[Peace-discuss] Re: marketplace mythologies
was:InsuranceCompanies Should Compete
E.Wayne Johnson
ewj at pigs.ag
Fri Dec 4 17:26:33 CST 2009
two entities in one market is not competition but is a sort of Nash
Equilibrium
the insurance industry assures that "adequate" funding for the hospitals is
available in such a situation.
What is driving the cost of such equipment?
Nothing intrinsic except the captive market and regulation of medical
instruments.
Part of the problem with the amerikan health care system is the aura of
magic they build around themselves
which allows for the Lie that "these costs are beyond our control", etc.
----- Original Message -----
From: <ls1000 at live.com>
To: "peace-discuss" <peace-discuss at lists.chambana.net>
Sent: Friday, December 04, 2009 1:41 PM
Subject: Fw: [Peace-discuss] Re: marketplace mythologies
was:InsuranceCompanies Should Compete
>
>
> It is interesting how one factor keeps being ignored - namely that
> competition in the hospital industry is a primary cause of increased
> medical
> costs independent of patent protection for drugs and limitations on
> foreign
> doctors. In an economic environment where hospitals within a given local
> are in competition with each other, they all have to have the newest
> latest
> and greatest of facilities, equipment, and range of offered services to
> remain competitive in the marketplace with the other hospitals in that
> market place. If the marketplace is small and unable to produce a
> population of consuming patients to support all the existing hospitals
> 24/7
> with enough users to make them profitable and/or attractive to staffs, the
> resulting duplication of services and equipment and facilities which each
> hospital sees as necessary to their survival in a competitive marketplace
> means that each hospital will have to raise their prices and charge more
> in
> order to pay for the non-fully utilized services, equipment, and
> facilities.
> Thus, in Champaign-Urbana, both Provena and Carle claim that they each
> need
> to have not only but the latest and most current MRI facilities, for
> instance, to be competitive with the other; but it is questionable if
> Champaign county and the surrounding areas have a large enough population
> to
> support full time utilization of two MRI facilities - not to mention the
> costs of those facilities, their operations, and the maintaining of them
> as
> current and up-to-date facilities - such as to allow the hospitals to
> retrieve their costs for the equipment and facilities and staffing as well
> as for their maintenance and upgrading. As a consequence, each hospital
> raises its prices in order to artificially support their being competitive
> with the other such that competition increases the costs of healthcare
> rather than reducing it as the Capitalist theory and myth suggests.
>
> The hospitals in an attempt to survive under these competitive marketplace
> conditions have been trying to expand their geographic territories so as
> to
> cover larger populations. However, apart from the increased costs of
> additional equipment, staffing, facilities, and administrative management
> requirements involved, this expansion into new and larger territories in
> searh of increasing the customer base puts additional competitive
> pressures
> on the hospitals who have to compete with the existing hospitals in the
> new
> territories as well as on the existing hospital facilities that already
> are
> in the new territories by now dividing up the existing population base of
> those new territories among the old and new hospital facilities, which -in
> turn - generates a predisposition and need for additional duplications of
> services and equipment to be competitive and the further increase in
> prices
> for service due to their not being enough customers to support the
> increased
> duplicate services, equipment, and facilities in those locals.
>
>
> --------------------------------------------------
> From: "Stuart Levy" <slevy at ncsa.uiuc.edu>
> Sent: Friday, December 04, 2009 12:39 PM
> To: "David Green" <davegreen84 at yahoo.com>
> Cc: "Peace Discuss" <peace-discuss at anti-war.net>
> Subject: Re: [Peace-discuss] Re: marketplace mythologies was:
> InsuranceCompanies Should Competemost
>
>>> On Fri, Dec 04, 2009 at 10:35:32AM -0800, David Green wrote:
>>>> Economist Dean Baker repeatedly argues that two (anti-market) things
>>>> artifically raise the cost of healthcare: Patent protection for drugs
>>>> and
>>>> limits on foreign doctors in the U.S., keeping doctors' earnings
>>>> artificially
>>>> high. I would add to that that medical schools should be open to all
>>>> comers
>>>> with basic undergraduate coursework. Drastically expand medical school
>>>> capacity, and let anyone who wants to sink or swim. Maybe we can learn
>>>> something from Cuba in this regard.
