our protection. We run it. The only alternative is to end it and put it in the hands of private enterprise, which is responsible to no one but those with a stake in it.

Which, by the way, is essentially what happened in post-USSR Russia, which is why you need bribes to buy almost anything there.

Finally, Robert, your definition of socialism seems to be anything that takes money from someone else and allocates it towards another. By loose definition, that makes our entire country socialist.

Robert Taylor said...

Well that's right Ian. There's no nitpicking on my part. All programs, whether it is Obamacare or the Military are Socialist programs. Roads are Socialist. Schools are Socialist. I am simply staying consistent on my definitions. These are not opinions.

Moreover, because taxes are not voluntary in this country, these programs are clearly Socialist Authoritarian programs. In other words, all peoples living between the borders of the country are forcefully subject to paying without exception. Authoritarian.

It seems you support the expansion of these compulsory programs and distribution of wealth. This is not the position of liberals from whom the word come from Liberty.

Simply saying that the government is "us" and we are the government doesn't remove the fact that there are people like myself that are opposed to the plans of the government. If I feel no connection or agreement with the government then it is clearly an authority over me. It is not me. It is not protecting my values moral or otherwise.

Ian McGibboney said...

I actually agree with you on the definition of socialism, Robert, and I've mentioned that in many past blogs. What I'm saying here is that using such an all-encompassing definition of socialism derails your vision of it as a boogeyman.

As much as you claim to despise government and its supposed authority over you, I'll bet you couldn't live a single day without using something the government has made or compelled a company to make better: roads, cars, food, sidewalks, even your own home. Hell, how about currency? I don't know how you feel about so-called fiat cash or the gold standard, but I bet you still use it, don't you?

Sure, there are instances of government overreach. But single them out. Saying you're a proud island lends no credence to your points.

Robert Taylor said...

Ian, non of my animosities from the government are based on delusions. I've layed out a clear case for why I think government is the wrong direction for society to take.

But don't get me wrong. Unlike the republicans that bastardize libertarian ideas, I don't believe myself to be an island and I stand strongly as ever against the concept of someone pulling themselves by their own bootstraps. All of society and this country is the result of cooperation and exchange. Exchange. Exchange. Exchange is what determines value. Yes I have my own bootstraps, and I may require your services to help me tie them. But they are mine and my hiring you should be voluntary.

And yes clearly I think that because my unwaivering support for non-aggressive society based on free will I believe I stand on higher ground on that concept that is so important for you to bring up: morals. I consider the basis of a satisfactory universal ethic and a point that loses all the good you're trying to promote. Forcing people to do things for the "greater good" is oxymoronical and in my opinion a great injustice. The greatest even because it's inconsistent but promoted as a morally superior position with all it's inconsistencies.

Robert Taylor said...

Ian, are you aware of Noam Chomsky's Anarcho-socialist position? What do you think?

Ian McGibboney said...

Personally, I'd rather pay a few dollars a year in taxes to support public roads rather than pay a few dollars every time I have to drive down somebody's private road because that's what the "exchange" rate is.

Capitalism is about profit. It isn't self-regulating toward the public's benefit. Trying hard to tie this discussion back to health care, we've seen why insurance companies need more oversight: because they do what's best for them, not the customer/patient. Covering catastrophic injuries cuts into their profits, so they'd drop people. And I know you're going to say: If the client isn't satisfied with their service, get another carrier, right? Free market. But it's not nearly that simple, for reasons I shouldn't have to go into. As I've said before, not everything needs to be a shopping mall. If I get mugged and bludgeoned, I call 911, not various providers to get the best rates. But I digress.

Anarchy in any form is a form of legalized extortion. And I'd be far more afraid of that than some governmental boogeyman. And that fact that Noam Chomsky advocates (at least in 1976) for a form of anarchy is not going to sway me on that.

Robert Taylor said...

LOL Actually Chomsky published his book Chomsky on Anarchism in 2006, not 1976. He's actually spoken about his views extensively. He's spoken of his hope for a socialist democratic world based on voluntary cooperation. Just wanted to suggest another viewpoint that agrees with your economic views while taking the Authoritarianism out of the picture. Maybe you should read the book. Either way I disagree.

Capitalism is about profit? Human action is about profit. And yes capitalism is designed to benefit the public's interests. I'm happy to provide you links with actual forms in which a free market would resolve problems like roads and healthcare but I don't see how anarchy would be a form of legalized extortion. Extortion is a method of the singularly powerful, like governments. Now if you meant extortion's synonym blackmail, I don't find anything wrong with blackmail...

Ian McGibboney said...

The problem with any system of unregulated, collective sharing (communes, communism, absolute socialism) is that it works only in a vacuum and unravels the first time something goes wrong.

This is also true of anarcho-capitalism and a pure free market.

The system we've got now, where people pay into and vote for a government to protect us from the excesses of both extremes, is not perfect, but it works. And it doesn't have to be perfect to work, whereas both extremes do.

So that's my take on it. I think this discussion has veered away from its original subject, as it often does between us. Agree to disagree.

heykelley said...

Very well said Ian.If people want to call me a Socialist because I think a one payer universal healthcare system would be best suited to address the very real and very serious problems we are presently experiencing with healthcare....just fine. But it is disingenuous. In a society, I think socialist ideas have a place as well as free market and capitalist ideas. There is no perfect system....the answer truly is somewhere in the middle of all of them for the very reason you pointed out...it doesnt have to be perfect to work. But now back to healthcare:
If we have a true free market society, I still never get a direct and feasible answer to what are we supposed to do with the people who have chosen not to buy medical insurance or cant afford to, who then show up at the hospital in desperate need of lifesaving medical care?....and I do truly doubt that even Robert would suggest that we refuse them lifesaving medical care....so then....someone has to pay. Charity alone is not the answer because it is not guaranteed and because it would not be enough. Charities do well and play an important part when the care being provided is unsophisticated, cheap, and often palliative. The complicated, resource consuming,and time intensive lifesaving medical interventions that are used regularly and with greater and greater success in todays modern medical practice couldnt possibly be paid for by charity alone. On an average day, a walk through my small 14 bed local adult ICU unit would reveal approximately 2 to 3 adults under 65 without any form of health insurance, 3 to 4 adults under 65 with health insurance coverage, and then 7 to 8 adults over 65 and retired who are being covered by medicare. I would include here that the age of the clientele are getting older and older. We didnt need medicare prior to the 60's for the simple fact that our medical advances werent where they are today. Back then, sure Doctors would see some of their elderly clients for free because all they were offering was a reassuring presence and a few aspirin.....now they have any number of complicated life- prolonging and at times(but not always) life improving procedures in their arsenal and trust me...theyre not going to give it away for free.
The other thing that comes to my mind when we discuss the "free market" and healthcare is the assumption that people are actually rational when it comes the healthcare of themselves or their loved ones. A "free market", I presume in order to work well, would have to have consumers thinking rationally about the products and their perspective costs. I know I do this everytime I shop for anything or actually for any service....except healthcare....In my experience, I have never heard anyone utter anything other than they want the VERY BEST for their Mom or Dad or Son or Daughter......and very irrationally they assume more expensive MUST always be better or, at the very least, they never want to come off as if they were pinching pennies when dealing with the healthcare of their loved one. A medical product or procedure that is more expensive is almost always preferred than a cheaper one, even when patients and their families are given information that doesnt support the more expensive one as being any better....why?...because healthcare is truly unlike any other service or product out there and therefore wont behave the same as other products or services in a free market.