Go Back   Bloggingheads Community > Diavlog comments
FAQ Members List Calendar Search Today's Posts Mark Forums Read

Notices

Diavlog comments Post comments about particular diavlogs here.
(Users cannot create new threads.)

Reply
 
Thread Tools Display Modes
  #1  
Old 06-11-2009, 07:58 PM
Bloggingheads Bloggingheads is offline
BhTV staff
 
Join Date: Nov 2007
Posts: 1,936
Default Health Care Showdown (Mark Schmitt & Megan McArdle)

Reply With Quote
  #2  
Old 06-11-2009, 09:05 PM
I'm SO awesome!
Guest
 
Posts: n/a
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

megan, i think you might be the greatest internet troll that has ever lived because this is gonna get some serious commenting once the video starts to work correctly. you are so lacking in courage, intelligence and common sense i can't even believe it. i've never seen a sadder or more bitter apologist mouthpiece for rich people and the opposite of the public's interest in my life.
the fact the mark has to deal with you or that anyone would ever take a libertarian seriously for any reason just hurts my brain. hey, how's that free market working out for you? thanks a lot for supporting a philosophy that has not only ruined the world's economy but for being so rigid that you continue to do so afterwords. THE ONLY THING STANDING IN OUR WAY FROM REFORM IS PEOPLE LIKE YOU. wow, how does the rest of the world do it? there are so many distractions and lies in this diavlog i can't even believe it.
this one was not only a record for you but i have to believe it's a world record for "largest and most complete" load of right wing/libertarian propaganda ever assembled in one place. gee, THANKS FOR LOOKING OUT FOR US. you are a sell out.

Last edited by I'm SO awesome!; 06-11-2009 at 09:07 PM..
Reply With Quote
  #3  
Old 06-11-2009, 09:11 PM
claymisher claymisher is offline
 
Join Date: Mar 2008
Location: Newbridge, NJ
Posts: 2,673
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Yeah, France, Canada, Holland, Germany, those places don't really exist. Really. So we can't copy their best ideas. And they're foreign. Or something.

I'd like some large country to fully take on the libertarian economic system so we can see it in practice. Then we can write it off as soundly as communism as been written off. Until then we'll keep hearing bullshit about mythical fantasy systems and how "real" libertarianism has never been tried. I doubt libertarianism would even last as long as communism did.

I can't take it anymore. If everybody is going to pay libertarians so damn much attention I want equal time for communists.
Reply With Quote
  #4  
Old 06-11-2009, 09:40 PM
themightypuck themightypuck is offline
 
Join Date: Feb 2008
Location: Pasadena
Posts: 506
Send a message via AIM to themightypuck
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

It is interesting that there are 3 libertarians in a row in the vlog queue.
Reply With Quote
  #5  
Old 06-12-2009, 12:34 AM
I'm SO awesome!
Guest
 
Posts: n/a
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

yes! that's seriously what we should do from now on. every time some "angels on the head of a pin" apologist comes on we should respond with communist rhetoric. or maybe next time i'll just go with extreme libertarianism to try to one up them either way it doesn't matter cuz ideologues never chenge their mind.
Reply With Quote
  #6  
Old 06-12-2009, 03:17 AM
claymisher claymisher is offline
 
Join Date: Mar 2008
Location: Newbridge, NJ
Posts: 2,673
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by I'm SO awesome! View Post
yes! that's seriously what we should do from now on. every time some "angels on the head of a pin" apologist comes on we should respond with communist rhetoric. or maybe next time i'll just go with extreme libertarianism to try to one up them either way it doesn't matter cuz ideologues never chenge their mind.
Great idea. We should do both simultaneously to maximize the effect. Let's call it Extreme Ironic Commulibertarianism. Here goes:

The constitution isn't valid because I never signed it and it's an instrument of capitalist oppression. Property is the bulwark of liberty and is also theft.
Reply With Quote
  #7  
Old 06-12-2009, 12:06 PM
I'm SO awesome!
Guest
 
Posts: n/a
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

nice i'll try to think up so good ones for next time.
Reply With Quote
  #8  
Old 06-11-2009, 09:09 PM
Freddie Freddie is offline
 
Join Date: Nov 2006
Posts: 110
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

I don't, actually, care about efficiency arguments. At all. I care about moral arguments.

Here's the situation for Megan and others who oppose health care reform: there are very many people in this country who are incapable of procuring necessary health care when they desperately need it because of their financial and employment situation. The exact numbers are of great controversy. But the most jaundiced, partisan opponents of health care reform must admit that they number in the millions. People can't get health care when they're sick because they can't afford it, in the country with the most powerful economy in the history of the world.

And this not only leaves them suffering, or leaves them in financial ruin. It does kill people. Yes, everyone has guaranteed access to emergency care. Emergency care does not provide the kind of early screening that can save countless lives with preventative care. People die in this country because they put off going to the doctor because they can't afford it, and they only are diagnosed after it is too late for them to be adequately treated. Happens all the time; happens every day.

So the question that we must insist on asking Megan, et al, is what she and they would have these sick people do. What should they do, if they can't get a job that provides health benefits? What should they do?

