The Left Just Doesn’t Appreciate “The Miracle”

 

I’m friends with many different sorts of people, as my Facebook feed would attest. My acquaintances range from Anarcho-capitalists to religious conservatives to people who are, well … socialists. I’m frequently reminded of that fact whenever I log on and find things like this:

When I saw this yesterday, I was sorely tempted to respond. However, Facebook doesn’t lend itself to carrying out this sort of chewing, so I decided to bring it here to begin digesting it. Yet, where does one even begin with such a movable feast?

For starters, some additional details. The post came from a friend of mine (who shall remain nameless here) who shared this complaint from a fellow disabled person — he too is a paraplegic and is a college instructor. Admittedly, if you’re disabled, the situation described is a serious impediment. His complaint extends further though, and goes on to indict the free market as this is a thing which it “cannot solve” and a situation about which we should be “ashamed.”

Let’s begin by clearing the ground of the underlying complaint. If we take it at face value, I can see several issues from the get-go. Even not knowing the whole story, how plausible is it to think that a company whose client is in good standing with them would simply elect to stop taking their money? I suppose it’s possible, but there are service providers for nearly everything, and a great deal of competition to boot. A comparable service is likely available at similar prices. Perhaps this person is in arrears on payments to their in-home assistance? Perhaps she’s earned a reputation among such service-providers as a person who pays slowly or not at all? Maybe she’s just a pill to deal with. Relatedly, doesn’t she have any family who could help her? Does she have friends or perhaps her employer values her enough to lend assistance in this matter? These are all fundamentally unknowable to us unless we were to honestly discuss the details with her, but more importantly: these are issues which have nothing to do with the Free Market and its ability to help consumers of products and services meet producers at agreed-upon prices.

Now I want to tackle my friend’s complaint head-on. In this particular case, he accuses the Free Market of “not being able to solve” this problem … which is approximately like accusing hammers of being bad because you can’t eat soup with them.

Wrapped up in his complaint is also a series of incorrect assumptions: First, that people have a “right” to healthcare, second, that the Free Market deprives people of this “right” and third that we even have a “free market” in healthcare to begin with.

The assertion that we have a “Right” to healthcare has been widely asserted and frequently debunked. For starters, Rights are things which don’t cost other people anything for you to exercise. My right to swing my arm stops at the end of other people’s noses. Economically, healthcare is a competitive, exclusive consumer good. If one person consumes a unit of healthcare, it is unavailable for another person to use. Somebody must pay for that unit of healthcare … unless we are going to expropriate people’s labor and turn them into healthcare-providing slaves. But the left doesn’t like or comprehend that resources like “the number of hours healthcare providers work” are finite but demand is essentially infinite. The Free Market (nominally) allows for the division of those finite resources via the price mechanism.

Next comes the idea that the Free Market is bad because of how it divides up this limited resource. Is it also bad because it divides people’s labor in every other field in the same fashion, with certain jobs or skills being more valuable than others? Brain Surgeons earn considerably more than tellers at Wal-Mart. Is that fact merely arbitrary or is it entirely appropriate given the very rare combination of desire, skill and years of training which go into making a person a Brain Surgeon? Not to mention the fact that if you need a brain surgeon, you probably don’t want a Wal-Mart teller to wield the blade. (Bob’s Discount Brain Surgery’s prices can’t be beat! We consistently get three stars on Yelp!)

Last comes the notion that we even have a genuinely “Free Market” in healthcare, which is a laughable idea on its face. Is there an industry in this nation which is subject to more government regulation or subsidy than Healthcare? Far from being a “free market,” healthcare more closely resembles a “state-funded agency” when you consider where the monetary inputs come from. In 2013, some 64% of all healthcare spending was provided by the Government via programs such as Medicare, Medicaid, sCHIP and the VA. It’s arguable that part of the reason why Healthcare is so expensive in the first place is that the Government has flooded the zone with so much money that the “third party payer effect” hopelessly distorts the price mechanism. After all, are you going to be more or less likely to order an expensive meal and dessert at a restaurant if you knew somebody else was picking up the tab?

