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[Reelya]

26% infant mortality in 1960, 6.9% today. Your source GreatJustice.

Life expectancy increase from 69.7 to 77.8. An aging population get's a lot more expensive to treat, too. Cost of medical treatment by age is not linear, it's definitely exponential.

[Frumple]

Disturbingly, I think I can see the canned response to that. You'd have to compare mortality rates across nations in 1960 vs today.* If the states were ranked over ~50 back then, then there's been relative degradation. Which, going by this US was ranked somewhere around 14th (counted 13 with a lower number) back in 1960, as compared to around 49th in 2012 (Though there's some source conflict there; the latter's from the CIA numbers, the former from the UN). Or 34th in the '05-'10 period, if you're sticking to the UN stuff.

Of course, going by the ones that ranked above, it looks like the path that would have the best odds of decreasing infant mortality, at least, would be a stronger socialized medical system. Most of the ones above us are socialized to a greater degree than the states, from what I understand.

*E: Even that wouldn't quite be ideal, as things like demographics (urban/industrial vs rural/agricultural), and population and country size would factor in, but it's a decent enough heuristic, I guess.

[Reelya]

Let me head off greatjustice then "because America's infant mortality hasn't fallen as fast as socialized health countries, that's PROOF we need a libertarian health system".

[GoombaGeek]

Oh, that's what's going on!

Quick, I never learned what libertarians are. You have thirty seconds to say something unfavorable about them and influence my poor impressionable mind forever. (And while you're at it, what would a libertarian health care system be like?)

[Reelya]

A Libertarian health system wouldn't have any doctor licensing system at all. So anyone could open up shop and call yourself "doctor". This will improve accessibility for "doctors" and reduce costs. The mechanism that will control quality is that if too many of your patients die, then you won't get customers. So the "free market" will reward those doctors who aren't serial killers. But you'll be free to change your name and practice medicine in another town where nobody knows you as the "granny killer". You could also forge documents claiming you went to a prestigious medical school, since the law against that won't exist under libertarianism.

There will be no form of subsidies like medicare / medicaid. Everything would be up-front payment, private hospitals, or competing private health insurance. There will be no taxes, and no mandated savings for health care or retirement, because those oppress our self-determination to live in the moment.

Insurance providers would be free to write the contracts any way they like or exclude sick people from insurance altogether, or have clauses where they can more or less rewrite the rules any time they like, just like credit card issuers and cell phone providers can. Note that it would be part of a libertarian social system, so there would be no food, drug or product standards at all and selling faulty products, misleading advertising and misleading contracts would be entirely legal. If anything adverse happened to you or your family, friendly litigation would ensure justice.

But if something you buy kills you, it's not the sellers fault, it's you fault as soon as you take possession of the product, you know, since you freely gave your money to that person in a free and fair exchange, they're not liable if it explodes 5 seconds after purchase.

Also, drugs could be sold with false advertising without any clinical testing (in fact, they could legally lie and claim they tested it, because the law won't exist) and companies would not be held liable if you got sick or died, because those laws wouldn't exist anymore.

If anything happened to you from using any of these "free market" medical services, they would not be liable, because government enforcement would not exist. But you could take them to court to try and get some compensation.

[GoombaGeek]

Sounds fun!

It's got to be better than all the current systems!

EDIT: that was a joke you guys please come back

[Meansdarling]

lol So is that really what it would be like?

Sounds like the wild wild west.

[GreatJustice]

Let me head off greatjustice then "because America's infant mortality hasn't fallen as fast as socialized health countries, that's PROOF we need a libertarian health system".

Infant mortality is measured differently in the US compared to in other countries. Apples and oranges.

At any rate, I'd say "infant mortality was higher" would fall under common sense; of course it was higher, medical technology in 1960 was vastly inferior to where it is today. See, that's a problem with measuring healthcare systems across fifty years.

However, it is pretty clear that the increase in the cost of American healthcare isn't proportionate the increase in quality.

A Libertarian health system wouldn't have any doctor licensing system at all. So anyone could open up shop and call yourself "doctor". This will improve accessibility for "doctors" and reduce costs. The mechanism that will control quality is that if too many of your patients die, then you won't get customers. So the "free market" will reward those doctors who aren't serial killers. But you'll be free to change your name and practice medicine in another town where nobody knows you as the "granny killer". You could also forge documents claiming you went to a prestigious medical school, since the law against that won't exist under libertarianism.