>>>>
>>>> DG
>>>
>>> yes, that's a good point. i'm uncomfortable with Baker's simply
>>> lowering
>>> limits on foreign doctors -- not because we'd suffer, but because it'd
>>> drive
>>> a brain drain -- our overinflated health costs will draw doctors from
>>> places
>>> that need them more than we do. but i really like the idea of wider
>>> access to
>>> medical school to increase the supply of trained medical people here
>>> (whether
>>> doctors or not).
>>>>
>>>>
>>>>
>>>> ________________________________
>>>> From: Ricky Baldwin <baldwinricky at yahoo.com>
>>>> To: E. Wayne Johnson <ewj at pigs.ag>
>>>> Cc: Peace-discuss <peace-discuss at lists.chambana.net>
>>>> Sent: Fri, December 4, 2009 12:07:46 PM
>>>> Subject: [Peace-discuss] Re: marketplace mythologies was: Insurance
>>>> Companies Should Compete
>>>>
>>>>
>>>> And Leahy deserves it, but it's not necessarily timely on the occasion
>>>> of his being right about something.
>>>>
>>>> And I happen to think, I'm afraid, that it is you who are not digging
>>>> deep enough into the problems with competition or health care. Single
>>>> payer certainly does actually cut costs - hugely. I'd read up on it
>>>> again if I were you. It does this mainly by eliminating an entire
>>>> layer of bureaucratic nonsense that insurance companies thrive on -
>>>> that's right, bureaucracy isn't just for the government; in fact not
>>>> even mostly - and by eliminating the profit necessity on the insurance
>>>> side. That is, an insurance company always has to charge more simply
>>>> because they have to turn a profit. That money has to come from
>>>> somewhere. It mainly comes from labor, as profit normally does, but
>>>> holding labor costs constant you can assume the consumer pays more.
>>>>
>>>> Why do we care about labor costs? Well, if we work for a living the
>>>> answer is fairly obvious. That's us. We are the labor cost. Lowering
>>>> labor costs means we get paid less. I don't work for an insurance
>>>> company, you say. But it doesn't matter, because the economy is not a
>>>> loose association of little budget-islands; it's an interconnected
>>>> system. One company lowers labor costs, the others need to as well.
>>>> That's back to that "competition" idea again. This is another one of
>>>> the ways competition is enormously destructive: because it privileges
>>>> profit over human needs - specifically it privileges the increasing
>>>> concentration of profits over the supplying to people of what they need
>>>> to live.
>>>>
>>>> There is no denying that the effects of some regulations have the
>>>> effect that Wayne describes. It's just that it's not the whole
>>>> picture, and not even the most important part of it. For one thing, as
>>>> I said before, the shutting out of competitors is not solely - or even
>>>> primarily - an effect of regulation; it's mainly a direct consequence
>>>> of "market" forces themselves. Different regulations simply work
>>>> differently, so it really doesn't make sense to generalize in the way
>>>> you're doing - which I realize is the way we are often taught to do.
>>>>
>>>> It's not that competition doesn't exist (the way the so-called "free
>>>> enterprise" system doesn't exist), or that regulation is always good or
>>>> bad. It depends on the effects.
>>>>
>>>> Similarly, another (related) golden icon is the Law of Supply and
>>>> Demand, which as Marx famously noted, works - like the Law of Gravity
>>>> works when your house falls in on you.
>>>>
>>>> Ricky
>>>>
>>>> "Speak your mind even if your voice shakes." - Maggie Kuhn
>>>>
>>>> --- On Thu, 12/3/09, E. Wayne Johnson <ewj at pigs.ag> wrote:
>>>>
>>>>
>>>> >From: E. Wayne Johnson <ewj at pigs.ag>
>>>> >Subject: Re: marketplace mythologies was: Insurance Companies Should
>>>> >Compete
>>>> >To: "Ricky Baldwin" <baldwinricky at yahoo.com>
>>>> >Cc: "Jenifer Cartwright" <jencart13 at yahoo.com>, "Peace-discuss"
>>>> ><peace-discuss at lists.chambana.net>
>>>> >Date: Thursday, December 3, 2009, 9:14 PM
>>>> >
>>>> >
>>>> >Ricky,
>>>> >
>>>> >I guess I really was poking fun at Leahy's doublespeak and the
>>>> >ideologic play on words
>>>> >it puts him in. Patrick Leahy has contributed as much to the
>>>> >bureaucratic morass that
>>>> >characterizes the highly regulated practice of medicine in Amerika.
