wjr@x.UUCP (Bill Richard) (09/25/85)
<taxation> Note: This is STella Calvert, a guest on ...decvax!frog!wjr. In article <756@cybvax0.UUCP> mrh@cybvax0.UUCP (Mike Huybensz) writes: >In article <568@x.UUCP> wjr@x.UUCP (STella Calvert) writes: >> No, no, no! I will be carrying (probably on the back of my medicalert >> necklace) a toll-free number to notify my medicare plan that I am in need of >> service. That plan will have some qualified (by my standards) personnel on >> the scene as soon after I call (or you as my agent) as I am willing to pay >> for. Response time is important. So is quality of care. I'll pay for both, > >If you are rich enough to afford that sort of medical service, you can buy it >right now. The only thing that might make it slightly more expensive is >that you still need real doctors. The big thing that will make it cheaper is that I will be using my former tax dollars to pay the premiums. Think about it. Now I pay for coverage in aftertax dollars. When I get all the value my customers are willing to pay, I can afford to pay for more of the good they produce. > >People who can't afford high medical premiums (many plans cost about $2000 a >year) will still have difficulty. Please read the next sentence twice. Medical care is expensive because it is a limited resource; it is a limited resource because the present government requires that you have a union card from the AMA to apply the science that should be common property. > >Assuming a real libertaria, then your flavor of medicine is quite likely to be >Dr. Smith's Astrological Aura Manipulation. Once you remove medicine and Ad feminam arguments? Or just that you don't see where libertaria is different. I was fairly careful not to specify the medical model I would support (take that discussion to net.med and "n" past it). I don't think I've noticed you posting to net.adhominem, though. >medical practice from regulation, you end up with the full spectrum of >snake oil and other fraud, only now with better advertising. Look at all >the people who use fraudulent (unregulated and sometimes lethal) diet >plans. Advertising dollars generate much better profits than research or >training dollars, and advertising reaches a much larger audience than product >comparisons. If you were brought up within a libertaria, bombarded with >propaganda and counterpropaganda, with no statistics you could trust, Where do you get THAT? In a libertaria, if you attempt to defraud me, I post bond and file an account of your wrongdoing on as many information nets as I can afford to post bond on. If you dare, if you want to risk _your_ bond, you sue me for libel. Adjudicators on the various nets investigate, the bonds we posted would be returned or applied to the cost of running the services as the facts require, and only people silly enough to listen to only one expert would be in any danger of being misled. And because it is in my interest to monitor the treatment less wealthy people receive (I may join that class with my next bad business decision.) I contribute to something rather like legal aid, which guarantees the bond for folks that can't cover their own. Perhaps the legal aid fund would need some way of fairly refusing to finance suits by people who have demonstrated that they never have a case -- they should pay for their hobby, and if they can afford the damages for nonsense suits they can surely afford their bonds. Mike, I'm sure you can find the holes in this one. >you would probably pick a popular, well advertised quackery. After all, >it would probably be cheaper than the best medicine. Kidney machines too >expensive? Oh, then they're bad for the aura. Pills cheap? They brighten >the aura. And let's not forget the addictive "health" prescriptions, >whose ingredients need not be divulged. But wait, you need psychic >surgery for your muffler bearing (oops, that was the "doctor"'s previous >employment.) > You assume, it seems, that people make decisions only on the basis of cost. Do you ride a bike rather than owning a car? Do you eat soybean extract or beef? If you smoke tobacco, do you handroll Top? I know I consider other factors and I hope you do. >> I will also be paying, in my premiums, for the right to call my plan if I >> encounter a John Doe who does not appear to have medical coverage. > >Very generous of you. I'm sure that your provider will provide enough >disincentives to reign your generosity in, and thus prevent your >distribution of medical services to everyone in libertaria. Disincentives? What disincentives? It's all in the rate structures. If you want to be a selfish s0n of a b|tch and have one-person coverage, you'll pay the single-person rate. If I want John Doe coverage, I'll PAY for it. And I'll shop for a plan that sets rates for it. My self-interest demands that I avoid the kind of devil-take-the-hindmost libertarianism you describe, because I may someday be hindmost. (In fact, since I value many things more than cradle-to-grave financial security, I'm planning for it.) And since I am paying for that coverage, I will determine (not you and not the insurance company) how much Samerit I can acquire. STella Calvert (guest on ...!decvax!frog!wjr) Every man and every woman is a star.
