The Battle Bar, Our Wretched Hive of Scum and Villainy

Started by psmith819923,287 pages

This is idealistic at best, but more accurately described as deliberately reckless. This is basically the textbook case of market failure; when a person's life is on the line there is not much room for rational comparison of alternatives nor time for competitive selection of services. There is always a time- or geographic- or panic- based distortion of a patient's decision.

But....As the guy above me defined it, the consumer would have a choice between UHC and private healthcare, in which case he IS choosing one over the other. Whichever one he chooses will be intimately involved in a life or death situation. So explain to me how that's different than what you're saying?

More to the point, we already have had a largely free market in which the current problems developed. Unless you want to regulate some barrier to insurance companies, rational consumers will always seek to buy insurance based on asymmetric information (and impose their unique risk profile on a larger pool of insurance consumers). So not only does a completely free market not fix our current problems, it ends up causing them in the first place.

No, we do not have a largely free market, we have the illusion of one. This debate tires me really. One side says that the free market caused the problems in the first place. The other side says it too oversight.. My idea for free market healthcare assumes we get rid of 3rd party interruptions (insurance companies).

I strongly believe that basic healthcare is a good which has to be provided by the government in order to achieve any kind of equitable treatment of different demographic groups.

And when you can find evidence of such a thing existing successfully for 300 million people, let me know.

For example, Hospitals which charge $50 for a saline drip do so on the assumption that an insurance company is covering the bill. However, the hospital can not really consult with the patient about every health-care decision; patients are by definition either unable or unfit to evaluate their own care. So the decision to push fluids (at whatever price) is not one that can be optimized by rational agents operating in a market! Even fully rational consumers will fail to judge reliably between transactions which are beneficial to them and those which are unnecessary

Maybe it's late but you've lost me. First, ive recently learned that for whatever reason, my brain cannot process "confuse A with B", or "confuse A for B" or "replace A for B" or "replace A with B". I CANNOT for the life of me move past this. At ANY point. But knowing what I know about system inefficiencies and market distortions, I assume you think I'm looking at inefficiency when I'm really looking at a market distortion. I don't understand your example here either (again, probably because it's late). What does a hospital charge have to do with consultation about necessary/unnecessary treatment? Regardless of the charge, the doctor tells me if something is necessary or optional, and then I look it up for myself so I can act as my own rational agent in conjunction with the doctor. So instead of paying $500 for an MRI, I could pay $75 because the hospital won't have to worry about insurance company fighting over 70% of the bill. Again, I don't see where you go from discussing hospital costs with or without 3rd parties, to the benefit of rational decisions.

So even if Hospitals were constrained to charge only prices that consumers are willing and able to pay, there is a clear and persistent market distortion in the sense that consumers of healthcare are axiomatically incapable of even approaching full information, let alone making rational decisions.

Give me an example of full information. I get wisdom teeth removed, my insurance covers a portion, with full anesthesia it costs let's say $1,000. Explain to me the necessity of rational information if the procedure foregoes the insurance companies and costs me $100. The difference between "necessary" and "optional" is still there, except that "optional" has become more appealing to me since the cost is significantly reduced. What am I missing?

YouTube video
This was actually very well done.

Originally posted by psmith81992
But....As the guy above me defined it, the consumer would have a choice between UHC and private healthcare, in which case he IS choosing one over the other. Whichever one he chooses will be intimately involved in a life or death situation. So explain to me how that's different than what you're saying?

Oh, I wasn't endorsing anything anybody else said.

My point is this: consumers are not able to choose rationally between different health procedures. The market for health procedures is not a good candidate for a free-market system of resource allocation.


No, we do not have a largely free market, we have the illusion of one. This debate tires me really. One side says that the free market caused the problems in the first place. The other side says it too oversight.. My idea for free market healthcare assumes we get rid of 3rd party interruptions (insurance companies).

I don't believe that a "free market" ideology would actually eliminate insurance companies. Mitigation of risk is a perfectly rational course of action for any kind of consumer, and if the government steps in and prevents insurance companies from forming then the market isn't really "free," is it?

Additionally, I believe that the problem does not lie with insurance companies. Even without insurance companies, consumers would be unable to choose their health care operations rationally.


