CLUELESS CATHY
Let's treat Healthcare like a utility, like gas and water. Heathcare profits should be controlled.
ME
Healthcare does not mean medicine. It's not a synonym.
The word healthcare was coined by a bureaucrat in 1940. It means Congress pays the bills. Medicaid and Medicare are examples of healthcare.
Medicine is a product.
Would you treat the manufacture and sale of smartphones and cellular telephone service as a utility? Would you treat the manufacture and sale of cars as a utility?
Would you treat the manufacture and sale of houses a utility?
No? So why would you advocate for medicine to be done so?
Instead, advocate for hyper-competition. If you enjoy low prices on other products because of competition, you would enjoy low prices on medicine for the same reasons.
CLUELESS CATHY
Let's start with your conservative free-market nirvana, where buyer and seller each armed with perfect information come together in a voluntary transaction.
ME
With your lame attempt at ad hominem through innuendo — "Let's start with your conservative free-market nirvana" — you have announced that you don't really desire to talk about this rationally. Also, you have committed the fallacy of ad hominem through innuendo.
CLUELESS CATHY
But from the get-go, the patient-as-consumer faces a knowledge asymmetry almost impossible to overcome. Americans' general deference to physicians isn't just a cultural trait, it simply reflects the expertise and training regarding diagnoses, possible treatments, and likely outcomes doctors possess and their patients do not.
For some cases and for some conditions, the layman can narrow that yawning information gap. But WebMD or no, it can't be eliminated.
But even if the diagnoses, treatments and cures for heart disease, diabetes or depression could be purchased in a free market, in the United States the buyer simply doesn't—or—can't know what price he or she will pay. Hospital prices for drugs, supplies, and procedures are completely opaque.
ME
Before 1965, hospitals routinely produced price lists for known services like pregnancy.
Because third parties pay for most Americans, doctors fail to advertise their prices.
However, when Americans buy elective medicine and surgery, Americans buy from sellers of elective medicine and surgery who not only advertise on prices but compete rigorously on price and quality.
Americans defer to the expertise of lawyers and yet lawyers reveal their prices. Americans defer to the expertise of car mechanics and yet mechanics reveal their prices.
Congress has a near monopsony and thus sets the prices on all medicine. In fact, $6.50 of every $10 spent on medicine is spent by Congress through Medicaid, Medicare and Veteran's Administration.
Get Congress out of medicine — end Medicaid and Medicare — and prices will fall.
CLUELESS CATHY
"Health" is not a commodity. Those who believe that choosing a health care product or service is no different than buying a car, television, or cell phone might feel differently after, say, developing colon cancer.
ME
Health isn't product at all. Health is a state of the individual. Health exists independent of medicine.
Medicine doesn't make health. Medicine eradicates disease. Medicine and surgery are not healthcare.
CLUELESS CATHY
As it turns out, that mystery pricing is one of the hallmarks of the American model that spends $2.8 trillion a year (over 17 percent of GDP) on health care, more than Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain, and Australia combined."
ME
Americans subsidize medicine worldwide. The drugs are developed here. The machines are developed here. Foreigners enjoy a windfall.
CLUELESS CATHY
I know how much my cell phone, car and house insurance cost.
ME
You seem to be like most. You're confusing costs with prices. Costs are outlays. Prices are rates.
You have made a complaint about the lack of transparency of prices and then you blather about costs.
CLUELESS CATHY
Have you ever been to a doctor in your life?
ME
Do you see how your question lacks relevancy?
CLUELESS CATHY
Typical deflection. Again... Have you ever been to a doctor or used healthcare insurance or Medicare or Medicaid?
ME
Your expression reveals that you fail to understand reality. The right question is this: Have you ever hired a doctor?
There is no such thing as healthcare insurance. Healthcare means Congress pays the medical bills. Medicaid and Medicare is how Congress does that.
Those programs are specific welfare given based on qualification (income and age respectively). Welfare isn't insurance.
You have asked the equivalent to this: Have you ever gone to a mechanic. But mechanics fix cars and not people.
So the right question is this: Have you ever hired a car mechanic to fix your car?
People hire doctors. Doctors sell the product of medicine.
Why do you believe malpractice can exist as a concept?
Anyone hires a doctor to sell medicine. Any doctor claims to know medicine (the practice of medical arts).
If a doctor does something that is not what he claimed he could do, he has liability (subject to lawsuit and upon loss, subject to damages).
CLUELESS CATHY
How do you hire a doctor if you're in a car crash and unconscious?
ME
If a 17-year old driver ends up in a car crash and unconscious, his custodial parent has authority and capacity.
In every state, there are provisions in law, which account for such matters.
It's likely that you do not know what authority means and what capacity means.
CLUELESS CATHY
But what if someone has no family or next of kin. Tell me again how someone, who is in a car accident and is unconscious can "hire" a doctor.
ME
In every state, there are provisions in law, which account for such matters.
In all states, law authorizes agents of the state to hire doctors on behalf anyone who temporarily lacks capacity because the presumption made lawgivers in all of the states awhile ago is simply this: if any individual were conscious and of sound mind in an emergency situation, that individual would put himself in liability to buy medicine and surgery on automatically given credit.
As a proviso of providing medicine, lawgivers require doctors, surgeons, hospital operators and other allied personnel to provide medicine and surgery in exchange for debt owed.
CLUELESS CATHY
Your word salad explanation means you're running away from the question.
ME
Your lame attempt at ad hominem "word salad" amuses.
Meanwhile my writing is precise. My words express precision and clarity not seen in almost all.
CLUELESS CATHY
As I lie under that bus in the road, what if my insurance company refuses to pay for my care? What if the insurer tried to intervene in my care to their own benefit instead of mine? What if the company with which I contracted for insurance services collapses and cannot pay for my medical care when I need it?
ME
There is provision in law for all of these matters. That is why we have courts to adjudicate matters.
CLUELESS CATHY
Under an insurance system without effective, powerful regulation, the market forces that would exist in a face to face transaction between consumer (patient) and supplier (doctor) disappear, replaced with a grim gamble in which the insurance company has every incentive to cheat.
We cannot maintain an insurance-based system of health care unless there is some force aligned with the consumer that has the superior authority and financial backing to hold the insurance providers to their end of the deal.
ME
Insurers are risk specialists who work on behalf of their risk pool participants. Insurers are a boon to mankind.
CLUELESS CATHY
The medical industry exists almost entirely to serve people who have been rendered incapable of representing their own interests in an adversarial transaction.
ME
Like any industry, participants of the medical industry exist only to serve their own self-interests. Yet, because they have become adept at crony politics, unlike participants of competitive industries, no longer do they need to serve the recipients of medicine and surgery with respect to price and quality. Instead, they operate in collusion with politicians.
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