mrh@cybvax0.UUCP (Mike Huybensz) (10/01/85)
In article <776@x.UUCP> wjr@X .UUCP (STella Calvert) writes: > >If you are rich enough to afford that sort of medical service, you can buy it > >right now. The only thing that might make it slightly more expensive is > >that you still need real doctors. > > The big thing that will make it cheaper is that I will be using my former > tax dollars to pay the premiums. Think about it. Now I pay for coverage in > aftertax dollars. When I get all the value my customers are willing to pay, > I can afford to pay for more of the good they produce. That's assuming (without any estimates or justification) that you will be able to substitute or do without current government services for less. I'm not saying that you can't make such an accounting, just that the money you pay in taxes isn't simply thrown away: you receive benefits in return that you will probably desire in libertaria. And they aren't free. > >People who can't afford high medical premiums (many plans cost about $2000 a > >year) will still have difficulty. > > Please read the next sentence twice. > > Medical care is expensive because it is a limited resource; it is a limited > resource because the present government requires that you have a union card > from the AMA to apply the science that should be common property. Medical care is expensive for a number of reasons. It is intensive in its use of high-cost facilities (such as hospitals, offices, equipment, esoteric drugs) that must have high quality and reliability. And it is intensive in its use of the time of highly trained personnel. Medical care is also expensive because despite the expense it can be cost effective, from the standpoint of an investment by society, a family, or an individual. Essentially, any of the above can profit from a purchase of medical services by increases in the potential life earnings of the patient. Standards of quality (such as "union cards") help ensure the safety of the investment. > >Assuming a real libertaria, then your flavor of medicine is quite likely > >to be Dr. Smith's Astrological Aura Manipulation. > > Ad feminam arguments? Or just that you don't see where libertaria is > different. I was fairly careful not to specify the medical model I would > support (take that discussion to net.med and "n" past it). I don't think > I've noticed you posting to net.adhominem, though. This wasn't meant as derisive, but rather as an example of something possible and likely once standards of judgement are relaxed. > > Once you remove medicine and medical practice from regulation, you end > > up with the full spectrum of snake oil and other fraud, only now with > > better advertising. Look at all the people who use fraudulent (unregulated > > and sometimes lethal) diet plans. Advertising dollars generate much better > > profits than research or training dollars, and advertising reaches a much > > larger audience than product comparisons. If you were brought up within a > > libertaria, bombarded with propaganda and counterpropaganda, with no > > statistics you could trust, > > Where do you get THAT? In a libertaria, if you attempt to defraud me, I post > bond and file an account of your wrongdoing on as many information nets as I > can afford to post bond on. Oh? And how are you or anyone else going to decide that? "XXXX penicillan is no good, I nearly died!" How will someone determine the truth of this? How will anyone decide between 1) tampering 2) a bad batch 3) you are allergic 4) you had a resistant strain of bug 5) you are lying 6) you took the wrong dose 7) something unrelated almost killed you 8) ineffective drug? Assuming, of course, that you have the resources to post bond, as a public spirited thing to do? How would you profit? > If you dare, if you want to risk _your_ bond, > you sue me for libel. Adjudicators on the various nets investigate, the bonds > we posted would be returned or applied to the cost of running the > services as the facts require, and only people silly enough to listen to > only one expert would be in any danger of being misled. And because it is > in my interest to monitor the treatment less wealthy people receive (I may > join that class with my next bad business decision.) I contribute to > something rather like legal aid, which guarantees the bond for folks that > can't cover their own. We already have fine, working systems of monitoring for danger and effectiveness of products and medical treatments. They have recently found quite obscure problems, such as AIDS (early on, well before it was obvious), toxic shock syndrome, contaminated watermelons, etc. And for this you want to substitute an uncoordinated, undirected system with built-in noise? > >you would probably pick a popular, well advertised quackery. After all, > >it would probably be cheaper than the best medicine. Kidney machines too > >expensive? Oh, then they're bad for the aura. Pills cheap? They