But all of this misses the fundamental point: that without there being some manner of free market in health care… many of the services which the central planners’ dream of divvying up more equitably simply wouldn’t exist in the first place. When I say “The left doesn’t appreciate The Miracle” (in the Goldbergian, Suicide of the West sense) the mere existence of these services is a manifestation of it.

The fact that services such as personal healthcare assistants who will come to your home to do things like “help you bathe” exist in the first place is largely because of the free market. But the left presumes the production of such goods and services as if the market for that labor were static. The thought that such a thing wouldn’t exist without that market doesn’t seem to occur to them, just as its mere existence doesn’t imply their right to have it.

Then there’s the aspect of the future to consider. My contention is that my friend is fundamentally incorrect in his assertion that the Free Market can’t solve this problem – especially if “solving” it in his mind means free healthcare for everybody. In fact, the exact opposite is the case. Who else but the free market and the entrepreneurs associated with it have any hope of easing the burdens with which the disabled live? Is it possible that Honda or Toyota could develop a “home healthcare assistance robot” that can help people meet these basic needs — like this one — and obviate the need for more expensive home healthcare workers? We may never find out if the left get their way, as I can see their next complaint warming up in the bullpen: It isn’t “fair” because only the “Rich” could afford to purchase such golems.

This is at its core the lack of gratitude that Jonah talks about in Suicide of the West: That because The Miracle of Democratic Capitalism doesn’t produce a utopia or Immanentize the Eschaton that it is necessarily grubby, bad and in need of being throttled. But the left doesn’t consider the alternative, where we don’t even get the luxury of contemplating how to divide up such riches in a fashion more pleasing to their eyes. They might, in their anger and impatience kill the very process through which these problems are ultimately ameliorated.

I’m certainly not ashamed to make that argument.

There are 79 comments.

Become a member to join the conversation. Or sign in if you're already a member.
  1. Basil Fawlty Member
    Basil Fawlty
    @BasilFawlty

    How can the government allow this to happen to the cat?

    • #1
  2. Arahant Member
    Arahant
    @Arahant

    The thing that stuck out for me was that the person was claiming to have a master’s degree and puts out a highly ungrammatical plea.

    • #2
  3. Basil Fawlty Member
    Basil Fawlty
    @BasilFawlty

    Arahant (View Comment):

    The thing that stuck out for me was that the person was claiming to have a master’s degree and puts out a highly ungrammatical plea.

    And this would be notable why?

    • #3
  4. Hoyacon Member
    Hoyacon
    @Hoyacon

    Your points regarding the market are well taken, but I have to go with insufficient info, even with you filling in the blanks.  If I had a better idea of why no services were available, well, then we might be able to judge this.

    • #4
  5. Shawn Buell (Majestyk) Contributor
    Shawn Buell (Majestyk)
    @Majestyk

    Hoyacon (View Comment):

    I have to go with insufficient info, even with you filling in the blanks.

    I don’t think it changes anything else.  My rebuttal of my friend’s assertions remain valid even if the underlying circumstances change.

    • #5
  6. Hoyacon Member
    Hoyacon
    @Hoyacon

    Shawn Buell (Majestyk) (View Comment):

    Hoyacon (View Comment):

    I have to go with insufficient info, even with you filling in the blanks.

    I don’t think it changes anything else. My rebuttal of my friend’s assertions remain valid even if the underlying circumstances change.

    They do (and note my slight revisions above).  But it’s possible the rebuttal–while well stated–may not even be necessary.  I am attempting to not be judgmental about this particular person, but, as a general matter, haven’t we all encountered those who fault the system when they should be looking close to home?  

    • #6
  7. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Is this a she? Reads like it. 

    • #7
  8. Shawn Buell (Majestyk) Contributor
    Shawn Buell (Majestyk)
    @Majestyk

    Bryan G. Stephens (View Comment):

    Is this a she? Reads like it.

    My friend is a he, the complainant is a she.

