The Logical Inconsistency of Single-Payer Health Care System Supporters

by Jan 28, 2014Health & Vaccines, Liberty & Economy46 comments

Here’s a Twitter conversation I recently had that is illustrative of how supporters of a single-payer health care system of necessity are unable to maintain any logical consistency. For example, notice how they are supporting a petition advocating the need to “End the For-Profit Health Care Marketplace”, but watch their replies when I press them […]

Here’s a Twitter conversation I recently had that is illustrative of how supporters of a single-payer health care system of necessity are unable to maintain any logical consistency. For example, notice how they are supporting a petition advocating the need to “End the For-Profit Health Care Marketplace”, but watch their replies when I press them on the ridiculousness of this idea of eliminating any profit motive. And notice how Simi complains about the lack of market competition for expensive drugs, but then defends the practice of government granting to Big Pharma companies effective monopolies (and notice how, when pressed about this inconsistency, she is completely unable to form an argument and therefore feels it necessary to resort to simply insulting my intelligence). Then comes the real kicker when Simi makes an absolutely Orwellian comment about supporting market prices… All so fascinating!

And that was that.

UPDATE (1/28/2014, 1:15pm)

UPDATE (1/28/2014, 2:00pm)

UPDATE (1/28/2014, 9:35pm)

C.Jay Engel at ReformedLibertarian.com witnessed my Twitter “debate” with these two characters and wrote a blog post about it. I naturally got a chuckle out of this:

One site that I have recently been following is Jeremy Hammond’s. He writes on a variety of different topics, among them simple principles of economics. He is often in a Twitter debate. And I often have my feet up while I munch popcorn.

C.Jay’s additional observations about the subject are worth reading.

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About Jeremy R. Hammond

About Jeremy R. Hammond

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46 Comments

  1. Leo Gerald Harold

    I will respond to Hammond’s first question, do doctors working in single payer systems like Canada’s make a decent living? I worked and lived in Cda and the US and worked for companies that provided products and services to patients and providers, docs in both countries were much better of financially than most other workers.
    They do not have any problems moving up in their profession or making good money.
    Jeremy, look at Medicare in the US, very few doctors will refuse to treat MC patients and what they are paid for their services is obviously enough for physicians to be among the top 5% of earners.

    Reply
    • Jeremy R. Hammond

      Leo, I never asked the question of whether doctors working in single-payer systems like Canada’s make a decent living. I asked how it is possible for doctors to make a living if profits in health care are outlawed. Evidently, doctors in Canada do work for profit, while helps illustrate my point about how ludicrous it is for people to advocate eliminating profit motives in health care. As for Medicare and the willingness of doctors to accept it, define “very few”. One could just as well say very many doctors refuse to accept it, and this would be a perfectly accurate statement depending on how one defined “very many”.

      Reply
      • Leo Gerald Harold

        Jeremy, my experience working in the Health Care field in Florida,NC and SC and meeting at least 100 physicians would lead me to estimate “very few” to be less than 10% of physicians. Now if you were to ask about Medicaid, that number would jump to over 50% who would not see Medicaid patients in their private practice, however, would treat them in emergency situations or as part of their hospital responsibilities.Medicaid in some states reimburses providers so little, like about 20% of Medicare fees, that only physicians who have learned to profit from Medicaid by billing a multitude of treatment codes, often medically unnecessary, however, necessary to pad the claim sufficiently to make the visit worthwhile can make a decent living .A personal friend, a general surgeon in GA, actually rec’d a check from Medicaid for less than $8.00 for an emergency appendectomy performed in his hospital near Atlanta.
        The profit motive for providers in a single payer system is really about determining a fair value for services rendered by a provider and it seems that Medicare is doing that sufficiently well. I am a Medicare Part A and B beneficiary residing in FL and have been treated in CA,SC,NC, GA,FL and Utah and have never been refused service.
        My problem is that in the USA, Medical Insurance Cos are involved and add nothing to the medical care experience yet charge relatively high admin costs and make profits on the medical care while adding nothing to the quality or effectiveness of the Patient/provider experience. Why??
        A neurologist I know well practiced for a while in Canada, and had a secretary he shared with 2 other neurologists and he did his own medical claims in 30 minutes at the end of his day, dropped his claims in the mail each night as he left the office and rec’d his money in his account 3 weeks later. No fuss, no muss. Now he practices with 2 other neurologists and their group has an office manager, secretary and 3 clerks to handle Insurance claims and patient copays and collections.The 3 MD group will not schedule a Medicaid patient for an office consultation unless it is a Workmens Compensation consultation forv which they are paid in excess of the Medicare and Ins Cos normal fee.
        I know many MDs in Canada, the UK and a few in France and none are living in less than the 15 upper percentile range of incomes.

