Doctor Fate wrote:We can't adopt the Swiss system. Why not? Because voters won't accept it until/unless they know a market-based system will work. The "s" word (not 'Switzerland,' 'socialism') will put off 60% of Americans. Those are the facts.

Firstly, is the Swiss system 'socialist'? Provision is largely private. Insurance providers are largely private. There is mandated insurance with heavy regulation, but there's a fair market and a range of choice when it comes to insurers (and their products which can include extra cover), the co-payments, and where patients go.

Secondly, my point is that Americans need to grow up and consider 'what works' instead of 'what ideology'. Your response seems to be that they won't. Well, in that case they'll continue to have this bizarre debate where either nothing gets changed, or the reforms just add to the chaos, but whatever the outcome, everyone gets more angry and the costs increase while outcomes are not much better than anyone else's.

Again...

steve

When was AT&T broken up? Did that change things? When long-distance became a competitive industry, did it raise or lower costs, or did they remain the same?

Steve, once again, the original regulation of the phone industry was because of the nature of the technology. It had to be a monopoly by geography. And therefore required regulation.
Once technology freed consumers from the requirements of geo monopoly technology, competition arrived. Yes.
But you are misunderstanding cause and effect. The regulation did not stop innovation. All the innovation that lead to LD switching equipment improvements and radio transmission (cell phones) was being done during the price regulated period. The price regulationm in Kansas (or whereever) had nothing to do with dampening inovation.
You are absolutely right that the innovation brought about competition, and the presence of competition saw an end to the need for regulation of pricing.
But you can't claim that the early regulation of geomonopolies pricing had anything to do with stoppping competition. What stopped competition was that the technologies that would allow competition (relatively cheaply installed retransmission towers) were not developed yet. Until then, the only way to build and operate phone companies was on geo monopoly basis....
You've got your cart and horse mistaken. If you'd like to examine why this has any application in the delivery of medical service, try again.

Ray Jay wrote:These cross country comparisons are challenging. There are so many obese people in this country it is unnerving.

It is unnerving. As I suggested in another thread, the healthcare debate in the US is missing the whole aspect about our failure to be healthy compared to other nations. Yes I'm sure if you need a quadruple bypass that the American system is going to get you that better than any other. But honestly I'd rather not need the quadruple bypass. I was stunned to learn that Japanese men smoke twice as much and live four years longer. That tells me we have a narrative about health in America that is REALLY off the mark.

Archduke Russell John wrote:Because the ideology difference is the point.

To you, maybe. I'm just old fashioned in that I want to consider silly stuff like 'how much does it cost', 'does it result in better health outcomes' and 'do sick people get the treatment they need without a dire threat to their livelihoods'.

There are just some thing Government should not be doing. The question is where to draw the line.

I would draw it at 'what works'. For some value of 'works', which is where the real debate lies. We can argue that the costs of government healthcare in terms of personal liberty means that it doesn't work. Fine.

After all, the government could buy all food a mandated prices that are currently lower then market prices and then give it to people at centralized location. That would be cheaper and the government could insure everybody ate nutritiously thereby controlling healthcare spending.

I doubt that would 'work', for several reasons, but it's a digression on a digression so let's not go there.

However, nobody in their right mind would agree to that plan because it is a clear beyond the scope of what services a government should provide.

Really? I think you should research the history of governments back to ancient times. Ensuring that the people were fed to a basic level was considered pretty much a basic ideal of government in many early civilisations. If anything, agriculture pretty much created government. But we are still digressing.

Just because government may be able to do it cheaper doesn't mean it should be doing it.

But there are alternative systems that are not government-run that work a lot better than the USA's does. The starting point surely should be that what you have now does not work, and you need to improve it. My post did not say "you need to grow up and implement a socialist healthcare system", for a reason. Like Steve, you have missed the point.

neal
As I suggested in another thread, the healthcare debate in the US is missing the whole aspect about our failure to be healthy compared to other nations

Thats fixing a seperate problem Its related to general well being yes. And has implications for the over all cost of health care. But you're given a comparison here. Which system delivers required health care service more efficiently and more effectively. If this were a business decision like choosing which model of transport truck carries freight more efficeintly or effectively the choice would be obvious. And everyone who claims to be a fiscal conservative could understand why the choice was made...
But in this case there's an ideology involved, and besides grasping at straws and debating nits, there's a reliance on a core belief that socialism is bad. Always.
It would be like an owner of a trucking company committing to the less efficient more expensive line of trucks because the better value trucks were blue. And he dislikes the colour blue.

