Privatized For Profit Medicine.. Cheaper. True Free Market Principles.

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Reason is a libertarian monthly print magazine covering politics, culture, and ideas through a provocative mix of news, analysis, commentary, and reviews.​

Readers beware.
 

TheBestYouCan

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Surprise surprise surprise......


Reason is a libertarian monthly print magazine covering politics, culture, and ideas through a provocative mix of news, analysis, commentary, and reviews.​

Readers beware.

Surprise, Surprise, surprise... Sargon offering nothing of substance to the discussion other than poisoning the well.
 

Bardox

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Putting aside the fact I don't believe the medical field should be a "market" or "industry" any more than the fire department or highway patrol, the article does make several good points. I think the "VS. Obamacare" in the title is just there to get people to read the article. The provision in Obamacare that is mentioned isn't directed at nor does it effect places like theirs. The article does show clearly that healthcare can be affordable if you get the suits out of the mix. Well worth a read.

I think it's a great article and there should be many more centers like that one. I plan to share this anyone who will listen. Great find.
 

citr

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It's great, but I'm not sure how replicable their model is. They've carved out a great niche in a fucked-up system, but it is by mostly evading the core problems that make our healthcare so expensive. They don't accept medicare/medicaid, they aren't technically a hospital, and I would have to assume they don't have an ER. This is all great business positioning by the founder, but they're not really in position to compete against the larger actual hospitals (such as the one he still works at) and retain their low costs. So it's not a fundamental rethinking of the industry--they are just very adept to seeing its flaws and offering a cost-effective workaround.

I'm not a medical insider or anything, this is just all my two cents. But once you operate an ER you run into the problem of how to most efficiently cover the free services provided. Because as a society we have pretty roundly decided that one should not turn away a person with a medical emergency at the doors of an ER. Similarly we have decided that people with already diagnosed illnesses should have some way of obtaining insurance (though this is more contentious and not as "roundly decided" as the ER thing). When you accept these facts you run into the problem of how insurance companies can exist and still turn a profit, and they both have to basically cover non-paying customers and customers who are not worth the hassle.

In reaction to this it would seem like one of three things would have to happen: 1) premiums rise to an almost untenable rate (and perhaps to the point that customer loss is so great that the price hike has done nothing to address the free rider problem), 2) insurance companies have to find some way of obtaining a huge and near-guaranteed customer base, or 3) insurance is simply no longer profitable.

My personal opinion is that at a certain baseline level, private insurance should simply not be in the game. Go single-payer for all "you need this to not die" healthcare (and some degree of preventative care that can be proven to pay for itself in the reduction of future "you need this to not die" care) and keep the margins basically non-existent. Make this level of coverage sufficient but generally unpleasant, opening up the market for private insurance to get in the game with premium packages.

I simply don't see, right now, what value private insurance adds to the consumer right now, in our current situation. It's a dying racket filled with people who are jamming the bureaucratic channels in order to preserve their revenue streams, somewhat like the dying record label industry. Certain widespread moral dictates have made this aspect of the industry unprofitable. They should adjust to the market and get in at a level where they have more room to maneuver. (Of course I say this, but obamacare was a big win for them, and dead revenue channels can be clung to for quite some time if you're properly embroiled in legislation, so they'd probably laugh at this suggestion.)

But grats to the guys in the story. I've been wondering a lot lately about what market opportunities might have opened up as the industry changes, and it's cool to see them taking advantage.

Also it's questionable how much obamacare really relates to the article. It reads like something that was plugged in by an editor as linkbait.
 
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dude_007

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The main premise of the article, that the primary reason for high healthcare costs is the third-party payer system, is highly arguable. There are many other confounding factors: ever-increasing doctors fees, expensive technology, lab costs, pharmacy costs, ER patients who don't have insurance or money, cost of living increases for staff, more elderly in the population, higher percentage of poor & uninsured people, management fees, lawyer fees, fines, inflation of supplies, etc.
 

