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

Rockefeller Looking to Grant Open Source (Linux Journal)

Posted May 4, 2009 0:13 UTC (Mon) 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)

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

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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.