Because make no mistake, conservative intransigence on this issue causes enormous suffering, hopelessness, financial disaster and death. Make no mistake.
Reply With Quote
  #9  
Old 06-11-2009, 09:11 PM
claymisher claymisher is offline
 
Join Date: Mar 2008
Location: Newbridge, NJ
Posts: 2,673
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

(It's cool when Freddie posts here.)
Reply With Quote
  #10  
Old 06-12-2009, 07:33 AM
Bloggin' Noggin Bloggin' Noggin is offline
 
Join Date: Oct 2006
Posts: 893
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by Freddie View Post

So the question that we must insist on asking Megan, et al, is what she and they would have these sick people do. What should they do, if they can't get a job that provides health benefits? What should they do?
They should die so that the wealthy here and the poor of other countries that do control drug prices will have more and better drugs -- more people will live longer and have longer sexual lives in the rest of the world as a result of their deaths. Perhaps people in the rest of the world will put up plaques thanking the American poor for their unselfish sacrifice.

Some libertarians are natural rights theorists of a particularly absolutist bent (Ayn Rand, Robert Nozick). Others (like Megan) appear to be people who believe that Economics provides you with a complete moral system: One part crass utilitarianism ("seek the greatest overall good, no matter how that's distributed") and one part modified Alexander Popism ("Whatever is is right" -- so long as the market is doing it, not Government).

Will Wilkinson apparently accepts Rawls's focus on the worst off and has nice things to say about Canada, so I wonder what he would say about health care.

Last edited by Bloggin' Noggin; 06-12-2009 at 07:51 AM..
Reply With Quote
  #11  
Old 06-11-2009, 09:42 PM
holyworrier holyworrier is offline
 
Join Date: Oct 2008
Posts: 49
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Megan says that when the government is the only buyer, there's no market. This is a funny thing for a market fundamentalist to say. It only takes three parties to make a market. Two sellers, one buyer.
Reply With Quote
  #12  
Old 06-11-2009, 10:04 PM
uncle ebeneezer uncle ebeneezer is offline
 
Join Date: Feb 2007
Posts: 3,332
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Bloggingheads young libertarian rule #1: WW>MM
Reply With Quote
  #13  
Old 06-11-2009, 10:08 PM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by uncle ebeneezer View Post
Bloggingheads young libertarian rule #1: WW>MM
"The Ebeneezer Inequality."
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
  #14  
Old 06-11-2009, 11:49 PM
uncle ebeneezer uncle ebeneezer is offline
 
Join Date: Feb 2007
Posts: 3,332
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Just one segment of the Ebeneezerian Quality Spectrum: HH>=WW>MM>AA
Reply With Quote
  #15  
Old 06-11-2009, 10:51 PM
cognitive madisonian cognitive madisonian is offline
 
Join Date: Oct 2008
Posts: 648
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Not bad, but anyone calling themselves a libertarian who voted for Obama is seriously deluded or not actually a libertarian.
Reply With Quote
  #16  
Old 06-16-2009, 01:58 PM
Tara Davis Tara Davis is offline
 
Join Date: Feb 2008
Posts: 193
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by cognitive madisonian View Post
Not bad, but anyone calling themselves a libertarian who voted for Obama is seriously deluded or not actually a libertarian.
I call myself a libertarian and voted third-party, but I disagree.

Most people (not me, but most people) see voting in Presidential elections as an act of choosing the lesser evil. They don't vote for the candidate they want, but to stop the other person.

John McCain may very well be the most anti-libertarian Republican to run for the office of President in a general election in my lifetime. Worse than Ford, Nixon, or either Bush (and that's clearing a very high bar!)

I mean, the guy co-authored a bill which suppresses free speech. Obama has taken a lot of positions to which a libertarian may object, but nothing quite so disqualifying as that.
Reply With Quote
  #17  
Old 06-11-2009, 10:07 PM
holyworrier holyworrier is offline
 
Join Date: Oct 2008
Posts: 49
Default Megan's flawed utilitarian analysis

A so-called utilitarian approach to health care, which states that private markets produce the greatest innovation which benefits the most people, is seriously flawed. The poor are not affected either way if innovation slows or doesn't. They can't afford it anyway. They will die significantly sooner than their more affluent counterparts no matter what drugs were available. So you can say 'we're going to take a chance on innovation slowing in favor of providing the basics to the poor, to try to help them live a little longer. The more affluent majority are going to outlive them anyway'. Or you can say 'we want to maintain a system based on the market which provides excellent drugs and more nuanced, subtle choices to the affluent majority, and let the (growing number of) poor continue to die prematurely'. What you are doing by opting for the latter course is to give those with an advantage an even bigger one. This is not true utilitarianism.

This is assuming that innovation would slow or disappear, not if the profit motive disappears, which won't happen, but merely if it is diminished somewhat. This is pure speculation on the libertarians' part.

Last edited by holyworrier; 06-11-2009 at 10:17 PM.. Reason: More appropriate title
Reply With Quote
  #18  
Old 06-11-2009, 10:53 PM
pampl pampl is offline
 
Join Date: Oct 2008
Location: Seattle
Posts: 750
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by holyworrier View Post
A so-called utilitarian approach to health care, which states that private markets produce the greatest innovation which benefits the most people, is seriously flawed. The poor are not affected either way if innovation slows or doesn't. They can't afford it anyway. They will die significantly sooner than their more affluent counterparts no matter what drugs were available. So you can say 'we're going to take a chance on innovation slowing in favor of providing the basics to the poor, to try to help them live a little longer. The more affluent majority are going to outlive them anyway'. Or you can say 'we want to maintain a system based on the market which provides excellent drugs and more nuanced, subtle choices to the affluent majority, and let the (growing number of) poor continue to die prematurely'. What you are doing by opting for the latter course is to give those with an advantage an even bigger one. This is not true utilitarianism.
Your premise - that medical innovation doesn't "trickle down" - is wrong. One obvious example, out of many, is new AIDS drugs. Charitable programs immediately start sending them overseas, and even discounting charity it's only a short period of time before they become available for 1% of the price from local manufacturers. Now, it's true that this wouldn't be as possible if the world were as pharma companies wish it and IP laws were strictly enforced everywhere, but that's not close to the world we live in or even the world being offered by Ms. Jane Galt herself.

