Is Obamacare Capitalism in Action?

[dblack]

The market cannot compel people to purchase items with the threat of violence. For example, Apple cannot dictate that every American of a certain age must purchase an iPhone or face a fine and possible jail time. On that basis alone ObamaCare is not remotely capitalist.

When you purchase a car in certain states you are compelled to provide proof of insurance. When you purchase a home some states compel you to have homeowner insurance. Are neither of those market transactions "remotely capitalist"?

Nope

 

[dblack]

So given your definition of capitalism as excluding the "forced purchase" of anything besides only what you want to buy that will exclude all cell phone purchases where you have to have a 2 year contract and other such deals. All leases of any equipment that required a service contract would also not be capitalism. Neither would something like a bank checking account or credit card where you are forced to pay fees and interest for that matter. How about a happy meal that forces you to purchase a soda that you don't want? In order to get to your version of "pure capitalism" we have to have the absolute right to not purchase anything we don't want, right?

What you describe are not forced purchases. I chose not to have a credit card. I have not bought a happy meal in years. I entered into my cell phone contract on my own free will; neither the government nor the phone company made me do it.

They are if you cannot obtain what you want in any other manner.

No, being unable to obtain what you want isn't a 'forced purchase'.

 

[dblack]

If Republicans Love Competition, Why Do They Still Hate Obamacare? | Joe Conason

When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition!
...
It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us -- in the abstract.

What they don't seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace -- and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.

That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or "silver") health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.

The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies -- and certainly nothing like the health insurance "exchanges" created by Obamacare to guide consumer choices.

In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. "That's a very different dynamic for these companies, and it's prodding them to be more aggressive and competitive in their pricing," explains Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reform.

For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.

But why do self-styled conservatives continue to hate health care reform with such ferocity? They may not care that it is truly "pro-life" and "pro-family," with the clear promise of saving thousands of lives annually among families that were previously uninsured. Yet they should surely appreciate a statute that promotes competition where there was none, improving services and reducing prices through freer enterprise.

...

For what we can now observe in practice is that the Republicans perversely prefer a corporate marketplace without competition over a marketplace with competition overseen by government. While European conservatives have long accepted the need for strictly regulated markets, especially in health care, their American counterparts would rather allow corporate power to run unchecked at whatever cost.

...

So the Congressional Republicans persistently attack and undermine reform, as they did by passing a resolution this week to delay the law's individual mandate.
...
And they did so despite warnings from the insurance industry that a delay would only increase rates for everyone.

Supporters of the Affordable Care Act have long reassured each other that the law would gain popularity someday. But if present trends continue, the public may come to realize as early as next year that the benefits of Obamacare greatly outweigh the flaws --

...

So the question posed for the CDZ is Obamacare true capitalism in action?

It's not a free market, if that's what you mean by 'true capitalism'. You addressed this thread to Republican opposition, and I can't speak for what Republicans value in a free market. For me though, the true appeal of a free market isn't competition. I don't prefer it because it's the most efficient way to manage labor and resources (it might or might not be - I don't really care). I don't advocate for the free market because it will make us more prosperous or because it rewards virtue and punishes sloth (sad fact: I'm quite slothful myself). I fight for a free market because its free. It leaves it up to each of us how to choose how we will spend our time and money. Any system that violates that freedom, as PPACA does in so many ways, stands in stark contrast to a free market, and to any version of capitalism the presupposes a free market.

 

[Kevin_Kennedy]

When you purchase a car in certain states you are compelled to provide proof of insurance. When you purchase a home some states compel you to have homeowner insurance. Are neither of those market transactions "remotely capitalist"?

As a matter of fact they're not. Anything that can force you to purchase its product is not market-based, and thus not capitalism.

So given your definition of capitalism as excluding the "forced purchase" of anything besides only what you want to buy that will exclude all cell phone purchases where you have to have a 2 year contract and other such deals. All leases of any equipment that required a service contract would also not be capitalism. Neither would something like a bank checking account or credit card where you are forced to pay fees and interest for that matter. How about a happy meal that forces you to purchase a soda that you don't want? In order to get to your version of "pure capitalism" we have to have the absolute right to not purchase anything we don't want, right?

