Does the Typical Person Spare No Costs to Save His or Her Life?

by Don Boudreaux on November 2, 2009

in Health, Myths and Fallacies

Here’s a letter that I sent back on June 17th to WWL radio (870 on your AM dial in the NOLA area):

A listener called in today during the one o’clock hour to assert that “health care isn’t like other services” – and so it can’t be supplied reliably on the market because people are willing to “incur any cost to save their lives.”

First, if this assertion is true, it’s unclear how matters would be improved by socializing the payment of medical expenses.  Second, everyday experience shows that this assertion, in fact, is false.  If people really are desperate to save their lives at all costs, then everyone would exercise regularly, eat only healthy foods, and completely avoid rock climbing, horseback riding, snow skiing, and tanning booths.  No one would smoke, drink to excess, or have unsafe sex. Women would never get pregnant, as there’s still some positive chance of dying while giving birth.

Unless and until people stop behaving in ways that reduce their life-expectancies, it’s mistaken to believe that each of us is committed to living longer at all costs.

Sincerely,
Donald J. Boudreaux

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Anonymous November 2, 2009 at 3:11 pm

I made this exact same point to my wife – talking about exploding health expenditures actually, and I told her it would be crazy for her to waste a fortune on a treatment that might save my life, particularly if my life was at risk when I was older.

Needless to say, that didn’t go over so well. I was flattered, but it made me realize most people don’t think like economists. If she were actually put in that situation (God forbid), though, I’d agree with you – she’d probably be more realistic about what’s feasible and what’s not. And if it’s feasible for God’s sake get me the treatment!!!! :)

Anonymous November 2, 2009 at 3:37 pm

Right. These treatments are really expensive and they usually don’t “save” lives; they simply delay death for a few months. The elderly patient with a critical disease doesn’t jump up and start doing a jig after receiving million-dollar treatments.

Anonymous November 2, 2009 at 4:20 pm

I was flattered, but it made me realize that most people don’t think like economists. – Daniel

I think Daniel hit the nail on the head — seeming to ignore the costs is about signaling that you care.

Anonymous November 2, 2009 at 4:27 pm

Exactly. And I don’t even know if it’s a conscious signaling. They probably honestly think they will “do anything”. Caught in a different sort of situation that didn’t involve monetary costs, I would probably make the same mistake talking to her. That’s natural – but it doesn’t make it accurate.

Really, it’s the people who DON’T ignore all the costs that are the weird, unnatural ones. Rationality is a trait that has evolved much more recently than blind emotional devotion :)

Anonymous November 2, 2009 at 5:15 pm

Exactly. And I don’t even know if it’s a conscious signaling. They probably honestly think they will “do anything”.

Human beings try to signal their altruism, trustworthiness, and value as a trade partner; they wish to establish mutually beneficial social relations. But they are competing against other human beings; consequently, they need to “sell themselves” as though in a job interview. Thus exaggeration becomes the norm, and the more human beings believe their own exaggerated signals the more convincing those signals become. In other words, self-deception becomes a evolutionary strategy.

Anonymous November 2, 2009 at 8:09 pm

This over-exaggeration signaling is bankrupting the United States. Thus leading to an evolutionary dead end.

Anonymous November 3, 2009 at 4:10 am

There are a handful of signalers that comment on this very blog. But do they spend their own money (or provide their own resources)? There’s a physician that many of us know and loathe…do you suppose that he dedicates a portion of his own time to provide no-cost-to-patient care for those that cannot afford his normal going rates? Would we even get a straight answer to the question; signaling always being in effect with the loudest of altruists?

Anonymous November 2, 2009 at 8:10 pm

DK said:

Really, it’s the people who DON’T ignore all the costs that are the weird, unnatural ones. Rationality is a trait that has evolved much more recently than blind emotional devotion :)

Then count me as weird and abnormal that I don’t let my emotions rule me.

Anonymous November 2, 2009 at 3:43 pm

We all have to die of something, I’d just prefer that I don’t die from excess government.

