Free Market and Socialized Medicine - why not both?

Free Market is available in some countries that have single payer, for those who want a private room and gourmet meals.

It's available in the UK. I love their system. Everyone is fully covered, but if you want to pay extra, you can get the gold treatment with a private supplemental health insurance policy. Even if you decide on paying for private insurance, it's less than what we pay here in the US.

Right, but you're sort of skipping over the controversy that creates. To wit:

Hospitals accused of creating 'a two-tier' health system after accepting payments for treatments available on the NHS

Also, this bit seems to indicate where we're heading by nationalizing health care:

Examples include Homerton University Hospital NHS Foundation Trust in East London, which tells patients in need of fertility treatment that they have the option of NHS, private, or self-funded care.
It states: ‘Self-funding NHS patients are those who have to pay us for their treatment costs by cash or credit care prior to starting the treatment.
‘This option allows you to have your treatment when you are not eligible for NHS-funded treatment or you wish to have your treatment with a minimal wait.’
Reasons for being refused NHS-funded fertility treatment range from the woman’s age to her weight or her husband’s refusal to give up smoking.

(really? NHS refused her treatment because her husband refused to quit smoking???)

OR

Will foundation trust reforms lead to a two-tier NHS? | Healthcare Network | Guardian Professional

NHS staff slam 'two-tier' system | UK | Express.co.uk - Home of the Daily and Sunday Express

The point of all this is that a two-tiered system defeats the purpose of most of the health care reform agenda. Allowing richer patients to buy better treatment re-introduces the very thing they're trying to eliminate. They don't want the relative quality of a person's health care to depend on their ability to pay.
 
The point of all this is that a two-tiered system defeats the purpose of most of the health care reform agenda. Allowing richer patients to buy better treatment re-introduces the very thing they're trying to eliminate. They don't want the relative quality of a person's health care to depend on their ability to pay.

The rich are always going to get better treatment regardless of whether they pay more for it or not. They're more confident when dealing with doctors and other caregivers, ask more questions, research options, and go with the best of those presented, treating their caregivers as equals and team members, and advocating for their own interests, just as they would in business.

The poor are more apt to be deferential to doctors, and less confident in seeking out other options. The quality of their care is more dependent upon whether they are fortunate enough to pick a good doctor. The poor can also ill afford the kind of expensive treatment extras that the rich easily pay for, like extensive physio therapy and in-home re-habilitative treatment, which aren't covered in single payer plans.

And you don't need to be wealthy to jump the queue, you just need a primary care doctor with a good referral network. My GP is not the best doctor I've ever had, but he gives the best referrals of any doctor I know. My daughter's pediatrician teaches at the University of Toronto, and is the best I've children's doctor I've ever seen, in addition to which, he knows the best doctors in their fields throughout the U of T network.

Where you live and who you know, are always the great deciding factors, in any system.
 
The point of all this is that a two-tiered system defeats the purpose of most of the health care reform agenda. Allowing richer patients to buy better treatment re-introduces the very thing they're trying to eliminate. They don't want the relative quality of a person's health care to depend on their ability to pay.

The rich are always going to get better treatment regardless of whether they pay more for it or not. They're more confident when dealing with doctors and other caregivers, ask more questions, research options, and go with the best of those presented, treating their caregivers as equals and team members, and advocating for their own interests, just as they would in business.

The poor are more apt to be deferential to doctors, and less confident in seeking out other options. The quality of their care is more dependent upon whether they are fortunate enough to pick a good doctor. The poor can also ill afford the kind of expensive treatment extras that the rich easily pay for, like extensive physio therapy and in-home re-habilitative treatment, which aren't covered in single payer plans.

And you don't need to be wealthy to jump the queue, you just need a primary care doctor with a good referral network. My GP is not the best doctor I've ever had, but he gives the best referrals of any doctor I know. My daughter's pediatrician teaches at the University of Toronto, and is the best I've children's doctor I've ever seen, in addition to which, he knows the best doctors in their fields throughout the U of T network.

Where you live and who you know, are always the great deciding factors, in any system.

But do you think money should be factor? I ask because I've heard quite a few people say it shouldn't, and that's a far more radical goal than a social safety net or the like. Likewise, it implies a radically different policy to achieve.
 
Yes, and maybe that's the only way it goes. Kind of seems like that's the great public policy problem of our time. How do we break up entrenched interests who use the government to everyone else's detriment without a painful explosion?

Or maybe...how do we create the explosion without making it so painful?