The real reason I wanted to respond, though, is that you're wrong about utilitarianism. It's blind to poverty, wealth, and other advantages and disadvantages. A true utilitarian would support the world being crushed under grinding poverty as long as there was someone, somewhere being made really, really happy by it. That's part of why true utilitarianism is so unpopular- even Bentham had to fudge the rules. You could make a very strong case that utilitarianism is wrong here but I don't think you can just reverse what the word means. I don't know why you would want to appropriate the label anyway, it doesn't have much cache. Why not say true ballin' is devoting time to helping the poor? Or that true conservatives are interested in conserving the health of the neediest?
Reply With Quote
  #19  
Old 06-12-2009, 12:14 AM
holyworrier holyworrier is offline
 
Join Date: Oct 2008
Posts: 49
Default Re: Megan's flawed utilitarian analysis

I disagree with your take on utilitarianism. I used the term in the same sense as did Megan, and the sense in which the term is generally understood. The greatest good for the greatest number, or the least harm for the greatest number.

You are right about some select drugs trickling down. If they are sent overseas, that has no bearing on the topic at hand. Completely apart from the debate about health care, the poorer one is, the shorter, statistically, one is likely to live. That is a built-in disadvantage which our market-based system compounds.
Reply With Quote
  #20  
Old 06-12-2009, 06:02 AM
pampl pampl is offline
 
Join Date: Oct 2008
Location: Seattle
Posts: 750
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by holyworrier View Post
I disagree with your take on utilitarianism. I used the term in the same sense as did Megan, and the sense in which the term is generally understood. The greatest good for the greatest number, or the least harm for the greatest number.

You are right about some select drugs trickling down. If they are sent overseas, that has no bearing on the topic at hand. Completely apart from the debate about health care, the poorer one is, the shorter, statistically, one is likely to live. That is a built-in disadvantage which our market-based system compounds.
That isn't the sense it's generally understood, though. Wherever that summary came from it's pretty misleading. Utilitarianism is choosing whatever action produces the most utility, meaning (happiness/pleasure per person benefited * number of people benefited) - (harm per person hurt * number of people hurt). That doesn't involve simply maximizing the number of people, as well it shouldn't: that reasoning leads to even worse '51% enslaving 49%' outcomes than utilitarianism normally gets accused of.

I'm not sure I understand your complaint here. If it's a question of the poor getting medicine, then international consequences are much more important than domestic ones. Being poor in America is still a relatively high standard of life. If it's just about being able to compete in the market, then I have to point out that most of those added years of lifespan aren't spent competing, they're spent in retirement
Reply With Quote
  #21  
Old 06-12-2009, 09:00 AM
holyworrier holyworrier is offline
 
Join Date: Oct 2008
Posts: 49
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by pampl View Post
That isn't the sense it's generally understood, though. Wherever that summary came from it's pretty misleading. Utilitarianism is choosing whatever action produces the most utility, meaning (happiness/pleasure per person benefited * number of people benefited) - (harm per person hurt * number of people hurt). That doesn't involve simply maximizing the number of people, as well it shouldn't: that reasoning leads to even worse '51% enslaving 49%' outcomes than utilitarianism normally gets accused of.
The Classical Utilitarians, Jeremy Bentham and John Stuart Mill, identified the good with pleasure, so, like Epicurus, were hedonists about value. They also held that we ought to maximize the good, that is, bring about ‘the greatest amount of good for the greatest number’.

http://plato.stanford.edu/entries/ut...anism-history/

Take a fucking poll.

Quote:
Originally Posted by pampl View Post
I'm not sure I understand your complaint here. If it's a question of the poor getting medicine, then international consequences are much more important than domestic ones. Being poor in America is still a relatively high standard of life. If it's just about being able to compete in the market, then I have to point out that most of those added years of lifespan aren't spent competing, they're spent in retirement
Whether the poor in foreign countries get cheap medicine or not is not relevant to this discussion of the American health care system. The relative poverty of Americans is not relevant to this discussion of the American health care system. Whether or not a person can compete in the market after retirement not relevant to this discussion of the American health care system. Neither are any of your points relevant to the point I made, which is that maintaining our current profit-oriented system, which produces innovations accessible to only the affluent, compounds the advantages the affluent already have over the poor, which, contrary to Megan's little riff on utilitarianism, does not ensure the greatest good for the greatest number. Rather, it disproportionately increases the good already enjoyed by the greatest number, rather than decrease the disparity, which would be a more utilitarian act.

No one, no libertarian, "would support the world being crushed under grinding poverty as long as there was someone, somewhere being made really, really happy by it."

