Republican Debates

[Anomaly]

Just now, Nihil Obstat said:

Personal freedom in the American context is only a contingent right anyway.

I disagree. The system does not have to profit from healthy people or sick people in the context of their utilization of health care. That is not a necessary feature of either funding or delivery. (It can, certainly, and I would not necessarily argue that it should not.) The real discussion is about what mix of private and public funds is used to finance the system, and what delivery methods are used to best allocate care.

Wrong.  It is essentially and fundamentally dependent on profiting from the healthy or those with greater wealth.  Whether public or private funds, the healthier and wealthier will always pay more than they get in return. Period.   

All that is left is:

1: arguing for justification for them to pay more than they'll ever get back

2: defending those who can't pay and need more not caused their behaviors, from being lumped with those who need more or can't/won't pay as natural consequences of their actions.  

[Nihil Obstat]

16 minutes ago, Peace said:

Personal freedom in a Catholic context is only a contingent right, is it not?

We would have to define terms more precisely, which is why I equivocated.

6 minutes ago, Anomaly said:

Wrong.  It is essentially and fundamentally dependent on profiting from the healthy or those with greater wealth.  Whether public or private funds, the healthier and wealthier will always pay more than they get in return. Period.   

All that is left is:

1: arguing for justification for them to pay more than they'll ever get back

2: defending those who can't pay and need more not caused their behaviors, from being lumped with those who need more or can't/won't pay as natural consequences of their actions.  

No, I believe you are very wrong. In fact I bet if you did a profit/loss analysis, there is no system in the world that actually profits on health care. I think you are confusing profit with cashflow. Healthy people in general are net contributors and less healthy people are net withdraw-ers when it comes to a cashflow analysis.

I am not sure if you realize, but the US does not have a private health care system. It has private elements, as nearly all systems do, but as a percentage of public versus private funding, the US actually spends more than many countries that have implemented universal health care systems. So basically your government pays more, your citizens also pay more, and in general outcomes are mediocre at best (EDIT: given comparable levels of spending).

Edited April 19, 2016 by Nihil Obstat

[Anomaly]

11 minutes ago, Peace said:

What definition of profit are you using? In your first post, when you wrote "Profits are not a bad thing.  It's motivation to build a hospital or create a new drug", you appear to use the term in the classical economic sense. But in your most recent post you appear to equate the term "receive money" with "make profit". But these are two entirely different things.

When I say "profit" I am using the term in the classical economic sense of the term:

Profit is a financial benefit that is realized when the amount of revenue gained from a business activity exceeds the expenses, costs and taxes needed to sustain the activity. Any profit that is gained goes to the business's owners, who may or may not decide to spend it on the business.

Profit is not money that is used to pay for the care of sick people. Profit is money that is given to the owner of a business, after which the owner can then spend the money in any manner that he wishes (be it on health care for the poor, or a new Porsche).

Taking insurance and hospitals for example, you can have for profit insurance companies and for profit hospitals, but you can also have non-profit insurance systems and non-profit hospitals. These exist in many countries. So I do not think you are correct to say that the whole idea is to make profit. In some systems it is. In other systems it is not.

But if you simply mean "you need to receive money to pay for health care services" then I agree with you (but I think that is rather obvious).

Personal freedom in a Catholic context is only a contingent right, is it not?

Profit is the difference between cost and income.   Who receives and what is done with the profit is something entirely different and just playing with semantics. 

[Nihil Obstat]

1 minute ago, Anomaly said:

Profit is the difference between cost and income.   Who receives and what is done with the profit is something entirely different and just playing with semantics. 

Sorry, but I do not think you know what you are talking about here. Who receives the profits? What is done with the profits? The question itself shows how deeply you have misunderstood the entire subject.

[Anomaly]

4 minutes ago, Nihil Obstat said:

We would have to define terms more precisely, which is why I equivocated.

No, I believe you are very wrong. In fact I bet if you did a profit/loss analysis, there is no system in the world that actually profits on health care. I think you are confusing profit with cashflow. Healthy people in general are net contributors and less healthy people are net withdraw-ers when it comes to a cashflow analysis.

I am not sure if you realize, but the US does not have a private health care system. It has private elements, as nearly all systems do, but as a percentage of public versus private funding, the US actually spends more than many countries that have implemented universal health care systems. So basically your government pays more, your citizens also pay more, and in general outcomes are mediocre at best.

It's not that complicated.   It is unarguable insurance is a method to create a profit from some and give it to others.

Justifying the taking and giving based on "merit" does not redefine the math. 

Be honest, and there is honest conversation. 