        Jeremy, what does United Healthcare, Aetna,BC/BS provide toward the health and welfare of US citizens? Simple question, difficult answer. The admin and profits of all the Ins Cos is probably 1/3 of our total $2.7 trillion medical bill, a total waste of money.

      • Jeremy R. Hammond

        This idea of “fair value” is meaningless. Doctors who refuse Medicare/Medicaid patients because the government’s reimbursement is so low evidently don’t regard it is “fair value”. Prices should be determined by the market and its pricing system based on supply and demand, not government fiat based on the arbitrary whims of bureaucrats about what constitutes “fair value”.

        As for the third-party payer system that you rightly criticize, it, too, is a consequence of government intervention in the market.

      • Leo Gerald Harold

        The Medicare reimbursement is arrived at in consultation with representatives of the various medical associations and MEDPAC. The amounts are established for example for a colonoscopy and then adjusted for then various places that the procedures may be performed and the relative cost of living in the various parts of the USA, as an example San Francisco physicians may receive 128% of the MEDPAC average price while a physician in Little Rock will receive 82% of that established MEDPAC pricing, I’m surprised Jeremy that you are not familiar with the concept of payment Medicare uses.
        Providers can bill more but Medicare does not allow them to collect more than the copays based on MEDPAC fair value from MC beneficiaries.

      • Jeremy R. Hammond

        Again, this concept of “fair value” is meaningless. The fact that the bureaucrats consult with medical associations when determining how to fix prices doesn’t change what I said. Prices should be determined by the market, not dictated by by bureaucrats. Prices play a crucial role in the market, helping to direct scarce resources to productive ends according to consumer preferences. When government engages in price fixing, as it does in health care, it creates distortions and inefficiencies in the market, resulting in rising costs. Absent the market’s pricing system in which prices are determined by supply and demand, bureaucrats seeking to dictate prices by fiat at best can do so only arbitrarily, based on whatever subjective notion they have of “fair value”. Again, doctors who refuse to accept Medicaid/Medicare patients evidently don’t agree it’s “fair value”. The reason health care in the US is so unaffordable in the first place is because of the massive government intervention in the market we have. Calling for even more government intervention, therefore, as the solution meets Einstein’s definition of insanity. The solution is getting government out of the business of health care, not even more attempts to centrally plan our care for us.

      • Leo Gerald Harold

        Jeremy, you never commented on my number one criticism I expressed about the US system, the total uselessness of Health Care Ins Cos in the US systems. It is the Ins Cos that set the prices in all aspects of the health care chain except Medicare and Medicaid.
        That is about 2 trillion dollars of the system in the US..
        Doctors can actually set their own prices in this market, however, the Ins cos will pay what they have established as their reimbursement rate and patients would be responsible for the balance.
        As an example, when I broke my leg skiing in Utah, the hospital bill was $23k, Medicare paid the hospital $6k and I paid $1,200.00, my Medicare deductible and the hospital wrote off the balance. Had I been an uninsured patient I would have been responsible for the total bill. Had I been insured, the Hospital would have been paid the ins co reimbursement rate that had been negotiated with the provider and that is generally close to the Medicare reimbursement rate in most areas of the country. However, I would have been responsible for my deductible under whatever plan I had purchased, that is the way it is under ACA.
        Ins Cos are adding nothing.

      • Jeremy R. Hammond

        I did comment on that, Leo. As I said, “As for the third-party payer system that you rightly criticize, it, too, is a consequence of government intervention in the market.” Again, the solution is to get the government out of the business of health care, rather than to have even more central planning.

