Thebastidge: Just basic healthcare
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    Sunday, July 05, 2009

    Just basic healthcare

    Had a good conversation with friends this weekend. Good-hearted people, all well enough off to have health insurance, mostly as a work benefit, still on the upswing of our careers, and unlikely to ever be left without health insurance or other options for very long.

    They're all in favour of basic coverage for everybody, without really being invested in discovering what that would take. Emotionally, they are simply compassionate enough to want everybody to have "the basics" covered.

    I think we may have opened a couple minds to the economic realities of the situation as it stands. These are not dumb people (you know who you all are lol) but I get the impression they simply haven't looked into the system deeply enough to understand how it works.

    Well, here's how it works from an end-user perspective, and if you can wrap your heads around that, I'll feel like I have at least gotten "the basics" covered.

    Some more resources:

    Despite the increases, Canada, with 12 CT scanners and 6 MRI machines per million population, falls below the Organisation for Economic Co-operation and Development (OECD) median

    Here we see some of the trade-offs of the patient not being the one directly responsible for payment. Would more testing help or hurt? It's something that should be negotiated between the doctor and patient, depending upon the individual facts of the individual's illness, but our system increasingly encourages us to go for the maximum because we don't pay for it.

    Here we see that even when people are waiting too long for treatment, Government-run healthcare monopolies care moe about punishing the private operators who do provide a timely service, than actually providing the necessary service. This is because of Pournelle's Iron Law of Bureacracy:

    In any bureaucracy, the people devoted to the benefit of the bureaucracy itself always get in control and those dedicated to the goals the bureaucracy is supposed to accomplish have less and less influence, and sometimes are eliminated entirely.

    Also stated as: any bureaucratic organization there will be two kinds of people: those who work to further the actual goals of the organization, and those who work for the organization itself. Examples in education would be teachers who work and sacrifice to teach children, vs. union representative who work to protect any teacher including the most incompetent. The Iron Law states that in all cases, the second type of person will always gain control of the organization, and will always write the rules under which the organization functions.

    Which means, in the end, any organization will eventually come to serve the purpose of its own existence, over any purported mission it was originally designed for. It's social evolution, and it responds to the same survival imperative to which individual organisms are subject. The 'best' way to do that is to increase the scope of the stated mission, to consolidate power, eliminate competition, etc.

    But competition is what drives prices down, and causes innovation (evolution). So a bureacracy will ALWAYS stagnate the economic ecosystem, until one of them dies.


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