Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/18/84; site x.UUCP Path: utzoo!watmath!clyde!burl!ulysses!gamma!epsilon!zeta!sabre!petrus!bellcore!decvax!ucbvax!ucdavis!lll-crg!seismo!harvard!think!mit-eddie!cybvax0!frog!x!wjr From: wjr@x.UUCP (Bill Richard) Newsgroups: net.politics.theory Subject: Re: Medicalert Message-ID: <797@x.UUCP> Date: Thu, 10-Oct-85 22:47:20 EDT Article-I.D.: x.797 Posted: Thu Oct 10 22:47:20 1985 Date-Received: Mon, 14-Oct-85 04:07:05 EDT References: <776@x.UUCP> <778@cybvax0.UUCP> Reply-To: wjr@x.UUCP (STella Calvert) Distribution: net Organization: Charles River Data Systems, Framingham MA Lines: 130 Note: This is still STella, disclaiming wjritude and organizational affiliation -- how DO you set organization if you're posting from someone else's account using rn? Please send mail! In article <778@cybvax0.UUCP> mrh@cybvax0.UUCP (Mike Huybensz) writes: >In article <776@x.UUCP> wjr@X .UUCP (STella Calvert) writes: >> The big thing that will make it cheaper is that I will be using my former >> tax dollars to pay the premiums. Think about it. Now I pay for coverage in >> aftertax dollars. When I get all the value my customers . . . pay, >> I can afford to pay for more of the good they produce. >That's assuming (without any estimates or justification) that you will be >able to substitute or do without current government services for less. I'm >not saying that you can't make such an accounting, just that the money you >pay in taxes isn't simply thrown away: you receive benefits in return that >you will probably desire in libertaria. And they aren't free. But there are lots of "benefits" I won't have to pay for. The bureaucretins that "administer" my tax dollars via Social Insecurity for one. I would not voluntarily support some of the Army Corpse of Engineers' efforts; and I certainly would concentrate on civilian space programs rather than ABM, ASAT, and the rest of that alphabet. When (and yes I'm ashamed of myself for it) I was a government bureaucretin, I was paid (as a GS-3, I think) about twice what a friend who was on AFDC was paid. And so forth. There are real goods, like roads, regional defense, and the Smithsonian Institution, that I will gladly support. But I don't really _want_ to support the Infernal Robbery Service, the Drug Enforcement Administration, or the Commerce Department. >Medical care is expensive for a number of reasons. It is intensive in its >use of high-cost facilities (such as hospitals, offices, equipment, >esoteric drugs) that must have high quality and reliability. And it is >intensive in its use of the time of highly trained personnel. All this is true, but added on to this necessary cost is the burden imposed by a government-sponsored monopoly. And that burden is not only financial. >Medical care is also expensive because despite the expense it can be cost >effective, from the standpoint of an investment by society, a family, or >an individual. Essentially, any of the above can profit from a purchase >of medical services by increases in the potential life earnings of the >patient. Standards of quality (such as "union cards") help ensure the >safety of the investment. I agree that medical care will remain expensive. However, every doctor who has misdiagnosed me or a member of my family had a union card and several attractive diplomas from recognized medical schools. So I don't feel that my investments in medical care are safe until that doctor has fielded a few emergencies for me. Have you ever tried to find out from his union hall what other complaints had been lodged against a physician you had retained? I tried that once, but I never did get a straight answer from them. When they did get rid of him some year and a half later, it got a paragraph on an inside page of the newspaper. I'm sorry, but I can't quite see where the ensuring of safety is done. Not through the AMA, however. >>Where do you get THAT? In a libertaria, if you attempt to defraud me, I post >>bond and file an account on as many information nets as I >> can afford to post bond on. >Oh? And how are you or anyone else going to decide that? "XXXX penicillan >is no good, I nearly died!" How will someone determine the truth of this? >How will anyone decide between 1) tampering 2) a bad batch 3) you are >allergic 4) you had a resistant strain of bug 5) you are lying 6) you took >the wrong dose 7) something unrelated almost killed you 8) ineffective drug? >Assuming, of course, that you have the resources to post bond, as a public >spirited thing to do? How would you profit? Not, "Dr. John's Snake Oil is no good, I nearly died!" but "I took a course of Dr. John's Snake Oil and my snake still squeaks." 8-) Seriously, the same way they do now -- on the weight of the evidence I am able to muster. It might be sufficient to say, "I took my friend Sue to Clyde's Emergency Room and they treated her for PID. The next day she began bleeding and almost died from a ruptured tubal pregnancy. This was diagnosed at Mork's Health Shoppe." I don't want to hand-wave anything you consider important, but while I haven't got a fully-debugged medical system worked out, I don't think the United Statists medical system would be the template I'd choose. And my reward for this would be the knowledge that I was protecting anyone else who shared my medical standards from Clyde's Malpractice Emporium. Evolution in action, sir! If a doctor can't do his job, he won't have the opportunity to do a job on me. And I doubt I'll be at greater risk than at present. >We already have fine, working systems of monitoring for danger and >effectiveness of products and medical treatments. They have recently found >quite obscure problems, such as AIDS (early on, well before it was obvious), >toxic shock syndrome, contaminated watermelons, etc. And for this you want >to substitute an uncoordinated, undirected system with built-in noise? While I was in Berkeley, I was advised not to go to a vampire shop (plasma bank). The doctor who so advised me later admitted that he was concerned about the disease that later was recognized as AIDS. Because his union would have come down on him for prematurely discussing his (labelled) suspicion that there was a deadly disease transmitted by blood products, I continued to donate. He was unable to pass on his guess that there MIGHT be a hazard, and I am unwilling to take anything on a mere "because I say so". As it happened, since I took seriously his warning to the extent that I verified the numbers on my cells VERY carefully, I got away with it. Six or seven years later, though, I still wonder why I couldn't have been told "There is a cluster of incidences of an immune-system-suppressing disease which MAY be transmitted by blood products. Be careful! Insist on seeing them unwrap your IV kit at your chairside." As long as doctors have the state-protected monopoly, some things just don't get out. In other words, I prefer an "undirected system with built-in noise" to a monopoly controlled system with built-in noise. >I greatly admire your stated values, which are quite different from those >I've heard espoused by other libertarians (who mostly sound like Calvanists.) >But the simple fact of an increased rate for "Samarit" is exactly the kind >of disincentive I'm talking about. And many people wouldn't want that expense. Fine! This next point is starting to give me a bad case of deja vu, but if I ever live in a libertaria it will only be because most of the population agrees to make the change. Including the people who volunteer at hospitals, donate to the disease of the month drive, and work for that misty entity, the common good. If most people weren't willing to care for the hindmost to some extent, we wouldn't have our present crippled health and welfare systems. If we can devise something that works at least as well, the same people who now console themselves for being taxed with the idea that they are benefiting the needy will find another way to do so. One with lower overhead. STella Calvert (guest on ...!decvax!frog!wjr) Every man and every woman is a star. Sorry this took so long to answer, but I've had a hurricane, a visitor from out-of-town, and a wedding (mine) all in the same week, and couldn't find time to read news, or write anything more complicated than thank-you notes.