      • Leo Gerald Harold

        I don’t know about the US 3rd party payer system and how it evolved because I was a Canadian citizen until I was transferred from Canada to the US in ’91 and naturalized in 2000 in NC.
        I was working in the pharma industry in Canada when Canada introduced their Universal Health Care system in ’70 and knew several doctors who decided to opt out because they were at the end of their career and had practices with enough well-off patients that they could practice boutique medicine before it was so called. Their patients were required to pay cash for their services and they could charge whatever price they charged. A comical incident occurred on the first day for a doctor I knew well who could not opt out until the program was 90 days old. He was a cardiologist and was called just after midnight on the first day to the home of one of Canada’s richest men who was suffering chest pain. Normally he would have charged $1,000 for such a visit and he rec’d $80.00 from the newly created single payer system. I’m sure he rec’d extra from his patient but he found it amusing.I only knew of about 3 doctors who opted out of the system then.Now doctors can establish private clinics and charge whatever they want for their services in their private clinics. A friend of mine travelled Canada last summer for a colonoscopy that would have cost between $5k-$7k in Boston and had it done in a Montreal clinic for $700.00.
        When I talk about a single payer system I am referring to a single payer system that has the government paying all providers. Canada changed fairly easily in 1970 and the US could change as well by extending Medicare to all.
        Yes, the fees would be established by government in conjunction with provider organizations and providers and providers could opt out but it would work.

      • Jeremy R. Hammond

        “I don’t know about the US 3rd party payer system and how it evolved…”

        Please see here: https://www.jeremyrhammond.com/2013/09/10/krugman-hails-premiums-for-health-insurance-continuing-upward-as-the-right-direction-no-kidding/

        “Now doctors can establish private clinics and charge whatever they want for their services in their private clinics. A friend of mine travelled Canada last summer for a colonoscopy that would have cost between $5k-$7k in Boston and had it done in a Montreal clinic for $700.00.”

        You seem to be arguing my point for me.

        “When I talk about a single payer system I am referring to a single payer system that has the government paying all providers. Canada changed fairly easily in 1970 and the US could change as well by extending Medicare to all.”

        But you just pointed out that in Canada, government isn’t paying for all providers, that there are private clinics where doctors can set their own prices, and that this oasis of a free market in Canadian health care results in far lower prices than in the heavily centrally-planned US system. So your argument contradicts itself.

  2. TBonius

    I think it’s you who is having trouble with logic. When people call for ‘not for profit’ healthcare, they’re referring to insurance/administrative component. They are not suggesting that physicians should not be paid (obviously). Someone else has explained how fee-for-service billing works under single payer – with fees negotiated between gov’t and professional medical associations. You would prefer they be set by the free market. But there are problems with that: 1) patients themselves can’t negotiate prices due to information asymmetry 2) private insurers could negotiate on behalf of patients, but this is pretty far from a market system and given the market concentration private insurers, the end result would resemble what you have in single payer. Your analogy to people purchasing food misunderstands the information asymmetry problem: people of average education are capable of processing the info needed to grocery shop; but health care purchases are much more complicated and consequential. This info asymmetry problem is probably the most-cited argument against a free market in health services. That you are unfamiliar with it suggests that you really do need to read more widely.

    Reply
    • Jeremy R. Hammond

      As you can see above, TBonius, in many cases, when people call for ending profits in healthcare, they have no idea what they are actually advocating.

      The suggestion that the consumers would not be able to influence prices, the implication that medical care providers could just charge whatever they want regardless, in a free market is nonsense. People are perfectly capable of processing the info needed to go see a doctor. Speak for yourself if you think they are too stupid to do so.

      Reply
      • TBonius

        Actually your interlocutors in the above tweet discussion do not seem at all confused to me. You attribute to people an interpretation of ‘not for profit healthcare’ that nobody actually intends. You pretend there’s an inconsistency between (a) accepting that patent protections are needed to incentivize pharma research and (b) recognizing that drugs may as a result be unaffordable without some gov’t regulation for risk pooling. You call the problem of information asymmetry ‘meaningless’ with no argument other than a belief in the free market. I’m sorry but you really do give the impression of having not read any scholarship on this topic.

