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Patently stupidPatently stupidPosted Oct 9, 2012 22:20 UTC (Tue) by drag (subscriber, #31333)In reply to: Patently stupid by dashesy Parent article: The Patent, Used as a Sword (New York Times)
This is extremely unclear if this is absolutely true or not.
Unfortunately if it Is true that certain essential services like 'health care' and other tasks can only be properly done by government... then all I can say that we are well and truly screwed because the governments, essentially all governments and especially the USA one, are ran by either evil men and/or incompetent morons. It means that there is no possible solution for the plight we are in right now.
So far, at least in the USA, the best solution they have come up with so far to reduce the price of health care and provide universal coverage is 'Make it illegal not to buy health insurance'. This sort of thing does not fill me with much confidence.
But that is neither here nor there.
The reality is:
The government is destroying technological progress, destroying the profitability of competitive corporations, and strangling innovation through it's use of laws the government says is designed to promote progress, increase profits, and artificially boost the rate of innovation.
There are people in there that ACTUALLY BELIEVE that the problem isn't that the patent system is terrible, but the fact that everybody else in the world is not forced to run under the same system.
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Patently stupid Posted Oct 10, 2012 13:26 UTC (Wed) by robert_s (subscriber, #42402) [Link]
"Unfortunately if it Is true that certain essential services like 'health care' and other tasks can only be properly done by government... then all I can say that we are well and truly screwed because the governments, essentially all governments and especially the USA one, are ran by either evil men and/or incompetent morons. It means that there is no possible solution for the plight we are in right now."
Ah, an American. You haven't really travelled much outside the US, have you? Government-run health care works surprisingly well in many countries, though I can only personally vouch for the UK.
Patently stupid Posted Oct 10, 2012 19:02 UTC (Wed) by Jonno (subscriber, #49613) [Link]
I can vouch for Sweden. There are some longish waiting list for some treatments, and the "bed-side-manner" of doctors tend to suck, but no matter what health care you need, you will eventually get it, and you never, ever, have to pay more than SEK 300 (~ €30) for it.
And yes, that includes the € 6'000'000 hearing implant the deaf child needs in order to start hearing. She was on the news as a human interest story recently. The cost was only mentioned in passing, the news wasn't that a girl got an expensive treatment, it was how exalted she was when hearing her mother say her name for the first time.
*That* is what a 32% income tax + 20% VAT buys you...
Patently stupid Posted Oct 10, 2012 19:05 UTC (Wed) by dlang (✭ supporter ✭, #313) [Link]
government run healthcare works well enough if you have the option of ignoring it and getting your healthcare someplace that's not govenment run
Patently stupid Posted Oct 11, 2012 10:00 UTC (Thu) by nix (subscriber, #2304) [Link]
That's true in every government-run health service I am aware of -- though of course the government-run health service is much larger than the private ones, so will have more of those rare and difficult cases (and rare equipment) that comes with large scale. This leads to the comical situation in the UK where you pay through the nose to go to a private hospital, and if the problem is really difficult you find yourself being fixed at an NHS specialist hospital because that's the nearest, best (or, sometimes, only) hospital that can fix whatever is wrong with you.
Patently stupid Posted Oct 11, 2012 10:07 UTC (Thu) by man_ls (subscriber, #15091) [Link] Yes, and of course you have to pay for public health care even if you are not using it -- you cannot just "ignore it" as dlang suggested. Anyway the price of public health care + private insurance is _much_ lower than paying just for private insurance in places where there is no public service -- and coverage is much better too.
Patently stupid Posted Oct 11, 2012 10:53 UTC (Thu) by andresfreund (subscriber, #69562) [Link]
> Yes, and of course you have to pay for public health care even if you are not using it
In Germany at least you can get private health insurance without paying the state organized one. You have to have either private or state organized health care though (or some other options, but that would go too far).
Patently stupid Posted Oct 12, 2012 0:21 UTC (Fri) by cortana (subscriber, #24596) [Link]
What happens if you need treatment that your private insurance won't cover?
Patently stupid Posted Oct 12, 2012 3:01 UTC (Fri) by dlang (✭ supporter ✭, #313) [Link]
you fund it yourself. But you have the option because there are people who will take money to treat you.
In a pure government run system, paying for treatment yourself is not allowed.
That's why I said that government run systems only work when you have the option to not rely on them.
for all that people have been claiming that medical care in the US is a disgrace and behind the rest of the world, when people with money really need treatment, they come to the US to get it (except when the AMA has not blessed the treatment, then the people with money go where the AMA doesn't block new treatments)
This indicates that while the 'health care system' may not be what you want, the medical care available is what you want.
the problem is trying to find a way to solve the problems without loosing the advantages.
Patently stupid Posted Oct 12, 2012 7:58 UTC (Fri) by ekj (guest, #1524) [Link]
Medical care has (strongly) diminishing returns. For a given investment, the return is much higher by investing in those who receive little to no medical care, instead of investing further in those who already have good medical care.
You're saying that in a fully governmental medical system, there's a risk that a few people who get only good care, but could avoid paying out-of-pocket for excellent care, are worse off. Countries with universal healthcare don't typically have any rules prohibiting buying additional care for yourself though, so this is largely a strawman.