>>>> >
>>>> >You are not digging deep enough into the medical-industrial-legal
>>>> >complex
>>>> >and the web of rules and regulations that prevent competition.
>>>> >
>>>> >Single-payer only changes who pays. It doesnt change the cost.
>>>> >Single-payer just ensures the foxes of the medical industry that the
>>>> >hens are plump and well-fed.
>>>> >I want to stomp on the foxes.
>>>> >
>>>> >One not need to call upon the dark annals of history to refute your
>>>> >argument against the
>>>> >benefits of competition. A few days ago I became leery that my auto
>>>> >insurance was getting more and more expensive.
>>>> >A few clicks on the internet last night...now I am saving $126 per
>>>> >month without having
>>>> >to speak with any insurance salesman at all. Competition in the
>>>> >marketplace is a good thing.
>>>> >
>>>> >Surely you are not so semiotically inflexible that you can't engage in
>>>> >metaphor about the marketplace.
>>>> >Perhaps you prefer to have Big Sibling make all of our choices for us?
>>>> >Or just for the rest of us?
>>>> >
>>>> >*
>>>> >Regulation serves abusive corporations because it raises the bar for
>>>> >new entrants.
>>>> >It's another case of the collusion of the "left" at its worst
>>>> >("stupid") and the
>>>> >"right" at its worst ("evil"). The "do-gooders" want more regulations
>>>> >because they think that more regs will make
>>>> >their miserable and pathetic fear-driven lives "safer". The
>>>> >greed-driven corporate plutocrats accept more regulations
>>>> >with glee, because for them it represents a way to slime their
>>>> >competition out of the market.
>>>> >
>>>> >The great bulk of the work of the FDA is no longer to provide consumer
>>>> >protection but to
>>>> >provide a competition free shelter for the entrenched companies who
>>>> >produce materia medica.
>>>> >
>>>> >Even the Obots bumped up against an impediment with their own goofy
>>>> >regs in delivering the flu vaccine,
>>>> >and the government had to declare an emergency to bypass its own
>>>> >competition limiting rules.
>>>> >
>>>> >The insurance companies paid a lot of money to their lobbyists to get
>>>> >those exempting regulations passed.
>>>> >Practically No one in America seems to be serious about providing
>>>> >decent medical care at a reasonable price.
>>>> >
>>>> >
>>>> >
>>>> >
>>>> >On 12/3/2009 5:15 PM, Ricky Baldwin wrote:
>>>> >Um ... REMOVING their EXEMPTION from anti-trust laws is "getting the
>>>> >government out of the way"???
>>>> >>
>>>> >>This is a common misconception of how the famous "marketplace" (a
>>>> >>ridiculous name, anyway - as if Exxon and GM were just tables at
>>>> >>Lincoln Square). But this misconception is at the very heart of the
>>>> >>fog that keeps the economic emperors (clothes or not) in power. It
>>>> >>is the insidious myth that, but for the interference of "government",
>>>> >>free competition would keep businesses honest, efficient and
>>>> >>meritorious, even serving humanity, etc.
>>>> >>
>>>> >>In fact the reality, as long history shows repeatedly, is quite
>>>> >>different, and often opposite. Left to their own devices (or the
>>>> >>devices they can creatively acquire) profitable businesses engage in
>>>> >>ruthlessly destructive wars, the very least result of which is
>>>> >>anything resembling "efficiency" -- with the possible exception of
>>>> >>human needs (such as clean water, air, land, food, etc.) -- and very
>>>> >>quickly consolidate themselves horizontally and vertically into
>>>> >>monopolies that act as they please with the lives of the puny humans
>>>> >>trespassing on the surface of their planet.
>>>> >>
>>>> >>It is against this trend, as a block and tackle against gravity, that
>>>> >>the government enforces (when it does) anti-trust laws. But there
>>>> >>are always opponents, who stand or believe they stand to benefit from
>>>> >>monopolizing trends. There are others who believe this trend is so
>>>> >>powerful that anti-trust laws are by nature inefficient (working
>>>> >>against gravity), and the proper response of a people organized ought
>>>> >>to be not just to allow monopolies to form, but in fact to aid them,
>>>> >>with the eventual goal of then using the government to take them over
>>>> >>and run them in the community interest. This of course assumes
>>>> >>better government than we ... have ... have had ... in ... forever.