brighten > >the aura. And let's not forget the addictive "health" prescriptions, > >whose ingredients need not be divulged. But wait, you need psychic > >surgery for your muffler bearing (oops, that was the "doctor"'s previous > >employment.) > > You assume, it seems, that people make decisions only on the basis of cost. > Do you ride a bike rather than owning a car? Do you eat soybean extract or > beef? If you smoke tobacco, do you handroll Top? I know I consider other > factors and I hope you do. Providers of medical services will look for ways to increase their profit margins, unless there is a standard. You see it in business all the time: the best product doesn't make the best profit. And yes, I do ride a bike because it is cheaper. I got rid of my car last year. > >> I will also be paying, in my premiums, for the right to call my plan if I > >> encounter a John Doe who does not appear to have medical coverage. > > > >Very generous of you. I'm sure that your provider will provide enough > >disincentives to reign your generosity in, and thus prevent your > >distribution of medical services to everyone in libertaria. > > Disincentives? What disincentives? It's all in the rate structures. If you > want to be a selfish s0n of a b|tch and have one-person coverage, you'll pay > the single-person rate. If I want John Doe coverage, I'll PAY for it. And > I'll shop for a plan that sets rates for it. My self-interest demands that > I avoid the kind of devil-take-the-hindmost libertarianism you describe, > because I may someday be hindmost. (In fact, since I value many things more > than cradle-to-grave financial security, I'm planning for it.) And > since I am paying for that coverage, I will determine (not you and not > the insurance company) how much Samerit I can acquire. I greatly admire your stated values, which are quite different from those I've heard espoused by other libertarians (who mostly sound like Calvanists.) But the simple fact of an increased rate for "Samarit" is exactly the kind of disincentive I'm talking about. And many people wouldn't want that expense. -- Mike Huybensz ...decvax!genrad!mit-eddie!cybvax0!mrh
wjr@x.UUCP (Bill Richard) (10/11/85)
Note: This is still STella, disclaiming wjritude and organizational affiliation -- how DO you set organization if you're posting from someone else's account using rn? Please send mail! In article <778@cybvax0.UUCP> mrh@cybvax0.UUCP (Mike Huybensz) writes: >In article <776@x.UUCP> wjr@X .UUCP (STella Calvert) writes: >> The big thing that will make it cheaper is that I will be using my former >> tax dollars to pay the premiums. Think about it. Now I pay for coverage in >> aftertax dollars. When I get all the value my customers . . . pay, >> I can afford to pay for more of the good they produce. >That's assuming (without any estimates or justification) that you will be >able to substitute or do without current government services for less. I'm >not saying that you can't make such an accounting, just that the money you >pay in taxes isn't simply thrown away: you receive benefits in return that >you will probably desire in libertaria. And they aren't free. But there are lots of "benefits" I won't have to pay for. The bureaucretins that "administer" my tax dollars via Social Insecurity for one. I would not voluntarily support some of the Army Corpse of Engineers' efforts; and I certainly would concentrate on civilian space programs rather than ABM, ASAT, and the rest of that alphabet. When (and yes I'm ashamed of myself for it) I was a government bureaucretin, I was paid (as a GS-3, I think) about twice what a friend who was on AFDC was paid. And so forth. There are real goods, like roads, regional defense, and the Smithsonian Institution, that I will gladly support. But I don't really _want_ to support the Infernal Robbery Service, the Drug Enforcement Administration, or the Commerce Department. >Medical care is expensive for a number of reasons. It is intensive in its >use of high-cost facilities (such as hospitals, offices, equipment, >esoteric drugs) that must have high quality and reliability. And it is >intensive in its use of the time of highly trained personnel. All this is true, but added on to this necessary cost is the burden imposed by a government-sponsored monopoly. And that burden is not only financial. >Medical care is also expensive because despite the expense it can be cost >effective, from the standpoint of an investment by society, a family, or >an individual. Essentially, any of the above can profit from a purchase >of medical services by increases in the potential life earnings of the >patient. Standards of quality (such as "union cards") help ensure the >safety of the investment. I agree that medical care will remain expensive. However, every doctor who has misdiagnosed me or a member of my family had a union card and several attractive diplomas from recognized medical schools. So I don't