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Not saying this should replace hospitals, but I think a center like that one in every heavily populated area would force down wasteful medical costs in hospitals and possibly the rest of the medical field. Something Obamacare doesn't come close to dealing with... yet.

The article is more about a comparison of what a center like this can do for patients verses what Obamacare can do for patients. I still think a single payer system is the way we should go, but... take what you can get I guess.
 

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It's great, but I'm not sure how replicable their model is. They've carved out a great niche in a fucked-up system, but it is by mostly evading the core problems that make our healthcare so expensive. No, they actually ARE addressing the core issue of high healthcare costs and that is the absence of market competition. They don't accept medicare/medicaid, they aren't technically a hospital, and I would have to assume they don't have an ER. This is all great business positioning by the founder, but they're not really in position to compete against the larger actual hospitals (such as the one he still works at) and retain their low costs. So it's not a fundamental rethinking of the industry--they are just very adept to seeing its flaws and offering a cost-effective workaround.

I'm not a medical insider or anything, this is just all my two cents. But once you operate an ER you run into the problem of how to most efficiently cover the free services provided. Because as a society we have pretty roundly decided that one should not turn away a person with a medical emergency at the doors of an ER. Similarly we have decided that people with already diagnosed illnesses should have some way of obtaining insurance )Yet this defeats the very idea of "insurance" and will result in higher premiums for everyone else.)(though this is more contentious and not as "roundly decided" as the ER thing). When you accept these facts you run into the problem of how insurance companies can exist and still turn a profit, and they both have to basically cover non-paying customers and customers who are not worth the hassle. (Its easy. They make a profit by raising their premiums. This is the problem. Insurance companies do not care how much the cost of healthcare is because they will simply raise their premiums to cover it.)

In reaction to this it would seem like one of three things would have to happen: 1) premiums rise to an almost untenable rate (and perhaps to the point that customer loss is so great that the price hike has done nothing to address the free rider problem (heres the problem. most consumers do not care because most insurance policies are employer provided), 2) insurance companies have to find some way of obtaining a huge and near-guaranteed customer base, or 3) insurance is simply no longer profitable. (As long as they can raise premiums they will always be profiftable. Insurance companies are not the problem!!! The cost of healthcare, past along to insurance companies, which are then past along to consumers through premium hikes, ARE THE PROBLEM. Its healthcare costs. Its $95 advils, and $1200 bed pillows.)

My personal opinion is that at a certain baseline level, private insurance should simply not be in the game. Go single-payer for all "you need this to not die" healthcare (and some degree of preventative care that can be proven to pay for itself in the reduction of future "you need this to not die" care) and keep the margins basically non-existent. Make this level of coverage sufficient but generally unpleasant, opening up the market for private insurance to get in the game with premium packages.(this still will not address the underlying problem.)

I simply don't see, right now, what value private insurance adds to the consumer right now, in our current situation. It's a dying racket filled with people who are jamming the bureaucratic channels in order to preserve their revenue streams, somewhat like the dying record label industry. Certain widespread moral dictates have made this aspect of the industry unprofitable. They should adjust to the market and get in at a level where they have more room to maneuver. (Of course I say this, but obamacare was a big win for them, (yes it was) and dead revenue channels can be clung to for quite some time if you're properly embroiled in legislation, so they'd probably laugh at this suggestion.)

But grats to the guys in the story. I've been wondering a lot lately about what market opportunities might have opened up as the industry changes, and it's cool to see them taking advantage.

Also it's questionable how much obamacare really relates to the article. It reads like something that was plugged in by an editor as linkbait.

The problem with our healthcare system is that the patient does not have an incentive to act like a consumer when it comes to their healthcare choices. If people were forced to shop for healthcare services the same way they shop for TV's and cars, healthcare costs would collapse and insurance premiums would collapse, making it affordible for low income families to purchase insurance on their own. Lobbyists have prevented this kind of reform from happening and Obamacare does ZERO to do this as well.

 

rogerg

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Surprise surprise surprise......

Reason is a libertarian monthly print magazine covering politics, culture, and ideas through a provocative mix of news, analysis, commentary, and reviews.
Readers beware.

