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#26 2017-02-27 20:16:12

Big A.D.
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Re: Medical care before the state

bordsilver wrote:
mmm....shiney! wrote:

I think bordie's post is primarily about GP service delivery, rather than the more complicated health requirements which go beyond socialised health care.

Yes, the post was about a contemporary emergence of a voluntary system for obtaining inexpensive health care. Worth noting that the "Concierge medicine" approach was previously one of the models that the Friendlies implemented.

As stated near the start of the thread there is no "one-size-fits-all" approach to something as complicated as medical care with long tails. It is best thought of as a system of overlapping options, each with their own advantages and disadvantages. The Concierge medicine is a component that can suit some people's circumstances very well and others not at all.

What I find fascinating about it is that that someone has re-branded a basic socialized model as "Concierge" so Americans don't have to admit to using a socialist system.


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#27 2017-02-27 21:03:18

mmm....shiney!
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Re: Medical care before the state

Big A.D. wrote:
bordsilver wrote:
mmm....shiney! wrote:

I think bordie's post is primarily about GP service delivery, rather than the more complicated health requirements which go beyond socialised health care.

Yes, the post was about a contemporary emergence of a voluntary system for obtaining inexpensive health care. Worth noting that the "Concierge medicine" approach was previously one of the models that the Friendlies implemented.

As stated near the start of the thread there is no "one-size-fits-all" approach to something as complicated as medical care with long tails. It is best thought of as a system of overlapping options, each with their own advantages and disadvantages. The Concierge medicine is a component that can suit some people's circumstances very well and others not at all.

What I find fascinating about it is that that someone has re-branded a basic socialized model as "Concierge" so Americans don't have to admit to using a socialist system.

Socialized or socialist?  wink


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#28 2017-02-27 21:42:20

bordsilver
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Re: Medical care before the state

Big A.D. wrote:
bordsilver wrote:
mmm....shiney! wrote:

I think bordie's post is primarily about GP service delivery, rather than the more complicated health requirements which go beyond socialised health care.

Yes, the post was about a contemporary emergence of a voluntary system for obtaining inexpensive health care. Worth noting that the "Concierge medicine" approach was previously one of the models that the Friendlies implemented.

As stated near the start of the thread there is no "one-size-fits-all" approach to something as complicated as medical care with long tails. It is best thought of as a system of overlapping options, each with their own advantages and disadvantages. The Concierge medicine is a component that can suit some people's circumstances very well and others not at all.

What I find fascinating about it is that that someone has re-branded a basic socialized model as "Concierge" so Americans don't have to admit to using a socialist system.

Or they could call it a "mutual" system like the old days. wink

It's a bit like the term "sharing economy" being touted like it was something new when it's been around for millenia.


The only good tax is a repealed tax.

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#29 2017-02-27 22:00:22

Big A.D.
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Re: Medical care before the state

mmm....shiney! wrote:
Big A.D. wrote:
bordsilver wrote:

Yes, the post was about a contemporary emergence of a voluntary system for obtaining inexpensive health care. Worth noting that the "Concierge medicine" approach was previously one of the models that the Friendlies implemented.

As stated near the start of the thread there is no "one-size-fits-all" approach to something as complicated as medical care with long tails. It is best thought of as a system of overlapping options, each with their own advantages and disadvantages. The Concierge medicine is a component that can suit some people's circumstances very well and others not at all.

What I find fascinating about it is that that someone has re-branded a basic socialized model as "Concierge" so Americans don't have to admit to using a socialist system.

Socialized or socialist?  wink

The suffix is irrelevant.

Removing the word "social" from the description and replacing it with "concierge" so that people feel empowered (even though they're using a social model) is genius.

It also says a lot about Americans' inability to grasp nuance. And reality, come to think of it.


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#30 2017-02-27 22:28:01

mmm....shiney!
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Re: Medical care before the state

On the contrary there's a big difference. Something to do with coercion v voluntarism just quietly.