Randy November 2, 2009 at 4:23 pm

Well put.

James November 2, 2009 at 3:57 pm

I think the stronger argument is that anyone inherits anything from anyone. If, as described, people attempt to eek out every last minute of life no matter the cost, every person on the planet would die broke.

Underwriterguy November 2, 2009 at 4:24 pm

Perhaps you missed the point: people will “incur any cost” (but of other people’s money) to prolong life. Living a healthy life is the equivalent of spending one’s own money and therefore less popular.

Methinks November 2, 2009 at 4:57 pm

well said!

anon November 2, 2009 at 4:46 pm

Prof. Boudreaux,

Actually, the listener might have a point, but not the one she intends to make. If s/he meant that people are willing to spend any amount someone else’s money to save their own lives…then she would be correct.

When one spends someone else’s money for their own benefit, that person is usually concerned with maximizing benefit without regard to cost.

I would see this as a very strong argument against socializing the payment of medical expenses.

Larry November 2, 2009 at 5:17 pm

The initial premise is wrong on the face of it.
Hardly a day goes by when we here don’t hear fo people who have said “No more. The treatments are more debilitating than the disease is. Let me me go in peace and comfort.”

There are lots of people who believe that death is not the worst thing that can happen to them.

Lots of people have issued durable powers of attorney with specific instructions that give lie to the initial premise.

And add to the lower list–nobody would ever live more than a minute from an ER. But there are lots of people who live in the Yukon that is fundamentally unreacheable.

Seth November 2, 2009 at 5:27 pm

To borrow a phrase from Mike Munger, this idea violates our “moral intuition”. I found that out when I tried to tell my brother that when he downsized his vehicle from an SUV to sedan to “help the environment and save on gas,” that he instinctively evaluated the trade-offs, which included safety, and chose what he thought was best. He was adamant that he didn’t trade-off safety, in fact he would never do that, even though I was able to produce stats that showed that his new vehicle had a higher mortality rate in accidents than his old vehicle.

Anonymous November 2, 2009 at 5:58 pm

Does he have kids? Amazing how some people are willing to gamble with OTHER people’s lives for their leftist ideology.

Gil November 3, 2009 at 2:07 am

Gee do some people think driving down the street amount bumper car action? No sensible driver should be crashing into anyone or anything! Besides he probably safer as SUVs like to roll over.

Anonymous November 2, 2009 at 5:35 pm

Personally my experience and observations tell me that many elderly are kept alive long after they are ready to go, long after they long to be released, and primarily because the American people have been indoctrinated to believe that they have to keep poor mom, pop, gramps, alive as long as medically possible because otherwise they will be known as cruel and heartless kids. So we exhaust enormous amounts of money and quite frequently other people’s money since such assisted life maintenance is government funded, all to keep some one chained to a non-life because we can’t be brave and let them go as they want.

And, I don’t think this “keep ‘em alive at all costs for as long as possible” is religion driven. I think it is society driven.

My father-in-law, not a paticularly religious man, in the deep throes of altzheimers, in a rare brief moment of lucid awareness told my wife on one of her visits that Jesus came for him, was standing there by the fireplace in the community room, and the staff wouldn’t let him go. He did this with tears in his eyes, he wanted to go. Even if my wife and her sister, the only two children he had, told the staff to cease feeding him and to allow him to slip away…..who would have obeyed? What place wouldn’t have said no, and done so in fear of government persecution even above my wife and her sister’s wishes and instructions formed by knowing what their Dad truly wanted.

We humans can be severely inhuman sometimes. I have other anecdotes from a time previous to my meeting my wife that also help me form mu opinion, evidence of what I term sheer inhumanity to those whom we express love.

Anonymous November 2, 2009 at 5:58 pm

Even though that attitude has now permeated all society, it’s root is in Christianity. That is the evil that must be expunged.

