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I'm fascinated by the debate over fixing/expanding the healthcare system in the United States. The issue is so complex that people understandably fall back on basic philosophies of the free market system to reach an opinion. For example, if you think the government tends to screw up everything it touches, and the free market does a good job, you might come down on the side of less government involvement in the healthcare system. But that view ignores the confusopoly effect.

A confusopoly - a term I concocted several years ago - is any industry that intentionally makes its products and services too complicated for comparison shopping. The best examples of confusopolies are cell phone carriers and insurance companies. And health insurance companies might be the most confusing confusopoly of all. I suspect that no individual has the knowledge, time, and information necessary to effectively compare two health insurance plans. And in that environment the free market doesn't operate efficiently.

Some people support the so-called Public Option for healthcare, where the government would offer health care in competition with the free market. The idea is that private companies would eventually lower prices to compete with the government's low cost option. That sounds good on paper, but the reality is that the private industry folks would use the uncertainty of the confusopoly to convince people that the government option would somehow end up killing its subscribers, e.g. "Sure, it looks inexpensive until your kidney starts hurting."

I think a better role for government would be shining a light on the existing private healthcare plans in a way that would help consumers choose the most economical option. The government did this successfully with the bank loan industry when it required all loans to have an APR, which is a single number that allows consumers to compare one loan to another. Healthcare can't be boiled down to a single number, but I suspect you could come up with a report card and some sort of average cost per subscriber. That way, consumers could shop wisely, and the free market might work the way it is meant to work.

Here's a concrete example. I have a health care plan that allows me to e-mail my doctor through the plan's website, and I usually get an answer in an hour or two. For 90% of the minor issues that would otherwise require a visit to the doctor, my doctor handles them in about half a minute by e-mail, including sending an electronic prescription to the pharmacy if needed. It is a HUGE time saver for me, and a big money saver for them, which I hope gets translated into keeping my premiums low. So here's my question to you: Which health care insurance do I use?

If you know the answer from something I wrote in the past, don't give it away in the comments. The point is that you can Google all day long and never find a way to compare health insurance plans on price or features. That's a problem that I think the government could fix.

 
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Sep 26, 2009
I don't pretend to speak for any soldiers. Do you believe that when you speak, you speak for all soldiers that none of them have ever had to do anything against their will, because otherwise they would have had state power used against them.
 
 
Sep 26, 2009
And blackwater provided a lot of necessary services and it seems like everyone convicted of wrongdoing is being dealt with. Is their no history of the US military's officials engaging in illegal/immoral activities or war crimes?
 
 
Sep 26, 2009
"Which brings me back to my original point. If I can find a 20 year old who's willing to lead 50 other 20 year olds into combat for the sake of his country, all for less then $50k a year; why can't I find a 30 year old to remove my brain tumor for less then $2.4 million a year?"

To each according to their means and to each according to their needs, is that it? Or is it said the other way around? LOl
 
 
Sep 26, 2009
"So you really think a hammer is worth $400."

Sounds like they need to find another contractor. Or just say F it and NOT FIGHT WARS.
 
 
Sep 26, 2009
"Some of them turned tail and ran when the bullets started flying and left the soldiers they were supposed to be supporting, soldiers that were getting paid 5 times less then what they were. But that's what happens when you're only in it for the money."


YEp, yep, yep as did revolutionary war soldiers during our war for independence. War is pretty stupid all around, don't you think. Every state military has had its share of bad soldiers as well as good ones. You just believe, GOVT good Corporate bad.


 
 
Sep 26, 2009
"Problem is that they're getting paid 5 times more than their Army counter-parts, and some of them still aren't fighting.
That's because some things are worth doing even though they don't make us rich. And I believe we lose sight of that when we start concentrating on the pay check."

If a company feels that it's worth paying them that, that's their choice, dumb or not. If the government feels that it's worth paying said company for it's services, that's it's choice. If the people elect said government, then it's their choice. Dumb or not. The world's not perfect. Sucks doesn't it? At least we can live by some basic tenets of freedom at the very least....
 
 
Sep 26, 2009
"If you think our soldiers are fighting in Iraq because they are being forced to, then you don't understand soldiers. I could try to explain to you why they are fighting, but somehow I don't think you would understand. But I'll give you a hint. It's not for the money, ether."

Are they allowed to say no? Are they??? Well, if they aren't, THEY"RE BEING FORCED TO FIGHT. You act once again as if money is something evil. Money simply represents resources. Resources that we all need to live. I don't pretend to know why each individual soldier fights, I'm simply pointing out that they have no choice either way.
 
