ACA Repeal/Replace: Progressives Face Moral Dilemma

[David Horn]

(01-16-2017, 02:20 AM)Warren Dew Wrote: Three points here.

OK

Warren Dew Wrote:First, perhaps the main reason they are cheaper is that all the drug research is paid for by us, and they only pay the costs of manufacture.  Legalizing re-importation of drugs would fix that, making them pay their fair share of the research costs, and reducing the share we have to pay.

But we selectively disallowed that as Big Pharma made sure it was excluded.  I agree, lowering drug prices would be a big plus, but re-importation is not the way.  Just negotiate directly.

Warren Dew Wrote:Second, their systems aren't like Medicare.  The most successful of the European systems, which is questionably more cost effective than our private insurance system after adjusting for drug prices mentioned above, essentially has the government paying for private insurance selected by the individual, and not paying the providers directly.  So the idea that Medicare for all is the way to go is highly questionable.

What systems are those?  Only the Swiss and the Japanese do that, and neither is the best-of-the-best.  The two best are typically the Italians and French.  I'm less familiar with the Italian system, but the French employ private providers but pay a fixed rate for services.  I believe they also use private concerns for billing, which is not what you described.

Warren Dew Wrote:Third, if we're going to have a major revamp of the system, why not move to a genuinely free market system, or at least closer to it?

There is no such thing as a free market in healthcare, any more than there is in policing -- and for the same reason. The market is good at providing goods and services we desire, but mandatory demand services are not part of that model. How do you shop around for the best emergency room following a car accident or heart attack? You don't! How do you shop for services you don't really understand, when the entire knowledge base resides with the providers? You don't! What is the price of a new hip? You don't know, and, apparently, the providers don't either. The 'price' can vary by several hundred percent.

Why you neoliberals seem unable to understand that is beyond me.