Any could call themselves "doctor", just like anyone can call themselves King. They couldn't claim to have gone to a prestigious medical school, since that would constitute fraud, which would be coercive and thus a crime. Ratings agencies similar to the Canadian Standards Association and Underwriter Laboratories would crop up, though many exist in a limited form already. 

There will be no form of subsidies like medicare / medicaid. Everything would be up-front payment, private hospitals, or competing private health insurance. There will be no taxes, and no mandated savings for health care or retirement, because those oppress our self-determination to live in the moment.

Costs would be forced to remain low so as to remain competitive, and the poor would be able to receive care through charity hospitals or mutual aid associations. People would not be forced by the government to pay for a "retirement plan" that pays substantially less than one could get by putting it in a decent hedge fund and has its payout dates changed arbitrarily so that those who enter the system later get paid less than what they put in.

Insurance providers would be free to write the contracts any way they like or exclude sick people from insurance altogether, or have clauses where they can more or less rewrite the rules any time they like, just like credit card issuers and cell phone providers can. Note that it would be part of a libertarian social system, so there would be no food, drug or product standards at all and selling faulty products, misleading advertising and misleading contracts would be entirely legal. If anything adverse happened to you or your family, friendly litigation would ensure justice.

Insurance providers would only be present for the worst of unforeseen situations. Since they would not be forced by states to cover certain things, they would offer far higher payouts for these unexpected circumstances, would have far lower premiums, and would be far more flexible regarding pre-existing conditions (which would now prevent you from getting insurance for that specific condition, but not unrelated problems). They would also have to remain flexible to keep up with competition, which would be far greater when things such as mutual aid and new companies came into the picture. Food and drugs would be regulated the same way appliances are, with competing certification agencies in turn backed up by third parties such as insurance companies. Huge pharmaceutical companies would not be favoured as under the present system, so innovation would increase and cronyism would be reduced.

But if something you buy kills you, it's not the sellers fault, it's you fault as soon as you take possession of the product, you know, since you freely gave your money to that person in a free and fair exchange, they're not liable if it explodes 5 seconds after purchase.

If someone sells you something that has adverse affects without warning, they would be sued, again, for fraud. If someone sells you something and warns you of a certain percentage chance of causing Problem X and Problem X arises, then they would not be sued as you knowingly made the decision.

However, if you were dying of a horrible disease and only Medication X could help you, the government would not actively prevent you from buying Medication X because it has a tiny chance of causing an unpleasant side effect. It would be the decision of the patient rather than a bureaucrat in the FDA.

Also, drugs could be sold with false advertising without any clinical testing (in fact, they could legally lie and claim they tested it, because the law won't exist) and companies would not be held liable if you got sick or died, because those laws wouldn't exist anymore.

See above. Clinical testing would likely be common via third party licensing agencies, not to mention insurance companies (since you wouldn't want to have to make constant payouts because your clients are taking dangerous drugs that you haven't stipulated aren't covered). If you got sick or died, the pharmaceutical company would be held responsible to the victims, not a government agency that would fine them an arbitrary amount. People would not be exposed to the moral hazard of relying on a single source that they assume is always correct compared to multiple reliable sources that they would double check.

If anything happened to you from using any of these "free market" medical services, they would not be liable, because government enforcement would not exist. But you could take them to court to try and get some compensation.

See above, again.

[Reelya]

The real question greatjustice, is that you want to go back to the health system of 1960, i pointed out that infant mortality fell from 29% to 6.9% in America. Apples and apples. Or are you going to claim that how infant mortality is measured has changed in America?

You made a big deal about increasing health costs since 1960 being a bad thing, but are you going to ignore improvements in treatment which correlate with those increased costs? Remember i cited the change in infant mortality from the same source you brought to the table.

[Leafsnail]

]

Which? The 1960 healthcare costs?

Allow me to re-source everything from the very first time I brought this up:

Sources of healthcare spending (Proving my "largely paid for out of pocket conjecture"):

Spoiler (click to show/hide)

Costs of American healthcare in 1960, adjusted for inflation (Proving the "affordable conjecture"):

Spoiler (click to show/hide)

http://www.clearpictureonline.com/1960-US%20State%20Health.html

Mutual Aid Associations (indirect and takes a bit of work to sift through) (Proving the "MAA's generally received high quality healthcare alongside low costs through discernment conjecture"):

Spoiler (click to show/hide)

http://www.amazon.com/Immigrant-Associations-American-Identity-1880-1939/dp/0674444175

(NOTE: Other sources, less direct but more specific, can be provided on request)

That covers... most of the things that aren't easily found with a google search or common sense.