      • Jeremy R. Hammond

        Dude, if they didn’t think there should be no profit in health care, then they shouldn’t advocate to, quote “end the for-profit healthcare marketplace”, unquote.

        That is just as inconsistent as complaining about Big Pharma’s control over the market while defending the government practice of granting them an effective monopoly.

        As for “information asymmetry”, my reply was every bit as substantive as your assertion. You asserted that this was a problem with no argument other than a belief that a free market can’t work, so it is hardly required of me to do more than express my own contrary view that consumers aren’t too stupid to know how to take charge of their own health care that the require government to do it for them.

      • TBonius

        On para. 1 – see my police analogy. On para 2. see sentence 3 of my last reply (it is possible to defend x while wanting to mitigate the negative effects of x; that you deem this ‘logical inconsistency’ reveals the ideological rigidity of your thinking on public policy). On para. 3 (info asymmetry) the difference is that every scholarly work on health economics accepts on page 1 that info asymmetry is a problem for market-based solutions in the healthcare market. I’m afraid the burden is therefore heavier on you, just like if you wanted to weigh in on a physics debate while denying gravity.

      • TBonius

        No amount of incentives will cause consumers to prepare effectively for the complexities and uncertainties of their future health care needs. When faced with a health crisis you’re not in a position to shop and compare; our health care needs are obviously for more personalized than our car or computer needs; and the consequences of bad decisions re. health care are graver and more irreversible than mistakes in car or computer purchase.

        Again the very logic of your reply is silly. You seem to imply that there’s some contradiction in my pointing to the problem of info asymmetry while advocating ‘a system that only exacerbates that asymmetry’. Suppose I say that children should not be allowed to drive cars because they lack the requisite judgment and motor skills. Now imagine this brilliant reply: “I’ll simply observe that you think children shouldn’t drive because they lack judgment and motor skills, and yet your proposal to keep them off the road only exacerbates those problems by denying them the opportunity and incentive to hone their driving skills.”

      • Jeremy R. Hammond

        I disagree. I think most consumers are just as capable of taking charge of their own health care as they are of being able to choose a car or a computer.

        And what is “silly” is the inconsistency of, on one hand, arguing that consumers aren’t capable of shopping for their own health care due to “information asymmetry” while at the same time advocating a system that exacerbates the problem by disincentivizing consumers from educating themselves about their own health and care options and that produces a one-size-fits all approach to health care.

        It’s hilarious that you don’t see the problem with your analogy: that, yes, learning how to drive a car requires actually doing it. You make this analogy as though this wasn’t true! LOL! I learned how to drive a car by doing it, same as you. Incidentally, I was just a child, probably about 8 or 9, when I learned how to drive.

      • TBonius

        Ok, you ‘think’ consumers are just as able to shop for health care as for cars of computers. Every health economist disagrees with you, and there’s no functioning free market health care system in the developed world. So this is entirely an article of libertarian faith.

        There is nothing silly in recognizing the problem of info asymmetry and using regulation, risk pooling etc. to address that problem. Your free-market solution is based purely on wishful thinking, is explicitly rejected by all health economists, and has no real world examples.

        It’s mind boggling that you think you’ve spotted a problem with my analogy, and that you resort to this childish LOL trolling. Of course I recognize that you learn to drive by driving. But there are road safety concerns associated with being over-optimistic about people’s learning-curve, and accordingly we do not allow children to drive cars.

        Let’s be clear: Are you saying that children should be allowed to drive cars? Assuming not, how would you reply to someone who argued that denying licenses to children only exacerbates their inability to drive?

      • Jeremy R. Hammond

        Every health economist disagrees with you…

        I didn’t argue that information asymmetry doesn’t exist, I simply observed that it exists pretty much everywhere in the market. Consumers purchase goods and services from those who are much more knowledgeable about them all the time. If every health economist disagrees with this, they are evidently all idiots. But, of course, they don’t deny this self-evident truth. That would be silly.

        It didn’t know it was possible to “troll” one’s own website! LOL! And I didn’t know using “LOL” to indicate I think something is funny was “childish”. LOL!