 
Sep 26, 2009
"They're being paid exactly what is required to get them to fight. "

Problem is that they're getting paid 5 times more than their Army counter-parts, and some of them still aren't fighting.
That's because some things are worth doing even though they don't make us rich. And I believe we lose sight of that when we start concentrating on the pay check.
 
 
Sep 26, 2009
"Also, the cost of using having a large national standing army is almost too great to not be constantly at war."

We have a large national standing military because almost every other country does. When a gun fight starts the worst thing to be is the guy without a gun.

"Plus, I think that you shouldn't be able to force anybody to fight."

If you think our soldiers are fighting in Iraq because they are being forced to, then you don't understand soldiers. I could try to explain to you why they are fighting, but somehow I don't think you would understand. But I'll give you a hint. It's not for the money, ether.

Which brings me back to my original point. If I can find a 20 year old who's willing to lead 50 other 20 year olds into combat for the sake of his country, all for less then $50k a year; why can't I find a 30 year old to remove my brain tumor for less then $2.4 million a year?
 
 
Sep 26, 2009
"What did blackwater do that hasn't been committed by almost every national military in Fing history? "

Some of them turned tail and ran when the bullets started flying and left the soldiers they were supposed to be supporting, soldiers that were getting paid 5 times less then what they were. But that's what happens when you're only in it for the money.

"I don't buy that the military contractors are inefficient as they have to at least be somewhat efficient in order to make a profit."

So you really think a hammer is worth $400.

"The actual soldiers do the jobs that are required of them, but the military bureaucracy and the people in charge of the resources use those resources inefficiently."

You're right, the bureaucracy decided to hire Black Water. Too bad they didn't do the job that was required of them.
 
 
Sep 25, 2009
"A bunch of over-paid mercenaries running around Iraq only fighting when they feel like it. Yea, great idea."

They're being paid exactly what is required to get them to fight. Just how the jack in the box pays its workers what is required to get them to flip burgers. That is how it's supposed to work. Are you arguing that someone should be forced to fight against their will or financial motives?
 
 
Sep 25, 2009
"We've already privatized a portion of our military."

I would say that most of the non combat role was privatized long ago. The military doesn't build its own tanks and guns, they've pretty much always contracted that stuff out. The only parts of the military that are still controlled by the military allocate resources inefficiently. Also, the cost of using having a large national standing army is almost too great to not be constantly at war. If the government contracted out most or all of its defense, the cost would be lowest when we weren't at war, thus creating a financial incentive for stability. Plus, I think that you shouldn't be able to force anybody to fight. You should have to pay them enough that they think it is worth it. How many soldiers were asked if they wanted to go to Iraq?
 
 
Sep 25, 2009
What did blackwater do that hasn't been committed by almost every national military in Fing history? That's the illusion, that state run military's are "controlled." Using mercenaries when actually engaged in war would be cheaper than having a standing army supported by a bureaucracy in which many of the best soldiers never even see combat. I don't buy that the military contractors are inefficient as they have to at least be somewhat efficient in order to make a profit. The actual soldiers do the jobs that are required of them, but the military bureaucracy and the people in charge of the resources use those resources inefficiently.
 
 
Sep 24, 2009
Isn't the Internet Great? It brings people together from all walks of life. For example tkwelge is the first person I've ever met who doesn't get queasy at the idea of having our military being run by some large corporations.

I still have to disagree though. We've already privatized a portion of our military. I'm sure that tkwelge thinks that Black Water has been a great success. Unfortunately, most Iraqi war veterans and pretty much the entire population of Iraq disagrees. A bunch of over-paid mercenaries running around Iraq only fighting when they feel like it. Yea, great idea.

And as for the military being "awful" and "full of waste and inefficiency"? When I was in, the only waste and inefficiency I saw was from the private contractors who were using their military contracts to make a quick buck. My fellow soldiers and I took our jobs pretty seriously even though we knew we were over-worked and under-paid. We didn't join to get rich. We signed up to protect our fellow countrymen. It's too bad our health care industry doesn't have the same attitude.
 
 
Sep 24, 2009
The astonishing thing to me about the healthcare debate is that the same folks who think that Karl Rove and Dick Cheney are “out to get them” can hardly wait to put future Rove’s and Cheney’s in authority over their own physician – So, did I miss a meeting?
 
 
Sep 24, 2009
You don't have anything like that in the U. S.: http://en.wikipedia.org/wiki/Stiftung_Warentest ?
 
