America's aversion to socialism ?

[mheslep]

Sure.

"[URL ECONOMIC ANALYSIS OF A DRUG-SELLING
GANG’S FINANCES
[/URL]

Levitt did a video presentation as well that's very good.
Why do crack dealers still live with their moms?

 

[russ_watters]

Well, first, congratulations. You don't pay a lot for health insurance in European terms, my bill is double of that.

That's just the out of pocket cost - it doesn't include the employer's match. It was just for illustration of what happens when you socialize it.

If I look at the problem then health cost are dependent on the amount of health care a public needs. No matter what system, MDs always take care that health care will be given, even if a person didn't pay for it. And the public will pay that bill anyway.

Therefor, I just think that the cheapest solution is just to look at what health care is needed (and tax it.)

I.e., if you need a hospital per 100k people, you should derive the cost for that, employ a few hundred doctors, and let them figure out what the best health care should be. (IMO, they will because that's just what they do.) There's nothing else to do. Even an insurance company is overhead since you implemented a second system because it may as well just be taxed.

Even if true, none of that has much bearing on what people will actually pay. That's my point that you are still missing.

 

[MarcoD]

That's just the out of pocket cost - it doesn't include the employer's match. It was just for illustration of what happens when you socialize it. Even if true, none of that has much bearing on what people will actually pay. That's my point that you are still missing.

No, there's is the point how the bill will be divided, I get that. Whether flat or fairly taxed, that's a matter for politics. But in a free market deregulated system, I am pretty sure you'll just end up paying a 'fair' share - bigger wallet => more costs. Moreover, in a deregulated system there isn't any upper bound of what you end up paying, except for your wallet. The insurance company will want to maximize share, the MDs will want to maximize share, the hospital directors will want to maximize share, everything works against you. That's why I believe in taxing it and fixing the budget from the top, and just let that budget trickle down to the end health care giver. I don't think anything can be cheaper or more just.

 

[daveb]

Why don't review the posts assembled in this thread by the member with a cumulative one (1) post - and my responses to them?

And he still has only 1 post listed, despite having numerous posts in this thread, so pointing out that he has only 1 post is disingenuous since you obviously know he has more than 1, and that it's a bug in the system (or something else, I don't know how posts are tallied).

 

[russ_watters]

No, there's is the point how the bill will be divided, I get that. Whether flat or fairly taxed, that's a matter for politics.

No, I don't think you get it: regardless of which common tax scheme you use, substantial redistribution is always a component of socializing it - and the effect is much larger for most people than any potential benefit or loss in system
efficiency. You are focusing on a relatively small, secondary effect of socialization and ignoring the socialization itself.

 

[WhoWee]

And he still has only 1 post listed, despite having numerous posts in this thread, so pointing out that he has only 1 post is disingenuous since you obviously know he has more than 1, and that it's a bug in the system (or something else, I don't know how posts are tallied).

Political posts don't count towards your total. Please consider this discussion in another thread - post number 5:

https://www.physicsforums.com/showthread.php?t=529895

"Evo

Posts: 16,996
Degree: gardening
Re: Why do we react differently on political threads than we do on scientific ones?
Originally Posted by Pengwuino
"Then again, I've noticed certain people on the forum have never posted a single post out of GD/P&WR... smells like Troll."

(EVO)
That's another thing we are considering, in order to be allowed to post in P&WA, members will first need to have a minimum of 500 posts outside of the lounge. This will ensure that P&WA is a perk for dedicated members."

 

[mheslep]

Consider that the market system now provides food, air travel, communications, entertainment, etc. It does this, I think, remarkably efficiently, with China being perhaps the most recent example in a long line of successes. The market system in China has literally raised hundreds of millions out of abject poverty, after the prior horrific implementation of the Maoist centrally planned state kept them their for decades. To those who suggest a health care system must be budgeted "from the top", or centrally planned, I ask why health care must be administered this way and in particular why you are unable to imagine that no other system "can be cheaper or more just"?

 

[russ_watters]

I rather suspect you have the premise of the question (the last line) wrong...

More importantly, the question is irrelevant to the primary purpose and flaws in (or, rather, why some Americans dislike) socialism.

 

[mheslep]

I rather suspect you have the premise of the question (the last line) wrong...

That they can not imagine anything better is wrong? That was the phrase used by MarcoD above.

 

[russ_watters]

That they can not imagine anything better is wrong? That was the phrase used by MarcoD above.

Edit: er, i think i misread...disregard that first part of my post.