Yes! readers beware of lower healthcare costs and more efficent delivery systems! Oh the humanity!!!!!!

So sad. If its not communism, your just not interested huh Sargon?
 

Fuzzy_

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Surprise, Surprise, surprise... Sargon offering nothing of substance to the discussion other than poisoning the well.

Why don't you analyze the inflammatory article you linked to, other than saying it's "fascinating"? Your posts in this thread have had no more substance than Sargon's. Private medicine seems like a worthwhile debate since "socialist" Obamacare is going to mandate private health insurance.

Fuzzy didn't reply to you here because it appeared that you were just being antagonistic by claiming that formal free markets didn't exist in the US. Judging by this thread, it appears Fuzzy made a good call.
 

h0neymustard

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I think Integris, who ran the other hospital in the video, said that the Surgery Center works because their patients didn't have to subsidize the people who don't pay.
 

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I get a kick out of LIBERTARIAN being bolded by Sargon, as though that somehow automatically discredits any idea put forth in the magazine, although the Alternet's and MotherJones' are somehow infallible.

Sargon, you clearly disagree with the substance (or lack thereof in your opinion) of the article, but offer a why as opposed to demonizing it.
 

Penis Aficionado

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The problem with our healthcare system is that the patient does not have an incentive to act like a consumer when it comes to their healthcare choices. If people were forced to shop for healthcare services the same way they shop for TV's and cars, healthcare costs would collapse and insurance premiums would collapse, making it affordible for low income families to purchase insurance on their own. Lobbyists have prevented this kind of reform from happening and Obamacare does ZERO to do this as well.

Wait till you're 70 and get a cancer diagnosis, and see if you feel like "shopping for healthcare services the same way you shop for TVs and cars."
 

TheBestYouCan

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Why don't you analyze the inflammatory article you linked to, other than saying it's "fascinating"? Your posts in this thread have had no more substance than Sargon's. Private medicine seems like a worthwhile debate since "socialist" Obamacare is going to mandate private health insurance.

Fuzzy didn't reply to you here because it appeared that you were just being antagonistic by claiming that formal free markets didn't exist in the US. Judging by this thread, it appears Fuzzy made a good call.

And you just added what to the discussion? Hard to look in the mirror when you're "Fuzzy".
 

TheBestYouCan

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The main premise of the article, that the primary reason for high healthcare costs is the third-party payer system, is highly arguable. There are many other confounding factors: ever-increasing doctors fees, expensive technology, lab costs, pharmacy costs, ER patients who don't have insurance or money, cost of living increases for staff, more elderly in the population, higher percentage of poor & uninsured people, management fees, lawyer fees, fines, inflation of supplies, etc.

Wouldn't the premise of the article and the clinic it speaks about be evidence to the contrary of everything you just said?
 

AtomicMouse1950

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What you seem not to get is... We were under the free market systems with health care before Obamacare. When it was under the free market system, Health care companies could cease/cancel health care for any individual, who was diagnosed with cancer, or any other serious disease. Or worse still, increase the deductible on a patient, or not pay the claim in whole or even in parts. That was the privatized system, pre-Obamacare. That's why Mitt Romney, remember him?... developed comprehensive healthcare for all people of Mass., to fight the rising costs of pre-Obamacare, health care. So you don't have anyone over a barrel. Privatized healtch-care is the thing of the past. Even the Supreme Court did not overturn health care, or the ACA, or Obamacare.


Surprise, Surprise, surprise... Sargon offering nothing of substance to the discussion other than poisoning the well.
 

AtomicMouse1950

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The Republican Governors have not developed their half of Obamacare. They were supposed to, adopt the exchanges, to lower the cost for everyone. The Governors have refused to accept the Gov't money for doing that. Trying to undermine Obamacare for political reasons. Mind you the states opting out, and refusing to accept the money, are hurting their own people who are sick and need the exchanges, to opt in. It's the narrow political view of the Republican Governors to dump the exchanges, so they're killing their own people, not Obamacare. And further, the Hospitals are going to loose too. The exchange monies were also supposed to go to them as well. Without the monies, the hospitals can't treat the people who are truly sick. I hope the hospitals decide to send letters of outrage to those Governors who've refused to accept the exchanges. In the long run, The Government will still pay for the exchanges that the Governors have refused to do so, eventually. In the meantime, who loses? The people that need Obamacare the most. Many will die, before the Government can do something about this.
 