 
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Sep 24, 2009
Insurance is a confusopoly. Health care is not. Doctors are not confusopolists. Being against Insurance and being against the market are too different things. Insurance is actually socialistic by nature as it involves spreading one persons cost across several "payers."
 
 
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Sep 24, 2009
"To all the people who suggest that an easy way to improve the insurance competition problem is to let people buy insurance from other lower cost states, that is a flawed plan. Many medical standards are set at the state level by the state medical boards. Most states also have Insurance commissions that set standards and regulate insurance rates. Insurance companies study those standards and requirements then create insurance plans that meet the needs of patients, abide by the state medical standards, abide by the state's insurance standards, and create some profit for the company. If an insurer who offers plans in a state with less costly standards are forced to offer that same plan to patients in another state with more costly standards, then the insurance companies will be forced to raise the rates in the cheaper state to cover that potential loss."

Or we could just reduce regulation...... Or they could charge the person in the more expensive state more or the person in the less expensive state less.....This is a good argument for deregulating healthcare or at least creating one national set of standards. However, saying that "because our regulations suck, we need more government involvement and support," is just missing the forest for the trees. Do you not hear your own arguments? I really hate the way that scott's blog is full of people who believe that the government is the not only a solution, but THE solution. And of course, doing anything for money or "profit" is wrong (even though profit is the income of the entrepreneur plus the cost of developing services, and it is a cost that exists somewhere, no matter how the government pushes monopoly money around).

 
 
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Sep 24, 2009
"Our Interstate Highway System gives us the freedom to travel almost anywhere in the country. It builds commerce and if it disappeared tomorrow, our country would come crashing to it’s knees. Does anyone here believe that the private sector would have the ability to come together and build anything like it?"

Actually, there are privatized highways that electronically charge a small toll every time you choose to use them. There is no free rider problem and congestion is almost non existant. It does cost money, but so does the private road system. Not to mention that the the government subsidization of automobile transportation has made us more and more dependent on finite fossil fuels and it also encourages people to live further away from the center of the city. This is the main cause of the suburban sprawl that the US is now realizing to be a bad idea. So you're wrong there.

"And here’s a government program that you will never hear an anti-government type mention, the U.S. Military. It’s arguably the best-equipped, most powerful armed force on the planet. And it’s 100 percent funded by the U.S. Government through our tax dollars. Our under-paid, over-worked service members pledge their lives to keep us from getting killed by foreign invaders. Why can’t the government make the same pledge to keep us from getting killed by cancer? After-all, there’s only one kind of dead"

We could privatize the military, also. In fact,it would be the most moral thing to do. And I've mentioned this before :) The military is awful. It's full of waste and inneficiency. People are locked into long term contracts which require them to fight even if they don't want to. In an ideal privatized military, all jobs are performed on a pay as you work basis. Nobody could ever be forced to fight in any war against their will. If they decide to fight, they would make 150,000 dollars per year (contractors working for dynecorp and other private military groups commonly get paid large amounts of money, because they can't force their soldiers to fight), and if they decide not to, they wouldn't get paid anything, and they might lose their job, but at least this puts choice in the hands of the soldier who will now also be paid properly for his/her service. I'm sure that you're thinking, "Well if they pay their soldiers more, then won't this be hugely expensive?" but you'd be wrong. Private companies can afford to better equipment, better people, and make a profit for less money, because the government does so many "in-between" jobs in the most inneficient way possible.
 
 
Sep 23, 2009
Just to clarify JavTO's comment.
Under canadian law, a health care provider can either receive public funding (through the universal insurance paid for by tax revenues and governed by the provinces) or they can charge patients directly, they may not do both. Since most services are covered by the public insurance there is very little demand for doctors who charge directly (mostly the services not covered such as cosmetic surgery or vision correction)

In Alberta, the largest health care provider is Alberta Health Services, which is operated by the government. Similar organization exist in other provinces. The second largest is Covenent Health, which is a non-profit health service provider run by the Catholic church. There are other smaller for profit and non-profit providers thoughout the province. These are all funded on a per-service basis by the universal health insurance policy operated by the government. Our taxes are our premiums. Because everyone is covered by this, there is no demand for other insurance policies except for services that are not covered (Drugs, dental, travel.) Those are covered by private insurance companies or paid out of pocket.

The problem arises in that the government can't run the universal insurance like a real insurance company, because they have to cover everyone whether they paid their share of premiums or not, and they can't charge deductibles, and they seem to be incapable of managing money period; thus rather than insurance costs being paid out of a huge pool of assets like a normal insurance fund, it comes out of taxes or is borrowed.



 
 
 
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