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The information on Groklaw is not intended to constitute legal advice. While Mark is a lawyer and he has asked other lawyers and law students to contribute articles, all of these articles are offered to help educate, not to provide specific legal advice. They are not your lawyers.

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Here is the real issue | 355 comments | Create New Account
Comments belong to whoever posts them. Please notify us of inappropriate comments.
Here is the real issue
Authored by: Wol on Saturday, June 30 2012 @ 07:09 PM EDT
Add in the fact that the uninsured are not only a cost on the insured in that
the insured pay higher premiums, they are also a *threat* to the uninsured,
resulting in even higher premiums still!

Let's take measles, for example. Some kids just can't be vaccinated. But if we
get 85% of the population, we won't get an outbreak because the proportion of
unvaccinated kids is too small.

Now let's assume that 5% of kids can't be vaccinated, and 10% can't afford it
... reasonable figures?

What happens if your kid is one of that 5%? Insured or not, your kid could be
killed or crippled for life because those others couldn't afford the vaccine.

There's a lot of evidence that - for primary healthcare at least -
"free" healthcare costs society an awful lot less than picking up the
pieces after people who can't afford it get sick.

(I just wish we had the French system, where there's a nominal charge for
accessing the service, to discourage hypochondriacs. My wife was an
administrator in a GP surgery and while I take her stories with a pinch of salt
some of them are simply amazing ...)

Cheers,
Wol

[ Reply to This | Parent | # ]

What are market conditions?
Authored by: Anonymous on Saturday, June 30 2012 @ 10:25 PM EDT

Textbook definitions of what constitutes a market differ in their nuances. Wilfredo Paretto, Friedrich Hayek, and many other economists have formulated their own versions. Normally the requirements are along these lines:
- there is a sufficent number of comparable and independent buyers and sellers that the entry or exit of any one of them does not materially change the market
- the participation of the buyers and sellers is voluntary, that is, the sellers are free to not sell, and the buyers are free to not buy
- there is a flow of correct information allowing buyers to make informed purchasing decisions

It is a fundamental belief of free marketeers that IF market conditions exist for a given part of the economy THEN the market is the most efficient way of allocating resources in that part of the economy.

Market conditions exist for some parts of the economy more clearly than for others. A farmers' market is a good example of market conditions being satisfied. The farmers' market may have many stalls selling more or less the same foodstuffs, and lots of buyers understand lettuce and cucumbers well enough to make their choice. Utilities such as gas, water, and sewers just as clearly do NOT satisfy market conditions, because the cost to sellers of building competing infrastructures is prohibitive or downright impossible. Even free marketeers will concede that in these parts of the economy, regulated monopolies are inevitable, although they may argue about whether the monopolies should be privately or publicly owned.

The trouble with the health care business is that buyers are under duress to participate (particularly for emergency care), so arguably market conditions don't exist. Buyer duress, if unchecked, allows sellers to charge more. In this case, even believers in markets may feel that regulation is needed. The grand bargain made in most Western societies other than the USA is to assume market conditions don't apply to health care. Thus, Western Europe, Canada, Australia, etc. have health care systems which blend some features of free enterprise with substantial government intervention.

The country most like the USA is probably Canada. There, health care is a provincial (i.e. state) jurisdiction. In most provinces, the government is both the main insurer and price setter. This system ends up having both advantages and disadvantages compared to the US approach. Generally speaking, Americans with lots of money and/or insurance coverage receive better care than Canadians, while Americans with little money and/or coverage receive worse care than Canadians. Canadians sometimes have trouble finding general practitioners, and can face long waiting lists to see specialists, but the system works efficiently otherwise.

The overall effect is that Canada receives better outcomes on macro indicators (lower infant mortality rates, longer life expectancy, and so on) while spending HALF as large a portion of their GDP on health care as the USA. That's in a country with a per capita GDP comparable to ours.

[ Reply to This | Parent | # ]

Here is the real issue
Authored by: Anonymous on Friday, July 13 2012 @ 01:56 PM EDT
The U.S. granted the health care market an anti-trust exemption in 1948. The
government has marked this industry as special and not subject to normal open
market preserving conditions or regulation--the regulation focuses on efficacy
and professionalism, not competition. The practitioners are effectively a
protected guild that operates as a monopoly. It irks me when some speak of this
Trust as if it were a real open market--it hasn't been for over 65 years. It's
hard to make an argument on the effect of competition on prices when there is
not true competition.

[ Reply to This | Parent | # ]

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