Rockefeller Looking to Grant Open Source (Linux Journal) [LWN.net]

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 1, 2009 17:10 UTC (Fri) by clugstj (subscriber, #4020)
In reply to: Rockefeller Looking to Grant Open Source (Linux Journal) by jordanb
Parent article: Rockefeller Looking to Grant Open Source (Linux Journal)

I'll take a "corrupt, inefficient" industry over a "corrupt, inefficient" government-run industry any day. Without government intervention, eventually the "corrupt and inefficient" die off, but with the government in control, they make it permanent.

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Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 2, 2009 15:19 UTC (Sat) by job (guest, #670) [Link] (11 responses)

Or you could see it the other way around: with an inefficient governmental organization you have the democratic influence to change it. An inefficient private organization is stuck forever. There are merits to both views. In practice however the two are intertwined (think record companies and perpetual copyright extension).

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 3, 2009 12:08 UTC (Sun) by jospoortvliet (guest, #33164) [Link]

+1 for this "things aren't either black or white" approach. Personally I
wouldn't know what would work better for healthcare - public or private
sector. But whatever is chosen, democracy - eg government needs to have a
strong influence to protect 'customers'. We're talking life and death
here.

And I'm leaning towards mostly-government-run healthcare. The US
healthcare is pretty much the most 'private' healthcare in the world, AND
the most expensive. We (the dutch) are experimenting with privatising
healthcare, and while I support experimentation in general, I'm a bit
unsure about what to expect. Then again, we have a much stronger oversight
so at least quality won't be a problem.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 3, 2009 22:17 UTC (Sun) by bojan (subscriber, #14302) [Link] (9 responses)

> An inefficient private organization is stuck forever.

Generally speaking, inefficient private organisations are quashed by the competition.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 3, 2009 22:30 UTC (Sun) by jordanb (guest, #45668) [Link] (8 responses)

I completely agree... in a properly functioning classical free market---which health care is not and can never be.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 4, 2009 0:13 UTC (Mon) by clugstj (subscriber, #4020) [Link] (6 responses)

Why can health care not be a free market (except for the fact that the present administration doesn't want it to be).

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 4, 2009 3:17 UTC (Mon) by jordanb (guest, #45668) [Link] (5 responses)

Due to your rapid-fire double-response, I suspect this is probably an emotional topic for you and any attempt at a contrary response will not come to any useful end. I'm going to try anyway :) but I'll keep my remarks short.

Logically, emergency care is something that has a certain.. price in-elasticity. People will willingly bankrupt themselves in exchange for life-saving treatment. Moreover, someone suffering from a heart attack isn't going to be shopping around for the best rate in town. Such a situation lends itself to an unbounded increase in cost of care as the market searches for the price that consumers will not bear. This happens regardless of if the consumer is paying for the care directly---and in fact hospital bills for those who are uninsured are generally much higher than what insurance companies (who use their buying power to exert downward pressure) pay for the same treatment[1].

We can see that prices are rising very clearly in the fact that the size of the healthcare industry was 13.7% of US GDP in 1993, and now stands at 16.3 percent. It is projected to be pushing 19.5% of the total US Domestic Product in 2017, with spending rising at 6.7% per annum[2].

This country is rapidly growing a health care industry that we can not afford. I think that like with the massive increase in home prices and commiserate increase in the size of the banking sector, the other shoe will drop for the industry at some point---probably sooner rather than later---and will likely come as the result of the "invisible hand" of public outcry being heard in Washington.

This will be due to, on the one hand, an increasingly large portion of this country being shut-out from the system due to unaffordability, and on the other hand, the continuing collapse of the employer-provided health care and the coming crisis in the cost of state-funded entitlements which can not continue to bare the rising costs.

[1] http://www.alternet.org/story/16466/
[2] http://www1.va.gov/vhareorg/ffc/FFC2008Panel3.pdf

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 5, 2009 0:54 UTC (Tue) by dlang (guest, #313) [Link]

it's not unusual for the bills for the uninsured to be 3x-5x the amount that insurance companies pay.

it's also not at all unusual for the medical providers to accept 20-30% of their billed 'fee' from such individuals (basicly getting the same amount of money either way)

this means that the 'normal fees' are really just a fiction and are only paid by people who don't have the time or expertise to negotiate.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 5, 2009 17:56 UTC (Tue) by clugstj (subscriber, #4020) [Link] (3 responses)

You've conveniently ignore any and all reasons for the current situation. The statistics you quote in no way support your claim that the free market can't work for health care.

The nation as a whole is getting older which will by necessity result in rising use of the healthcare industry.

You've also ignored the fact that a large percentage of the uninsured's medical bills are written off by hospitals because they know they will never get the money. So, the insured are already carrying the load for the uninsured.

How many people are turned away at ER's because they can't afford treatment? The answer is effectively none.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 5, 2009 18:05 UTC (Tue) by martinfick (subscriber, #4455) [Link]

How many people are turned away at ER's because they can't afford treatment? The answer is effectively none.

Which, of course, is indeed far form a free market. It's more like socialism in disguise, but with the real cost of socialism (over inflated cost of everything and mostly burdened by those who are responsible and with upper middle income) visible instead of hidden in a nebulous all encompassing tax increase. :)

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 5, 2009 18:46 UTC (Tue) by dlang (guest, #313) [Link] (1 responses)

I believe that it's illegal to turn someone away in an ER.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 7, 2009 8:40 UTC (Thu) by tialaramex (subscriber, #21167) [Link]

It's sort-of illegal to refuse to stabilise patients. What happens on the axis between "minimum work to stabilise in the expectation that the patient will die shortly afterwards, preferably at home" and "actually fix the patient's problem" depends on the hospital's policies, whether an ER doctor likes your face, and how expensive it will be to fix your problem.

Don't compare the clinical outcomes between "uninsured" and "insured" patients arriving at an ER if you've cherished the idea that an ER law protects those in need -- you won't like what you find.

The ER is a fraction of the problem anyway. Suppose you're like me, all you have wrong with you is enlarged lymph glands. That's no emergency. No ER for me. Fortunately I live in a country which grasped the benefit of providing universal healthcare, so they diagnosed and treated my cancer.

The (current) US system says I should have stayed at home until the cancer spread and my symptoms became an emergency. This is "cost effective" so long as you don't consider unnecessary deaths as a cost.

IT contractors needn't worry though, despite healthcare being largely government controlled in my country, there are still plenty of expensive IT projects which can fail or go spectacularly over budget and - unlike a private healthcare provider - the government is unlikely to sue you since the court case would be embarrassing.

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 4, 2009 0:30 UTC (Mon) by clugstj (subscriber, #4020) [Link]

I've seen health care work quite well as a free market when I was young. But then four things happened. 1) People began to view health insurance a right (i.e. something you should not have to work for). 2) People now believe that their health is worth every penny of someone else's money, but not a bit of their own (due to the fact that most people get health insurance as a "benefit" of their job [ they don't directly pay for it, so they don't notice the monetary cost ] ). 3) Ambulance-chasing dirtbag lawyers with high-profile, massive settlements causing doctors' liability insurance costs to skyrocket. 4) Doctors' offices needing to hire large amounts of staff to handle the paperwork that they need to file to just get paid for work that they've already done.

The government running health care will not fix any of these problems, but will create new and much worse ones. It's really quite simple. That which you do not have to work for will not be appreciated.