The problem is the entrenched interests have an almost limitless amount of money and they lie and lie and lie to protect them. The entrenched interests in the United States - big insurance, the AMA, and big pharma, are three of the wealthiest lobbies in the country and their continuing income and profits are dependent upon the status quo. Because they have the money to buy air time, lobbiests, and PR firms, they spend a lot of time and money frightening people about government funding single payer health care systems.

The government enabled these entrenched interests to put the squeeze on us. Now we have to trust that government will protect us from them.
 
... I don't have an answer except, that it completely has to fall apart and be built back up.

While that wasn't necessarily his "prescription", Olson's historical analysis showed that's usually the remedy.

Yes, and maybe that's the only way it goes. Kind of seems like that's the great public policy problem of our time. How do we break up entrenched interests who use the government to everyone else's detriment without a painful explosion?

Or maybe...how do we create the explosion without making it so painful?

There was an explosion in the financial markets, but instead of allowing it to correct as it must, they bailed it out. Free market corrections are not allowed & have not been in our life-time. Ronald Reagan added to FDR's government encroachments & created "The President's Working Group on Financial Markets" & it's been full on government controlled markets every since. Free Markets are a fucking pipe dream. You can't starve the government beast because they have a printing press that supports them & bails out the rich. It's time to vote against the middle class subsidized rich that support the plutocrats. Cut taxes on the middle class & raise them on the 1%.
 
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Anyone who thinks there is a free market should be punished by writing "There is no such thing as a free market." One million times.

"In actual fact, there is no such thing as a "free market." Markets are the creation of government... Governments provide a stable currency to make markets possible. They provide a legal infrastructure and court systems to enforce the contracts that make markets possible. They provide educated workforces through public education, and those workers show up at their places of business after traveling on public roads, rails, or airways provided by government. Businesses that use the "free market" are protected by police and fire departments provided by government, and send their communications - from phone to fax to internet - over lines that follow public rights-of-way maintained and protected by government.

And, most important, the rules of the game of business are defined by government. Any sports fan can tell you that football, baseball, or hockey without rules and referees would be a mess. Similarly, business without rules won't work.

Which explains why conservative economics wiped out the middle class during the period from 1880 to 1932, and why, when Reagan again began applying conservative economics, the middle class again began to vanish in America in the 1980s - a process that has dramatically picked up steam under George W. Bush.

The conservative mantra is "let the market decide." But there is no market independent of government, so what they're really saying is, "Stop corporations from defending workers and building a middle class, and let the corporations decide how much to pay for labor and how to trade." This is, at best, destructive to national and international economies, and, at worst, destructive to democracy itself.

Markets are a creation of government, just as corporations exist only by authorization of government. Governments set the rules of the market. And, since our government is of, by, and for We The People, those rules have historically been set to first maximize the public good resulting from people doing business. " Democracy - Not "The Free Market" - Will Save America's Middle Class


"The moral, political and social objections to market liberalism [libertarianism] and the market itself. The market is not a neutral 'process', it is a structure deliberately imposed, to implement the goals of a liberal ideology. It can be ethically assessed, and rejected, on that basis: criticism of the market overlaps with general critique of [libertarianism] liberalism." The ethics of the free market: why market liberalism is wrong.


"These sensible suggestions will be demonized by ideological “free market” economists and opposed by the offshoring corporations, whose swollen profits allow them to hire “free market” economists as shills and to elect representatives to serve their interests." CPR for the Antiwar Movement » Counterpunch: Tells the Facts, Names the Names


Summary
Timeline of the Great Depression
The Great Depression, to 1935
 
^^^^^
Total 100% communistic bullshit.

Markets arise organically from consenting adults freely exchanging perceived value for perceived value....Those freely agreed upon transactions require no pinko gubmint protection racketeers, imposing themselves upon the marketplace as the self-proclaimed "referees".
 
Anyone who thinks there is a free market should be punished by writing "There is no such thing as a free market." One million times.

"In actual fact, there is no such thing as a "free market." Markets are the creation of government...


... football, baseball, or hockey without rules and referees would be a mess. Similarly, business without rules won't work.

Apologies for the opportunistic edit, but I think this gets to the misconception at the core of your argument. You're struggling with the incorrect assumption that a free market is one without rules. It's similar to what critics of libertarianism in general do, when the first reframe it as anarchy.

The whole point of government (in my view) is to maintain rules that protect freedom. And the basic laws that protect people and property, and make trade possible, are necessary for a free market. The problem is that not everyone agrees that the purpose of law is to protect freedom. Many people want to use law for the opposite - as a tool to violate the freedom of their neighbors for their own benefit.
 