Anonymous November 2, 2009 at 10:30 pm

I am not sure about that, Arrowsmith, I see a broader mix in that pie. I have been around on this ball of dirt for awhile and most of those early years were definitely Bible Belt, blue nose, blue law, living; but that living came before people farmed out their old ones to nursing homes, assisted living homes, and Hospices. They kept them home and nourished them as they could until those older folks died. Yes, it was a burden but that’s what went down.

Social security, medicare, medicade, and insurance changed all that. So, I can’t lay it off on Christianity so easily. Christianity is in the mix, but I think a minor element. We did not see the proliferation of said care homes until well until into the late 1960s. Now there is one on every corner it seems.

It is big business, and big business can buy influential congress critters. I work regularly with lawyers that feed just off “nursing home abuse” and are stinking rich from it. Big money in it, that is the evil that I see that should be expunged.

Anonymous November 2, 2009 at 11:04 pm

Whatever the root cause, the fact is that 90% of the people refuse to think about end-of-life issues AT ALL, much less logically.

Anonymous November 3, 2009 at 12:50 am

True

Anonymous November 2, 2009 at 8:10 pm

Likewise if the assertion that market based health care was so much better and effecient it certainly would exist somewhere in the world… it doesn’t.

Socialized medicine is the rule and where it exist cost are down and longevity up. And because people do value their lives and money we should not experiment with a free market system that has little chance of success as defined by the average person.

Anonymous November 2, 2009 at 8:52 pm

Market based healthcare does exist. In India for example, insurance companies are not involved in many of the medical procedures. We basically pay the doctor or the hospital for the treatment or procedure as the case may be. It works fine. In the US too, if true market based healthcare would be implemented, everything would become market adjusted, and all costs would come down, including medical college tuitions, and doctors’ salaries. The AMA would never allow this, I agree, but the answer is not socialized medicine.

Anonymous November 2, 2009 at 11:08 pm

How much does a kidney transplant go for? Including the preceding hemodialysis and the immunosupressives afterwwards.

MWG November 2, 2009 at 11:19 pm

It’s far more expensive than it would be if the governments lifted the ban on the sale of organs.

http://reason.tv/video/show/organ-transplants

Anonymous November 3, 2009 at 12:29 am

If you consider the actual monetary bill that the hospital would charge you, the cost in India would be around one tenth of that in the US. Of course, there aren’t as many good hospitals there as there are in the US. But here, the poorly insured or the not insured are screwed as they are charged an inflated medical cost as opposed to the actual market price. What I would really attack though is not big surgeries, it is actually small check-ups and simple care that the patient in India pays out of his pocket for, but the patient in the US pulls out an insurance card for. A simple visit to the doctor for basic symptoms like cough, sneezing and fever etc would result in a visit cost of Rs 50 and a pharmacy bill of Rs 100, which comes out to $3! (roughly)

Anonymous November 3, 2009 at 2:18 am

So in other words a poor person in India doesn’t get a kidney transplant because even if it’s 1/10 the cost here 1/10th of a million is more then most poor and lower middle class people can afford. So do they just die in India? Well here they get a transplant because we have medicaid.

Anonymous November 2, 2009 at 8:59 pm

Can one of you free market health care proponant please explain to me just what the hell you are thinking?

Let’s assume you have a free market system, you are healthy and have an insurance plan. Then lets say you suddenly come down with a rare form of cancer. Why do you think an insurance company is going to keep you on their plan or not jack up your rates just like auto insurance companies do after one accident? Or maybe then they’ll drop you and you’ll be left trying to find coverage when no one in their right economic mind would cover you.

What do you think the cost of insurance will be for a senior over 65 much less one with pre-existing conditions?

I really have no idea how you think this will work out for you. You could eat all the fruits and vegetables you want then some random disease or accident could bankrupt your family and there’d be no one willing to treat your expensive condition.

Anonymous November 2, 2009 at 9:15 pm

I’ve got news for you muirdog, end of life treatment is the first thing to go under single-payer. But keep up the delusion that your magical fairy socialist wand will give you everything you want.

Anonymous November 2, 2009 at 10:54 pm

You didn’t answer the question did you.