    • #8
  9. Kozak Member
    Kozak
    @Kozak

    I would suggest moving to Cuba

    Or Venezuela

    They clearly have a compassionate Socialist solution.

    • #9
  10. Kozak Member
    Kozak
    @Kozak

    Generally it’s been my experience that patients that have no friends or family willing to pitch in and get dumped by doctors or home health agencies are impossible to deal with.

    • #10
  11. Arahant Member
    Arahant
    @Arahant

    Basil Fawlty (View Comment):

    Arahant (View Comment):

    The thing that stuck out for me was that the person was claiming to have a master’s degree and puts out a highly ungrammatical plea.

    And this would be notable why?

    Yeah. I know. I know.

    • #11
  12. Ontheleftcoast Member
    Ontheleftcoast
    @Ontheleftcoast

    Shawn Buell (Majestyk): Even not knowing the whole story, how plausible is it to think that a company whose client is in good standing with them would simply elect to stop taking their money? I suppose it’s possible, but there are service providers for nearly everything, and a great deal of competition to boot.

    Quite plausible. Intuit, for one.

    Apparently holding on to money due their (now) former clients until forced to disgorge it.

    Here

    And here.

    • #12
  13. Zafar Member
    Zafar
    @Zafar

    Shawn Buell (Majestyk): In 2013, some 64% of all healthcare spending was provided by the Government via programs such as Medicare, Medicaid, sCHIP and the VA. It’s arguable that part of the reason why Healthcare is so expensive in the first place is that the Government has flooded the zone with so much money that the “third party payer effect” hopelessly distorts the price mechanism.

    Look it’s persuasive on the face of it, but if you compare what is spent on healthcare in comparably prosperous countries (iow, compare the US to Canada and Australia rather than to third world countries like Cuba), you’ll find very similar health outcomes but with half the expediture (measured as a % of GDP).  That is fact, how to explain it and reconcile it with competition = lower prices (which I also totally believe, btw).

    Who that third party is, and in fact whether there is one or there are many, seems to be directly relevant to the outcome.  Or rather, whether the market works more to the benefit of the provider or the consumer.

    After all, are you going to be more or less likely to order an expensive meal and dessert at a restaurant if you knew somebody else was picking up the tab?

    If I was picking up the tab for thirty 300,000,000 steak dinners I could doubtless negotiate a better per dinner price than I could if I was just paying for my own.

    That is also the magic of the market, but it’s an instance where it’s used by single payer to deliver a broad public good.

    This instance – a paraplegic woman [?] being dropped by home care providers for whatever reason – confuses health insurance with disability insurance.  Which is also something that I (unsurprisingly) think should be both universal (single payer) and delivered to individuals by a free market.  Which places constraints and responsibilities on providers and consumers both.

    I’m honestly curious as to why they’ve dropped her.  Any idea?

    • #13
  14. Chris Member
    Chris
    @Chris

    Arahant (View Comment):

    The thing that stuck out for me was that the person was claiming to have a master’s degree and puts out a highly ungrammatical plea.

    There but for the grace of God go I, but I was struck by the mention of the master’s degree at all.  

    I understand the logic of “As someone who is still employable if they can receive at home services, I would hope that the state would still want a taxpayer and could somehow help deliver me that service” or some such.   That said, a master’s degree is not the determinant of that.  My own bias is that the inclusion betrays an underlying dissatisfaction with “the market” not recognizing the greatness of the writer and an unhappiness that XYZ people earn more despite NOT having a master’s degree.  It’s a tough way to go through life, although not an uncommon emotion of youth.

    And, to @Kozak ‘s observation above in #9, the dream that the state provides what I want is in stark contrast to the reality of what they want to provide.  Unless you are first among equals – and hopefully the master’s degree will provide that?

    • #14
  15. Dorrk Member
    Dorrk
    @Dorrk

    I’m trying to figure out how someone can be so infirmed that they cannot provide or procure basic care for themselves at home, and, yet, is somehow able to hold down a demanding/prestigious job (unless their caretaker usually follows them to work, too). Isn’t this really a complaint about the poor insurance provided by their employer? Assuming it’s a college, I would imagine it’s pretty good coverage, too.