I still think the second part is important, though because I see that part of the discussion as a red herring.

 

[CAC1001]

Universal healthcare need not be socialized medicine remember. France, what we think of as being a literal quasi-socialist country, does not have a socialist healthcare system. Their system is a combination of public, private and not-for-profit entities. Private healthcare in France treats more than 50% of surgeries and more than 60% of cancer cases.

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

 

[Dale]

Government healthcare: Your life and death decided with the compassion of the IRS and the efficiency of the DMV.

 

[apeiron]

Universal healthcare need not be socialized medicine remember. France, what we think of as being a literal quasi-socialist country, does not have a socialist healthcare system. Their system is a combination of public, private and not-for-profit entities. Private healthcare in France treats more than 50% of surgeries and more than 60% of cancer cases.

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

Logic would suggest a mixed model. You don't want everything done by the state (the largest scale) or left to the individual (smallest scale). Instead you want things spread optimally over all possible scales of social organisation (and yes, individual responsibility).

So what that looks like is the state doing what is optimal in terms of scale of economies and critical need (so setting a universal baseline under which it is not sensible to allow its citizenry to fall, then also being responsible for that which the large scale can provide more cheaply). But then not doing the soft stuff, the optional stuff, the frills, the stuff more efficiently contracted out).

So you want public emergency rooms (who else could provide the economies of scale and integration of service). But when it comes to cosmetic surgery or hip replacements, this starts to become the responsibilty of individuals. Or when it is minor stuff, you push it out to GP clinics and even e-medicine.

This is actually what real world health systems are doing. All this talk about state vs individual is missing the point when it pretends that effective societies can only be run on either a totally individual, or totally collectivised basis. To talk like that is a caricature of political or economic debate.

 

[daveb]

Universal healthcare need not be socialized medicine remember.

This is an important point to remember. Although I haven't read the whole thing, AFAIK "Obamacare" is not socialized healthcare (in the idea that you have no choice in doctor, what healthcare you receive, etc.) - it's subsidized healthcare (in that it just requires you to have insurance).

 

[mheslep]

Socialized healthcare does not mean one has zero choice in doctor, though it may be so. This is not the case in the UK's NHS for instance, certainly a case of socialized medicine. Rather it means the doctors, nurses, hospitals work directly for or are controlled by the state. Under Obamacare the state will not write the doctors paychecks, but like energy and telephone utilities it will largely control them, setting salary caps, specifying numbers of specialists and types of treatment programs.

 

[mheslep]

Universal healthcare need not be socialized medicine remember. France, what we think of as being a literal quasi-socialist country, does not have a socialist healthcare system. Their system is a combination of public, private and not-for-profit entities. Private healthcare in France treats more than 50% of surgeries and more than 60% of cancer cases.

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

The publicly run or controlled portion where the government owns the hospitals or determines fees is socialist, just as it is in the US.

 

[WhoWee]

Socialized healthcare does not mean one has zero choice in doctor. This is not the case in the UK's NHS for instance, certainly a case of socialized medicine. Rather it means the doctors, nurses, hospitals work directly for or are controlled by the state. Under Obamacare the state will not write the doctors paychecks, but like energy and telephone utilities it will largely control them, setting salary caps, specifying numbers of specialists and types of treatment programs.

The Medicare reimbursement rates are the standard for the insurance industry.

 

[czelaya]

One factor that tends to be overlooked in health care are the areas of medicine that are the most free market oriented(if this has been already stated please delete).

Lasik surgery is not regulated by insurance companies or the government. When it was first introduced the cost of eye surgery was expensive. However, fierce competition amongst doctors and the lasik industry have driven the cost of the surgery in spite of inflation. Currently lasik surger is cheaper, safer, and has advanced substantionaly.



I'm sure if lasik became an insurance option and subdized by government, the cost of the surgery would sky rocket.

 

[mheslep]

One factor that tends to be overlooked in health care are the areas of medicine that are the most free market oriented(if this has been already stated please delete).

Lasik surgery is not regulated by insurance companies or the government. When it was first introduced the cost of eye surgery was expensive. However, fierce competition amongst doctors and the lasik industry have driven the cost of the surgery in spite of inflation. Currently lasik surger is cheaper, safer, and has advanced substantionaly.

...
I'm sure if lasik became an insurance option and subdized by government, the cost of the surgery would sky rocket.

https://www.physicsforums.com/showpost.php?p=1616468&postcount=116" (no employer tax break, no insurance), where costs have remained almost flat for a decade while regular medical insurance went up ~9% last year alone.

