no third solution

Blogging about liberty, anarchy, economics and politics

Is For-Profit Healthcare as Immoral as ‘Death Panels’?

August 16th, 2016

Stethoscope on a printed sheet of paper

My friend Matt notes that while this “isn’t exactly the ‘death panel’ that Fox News was trying to scare you with, [it] most certainly falls in to the category of fallout associated with nationalizing medical treatment”, in response to this Scientific American piece :

Hospitals across the United States are throwing away less-than-perfect organs and denying the sickest people lifesaving transplants out of fear that poor surgical outcomes will result in a federal crackdown.

One reply says:

I don’t disagree with some of your logic here, but I also feel that you would have to agree that healthcare based on profit is equally immoral

No, I don’t and you’re wrong.

In its current state, for-profit health care is not without problems — many of them — but this specific act is active and deliberate evil due fundamentally to the nationalization and which supplants even a person’s ability or willingness to pay, or to take on risk. It is a medical equivalent of cash-for-clunkers, of plowing under the fields even while millions starved during the great depression, or the oft-lambasted regulations which prevent grocery stores from donating produce, etc.

In these cases, there are some quantity of goods which people want and would be willing to take, but which are being deliberately withheld from them (and destroyed).

Now, you may counter that under the price system, some people may suffer or die as well because they can’t afford the service (why it costs as much as it does, and whether it ought to cost that much is a different topic). While you may prefer a different distribution of kidneys than the price system provides, it is absolutely without question that if there are fewer kidneys to go around because the hospitals are literally throwing them in the trash, fewer people’s needs will be met as a result.

I don’t see how death from “I can’t afford a transplant” is any worse, objectively, than death from “some panel at the hospital decided that even though I’d been on the wait list for 18 months, and was ‘next in line’ for a kidney, that someone else’s need was more urgent, so I didn’t get my transplant”. Especially when there will necessarily be more deaths arising from the latter than from the former.

There’s No Such Thing as Free Obamacare

September 12th, 2012

A friend of a friend who’s a hardcore Obama supporter through thick & thin and also a stay-at-home mom opines, “I like Obamacare because it means I’ll get free vaccines for my son.”

Oh. You wanted a lesson in life? Here goes:

For starters, no it’s not fucking free. You personally might not have to pay for it but that does not make it “free”. Everything has a cost, and the failure to grasp this concept is failure to grasp the fundamental laws of reality.

Now that we’ve gotten today’s lesson in metaphysics out of the way and we can agree that it’s not “free”, you have some explaining to do. 

You have to explain why someone else has to pay for the things you want, for instance explain why my wife and I (who both work) should be forced to pay to support your choice to not work? You would never dream of holding me as your slave and forcing me to provide for you, yet the policies you favor, and more specifically the political means by which you seek to effect your desired outcomes, are essentially just that.

And don’t give me any crap about the people who “can’t afford it” because:

  1. You’re not in that class and it’s an insult to anyone who is if you’re insinuating that, and 
  2. By and large people can or could afford things but they are prevented or otherwise forcibly deprived means of doing so (cf., Scratching by: How Government Creates Poverty as We Know It, On Breaking Your Legs and Giving You Crutches: A Response To A Liberal) and/or 
  3. They just choose not to because they’ve been conned in to believing, just like you, that these things are “free” and that they are entitled to them without providing for them.

Also, you need to explain why this mentality of yours isn’t exactly the same as the “selfishness” you abhor when a libertarian wants to keep the whole of her own earnings in order to provide for her own family, well-being, needs, etc.

But I’m pretty sure what I’m hearing right now is the sound of deaf ears not listening.

Why Does the U.S. Spend More on Health Care?

September 1st, 2010

The fact that the US spends more on health care is not particularly alarming. The NYT points out that, for the last 50 years the US has always spent more (as a % of GDP) on health care than the rest of the developed world. The problem is the velocity of change: health care expenditures are rising considerably faster in the US.

health care spending trend, OECD nations, 1960-2008

If you want to make something more affordable, you cannot continue to spend more money on it, nor can you continue policies which encourage bloat and bureaucracy. To be quite fair, there are dozens if not hundreds of factors that have contributed to the price increases.

  • The $100B/year tax subsidy given to corporations is pretty pervasive. Anyone who doesn’t work for a large corporation is at a disadvantage, unable to write off their health care expenses as tax-free — and more unfairly handcuffs people to their jobs.
  • The digital age has rapidly accelerated the development of new techniques and new technologies over the past few decades, but many of these procedures are extremely expensive (a problem that is exacerbated by the fact that many people view health care and insurance as a “Free Lunch”).
  • The technological advances have allowed us to live longer than ever before — but there is a price to pay. An aging population will always require more attention as the frailty of old age sets in: everything from reading glasses to new drugs and procedures to elder care and hospice.

But something else happened in the 80s that contributes to this problem: The AMA, an evil cartel the sole purpose of which is to extract the highest possible monopoly rents for its member doctors, with the collusion of congress, began restricting the number of new and potential doctors, in spite of an obviously aging population.

The marketplace doesn’t determine how many doctors the nation has, as it does for engineers, pilots and other professions. The number of doctors is a political decision, heavily influenced by doctors themselves…

The United States stopped opening medical schools in the 1980s because of the predicted surplus of doctors.

— via USAToday

The moratorium on new medical schools was not overturned until 2002 when the damage was already well underway. Thirty-ish years later, despite spending more, the US has fewer doctors, fewer nurses, and fewer hospital beds per capita than the OECD average [source: pdf].

This problem is going to take years to fix. I pointed out the metaphysical problem last time: there is already a shortage problem, and it’s only going to get worse if someone pronounces that medical care (provided by whom? at what costs?) will be an American birthright. A shiny new label that says “Universal Single Payer Awesome Health Care America Fuck Yeah!” isn’t going to work, the entire “system” is broken, and rotten to the core.

no third solution

Blogging about liberty, anarchy, economics and politics