>The hard question and, I suspect, the place where you and I part company is over what is in the public interest and what is not. Helmet laws are a good example. Bike helmets for kids fit into the first category above, so let's leave those out and talk about motorcycle helmet laws. The real question is whether motorcyclists who don't wear helmets and get into accidents end up costing the public money. Now, in your view of how things should work, they wouldn't because public money wouldn't be used for anyone's health care. In my view, the government is the payer of last resort. In that scenario, the cyclist who goes without a helmet, crashes and winds up needing a lifetime of car costs us both a lot of money.
For that matter, the current system of commercial healthcare is costly in several ways - and counterproductive marketwise. But it is so in the total, general sense; those who make big money on it (at the expense of everybody else) may see it differently.
A person who buys subgood health insurance, gets hosed several times: first, buying fake goods. The insurance doesn't really insure them, there's small print, and when they're the most vulnerable, the small print kicks in (or maybe doesn't, but they have to pay the bill first, pay an expensive lawyer next and then weather a lengthy lawsuit... with uncertain outcome). The hospital had to be competitive, so they had to buy the same expensive hardware as the guys across the street, or better, so the doctor may elect to do something more expensive (use brand name drugs instead of generics) etc etc. All in all, there's a good chance that for many people a health issue may mean losing a lot, including a job (yeah I know a guy who lost two jobs in a year for common colds - he didn't have insurance then, and didn't really need to visit a doctor for that).
Who made money: health insurance industry, hospital, pharmaceutical industry.
Who lost: the guy, his family.
Who also lost?
- His employer - who loses a worker in the middle of something, loses time/money on getting the work done by others or later, fires the guy and then loses time/money looking for replacement. Takes weeks, if not months.
- The state, for the retail tax. This guy won't be buying this or that, his savings are gone.
- Many local businesses, because not only this guy won't be shopping much around, he and his family are actually living off the help extended by wider family and who knows who, and all that money goes to bare subsistence, not buying books and new cars.
- Real estate market - this guy, his family, and whoever is helping him, are out of circulation for housing. They're scrambling to stay where they are if they can, they aren't buying anything anytime soon. Demand scores a few less.
- His health insurance has mostly lost money for the part it had to pay, which it may not have had to, if the guy remained healthy - he had a condition which could have been cured with a few pills if found on time. However, the insurance seller doesn't provide preventive measures, because the customers switch providers so often (actually, their employers do), so why save money for competitors? It's easier to pay the cost of patching him up (not really curing him - just getting him up and running), and to just try their bestest to pay as little as possible.
- Government at various levels, because whoever lost money here is paying less taxes, or becomes a beneficiary.
- The hospital has actually had extra costs - in this business model, it can't afford to have too many expensive doctors, and there aren't any cheap doctors because their studies aren't over until they're approaching thirties - so it has to pay what doctors (and specially residents) to work extra hours, please no more than 100/week, so it would remain profitable, but that increases the risk of human error, so it has to invest in hardware, software and liability insurance (which is a tacit confession that they expect screwups).
So all these guys are actually losing money or are able to make some only under extreme pressure. Who is left? Health insurance seller (who still DOES make a lot), pharmaceuticals.
Now in the countries where the health insurance is not a business but organized as a commons, usually as a governmental agency, it is non-profit, it can negotiate the price with pharmaceuticals, it organizes things (so you don't have three competing hospitals all buying the same CT scanners and then incurring loss when they are underutilized) and generally gets things done for far less money while keeping the people generally healthy, catching diseases before they advance, saving millions of work hours and even having statistics to track how are they doing. Saves a lot of money to everyone, except those who profit from chaos.
BTW, I still don't understand why are American pharmaceutical companies selling their expensive drugs in other countries so far below its market price? I mean, the price here is the honest market price - what they sell them for in Canada must be unfair competition.
