[philo]

public healthcare is a nice idea but we can't afford it.  We should allow competition without subsidies, the privatisation of the healthcare system at the moment get the hand outs from government so what's the difference?  I'd like a free market, no government involvement at all.  Competition will drive higher standards


EDIT:

I have no problem with the government helping those who need it, but the young people should be allowed to opt out of paying taxes towards things like the military industrial complex, healthcare and welfare.
We could still allow some money for the elderly who depend on it etc if we cut the military spending and the wars.  We could also cut the 45 million a day we send to Brussels each day which could help.  Small government is the only solution, a recession is the markets answer to the bubble economy - we should embrace the recession as its the solution to the years of bad investments and borrowing too much as a result of artificially low interest rates.

Is it impossible to think that interest rates could go to 10%? 20%?

When the real economic collapse comes then it doesn't matter if your getting helicopter Merv to drop money out of a helicopter. 
The fundamentals are wrong and a correction needs to occur. 

[slackline]

public healthcare is a nice idea but we can't afford it.  We should allow competition without subsidies, the privatisation of the healthcare system at the moment get the hand outs from government so what's the difference?  I'd like a free market, no government involvement at all.  Competition will drive higher standards

Read the links I posted and other evidence based literature, such competition does not improve standards, rather it leads to over-prescribing, cutting corners (to maximise profits) and in turn lower standards of care (in part reflected in the life-expectancies cited earlier in the thread).

I wasn't particularly asking whether you thought it was sustainable or how it should be funded though.  As with every aspect of large government bodies/companies there will be some wastage and some savings could be made, but a public healthcare system that provides the basic needs of a society can be funded publicly at higher standards than those provided privately. 

I'd love to have a say in how my taxes are used but realistically thats not going to happen.  If you can afford private healthcare then I doubt the burden of paying your tax is going to be much of an issue.

[Fultonius]

I don't know how you can keep drumming that "free market efficiency" drum without ANY backup.

It's as if you just believe it to be true and therefore it is. As slackers has pointed out, all the evidence points to the opposite conclusion.

Have you ever properly worked in the private sector? In a world beyond idealistic economic models?

I've spent the last 5 years working offshore for an Oil and Gas services company (doing pipeline and rotating equipment vibration investigations - thankfully out of it now!)

In my experience, you would not believe the amount of waste that occurs in the "perfect free market economy". Things like turning up to a platform on the request of the client to look at a compressor. Turns out the compressor has been out of action for 2 weeks and will be for another 2. We can only do our survey with it online. So, the client still pays us our £50k or whatever as we've been out there and sat on our arse for a few days before getting sent home to go and do it again another day.

This is not an isolated incident, it happens all the time. Who pays for this?  Not the producers....no....it's gets passed on to the consumer. You wonder why the oil price is so high? (Well, a large percentage is due to price fixing) but the baseline cost of production is rising, not falling.

Go and read The Undecover Economist and get some balance on the issue of public healthcare.

No one can disagree that privatising healthcare will, in the short term, reduce government spending. But it will, in the long term, lead to an increase in national spending on healthcare.  Someone's got to pay for it, so it either gets paid through taxation, or directly by the consumer. If privatised, we will also have to pay for the profits of the healthcare providers, and, pay again to fix the balls-ups that will occur. (like the old peoples homes in England)

One is cheap, effective and has no incentive for profit maximisation, but with room for improvement. The other is expensive, wasteful and has not been proven to provide any improvement to care.

All it will do is line the healthcare providers pockets with loads of PUBLIC money, just directly, rather than through taxation.




I don't say any of this on idealogical grounds. I'm all for efficiency in the public sector, reduction of state provided services where the private sector has been proven to be more effective.  I think that unemployment benefits should be reduced, but this money (and more) should be spent on much better services that can aid people to get back into work, rather than trap them in the welfare state.  However; unlike you I would like all government decisions to be based on evidence based research...

[drdeath]

 

 As true today as it ever was:

The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.

John Kenneth Galbraith

[philo]

before I went into education I worked in web and graphic design.  It was fine actually but i'd rather spend most of the year surfing.  I only plan to be in this country for another couple of years then I can finally fuck off towards Asia.  For the same reasons above. 
Idealistic or not, liberty will prevail.  When we talk about the efficiency and the "running" things, the government doesn't run anything, free people run things. 
In your example Fultonius, the burden of waste lies with the company and not dumped onto the tax payer by the government.

Look at Northern Rock and Branson, the fact that he didn't want to buy up the bad assets etc shows that they are worthless.  They knew they were worthless back then and "we" still bailed them out. 