Poor comparisons. You don't have to buy a Happy Meal or a cell phone in the first place.

 

[FA_Q2]

As a matter of fact they're not. Anything that can force you to purchase its product is not market-based, and thus not capitalism.

So given your definition of capitalism as excluding the "forced purchase" of anything besides only what you want to buy that will exclude all cell phone purchases where you have to have a 2 year contract and other such deals. All leases of any equipment that required a service contract would also not be capitalism. Neither would something like a bank checking account or credit card where you are forced to pay fees and interest for that matter. How about a happy meal that forces you to purchase a soda that you don't want? In order to get to your version of "pure capitalism" we have to have the absolute right to not purchase anything we don't want, right?

Poor comparisons. You don't have to buy a Happy Meal or a cell phone in the first place.

Add to that the fact that those products can indeed be purchased without said unwanted extras. The market provides that which customers demand and non-contract cell phones, hamburgers not in happy meals and credit cards without service fees are all provided should you be looking for those services.

For the OP:
I fail to see how you can deliberately twist the meaning of capitalism to fit here. There is nothing capitalist about a system that requires through force of law that you purchase a product. Certainly competition is a good thing and should be encouraged. Even the exchanges themselves are not anti-capitalist. Hell, they are even a good idea. The problem is not that Obamacare establishes the exchanges but that they throw capitalism out the window when they dictated insurance companies’ profits, forced customers to purchase the product and then defined the product itself. At the end of the day I am left asking what the hell the insurance companies exist for anyway at this juncture? You essentially got your single payer with a corporate middleman who gets paid to simply deliver what the government wants them to deliver. This is corporatism at its very worst and most corrupt. The only thing that is scarier than the government taking this type of action is the fact that people actually support this blatant cronyism.

 

[Derideo_Te]

So given your definition of capitalism as excluding the "forced purchase" of anything besides only what you want to buy that will exclude all cell phone purchases where you have to have a 2 year contract and other such deals. All leases of any equipment that required a service contract would also not be capitalism. Neither would something like a bank checking account or credit card where you are forced to pay fees and interest for that matter. How about a happy meal that forces you to purchase a soda that you don't want? In order to get to your version of "pure capitalism" we have to have the absolute right to not purchase anything we don't want, right?

Poor comparisons. You don't have to buy a Happy Meal or a cell phone in the first place.

Add to that the fact that those products can indeed be purchased without said unwanted extras. The market provides that which customers demand and non-contract cell phones, hamburgers not in happy meals and credit cards without service fees are all provided should you be looking for those services.

For the OP:
I fail to see how you can deliberately twist the meaning of capitalism to fit here. There is nothing capitalist about a system that requires through force of law that you purchase a product. Certainly competition is a good thing and should be encouraged. Even the exchanges themselves are not anti-capitalist. Hell, they are even a good idea. The problem is not that Obamacare establishes the exchanges but that they throw capitalism out the window when they dictated insurance companies’ profits, forced customers to purchase the product and then defined the product itself. At the end of the day I am left asking what the hell the insurance companies exist for anyway at this juncture? You essentially got your single payer with a corporate middleman who gets paid to simply deliver what the government wants them to deliver. This is corporatism at its very worst and most corrupt. The only thing that is scarier than the government taking this type of action is the fact that people actually support this blatant cronyism.

Given that no one is willing to agree on the concept that capitalism relies upon competition for whatever reasons they have stated we are left with the fundamental question about the morality to make a profit off of the misfortune of others. Certainly competition amongst corporations where making a better product results in greater profits than competitors is a sound principle. However when all of the HMOs are essentially selling an identical product, namely healthcare insurance, where is the competition and just how much of a profit can you squeeze out of the parents of a sick child? Yes, that is an emotional argument to make but we are dealing with a situation where healthcare bills are a major driving factor in personal bankruptcies. At what point does the right to make a profit to the point when it results in bankrupting the consumer do more harm than good to the economy as a whole?