And when you can find evidence of such a thing existing successfully for 300 million people, let me know.

🙄
Obamacare is off to a p good start, eh?


Maybe it's late but you've lost me. First, ive recently learned that for whatever reason, my brain cannot process "confuse A with B", or "confuse A for B" or "replace A for B" or "replace A with B". I CANNOT for the life of me move past this. At ANY point. But knowing what I know about system inefficiencies and market distortions, I assume you think I'm looking at inefficiency when I'm really looking at a market distortion. I don't understand your example here either (again, probably because it's late). What does a hospital charge have to do with consultation about necessary/unnecessary treatment? Regardless of the charge, the doctor tells me if something is necessary or optional, and then I look it up for myself so I can act as my own rational agent in conjunction with the doctor. So instead of paying $500 for an MRI, I could pay $75 because the hospital won't have to worry about insurance company fighting over 70% of the bill. Again, I don't see where you go from discussing hospital costs with or without 3rd parties, to the benefit of rational decisions.

I believe that the emphasized portion is simply false. This is a question that could be settled by research; I am sure that patients' ability to successfully participate in their own care has been researched. My suspicion is that people are not good at this function. I think that even people who are well-equipped to participate in care-decisions (like doctors) will do poorly when confronted by their own health-needs.

Because of this belief, I am arguing that even a market system free of 3rd party distortions will fail.


Give me an example of full information. I get wisdom teeth removed, my insurance covers a portion, with full anesthesia it costs let's say $1,000. Explain to me the necessity of rational information if the procedure foregoes the insurance companies and costs me $100. The difference between "necessary" and "optional" is still there, except that "optional" has become more appealing to me since the cost is significantly reduced. What am I missing?

Wisdom teeth is less of a challenge for the free market to deal with. My concern is for life-or-death operations like dialysis or immediate emergency care. There is no way for a person with Kidney failure to shop around and agree to only mutually beneficial trades.

Even slow-moving diseases struggle to fit into the free-market system. If a patient is feeling better, but not yet cured, then they have a powerful, coercive* incentive to get up and go back to work. This is an example where a person may make a (rational) choice that sacrifices their health in service to their financial outlook.

Spoiler:
*Poverty is coercion.

Additionally, hospitals oftentimes render treatment with patient agreement even if the patient is not in a frame of mind to make legally binding agreements otherwise. For example, using the previous example of acute pancreatitis, you are given powerful pain killers to keep you out of pain (as they can only treat the symptoms of a failing or swollen pancreas, not cure it). You may remain like this for days, while doctors come in and ask you questions, prescribe treatment, and the bills add up. At no point are you sober/rational enough to make decisions. You just get a bill two weeks later in the mail with 10k attached, which even if you're insured currently means you're still responsible for up to 2k or more.

There's not an opportunity to "shop around smartly" in all situations. When people require emergency care or perhaps are geographically unable to shop around, they must get care where and when they can. Or sometimes go without at the expense of their health.

Why so quiet?

Dunno. Theres just not been much activity lately. And peps who generate activity have been rather absent.

Er.... I bought Final Fantasy 7 on Steam today. Its been so long since I played it. Lets see if this 'best game ever' holds up.

Prepare for grinding, Lego-anatomy, and dark dark ass atmosphere.

Sure... dark atmosphere.....

K, I might need to check out gamefaqs so I can find all of the stuff I need to dress Cloud up like a girl so HE will be picked for the sex with Cornelo. Oh hey, I remember this scene! Its where Cloud gets buttraped by a dozen muscular men in a hot tub.

Wow so dark. 😉

Have you guys read Worm? It is a serial fiction about superheroes, where everybody uses their powers to the maximum possible effect.

The plot and characterization are phenomenal and the (large) cast is fully fleshed out' even seemingly small characters are fully realized.

No, but just starting watching The Walking Dead lately after loads of people kept going on about it. And that is one awesomely freaky show.

Originally posted by DARTH POWER
No, but just starting watching The Walking Dead lately after loads of people kept going on about it. And that is one awesomely freaky show.

Watch the previous seasons on Netflix, if you want to get some greater context.