In fact, do you agree with the bailouts of the banks and too big to fail?

[Andy B]

To my uneducated eyes, you seem to be just repeating yourself, without attempting to answer many of the questions put to you Philo.

Idealistic or not, liberty will prevail.

Do you not think that this "liberty" would be only confined to those who could afford it under your economic vision?

[slackline]

No I don't agree with the bailout of the banks/too big to fail.

That doesn't provide evidence that private healthcare improves standards which is the very specific point I am labouring because you have repeatedly said you "argue" or just plain believe that "competition will drive standards up".

If you're sitting on some information that supports your stance on this very specific point within the various facets of what is being discussed then I'd be very grateful of a link as it is contrary to all the peer-reviewed research I've read.

[Stubbs]

but the young people should be allowed to opt out of paying taxes towards things like the military industrial complex, healthcare and welfare.

Are you suggesting that national security is put on the free market too, perhaps we could have three different armies and decide which on is doing best, and pay them to defend us?

[philo]

the role of government is to defend our life and our liberty.  National defence and promoting democracy by force in other nations are two separate things.  People misread this as "isolationist" but an isolationist country is like North Korea.  We should be able to trade and communicate with other countries instead of bombing them. 
Look up the meaning of "military industrial complex" next time

I should of made clear, I am for a defence of our borders but we should not go into nation building and helping america be the policeman of the world.

[Stubbs]

This is your definition of the role of government, and it sounds like it originates from the formation of the United States to me.

I did, this included me looking up the meaning, and reading Eisenhower's address from which the term originates.

All your answers have a copy and paste feeling to them, is there a libertarian handbook we can read, rather than you just quoting the bits that suit you?

[philo]

haha no I type them all myself, I do realise that it looks a bit constructed and I constantly edit my posts to add other information.  Theres many questions going on through each post and a lot of explanations. 

I could just point you to the Mises Institute that teaches the Austrian Economic school of thought.  Might explain things better than I can about certain topics.  Everything I post is my views and understandings, whether you agree with them or not.

http://mises.org/

EDIT:

Your correct, that is MY understanding of the role of government, I wish we had a constitutional republic like the US where 51% do not control 49% but we cannot be perfect

[slackline]

We should be able to trade and communicate with other countries instead of bombing them. 

No, you've got that all wrong, we trade with them and then bomb them...

.....the US where 51% do not control 49% but we cannot be perfect

  You looked at the votes for the last two elections (and countless others) here in the UK in relation to the number/percentage of votes cast for each party and how these translated into seats won haven't you?

[philo]

Indeed it is a complete joke, i voted YES for AV but its still a floored system.  Too many politicians have safe seats, we could do with an open primary system so we could hold our elected officials feet to the fire.  Hicks died far too young!


Here's a couple of articles weighing up competition in healthcare.

http://content.healthaffairs.org/content/24/6/1512.full

http://www.efm.bris.ac.uk/ecsb/papers/deaths.pdf

BBC healthcare costs:  (2009) can anyone find a more recent update?
http://news.bbc.co.uk/1/hi/health/8201711.stm

[slackline]

Here's a couple of articles weighing up competition in healthcare.

http://content.healthaffairs.org/content/24/6/1512.full

A retrospective piece, scarce on evidence as to whether privatisation actually improve standards (no actual quantitative statistics at all).  Basically says that patients are customers and companies need to provide high levels of service at a price their consumers are happy with, which is exactly what you'd expect under a free-market.

http://www.efm.bris.ac.uk/ecsb/papers/deaths.pdf

Reinforces what I've been saying, from the abstract...

...we find that the relationship between competition and quality of care appears to be negative. Greater competition is associated with higher death rates, controlling for patient mix and other observed characteristics of the hospital and the catchment area for its patients. However, the estimated impact of competition is small.

BBC healthcare costs:  (2009) can anyone find a more recent update?
http://news.bbc.co.uk/1/hi/health/8201711.stm

That shows me the US spend a shit load for not much better.  If you're advocating the French system which is non-opt out compulsory social insurance, to my mind thats equivalent to a tax.

I'm not yet convinced that privatisation leads to an improvement in standards of healthcare I'm afraid.

[drdeath]

Not scared to be the internet pedant in this kind of stramash, I find myself compelled to wade in here...

When someone advocates the discussion of competing complex models of economic and political philosophy it would serve them best not to insert ludicrous malapropisms such as referring to AV as a 'floored system'...

And you are apparently 'in education'....Good grief.