        Nice to see you acknowledge the flaw in your analogy. I’ve nothing further to say about it.

      • TBonius

        Yet again, dodging my question, changing the subject, using childish giggling in place of substantive argument, calling experts in this field ‘idiots’. That must go over well in academic seminars.

        BTW: As I explained, health economists do not deny the existence of info asymmetry elsewhere. They claim that it is much more severe in the health care context. I explained this a little but you can’t seem to retain anything other than the facile precepts of free market libertarianism.

        I’m giving up on this.

      • TBonius

        ps. It might be illuminating to think of other essential services. Is policing a ‘for profit’ enterprise in the US? No, not in the sense that we normally mean by ‘for profit’. Someone operating under a confusion analogous to yours here might think they are exposing a inconsistency by asking, “How are police supposed to make a living?” But obviously that’s dumb.

      • Jeremy R. Hammond

        You are simply defining any enterprise that operates not in the free market but which is rather dependent upon the use of government force to expropriate the wealth required fund it as “not for profit”. Obviously, that’s dumb.

      • TBonius

        I haven’t ‘defined’ anything. I’ve given an example: Police are a ‘not for profit’ enterprise. Nobody thinks they *should* be a for-profit enterprise (do you?). Advocates of single-payer think health care should be financed like policing. (Is it ‘logically inconsistent’ to advocate not-for-profit policing? I don’t think you have a firm grasp on logical consistency)

      • Jeremy R. Hammond

        I haven’t ‘defined’ anything.

        Speaking of not having a firm grasp on logical consistency, yes, you have, i.e., “the sense that we normally mean by ‘for profit'”. That’s defining it. By definition.

      • TBonius

        Sorry, offering an uncontroversial example of something is not the same as *defining* it. ‘Defining’ a term involves specifying criteria for its application. For example, one might specify the following as a defining criteria of not-for-profits: “that which is… dependent upon the use of government force to expropriate the wealth required fund it.” Recall, that was the definition of not-for-profit you attributed to me, with no basis whatsoever. It’s an obviously silly definition, because not-for-profit enterprises can arise without any government coercion (e.g., co-ops, or non-profit insurance schemes). I understand why you want to impute this definition to me though: it turns the conversation into a simplistic debate over libertarianism.

        Anyway, are you disputing that policing is (or should be) a not-for-profit enterprise? Assuming you accept that policing is a not-for-profit, the question arises: How are police to earn a living if they can’t profit from their labor like everyone else? Dumb question whether you plug in police or doctors.

      • Jeremy R. Hammond

        To tell what you mean when you use a term is to define it. By definition. I am simply observing that the apparent distinction you draw between a for-profit and a not-for-profit enterprise is that the latter draw revenue not from voluntary exchange on the free market, but through the use of government force to expropriate wealth.

      • TBonius

        I don’t know how that’s ‘apparent’ given that I’ve never said that (a) I haven’t offered a definition and (b) i explicitly rejected the financing-by-government-coercion definition you attributed to me. And I repeat, offering an example of a term (policing as an example of non-profit) is not the same as defining it. That’s why judges ruling in obscenity cases can and do sensibly say, “I can’t define pornography, but I know it when I see it.”

      • Jeremy R. Hammond

        I would think that if the apparent distinction I observed wasn’t in fact the distinction you were making you would by now have clarified it. It take the fact that you’ve not offered any alternative distinction as evidence that my observation is accurate.

        And I repeat, telling what you mean when you use a term is defining it. By definition.

      • TBonius

        Definitions of not-for-profit are readily available, but if you insist: a non-profit enterprise is one that uses its surplus revenues to achieve its goals rather than distributing them as profits or dividends.

        I can’t explain the difference between defining a concept and offering examples any further. It is an elementary and self-evident distinction. I’ve given the example of judges who offer examples of pornography while claiming they can’t define the concept. Apparently you know something about conceptual analysis that has eluded US Supreme Court Justices.

        It should concern you that your strategy here (and on info asymmetry) consists entirely of restating your prior assertion, or changing the subject. “[A]nalysis from outside the standard framework…” is one way of describing it – assuming the standard framework is reasoned discourse.