5 minutes ago, Nihil Obstat said:

Sorry, but I do not think you know what you are talking about here. Who receives the profits? What is done with the profits? The question itself shows how deeply you have misunderstood the entire subject.

Lol. Typical. 

[Nihil Obstat]

2 minutes ago, Anomaly said:

It's not that complicated.   It is unarguable insurance is a method to create a profit from some and give it to others.

 

We are not talking about insurance. Insurance comes later. We are talking about the public/private mix of health care financing. Whether or not insurance companies profit from health care does not really have much to do with whether health care as an industry is profitable on a large scale. Do you actually know how the US finances health care, particularly in proportions of private and public spending? Do you know how that compares to other countries with different financing and delivery systems? I do not think you really understand the basic features of the system you are trying to explain to me.

[Peace]

34 minutes ago, Anomaly said:

Profit is the difference between cost and income.   Who receives and what is done with the profit is something entirely different and just playing with semantics. 

It really was not my intention to play semantics. You appear to be using the term "profit" in a manner that is different than the commonly understood definition of the term, which has caused some confusion I think.

Let's say you have a private insurance system. You have:

1) Owners of an insurance company

2) Healthy People who buy insurance from the company and who receive a smaller amount of medical services because they are healthy.

3) People in poor health who buy insurance from the company and who receive a larger amount of medical services because they are in poor health.

4) Doctors, nurses, staff, etc. who perform the health-care services and are paid by the company.

Profit (Classical Definition) = (The amount of money paid by (2) and (3) ) - (the amount of money that is paid to (4) ).  This profit is then returned to (1).

The way that you use the term profit is quite different. You appear to mean something like this:

Profit (Anomaly Definition) = (The amount of money paid by (2)) - (The amount of money that is paid to (4) to provide medical care services to (2) ). This money is then used to pay money to (4) to provide medical care services  to (3), as well as to provide money back to the owners in the form of profit in the classical sense.

I think that me and Nihil are using the term "profit" in the classical sense, while you are using the term "profit" in a very different sense. I do not think the difference is one of semantics. We are in fact talking about very different things.

Edited April 19, 2016 by Peace

[Anomaly]

12 minutes ago, Nihil Obstat said:

We are not talking about insurance. Insurance comes later. We are talking about the public/private mix of health care financing. Whether or not insurance companies profit from health care does not really have much to do with whether health care as an industry is profitable on a large scale. Do you actually know how the US finances health care, particularly in proportions of private and public spending? Do you know how that compares to other countries with different financing and delivery systems? I do not think you really understand the basic features of the system you are trying to explain to me.

Of course if you disagree, you believe the other person is ignorant.  Whether the system is run by private institutions or a government, or a combination, some will pay more than they receive.   Some will receive more than they pay.  That is the whole point or we would just pay as we go, period. 

If you need a new lung, do you think you would ever live long enough or earn enough to pay for it?  Do you think all or most 1,200 lung recipients per year paid for it with solely their own contributions (past, current, future).   

Every scheme has to take in enough to pay out. You have to have net contributors to afford net recipients.  What is done with those profits is an issue, whether it's paying for a new boat or a new lung, we are then in a discussion how much to profit from net contributors and who gets the profits.  

[Nihil Obstat]

7 minutes ago, Anomaly said:

Every scheme has to take in enough to pay out. You have to have net contributors to afford net recipients.  What is done with those profits is an issue, whether it's paying for a new boat or a new lung, we are then in a discussion how much to profit from net contributors and who gets the profits.  

The point of public finance is that in the short run, no they do not. They can pay out far more than they take in. And when it comes to the financing of healthcare, being one sector among many, they could face net losses perpetually which are covered by profits elsewhere. Which is, I would wager a fairly significant amount of money, the case in every developed country. In that sense it is just one division of a large company. And again, you seem to be unaware of the actual financing of American health care. I will say it again: you do not have a private system.

Edited April 19, 2016 by Nihil Obstat

[Anomaly]

2 minutes ago, Peace said:

It really was not my intention to play semantics. You appear to be using the term "profit" in a manner that is different than the commonly understood definition of the term, which has caused some confusion I think.

Let's say you have a private insurance system. You have:

1) Owners of an insurance company

2) Healthy People who buy insurance from the company and who receive a smaller amount of medical services because they are healthy.

3) People in poor health who buy insurance from the company and who receive a larger amount of medical services because they are in poor health.

4) Doctors, nurses, staff, etc. who perform the health-care services and are paid by the company.

Profit (Classical Definition) = (The amount of money paid by (1) and (2) ) - (the amount of money that is paid to (4) ).  This profit is then returned to (1).