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#31 2017-02-27 23:25:10

bordsilver
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Re: Medical care before the state

mmm....shiney! wrote:

On the contrary there's a big difference. Something to do with coercion v voluntarism just quietly.

I saw the difference smile


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#32 2017-02-27 23:30:02

mmm....shiney!
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Re: Medical care before the state

bordsilver wrote:
mmm....shiney! wrote:

On the contrary there's a big difference. Something to do with coercion v voluntarism just quietly.

I saw the difference smile

I would hope you would.  cool


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#33 2017-02-28 08:25:10

Roswell Crash Survivor
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Re: Medical care before the state

Big A.D. wrote:

Removing the word "social" from the description and replacing it with "concierge" so that people feel empowered (even though they're using a social model) is genius.

It also says a lot about Americans' inability to grasp nuance. And reality, come to think of it.

Anyone who uses a 'credit card' is really using a 'unsecured debt card'. Same branding trick.


The Roswell Crash Survivor

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#34 2017-02-28 23:59:53

Big A.D.
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Re: Medical care before the state

mmm....shiney! wrote:

On the contrary there's a big difference. Something to do with coercion v voluntarism just quietly.

That's my point: if the system is more efficient and delivers better results, it will be and do that regardless of whether people join it voluntarily or whether they join because they have to.

So why even bother discussing it? Why have a hundred different health care plans and HMOs and PPOs and give people the illusion that they can make a meaningful choice when all they really need is the ability to go to the doctor when they're sick?


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#35 2017-03-01 00:28:24

mmm....shiney!
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Re: Medical care before the state

Big A.D. wrote:
mmm....shiney! wrote:

On the contrary there's a big difference. Something to do with coercion v voluntarism just quietly.

That's my point: if the system is more efficient and delivers better results, it will be and do that regardless of whether people join it voluntarily or whether they join because they have to.

So why even bother discussing it? Why have a hundred different health care plans and HMOs and PPOs and give people the illusion that they can make a meaningful choice when all they really need is the ability to go to the doctor when they're sick?

Putting aside the notion that forcing people to join a health plan such as Medicare for instance is immoral, the idea that a system that is financed entirely through coercion would not have any marked difference in service delivery, efficiency and response to customer needs than a voluntary system financed by satisfied customers free to opt in or out out to another provider is laughable and not borne out by evidence.


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#36 2017-03-01 09:17:31

Lovey80
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Re: Medical care before the state

vicissitudes...? Really? Is the intended audience Ludwig Von Mises and his generation?

Last edited by Lovey80 (2017-03-01 09:17:49)

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#37 2017-03-01 16:45:31

bordsilver
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Re: Medical care before the state

Lovey80 wrote:

vicissitudes...? Really? Is the intended audience Ludwig Von Mises and his generation?

A couple of decades ago I won first prize at the regional art show with a work I titled "Vicissitudes of life" big_smile

I like expressive words like this and I only tend to dumb them down if I expect renovator's going to read my post.


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#38 2017-03-01 17:30:01

mmm....shiney!
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Re: Medical care before the state

Why not have a hundred different health care plans and HMOs and PPOs? (Whatever they are.)

Hayek wrote:

selection by evolution is prevented by government monopolies that make competitive experimentation impossible.


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#39 2017-03-01 19:14:49

Big A.D.
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Re: Medical care before the state

mmm....shiney! wrote:

Why not have a hundred different health care plans and HMOs and PPOs? (Whatever they are.)

Hayek wrote:

selection by evolution is prevented by government monopolies that make competitive experimentation impossible.

Yes, but on the other hand there is the problem with overchoice which leads to the consumer becoming stressed and overwhelmed by being presented with too many options. They know the sheer number of choices available means they have a high likelihood of picking a sub-optimal one and since they'll probably never find out how good or bad their ultimate choice was, they inevitably resent the whole process and assume they're being quietly ripped off.


