Politics debate continued from multiculturalism thread

[Adam Smith]

Originally posted by KrazyHorse
I worry about the contracting system in health care, however. The contracting party (insurance, in most cases) would have to be very careful to avoid allowing the provider to skimp on necessary expenses. The problem here is that there's an agent between the consumer and the provider (the insurance company) who should not necessarily be trusted to put the consumer's interests ahead of their own. They might be incentivised to not ask too many questions about details in the contracts with providers if the right price is set.

Absolutely. These and other kinds of agency problems are part of what makes health care markets so tricky. Many countries have gone to government sponsorship in an effort to reduce or eliminate for-profit agency problems. But this may raise other problems re the efficiency of government enterprises. Other posible solutions in the US might include not for profit HMO's / cooperatives, or a strong medical care appeals process. (I don't particularly like the appeals process solution because it is ex post, and can saddle consumers with large transactions costs.)

[Odin]

Originally posted by aneeshm
I've always thought this to be a false dichotomy. Why can't we have parallel governmental and non-governmental systems, both competing (with the obvious condition - the government can't create unfair advantages for itself)? Even though I'd be in favour of a totally private system, a compromise is possible, and that's what we have here in India.

Because then the rich will let the public system go to crap.

[Snotty]

Originally posted by Ned
Just as a point of reference, over my entire life only one or two doctors appointments were made days in advance. This includes eye appointments. Whenever I have had to see a doctor, I just have to give a call and I get an appointment that same day. If my regular doctor is not available, I see another on staff.

I can hardly imagine a system that would force you to wait if you are sick or injured.

for my GP I have not had to wait more than half a day during the daytime to see him, or simply walk into the 'walk in centre' and see a doctor within 1/2 hour. Ive got good service as have others in my suburb, but this is the kind of service thats sought as the ideal.

Seeing a specialist would be through your GP and so would probably require organizing a future appointment. As an example of referral to specialist the government has a target of at most, from referral, 14 days to see a rapid access chest pain clinic with a cardiologist, if thats what your GP thinks you need. I thought it was 7 days.

[Elok]

Originally posted by Ned
I can hardly imagine a system that would force you to wait if you are sick or injured.

http://en.wikipedia.org/wiki/Triage

[aneeshm]

Originally posted by Odin


Because then the rich will let the public system go to crap.

That's not really a valid objection, because the public system is run from money coerced from the rich anyway.

[GePap]

Originally posted by aneeshm


That's not really a valid objection, because the public system is run from money coerced from the rich anyway.

Given that the rich are be definition the biggest beneficiaries of any existing system, they better have no complaints.

[aneeshm]

Originally posted by GePap


Given that the rich are be definition the biggest beneficiaries of any existing system, they better have no complaints.

Not really. In India. the middle classes and the rich prefer to use the private system, because it is more efficient and overall better.

[KrazyHorse]

reducing their incentive to work

?

Are they going to become construction workers instead?

Canada has lower wages for doctors than the US, but they're still quite high relative to other highly-trained professionals (PhDs in sciences and engineering). There are no problems filling up the med schools with students...

[KrazyHorse]

I don't particularly like the appeals process solution because it is ex post

Quite.

[Drake Tungsten]

Are they going to become construction workers instead?

Most aren't going to change careers, although doctors are certainly smart enough to succeed in a variety of other high-paying careers if they wanted to. It's likely that most of them will work less hard at their jobs, though. People respond to incentives...

[KrazyHorse]

Most aren't going to change careers, although doctors are certainly smart enough to succeed in a variety of other high-paying careers

Doctors are no more intelligent, on average, than people in any other highly-trained profession, and are significantly less so than people in some. Yet they get paid more (yes, even in Canada) than people in those other professions. There is no paucity of applicants to medical school, Drake. Quite the opposite.

[KrazyHorse]

It's likely that most of them will work less hard at their jobs, though

If they get paid 20% less then all of a sudden they'll become worse doctors?

Horse****. Most doctors actually care, either about their patients or simply about the quality of their craftsmanship.

[Drake Tungsten]

Doctors are no more intelligent, on average, than people in any other highly-trained profession

And that contradicts my statement that doctors are "smart enough to succeed in a variety of other high-paying careers" how exactly?

f they get paid 20% less then all of a sudden they'll become worse doctors?

They won't become "worse doctors". They will, however, naturally respond to the lowered incentive to work by expending less effort on their work. It's common sense. Would you be as willing to put up with all the bull**** doctors do if you suddenly lost a fifth of your pay?

[Jon Miller]

Originally posted by Drake Tungsten

Doctors are no more intelligent, on average, than people in any other highly-trained profession

And that contradicts my statement that doctors are "smart enough to succeed in a variety of other high-paying careers" how exactly?

f they get paid 20% less then all of a sudden they'll become worse doctors?

They won't become "worse doctors". They will, however, naturally respond to the lowered incentive to work by expending less effort on their work. It's common sense. Would you be as willing to put up with all the bull**** doctors do if you suddenly lost a fifth of your pay?

Physicists work as many hours as doctors (in some fields/etc) and get payed less than 30% of what doctors make.

Now yeah, you don't have some of the emotional issues.

JM

[Drake Tungsten]

Physicists work as many hours as doctors (in some fields/etc) and get payed less than 30% of what doctors make.

Some people like physics enough that they will work long hours for 30% less than what doctors make, but there's plenty of people out there who have no predisposition toward physics and consider the cost/benefit ratio of being a physicist to be unfavorable.

Similarly, some people like being/want to be a doctor so much that they wouldn't consider doing anything else even if their pay got slashed 20%. But there's plenty of people out there who have no predisposition towards medicine who may find the cost/benefit ratio unfavorable if salaries cut drastically cut...