>>>> >>
>>>> >>(Even when opportunities arise, i.e., the bailouts, our government
>>>> >>smiles and announces that the problem was the biggest corporations
>>>> >>hadn't stolen enough yet, fast enough, so we'll just give it to
>>>> >>them - poor, little, inefficient thieves.)
>>>> >>
>>>> >>Others say - as in the case of the proposed merger between NBC and
>>>> >>Comcast - they are already too big; bust 'em up. They are given
>>>> >>permission (by us) to run these shell games, er, enterprises on our
>>>> >>land, our airwaves, using our waters and forests, etc., and we have
>>>> >>the right to set some parameters.
>>>> >>
>>>> >>But even proponents of this view often assume that competition is
>>>> >>inherently good. It isn't. It's often incredibly destructive and
>>>> >>wasteful, besides being inhumane. It leads sweatshops in New York
>>>> >>and Indonesia, slavery in Florida's fields and in the homes of the
>>>> >>well-to-do, the brothels of LA and Thailand, etc.
>>>> >>
>>>> >>On a more mundane level, it's competition that meant that when we
>>>> >>lived in Champaign on a certain morning of the week every week we had
>>>> >>to be awakened repeatedly starting at 2am by THIRTEEN garbage trucks
>>>> >>going up and down our street, each collecting a can here and there
>>>> >>and moving on. This uses several times the fuel, produces several
>>>> >>times the pollution, etc., as a city service - and as a result raises
>>>> >>the price to the "consumer" (funny term when you mean throwing away
>>>> >>trash, isn't it?). Examples of this type are nearly infinite. Yet
>>>> >>we persist in the belief that competition somehow helps us.
>>>> >>
>>>> >>But lest we (ok, I) digress too far, the issue here is health care.
>>>> >>Do these bozos deserve exemptions from anti-trust laws? Did Al
>>>> >>Capone? But the real answer to our health care woes is complex,
>>>> >>surely, but just as surely includes some form of universal plan that
>>>> >>covers everyone - single payer, national health, something. I don't
>>>> >>say its perfect in places like England and Canada - the people there
>>>> >>complain about it all the time - but when they hear about "our"
>>>> >>system, they react as if you just proposed cannibalism. That's how
>>>> >>barbaric it is.
>>>> >>
>>>> >>We'd all know it if we weren't scared stiff of the Jews, Commies,
>>>> >>atheists, gays and immigrants hiding under our beds and in our
>>>> >>bedroom closets.
>>>> >>
>>>> >>Ricky
>>>> >>
>>>> >>"Speak your mind even if your voice shakes." - Maggie Kuhn
>>>> >>
>>>> >>--- On Thu, 12/3/09, E. Wayne Johnson <ewj at pigs.ag> wrote:
>>>> >>
>>>> >>
>>>> >>>From: E. Wayne Johnson <ewj at pigs.ag>
>>>> >>>Subject: Re: [Peace-discuss] Fw: Insurance Companies Should Compete
>>>> >>>To: "Jenifer Cartwright" <jencart13 at yahoo.com>
>>>> >>>Cc: "Peace-discuss" <peace-discuss at lists.chambana.net>
>>>> >>>Date: Thursday, December 3, 2009, 3:42 PM
>>>> >>>
>>>> >>>
>>>> >>>Yes!
>>>> >>>
>>>> >>>Get government out of the way (by removing the nanny-state
>>>> >>>corporate-welfare protection)
>>>> >>>and let the Free Market Operate.
>>>> >>>
>>>> >>>Amen, Sister!
>>>> >>>
>>>> >>>"a free and fair marketplace. "
>>>> >>>
>>>> >>>That's the stuff!