      • Jeremy R. Hammond

        Yes, it is elementary and self-evident that when you tell what you mean when you use a term, you are defining it.

        The definition of “non-profit” you just provided applies to entities in the market that derive revenue but whose owners do not receive any profits thereof. It seems rather meaningless to apply that description to entities that rely on government force to expropriate the revenue upon which their continuance depends.

      • TBonius

        1. Your wording “when you tell what you mean” glosses over the key distinction. When you ‘tell what you mean’ by offering a criteria for the application of a term, then you are defining. When you ‘tell what you mean’ by offering examples, you are not defining.
        2. I have said multiple times now that not-for-profits do not (as a defining condition) rely on government force. For example, we could have a voluntary not-for-profit health insurance scheme.

        I have no idea what you mean in saying it’s ‘meaningless’ to apply my correct, widely-accepted definition of not-for-profit to your idiosyncratic, ideologically-driven definition.

      • Jeremy R. Hammond

        1. This misses the whole point that the criteria is quite clear.

        2. You argue that (a) police departments are non-profit entities and then that (b) police departments do not rely on government force. No further comment from me would seem required.

        3. It is little wonder you do not understand what I mean when I say it is “meaningless” to describe as “non-profit” entities that rely on government use of force to expropriate the revenues necessary for them to operate when you do not recognize that, e.g., government law enforcement agencies do precisely so.

      • TBonius

        1. Apparently it’s not yet clear enough for you to understand.
        2. This is confused in multiple ways:

        (a) I argued that state coercion is not a *defining feature* of not-for-profits; some may be funded by coercive taxation, others by voluntary contributions.
        (b) you are confusing the role of coercion in an enterprise’s financing vs. coercion in its operations. In short, the fact that police are non-profit and employ coercion does not demonstrate that *all* non-profits employ coercion. You are committing the association fallacy: like arguing that Socrates is a man, and Socrates is Athenian, therefore all men are Athenians.

        Here again, your logical error traces back to your refusal to distinguish between *individual examples* of a class and the *defining conditions* of membership in that class. Thus you take police (an example of a non-profit), notice police use coercion, and arrive at a mistaken definitional claim (i.e., that all non-profits are coercive). Nobody who need this explained to them has any business trolling people for logical inconsistency.

      • Jeremy R. Hammond

        1. If it wasn’t clear to me, I wouldn’t have said it was “quite clear”.

        2. Whether you argued it or not, in contrast to a non-profit entity operating in the free market, in the case of state enterprises such as law enforcement, coercion is a defining feature.

      • TBonius

        1. The criteria for non-profits is quite clear to you? I feel like I’m having to again and again untangle your false assumptions and inferences about same, while you keep shifting ground.

        2. To wit, you’re shifting ground yet again: whereas previously you seized on the coercive function of police power to make your point, now you’ve shifted to saying that any ‘state enterprise’ must necessarily be coercive (presumably because state enterprises rely on taxation). But of course we *weren’t talking* exclusively about state enterprises; we were talking about non-profit enterprises – a category that cross cuts government/non-government divide.

        I would add that in trying to address your ever-shifting argument, we’ve been led completely away from the issue at hand. Is it illogical to advocate a model of financing health care that mimics (say) the financing of police services? (Recall your original argument was that this was illogical because: how would doctors/policemen be paid?)

        Through all your flailing, one thing is clear: your objection is not one of logic but one of ideology: you don’t want state coercion in health care markets as a matter of principle. And you think single payer can’t be achieved without state coercion. And you think free market solutions will work instead, but you have nothing but armchair intuitions to offer in support of that belief.

      • Jeremy R. Hammond

        1. Yes, the criteria is quite clear to me. Obviously, since I’ve pointed it out repeatedly.

        2. “Shifting ground?” On the contrary, I’ve been perfectly consistent. Police departments are state enterprises, which was the specific example you used when you stated what people mean by “non-profit”. Hence my pointing out of the apparent criteria (see point “1”).

        If the goal is better health care outcomes. i.e., higher quality services at lower prices, then, yes, advocating state control over our health care is most illogical.