Do you work here by any chance?

[philo]

AV still allows "safe" seats, as I said - id prefer open primaries when people can vote for who they want and it might actually change things.

Slackers, the US system is fucked too.  By privatising healthcare, I don't mean the subsidised Medicare/Medicaid system of the US.  We have not tried free market competition so how can we compare to it?  Get the government out completely - then we would not have any lobbying for who gets to supply the drugs etc. 
The French system too, the government should not be involved at all

To add, I'm looking at the bigger picture.  We are still going deeper into debt, stimulus and QE does not work.  If debt is the problem, how is creating more debt the solution?  If we are serious about growth then we need to cut.  Cutting across the board, health, welfare, military, everything.  Im no expert in the healthcare service but in my opinion, and ill try gather figures (though its hard as systems of practical existence are quickly threw out by the politicians) 

People should understand Austrian Economics, I'll post some things to try clear a few things up


To those who are looking for more information, http://mises.org/ is a great source of information.
Do your own research, I have attached a couple of examples that I have read below, there will be more on here:
http://mises.org/periodical.aspx?Id=4

Most are sourced from  "THE QUARTERLY JOURNAL OF AUSTRIAN ECONOMIC"  which is an excellent read.

Looking at socialised healthcare and socialism:
Slackers, alot of this is looking at the problems that the US system would have with Obamacare, some reference to the UK:

http://mises.org/daily/3613

http://mises.org/freemarket_detail.aspx?control=279

http://mises.org/daily/3586

http://mises.org/journals/qjae/pdf/qjae13_2_2.pdf

http://mises.org/journals/qjae/pdf/qjae4_4_6.pdf


Less important to read:

http://mises.org/journals/qjae/pdf/qjae10_4_1.pdf

http://mises.org/journals/qjae/pdf/qjae10_1_3.pdf


Broader scheme of things and Austrian Economics:

If Pure markets are so good, why don't they exist?
http://mises.org/journals/qjae/pdf/qjae13_2_2.pdf

Before and after the Euro.  Strategies for sound currencies:
http://mises.org/journals/qjae/pdf/qjae5_4_2.pdf

[tomtom]

Hmm... a look at the Mises Institute sadly had my 'propogandameter' (tm) hitting a 9.5 and rising...

It didnt feel like there was much balance there...

A little gentle googling also revealed a rather unsavoury past with some racisist and homophobic comments coming from some of its members (President IIRC..). Though this was over 10 years ago... and some of it may be linked to a history of its links to the confederation and the 'deep south' (it is based in Austria Alabamha, not Austria, Austria...). There were also some more recent allegations of bullying of web posts/message boards etc... that were critical of its views. 

[slackline]

Slackers, the US system is fucked too.  By privatising healthcare, I don't mean the subsidised Medicare/Medicaid system of the US.  We have not tried free market competition so how can we compare to it?  Get the government out completely - then we would not have any lobbying for who gets to supply the drugs etc. 
The French system too, the government should not be involved at all

Here in lies a crux to your stance.....

Under your proposed free market competition what happens to those who can't afford privatised healthcare??????

What do you propose such people do/happens to them when they get ill or injured*?

A few alternatives would be...

a) Ah well, they didn't have the foresight to pay for it, its their loss, fuck 'em.

b) Ah well, they couldn't afford to pay for it, its their loss, fuck 'em.

c) Ah well, they couldn't afford it or lacked the foresight but we are humans, so lets be altruistic and help them.

d) Ah well, yes, hmm, errr well I hadn't accounted for that portion of society.

Of these three options I would prefer c) because lets face it, in Western societies the standard of living is for the majority pretty damn good.  Under such a system you then end up with people like yourself who seem to resent state provided healthcare being available for all, when yourselves are just as much in need of it, but don't like the fact that there are those who, for whatever reason, can't afford to pay for it the same way yourself has done (or would like to).

However, given that everyone needs healthcare at some point its fairly reasonable to say that its a basic human right (if you disagree with this then please say so and I shall not bother wasting my time any further).

Given its something that everyone needs, surely the best approach would be to get value for money, which, based on the evidence I have cited is not achieved through a free market healthcare system.