feel that my investments in medical care are safe until that doctor has fielded a few emergencies for me. Have you ever tried to find out from his union hall what other complaints had been lodged against a physician you had retained? I tried that once, but I never did get a straight answer from them. When they did get rid of him some year and a half later, it got a paragraph on an inside page of the newspaper. I'm sorry, but I can't quite see where the ensuring of safety is done. Not through the AMA, however. >>Where do you get THAT? In a libertaria, if you attempt to defraud me, I post >>bond and file an account on as many information nets as I >> can afford to post bond on. >Oh? And how are you or anyone else going to decide that? "XXXX penicillan >is no good, I nearly died!" How will someone determine the truth of this? >How will anyone decide between 1) tampering 2) a bad batch 3) you are >allergic 4) you had a resistant strain of bug 5) you are lying 6) you took >the wrong dose 7) something unrelated almost killed you 8) ineffective drug? >Assuming, of course, that you have the resources to post bond, as a public >spirited thing to do? How would you profit? Not, "Dr. John's Snake Oil is no good, I nearly died!" but "I took a course of Dr. John's Snake Oil and my snake still squeaks." 8-) Seriously, the same way they do now -- on the weight of the evidence I am able to muster. It might be sufficient to say, "I took my friend Sue to Clyde's Emergency Room and they treated her for PID. The next day she began bleeding and almost died from a ruptured tubal pregnancy. This was diagnosed at Mork's Health Shoppe." I don't want to hand-wave anything you consider important, but while I haven't got a fully-debugged medical system worked out, I don't think the United Statists medical system would be the template I'd choose. And my reward for this would be the knowledge that I was protecting anyone else who shared my medical standards from Clyde's Malpractice Emporium. Evolution in action, sir! If a doctor can't do his job, he won't have the opportunity to do a job on me. And I doubt I'll be at greater risk than at present. >We already have fine, working systems of monitoring for danger and >effectiveness of products and medical treatments. They have recently found >quite obscure problems, such as AIDS (early on, well before it was obvious), >toxic shock syndrome, contaminated watermelons, etc. And for this you want >to substitute an uncoordinated, undirected system with built-in noise? While I was in Berkeley, I was advised not to go to a vampire shop (plasma bank). The doctor who so advised me later admitted that he was concerned about the disease that later was recognized as AIDS. Because his union would have come down on him for prematurely discussing his (labelled) suspicion that there was a deadly disease transmitted by blood products, I continued to donate. He was unable to pass on his guess that there MIGHT be a hazard, and I am unwilling to take anything on a mere "because I say so". As it happened, since I took seriously his warning to the extent that I verified the numbers on my cells VERY carefully, I got away with it. Six or seven years later, though, I still wonder why I couldn't have been told "There is a cluster of incidences of an immune-system-suppressing disease which MAY be transmitted by blood products. Be careful! Insist on seeing them unwrap your IV kit at your chairside." As long as doctors have the state-protected monopoly, some things just don't get out. In other words, I prefer an "undirected system with built-in noise" to a monopoly controlled system with built-in noise. >I greatly admire your stated values, which are quite different from those >I've heard espoused by other libertarians (who mostly sound like Calvanists.) >But the simple fact of an increased rate for "Samarit" is exactly the kind >of disincentive I'm talking about. And many people wouldn't want that expense. Fine! This next point is starting to give me a bad case of deja vu, but if I ever live in a libertaria it will only be because most of the population agrees to make the change. Including the people who volunteer at hospitals, donate to the disease of the month drive, and work for that misty entity, the common good. If most people weren't willing to care for the hindmost to some extent, we wouldn't have our present crippled health and welfare systems. If we can devise something that works at least as well, the same people who now console themselves for being taxed with the idea that they are benefiting the needy will find another way to do so. One with lower overhead. STella Calvert (guest on ...!decvax!frog!wjr) Every man and every woman is a star. Sorry this took so long to answer, but I've had a hurricane, a visitor from out-of-town, and a wedding (mine) all in the same week, and couldn't find time to read news, or write anything more complicated than thank-you notes.