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Comment by bluedanieru | Hacker News Reader

So your response to a dysfunctional government that can't even implement something as basic as health care is to say "screw it" and cut everyone loose? Health care is a public good, it belongs in the public domain. Quit electing stupid partisan assholes to run your government and you might get some policy that isn't designed for the sole purpose of benefiting special interests.

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Health care is not a public good (in the economic sense of the word). To be a public good it has to be non-rival and non-excludable. It is definitely rival (the surgeon can't operate on two people at once). And, it is only non-excudable to the extent that society won't let people die just because they aren't able to pay.

There are plenty of reasons to think health care will not be efficiently produced by the market (adverse selection in health insurance is one). But, the reason the government will do such a bad job isn't that we have "stupid partisan assholes". It's that the incentives for government bureaucratic are all screwed up (see public choice theory). The problem is deeper than politics.

The first paragraph seems weird. Does the fact that bluedanieru used a term in a sense other than economism jargon change the point? It seemed to have a clear meaning to me; I can't even tell if you disagree with it.

The second has a straightforward answer: universal health care has been implemented successfully in basically every industrial democracy (including the USA, for people over 65). I'd like one of those, please.

The idea that there are first-principles reasons why this "can't work" when it so clearly can and does is just ridiculous. But I see it again and again. It's like libertarians have never been to Canada (or don't have grandparents).

I was just responding to his "it's a public good so it should be provided by the government". In economics, public goods are automatic things that should be done by the government because the market would fail miserably. I wasn't using jargon for jargon's sake.

Your advocacy for universal health seems to have two parts:

1. It would be nice for someone else to pay for my health care.

2. Universal health care in other countries is better than what we have in the U.S.

My responses would be:

1. Everyone would like this, but it doesn't make us any better off in aggregate. (If you want to redistribute income, it doesn't have to be done via healthcare).

2. Is debatable. There are trade-offs. Look at wait times in Canada. What about innovation over time. Maybe other countries are free riding off of our innovation. Just because costs aren't as visible don't mean they don't exist.

I'm not against all government intervention into healthcare. But, we should understand why the market is failing and how the government is correcting those failures. That is the only way to make good choices about the trade-offs involved. Otherwise, we are just setting ourselves up for failure in the long run.

>> Look at wait times in Canada

What about them? Wait times are only an issue for urgent care situations, and you can't assume that wait times are problematic for all cases. The urgent cases usually get shorter wait times than the less urgent ones.

Most Canadians are pretty happy with the health care system and get a good laugh at how US politicians like to point out the flaws in our system. It may not be perfect, but it's pretty damned good.

As a Canadian who has had cancer twice, I can tell you first hand that the time between diagnosis and treatments were never a problem for me. I received excellent care, and have had access to all the diagnostic tests that I've needed.

It is not true that wait times are only an issue for urgent care situations. If my grandmother can not walk without hip replacement surgery, and she is going to wait in a bed in for months, I'm happy to send her to the states for surgery.

Excessive wait times have been an issue for a very long time. Things are getting better, in part because there is a drastic comparison to quality of life health care across the border.

http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/M...

But what would the case be for an American grandmother under 65 without insurance or relatives who have the means to pay for the hip replacement?

EDIT: For those interested in the wait time stats for Canada, the CIHI has statistics compiled annually.

http://waittimes.cihi.ca/

I am not intracately familiar with the services provided in the states, but I believe the answer is Medicare for retirees and Medicare for the uninsured poor. Medicare would cover the cost of many non-elective quality of life procedure.

I'm sure these programs are not all encompassing, and free or reduced cost solutions like Catholic hospitals are not ubiquitous, hence the discussion in the States about reform.

Medicare is pretty good proof that the government can infact do a decent job of health care. At least compared to private insurance.

health care != health insurance.

No, his response is to actually lower health insurance costs.

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