Looking at socialised healthcare and socialism:
Slackers, alot of this is looking at the problems that the US system would have with Obamacare, some reference to the UK:

http://mises.org/daily/3613

http://mises.org/freemarket_detail.aspx?control=279

http://mises.org/daily/3586

http://mises.org/journals/qjae/pdf/qjae13_2_2.pdf

http://mises.org/journals/qjae/pdf/qjae4_4_6.pdf


Less important to read:

http://mises.org/journals/qjae/pdf/qjae10_4_1.pdf

http://mises.org/journals/qjae/pdf/qjae10_1_3.pdf

I'll read those later, but the main problem with the US system is exactly what I've highlighted above, it purports to be fully privatised, and yet there is a large proportion of the population who simply can not afford the premiums which, as I've already highlighted, are artificially inflated because unnecessary tests/futile treatments are undertaken because what the fuck does it matter the insurance companies will pay, which is a vicious circle.

It would be lovely to think that we can/do live in a utopian society where everyone is affluent and can afford everything at the prices they are charged, but to take a few words from Ice-T's opener.....



(i.e. "Shit ain't like that, its real fucked up...")

So you're being exceptionally idealistic (usually its me being accused of this).  If you purport to wish to have value for money with regards to healthcare and actually believe that everyone is entitled to it (this is perhaps the caveat that is unclear to me) then this is best achieved through a publicly funded healthcare system which does provide value for money (i.e. the aforementioned QALYs).

Basically, with regards to healthcare,  you seem to be devoid of a fairly unique (out of all animal behaviors) human trait of compassion/altruism for helping those less fortunate than yourself because you don't think that anyone has the 'right' to healthcare which I find quite disappointing.  Compassion/altruism for others of our species (without recourse to nepotism) is pretty much one of the defining features that sets us apart form other animals (disregarding being bipedal).

As I've already said I'm picking on one very specific aspect of what you've written.  Its not because I don't believe what you are saying, its because the evidence so far shows that privatised healthcare does not lead to improved standards as you seem to believe.  Ignore this if you like, but you can't change facts.

[philo]

Slackers, I agree the US system is not the solution, its the government who guarantees the insurance so that's one of the reasons the prices have sky rocketed. 

If you look at what happened before the introduction of Medicare/caid in the US you can see no one was left to die, there were charity run hospitals and even (god forbid) church run hospitals where people were looked after for free.  It's not until the government got involved and prices rose and priced out the charity hospitals etc

you might find this interesting slackers
http://freenation.org/a/f12l3.html


RP is not racist or a homophobe by the way tomtom

and here is a nice video for you to watch about RP and the economy:

[slackline]

It didnt feel like there was much balance there...

Highly unlikely to given that it states that it...

...serves as the world's leading provider of educational materials, conferences, media, and literature in support of the tradition of thought represented by Ludwig von Mises and the school of thought he enlivened and carried forward during the 20th century

..so they'll just be banging out shit that supports that school of thought rather than being open to peer review/critique (in that spirit similar to the Myers-Briggs Foundation/bullshit).

[slackline]

Austerity isn't the solution was interesting, be good to hear what others with greater understanding/insight think of the points made.

[slackline]

Cheers, I realised a while ago that economics is in no way science and is basically pure conjecture.

I can see that for some countries austerity is likely the only solution due to debt, but is it the best solution for all if, as is mentioned in the article, based on history/experience it only worsened the situation?

Thats not to say that the opposite extreme of throwing caution to the wind and spend, spend, spending.

[gme]

Stiglitz ideas partly make sense to me but partly don't. I, probably like most people, don't know much about the finer points of world economics and when i try to read about it it ends up going over my head and i just turn the pages to the sport section.

However i know enough about my own personal financial situation to think that making cuts in spending is essential when times are hard and you cant see income increasing in the foreseeable future and then work harder to try and improve your financial position.

I presume he is suggesting that we continue to borrow and invest, in infrastructure projects, our way out of the situation we are in but is this not partly how we got ourselves in the mess we are in now.

I personally think that what we are doing in the UK is about right, cuts have to be made but we need to invest in the right kind of projects ie Energy production and transport as Stiglitz suggests. And this appears to be the way we are heading.

I never thought i would side with the torys but it would appear that at the moment i do. (didnt vote for them or the other mob in power)

[slackline]

Mobile versions of Wikipedia aren't blacked out today apparently (not checked though as the building I'm working in today is killing phone signal).

[philo]

The problem is when the austerity is placed upon the tax payers to bail out the banks etc.  The only way we can get out of this is to save more and cut spending.  The problem with these massive infrastructure projects that are rolled out by the government when we simply cannot afford them.  I wonder how much the Birmingham - London rail service will actually cost, it will create jobs temporarily and will probably buy the votes of those affected but at the expense of everyone who pays taxes to pay for it. 
I still believe that if there is a genuine supply of a service or or project, there will be private investment and incentive to do it.