Anonymous November 2, 2009 at 10:22 pm

muirchihuahua,

If you come down with a rare form of cancer, will you expect a rare form of treatment? What are the rare forms of treatment for rare forms of cancer?

I know people who have had rare forms of cancer and only had the ole standard chemotherapy offered by any facility any where, at any time. As a matter of fact government actively prevented any facility to offer any treatment other than the standard chemotherapy.

The only good thing about it was their insurance company did not drop them or raise rates, they just paid for the chemo which did nothing and the people died any way.

You socialist are the only the people in the world that pollute the soup in the pot by peeing in it and then using the taste of that pot to declare as proof that there is no such thing as good soup.

In short, you fuck up life with your stupidity and then use the fact that life is now fucked up to declare that life was never good in the first place because if life was good then you wouldn’t have been able to fuck life up. Then you strut away in wonderment at your own brilliance.

The remarkable thing is that I have never met or read a socialist that had any better grasp on reality than you, and that says a lot about how collective stupidity works.

Anonymous November 2, 2009 at 11:06 pm

vidyohs,

You must be a miserable person having to live in this sociallst collectivist country. But I guess having government provided pension and health care takes a little of the sting off for you… since you’re able to ignore the contradiction of your life and your faith.

Vidyohs don’t you understand in your world you’d be nothing more then a Cratchit or a Twist or a Pip or a Weller…with no government pension to fall back on. THEN you’d have something to bitch about.

louh November 2, 2009 at 11:12 pm

Very well said, and of course absolutely true.

MWG November 2, 2009 at 11:18 pm

“What do you think the cost of insurance will be for a senior over 65 much less one with pre-existing conditions?”

It’ll be much more expensive than it would be for a 30 yr. old with no PE conditions. What’s your point?

Old people should naturally have to pay more as they’re the ones who cost the most. They’re also the ones with the most disposable income and can therefore more easily afford it. The younger part of the population (If they’re smart) will factor in the greater cost of healthcare as they save for retirement.

That’s a basic answer. To someone like you I’d say that all of us agree that the healthcare “system” (whatever that means) in the US is extremely flawed. Why is it tied to employment? Why does my insurance need to cover things like acupuncture if I don’t need/want it to? Why can’t I by insurance from NY if I’m living in CA? The answer? Government. Your solution? MORE government. You’re an idiot.

Anonymous November 3, 2009 at 2:27 am

You didn’t answer the question did you… well you did answer it for older people… they just get to die or go broke in most cases because they won’t have the savings for such illnesses.

But what about the 25 year old who comes down with AML (leukemia). They just die ?? You haven’t thought this through have you?

Bring back Poor Farms and Debtor Prisons right?

What a brutal miserable land of gentry your world would be. But it seems simple so you glom onto it… because you like simple.

Do you watch Scrooge and think it has a sad ending? Do you watch It’s a Wonderful Life and find yourself rooting for Potter?

MWG November 3, 2009 at 3:22 am

So your answer to those poor souls who happen to be unlucky in life is to force EVERYBODY into govt. controlled healthcare. That’s like burning down a house because of fruit flies in the kitchen. You’re an idiot.

Oh, and I have a brother who is disabled and I know full well the ramifications of that, so you might want to think about that before you try and label me an insensitive bastard you moron.

Anonymous November 3, 2009 at 7:16 am

“So your answer to those poor souls who happen to be unlucky in life is to force EVERYBODY into govt. controlled healthcare.”

MWG

OK that does it…YOU forced me to go Hayek on your ass…

“”Nor is there any reason why the state should not assist the individuals in providing for the common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance- where, in short, we deal with genuinely insurable risks- the case for the state’s helping to organize a comprehensive system of social insurance is very strong.”

F.A. Hayek

There he is. F. frickin A. Hayek explaining to you why I’m NOT the idiot. There’s nothing left for you to say.

RL November 2, 2009 at 11:28 pm

Why do I think the insurance company will cover the cancer? Same reason I think the fire insurance company will pay up after my house burns down?