That looks pretty interesting, Nem. Nice find.

Originally posted by DARTH POWER
No, but just starting watching The Walking Dead lately after loads of people kept going on about it. And that is one awesomely freaky show.
Just watch the first episode and leave it at that. The pilot can't be topped.

Originally posted by Lord Lucien
Just watch the first episode and leave it at that. The pilot can't be topped.

Disagree here. But then again, you like FO3 more than FO:NV, so your taste is suspect.

My point is this: consumers are not able to choose rationally between different health procedures. The market for health procedures is not a good candidate for a free-market system of resource allocation.

Ok.. Lets expand upon this. You're saying a free market system would not work for health procedures? Are you then asserting that government run healthcare would? And why? Explain how government run (I say government run because that's how this universal healthcare is used, I know the government doesn't actually run it)healthcare reconciles the issue of rational choice?

I don't believe that a "free market" ideology would actually eliminate insurance companies. Mitigation of risk is a perfectly rational course of action for any kind of consumer, and if the government steps in and prevents insurance companies from forming then the market isn't really "free," is it?

Eh technically but not really. If the stipulation for a free market economy in the healthcare section is that there can be no 3rd party programs, then it is a free market economy based on that one stipulation. It's a matter of how you see it I guess. You're not wrong and neither am I but I see your point in this regard.

Obamacare is off to a p good start, eh?

You're kidding, right?

I am sure that patients' ability to successfully participate in their own care has been researched.

I'd like a little more clarity than "I am sure".

My suspicion is that people are not good at this function. I think that even people who are well-equipped to participate in care-decisions (like doctors) will do poorly when confronted by their own health-needs

Then I'm afraid I'm again missing your point. If the question of government run healthcare vs. free market healthcare was simply the failure or success of rational choice, why does the government run healthcare win out? You're eliminating the free market healthcare but what's the advantage of government run healthcare?

My concern is for life-or-death operations like dialysis or immediate emergency care. There is no way for a person with Kidney failure to shop around and agree to only mutually beneficial trades.

I would think in the ideal free market healthcare system, price lookups for all sorts of care and surgeries would be publicly available, no?

Additionally, hospitals oftentimes render treatment with patient agreement even if the patient is not in a frame of mind to make legally binding agreements otherwise. For example, using the previous example of acute pancreatitis, you are given powerful pain killers to keep you out of pain (as they can only treat the symptoms of a failing or swollen pancreas, not cure it). You may remain like this for days, while doctors come in and ask you questions, prescribe treatment, and the bills add up. At no point are you sober/rational enough to make decisions. You just get a bill two weeks later in the mail with 10k attached, which even if you're insured currently means you're still responsible for up to 2k or more.

I haven't thought a lot about not being in the right "frame of mind" when making a choice, and in a free market economy the costs again, would be significantly reduced. But I'm still not getting how Obamacare solves this issue? They're not doing the homework for you.

There's not an opportunity to "shop around smartly" in all situations. When people require emergency care or perhaps are geographically unable to shop around, they must get care where and when they can. Or sometimes go without at the expense of their health.

I addressed this with the idea of a public database. No real need to shop around if this can be ideally accomplished.

Not to mention, I find the initial stages of Obamacare rather amusing. I thought that if you liked your doctors and insurance, you would be able to keep both? What's with tens of thousands of people getting insurance cancellation mail?

I never said ObamaCare solved the issue. I said UHC would solve the issue. ObamaCare is a disaster.

Originally posted by Stealth Moose
I never said ObamaCare solved the issue. I said UHC would solve the issue. ObamaCare is a disaster.

The question was specifically for RH but I was wondering if you had an opinion as well. I guess that answered that. I don't fully understand the inner workings of UHC to debate its merits over a free market system. Or at least not to debate it to my fullest potential.

Originally posted by Stealth Moose
Disagree here. But then again, you like FO3 more than FO:NV, so your taste is suspect.
My taste is savory, you bitter nut.

The show is good generally, but that first episode...

It's all about the Ricktatorship.

The show's high moments for me are when child zombies get killed. I'm still waiting for the episode where they actually show a kid getting bit. The creepy little flower girl would do... nicely... mmmmm.