    EDIT: For some reason I got the impression that she was a college professor. I seem to have misread something.

    • #15
  16. Shawn Buell (Majestyk) Contributor
    Shawn Buell (Majestyk)
    @Majestyk

    I was able to suss out some additional information regarding this woman’s situation to add context, even though I’m not sure it’s germane to my arguments here.

    She is a paraplegic and works for an outfit called Lutheran Social Services of Upper Wisconsin.  Not for nothing, I find it hard to contemplate that a religious charity organization would not want to take care of its people if they are in distress.

    • #16
  17. Shawn Buell (Majestyk) Contributor
    Shawn Buell (Majestyk)
    @Majestyk

    Zafar (View Comment):
    If I was picking up the tab for thirty 300,000,000 steak dinners I could doubtless negotiate a better per dinner price than I could if I was just paying for my own.

    I recall the Obamacare fight and specifically how the notion of things like “mass purchases of pharmaceuticals” was essentially off the table.  It’s one thing to note that you can get group discounts, it’s another thing entirely to use your bargaining position to get them.

    There are lots of theories as to why Americans spend so much money on healthcare.  One, which seems plausible to me is that we have more money on average to spend on it.  But, I can’t help but notice that the attitude towards insurance which many people have is that it consists of “pre-bought” HC services.  And they don’t like to leave anything on the table.

    • #17
  18. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Shawn Buell (Majestyk) (View Comment):

    Zafar (View Comment):
    If I was picking up the tab for thirty 300,000,000 steak dinners I could doubtless negotiate a better per dinner price than I could if I was just paying for my own.

    I recall the Obamacare fight and specifically how the notion of things like “mass purchases of pharmaceuticals” was essentially off the table. It’s one thing to note that you can get group discounts, it’s another thing entirely to use your bargaining position to get them.

    There are lots of theories as to why Americans spend so much money on healthcare. One, which seems plausible to me is that we have more money on average to spend on it. But, I can’t help but notice that the attitude towards insurance which many people have is that it consists of “pre-bought” HC services. And they don’t like to leave anything on the table.

    And the insurance companies work hard to not to pay providers, going as far as giving a bonus to staff who drag out a payment. They create as many hoops as possible. When it is the government, like Medicaid, they will make getting paid harder and harder, cutting costs without cutting services. 

    • #18
  19. Arahant Member
    Arahant
    @Arahant

    Shawn Buell (Majestyk) (View Comment):
    There are lots of theories as to why Americans spend so much money on healthcare. One, which seems plausible to me is that we have more money on average to spend on it. But, I can’t help but notice that the attitude towards insurance which many people have is that it consists of “pre-bought” HC services. And they don’t like to leave anything on the table.

    Everything that is not pure, free marketism is just some other rationing scheme. We spend more because we ration less. If people can afford it directly or indirectly through a third-party, they can buy it here. It’s that simple. I had a friend in Canada. She started having seizures. She got on a waiting list for a test, waited, got the test, waited for results, and then got on the waiting list for the next test, lather, rinse, repeat. The waiting lists were a form of rationing. Why did they have waiting lists? Because they had limited equipment, limited facilities, and limited numbers of doctors. She finally got an MRI about six months after the seizures started, because they had eliminated possibilities through previous tests, but the waiting lists were about a month apiece. The MRI showed an aggressive brain tumor. It would have been curable six months earlier. It would have been curable even two months earlier. Sorry about that, but she was on the waiting lists back then. It was too late, and she died.

    I had an incident here in the States. They ran about ten different tests within twenty-four hours, including an MRI. It didn’t take six months of waiting lists, it was the same day. What’s the difference? Currently, about a 4:1 higher density of MRI machines per capita in the US than in Canada. Both incidents were now more than ten years ago, and the difference was probably starker back then. The choice to invest double the percentage of GDP into healthcare creates differences. Result: I’m alive and typing, and was able to attend my friend’s funeral in Canada.