Or, perhaps to use Ricky's analogy further, to refuse to even consider looking at better value trucks, just in case they happen to be blue, even if they aren't, simply because the suppliers of his current truck say that they probably are.

rickyp wrote:Well fine, archduke. I'll draw the line where the abundant evidence suggests that socialized health care makes more sense. You're usually susceptible to evidence. How do you feel today? Can you abide the word socialism if it means you get better, cheaper health care? Or will your head explode at the very thought?

Ricky,

It's got nothing to do with "socialism". I accept there are certain things Gov't can do better. Rather what are the limits on government? Realistically Government can force anything to cost less money by mandating a maximum price, use taxes to subsides those cost and it's police powers to enforce the mandated prices. What is the cut off? At what point does Government stop being responsible?

danivon wrote:But there are alternative systems that are not government-run that work a lot better than the USA's does. The starting point surely should be that what you have now does not work, and you need to improve it. My post did not say "you need to grow up and implement a socialist healthcare system", for a reason. Like Steve, you have missed the point.

Well, in honesty, I was reacting to Ricky who argues for almost exclusively for a government run system. Further, I have more then once said I could support a system that does not include government run healthcare. As a matter of fact, I have more then once said the best thing to do would be to just open medicaid up to purchase at subsidized rates. Let people purchase it if they so choose.

The Swiss system or the Dutch system also seem interesting. The Dutch system is basically giving Medicare Part A and Part C to everybody, while keeping Part B for seniors only. The problem those systems all have in the US though is the Insurance mandate. The Federal Government does not currently have the authority to require individual to purchase something.

Russell, but you were quoting and replying to me. Hence my assumption that it was my points you were reacting to.

I note with interest that you are more happy to accept subsidy (which to me is closer to socialism) than a mandate (which is not socialist, per se). Like the Swiss system, the Dutch provision is largely private.

And again, I'm unsurprised that the debate wheels around to the Constitution (which doesn't really, as far as I can tell, definitively say that the Federal Government cannot mandate health insurance under 'general welfare'). That's just a part of the 'principles' v 'practicality' argument. When the Constitution doesn't serve the nation well, you can amend it. Somehow I doubt that you would be willing to support an Amendment to allow a mandate. So the principle seems to outweigh the consideration of whether it 'works'.

How about we try and find a system that works better than the American one in terms of efficiency and effectiveness but doesn't have a compulsion element? Is there such a system? Has one been tried elsewhere and what happened?

RJ - the USA does look good on cancer survival rates. But the UK is one of the fastest improvers (it really annoys me that the Tories here talk about our poor rates and refer to data from the 1980s and1990s, when since then we've seen a marked improvement - especially as it was them in power in the bulk of the 1980s-90s and the NHS was underfunded).

However, cancer survival rates are not actually the rates of properly surviving cancer as a layman might understand it (such as people who go into remission). They are the rates of people who live for five years after cancer is detected. If you drop dead five years and a day later, riddled with tumours, you are in the 'survived' column. If you have an unrelated heart attack or car accident in the five years, you are not. What the USA is very good at is detecting cancer at early stages. This helps treatment to be more successful (I agree), but it also means that people are more likely to survive the five years. While some cancers are aggressive, others are more 'slow burn'. A prime example of the latter is prostate cancer. A lot of men get it, particularly as they get older. If they live long enough, it might actually kill them. For a lot of people, even those diagnosed, it's not what they die of, even if it isn't cured.

While cancer is a serious set of conditions, it's not the only health concern either. Cardio-vascular is a source of many problems, as are diabetes and infectious diseases.

I agree with you that early detection would skew the data a little in favor of the US. Of course, how much is pretty hard to figure out. We have our most robust data on 5 year survival rates for cancer. Other diseases are harder to measure in this way. Diabetes and heart disease are relatively more based on diet and lifestyle. Similary, other stats, such as general life expectancy (as presented by Neal), are also skewed by behavior, genetics, and social factors.

I think everyone on these pages has agreed that the mishmosh of regulation, government involvement, private sector activity, and employer paid insurance is not working in the US. I welcome these cross country comparisons.