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#40 2017-03-01 19:33:37

mmm....shiney!
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Re: Medical care before the state

Big A.D. wrote:

Yes, but on the other hand there is the problem with overchoice which leads to the consumer becoming stressed and overwhelmed by being presented with too many options. They know the sheer number of choices available means they have a high likelihood of picking a sub-optimal one and since they'll probably never find out how good or bad their ultimate choice was, they inevitably resent the whole process and assume they're being quietly ripped off.

There's got to be a simpler way to say what I'm about to say:

By what authority do you or an agent such as a bureaucrat possess the right to restrict the choices available to individuals as they go about satisfying their needs? Life is stressful Big AD, authorising the decisions about medical choice or mandating who can supply/not supply consumer need to an individual by a* core group of unrelated, anonymous policy makers completely unaware of the individual's circumstances and desires is not really a great argument or strategy if you're trying to reduce patient stress, for example:

http://medicalmarijuananews.xyz/austral … treatment/

*Edited for grammar.

Last edited by mmm....shiney! (2017-03-01 21:45:41)


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#41 2017-03-01 20:11:03

bordsilver
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Re: Medical care before the state

mmm....shiney! wrote:
Big A.D. wrote:

Yes, but on the other hand there is the problem with overchoice which leads to the consumer becoming stressed and overwhelmed by being presented with too many options. They know the sheer number of choices available means they have a high likelihood of picking a sub-optimal one and since they'll probably never find out how good or bad their ultimate choice was, they inevitably resent the whole process and assume they're being quietly ripped off.

There's got to be a simpler way to say what I'm about to say:

By what authority do you or an agent such as a bureaucrat possess the right to restrict the choices available to individuals as they go about satisfying their needs? Life is stressful Big AD, authorising the decisions about medical choice or mandating who can supply/not supply consumer need to an individual or core group of unrelated, anonymous policy makers completely unaware of the individual's circumstances and desires is not really a great argument or strategy if you're trying to reduce patient stress, for example:

http://medicalmarijuananews.xyz/austral … treatment/

I'd just say that if "too many options" is a problem* then there is automatically a market opportunity for reducing the number of options. Indeed, pretty much every shopkeeper does this as a matter of course. They restrict the number of products available to ones that they think match the range of needs/wants of their consumer base. Add in the fact that there are multiple shopkeepers within each market segment and competition serves to select the shopkeepers that do the best of job reducing the number of options.




*which evidence suggests that at times there may be - but often it depends on how you analyse the evidence.


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#42 2017-03-01 20:36:24

Big A.D.
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Re: Medical care before the state

mmm....shiney! wrote:
Big A.D. wrote:

Yes, but on the other hand there is the problem with overchoice which leads to the consumer becoming stressed and overwhelmed by being presented with too many options. They know the sheer number of choices available means they have a high likelihood of picking a sub-optimal one and since they'll probably never find out how good or bad their ultimate choice was, they inevitably resent the whole process and assume they're being quietly ripped off.

There's got to be a simpler way to say what I'm about to say:

By what authority do you or an agent such as a bureaucrat possess the right to restrict the choices available to individuals as they go about satisfying their needs? Life is stressful Big AD, authorising the decisions about medical choice or mandating who can supply/not supply consumer need to an individual or core group of unrelated, anonymous policy makers completely unaware of the individual's circumstances and desires is not really a great argument or strategy if you're trying to reduce patient stress, for example:

http://medicalmarijuananews.xyz/austral … treatment/

I don't agree with the premise that people (patients) know or understand their medical needs, or that their circumstances or desires necessarily play an important part in their treatment.

That's what doctors are for.

Private providers trying to sell health care packages tailored to your personal circumstances are essentially trying to outperform the "market" in sick people. Given enough people, it's not that difficult to figure out how many people are going to need treatment for any particular condition, so having private providers cherry-pick the healthy ones means all the difficult, complicated cases get either left in a state run safety net system (which taxpayers pick up the tab for) or outside of any kind of system (which means they suffer and die).