Since that was the reality driving the need to reform the healthcare system the concept of introducing competition in order to bring down prices makes sense. The demand for an "informed consumer" who can decide for themselves what level of insurance to purchase to meet their needs was addressed by the exchanges. This is akin to giving people a choice to purchase "green energy" via their utility bills. It goes even further with the deregulation that allows the consumer to pick the source of their gas bill too. So informed consumers get to choose who provides the electricity and gas in their homes. The same competitive principle is now being applied to healthcare. Instead of having to take a job just because it has healthcare benefits workers can now opt to take other positions and purchase their own healthcare directly from a range of choices. If this isn't capitalism in action then what is it?

 

[dblack]

Given that no one is willing to agree on the concept that capitalism relies upon competition ...

You're making a simple logic error here. Regardless of whether capitalism requires competition, it also requires a free market. You're claiming that because the exchanges feature (a limited kind of) competition, they implement capitalism. Competition may be seen as necessary for capitalism, but it's not sufficient.

If this isn't capitalism in action then what is it?

It's corporatism.

 

[Derideo_Te]

Given that no one is willing to agree on the concept that capitalism relies upon competition ...

You're making a simple logic error here. Regardless of whether capitalism requires competition, it also requires a free market. You're claiming that because the exchanges feature (a limited kind of) competition, they implement capitalism. Competition may be seen as necessary for capitalism, but it's not sufficient.

So by your definition the existing healthcare system (prior the the ACA) where there is neither competition nor a "free market" is simply a means by which HMO's can make whatever profits they deem fit. The exchanges will open up the "free market" by allowing consumers to choose from a far greater range of options than were previously available.

If this isn't capitalism in action then what is it?

It's corporatism.

Please clarify how you interpret the exchanges as corporatism.

 

[PhillyGuard]

Centralized planning, heavy-handed rules on product features, forced purchases does NOT equal capitalism.

 

[dblack]

Please clarify how you interpret the exchanges as corporatism.

Sure. Corporatism is, essentially, special-interest government. Under corporatism, the primary function of government is to operate as 'power-broker' granting privileges to various power-blocs in exchange for concessions and compromise. PPACA was, at its core, a corporatist 'deal' with the insurance industry. The government serves them up guaranteed customers via the mandate in exchange for guaranteed issue.

The exchanges form cartels that only privileged corporations may participate in. Further, by establishing mandatory coverage limits, they limit consumer options, forcing us all to conform to standard solutions that might, or might not, fit our needs.

 

[Derideo_Te]

Please clarify how you interpret the exchanges as corporatism.

Sure. Corporatism is, essentially, special-interest government. Under corporatism, the primary function of government is to operate as 'power-broker' granting privileges to various power-blocs in exchange for concessions and compromise. PPACA was, at its core, a corporatist 'deal' with the insurance industry. The government serves them up guaranteed customers via the mandate in exchange for guaranteed issue.

The exchanges form cartels that only privileged corporations may participate in. Further, by establishing mandatory coverage limits, they limit consumer options, forcing us all to conform to standard solutions that might, or might not, fit our needs.

Thank you for the clarification. Considering how many different definitions of corporatism exist it was inevitable that there would be one that could be made to fit this situation (and any other for that matter.) From this explanation it appears as though you see this as a bad solution to the problem of healthcare in America. What would be your preferred alternative?

 

[dblack]

Thank you for the clarification. Considering how many different definitions of corporatism exist it was inevitable that there would be one that could be made to fit this situation (and any other for that matter.) From this explanation it appears as though you see this as a bad solution to the problem of healthcare in America. What would be your preferred alternative?

Well, to begin with, doing nothing is better than doing something that will make things worse. So simply repealing PPACA and replacing it with nothing is preferable to allowing it to become the status quo.

But there's no denying the health care market is deeply dysfunctional. The biggest problem, however, isn't a lack of competition among insurance companies. It's a lack of downward price pressure on health care providers. And that's a direct result of too much insurance. Insurance makes sense as a hedge against unforeseen risk - especially risk that would be financially catastrophic. But as a means of financing routine expenses it's stupid. At the personal level, it adds an unnecessary middle man in every single transaction it infects. At the macro level, it distorts consumer demand, obliterates price shopping and drive prices up in any market where it becomes the principle means of financing purchases. We need less insurance, not more.