 

[mheslep]

The Medicare reimbursement rates are the standard for the insurance industry.

That argues then that the socialization of medicine in the US extends beyond Medicare.

 

[maine75man]

That argues then that the socialization of medicine in the US extends beyond Medicare.

I'm not sure if it's that. Is anyone aware if that's the result of a legal mandate or just industry standardization.

It's possible that the government bean counters just did the work first. Insurance companies looked at it decided it was good enough, then figured they didn't need to pay people to repeat the same task.

If that's the case it less an issue of government control and more an issue of corporate welfare. With a government agency providing a free service for companies they would otherwise have to pay for in the open market.

 

[mheslep]

I'm not sure if it's that. Is anyone aware if that's the result of a legal mandate or just industry standardization.

It's possible that the government bean counters just did the work first. Insurance companies looked at it decided it was good enough, then figured they didn't need to pay people to repeat the same task.

? How do you know it is not other way around?

If that's the case it less an issue of government control and more an issue of corporate welfare. With a government agency providing a free service for companies they would otherwise have to pay for in the open market.

In a real market not dominated by Medicare/Medicaid, the real price would be set by negotiation by buyer and seller. As it is the purchaser crunches numbers and can "set a price", a fiction.

 

[WhoWee]

? How do you know it is not other way around?

In a real market not dominated by Medicare/Medicaid, the real price would be set by negotiation by buyer and seller. As it is the purchaser crunches numbers and can "set a price", a fiction.

Here's a few links.

https://www.cms.gov/apps/physician-fee-schedule/overview.aspx

http://www.ama-assn.org/ama/pub/phy.../the-medicare-physician-payment-schedule.page

https://www.cms.gov/medicaidrf/

http://www.gehealthcare.com/usen/community/reimbursement/docs/em_reimbursement_info_2011_DOC0941390.pdf

http://www.asha.org/practice/reimbursement/medicare/feeschedule/

 

[maine75man]

I'm not sure if it's that. Is anyone aware if that's the result of a legal mandate or just industry standardization.

It's possible that the government bean counters just did the work first. Insurance companies looked at it decided it was good enough, then figured they didn't need to pay people to repeat the same task.

? How do you know it is not other way around?

What do you mean by the other way around? Which statement do you think could be reversed? I was illustrating one potential conclusion based on the information presented about the private insurance industry using the governments fee schedule. I presented it as a possibility that might be an alternative to your conclusion and even requested information that might illuminate the question further.

If that's the case it less an issue of government control and more an issue of corporate welfare. With a government agency providing a free service for companies they would otherwise have to pay for in the open market.

In a real market not dominated by Medicare/Medicaid, the real price would be set by negotiation by buyer and seller. As it is the purchaser crunches numbers and can "set a price", a fiction.

I think I see what your getting at here. I agree that in a "real market" price is set by a negotiation between buyer and seller. But even if there was no such thing as Medicare/Medicaid wouldn't private insurers still implement a fee schedule of some sort. With insurance companies operating as intermediaries between consumers and providers your already creating something other than a "real market".

 

[mheslep]

... With insurance companies operating as intermediaries between consumers and providers your already creating something other than a "real market".

Agreed. Insurers plus employers as intermediaries due to employer health care tax advantage in the US.

 

[DoggerDan]

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

And yet their tax rates are still 40%...

 

[Zarqon]

And yet their tax rates are still 40%...

...and as I pointed out before, this number is still not that meaningful.

What matters (from a financial point of view) in the end is how much money you have over after all bills are paid, whether you pay those bills as a part of your tax or independently doesn't matter.

 

[mege]

...and as I pointed out before, this number is still not that meaningful.

What matters (from a financial point of view) in the end is how much money you have over after all bills are paid, whether you pay those bills as a part of your tax or independently doesn't matter.

It is meaningful in the situation regarding Germany and in general.

With Germany - they have about twice the average individual tax rate as the US, but yet many there still have to purchase their own health insurance. So where's the tax-to-service difference?