Last edited by holyworrier; 06-12-2009 at 09:13 AM..
Reply With Quote
  #22  
Old 06-12-2009, 11:20 AM
pampl pampl is offline
 
Join Date: Oct 2008
Location: Seattle
Posts: 750
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by holyworrier View Post
The Classical Utilitarians, Jeremy Bentham and John Stuart Mill, identified the good with pleasure, so, like Epicurus, were hedonists about value. They also held that we ought to maximize the good, that is, bring about ‘the greatest amount of good for the greatest number’.

http://plato.stanford.edu/entries/ut...anism-history/

Take a fucking poll.
Try actually reading the article you linked to. You're simply wrong.
Quote:
Whether the poor in foreign countries get cheap medicine or not is not relevant to this discussion of the American health care system. The relative poverty of Americans is not relevant to this discussion of the American health care system. Whether or not a person can compete in the market after retirement not relevant to this discussion of the American health care system. Neither are any of your points relevant to the point I made, which is that maintaining our current profit-oriented system, which produces innovations accessible to only the affluent, compounds the advantages the affluent already have over the poor, which, contrary to Megan's little riff on utilitarianism, does not ensure the greatest good for the greatest number. Rather, it disproportionately increases the good already enjoyed by the greatest number, rather than decrease the disparity, which would be a more utilitarian act.

No one, no libertarian, "would support the world being crushed under grinding poverty as long as there was someone, somewhere being made really, really happy by it."
Uh, actually most of those points are relevant to your criticism. First, Mcardle herself brought up the international market here. Unless you're saying foreigners aren't people then you have to count them. The relative poverty matters a great deal, unless you're saying that wealthy countries should just focus on compounding their wealth over poor countries instead of lending a helping hand.

Compounding advantages the affluent have over the poor is in some situations utilitarian, as well as ensuring the greatest good for the greatest number. Acting to decrease disparity is not necessarily utilitarian. You really ought to read that article, what you're talking about has nothing to do with utilitarianism and is closer to Rawls' theory of justice. Mills was a "classic liberal" and believed a free market was the embodiment of utilitarianism and that progressive taxation was robbery. Increasing equality simply has no intrinsic value in utilitarianism.

No shit no one would support that, that's why it's a common criticism of utilitarianism.
Reply With Quote
  #23  
Old 06-12-2009, 01:16 PM
holyworrier holyworrier is offline
 
Join Date: Oct 2008
Posts: 49
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by pampl View Post
Try actually reading the article you linked to. You're simply wrong.
MM prefaced her remarks on the market and innovation in terms of utilitarian argument. The market, according to her, creates greater good for a greater number. Am I wrong about her meaning? Three hundred million people in the US who will die of diseases we have no cure for, I think she said, and this number is far more than the number who will die for lack of health care. Therefore innovating for those many millions is more important than providing health basics for the fewer millions. Am I on the mark so far? Do you consider that her remarks properly reflect your interpretation of a utilitarian argument? Or do they reflect what I call the 'common understanding' of the nature of utilitarian theory? I interpreted them as the latter.

All I'm trying to do is take the sense of her usage of 'utilitarian' and show that her argument is flawed. I sensed I might get called on the complexities of all the variants of the philosophy, of which I am aware. I've read several papers on dense utilitarian problems. I don't care about that here. I'm taking MM's statement and dealing with it in the sense that it was made.

I made no reference to increasing equality. What I referred to was decreasing suffering for a greater number. Is that not a tenet of utilitarianism?

MM's and your reference to the plight of the world's poor is touching, but irrelevant, tangential, to a discussion of the flaws in the American health care system. And so what if the poor in America are better off than the poor in Bengal. They don't live in Bengal. If they did, they'd occupy the same social tier they occupy in the US, which is the bottom one. The poor in both places die prematurely. A discussion of the relative wealth of the poor in different countries is a pointless, masturbatory affair.

Does MM, or do you mean to imply that because a company can only make, say, 12% profit, that they will throw up their hands and say 'if I can't make 18%, this whole thing is just not worth the effort!' If higher profits mean greater innovation, why not encourage the pharmaceutical and technology companies to charge double what they get now? Wouldn't that benefit the world even more?
Reply With Quote
  #24  
Old 06-12-2009, 01:39 PM
pampl pampl is offline
 
Join Date: Oct 2008
Location: Seattle
Posts: 750
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by holyworrier View Post
MM prefaced her remarks on the market and innovation in terms of utilitarian argument. The market, according to her, creates greater good for a greater number. Am I wrong about her meaning? Three hundred million people in the US who will die of diseases we have no cure for, I think she said, and this number is far more than the number who will die for lack of health care. Therefore innovating for those many millions is more important than providing health basics for the fewer millions. Am I on the mark so far? Do you consider that her remarks properly reflect your interpretation of a utilitarian argument? Or do they reflect what I call the 'common understanding' of the nature of utilitarian theory? I interpreted them as the latter.

All I'm trying to do is take the sense of her usage of 'utilitarian' and show that her argument is flawed. I sensed I might get called on the complexities of all the variants of the philosophy, of which I am aware. I've read several papers on dense utilitarian problems. I don't care about that here. I'm taking MM's statement and dealing with it in the sense that it was made.

I made no reference to increasing equality. What I referred to was decreasing suffering for a greater number. Is that not a tenet of utilitarianism?
I agree that it reflects your understanding. I think it reflects mine as well. You did repeatedly make reference to increasing equality. Your exact words were that instead of "compounding advantage" it should "decrease disparity". That was your justification for it being utilitarian, which of course is a complete non-sequitor. We could decrease disparity by killing Bill Gates and throwing his money out at a big parade, it doesn't follow that it'll increase net happiness or decrease net spending.
Quote:
MM's and your reference to the plight of the world's poor is touching, but irrelevant, tangential, to a discussion of the flaws in the American health care system. And so what if the poor in America are better off than the poor in Bengal. They don't live in Bengal. If they did, they'd occupy the same social tier they occupy in the US, which is the bottom one. The poor in both places die prematurely. A discussion of the relative wealth of the poor in different countries is a pointless, masturbatory affair.