If I were task for designing policy to cure the problems in the health care market, I'd first look for all the ways government policy is propping up health insurance coverage and eliminate them. I'd also use the 'commerce clause' as it was intended and bust up all the protectionist regimes built up around state health insurance, and health care, regulation.

 

[Quantum Windbag]

If Republicans Love Competition, Why Do They Still Hate Obamacare? | Joe Conason

When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition!
...
It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us -- in the abstract.

What they don't seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace -- and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.

That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or "silver") health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.

The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies -- and certainly nothing like the health insurance "exchanges" created by Obamacare to guide consumer choices.

In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. "That's a very different dynamic for these companies, and it's prodding them to be more aggressive and competitive in their pricing," explains Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reform.

For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.

But why do self-styled conservatives continue to hate health care reform with such ferocity? They may not care that it is truly "pro-life" and "pro-family," with the clear promise of saving thousands of lives annually among families that were previously uninsured. Yet they should surely appreciate a statute that promotes competition where there was none, improving services and reducing prices through freer enterprise.

...

For what we can now observe in practice is that the Republicans perversely prefer a corporate marketplace without competition over a marketplace with competition overseen by government. While European conservatives have long accepted the need for strictly regulated markets, especially in health care, their American counterparts would rather allow corporate power to run unchecked at whatever cost.

...

So the Congressional Republicans persistently attack and undermine reform, as they did by passing a resolution this week to delay the law's individual mandate.
...
And they did so despite warnings from the insurance industry that a delay would only increase rates for everyone.

Supporters of the Affordable Care Act have long reassured each other that the law would gain popularity someday. But if present trends continue, the public may come to realize as early as next year that the benefits of Obamacare greatly outweigh the flaws --

...

So the question posed for the CDZ is Obamacare true capitalism in action?

It was based upon the Republican plan that opposed "Hilarycare" in the 1990's and intended to foster competition in the states so that "market rates" could prevail. Now that we see it coming into play will we find out if genuine competition does lower prices?

Alternatively are Republicans afraid that it won't actually lower healthcare costs and that could damage the credibility of their claim to "free markets"? Or are they looking at making a last ditch stand this Fall to prevent the implementation of Obamacare because they are afraid that it will work?

Please remember that this is the CDZ and the purpose of having these questions in this forum is to find the reality behind the emotional rhetoric. Thank you in advance for your responses. DT

In a word, no.

 

[Derideo_Te]

Thank you for the clarification. Considering how many different definitions of corporatism exist it was inevitable that there would be one that could be made to fit this situation (and any other for that matter.) From this explanation it appears as though you see this as a bad solution to the problem of healthcare in America. What would be your preferred alternative?

Well, to begin with, doing nothing is better than doing something that will make things worse. So simply repealing PPACA and replacing it with nothing is preferable to allowing it to become the status quo.

But repealing the ACA means the current dysfunctional system will remain in place and that is what is driving healthcare costs to completely unaffordable levels and causing bankruptcies that are harming the economy.

But there's no denying the health care market is deeply dysfunctional. The biggest problem, however, isn't a lack of competition among insurance companies. It's a lack of downward price pressure on health care providers. And that's a direct result of too much insurance. Insurance makes sense as a hedge against unforeseen risk - especially risk that would be financially catastrophic. But as a means of financing routine expenses it's stupid. At the personal level, it adds an unnecessary middle man in every single transaction it infects. At the macro level, it distorts consumer demand, obliterates price shopping and drive prices up in any market where it becomes the principle means of financing purchases. We need less insurance, not more.

If I were task for designing policy to cure the problems in the health care market, I'd first look for all the ways government policy is propping up health insurance coverage and eliminate them. I'd also use the 'commerce clause' as it was intended and bust up all the protectionist regimes built up around state health insurance, and health care, regulation.

Deregulating the current healthcare system will result in even worse healthcare. Without the FDA there would be no regulation on drugs. Without licensing of doctors, nurses, clinics and hospitals anyone could practice medicine. Anyone would be allowed to dispense drugs in any dosages. The system is incapable of regulating itself.