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Anyone who thinks there is a free market should be punished by writing "There is no such thing as a free market." One million times.

"In actual fact, there is no such thing as a "free market." Markets are the creation of government... Governments provide a stable currency to make markets possible. They provide a legal infrastructure and court systems to enforce the contracts that make markets possible. They provide educated workforces through public education, and those workers show up at their places of business after traveling on public roads, rails, or airways provided by government. Businesses that use the "free market" are protected by police and fire departments provided by government, and send their communications - from phone to fax to internet - over lines that follow public rights-of-way maintained and protected by government.

And, most important, the rules of the game of business are defined by government. Any sports fan can tell you that football, baseball, or hockey without rules and referees would be a mess. Similarly, business without rules won't work.

Which explains why conservative economics wiped out the middle class during the period from 1880 to 1932, and why, when Reagan again began applying conservative economics, the middle class again began to vanish in America in the 1980s - a process that has dramatically picked up steam under George W. Bush.

The conservative mantra is "let the market decide." But there is no market independent of government, so what they're really saying is, "Stop corporations from defending workers and building a middle class, and let the corporations decide how much to pay for labor and how to trade." This is, at best, destructive to national and international economies, and, at worst, destructive to democracy itself.

Markets are a creation of government, just as corporations exist only by authorization of government. Governments set the rules of the market. And, since our government is of, by, and for We The People, those rules have historically been set to first maximize the public good resulting from people doing business. " Democracy - Not "The Free Market" - Will Save America's Middle Class


"The moral, political and social objections to market liberalism [libertarianism] and the market itself. The market is not a neutral 'process', it is a structure deliberately imposed, to implement the goals of a liberal ideology. It can be ethically assessed, and rejected, on that basis: criticism of the market overlaps with general critique of [libertarianism] liberalism." The ethics of the free market: why market liberalism is wrong.


"These sensible suggestions will be demonized by ideological “free market” economists and opposed by the offshoring corporations, whose swollen profits allow them to hire “free market” economists as shills and to elect representatives to serve their interests." CPR for the Antiwar Movement » Counterpunch: Tells the Facts, Names the Names


Summary
Timeline of the Great Depression
The Great Depression, to 1935

Oh my word, this post is just so uneducated and naive it made me laugh, especially the part about how democracy, and not the free market, is what will save the middle class.
 
Anyone who thinks there is a free market should be punished by writing "There is no such thing as a free market." One million times.

"In actual fact, there is no such thing as a "free market." Markets are the creation of government... Governments provide a stable currency to make markets possible. They provide a legal infrastructure and court systems to enforce the contracts that make markets possible. They provide educated workforces through public education, and those workers show up at their places of business after traveling on public roads, rails, or airways provided by government. Businesses that use the "free market" are protected by police and fire departments provided by government, and send their communications - from phone to fax to internet - over lines that follow public rights-of-way maintained and protected by government.

And, most important, the rules of the game of business are defined by government. Any sports fan can tell you that football, baseball, or hockey without rules and referees would be a mess. Similarly, business without rules won't work.

Which explains why conservative economics wiped out the middle class during the period from 1880 to 1932, and why, when Reagan again began applying conservative economics, the middle class again began to vanish in America in the 1980s - a process that has dramatically picked up steam under George W. Bush.

The conservative mantra is "let the market decide." But there is no market independent of government, so what they're really saying is, "Stop corporations from defending workers and building a middle class, and let the corporations decide how much to pay for labor and how to trade." This is, at best, destructive to national and international economies, and, at worst, destructive to democracy itself.

Markets are a creation of government, just as corporations exist only by authorization of government. Governments set the rules of the market. And, since our government is of, by, and for We The People, those rules have historically been set to first maximize the public good resulting from people doing business. " Democracy - Not "The Free Market" - Will Save America's Middle Class


"The moral, political and social objections to market liberalism [libertarianism] and the market itself. The market is not a neutral 'process', it is a structure deliberately imposed, to implement the goals of a liberal ideology. It can be ethically assessed, and rejected, on that basis: criticism of the market overlaps with general critique of [libertarianism] liberalism." The ethics of the free market: why market liberalism is wrong.


"These sensible suggestions will be demonized by ideological “free market” economists and opposed by the offshoring corporations, whose swollen profits allow them to hire “free market” economists as shills and to elect representatives to serve their interests." CPR for the Antiwar Movement » Counterpunch: Tells the Facts, Names the Names


Summary
Timeline of the Great Depression
The Great Depression, to 1935

Oh my word, this post is just so uneducated and naive it made me laugh, especially the part about how democracy, and not the free market, is what will save the middle class.
That's our midcant...One of the most complete blends of central planner know-it-all ignorance, arrogance and naked snobbery as you will find anywhere. :lol:
 
Anyone who thinks there is a free market should be punished by writing "There is no such thing as a free market." One million times.

