RE: [LandCafe] Re: US Health Debate
It costs something like $300,000 to get a drug approved (or perhaps not) by our FDA. This means a small research firm cannot afford the process and must turn over their results to a large company which can afford it.
I am reminded of a doctor friend who had no liability insurance. Everything was owned by his wife. If he were sued, there would be nothing to sue for.
I remember being zinged by a good one on a television show debate, where a character said his lawyer refused to sue me because all he would get was practice! All anyone would get from this doctor was practice.
I don’t know the legal details, but it apparently worked.
The doctors we particularly need are those who save our lives after (say) a car wreck. We don’t want to make their work so unprofitable that they would refuse to do what must be done.
They are most likely to be sued and over here have enormous premiums. You’ll recall my Georgist friend who, confronted by the latest enormous premium increase, said ‘to hell with it’ and retired.
I suppose the one advantage of government licensing is that they can impose penalties for infringement, fraud, or whatever. I would think that in a stateless society, private firms would easily take the place government rather like Consumer Reports does now.
In a truly free market/stateless society we would not have state granted licences of course.
The most common suggested alternative is that doctors and other practitioners would require liability insurance. Liability insurance firms would have the economic incentive to insure practitioners who were least likely to cost them money in payouts, which, let's face it, is a much better incentive than any form of government/tax funded system has - when last were they made to pay out for someone they licensed going off the rails.
The insurance firms would have that incentive constantly - they could not rely simply on a practitioner's one-time reputation or qualification - they would need to demand continual professional development and so on.
At the consumer end, their medical insurance/savings schemes would also have an incentive to point their clients at doctors who were well thought of by the liability insurance firms. There's no need for a "state" to do the signposting, nor for an individual to have to pore over doctors' success stats - their own insurance people would be doing that constantly to get best value for lowest risk.
Same goes for pharmaceuticals - they would require liability insurance. Their insurance firms would have an incentive to make sure testing was adequate (but not so rigorous that their clients could not make money out of their developments). And the practitioners' and consumers' insurance firms would have an incentive to monitor the decisions of the pharmcos' insurance firms.
How many people suffer and die because a new drug that could help them is held up in a testing bureaucracy that has no real incentive to put such a drug on the market and every incentive to test it to death so they don't get blamed for any adverse effects?
I don't see a need for a "state" system in any of this. They have few incentives to push boundaries that might help people and no penalties if they actually do make a mistake - in fact they can probably use such an outcome to demand yet more tax money to rectify their internal problems!
Just my half-shilling's worth :)
On 1 Apr 2010, at 02:14, roy_langston1 wrote:
> Main problem as I see it is licensing. A kind ofI agree the problem is privilege, but licenses have
> privilege. Lose them. Instead, enforce truth in
> advertising. You a sports fan? In sports, we got
> so many statistics that analyze everything,
> including won/loss records. Forget licenses. Let
> doctors brag about their cured and healed -- and
> admit to their mistakes. Lose the god-on-earth
> attitude. How today surgeons resist the checklist,
> how in the past they resisted washing their hands.
a place in ensuring quality. The problem is that
the current licenses have little to do with quality,
and everything to do with restricting supply. There
is a very simple, elegant and effective solution to
this problem: let anyone who can pass an exam and
background check practice medicine, but require all
practicing doctors to pass the same exam and
background check periodically -- every 5 years, say.
> I see a different role for government. NotYes, rightful government defends our rights. Which
> granting licenses. Just defend our right to
> honesty in business.
is how we know that:
> Mainly, pay a CitDiv to shrink thecannot be right, as people have no right to a CD.
> workweek and reduce stress, the big killer.
People have a right to liberty, not to pocket rent.
You can never alter or get around that fact, no
matter how hard you try, or how industriously you
promote your CD idea. People have a right to use
land, not to pocket a portion of others'
production. You can say, "pay a CitDiv" until you
are blue in the face, but you will never, ever
change that fact. Never.
Reducing stress by securing everyone's equal rights
to use land via a universal, individual land tax
exemption makes sense: it will eliminate the
relentless financial duress working people currently
live under, struggling to make their mortgage or
rent payments while supporting themselves, their
families, government and the wealthy, privileged
overclass. Reducing the workweek makes less sense.
The problem is not that people work too much, but
that they are forced into jobs they don't enjoy
(and overlong, highly stressful commutes by car)
just to pay rent, taxes, interest, and every other
expense associated with supporting the idle,
wealthy, privileged, greedy, parasitic overclass in
the manner to which it demands to remain
accustomed. Restore people's rights to liberty, and
they will no longer feel constrained to live in
what amounts to wage slavery. People who have the
liberty to support themselves doing work they enjoy
don't have work-related stress no matter how many
hours they work.
-- Roy Langston
Jock Coats - altoxford.org - Action for Land Tax in Oxford
Warden's Flat 1e, J Block Morrell Hall, OXFORD, OX3 0FF
m: 07769 695767 skype:jock.coats?call
Jolly good, Walter!
--- In LandCafe@yahoogroups.com, "Harry Pollard" <henrygeorgeschool@...> wrote:
> Walter said:
> "Its mandates are promulgated either by the California Legislature, its
> various executive branch agencies, or both."
> This is fairy tale stuff. The legislature is corrupt. The Democrat majority
> politicians sit in their gerrymandered districts from which they cannot be
> evicted. The Republican minority have been equally gerrymandered so they are
> not likely to do anything that would upset the system. The principal
> activity of both parties appears to be chasing after money from the
> lobbyists who by far out-number them.
> Whatever the "California mandates" may be you can be sure they are written
> by the insurance companies.
I don't disagree with any of that, Harry. Money and politics are like sugar and teeth.