Getting back to the topic at hand, it doesn't seem to me that conservatives ignore evidence whereas liberals/socialists are data driven. It seems like both sides allow their particular biases to influence their particular opinion and present the data
that supports their world view, and discount the data that does not.

ray

Getting back to the topic at hand, it doesn't seem to me that conservatives ignore evidence whereas liberals/socialists are data driven. It seems like both sides allow their particular biases to influence their particular opinion and present the data
that supports their world view, and discount the data that does not

Well, I chose health care as an example where conservatives ignore evidence...and fabricate some. (One tires of hearing about the waiting lists in Canada as an example of social medicine gone wrong. Its only 3 procedure.s..) And there are examples in this debate where the ceaseless repetition of information demonstrated what I was postulating. Indeed even the Archduke has summarized his position as ideological and not really based upon eviddence at hand.
But i could have chosen one of a large number of issues.
- global warming
- prison sentences for criminals
- environmental protection...
There is clearly an anti-science anti-intellectual approach by many conservatives Ray Its not just that we all "choose information" but conservatives generally attack the scientific approach.
The standard tactic is to ignore the general premise of the information offered but attack some small point. As if by refutring that small point the whole premise is undermined.(The way atheists attack the fundamental understanding of the Bible. If this one thing is wrong, it must all be wrong.. Which is understandable if science, logic and rationale thought depended upon the need for comprehensive and universal agreement, and not something akin to a general tendency.)
The Climate gate scandal is a prime example.(3 emnails to discount an entire science!) Holding up one or two anecdotes as evidence to counter weight scholarly studies. You know; poorly run food stamp programs as a way to discount schoiarly health care studies.

on climate science you are most likely correct.
on health care you are partially correct.
on most matters of economics you are incorrect.

Ricky, I find your diatribes to be among the least well supported on this website, in spite of your claims to the contrary. Really. My perception is as real as yours.

What scholarly health care study has shown that the US could administer socialized medicine well? You have not made that case in a scientific way. (Which is always tough in the social sciences.)

Just on the cancer survival stuff, Danivon has rightly suggested that there may be nuance in the statistics. But he hasn't refuted them in a scientific way. He's just postulated, which is fine. But it certainly doesn't support the claim that my conservatism has been scientifically refuted by his liberalism. And the fact still remains that if he and I both got diagnosed with cancer in the year 2000, I had a 6 out of 9 chance of surviving 5 years whereas he has a 4 out of 9 chance. What is your intellectual, rational refutation of that point? Remember to use the scientific method.

rickyp wrote:But you can't claim that the early regulation of geomonopolies pricing had anything to do with stoppping competition.

Hmm, gee whiz, I thought monopolies were anti-competitive by definition. You know, only one company and they are accountable to no one except a utility board that typically approves every rate raise they ask for?

What stopped competition was that the technologies that would allow competition (relatively cheaply installed retransmission towers) were not developed yet.

Until then, the only way to build and operate phone companies was on geo monopoly basis....
You've got your cart and horse mistaken. If you'd like to examine why this has any application in the delivery of medical service, try again.

No, what stopped competition was the monopoly and the power that it held. MCI could have competed years before it did, if it was allowed to do so. Note well the lawsuits MCI had to file, the appeals AT&T slowed them with, etc. It took almost twenty years for them to establish themselves and, one could definitely argue, the monopoly system was a key to this.

Again, I think it is perfectly reasonable to ask: why do you believe the market CANNOT work? You say it "has not," but it is regulated and restricted beyond belief. How do you know that if said regulations and restrictions were minimized (companies must meet some financial thresholds, make full disclosure of policies, etc.) that competition WILL NOT work?

When in our history have medical insurance companies ever been allowed to compete on anything resembling a "free" market?

danivon wrote:And again, I'm unsurprised that the debate wheels around to the Constitution (which doesn't really, as far as I can tell, definitively say that the Federal Government cannot mandate health insurance under 'general welfare').

The Constitution was written to restrict the activities of the Federal government, not to enhance them. We rebelled for a reason and it wasn't to establish our own form of royal tyranny.

NB the 10th Amendment: "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

Taking your view of "general welfare," there really is no reason not to socialize housing, food, and clothing. After all, those are at least as important to "general welfare" as healthcare. There would be few restrictions on the Federal government if we accept your view.

what is the demand elasticity of housing?