Does MM, or do you mean to imply that because a company can only make, say, 12% profit, that they will throw up their hands and say 'if I can't make 18%, this whole thing is just not worth the effort!' If higher profits mean greater innovation, why not encourage the pharmaceutical and technology companies to charge double what they get now? Wouldn't that benefit the world even more?
It's neither irrelevant nor tangential. If the US system as it currently stands is subsidizing health research that benefits the rest of the world, then you can't really just say the rest of the world is subhuman and not worth moral consideration. It's like advocating the US switch to all coal power and waving away any environmental complaints because those will effect the rest of the world and we're just talking about the US's energy policy.

There are things in the world that are non-linear. For instance, if I drank one Coke now, I would be happy. If I had 5 Cokes, I'd actually be unhappy, not 5x as happy.
Reply With Quote
  #25  
Old 06-12-2009, 08:10 AM
Bloggin' Noggin Bloggin' Noggin is offline
 
Join Date: Oct 2006
Posts: 893
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by holyworrier View Post
I disagree with your take on utilitarianism. I used the term in the same sense as did Megan, and the sense in which the term is generally understood. The greatest good for the greatest number, or the least harm for the greatest number.
You are quoting the slogan, not the doctrine itself. Classical Utilitarianism tells you to maximize the aggregate happiness, counting every person's happiness equally. Effectively, it comes up with a sum, and sums do not say anything about what they are sums OF. I can get to 50 by adding 5 tens or I can add 1 + 1+1+1+46. pampl's criticism cannot be blocked at the get-go. It is not a knock-down argument as it stands though. The standard utilitarian response is that (because of diminishing marginal utility), it's more likely that a more even distribution of resources will tend to produce the greatest sum of happiness: give a dollar to a millionaire and he won't even notice -- give the same dollar to a poor person and he can get something to stave off starvation.
Quote:
You are right about some select drugs trickling down. If they are sent overseas, that has no bearing on the topic at hand.
True -- also, what drugs will trickle down overseas if the American market is the generator of drugs? Cialis and Levitra, Rogaine, the cornucopia of anti-depressants Megan is so relieved about and HIV medicines. But cures for the parasites etc. that afflict the poor in Africa, new vaccines etc.? Either government does these things or they don't get done.
Reply With Quote
  #26  
Old 06-12-2009, 01:15 PM
DoctorMoney DoctorMoney is offline
 
Join Date: Feb 2007
Posts: 305
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by pampl View Post
Your premise - that medical innovation doesn't "trickle down" - is wrong. One obvious example, out of many, is new AIDS drugs.
The problem is that care isn't about innovation. If you want to argue that the government shouldn't tax pharmaceutical companies at all to spur innovation, you might make some headway.

But you can't lump pharma and health care providers together as if their financial incentives are at all the same. It's like saying that we'll get better TV programming if we tax Samsung at a lower rate.

Health care access is a delivery system and drug research is content. We don't have a content problem in the US, we have an access problem. So every moment we sit here talking about innovation is one in which we are not discussing our actual problems.

Last edited by DoctorMoney; 06-12-2009 at 01:22 PM..
Reply With Quote
  #27  
Old 06-16-2009, 02:09 PM
Tara Davis Tara Davis is offline
 
Join Date: Feb 2008
Posts: 193
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by DoctorMoney View Post
The problem is that care isn't about innovation. If you want to argue that the government shouldn't tax pharmaceutical companies at all to spur innovation, you might make some headway.

But you can't lump pharma and health care providers together as if their financial incentives are at all the same. It's like saying that we'll get better TV programming if we tax Samsung at a lower rate.

Health care access is a delivery system and drug research is content. We don't have a content problem in the US, we have an access problem. So every moment we sit here talking about innovation is one in which we are not discussing our actual problems.
That discussion would be fine and dandy, if we weren't deluged with liberal think-tanks telling us we could pay for greater access simply by capping the *outrageous* profits of "Big Pharma."

If we can all agree that making the drug companies our corporate whipping boy doesn't actually solve any problems (and creates many more), then we can move on to a real debate about how to make sure people have access to adequate health care to those who otherwise can't get it without breaking the bank and/or taking services away from those who can afford better-than-adequate.
Reply With Quote
  #28  
Old 06-17-2009, 09:42 AM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: Megan's flawed utilitarian analysis

Quote:
Originally Posted by Tara Davis View Post
That discussion would be fine and dandy, if we weren't deluged with liberal think-tanks telling us we could pay for greater access simply by capping the *outrageous* profits of "Big Pharma."

If we can all agree that making the drug companies our corporate whipping boy doesn't actually solve any problems (and creates many more), then we can move on to a real debate about how to make sure people have access to adequate health care to those who otherwise can't get it without breaking the bank and/or taking services away from those who can afford better-than-adequate.
Tell this to an uninsured cancer patient looking at a $50,000 price tag for a single dose of chemo.
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
  #29  
Old 06-12-2009, 12:25 AM
JimS JimS is offline
 
Join Date: Oct 2008
Posts: 5
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Sorry, but if there is something that only affects 1500 people, we shouldn't be spending a nickel on it as long as so many other diseases remain.
Reply With Quote
  #30  
Old 06-12-2009, 12:50 AM
in2liberty in2liberty is offline
 
Join Date: Jun 2009
Posts: 1
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Megan,

England’s UH is based on rationing.
France’s is based on controlling costs.