        It is true I don’t want state coercion in health care markets as a matter of principle. That is not illogical. It is consistent with the goal of desiring the better outcomes I just mentioned. It is also true I think single-payer can’t be achieved without state coercion. That, too, is not illogical (self-evident, rather). It is likewise true that I think free market solutions will work better than government interventions. Yes, this is indeed something that can be intuitively understood; we can see all the problems government intervention has created, and it follows that the solutions to these problems is less government intervention, not more.

      • TBonius

        1. What you’ve pointed out repeatedly are inaccurate criteria for defining non-profit enterprises. I’ve given examples of how non-profits can operate with no state support or coercion. Examples are easy to come by: consider the YMCA or the Boy Scouts.

        2. Correct, police depts. are state enterprises. But not every characteristic of police departments is true of non-profits. (You haven’t wrapped your head around the association fallacy.) Police are not-for-profit. You’ll be surprised to learn however that not everyone at a non-profit wears a badge; not every non-profit is tax-financed; not every non-profit relies on state force. Consider again the YMCA or the Boy Scouts.

        3. For what must be the twentieth time you miss the point. I didn’t say that opposing single-payer on libertarian grounds was illogical. I said that other people are not being illogical when they disagree with your libertarian position. I would offer an analogy to illustrate the point, but you seem impervious to arguments and counter-examples.

        My takeaway from this tedious conversation is that I should not attempt to persuade free-market libertarians of anything. Their belief systems are closed to evidence and expert opinion, and they cannot follow basic rules of logic.

      • Jeremy R. Hammond

        You are arguing a deliberate strawman. To say 1) I’ve given “inaccurate criteria for non-profit enterprises” since there are such entities in the market and that 2) I’ve argued that since use of force is a defining characteristic of the latter that there fore it is also of the former, despite my having already several times made the distinction between those and entities that rely on government use of force to draw the revenue upon which they depend to operate, simply illustrates your own unwillingness to reason. I’m done with you.

        3) You asked if it was illogical to advocate a state-controlled model for health care in which government force was used to expropriate the wealth required to provide it instead of a free market system in which health care providers profit by competing to provide the best possible care for the lowest possible cost. I answered you.

        No, if the goal is better care for lower costs, it is not logical to advocate the former for the self-evident reason. Government bureaucrats do not know better than the market’s pricing system how to efficiently direct scarce resources towards productive ends to satisfy the preferences of consumers.

      • TBonius

        PS. I don’t know what you think this link to police chief magazine proves. A not for profit organization can look for revenue streams to finance its operations (as the police are doing here). Charities, government bodies, etc do so all the time. That doesn’t turn them into a for-profit.

      • Jeremy R. Hammond

        I would argue that any operation that seeks to maximize, quote, “profit potential”, unquote, is a for-profit operation. Again, the only distinction I can see between what you regard as “not-for-profit” is that instead of its revenue being drawn from voluntary exchange on the market, it is drawn from the use of government force to expropriate the wealth required to sustain it.

      • TBonius

        PS. When using the written word, you don’t need to write out the words ‘quote’ and ‘unquote’ in conjunction with quotation marks.

      • Myrto Ashe

        I know this is a year old–but fascinating. No, people have a lot of problems processing the info needed to see a doctor. If you have a headache, is this “stress” , a brain tumor, or meningitis? You are at the mercy.

  3. Myrto Ashe

    Here’s a topic I have been following since 1987, and I grew up in Canada and went to medical school under Single Payer system, then moved to US for family medicine residency. An analysis of alternative medicine, where the market forces apply (right? not my specialty there) may shed light on this whole debate. Since switching to functional medicine (non-conventional, if not “alternative”) I can see for the first time how the influence of the govt on healthcare is a problem. However, for acute care (serious accidents, urgent problems) we need something regulated. For chronic care, Big Pharma incentives become too powerful in our kleptocracy.

    Reply
    • Jeremy R. Hammond

      Yes, it is little wonder so many people are turning to so-called “alternative” practitioners. I’ve had my own miserable experiences dealing with traditional so-called health care professionals.

      Reply

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