I've not seen anyone claim that the medical care available to those with money in USA is a disgrace. The part that is disgraceful is at the other end of the scale.
Universal health care Posted Oct 12, 2012 8:14 UTC (Fri) by man_ls (subscriber, #15091) [Link] Right. The paradox that nix outlines above is that in countries with universal health care, often it is the public service the one that provides for the most expensive or advanced treatments, while private insurance excels at primary health care.I've not seen anyone claim that the medical care available to those with money in USA is a disgrace. The part that is disgraceful is at the other end of the scale.I have read that the worst part of the spectrum at the USA is not either rich people (who are well cared for) nor poor people (who have Medicaid), but the middle classes.
Universal health care Posted Oct 12, 2012 8:49 UTC (Fri) by ekj (guest, #1524) [Link]
Yes, that's often the case. If you're really poor, you qualify for governmental support in some form, and you're not vulnerable to financial loss because you have essentially nothing to lose anyway.
A lower middle-class person who gets sick with no health-insurance, risks losing the small amount of wealth he has, and to have the income of the family drop to welfare levels. A person with essentially zero wealth, and income which is already at welfare-levels is immune to financial woes of this sort.
According to CNN, medical debt is involved in 60% of the personal bankruptices that occur. I'm guessing that's mainly people who are neither wealthy nor dirt-poor.
Universal health care Posted Oct 12, 2012 9:23 UTC (Fri) by man_ls (subscriber, #15091) [Link] That is a real shame. I have a brother who received a kidney transplant from the public health care system, and I am aware that my family might have gone bankrupt if it had happened in the US. Having to choose between death and poverty is very sad and a bit dickensian; you need a writer that exposes such a shameful situation to the world, or something.
Universal health care Posted Oct 12, 2012 9:44 UTC (Fri) by cortana (subscriber, #24596) [Link]
> If you're really poor, you qualify for governmental support in some form, and you're not vulnerable to financial loss because you have essentially nothing to lose anyway.
You can lose your credit rating! This means you will pay significantly more for any kind of credit for many, many years in the future.
Universal health care Posted Oct 12, 2012 10:18 UTC (Fri) by ekj (guest, #1524) [Link]
True. But:
A) If you're "really poor", your credit rating is likely to be poor to catastrophic already.
B) It's still a larger loss to loose large fractions of your income, and all of your wealth, and your credit-rating, instead of losing only your credit-rating.
C) If you're "really poor", then there's very few situations where getting credit will help you, it will help short-term, but at a cost of additional pain longer term. The exception is if the short-term cost is for something that gives you additional income longer-term. (say buying a used car, to be able to commute to a new job you got)
Universal health care Posted Oct 13, 2012 0:56 UTC (Sat) by dlang (✭ supporter ✭, #313) [Link]
The biggest problem for the 'uninsured' is that they get chaged FAR more for the same medical care as someone who is 'insured'
My Insurance gives me a statement for each transaction that shows what the medical provider billed, what the 'negotiated' rate that the Insurance company is actually going to pay based on, and how much of that I owe.
I's very common for the insurance rate to be a 60% or larger discount of the price that an individual would have to pay. I've seen quite a few cases where what the provider accepts as 'payment in full' is a 90% discount off of what they would charge someone without insurance.
And it doesn't matter if the Insurance company is going to pay the bill, or if I am going to have to pay the bill (part of the deductable, past the limit for the year, etc)
If I could pay the same rates that the Insurance companies pay, I would not need to have any insurance beyond a 'catastrophic event' policy that wouldn't kick in without an event over say $10,000
Patently stupid Posted Oct 12, 2012 9:42 UTC (Fri) by cortana (subscriber, #24596) [Link]
I asked my question specifically in the context of andresfreund's statement that "In Germany at least you can get private health insurance without paying the state organized one". I would like to know what happens when you opt for private health insurance but then require a treatment that the insurance won't cover (and implicitly that you are unable to afford). The alternative being too horrible to contemplate, I assume that the state steps in and pays for it anyway--in which case, you don't _really_ have the option to go entirely private in the first place. Not that I'm saying that is a bad thing--unless you are loaded then getting ill in the US can bankrupt you at best, and leave you dead and your family bankrupt to boot at worst!
Patently stupid Posted Oct 12, 2012 10:10 UTC (Fri) by andresfreund (subscriber, #69562) [Link]
> I would like to know what happens when you opt for private health insurance but then require a treatment that the insurance won't cover
They are required to provide a certain level of care to be allowed to provide the required insurance. There are things the GKV ("Gesetzliche Krankenversicherung" - the state organized insurance) provides which the PKVs ("Private Krankenversicherungen" - (partially) profit oriented insurances) don't have to, but I know of none that are life critical. Many of the things not necessarily payed by PKVs are in the somewhat affordable range.
Does that answer the question?