The VA here in the states does both, and it does it to great effect. Patients fight to get into VA care. The patients are really hurting. But they get both great and inexpensive care.

When you go into the VA, your records are electronic, your doctor may change but he can read all your records, the doctors have a limited budget to work with, so they have no incentive to do needless medical tests.

Whereas, Medicare sucks because while we limit payments (control costs), it works within the current system, so doctors have ever good reason to do unnecessary shit they can bill for.

So here’s my point, before we go trying to push all people satisfied with their healthcare into some universal thing…. why not:

1. Turn the Medicare system into a VA-style system.
2. Use the new VA-style system to cover all the uninsured.

This would give us a tremendous first step toward electronic record keeping, we’d have a fixed yearly budget, so the doctors would have stop needless tests / treatments.

It’s a BOLD move, it is single payer – and it will house everybody who doesn’t have insurance.

And importantly it lets those who have the money to spend, buy all the extra crap their doctor can sell them on.
Reply With Quote
  #31  
Old 06-12-2009, 01:38 AM
TPGS TPGS is offline
 
Join Date: Jun 2009
Posts: 2
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Megan McArdle's thoughtful analysis of the Obama health care plan has clearly hit a nerve with those who are so emotionally vested in universal health care (and/or Obama) that they will not tolerate rational challenges to the thin plan that Obama and Orszag have laid out.

As Megan pointed out, once the government starts to lower the prices paid for pharms, the companies will stop investing in R&D (Mark was unable to provide examples of government controlled industries that deliver consistent innovation). And this argument can be extended to other health care sectors. When doctors' pay is controlled (i.e. lowered) by the government, over time the better students will stop going into medicine and we will have poorer quality doctors. When hospital administrators' salaries are capped, it will become a less desirable field, and ultimately the quality of hospital care will go down. Add to this the rationing of medical procedures and equipment, and it is clear that large incremental number of people will die under this plan.

Mark was also not able to give a convincing reason why, if the point of this "reform" is to lower the overall cost of health care, these reforms could not be tested first on Medicare and Medicaid. There are two reasons why we are getting the bum's rush on this plan: 1) A test would show that the Medicare and Medicaid patients would not be happy with the level of care delivered under the "reforms", and 2) The reforms would not deliver the promised savings because the increase in government waste/graft would offset any savings from placing controls on the private players in the system.

Rather than wiping out the highest quality health care system in the world that is well-received by 85%-90% of the population, the 10 - 15% who don't have coverage and who truly can't afford it (working poor) should be offered private policies subsidized by the government.
Reply With Quote
  #32  
Old 06-12-2009, 02:06 AM
I'm SO awesome!
Guest
 
Posts: n/a
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

wow! i guess all of the (made up) "facts" just happen to align with those who are interested is dragging their feet on health care. gee, i guess the rest of the industrialized world must.....not exist? i'm sorry, i'm gonna have to start referring to you guys as "Health Care Truthers."
you should attach this:
http://images.3d4medical.com/_a/stil...M000007589.jpg
to your tin foils hats and it'd be like a cute little antenna or something
Reply With Quote
  #33  
Old 06-12-2009, 03:20 AM
claymisher claymisher is offline
 
Join Date: Mar 2008
Location: Newbridge, NJ
Posts: 2,673
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by TPGS View Post
Megan McArdle's thoughtful analysis of the Obama health care plan has clearly hit a nerve with those who are so emotionally vested in universal health care (and/or Obama) that they will not tolerate rational challenges to the thin plan that Obama and Orszag have laid out.

As Megan pointed out, once the government starts to lower the prices paid for pharms, the companies will stop investing in R&D (Mark was unable to provide examples of government controlled industries that deliver consistent innovation). And this argument can be extended to other health care sectors. When doctors' pay is controlled (i.e. lowered) by the government, over time the better students will stop going into medicine and we will have poorer quality doctors. When hospital administrators' salaries are capped, it will become a less desirable field, and ultimately the quality of hospital care will go down. Add to this the rationing of medical procedures and equipment, and it is clear that large incremental number of people will die under this plan.

Mark was also not able to give a convincing reason why, if the point of this "reform" is to lower the overall cost of health care, these reforms could not be tested first on Medicare and Medicaid. There are two reasons why we are getting the bum's rush on this plan: 1) A test would show that the Medicare and Medicaid patients would not be happy with the level of care delivered under the "reforms", and 2) The reforms would not deliver the promised savings because the increase in government waste/graft would offset any savings from placing controls on the private players in the system.

Rather than wiping out the highest quality health care system in the world that is well-received by 85%-90% of the population, the 10 - 15% who don't have coverage and who truly can't afford it (working poor) should be offered private policies subsidized by the government.
France, Germany, Denmark, Holland, Canada.
Reply With Quote
  #34  
Old 06-12-2009, 10:19 AM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by TPGS View Post
Megan McArdle's thoughtful analysis of the Obama health care plan has clearly hit a nerve with those who are so emotionally vested in universal health care (and/or Obama) that they will not tolerate rational challenges to the thin plan that Obama and Orszag have laid out.

