Great common sense here. Wish I’d thought of that.

Another issue I had while having Medicaid is: out of 16 calls to doctor’s offices to find a primary doctor, I had 7 tell me they weren’t accepting new patients (this was after they asked what insurance I had), the remaining secretaries told me they’d have to check with the doctor and would call me back. I received one call back. When I was lucky to find a job I could buy good insurance (it took most of my check), for research purposes, I called the same doctor’s I called when I had Medicaid. There were no problems getting in, all but one who previously said they weren’t accepting new patients were now accepting new patients. Then, probably the most disturbing is the difference in treatment. As a Medicaid recipient, I had subpar medical care. The difference in care for the same health issues were surprising, especially evident when seeing a dentist. It was almost impossible to find a dentist; I had to drive an hour away after days of calling every place in a 30 mile radius, I had to keep going farther out. Then, when I was able to get regular insurance again and see my regular dentist who doesn’t accept Medicaid, he was upset I lost those teeth unnecessarily. What I’ve went through has disturbed me so badly, I feel a real sense of injustice. As you know, missing teeth makes it harder when they’re visible to find employment. This can create a vicious cycle that keeps people trying to climb out of poverty further down into it’s grip. I used to be an idealist, thinking doctors do whatever is needed for a person, surely they wouldn’t deny people adequate care because they’re poor at the time. What I found is healthcare is not equal for all!

Wow! Thank you for the insight into the emotional states of Medicaid patients vs those with no insurance. Your ESP is truly impressive.

“Without legal protections and institutions to carve out the issue of individual rights from democratic vote, democracy just degenerates into packs of wild dogs seeking to devour each other for survival.”
__

Do you inhabit a permanent irony-free zone?

“Legal protections”

Which have to be administered by society. Again, your “rights,” as empirical matters, exist to the extent that others will uphold and enforce them.

Theoretical philosophizing is great fun, to be sure, but it falls short of encompassing coherent reality, as aggravating as that might be.

Deductive axiomatic proofs work fine in Algebra I.

The costs are diffused, therefore no longer marginal, and the benefits uncertain, so also not marginal. Regardless, the pricing is distorted. Imagine if hotel in Vegas has guaranteed 90 % occupancy. The 10 % price is affected by the certainty of the 90 % occupancy.

The comparison to other public services is interesting. I don’t have a counterpoint at this moment but will have to think a bit about the NHS.

“The consumer, for want of a better term, does not incur the marginal cost of the marginal benefit.”

The uninsured cash pay sure as hell does. The insured see their deductibles, co-pays and premiums rising but are locked in a “can’t do without” service. The employer system sees the “marginal benefit”, especially those self insured.

We accept and support fire departments and water/sewer systems and road construction and police as necessary government run services paid through taxes, and we support private utilities being regulated by government, but somehow can’t fathom health care and its necessity as better handled by government. We complain about mega cartels in hospitals and insurance controlling the “system” yet think even less government regulation/control will make them more accountable.

The present system is delivering services but failing to control costs in relation to wage increases. Do you really think the private sector “cartels” are anxious to fix this? Maybe when we spend 20%+ of GDP on health care that sucks spending away from other industries will we get a big enough 2×4 across the head to wake us up.

I would be inclined to agree with 64 on this. The hospital prices is not free market capitalism. There are no price signals. The consumer, for want of a better term, does not incur the marginal cost of the marginal benefit.

Prices are distorted by third party payers.

The system has a lot of faults but adhering to free market capitalism is not one of them.

The role of the government is both necessary and necessarily complicates. The pill and its side effects are inseparable.

“Bear in mind these are all responses to and consequences of government regulation in one form or the other”

Hogwash. Government does not dictate architectural design. The fact that hospitals are in competition with each other is the reason they build what people blindly perceive will give them the best care – competition is the devil. Mega hospital systems are a natural course of corporate expansion. What you despise is capitalism health care – how do you wish it be ended, by “government” action?

I see by your comments you are a Libertarian – one step above anarchy. Libertarians profess that there is no community, but just every man for themselves. Under you view school taxes are “coercive govt taxation”.

If you are a real doc then you know that here no system binds you to rely on insurance, just go cash pay, it’s being done. You can treat the payers and scorn the rest.