In general - that 40% taxes that I would pay in Germany is 40% of my income that I don't get to make a choice on. For simplicity's sake (these numbers are all off, but still illustrative), let's say that America's individual tax rate is 20% (exactly half of DE). For the difference: an American spends 20% of their income on a car payment and insurance, where a German gets a car and insurance from the government (the rest of the taxes are spent in the same way). Would you rather have the government-issue car for that 20% of your income or have a choice in what car you get for the 20% of your income? This example is also presuming the utopian situation where the government could obtain, maintain, and provide cars for the same price as an individual in a free market with respect to cars. I would much rather be able to pick out a car myself than have a government issued car - sure I pay the same in the end, but the devil is in the freedom of the details. I get to make a choice about my life, that extra 20% of my labor is at my discression. If I choose to take the bus to work everyday and NOT own a car, what then? I'm still forced, by the (non)virtue of taxation to own a car and not do the most efficient and effective thing for me.

The question with socialism is: what is more important - freedom or equality? Forced equality intrinsically comes at the expense of freedom. Whereas enforced freedom does NOT intrinsically diminish equality.

 

[MarcoD]

The question with socialism is: what is more important - freedom or equality? Forced equality intrinsically comes at the expense of freedom. Whereas enforced freedom does NOT intrinsically diminish equality.

First off, you equate freedom to the amount of 'bling-bling' you own. Why? Second off, if the amount of 'bling-bling' defines freedom, then in a system where wealth is redistributed more evenly, people in general should be more free.

You'll need better reasons than some car example, which has nothing to do with what most people want: freely accessible and cheap public services.

 

[WhoWee]

First off, you equate freedom to the amount of 'bling-bling' you own. Why? Second off, if the amount of 'bling-bling' defines freedom, then in a system where wealth is redistributed more evenly, people in general should be more free.

You'll need better reasons than some car example, which has nothing to do with what most people want: freely accessible and cheap public services.

How does the personal choice of a car equate to "the amount of 'bling-bling' you own"? If I want a 5 door silver hatchback and my neighbor wants a 2 seat red coupe - either hardly 'bling-bling' - the compromise might be we both get a 4 door sedan?

IMO - if a citizen doesn't have a job and doesn't have a means to purchase food, shelter, transportation, or healthcare - then whatever the Government provides should be acceptable and appreciated. On the other hand, the persons paying taxes to make these charity programs available to people that can't help themselves - should be free to spend their remaining money as they decide.

 

[Zarqon]

It is meaningful in the situation regarding Germany and in general.

With Germany - they have about twice the average individual tax rate as the US, but yet many there still have to purchase their own health insurance. So where's the tax-to-service difference?

In general - that 40% taxes that I would pay in Germany is 40% of my income that I don't get to make a choice on. For simplicity's sake (these numbers are all off, but still illustrative), let's say that America's individual tax rate is 20% (exactly half of DE). For the difference: an American spends 20% of their income on a car payment and insurance, where a German gets a car and insurance from the government (the rest of the taxes are spent in the same way). Would you rather have the government-issue car for that 20% of your income or have a choice in what car you get for the 20% of your income? This example is also presuming the utopian situation where the government could obtain, maintain, and provide cars for the same price as an individual in a free market with respect to cars. I would much rather be able to pick out a car myself than have a government issued car - sure I pay the same in the end, but the devil is in the freedom of the details. I get to make a choice about my life, that extra 20% of my labor is at my discression. If I choose to take the bus to work everyday and NOT own a car, what then? I'm still forced, by the (non)virtue of taxation to own a car and not do the most efficient and effective thing for me.

Picking a car is not the same thing as the health insurance case. First of all because it's a very fictional case, since no modern social democratic country forces any type of car on it's citizens, they're always free to buy what the want (and indeed can afford). Secondly because health insurance is simply a matter of risk distribution, and the more people are in on it, meaning when the government makes sure everyone is in on it, the better and more efficient it has the potential to be.

The question with socialism is: what is more important - freedom or equality? Forced equality intrinsically comes at the expense of freedom. Whereas enforced freedom does NOT intrinsically diminish equality.

I don't agree with this assessment. I think that equality is essential to have freedom.

As an example to illustrate it, consider a person born in a poor family, trying to get a good education in a country like the US. Just because there is no law stating he can't attend a university doesn't mean he is equally free to do so as a person born into a rich family. The loss of this persons liberties is now not a principle one, but rather a practical one, although I would argue it is equally important.

(note, I know it is possible to get scholarships etc., but I'm talking about the average. A poor person in the US simply has less opportunities than a rich.)

 

[Zarqon]

How does the personal choice of a car equate to "the amount of 'bling-bling' you own"? If I want a 5 door silver hatchback and my neighbor wants a 2 seat red coupe - either hardly 'bling-bling' - the compromise might be we both get a 4 door sedan?