"In actual fact, there is no such thing as a "free market." Markets are the creation of government...


... football, baseball, or hockey without rules and referees would be a mess. Similarly, business without rules won't work.

Apologies for the opportunistic edit, but I think this gets to the misconception at the core of your argument. You're struggling with the incorrect assumption that a free market is one without rules. It's similar to what critics of libertarianism in general do, when the first reframe it as anarchy.

The whole point of government (in my view) is to maintain rules that protect freedom. And the basic laws that protect people and property, and make trade possible, are necessary for a free market. The problem is that not everyone agrees that the purpose of law is to protect freedom. Many people want to use law for the opposite - as a tool to violate the freedom of their neighbors for their own benefit.
That's no misconception....That's the rank arrogance of the authoritarian central planner in full bloom...He actually believes the communistic crap he posts.
 
That's no misconception....That's the rank arrogance of the authoritarian central planner in full bloom...He actually believes the communistic crap he posts.

You haven't the vaguest clue about what communism is or how it works. It's just your default insult for anything you're afraid of or don't understand. There are all sorts of governments which are both capitalistic and provide a much higher quality of life, better education and universal health care, for ALL of its citizens but which still manages to ward the brightest and hardest working or it's citizens with wealth.

"Central planning" is something that every large corporation and government does. It's not unique to communist societies. Central planning looks at needs, looks at resources, and deploys them as needed. Central planning isn't what make someone a communist, it's the belief that no one should be wealthy and that everone should make the same amount of money and everyone is absolutely equal.
 
Free Market and Socialized Medicine - why not both?
Because socialism relies upon coercion and and central control, while the free market utilizes consent and decentralized choices.

Funny that, most citizens of Canada and the UK don't seem too concerned about Socialized Medicine. I suppest some of you who agree with Odd-dude seek out forums such as this in other nations and ask if what odd-dude writes is true.

I have and not everyone is pleased with their system but few would trade for what we have.
 
'Zactly!....Canadians are so thrilled with socialized medicine, that those who can do so are flooding hospitals in places like Seattle, Minneapolis, Cleveland and Buffalo to get on-demand treatment....What a dazzling success story!

None of which addresses the point that the socialist model is based on coercion and the market model is based upon free consent.
 
That's no misconception....That's the rank arrogance of the authoritarian central planner in full bloom...He actually believes the communistic crap he posts.

You haven't the vaguest clue about what communism is or how it works. It's just your default insult for anything you're afraid of or don't understand. There are all sorts of governments which are both capitalistic and provide a much higher quality of life, better education and universal health care, for ALL of its citizens but which still manages to ward the brightest and hardest working or it's citizens with wealth.

"Central planning" is something that every large corporation and government does. It's not unique to communist societies. Central planning looks at needs, looks at resources, and deploys them as needed. Central planning isn't what make someone a communist, it's the belief that no one should be wealthy and that everone should make the same amount of money and everyone is absolutely equal.
Communist central planning doesn't share the wealth and prosperity, it redistributes poverty and lack.

Central planning done by corporations limits the losses of that corporation to that corporation, and generally doesn't harm the society at large....Can't say that when the authoritarian central planners of central gubmint screw the pooch.

No...They just blame anyone and everything but themselves, then demand that the hoi polloy pony up more in taxation and/or elimination of their liberties and the central planners will get it right this time.....Which they don't.

Then the apologists for communism like you go around saying that the only reason that authoritarian central control failed is that we didn't have the right tyrants and looters running the program....Happens every time.
 
I am convinced that the free market would provide the best health care system if it were ever allowed to do so. Of course, we've had nothing like a free market in health care since the 1950s. First there were 'maximum wage' laws post WW2 that were meant to encourage hiring, but instead resulted in employers adding benefits like health insurance. Then health insurance became an entrenched interest, and insurance providers arranged for the government to leave that benefit untaxed, so it became standard. Then Medicare came about and kind of ruined everything.

Since the 1950's, state and federal agencies have added a huge maze of regulations governing all aspects of health care, making it into a paperwork nightmare that is total nonsense for doctors and patients. And lawyers have found that the courts are willing to award millions to people who want to sue their doctors. This in turn has resulted in higher costs, much more conservative medical practices, and a closed industry for providers of medical products.

