T Nation

Peter Schiff on PMSNBC - Healthcare


#1

Jesus, I don't know how this guy keeps himself from swinging on these assholes that keep shouting him down like this:

Schiff is the fucking man. Apparently common sense, facts, reasoning, and logic are foreign concepts to liberals.


#2

The host is totally baiting him, I couldn't watch the whole video because of the insanity.


#3

Peter Schiff for president!

Edit*

Can we bring back tar and feathering? I would like to nominate this ED guy as the first one we try it on.


#4

That Ed guy is such a tool.


#5

I could never do politics, I would be punching people all day long.


#6

Isn't fun and refreshing to watch Schiff just laugh at this turkey and call it like it is.

Keeping his cool is the best way he can expose these media frauds. I bet there isn't one person who watched it -- Democrat, Republican, or otherwise -- that didn't feel some disgust toward the interviewer.

Let this be a lesson to never go on a State media outlet and express a dissenting opinion toward the State.


#7

.


#8

I would have slapped that fucking cunt. What a little bitch. I could never have stayed that composed.


#9

Oh man that was pure gold. The last minute had me in stitches. I need to watch more MSNBC


#10

http://www.schiffforsenate.com/

Looks like Schiff has some plans.


#11

That was horrible. That "news" guy was a tool. What's that fools name? I thought "Ed" kinda looked like "Rush" with a similar show (I've never watched).

This is as bad or worse than people shouting down others at healthcare town hall debates.


#12

I donated $200 to his campaign.


#13

Seductive, isn't it.

(Even with that ignorant excuse for a mechanical toaster interviewing him, Schiff is clear and purposeful.)

I happen to agree with him in two points:
1. University tuitions have inflated because of "low-cost" student loans. (However, among the major research universities, it is endowment and grant money that accounts for revenue; tuition is minor component of revenue.)
2. Insurance and government insurance (whether one calls it MediCare, MedicAid or Welfare) has inflated medical care costs, but not necessarily through the elimination of "free market" restraints on prices alone. (A provable hypothesis: costs for medical care for the elderly, after 1965, did not rise. I believe they were stable for years, and in the case of dialysis, I believe they fell. But aggregate demand and aggregate costs certainly rose.)

I have two arguments.

  1. I can accept his theory, but so far he, like other posters here, take no note of the practical consequences of ending insurance and government intervention. The dogma is that everything will eventually turn out perfectly: lower prices, lower costs, appropriate access, lower taxes, bread and roses. I do know when this state of bliss would occur--the invisible hand of the market will spank some very hard before utopia settles.

  2. He ignores another whole question. Can market forces be channelled to accomplish those same goals with private insurance and government insurance? Here is someone who might think so:
    http://www.amazon.com/Markets-Without-Magic-Competition-Medicare/dp/0844742619/ref=sr_1_1?ie=UTF8&qid=1249955915&sr=8-1
    This one is still on my to-read list, but the author has 38 years of work in this particular field.

One may challenge, "And where is your practical example of this working?"
(Answer available if anyone is interested.)


#14

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#15

That is why I included a reference to Mark Pauly's little book.

It is a little hard to condense 45 years of welfare economics, package it and sell it on this type of forum.
Pauly believes that market mechanisms are important to the restoration of balance of prices and access, and this balance can be accomplished through the use of insurance, and yes, optimal welfare. End entitlements, emphasize co-insurance, scale premiums, and patients become powerful participants in the market, partners with physicians, and not hapless objects of insurance companies or government.

I knew Kenneth Arrow only a little, and his "Uncertainty and the Welfare Economics of Medical Care" (1963) certainly leaves an impression, even now. (I freely paraphrased it in the other thread.) Pauly, among many others, carried the application forward (for almost 40 years!), and now I find that another generation of policy makers is completely ignorant of it. We are reliving, in the Obamacare debacle, the fruitless debates of Congress in 1972.


#16

Doc, The problem is once there is any sort of government intervention in the market there can be no freely floating market prices. The government, in fact, does dictate how much it will cost a doctor to perform a procedure -- in the case of Medicare/Medicaid this is most certainly the truth -- and may be a factor which helps account for the argument you give for prices not rising on the elderly. Well, duh. But you miss the fact that the costs are being diverted to those who aren't being protected by AARP, for example.