Remember when you made literally this EXACT same argument and I demonstrated that the socialist hellhole of the UK had both a cheaper and better healthcare system in the 1960s (amongst other refutations of your argument)?  Good times.

I already know you're going to argue that 1960s America wasn't a TRUE libertarian paradise now and that three selective facts about the UK shows that our healthcare system is actually the more libertarian somehow.

Costs were lower back then because dead people are cheaper than living people.  But other countries with clearly more socialized systems had it cheaper than the US even back then.

[ChairmanPoo]

It's a well known fact that socialized healthcare systems are more efficient than social-security arrangements, and light years beyond private insurance systems.

[MetalSlimeHunt]

Technically speaking, social security is partially a subset of socialized healthcare. It's just indirect.

[Frumple]

Let me head off greatjustice then "because America's infant mortality hasn't fallen as fast as socialized health countries, that's PROOF we need a libertarian health system".

Infant mortality is measured differently in the US compared to in other countries. Apples and oranges.

Yeah... if you had kept following the links in that thing, you would have ran into the notice that difference in reporting methods was ultimately found to not substantially explain the difference in rates between the states and elsewhere (coming from an '09 report, at least a year after what the blog posts were referencing.). As well, the reporting methods have standardized within WHO reporting countries, with five or six (Out of nearly two hundred) exceptions. So they're actually comparing apples and apples these days. That blog post was referring to another blog post that was referring to an unreferenced piece by a (singular) doctor done about four years ago. A little sketchy without some sources to back it up, and I wasn't able to actually find where they were getting the numbers from.

[Reelya]

If you look at citations, it's clear many other countries are every bit as inclusive of live births as America. There are some that exclude certain cases, but not all.

http://en.wikipedia.org/wiki/Infant_mortality#Comparing_infant_mortality_rates

The World Health Organization (WHO) defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. Many countries, however, including certain European states and Japan, only count as live births cases where an infant breathes at birth, which makes their reported IMR numbers somewhat lower and raises their rates of perinatal mortality.

Many countries, including the United States, Sweden and Germany, count an infant exhibiting any sign of life as alive, no matter the month of gestation or the size, but according to United States Centers for Disease Control (CDC) researchers, some other countries differ in these practices. All of the countries named adopted the WHO definitions in the late 1980s or early 1990s, which are used throughout the European Union. However, in 2009, the US CDC issued a report that stated that the American rates of infant mortality were affected by the United States' high rates of premature babies compared to European countries. It also outlined the differences in reporting requirements between the United States and Europe, noting that France, the Czech Republic, Ireland, the Netherlands, and Poland do not report all live births of babies under 500 g and/or 22 weeks of gestation.

Why does America have a "high rates of premature babies" according to the CDC? That isn't just a difference in reporting rates, it's a acknowledgement of having more actual premature babies. It could be due to obesity. Obese mothers are not good for baby.

And they noted that a grand total of 5 European countries used the 500 g / 22 weeks definition. The rest use the WHO definition. Sweden has half the infant mortality of the USA, and just as stringent reporting.

[Reelya]

The CDC report itself: http://www.cdc.gov/nchs/data/databriefs/db23.htm

All live births: Austria, Denmark, England and Wales, Finland, Germany, Hungary, Italy, Northern Ireland, Portugal, Scotland, Slovak Republic, Spain, Sweden, United States

Live births at 12 weeks of gestation or more: Norway

Live births at 500 grams birthweight or more, and less than 500 grams if the infant survives for 24 hours: Czech Republic

Live births at 22 weeks of gestation or more, or 500 grams birthweight or more: France

All live births for civil registration, births at 500  grams birthweight or more for the national perinatal register: Ireland

Live births at 22 weeks of gestation or more, 500 grams birthweight or more if gestational age is unknown: Netherlands

Live births at 500 or more grams birthweight:Poland

As can be seen, plenty of countries have the same criteria as the United States, and still have far lower infant mortality. Sweden and Finland stand out as world leaders on infant mortality, which catergorically DO NOT discount low-weight or premature births. Norway isn't far behind and "12 weeks" is pretty inclusive of viable births. The only country in the "all live births" category on this list which scores lower than USA is Slovak Republic.