Look, if someone wants to pay extra for seeing a GP who's receptionist has a nice smile and a low-cut top, or stay in a hospital where the food is made by an in-house Michelin starred restaurant, fine.

Individuals who whine that they can't afford those things if they also have to pay for an actual medical system that heals the sick isn't, in my view, a legitimate complaint.

If you're healthy and not a doctor, you probably don't know what kind of medical services you might need (and if you're not a lawyer, you probably won't understand a private insurer's policy terms and conditions either).

If you're sick, you probably don't care what the treatment is so long as it works and you get better again.

So how is any individual ever in the position to make an informed choice in choosing which health care plan to pay for?


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#43 2017-03-01 20:57:53

bordsilver
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Re: Medical care before the state

Big A.D. wrote:

:
:
If you're sick, you probably don't care what the treatment is so long as it works and you get better again.

So how is any individual ever in the position to make an informed choice in choosing which health care plan to pay for?

The dreaded asymmetric information problem. Have a read of the start of the thread which showed real-world tangible solutions to this very problem before socialised socialist medicine existed. In particular, take note of the 3rd group of service providers which encompasses a wide variety of contract practices. smile

Last edited by bordsilver (2017-03-01 21:03:09)


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#44 2017-03-01 21:30:06

Big A.D.
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Re: Medical care before the state

bordsilver wrote:
Big A.D. wrote:

:
:
If you're sick, you probably don't care what the treatment is so long as it works and you get better again.

So how is any individual ever in the position to make an informed choice in choosing which health care plan to pay for?

The dreaded asymmetric information problem. Have a read of the start of the thread which showed real-world tangible solutions to this very problem before socialised socialist medicine existed. In particular, take note of the 3rd group of service providers which encompasses a wide variety of contract practices. smile

I did read about them (with interest), but I don't see how they could be considered as much more than a step towards a universal socialized healthcare system.

Really, why would people organize and join friendly societies if they didn't benefit from paying a small, regular fee and spreading the risk of medical expenses over a whole bunch of other people?

Scale that up to a national level and you essentially get a universal system. Okay, it would have been too difficult to do that in the 19th century because administering a national scheme with the technology of the day would have made it impossible, but we have the technology to be able to do it now.


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#45 2017-03-01 21:43:48

mmm....shiney!
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Re: Medical care before the state

bordsilver wrote:

The dreaded asymmetric information problem.

And it's bedfellow the "principal/agent" problem.


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#46 2017-03-01 21:50:06

mmm....shiney!
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Re: Medical care before the state

Big A.D. wrote:

Really, why would people organize and join friendly societies if they didn't benefit from paying a small, regular fee and spreading the risk of medical expenses over a whole bunch of other people?

Scale that up to a national level and you essentially get a universal system. Okay, it would have been too difficult to do that in the 19th century because administering a national scheme with the technology of the day would have made it impossible, but we have the technology to be able to do it now.

By nationalised I asume you mean monopolised by government. Why would people join a friendly society? Because monopolies, especially government mandated or protected ones are notoriously inefficient and less effective than competitive privateers.


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#47 2017-03-02 02:08:53

Big A.D.
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Re: Medical care before the state

mmm....shiney! wrote:
Big A.D. wrote:

Really, why would people organize and join friendly societies if they didn't benefit from paying a small, regular fee and spreading the risk of medical expenses over a whole bunch of other people?

Scale that up to a national level and you essentially get a universal system. Okay, it would have been too difficult to do that in the 19th century because administering a national scheme with the technology of the day would have made it impossible, but we have the technology to be able to do it now.

By nationalised I asume you mean monopolised by government. Why would people join a friendly society? Because monopolies, especially government mandated or protected ones are notoriously inefficient and less effective than competitive privateers.