To make matters even worse -- a fact which I am sure you are very familiar with -- doctors will order every test and treatment and the customer does not even get to know the price he is going to pay because he is not treated like a customer. This completely destroys any notion of an accurate pricing structure since it is the doctor who is treated like a consumer by the HMO and not the patient who is the actual consumer of the good and ultimately must pay for it.

Without free floating market prices we can never know if resources are being used productively or if they are being wasted; nor will we know if more resources should be directed to further production of more goods. The result is just more waste and malinvestment and ever increasing prices while the supply diminishes.

And these subsequent price increases due to a diminishing supply are only felt by people who have to pay for their own care. Once we are taxed to pay for "free" care everyone will get to feel the pinch with a further diminished supply of health care and higher taxes on those already footing the greatest tax burden.

To answer your question about "channeling" the market to get private and government insurance to coincide I think you are missing the point. The market is a process whereby every individual actor makes choices that best suites his own interests. This means that prices must reach an optimal level where the supply will clear the market for the current level of demand only if prices are allowed to freely float; i.e, doctors can charge the prices they think appropriate and the customer can choose to go to another provider if he is not happy with the prices.

It just seems like common sense for me if a provider can offer lower prices and the customer had the ability to know this prices would come down or go up as necessary. You bring up a good point about who would profit from this though...ultimately if free floating prices brings about more health care at cheaper prices our point will be made -- everyone benefits -- even if in the short run we must pay initially higher prices.

It seems to me a sound pricing structure is key in this happening though.


#17

No, sometimes, and yes

Yes

Maybe

Yes

Yes. But there is that word "ultimately" again. I do not live by ultimately. I live in the present...tensely.

Yes!
There is much to agree with, but you see we are speaking past each other.

How do we establish sound pricing in a market which is not driven by free and efficient markets?
PRCalDude, and others, would argue to remove all insurance and mitigating instruments because, "ultimately," everything will come out right. Because monetarists and "hard free marketers" do not account for the uncertainty of health and the value of insurance, I have my doubts...

...as did Kenneth Arrow in the 1963 paper I cited above. Classic economic theory was unable--or just uninterested--to reconcile pricing, an inefficient asymmetric market, uncertainty mitigated by insurance, and welfare. (I would opine that Austrian economics absolutely cannot abide such thoughts.) Arrow did not win his Nobel for this single paper, but a whole field of enquiry developed after it.

The practical application is not so clear. I am an amateur, but if I follow the reasoning, if every consumer (patient) can be insured, it can be accomplished with competitive insurance for which coinsurance is graded by "wealth." So the patient, and not the doctor or insurance company, feels the pain of costs, and makes informed decisions about the value of various "products." This creates a new market for prices, and limits consumption "rationally."

Can Government be anything but malignant? Yes. It can issue vouchers to the poor--for premiums, and copays--and empower them to negotiate value and consumption. It can issue vouchers, and then back away. It is also cheaper to do this--far more medical commerce will remain in the private sector-- than to default to a "single payer" arrangement and onerous and eternal entitlements.

What might this accomplish? Well, it is redistributive--an absolute curse word around here. But I have news: we are both redistributive and inefficient and it will get worse. At least it calls on individuals to recapture responsibility, use market forces, limit expensive treatment of marginal personal value, and prices might even come down. And perhaps the poor in need of medical care would not be so dehumanized.


And it won't happen.

No one in the Executive Branch has any interest in a rational approach. That is clear now, as it was in 1993 and 1972.
No one leader in Congress thinks like this, and none are calling on the expertise of academics in the field.
However much I respect pluralist democracy, the constellation of interests will not coalesce behind this type of plan.


#18

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#19

I told you how. By allowing doctors to choose their prices and allowing customers -- you know, the patients -- to also be aware of prices. But you are right about insurance being part of the problem. The fact that most people do not have a choice about who their provider is has much to do with this issue.

But we can establish a sound pricing structure by allowing voluntary associations in medical care (between insurer, care giver, and patient) and thus the market will become efficient. Free floating prices are the only signal that allow for the most optimal efficiency to happen in the market.

No one ever questioned the efficiency of the market in medicine before the government became involved 40 years ago. Oh, I am sure many government economists claimed so but that was for the sake of THEM collecting a pay check from tax payers and nothing to do with the actual efficiency of the markets.


#20

I almost seems like there are only so many things a democratic political system can accomplish.

So, what are we going to sacrifice?

Democracy or free healthcare for all?