 

[bripat9643]

If Republicans Love Competition, Why Do They Still Hate Obamacare? | Joe Conason

When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition!
...
It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us -- in the abstract.

What they don't seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace -- and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.

That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or "silver") health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.

The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies -- and certainly nothing like the health insurance "exchanges" created by Obamacare to guide consumer choices.

In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. "That's a very different dynamic for these companies, and it's prodding them to be more aggressive and competitive in their pricing," explains Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reform.

For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.

But why do self-styled conservatives continue to hate health care reform with such ferocity? They may not care that it is truly "pro-life" and "pro-family," with the clear promise of saving thousands of lives annually among families that were previously uninsured. Yet they should surely appreciate a statute that promotes competition where there was none, improving services and reducing prices through freer enterprise.

...

For what we can now observe in practice is that the Republicans perversely prefer a corporate marketplace without competition over a marketplace with competition overseen by government. While European conservatives have long accepted the need for strictly regulated markets, especially in health care, their American counterparts would rather allow corporate power to run unchecked at whatever cost.

...

So the Congressional Republicans persistently attack and undermine reform, as they did by passing a resolution this week to delay the law's individual mandate.
...
And they did so despite warnings from the insurance industry that a delay would only increase rates for everyone.

Supporters of the Affordable Care Act have long reassured each other that the law would gain popularity someday. But if present trends continue, the public may come to realize as early as next year that the benefits of Obamacare greatly outweigh the flaws --

...

So the question posed for the CDZ is Obamacare true capitalism in action?

It was based upon the Republican plan that opposed "Hilarycare" in the 1990's and intended to foster competition in the states so that "market rates" could prevail. Now that we see it coming into play will we find out if genuine competition does lower prices?

Alternatively are Republicans afraid that it won't actually lower healthcare costs and that could damage the credibility of their claim to "free markets"? Or are they looking at making a last ditch stand this Fall to prevent the implementation of Obamacare because they are afraid that it will work?

Please remember that this is the CDZ and the purpose of having these questions in this forum is to find the reality behind the emotional rhetoric. Thank you in advance for your responses. DT

I can't imagine any idea more idiotic than the claim that we can't have competition without some huge government bureaucracy controlling everything down to the last detail. The only thing necessary for competition is for government to get out of the way. Government is what currently limits competition in the insurance marketplace today. The federal government allows state government to keep out of state insurance companies from competing with local companies. i don't even understand the point of insurance "exchanges." Currently every insurance company that does business in your state offers their rates and benefits on the internet. THere are web sites that compare all the policies offered by the various companies, and tells you their prices. Thy provide a link so you can go to each company's website and purchase a policy from them. What benefit does the "exchange" provide?

 

[bripat9643]

So the question posed for the CDZ is Obamacare true capitalism in action?

It was based upon the Republican plan that opposed "Hilarycare" in the 1990's and intended to foster competition in the states so that "market rates" could prevail. Now that we see it coming into play will we find out if genuine competition does lower prices?

Alternatively are Republicans afraid that it won't actually lower healthcare costs and that could damage the credibility of their claim to "free markets"? Or are they looking at making a last ditch stand this Fall to prevent the implementation of Obamacare because they are afraid that it will work?

Please remember that this is the CDZ and the purpose of having these questions in this forum is to find the reality behind the emotional rhetoric. Thank you in advance for your responses. DT

No, it's not. Capitalism is based on the free market. Obamacare is everything but a free market. The insurance companies WROTE the law for the most part that's why contrary to what was claimed in almost all cases insurance rates are going up, way up in some cases.

If you wanted real capitalism you would have seen the Federal regulations removed that prevented shopping outside of your state for insurance. The insurance companies have legal monopolies only enjoyed by pro baseball. All other companies aren't protected like that.

Agreed that they were "legal monopolies" but aren't the "exchanges" going to provide the ability to shop outside your state?

The only requirement for that to happen is for the federal government to repeal the law that prevents out-of-state companies from competing.