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Libertarianism is just an excuse for owners rights trumping equality. That's why it's a hot button word for college students who think Ron Paul is a genius. Who is more selfish and whinny that a 19 year old college student?
 

TheBestYouCan

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What you seem not to get is... We were under the free market systems with health care before Obamacare. When it was under the free market system, Health care companies could cease/cancel health care for any individual, who was diagnosed with cancer, or any other serious disease. Or worse still, increase the deductible on a patient, or not pay the claim in whole or even in parts. That was the privatized system, pre-Obamacare. That's why Mitt Romney, remember him?... developed comprehensive healthcare for all people of Mass., to fight the rising costs of pre-Obamacare, health care. So you don't have anyone over a barrel. Privatized healtch-care is the thing of the past. Even the Supreme Court did not overturn health care, or the ACA, or Obamacare.

No, Mouse, we weren't under Free Market anything before Obamacare. It's a common mistake many people make, mostly owing to political talking points where people blame what they call the "free market". What we really have (and still have) is a Crony Capitalistic Market. I'll outline the differences for you.

In a truly free market, anyone is free to enter into mutually beneficial contracts with each other, or not to. Government is only there to enforce those contracts once entered into. If a business cannot offer something that enough people want at a price they can afford, they go out of business. Someone else comes along, if there is a need for what that business was offering, and fills the gap with a better, more affordable solution. Business compete against each other via price and quality which keeps prices low and gives consumers choices.

In a Crony Capitalistic Market people with good intentions (and some with bad intentions) decide that laws would be a good way to make the market better, or more fair. Eventually, the businesses affected by those laws realize that having their own people in charge of enforcing and creating those laws can work to their advantage greatly, giving them an edge in the market that they otherwise could or would never reach. So, they get their people into office, or into regulatory positions. Now, the more laws that get passed, the better.

Many of the laws and regulations will be directly written or influenced by lobbyists for the very industries they are seeking to regulate.

Almost all of the laws and regulations will be enforced arbitrarily by former top level employees of the largest companies in the industries that are undergoing regulation. There is a reason the majority of FDA regulators are former COO's or CEOs or Presidents of Pharmaceutical and Food companies.

The more power is given to government over business, the more power business is given to govern itself by infiltrating the government and the less vulnerable it becomes to the only true way to hold a business accountable for bad practices, faulty products, etc... The Market.

In relation to Healthcare... as demonstrated in the article, when much of it is left to the market, it gets more affordable and efficient. But when you have a third payer system regulated by medical industry lobbyists, you get higher and higher costs... because nobody is really competing.. and you are being told where you insurance is accepted, so medical professionals really aren't having to earn your dollar.

Look at all of the examples of medical procedures not covered by health insurance to see how they are affected by price and customer service.. Laser Eye Surgery has plummeted, and doctors compete fiercely with one another for customers in that area, as well as plastic surgeries, offering much better customer service experiences than in areas where health insurance is the norm.


Libertarianism is just an excuse for owners rights trumping equality. That's why it's a hot button word for college students who think Ron Paul is a genius. Who is more selfish and whinny that a 19 year old college student?

Incorrect, though apparently a popular talking point for those who misunderstand Libertarianism.

The diversity of mankind is a basic postulate of our knowledge of human beings. But if mankind is diverse and individuated, then how can anyone propose equality as an ideal? Every year, scholars hold Conferences on Equality and call for greater equality, and no one challenges the basic tenet. But what justification can equality find in the nature of man? If each individual is unique, how else can he be made 'equal' to others than by destroying most of what is human in him and reducing human society to the mindless uniformity of the ant heap? - Rothbard
 
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