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charon wrote:

However imperfect competition is, even in conjunction with legal remedies, it's better than dealing with a legal monopoly.

I don't think you have the wherewithall, other than the mere ability to speak, to make this statement based on any absolute knowledge of which is actually better or why.

There is a zero sum aspect to competition which is affecting all things, health care in particular 'cause it's so darned expensive. Companies out to make a profit have to accept less when somebody attempts to undercut on price. Competitors can dance around on services or "intangibles" and skillful marketing for only so long and that does not necessarily open enough tertiary/tangential markets to offset the downward pressure. Companies want to maintain projected margins for the sake of their investors and the people who must ultimately pay for services pay more because they get paid less, which is one of the ways that companies seek to maintain their margins (be more "competetive").

So, people can't afford insurance, companies don't want to pay insurance because it's expensive and makes them less "competetive".

So. . . what ought we to do, charon?

isaly wrote:

charon wrote:

However imperfect competition is, even in conjunction with legal remedies, it's better than dealing with a legal monopoly.

I don't think you have the wherewithall, other than the mere ability to speak, to make this statement based on any absolute knowledge of which is actually better or why.

Historical experience plus common sense seems to make the case pretty well.

isaly wrote:

There is a zero sum aspect to competition which is affecting all things, health care in particular 'cause it's so darned expensive. Companies out to make a profit have to accept less when somebody attempts to undercut on price. Competitors can dance around on services or "intangibles" and skillful marketing for only so long and that does not necessarily open enough tertiary/tangential markets to offset the downward pressure. Companies want to maintain projected margins for the sake of their investors and the people who must ultimately pay for services pay more because they get paid less, which is one of the ways that companies seek to maintain their margins (be more "competetive").

So, people can't afford insurance, companies don't want to pay insurance because it's expensive and makes them less "competetive".

Competition drives down the price...which somehow makes the product less affordable?  I've lost you.

Edit: Whatever your argument is, I'll just note that it would be rather contradictory to argue that firms are concerned with competing with one another vis-a-vis the consumers, yet not actually concerned with serving those consumers well.

Last edited by charon (2005-02-22 4:13 pm)

isaly wrote:

Competition in all aspects of the larger marketplace tends to drive down wages and benefits to maximise profits, which is what we're seeing now and is one reason why there are so many un or under insured. The problem of healthcare is not solvable in a workable social sense in the abstract, it has to be dealt with in the context of it's cost in the real world where it has to be paid for.

Whether free market competition drives down the price of labor (quite debatable as an empirical matter especially considering that non-wage benefits have risen for decades, and quite debatable as a theoretical matter since firms have to compete with each other for labor as well as for consumers), it more importantly tends to drive down the price of everything else even faster.  That's certainly been true of practically everything but health care and, like I said, that's where there's been an increasingly unfree market.  So like I said, I advocate competition in that market for health care--it drives down prices as well as driving up quality.  What you've written here doesn't seem to get at that point, but at the labor market in general.

isaly wrote:

It makes no sense to punish people [for not being sufficiently productive or caught in a labor market where the work is not sufficiently valued] in terms of low wages and then turn around and make them more unproductive in terms of being impaired by a lack of adequate healthcare and/or time off.

Economic decisions aren't "punishment" and I wouldn't compare the two because we often suffer economic harm (or enjoy economic benefit) for things that we aren't personally responsible for--no complex economy could function otherwise.  That said, I don't mean to be callous but, if anything, the economy is least harmed when it is low-wage, low-productivity workers who are rendered unproductive by illness--something to keep in mind if it's impossible or excessively costly to provide complete health care to everyone, because it is a productive economy that will ultimately maximize the affordability of health care. 

If you're repeating your point that poor people need cheap health care the most, I agree with you, which is why I advocate competition in health care and limited personal subsidies if necessary.