 

[oldfart]

Sure. Corporatism is, essentially, special-interest government. Under corporatism, the primary function of government is to operate as 'power-broker' granting privileges to various power-blocs in exchange for concessions and compromise. PPACA was, at its core, a corporatist 'deal' with the insurance industry. The government serves them up guaranteed customers via the mandate in exchange for guaranteed issue.

The exchanges form cartels that only privileged corporations may participate in. Further, by establishing mandatory coverage limits, they limit consumer options, forcing us all to conform to standard solutions that might, or might not, fit our needs.

Thank you for the clarification. Considering how many different definitions of corporatism exist it was inevitable that there would be one that could be made to fit this situation (and any other for that matter.) From this explanation it appears as though you see this as a bad solution to the problem of healthcare in America. What would be your preferred alternative?

In reading through the thread it seems to me that the main point has been missed. From the perspective of economic thinking, public policy comes down to choosing the best way to get people to do (or refrain from doing) what is deemed in the public interest. Usually economists look for market solutions, incentives for desired behavior and disincentives for undesired behavior. Some political theory takes a different, legalistic, approach: ban what is undesirable. The concept of "rights" stems from the desire to limit what government can punish.

Now just like the old axiom of comparative economics ("You can be for markets, you can be for direction; but you can't be against both"), there really is no viable third choice: we can look for market solutions, we can look for legal/regulatory solutions, but we can't be against both. Realistically most solutions involve a mix.

When people start talking about absolute rights in connection to market solutions, thing get really weird really fast; just look at this thread! Suppose we all agree that everyone should have access to reasonably adequate health care, and hat this health care should be paid for through privately-owned health insurance companies. How do we assure that such insurance is available to everyone? Do we force insurance companies to accept all applicants (legalistic approach)? If so, how do we enforce it? Tort action by the public? Public subsidies and advantages such as access to the exchanges?

This discussion turned into a semantics duel with tortured and convoluted reasoning because it tried to apply a doctrine of absolute economic rights to an attempted market solution where it is not very helpful.

Milton Friedman addressed this issue concerning the role of government in the 50's when he broached the subject of government regulation of markets. One of his examples was regulation of weights and measures. Should the government require fair measure or should every consumer be responsible for verifying the accuracy of what they buy themselves? Do we infringe on the rights of the butcher when we legally require his scales to be accurate? Could the meat market exist if the government did not enforce fair weights?

It seems to me the thread has been discussing the absolute rights of market participants to be free of any government coercion; in essence to be free to cheat. This isn't about choice, it's about whether we want to have a market at all. Our current health care financing system is inexorably tending to self-annihilation. Eventually everyone becomes uninsurable and if current underwriting trends continue at some point health insurance will be unattainable for a large enough number of Americans that all of the health delivery system will be bankrupted by uncompensated care. Neither private charity nor public programs will have the resources to provide minimal services for the uninsured and the majority of the population will enter the death lottery. It already happens now and tens of thousands die every year in that lottery.

Now some people will be OK. The rich generally can afford their care, and some groups like military veterans will have public programs. A dwindling number of employers will still provide quality health insurance and some states like Massachussetts will cover almost everyone. And there will be a large pool of lottery participants whose number hasn't come up yet. But all of these groups are diminishing.

Obamacare is one ugly bastard of a health care financing system. Personally I think it will work pretty well and be an improvement over what we have now. Maybe it will buy enough time to straighten out what's really wrong with the health care system. It's a long way from perfect and is pretty much what is left when all the good ideas have been ruled out. But it will not get any better by trying to make it conform to a pure ideal of a market which has never and cannot in any circumstances exist.

 

[Derideo_Te]

No, it's not. Capitalism is based on the free market. Obamacare is everything but a free market. The insurance companies WROTE the law for the most part that's why contrary to what was claimed in almost all cases insurance rates are going up, way up in some cases.

If you wanted real capitalism you would have seen the Federal regulations removed that prevented shopping outside of your state for insurance. The insurance companies have legal monopolies only enjoyed by pro baseball. All other companies aren't protected like that.

Agreed that they were "legal monopolies" but aren't the "exchanges" going to provide the ability to shop outside your state?

