Hacker News Reader

Comment by rdtsc | Hacker News Reader

Actually given healthcare's state either camp can raise an equally long list of complaints to blame the opposite camp.

Socialists can say for example, if healthcare is left up to the market then monopolies would rise, the quality would become abysmal, the primary goal of hospitals, doctors and insurance companies is now profit as opposed to keeping people healthy. They might claim government is not doing enough. There should be a single payer option or price control options etc etc.

Libertarians and those who like to extol the virtues of free markets and hate government intervention can blame all the brokenness on government bureaucracy and regulation. If only companies could just handle everything themselves it would all be very clear and easy, kind of like with car insurance. There would be competition etc etc.

See, one can defend either position. So it is not 100% clear cut and obvious which is which.

View on HN

I totally agree with this.

Similarly, Socialists can point to most European countries that get superior service for much less cost, while Capitalists (I lean this way) point to amazing efficiency innovations that happen in countries with less regulated systems like India's[0]

What's clear is that our system has somehow found a way to be the worst of both worlds, very expensive, bad service, not universal.

[0]http://online.wsj.com/article/SB125875892887958111.html

Of course, from experience living in India for several years, the problem with "less regulated systems like India's" is simply that aside from basic reactive healthcare of the sort you'd get from your GP, the poor do not have access to healthcare there. While even being able to see a GP when necessary is admittedly slightly better than the US's system, it's still not good enough, from the point of view of someone who can now take NHS Scotland for granted.

This is not a problem of regulation, but of general lack of money and/or agreement of social cost sharing.

And some other low cost services are offered to some of the poor in India like heart surgeries, artificial ankles, ambulances, eyeglasses, psychiatric services. With some money and growth they could theoretically be offered to everyone in India.

> With some money and growth they could theoretically be offered to everyone in India.

Do you have any proof that charity is close-to-infinitely scalable and dependable to a point that a society can reasonably depend on it for something as basic a need as healthcare?

Or is it that you think that funnelling Government money through a for-profit company to treat people will somehow reduce costs?

While it's great that India has managed to get surgeries down to the sub-$1000 mark in many cases, the fact of the matter is that the Indian poor literally live on about a dollar a day, if not less - for an entire family.

I didn't made any argument about public vs private healthcare FINANCING. I simple said they need more money.

And i said india is good at low cost healthcare DELIVERY.

Financing and delivery are seperate parts and shouldn't be mixed thogheter in such dicsuossions.

How much money, exactly? Healthcare's expensive; it costs time and money to train professionals and develop techniques and drugs, and there's no real measurable payout. Keeping people alive doesn't provide the sort of ROI that markets are interested in.

The situation in India is still such that the majority of people cannot afford any significant, additional outgoings in the case of medical emergency. You're therefore implicitly talking about a healthcare system that provides everything you're imagining at zero cost at the point of delivery, which means that the entire cost needs to be taken up elsewhere. In countries where this approach is actually taken, it requires considerable tax income and a relatively wealthy population to provide it, and India simply isn't anywhere near there yet.

Assuming you manage to get enough money into healthcare, what then? Solving that particular issue doesn't mean that the level of regulation will be automatically appropriate - it's regulation that determines where the money ends up, and whether you spend everything on extending the lives of those who can afford to pay you back, or broadly improve quality of life for everyone. There are still massive regulatory issues in the Indian system (particularly around safety standards), and the odd interesting advancement doesn't change that - nor is increased spending going to fix it. They're separate issues that need to be tackled in tandem.

>point to amazing efficiency innovations that happen in countries with less regulated systems like India's

Those "amazing efficiency innovations" though are not doing any good to the 95% of the population there, that die even in the streets.

I'd rather have less "efficiency innovations" and more universal health care.

Those amazing efficiency innovations are also not doing any good to the women who are raped and murdered or the girl children who are malnourished.

See the logical fallacy? The fact that India has many problems (GDP/capita < 1 lakh/year, rampant horrible sexism) doesn't mean their medical system isn't highly efficient.

India is hardly efficient - you can't charge a populace for something they can't afford. What India did do was not care about international patent law and cranked out generics at pretty much their production price.

Which yeah - is actually pretty damn capitalist.

Reply on news.ycombinator.com