IMO - if a citizen doesn't have a job and doesn't have a means to purchase food, shelter, transportation, or healthcare - then whatever the Government provides should be acceptable and appreciated. On the other hand, the persons paying taxes to make these charity programs available to people that can't help themselves - should be free to spend their remaining money as they decide.

I agree, and this is also how it works in modern social democratic countries.

 

[mheslep]

If equality of result is essential to have freedom, what shall be done about the musical prodigy, or the mathematical prodigy? After all such children almost certainly are dependent on the inheritance of that talent to a degree from their parents. Shall they be placed in restraints, forced to play bad notes so the tone deaf can keep up?

https://www.youtube.com/watch?v=WJBeuR0xEP8

http://www.finallyequal.com/trailer.html
http://en.wikipedia.org/wiki/Harrison_Bergeron

 

[russ_watters]

I don't agree with this assessment. I think that equality is essential to have freedom.

As an example to illustrate it, consider a person born in a poor family, trying to get a good education in a country like the US. Just because there is no law stating he can't attend a university doesn't mean he is equally free to do so as a person born into a rich family. The loss of this persons liberties is now not a principle one, but rather a practical one, although I would argue it is equally important.

Where can I find those definitions of freedom and equality?

 

[mege]

Picking a car is not the same thing as the health insurance case. First of all because it's a very fictional case, since no modern social democratic country forces any type of car on it's citizens, they're always free to buy what the want (and indeed can afford). Secondly because health insurance is simply a matter of risk distribution, and the more people are in on it, meaning when the government makes sure everyone is in on it, the better and more efficient it has the potential to be.

If everyone had the same car, then parts would be homogenized - the efficiency could still be reduced to the same thing in the example. And it is just that - an example to show the absurdity of controlling one's income.

And how can a system that forces everyone to participate be more efficient? The ACA (or any other mandated health insurance) basically are putting cost-burdens on those with the lowest risk. It's not risk-sharing - it's risk-spreading. In traditional property insurance (the 'mutual' model) - 100 people each with 1% risk of getting flooded out put in 1% of the cost of rebuilding their houses - That's risk sharing. Risk spreading is 100% people with an average of 1% risk (50 with .5% and 50 with 1.5%) of flooding put in 1% of their costs - but the problem is that there are free riders. The 50 with 1.5% risk of flooding are getting a value! They're not actually paying proportional to their risk - this actually encourages them to take more risk. The same is true for health insurance - generally policies are grouped by risk, people are expected to pay according to their risk (determined by age, sex, etc). In a mandated system, where minimum risk expectations are set, you're essentially forcing individuals to over-cover (and allowing others to under-cover, but still get the full benefit). Those that are under-covered (paying less than their proportional risk) aren't going to reduce their risk seeking, while those that are over-covered, to get the full benefit, are going to take more risks. You've just upped the net risk of the whole market by forcing risk-spreading. (this is also why the costs per person WILL go up under the ACA per most models - but the collectivists see this as OK because now everyone is covered)

So again - net freedom is reduced as burdens are added to those with low risk (low burden).

This is not supposed to be freedom from personal responsibility...

I don't agree with this assessment. I think that equality is essential to have freedom.

As an example to illustrate it, consider a person born in a poor family, trying to get a good education in a country like the US. Just because there is no law stating he can't attend a university doesn't mean he is equally free to do so as a person born into a rich family. The loss of this persons liberties is now not a principle one, but rather a practical one, although I would argue it is equally important.

(note, I know it is possible to get scholarships etc., but I'm talking about the average. A poor person in the US simply has less opportunities than a rich.)

I echo russ_watter's question.

First off, you equate freedom to the amount of 'bling-bling' you own. Why? Second off, if the amount of 'bling-bling' defines freedom, then in a system where wealth is redistributed more evenly, people in general should be more free.

You'll need better reasons than some car example, which has nothing to do with what most people want: freely accessible and cheap public services.

I never said that an individual got a better car, infact I gave a situation where an individual would want LESS than the government provided him (although - if that individual wanted to spend 30% of his income and get a better car, he should be able to, but under the government system - he would be left with only 30% of his income because he woudl still be forced to have the government issued vehicle). The same could apply to health insurance: either in a central system or in a mandate the government is reducing choices. An individual could choose to have catastrophic insurance only, but unfortunately - under the ACA for example - that is no longer an option. An individual is forced to have comprehensive personal coverage. The same goes the other way - individuals that are 'over covered' ('Cadillac plans') are now being taxed out of the system, so everything is turned to the middle.