As Megan pointed out, once the government starts to lower the prices paid for pharms, the companies will stop investing in R&D (Mark was unable to provide examples of government controlled industries that deliver consistent innovation). And this argument can be extended to other health care sectors. When doctors' pay is controlled (i.e. lowered) by the government, over time the better students will stop going into medicine and we will have poorer quality doctors. When hospital administrators' salaries are capped, it will become a less desirable field, and ultimately the quality of hospital care will go down. Add to this the rationing of medical procedures and equipment, and it is clear that large incremental number of people will die under this plan.

Mark was also not able to give a convincing reason why, if the point of this "reform" is to lower the overall cost of health care, these reforms could not be tested first on Medicare and Medicaid. There are two reasons why we are getting the bum's rush on this plan: 1) A test would show that the Medicare and Medicaid patients would not be happy with the level of care delivered under the "reforms", and 2) The reforms would not deliver the promised savings because the increase in government waste/graft would offset any savings from placing controls on the private players in the system.

Rather than wiping out the highest quality health care system in the world that is well-received by 85%-90% of the population, the 10 - 15% who don't have coverage and who truly can't afford it (working poor) should be offered private policies subsidized by the government.
The ripe old counterfactual about pharma R&D is no more convincing now than it was any of the last million times it was trotted out by the industry or its apologists. If there's a profit to be made there will be pharma research, (most of which will find its way into the sewer of finding a new blockbuster, a chemical similar enough to somebody else's blockbuster to allow it to marketed as competitor) there will be R&D. The obscenity of the pricing of cancer drugs is no different than simply blackmailing the dying.

Do you really propose a system in which everyone with a chronic disease is lumped into a single gov't run pool? Because that's what would happen, with private insurers dropping all their diabetics, heart patients, cancer patients, MS, ALS, etc... in to the government pool while they, the private insurers hold onto those with little need of coverage.

I think neither you, nor Megan, have a clue.
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
  #35  
Old 06-12-2009, 10:45 AM
TPGS TPGS is offline
 
Join Date: Jun 2009
Posts: 2
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
If there's a profit to be made there will be pharma research. AemJeff
But there won't be a profit to be made. The big, evil pharma companies shouldn't earn a profit, that will be "cost savings" (or, more likely, spent to buy votes via union concessions, etc...). In your fairytale land, the scientists and researchers will show up everyday and work for free?
Reply With Quote
  #36  
Old 06-12-2009, 10:58 AM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by TPGS View Post
But there won't be a profit to be made. The big, evil pharma companies shouldn't earn a profit, that will be "cost savings" (or, more likely, spent to buy votes via union concessions, etc...). In your fairytale land, the scientists and researchers will show up everyday and work for free?
In my fairyland demand still drives research. Hard to imagine such a thing? Yours seems to be a somewhat binary world.
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
  #37  
Old 06-12-2009, 11:05 AM
gwlaw99 gwlaw99 is offline
 
Join Date: Jun 2007
Posts: 260
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

One of Megan's best performances. Usually I find she comments on things she doesn't have much knowlege on.

"If there's a profit to be made there will be pharma research, (most of which will find its way into the sewer of finding a new blockbuster, a chemical similar enough to somebody else's blockbuster to allow it to marketed as competitor) there will be R&D."

This makes no sense. What is a drug company going to do: spend billions on a new drug that could cure cancer or spend a few million slightly improving their current drugs (ie making a 4 hour drug into a 24 hour drug) and make significantly more profits? It's not a matter of IF they can make a profit. It's a question of how much profit they can make with their limited investment resources.
Reply With Quote
  #38  
Old 06-12-2009, 11:59 AM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by gwlaw99 View Post
One of Megan's best performances. Usually I find she comments on things she doesn't have much knowlege on.

"If there's a profit to be made there will be pharma research, (most of which will find its way into the sewer of finding a new blockbuster, a chemical similar enough to somebody else's blockbuster to allow it to marketed as competitor) there will be R&D."

This makes no sense. What is a drug company going to do: spend billions on a new drug that could cure cancer or spend a few million slightly improving their current drugs (ie making a 4 hour drug into a 24 hour drug) and make significantly more profits? It's not a matter of IF they can make a profit. It's a question of how much profit they can make with their limited investment resources.
I don't think I follow your pont, quite. I think the way the market is currently structured makes for a lot of bad incentives - comapared to the actual needs. Drug companies waste a lot of resources on reinventing Vioxx, or creating a new Statin, or whatever - or worse yet, finding a tiny tweak in a molecule so they can market an extremely similar variant on an older drug under a a new patent, extending their monopoly for another seventeen years. Speaking as somebody who is deeply deeply dependent on pharmaceuticals - of me twelve daily prescriptions, two are not generic, and one of the non-generics is insulin, which isn't available in generic form. Where is all the innovation, when out of all those drugs, only one is actually recent enough to covered by a patent?