Anonymous November 3, 2009 at 2:33 am

You might want to do a little research into how often insurance companies are able to weasel out of claims for all sorts of reasons.

Just google fire insurance claim not paid… and take of your rose colored glasses first.

Anonymous November 2, 2009 at 11:36 pm

Muppet wrote-

“Can one of you free market health care proponents* please explain to me just what the hell you are thinking?”

*edited for spelling and grammar

Do you read the posts? Do you read the comments?

Carl Pham November 2, 2009 at 11:55 pm

Why do you think an insurance company is going to keep you on their plan or not jack up your rates just like auto insurance companies do after one accident?

Because, you idiot, they will have a contract with you, and you, having recovered from your idiocy in time and evaluated your own interests objectively, will have insisted on a contract in which (1) they can’t raise their rates if you get sick, and (2) they can’t drop you from the policy if you continue to pay the premiums.

Geez, don’t you even watch the TV? I just saw a half dozen ads for individual health insurance in which a key selling point was a guaranteed no rate increase. This is also a routine selling point in life insurance, that your rate is locked in for a period of time, often for the entire 10 to 20 year term of the policy.

Of course, the insurance company prices the risk of your “rare form of cancer” into the fixed rate they’re willing to offer you. Luckily, since it’s a rare form of cancer, that doesn’t increase the premium by much.

But it might increase it more than you think is worthwhile, if you know (or think you know) you might not get that “rare form of cancer.” Maybe it’s breast cancer, and you’re male, and breast cancer in men is quite rare indeed. So you might choose to buy a policy which does not guarantee no rate changes. It will, of course, be cheaper up front, but now you run the risk instead of the insurance company of the rare form of cancer ruining the game plan.

Are you unable to mentally cope with the same situation that happens in mortgage lending? You can take out a fixed rate mortgage, where the bank runs the risk of inflation (that destroys the value of their loan), or you can take out a variable rate, where you run the risk of inflation (that jacks up your mortgage payment to where you can’t pay it). If you ask for a fixed rate, the rate will be higher because the bank is assuming the risk. But you have the choice. The bank will make either deal, because they can make money either way.

In the same way, a health insurance company is perfectly willing to make you a deal where your premium never changes and they don’t drop you as long as you pay the premium, as long as you’re willing to pay the extra premium this costs over a policy in which they can change the rate, or drop you, if you become unexpectedly expensive. They don’t care. They can make money either way.

What is impossible is the fantasy land where the insurance company charges you a fixed rate that is only good for permanently healthy people, i.e. which does not price in the risk of you’re becoming quite sick. That way lies bankruptcy. And you can’t fix the problem by making the Federal government into your insurance company. You can’t get something for nothing, and if a private insurance company can’t break even on a deal, neither can the government.

Anonymous November 3, 2009 at 12:35 am

well said…you kinda articulated everything I was thinking…muirgeo deserves his turn to speak…and we should not snub him for it…just cogently rebut his points like you did just now.

Anonymous November 3, 2009 at 1:10 am

Sir, you must be new here on the Cafe. You do not cogently rebut the non-cogent. You do not rationally discuss with the irrational. You do not debate the intellectually incapable. You do not overcome the socialist tape deck, muirduck, whose total input consists of pushing play on his socialist recordings of scripture, then rewind, then play, then rewind, then play, with presentation of fact or truth. Muirduck is incapable of anything but repetition of his socialist scripture, which he will happily defend unto your bankruptcy.

In short sir, muirduck-muirhuahua-muiridiot-muirfreak, is simply a waste of time and good for nothing more than the typical village idiot, an occasional laugh.

Anonymous November 3, 2009 at 2:43 am

“Sir, you must be new here on the Cafe. You do not cogently rebut the non-cogent. You do not rationally discuss with the irrational.”

vidyohs

Yes and let me introduce you to Mr vidyohs. He is an anarchist who just happens to have full government provided health insurance, a government pension and cheap food which tax payers subsidize.

That’s why we call him “MinArchMan…with a government pension”.