    Anecdotal? Sure. But what are statistics other than a billion anecdotes.

    • #19
  20. Arahant Member
    Arahant
    @Arahant

    Bryan G. Stephens (View Comment):
    When it is the government, like Medicaid, they will make getting paid harder and harder, cutting costs without cutting services.

    Nominally without cutting services, and nominally cutting costs. The costs are the same. The government’s price is lower due to bulk buying (as with Amazon or Wal-Mart), but the price for everyone else has to go up, since the costs to provide remain. The cost of being a healthcare provider also goes up. All that is happening is that the burden is being shifted as to who pays the real costs.

    • #20
  21. Tim H. Member
    Tim H.
    @TimH

    Aharant—

    That’s a good point about the costs with bulk pricing.  I’ll have to think about the details, but it makes sense  that you don’t reduce the actual costs this way.

    • #21
  22. Zafar Member
    Zafar
    @Zafar

    Shawn Buell (Majestyk) (View Comment):

    Zafar (View Comment):
    If I was picking up the tab for thirty 300,000,000 steak dinners I could doubtless negotiate a better per dinner price than I could if I was just paying for my own.

    I recall the Obamacare fight and specifically how the notion of things like “mass purchases of pharmaceuticals” was essentially off the table. It’s one thing to note that you can get group discounts, it’s another thing entirely to use your bargaining position to get them.

    I guess it’s a matter of political will and political agenda.

    Other countries’ Governments use this bargaining position, the US Government doesn’t.

    There are lots of theories as to why Americans spend so much money on healthcare.

    But a real disinclination to even consider the possibility that you’re being ripped off.  The reasoning (best health care in the world so of course it costs more than anybody else’s) sounds a bit truthy, to be honest. jmho.

    edit: I also think it becomes a matter of honour, so it’s hard to look at it with a cold eye.

    • #22
  23. Arahant Member
    Arahant
    @Arahant

    Tim H. (View Comment):

    Aharant—

    That’s a good point about the costs with bulk pricing. I’ll have to think about the details, but it makes sense that you don’t reduce the actual costs this way.

    It always comes out of somebody’s pocket. The exception is true wealth creation, but governments seldom do anything like that.

    • #23
  24. Zafar Member
    Zafar
    @Zafar

    Arahant (View Comment):

    I had an incident here in the States. They ran about ten different tests within twenty-four hours, including an MRI. It didn’t take six months of waiting lists, it was the same day. What’s the difference? Currently, about a 4:1 higher density of MRI machines per capita in the US than in Canada. Both incidents were now more than ten years ago, and the difference was probably starker back then. The choice to invest double the percentage of GDP into healthcare creates differences. Result: I’m alive and typing, and was able to attend my friend’s funeral in Canada.

    First of all: I’m glad you’re still with us.

    From your link, Japan has a higher density of MRI machines per capita (51.67)/million) than the US does (36.72/million).   So going by your logic healthcare in Japan should take up one and half times as much of national GDP as healthcare in the US, but that’s not the case:

    US 17.6%  vs Japan 9.5%.

    How to explain?

    Also: access to MRIs is limited by one thing in Canada (tax rates, # of MRI machines, etc.) but it’s limited by personal wealth and insurance in the US. Why is that a better way to do it? Especially if the whole shebang ends up costing so much more?

     

     

     

    • #24
  25. Zafar Member
    Zafar
    @Zafar

    Arahant (View Comment):

    Bryan G. Stephens (View Comment):
    When it is the government, like Medicaid, they will make getting paid harder and harder, cutting costs without cutting services.

    Nominally without cutting services, and nominally cutting costs. The costs are the same. The government’s price is lower due to bulk buying (as with Amazon or Wal-Mart), but the price for everyone else has to go up, since the costs to provide remain. The cost of being a healthcare provider also goes up. All that is happening is that the burden is being shifted as to who pays the real costs.