I don't believe that the actual needs of the people for whom pharmaceuticals could be helpful are particularly well aligned with the interests of the producers of pharmaceuticals. If the system gets shaken up a bit, if the formula governing where from, and how much, and howe to allocate R&D dollars were changed sugnificantly - I don't believe my interests are likely to be damaged, and I think of myself as a pretty representative member of the the class of people who benefit from the output of the pharma industry.
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
  #39  
Old 06-12-2009, 12:33 PM
gwlaw99 gwlaw99 is offline
 
Join Date: Jun 2007
Posts: 260
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by AemJeff View Post
Drug companies waste a lot of resources on reinventing Vioxx, or creating a new Statin, or whatever - or worse yet, finding a tiny tweak in a molecule so they can market an extremely similar variant on an older drug under a a new patent, extending their monopoly for another seventeen years..
Speaking as someone who had to try four variants of same type of drug to get one to actually work (some actually made my medical condition worse), I believe that things like "creating a new statin" are very beneficial and not just marketing. Also remember that statins were once completely new drugs that required billions in research to develop. With price controls, they may not have been profitable enough to develop in the first place.

Quote:
Speaking as somebody who is deeply deeply dependent on pharmaceuticals - of me twelve daily prescriptions, two are not generic, and one of the non-generics is insulin, which isn't available in generic form. Where is all the innovation, when out of all those drugs, only one is actually recent enough to covered by a patent?..
I don't really get what you are complaining about. 10/12 of your prescriptions are available cheaply as generic. How is this bad? Generic insulin production is banned by US law against generic biologics. Granted a change in the law is opposed by Pharm companies, but there are good arguments for and against allowing generic biologics.

http://drugtopics.modernmedicine.com....jsp?id=417490

Quote:
I don't believe that the actual needs of the people for whom pharmaceuticals could be helpful are particularly well aligned with the interests of the producers of pharmaceuticals.
Can you explain your reasoning for this conclusion more fully?


Quote:
If the system gets shaken up a bit, if the formula governing where from, and how much, and howe to allocate R&D dollars were changed significantly - I don't believe my interests are likely to be damaged, and I think of myself as a pretty representative member of the the class of people who benefit from the output of the pharma industry.
What kind of changes are you proposing?

I also don't think you addressed my major point that innovation for completely new drugs for fighting cancer (8 million deaths per year world wide), heart disease (16.7 million deaths per year workd wide), etc. would be completely stifled by price controls as there would be no economic incentive to develop such drugs. making improvements to existing drugs would be much more profitable. Although this type of research does have benefits as I argued above, truely innovative research will be crowded out.

2006 and 2007 were the first time cancer deaths per year have ever dropped in the US. Could this have ever been done without billions of dollars of research by Pharma companies?
http://www.sciencedaily.com/releases...0118095233.htm

Last edited by gwlaw99; 06-12-2009 at 12:44 PM..
Reply With Quote
  #40  
Old 06-12-2009, 02:48 PM
AemJeff AemJeff is offline
 
Join Date: Feb 2007
Posts: 7,750
Default Re: Health Care Showdown (Mark Schmitt & Megan McArdle)

Quote:
Originally Posted by gwlaw99 View Post
Speaking as someone who had to try four variants of same type of drug to get one to actually work (some actually made my medical condition worse), I believe that things like "creating a new statin" are very beneficial and not just marketing. Also remember that statins were once completely new drugs that required billions in research to develop. With price controls, they may not have been profitable enough to develop in the first place.



I don't really get what you are complaining about. 10/12 of your prescriptions are available cheaply as generic. How is this bad? Generic insulin production is banned by US law against generic biologics. Granted a change in the law is opposed by Pharm companies, but there are good arguments for and against allowing generic biologics.

http://drugtopics.modernmedicine.com....jsp?id=417490



Can you explain your reasoning for this conclusion more fully?




What kind of changes are you proposing?

I also don't think you addressed my major point that innovation for completely new drugs for fighting cancer (8 million deaths per year world wide), heart disease (16.7 million deaths per year workd wide), etc. would be completely stifled by price controls as there would be no economic incentive to develop such drugs. making improvements to existing drugs would be much more profitable. Although this type of research does have benefits as I argued above, truely innovative research will be crowded out.

2006 and 2007 were the first time cancer deaths per year have ever dropped in the US. Could this have ever been done without billions of dollars of research by Pharma companies?
http://www.sciencedaily.com/releases...0118095233.htm
I'm not arguing that pharma ought not be creating variants of various drugs, and trying to improve them. Clearly this is a big part of the mission. What I am saying is that a lot of the R&D money that inevitably becomes the focus of this sort of conversation is not spent on "innovation" and that the argument that the bulk of pharma profit is spent developing great new medications is simply false. Most of their effort is geared toward recreating past successes and incremental improvement to current art.

I'm personally quite aware of the improvements in cancer therapies, having seen several people survive far longer than it used to be that anyone had any right to expect. Do they need to charge tens and hundreds of thousands of dollars annually for newer therapies? Would there be no financial incentive to create such therapies if the cost to patients wasn't multiples of most people's annual income? I doubt it.

And, I'm perfectly happy that my medications are mostly generic. The argument is that the touted "innovation" isn't evident, when most medications that people actually take have been on the market long enough such that their patents have expired.

Pharmaceutical companies have every right to earn a profit. I shouldn't have to make that explicit. The arguments used to counter the idea that the current financial model under which they operate isn't necessarily optimal, are always over the top prediction of disaster if anything at all is changed. I see no reason to believe that's true. I don't believe that industrial market forces have any reasonable correlation with actual patient needs and I support as much regulation of the industry as it takes to create a set of forces that will help to align those things.
__________________
-A. E. M. Jeff (Eponym)
Magnets - We know how they work!
Reply With Quote
 


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -4. The time now is 09:26 PM.


Powered by vBulletin® Version 3.8.7 Beta 1
Copyright ©2000 - 2020, vBulletin Solutions, Inc.