Last edited by charon (2005-02-23 11:17 am)

isaly wrote:

charon wrote:

Whether free market competition drives down the price of labor (quite debatable as an empirical matter especially considering that non-wage benefits have risen for decades, and quite debatable as a theoretical matter since firms have to compete with each other for labor as well as for consumers), it more importantly tends to drive down the price of everything else even faster.

The fact is that people's purchasing power is declining both in terms of wage and salary stagnation and the cost of living.
things like utilities, food, housing and healthcare are certainly not less expensive as the result of the price of labor being driven down in terms of either wage/salary cuts and/or not keeping up with inflation and cost of living.

"Declining" over what time frame?  Declining in any meaningful sense?  No, trends show the opposite.  The most accurate way I can think of to measure the buying power of the wage earner is to take the average wage and use that to compute how long it takes to earn goods based on their price.  So measured, you get this:

Cox and Alm wrote:

...the cost of a half-gallon of milk fell from 39 minutes in 1919 to 16 minutes in 1950 to 10 minutes in 1975 to seven minutes in 1997. A sample of a dozen staples--a market basket big enough to provide three square meals a day--costs only 1.6 hours, down from 9.5 hours in 1919 and 3.5 hours in 1950.

The article goes on to discuss similar trends in housing, as well as plenty of other goods.  TV's, cable, washers & dryers, cars, computers, phones, microwaves...Just look around and it's pretty clear that ownership of these goods is continually on the rise.

That said, I simply noted at the beginning that competition is preferrable to monopoly, when we have to shop for goods and services.  I'm not sure how you contest that or if you're contesting it at all.  If you're arguing that that needs to be weighed against a downward force upon the wages of the workers within the industry, to whatever extent that that's true, there are less intrusive ways to solve such a problem than eliminating competition.

isaly wrote:

This isn't just a statement that poorer people need healthcare the most, it's an indictment of the policies that keep prices on some things so low and looking for greater and greater quarterly numbers (especially where the only way to increase 'growth' is to cut labor, cut pay, cut benefits while expecting gains in terms of productivity) as being part of the reason that healthcare is such an issue for lower income folks.

Yet as I've tried to show, health care is anomalous.  It doesn't fit into the general trend of greater affordability.  And I'd argue that that has to do with the government's increased intervention to drive a wedge between who's choosing what, and how much, to consume of health care resources and who's paying for it.

Last edited by charon (2005-02-23 2:20 pm)

well, the good news just keeps on coming:

+ = if we opt to have the medication administered by a healthcare professional, the cost is reduced to a single $20.00 copay instead of $250+ dollars.

- = the company i have been relying on for healthcare will close it's doors at the end of april, and having dropped below "group" status with the "hmo", leaves cobra (let alone cobra + $250.00 copay) as a non-option.


== we're totally out of luck as things stand now. smurf healthcare. smurf health "insurance," smurf "HMOs,"...
american health care stinks worse than 10 day old un-refrigerated fish.

gw's take on the whole issue is to reduce awards for malpractice, which amounts to approximately 2% of healthcare costs, and predictably relaxation of which will result in 0% savings to the patient and probably as much as 20% increase in health insurance CEOs income.

weeeeeeeeeee!
it's like not having any health care options at all.


snl skit about the watch with too many buttons:
"it's like asking a stranger for the time."

Last edited by [MA] Flying_Meat (2005-03-04 10:04 pm)

maybe.


it's gonna suck, either way, until at least one of my family dies from their malady.

erm, it's called avonex, but that would be telling what malady we suffer, no? heaven forbid anyone know. then certainly we are uninsurable. !!!!??!!?!??!??!?!?!!!?!??!?!!!!?!?!!?!!!!!??!?!???!??!?!?!!?!?!?! smurf!

thanks FK. i'll check it out.

curious though, that our doctor was either unaware, or unwilling to, provide the same information.

i'll continue to provide this thread with evidence of 'mer-ca's wunderf'l health care system in action.