    How does that work in other systems?

    Who does the Australian system shift the cost of a hip replacement onto, for example?  There’s basically one system and one price, right?

     

    • #25
  26. Arahant Member
    Arahant
    @Arahant

    Zafar (View Comment):
    So going by your logic

    That is not my logic. That is the logic you are projecting from what I said, which missed the point. Every system rations limited resources. Every system has a decision-making process in how it rations those limited resources. Our system is neither single-payer nor fully market-driven. It is liability-driven distorted by third-party payment overlays on what started as a market system. Each decision-making process that varies from direct consumer-payment markets makes other distortions to the markets and distribution of resources. Doctors’ guilds also distort the markets and prices that would be paid versus a free market. Having it so hospitals can’t turn away patients distorts the market and is factored into the price.

    While our market distortions make the system less efficient (i.e. it costs/wastes/redirects wealth more than it should) and less effective than a free market, it is still more adaptable and effective than single (government) payer. When a single payer controls it, they make all the decisions. The patients don’t make the decisions. The doctors don’t make the decisions. Government bureaucrats make the decisions. A government bureaucrat says, “We shall have one MRI machine per one million people.” He doesn’t worry about getting sued if he’s wrong and the number should be one machine per thousand people. People just have to wait their turn. He’s keeping the costs down, which is why the government took over healthcare in the first place, isn’t it? I mean, maybe if the machine manufacturers have the right kickback or contribute to the right politician’s campaign, that ratio could be changed, but it’s all in government hands. That is the single-payer choice. People are going to die who would not otherwise die, but costs are controlled.

    Our system is a distorted mess. At least half those high costs could be eliminated with tort reform, but enough of our politicians are bought off and the lawyer lobbies can raise enough stink that “tort reform will make doctors and hospitals unaccountable” that tort reform has not passed. But even with the distortions to price, people are living. People are getting the tests they need. I just don’t see why you hate these people and want them to die through single payer over a few extra shekels, you greedy, greedy man. 😉

    The last joke aside, it really is a matter of who makes the decisions about an individual’s health. Should it be the patients and their healthcare professionals? Should it be an insurance executive? Should it be a government bureaucrat? Choices and trade-offs. Government-run industries tend to be less efficient, effective, and adaptable. Everyone may get the same level of healthcare (except the politicians, of course), but it is a lower level overall and tends to kill innovation.

    • #26
  27. Arahant Member
    Arahant
    @Arahant

    Zafar (View Comment):
    Who does the Australian system shift the cost of a hip replacement onto, for example? There’s basically one system and one price, right?

    Why does a hip replacement in Australia cost so much more than in Argentina?

    • #27
  28. Zafar Member
    Zafar
    @Zafar

    Arahant (View Comment):

    Zafar (View Comment):
    Who does the Australian system shift the cost of a hip replacement onto, for example? There’s basically one system and one price, right?

    Why does a hip replacement in Australia cost so much more than in Argentina?

    The Australian dollar is very strong. Compared to the Argentinian….er…peso?

    Thats why I like the % of GDP comparison – it’s apples to apples.

    • #28
  29. Judge Mental Member
    Judge Mental
    @JudgeMental

    I don’t know if anyone has addressed R&D costs on drug pricing.  Many countries fix the cost on these drugs to not much more than manufacturing costs, so the entire R&D burden is being paid by the U.S., while the other countries, in effect, get generic pricing on everything.

    This is why the U.S. produces something like 80+% of all the new drugs.  Health care costs could be reduced substantially, as long as we are all okay with the reality that no new treatment will ever be introduced again.  Then we could have the same kind of generic pricing here.

    Or, other countries can pay more for drugs by kicking in for the R&D cost, and prices can drop here.  Something I believe Trump is trying to address.

    • #29
  30. Judge Mental Member
    Judge Mental
    @JudgeMental

    Image result for ben stein bueller images

    Buell… Buell… Buell…

    • #30

Comments are closed because this post is more than six months old. Please write a new post if you would like to continue this conversation.