Sachs Support Occupy Wall Street Movement; Goldman Pissed

[notyoueither]

Oh?

Yes.

Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not.

I'd suggest that you need to look at which ones, where, and how. Also, do the studies factor in cultural behaviour such as American over-prescription of tests? Rationing can be a good thing when the service is being squandered.

[notyoueither]

Healthy lifestyles do not necessarily reduce healthcare expenditures; everyone dies sometime. Smoking famously reduces healthcare expenditures because smokers die before they can consume as much care.

Yes, clearly there is a benefit to people living longer, happier lives - a very large benefit. That benefit is not, however, reduced healthcare consumption.

Treating a cancer patient is very expensive.

Having that patient live to 75 and blowing a heart is cheap. You also get another 10 to 20 years return on the sunk cost of investing in his youth.

[Aeson]

Kuci seems to want to avoid admitting that his own arguments and source would suggest we should offer a specific set of preventive healthcare.

[notyoueither]

My source.

[Kuciwalker]

Kuci seems to want to avoid admitting that his own arguments and source would suggest we should offer a specific set of preventive healthcare.

You mean, apart from the explicit statements I've made that more preventive healthcare may be a good idea because its benefits outweigh its costs?

[Aeson]

Well, his source quoted and referenced your source.

[Kuciwalker]

Treating a cancer patient is very expensive.

Having that patient live to 75 and blowing a heart is cheap. You also get another 10 to 20 years return on the sunk cost of investing in his youth.

Sorry, but the data support me here. Unhealthy lifestyles, particularly smoking and obesity, actually reduce total healthcare consumption.

Another source:

http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html

[Kuciwalker]

I'd suggest that you need to look at which ones, where, and how. Also, do the studies factor in cultural behaviour such as American over-prescription of tests? Rationing can be a good thing when the service is being squandered.

So you subscribe to one of the theories I described in #53: people choose to consume the wrong healthcare, therefore the government should step in and tell people which healthcare they may consume and which they may not.

[Kuciwalker]

Why do you think the government is better at doing so than private insurance, which faces similar incentives?

[Aeson]

You mean, apart from the explicit statements I've made that more preventive healthcare may be a good idea because its benefits outweigh its costs?

Just to make sure... You admit that we should add some preventive healthcare to reduce costs?

You seemed to be arguing against it and the very idea of it throughout the entire thread. The allowances you made seemed to be for the well-being being increased enough to offset increased costs, but I could have been wrong about that.

It certainly seems that in the best case, your arguments here have been intentionally obtuse and misleading. There is certainly reason to call for more preventive healthcare being provided than is currently. (As per your source.) Sure, we can't do every last preventive thing, but that's obvious. The question is to identify the ones we should do, and those we shouldn't, not deal with preventive healthcare as a binary issue.

[Aeson]

So you subscribe to one of the theories I described in #53: people choose to consume the wrong healthcare, therefore the government should step in and tell people which healthcare they may consume and which they may not.

This doesn't necessarily follow. Preventive healthcare being provided to those who cannot afford it for instance. It doesn't mean they choose to consume the wrong healthcare. They have no choice to consume it.

[a.kitman]

Sorry, but the data support me here. Unhealthy lifestyles, particularly smoking and obesity, actually reduce total healthcare consumption.

Another source:
http://www.nytimes.com/2008/02/05/he...1.9748884.html

beep beep boop

[Jon Miller]

So you subscribe to one of the theories I described in #53: people choose to consume the wrong healthcare, therefore the government should step in and tell people which healthcare they may consume and which they may not.

People aren't choosing health care is such a pure market fashion as you are implying.

There are huge subsidies for employer provided health care. These subsidies, in addition to the scale which large employers provide, mean that purchasing health insurance is how you get the 'most income'. The health insurance then determines which health care you get.

Since at no point are you actually choosing health care, you are not actually even thinking about health care you get from health insurance companies compared to health care without (and the money that your employer pays for you is not even something you think about). And actually, the health care system is so tied up with health insurance companies that many doctors will not even see you without health insurance. (in addition to all the people working to deal with health insurance claims from the doctors side and doctors/patients claims from the insurance side, this rises costs)

There is no 'working' health care market in the US.

There is in South Africa, for example, where most people can not afford health insurance and the free state system is massively overburdened. In South Africa it is much more like you go to the doctor and consult or order some care/etc, but at every point along the way you balance how much something costs and whether you need it versus something else (like food for the next year). It is very much that you are going and paying for the service.

JM
(Not saying South Africa is great, it isn't, at least in part because ~80% of the people are very poor. But it actually has a health care market, unlike the US. What health insurance that does exist in South Africa does something like 'cover XXXXX zar amount of health care per year' or 'pay for you to miss XX days of work'.)

[Kuciwalker]

Just to make sure... You admit that we should add some preventive healthcare to reduce costs?

I am essentially agnostic on policy (though PPACA was a ****ty law), because it's not clear how well market mechanisms work here. However, I am deeply suspicious that the government is reliably identifying cost-saving preventive healthcare that the insurance companies don't cover or wouldn't cover.

You seemed to be arguing against it and the very idea of it throughout the entire thread. The allowances you made seemed to be for the well-being being increased enough to offset increased costs, but I could have been wrong about that.

OB cited the well-worn talking point that we should use more widespread preventive care to reduce costs. This is a very, very common leftist claim that shows no awareness that the vast majority of preventive care doesn't reduce costs. Maybe OB really meant "we should implement the extremely limited set of preventive care that does reduce costs" but I doubt it.

It's certain that the measures in PPACA that were justified on those grounds aren't reliably targeted in the way you suggest.

It certainly seems that in the best case, your arguments here have been intentionally obtuse and misleading.

Only if you can't read. My VERY FIRST POST ON THE TOPIC:

"The idea that preventative health care reduces total healthcare consumption is one of the greatest feel-good lies the left tells itself. More preventative care almost always increases consumption, not reduces it. Sometimes (but not always) it also improves outcomes. The improved outcomes may be worth the extra resources, but they are not cost-saving measures in any way."

Every single one of these claims has been 100% supported by the evidence posted by me and NYE.

[Kuciwalker]

People aren't choosing health care is such a pure market fashion as you are implying.

You mean, apart from the numerous posts where I discuss how the US healthcare market is already thoroughly regulated and point out that historically market forces have not resulted in an efficient allocation of healthcare resources?

There are huge subsidies for employer provided health care. These subsidies, in addition to the scale which large employers provide, mean that purchasing health insurance is how you get the 'most income'. The health insurance then determines which health care you get.

Aside: do you think the left would ever support getting rid of those subsidies? They are its deliberate creation.

Since at no point are you actually choosing health care, you are not actually even thinking about health care you get from health insurance companies compared to health care without (and the money that your employer pays for you is not even something you think about).

Employers choose insurance based on cost and quality, insurers choose what treatments they provide based on cost and effectiveness. It is in many ways a decentralized version of the FDA model. Why doesn't it work?