States require insurance companies to cover all sorts of health issues, making insurance more expensive for everyone, especially healthy people. Now the federal government is getting in on that game too.

And all the while, the government keeps finding more ways to fund this mess. Governments now pay more for health care than consumers.

All this is to say we don't have a free market system at all. The USA just has its own uniquely stupid take on socialized medicine, and Obamacare is only making it more convoluted.

But it's a fantasy to think we could ever undo it. Voters aren't smart enough, the elderly benefit too much, and the interests are too powerful for us ever to unravel this mess and return to a free market system which would provide affordable, high quality health care for everyone.

What about a compromise? What if free market advocates drafted a plan where these things happened?
1) The US adopted a national health service, entirely funded by the government, ala Britain.
2) The same bill that created the national health service creates protected free market space for people who want to provide health care for a profit. The bill says that, so long as there is a national health service, there must also be space in the market for people to provide for-profit services with little to no regulation in a buyer beware environment. No federal, state, or local governments could restrict the activities of these companies, other than holding them to the law as it applies to every citizen. Voluntary interactions between patient and provider could be protected and they could do what they want.

That way, there would be a fully socialized system, which is what the voters want, and which we're already paying for, and there would be an opportunity for people to opt out of it if they're willing to pay.

Indeed.

Create a single payer system for all citizens, in essence Medicare for all – a very successful system.

Those who wish to do so and/or can afford it may then purchase actual health insurance as a supliment, insurance they hope they never use.

And health insurance companies can go back to the business of health insurance, raking in profits from premiums, and paying out as few claims as possible.
 
"In actual fact, there is no such thing as a "free market." Markets are the creation of government...

Ridiculous and dangerously ill-informed. A market is created when people come together to trade. The government sets rules that restrict the ability of people to trade and disrupts the market accordingly. A true free market is one with no government interference at all. A free market as is commonly spoken about these days is one where government is mostly out of the way. A market where there are lots of government interventions is still a market, but a poorly functioning one. The health care market is a wonderful example of this. Government interventions have made health care expensive, hard to get, and inferior.


Governments provide a stable currency to make markets possible.

How much did you pay for gas this week? What about last month? How about last year? How much did you pay for a routine health care procedure last year? How about ten years ago?

The costs of many goods has skyrocketed precisely because the government forces us to use a currency that is most certainly not stable. Your statement is kind of the opposite of realilty.

They provide a legal infrastructure and court systems to enforce the contracts that make markets possible.

Indeed we have decided that the government should provide most of this, and I think it's fine. But it's hardly necessary, and historians like David Friedman have thousands of years of example from history where courts and contracts were not the province of government, and everything worked out fine.

They provide educated workforces through public education,

Are you being serious when you say this? I can't tell.

and those workers show up at their places of business after traveling on public roads, rails, or airways provided by government.

True, but only because we've elected to have government provide those functions. Society would be just fine if we did this without a central authority.

And, most important, the rules of the game of business are defined by government. Any sports fan can tell you that football, baseball, or hockey without rules and referees would be a mess. Similarly, business without rules won't work.

I spent many years as an importer, dealing with all sorts of rules from two countries governing what could come into the country and what could leave. Despite all those rules, the 'rules of the game of business' had no governing authority. My trading partners and I had to trust that we would meet our agreements. If my manufacturer in China failed to deliver on a $5000 shipment, I was out $5000. There was no way it would make sense to try and sue someone in China over $5000.

The rule we followed was simple: Do what you agree to do. If either partner broke that rule, we knew we couldn't trust each other and couldn't do business.

Which explains why conservative economics wiped out the middle class during the period from 1880 to 1932, and why, when Reagan again began applying conservative economics, the middle class again began to vanish in America in the 1980s - a process that has dramatically picked up steam under George W. Bush.

This is just silly. Let me ask you something. Did government grow or shrink under Reagan? Did it grow or shrink under GW bush? Did it grow or shrink from 1880 to 1932?

The conservative mantra is "let the market decide." But there is no market independent of government, so what they're really saying is, "Stop corporations from defending workers and building a middle class, and let the corporations decide how much to pay for labor and how to trade." This is, at best, destructive to national and international economies, and, at worst, destructive to democracy itself.

I think the conservative mantra is better stated as, "Say we want smaller government but actually grow the government at least as fast as our opponents." But that's beside the point. "Let the corporations decide how much to pay for labor and how to trade" isn't a bad thing to do at all, provided the corporations aren't in bed with the government. I view the American corporation as a creature of government so I'd prefer to talk about individual actors. "Let businesses decide how much to pay for labor and how to trade." Lovely.
 

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