Patently stupid Posted Oct 12, 2012 10:43 UTC (Fri) by cortana (subscriber, #24596) [Link]
Very informative, thanks :)
Patently stupid Posted Oct 12, 2012 14:23 UTC (Fri) by nix (subscriber, #2304) [Link] Sorry for perpetuating this off-topic thread (remaining relevance to patents: basically nil).In a pure government run system, paying for treatment yourself is not allowed.Are there any such systems in the Western world? I'm not aware of any. For a long time the NHS had a rule that if you augmented NHS treatment with private treatment, you had to get the lot privately. The idea was to ensure a level playing field, but it caused a sufficiently large political storm when the policy came to light that it was revoked shortly afterwards. That's why I said that government run systems only work when you have the option to not rely on them.I don't see how you can come to that conclusion in the absence of any examples of your 'pure government-run systems' in modern economies. You are fighting against a man made not of straw but of vacuum. I might also point out that in the UK at least, most people who can afford private medicine still don't use it because they trust the NHS more. (The NHS is one of the most trusted organizations in the country, certainly far more so than the politicians who are its nominal bosses). In any case, as I mentioned above, particularly serious or complex conditions would probably get bounced to an NHS facility and NHS staff in any case, because only they have the scale to deal with them. The NHS has lots of problems, including perennial shortage of funds, but I don't see how you could say that it only works because of the existence of private facilities. Indeed when the NHS recently tried to rely on private facilities to do some of its more routine surgical work for it, it generally didn't work, with contracts mandating payment for operations whether or not they are ever carried out, a frighteningly high percentage of botched operations, and so forth. (This caused a pretty big scandal and a lot of severely indebted NHS trusts.)
Patently offtopic Posted Oct 12, 2012 22:33 UTC (Fri) by man_ls (subscriber, #15091) [Link] To bring back some semblance of relevance to software patents: yes, government-run services can be efficient and work well enough. No, not all government employees (or even politicians) are evil, stupid, greedy or megalomaniacal; many of them just want to do some public good, are hard-working and provide excellent services when allowed to do so.For the two remaining readers let me revisit for a moment drag's nth edition of the libertarian credo: Unfortunately if it Is true that certain essential services like 'health care' and other tasks can only be properly done by government... then all I can say that we are well and truly screwed because the governments, essentially all governments and especially the USA one, are ran by either evil men and/or incompetent morons.The emphasized (by me) sentence is not only untrue, but actively harmful: that there are evil and moronic people in the government should not hide the fact that there are also many hard-working, upright people, and even more important: that evil and moronic people are not a necessary evil. We want good governments, we should fight for them, not give up. I won't tell you how, but there are plenty of obvious solutions; from the easy (voting) to the hardest (devoting your life to politics). The same works for patents: we have fought software patents in Europe successfully before, we should keep doing it (more and better), and spread the word to other not so lucky countries. We have many powerful friends, and we have to fight hard to win. Software patents have done no good to software development, ever; like slavery, half-measures are no good; total abolition is the only way. And now let me roll down my banner and drift away.
Patently stupid Posted Oct 19, 2012 14:32 UTC (Fri) by robert_s (subscriber, #42402) [Link]
Sorry to dig up such an old thread - I rarely look back at my previous comments, but I have to take issue with this:
"That's true in every government-run health service I am aware of"
This is not a realistic portrayal of the UK NHS. To quote Simon Burns (no, I am no fan of his): "Our latest survey of over 70,000 patients shows that an overwhelming majority - 92% - say that their overall experience of the NHS was good, very good or excellent."
Patently stupid Posted Oct 20, 2012 14:59 UTC (Sat) by nix (subscriber, #2304) [Link]
I was trying to say that we have the option of ignoring the NHS and going private if we want to, not that the NHS isn't widely appreciated.
Patently stupid Posted Oct 23, 2012 15:44 UTC (Tue) by robert_s (subscriber, #42402) [Link]
Oh - perhaps I misread your and the parent's comments - do you mean you believe that the existence of a parallel private health care system actually serves to _improve_ the government health system itself?
An interesting view.
Patently stupid Posted Oct 23, 2012 17:41 UTC (Tue) by dlang (✭ supporter ✭, #313) [Link]
There may be some of that, but I was looking at it from another point of view.
Any health care system that's controlled by a single entity is going to have cases where it fails badly. It may work for many common cases, but if you are in the group that it is failing badly for, you need to have the option of using a different system.
Government run systems are not exceptions to this. They work when people have the option to go elsewhere. If people do not have the option to go elsewhere, you end up with a black market in medical care (or with those with enough money flying to other countries to get care)
In the western world no government has tried to lock things down this tightly, but from stories I've heard In the communist countries things have tended to be far more locked down.
Patently stupid Posted Oct 24, 2012 16:03 UTC (Wed) by nix (subscriber, #2304) [Link]
No, I don't think that. I was arguing against the OP's claim that government healthcare only works if you have the option of taking up private healthcare too, by pointing out that since the converse case (only government healthcare permitted) does not exist anywhere, you cannot argue the point one way or the other.
Patently stupid Posted Oct 11, 2012 12:50 UTC (Thu) by etienne (subscriber, #25256) [Link]
How does it handle the case of these extremely expensive treatments which double your life expectancy when your untreated life expectancy is three months, due to a very bad illness?
Complex and long procedure to get the money? What is the value of one month life?
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