The way that you use the term profit is quite different. You appear to mean something like this:

Profit (Anomaly Definition) = (The amount of money paid by (2)) - (The amount of money that is paid to (4) to provide medical care services to (2) ). This money is then used to pay money to (4) to provide medical care services  to (3), as well as to provide money back to the owners in the form of profit in the classical sense.

I think that me and Nihil are using the term "profit" in the classical sense, while you are using the term "profit" in a very different sense. I do not think the difference is one of semantics. We are in fact talking about very different things.

Both of you demonstrate you know nothing practical about business and finance.  There is net profit, gross profit, and various levels of operational profit.  

The simple fact is, most people pay more than they receive.   It is inevitable.  Even if it's taxes, it is a scaled contribution and distribution.   The money is not just printed or gathered from someone's irrelevant excess.  

The honest discussion is how much extra should people pay to contribute to others.  Is it worth an extra $4,000 or 10% of gross yearly to cover a liver transplant for an alcoholic or lukemia treatments for a teenager?   Who, and in what manner, does someone else benefit from the net profits of a group of healthier contributors?   

 

 

8 minutes ago, Nihil Obstat said:

The point of public finance is that in the short run, no they do not. They can pay out far more than they take in. And when it comes to the financing of healthcare, being one sector among many, they could face net losses perpetually which are covered by profits elsewhere. Which is, I would wager a fairly significant amount of money, the case in every developed country. In that sense it is just one division of a large company. And again, you seem to be unaware of the actual financing of American health care. I will say it again: you do not have a private system.

Now that is telling.   

So you're claiming the government can finance a net deficit for perpetuity?  Is there no limit to the size of the deficit?    Why don't we all have free education and unlimited healthcare now?

No wonder the concept of profit baffles you.   You must be an academic.  I never said the US has an entirely  private healthcare system.  Why do you keep fluffing that straw man?

[Peace]

14 minutes ago, Anomaly said:

Both of you demonstrate you know nothing practical about business and finance.  There is net profit, gross profit, and various levels of operational profit.  

The simple fact is, most people pay more than they receive.   It is inevitable.  Even if it's taxes, it is a scaled contribution and distribution.   The money is not just printed or gathered from someone's irrelevant excess.  

The honest discussion is how much extra should people pay to contribute to others.  Is it worth an extra $4,000 or 10% of gross yearly to cover a liver transplant for an alcoholic or lukemia treatments for a teenager?   Who, and in what manner, does someone else benefit from the net profits of a group of healthier contributors? 

Alrighty. I can't argue with that.

[Anomaly]

1 minute ago, Peace said:

Alrighty. I can't argue with that.

Cool.  It's not just profiteering by a few that is the problem. And the solution isn't just throwing money at it or putting the government in charge of it all.  Free abortions, assisted suicide for terminal and protected euthanasia for elderly may save money if we leave it a pragmatic government program that exists to eliminate private profit.

[Nihil Obstat]

33 minutes ago, Anomaly said:

Now that is telling.   

So you're claiming the government can finance a net deficit for perpetuity?  Is there no limit to the size of the deficit?    Why don't we all have free education and unlimited healthcare now?

No wonder the concept of profit baffles you.   You must be an academic.  I never said the US has an entirely  private healthcare system.  Why do you keep fluffing that straw man?

I am saying that the government financing of healthcare can, and almost certainly does, run at a net deficit. In every developed country in the world. That is the nature of publicly funded health care. Governments do not finance health care on a for-profit basis. Insurance companies can and do, but that is a secondary issue.

[Benedictus]

On 18/04/2016, 21:19:45, Nihil Obstat said:

Money is absolutely a central consideration. Healthcare, while a fairly unique industry, is absolutely affected - right to its very fundamental levels - by financial concerns. The fact is that the money has to come from somewhere, otherwise quality of care suffers. Because of this, some funding schemes are simply not possible because their funding mechanisms are insufficient.

We like to believe that there is no profit motive in health care. This is untrue. There are other issues, yes. It is not only about money. But it is literally impossible to understand and begin to address the issues in healthcare delivery without taking careful consideration of funding.

Money is important, yes. However, that should be on a broad scale in terms of the objective measure of a country or health system and not personal wealth.

If the decision relied on individual people with wealth to decide what should happen then they'd, at least mostly, will only do what's good for them and the system would be constructed in a bad way. Trying to convince a rich person to give more in tax to help a poor family is often a waste of time!

The privilege some people have and the reluctance they have to consider the wider needs of society shows they are incapable of leading healthy and dynamic reforms. It's the problem with much of the political engagement these days in many places.These people are self serving!

It is possible to deliver a good universal system for all people. It requires that the wealthy have a vote, but not a veto over the way forward.

[Nihil Obstat]

I agree, personal wealth and money as a general principle are very different topics.