>>>> >>>
>>>> >>>On 12/3/2009 3:25 PM, Jenifer Cartwright wrote:
>>>> >>>
>>>> >>>>
>>>> >>>>--- On Thu, 12/3/09, Patrick Leahy <info at leahyforvermont.com>
>>>> >>>>wrote:
>>>> >>>>
>>>> >>>>
>>>> >>>>>From: Patrick Leahy <info at leahyforvermont.com>
>>>> >>>>>Subject: Insurance Companies Should Compete
>>>> >>>>>To: "Jenifer Cartwright" <jencart13 at yahoo.com>
>>>> >>>>>Date: Thursday, December 3, 2009, 1:55 PM
>>>> >>>>>
>>>> >>>>>
>>>> >>>>>
>>>> >>>>>Dear Jenifer,
>>>> >>>>>On Tuesday, I took to the Senate floor and formally filed my
>>>> >>>>>amendment to repeal the antitrust exemption for health insurance
>>>> >>>>>companies.
>>>> >>>>>
>>>> >>>>>I look forward to debating this critical measure during our
>>>> >>>>>deliberations on the broader health care reform bill. After all,
>>>> >>>>>to bring insurance costs down, we've got to introduce more
>>>> >>>>>competition in the marketplace -- and my amendment will do just
>>>> >>>>>that.
>>>> >>>>>
>>>> >>>>>Already, nearly 40,000 members of our Leahy online community --
>>>> >>>>>including you -- have emailed their Senators urging support of
>>>> >>>>>this amendment, and 18 of my colleagues have now co-sponsored it.
>>>> >>>>>
>>>> >>>>>But we need more Senators to join us to get this critical
>>>> >>>>>amendment passed.
>>>> >>>>>
>>>> >>>>>Click here to invite your friends & family to forward an email to
>>>> >>>>>their Senators too -- and urge them to support our amendment to
>>>> >>>>>repeal the antitrust exemption for health insurance companies!
>>>> >>>>>
>>>> >>>>>Our amendment will introduce antitrust oversight to the health
>>>> >>>>>insurance industry, ruling out of bounds egregious
>>>> >>>>>anti-competitive conduct like price fixing that harms hard-working
>>>> >>>>>American families and raises costs. It's an outrageous loophole
>>>> >>>>>that must be closed.
>>>> >>>>>The health insurance industry should compete on a level playing
>>>> >>>>>field just like every other business in America, large and small,
>>>> >>>>>so that consumers know that the price they're being quoted is the
>>>> >>>>>product of a free and fair marketplace.
>>>> >>>>>That's why our amendment repealing the health insurance industry's
>>>> >>>>>antitrust exemption is so important -- but I need your help, right
>>>> >>>>>now, to get it passed.
>>>> >>>>>
>>>> >>>>>Click here to invite your friends & family to forward an email to
>>>> >>>>>their Senators too -- and urge them to support our amendment to
>>>> >>>>>repeal the antitrust exemption for health insurance companies!
>>>> >>>>>
>>>> >>>>>As we move forward with debate on the health care reform bill,
>>>> >>>>>much of our discussion will be about bringing costs down while
>>>> >>>>>expanding and improving insurance coverage.
>>>> >>>>>
>>>> >>>>>This amendment is a vital part of that effort, and we've got to do
>>>> >>>>>everything we can to get it passed. Please invite your friends &
>>>> >>>>>family to email their Senators now.
>>>> >>>>>
>>>> >>>>>Thanks so much for your help.
>>>> >>>>>
>>>> >>>>>Sincerely,
>>>> >>>>>
>>>> >>>>>Patrick Leahy
>>>> >>>>>U.S. Senator
>>>> >>>>>
>>>> >>>>>P.S. A vote on our amendment could come in a matter of days, so
>>>> >>>>>please take a few seconds, right now, to make your voice heard.
>>>> >>>>>Please invite your friends & family to email their Senators now.
>>>> >>>>>Visit LeahyForVermont.com
>>>> >>>>>
>>>> >>>>>
>>>> >>>>>Paid for by Leahy for U.S. Senator Committee, Inc.
>>>> >>>>>PO Box 1042
>>>> >>>>>Montpelier, VT 05601
>>>> >>>>>
>>>> >>>>>
>>>> ________________________________
>>>>
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>>>> >>>>>
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>>>> >>>>
>>>> >>>>
>>>> ________________________________
>>>>
>>>> >>>>_______________________________________________
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>>>> >>
>>>> >
>>>>
>>>>
>>>>
>>>>
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