Right, you mean like how the U.S. Department of Veterans Affairs has a monopoly on the Veterans Healthcare Administration that's consistently found to be more cost effective and have better quality of care than private sector equivalents?


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#48 2017-03-02 04:07:49

mmm....shiney!
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Re: Medical care before the state

Big A.D. wrote:

Right, you mean like how the U.S. Department of Veterans Affairs has a monopoly on the Veterans Healthcare Administration that's consistently found to be more cost effective and have better quality of care than private sector equivalents?

I didn't know about VA's cost effectiveness and quality of care, so i googled it.

President Obama's 2016 budget asks for authority to reallocate funds from a temporary program that Congress established last year to help military veterans struggling to obtain care at Department of Veterans Affairs health clinics.

The proposal would affect potential excess money from the Veterans Choice program, which allows eligible patients to seek treatment outside the VA hospital network if they have waited too long for an appointment or live far from the nearest agency medical center.

Congress and the president approved $10 billion for the temporary benefit last year in the wake of the VA's record-keeping scandal, which involved manipulation of scheduling data. The actions, detailed in various federal reviews and news accounts, hid treatment delays and may have helped managers earn bonuses.

https://www.washingtonpost.com/news/fed … 9ee9a7a464

The top official for veterans' health care resigned Friday amid a firestorm over delays in care and falsified records at veteran hospitals.

Veterans Secretary Eric Shinseki says he has accepted the resignation of Robert Petzel, the department's undersecretary for health care. Shinseki had asked for the resignation, a department official later said on condition of anonymity because he was not authorized to speak for attribution.

http://nypost.com/2014/05/16/top-vetera … e-scandal/


Veterans and some VA doctors say that the new "choice card" program, meant to reduce long patient wait times, is confusing and causing more stress.

The choice card issued by the embattled Department of Veterans Affairs was meant to end long wait times for veterans after last summer's scandal revealed that those who fought for their country were dying while waiting for care.

The card gives veterans who have been waiting more than 30 days for appointments or who live more than 40 miles from a VA facility the chance to see a private doctor.

But instead, some veterans say that when they attempted to use their card, the VA told them they had to live more than 40 "miles in a straight line, or as the crow flies," from their VA rather than Google maps miles, which makes the card harder to use. Several VA doctors e-mailed The Washington Post saying they themselves don't understand how to use the program

Another reader wrote in saying that her stepfather, Charles Schuster,  who died in 2009, recently received a card in the mail, a symbol of an agency still seemingly in disarray. "Gave me a good laugh," she wrote.

So far, 27,000 veterans have made appointments for private care with their cards, the VA said last week. It's a fraction of the 9 million veterans who depend on the delay-plagued VA health-care system, the largest network of health centers and hospitals in the country.

https://www.washingtonpost.com/news/fed … eff4542a79

The Department of Veterans Affairs has been spending at least $6 billion a year in violation of federal contracting rules to pay for medical care and supplies, wasting taxpayer money and putting veterans at risk, according to an internal memo written by the agency's senior official for procurement.

https://www.washingtonpost.com/politics … 430d89cca9

Yep, that monopoly.

Last edited by mmm....shiney! (2017-03-02 04:08:41)


The woolgrower's target shall be the good thriving of his flock and its pastures, and so of himself and those whose livelihoods depend on his enterprise.
"The Woolgrower's Companion", 1906.

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#49 2017-03-13 22:49:54

bordsilver
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Re: Medical care before the state

bordsilver wrote:
Lovey80 wrote:

vicissitudes...? Really? Is the intended audience Ludwig Von Mises and his generation?

A couple of decades ago I won first prize at the regional art show with a work I titled "Vicissitudes of life" big_smile

I like expressive words like this and I only tend to dumb them down if I expect renovator's going to read my post.

Attended a lender's presentation in Sydney yesterday and during the Q&A someone (not me) said "vicissitudes". It's mainstream. smile


The only good tax is a repealed tax.

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