The only requirement for that to happen is for the federal government to repeal the law that prevents out-of-state companies from competing.

Doesn't the PPACA do exactly that?

 

[Derideo_Te]

If Republicans Love Competition, Why Do They Still Hate Obamacare? | Joe Conason

When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition!
...
It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us -- in the abstract.

What they don't seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace -- and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.

That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or "silver") health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.

The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies -- and certainly nothing like the health insurance "exchanges" created by Obamacare to guide consumer choices.

In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. "That's a very different dynamic for these companies, and it's prodding them to be more aggressive and competitive in their pricing," explains Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reform.

For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.

But why do self-styled conservatives continue to hate health care reform with such ferocity? They may not care that it is truly "pro-life" and "pro-family," with the clear promise of saving thousands of lives annually among families that were previously uninsured. Yet they should surely appreciate a statute that promotes competition where there was none, improving services and reducing prices through freer enterprise.

...

For what we can now observe in practice is that the Republicans perversely prefer a corporate marketplace without competition over a marketplace with competition overseen by government. While European conservatives have long accepted the need for strictly regulated markets, especially in health care, their American counterparts would rather allow corporate power to run unchecked at whatever cost.

...

So the Congressional Republicans persistently attack and undermine reform, as they did by passing a resolution this week to delay the law's individual mandate.
...
And they did so despite warnings from the insurance industry that a delay would only increase rates for everyone.

Supporters of the Affordable Care Act have long reassured each other that the law would gain popularity someday. But if present trends continue, the public may come to realize as early as next year that the benefits of Obamacare greatly outweigh the flaws --

...

So the question posed for the CDZ is Obamacare true capitalism in action?

It's not a free market, if that's what you mean by 'true capitalism'. You addressed this thread to Republican opposition, and I can't speak for what Republicans value in a free market. For me though, the true appeal of a free market isn't competition. I don't prefer it because it's the most efficient way to manage labor and resources (it might or might not be - I don't really care). I don't advocate for the free market because it will make us more prosperous or because it rewards virtue and punishes sloth (sad fact: I'm quite slothful myself). I fight for a free market because its free. It leaves it up to each of us how to choose how we will spend our time and money. Any system that violates that freedom, as PPACA does in so many ways, stands in stark contrast to a free market, and to any version of capitalism the presupposes a free market.

So does that include the "freedom" to watch a loved one die simply because they cannot afford the "free market" healthcare that would have saved their life? Does healthcare have to obey "free market" principles? For your "freedom" to be absolute you should be able to purchase a nuclear missile on the "free market". Why shouldn't you have that "freedom" since it is your "time and money"? Where does you "freedom" stop? When the nuclear radiation leaking out of that device starts making your neighbors sick? Do you have a responsibility to ensure that they are not harmed by your "freedom" or does that impinge upon your "freedom"? Is it up to them to spend their "time and money" building a radiation proof shelter to protect themselves from your "freedom"? Aren't you now imposing an undue burden on both their "freedom" and their "time and money"?

So the reason for those questions is because if your neighbor contracts a highly contagious fatal disease your risk of becoming sick increases if your neighbor is not treated. If your neighbor doesn't have the "freedom" and the "time and money" to purchase their healthcare from the "free market" then your "life, liberty and the pursuit of happiness" are in jeopardy. Society is at risk when individuals are unhealthy. The economic cost of not having a healthy workforce is significant. So your individual "freedom" depends upon the health of your neighbors just as capitalism depends upon consumers with disposable income.

At some point pragmatism has to strike a balance between your absolute unfettered "freedom" and the reality that your "freedom" does have limitations. This thread has established that Obamacare is not "true capitalism in action" but that raises the question as to what is the alternative?

 

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This thread has established that Obamacare is not "true capitalism in action" but that raises the question as to what is the alternative?

The alternative, in my view, should have been expanding the safety net for the folks falling through the cracks, and then removing the incentives and ill-conceived regulations that have painted us into this corner in the first place. PPACA does the opposite on both counts, it undercuts existing safety nets, and pushes all of us into the dysfunctional financing models currently plaguing the health care market.