[detbuch]

Originally Posted by Pete F.

What it seems to me to happen is we can not consider things because they are looked at as the worst possible or destructive. I think we currently have a system with significant problems. I don't think the solution is to have no system or controls. Nor do I think the progressive "free" attitude is correct, but I do think that just like Transportation, Education, Military we as a society need to help one another.

I think what i posted the other day from The Grumpy Economist is the sort of direction that could work, so I'll repost it here:Let me here admit to one of the implications of this view. Single payer might not be so bad -- it might not be as bad as the current Medicare, Medicaid, Obamacare, VA, etc. mess.

But before you quote that, let's be careful to define what we mean by "single payer," which has become a mantra and litmus test on the left. There is a huge difference between "there is a single payer that everyone can use," and "there is a single payer that everyone must use."

Most on the left promise the former and mean the latter. Not only is there some sort of single easy to access health care and insurance scheme for poor or unfortunate people, but you and I are forbidden to escape it, to have private doctors, private hospitals, or private insurance outside the scheme. Doctors are forbidden to have private cash paying customers. That truly is a nightmare, and will mean the allocation of good medical care by connections and bribes.

But a single provider than anyone in trouble can use, supported by taxes, not cross-subsidized by restrictions on your and my health care -- not underpaying in a private system and forcing that system to overcharge others -- while allowing a vibrant completely competitive free market in private health care on top of that, is not such a terrible idea, and follows from my Op-Ed. A single bureaucracy that hands out vouchers, pays full market costs, or pays partially but allows doctors to charge whatever they want on top of that would work. A VA like system of public hospitals and clinics would work too. Like public schools, or public restrooms, you can use them, but you don't have to; you're free to spend your money on better options if you like, and people are free to start businesses to serve you. And no cross-subisides.

Whether we restrict provision with income and other tests, and thus introduce another marginal disincentive to work, or give everyone access and count on most working people to choose a better product, I leave for another day. It would always be an inefficient bureaucratic problem, but it might not be the nightmare of anti-competitive inefficiency of the current system.

I believe I already replied to that Grumpy Economist article by saying that it is quite similar to what "conservatives" proposed before Obamacare was passed. That was rejected by "liberals" in favor of Obamacare which your Grumpy economist characterizes as a mess. Progressive opposition to Grumpy's idea of "single payer" would make it impossible to achieve. Even more so if "conservatives" or Republicans propose such a thing.

Perhaps the problem of achieving what you seem to believe is a "sort of direction that could work", is because of what you previously referred to as the friction between what you believe in and what is impossible. Or maybe Grumpy's idea is unlikely, if not impossible, since you can apply to it what you said about my idea of freedom and the free market (which sounded rational and commonsensical to you)--it can be derailed because it is "innocent and could so easily be sidetracked by darker, more sinister motives or basic stupidity."