Anonymous November 3, 2009 at 5:00 am

I understand what you mean, but it does take some guts for a person with such leftist leanings to comment on a clearly libertarian blog. I guess I respect that a little. I do disagree with him on almost everything though.

Anonymous November 3, 2009 at 2:01 am

They can make money either way.

They can also lose money either way. The problem with this business model is that insurance companies will over-promise coverage to young, healthy premium payers and then go bankrupt when their policy holders are older.

Individual factors within an insurance company can benefit from this model, so they will. They won’t commit “fraud”, technically, because they’ll believe the promises they make as they make them. People believe all sorts of incredible things. The evidence is overwhelming, especially on Sundays.

You might expect the over-promising model to become untenable eventually, but it doesn’t. Ponzi schemes appear over and over again, and great or not, God certainly is not dead.

Anonymous November 3, 2009 at 2:39 am

OK then without looking;

Can your current health insurance recind your policy? Can they drop you after you get a new diagnosis? What is the yearly maximal coverage for your plan? Are you covered for a lung transplant in case of the diagnosis of pulmonary fibrosis? How about peripheral T-cell lymphoma ?

Anonymous November 3, 2009 at 5:19 am

Sigh. Again, your ignorance is simply astounding. Insurance covers risks you can’t predict. It does so at a certain price. Sometimes that price is lowered by not providing for unlimited spending. Isn’t that obvious to all thinking people? Is that not obvious to you? But ahhhh, I repeat myself.

Anonymous November 3, 2009 at 7:15 am

Russ answer the questions as they pertain to your policy. Do you now the answers? I hope so because if not you may have your ass exposed far more than you realize.

“A recent study found that 62 percent of all bankruptcies filed in 2007 were linked to medical expenses. Of those who filed for bankruptcy, nearly 80 percent had health insurance.”

http://www.nchc.org/facts/cost.shtml

Himmelstein, D, E., et al, “Medical Bankruptcy in the United States, 2007: Results of a National Study, American Journal of Medicine, May 2009.

Anonymous November 3, 2009 at 12:28 am

“What do you think the cost of insurance will be for a senior over 65 much less one with pre-existing conditions?”

Home insurance companies don’t “insure” houses in zones guaranteed to flood, either. Duh. If you weren’t a liberal and you actually believed in paying for these costs, you’d get together with your wealthy collectivist friends and devise ways to help people. This will never happen, because liberals give so much less to charity than non-liberals and because you don’t want to help people, but to find new and exciting ways to force people you don’t like to pay for your ill-considered schemes. I mean, come on! Insurance is a way to pool risk, not a way to transfer funds from current premium payers to new people who you’ve already described as guaranteed to need a bunch of free money!

Anonymous November 3, 2009 at 2:47 am

“What do you think the cost of insurance will be for a senior over 65 much less one with pre-existing conditions?” muirgeo

“Home insurance companies don’t “insure” houses in zones guaranteed to flood, either. Duh.”
JB

And this is pertinant to the discussion why??? Are you trying to say that if you get kidney failure just like when you have a house that can’t be insured you move to a new place and that will solve the problem? Is that the point you’re trying top make? Do you think that made sense?
Oh wait maybe you meant that people who turn 65 can avoid high costt premiiums by avoiding tirning 65 … brilliant Watson!! That’s real helpful…problem solved.

Anonymous November 3, 2009 at 7:28 pm

“And this is pertinant to the discussion why???”

It’s pertinent because you have problems keeping the basic facts straight and are unable to apply simple models of behavior to a given situation. If one sets up a system where a person can avoid contributing to an insurance pool when it’s believed he’s healthy, but can buy access to that pool of money for almost nothing when he’s sick, then the pool will shrink to nothing. When you ask a ridiculous question with an obvious answer, it makes one think that arguing with you is pointless.

If you wanted to guarantee a certain level of service to this type of patient regardless of whether he’d bothered to pay premia, then you could band together with all of the rich liberals. Charity hospitals used to be much more common in this country, but atheistic liberals couldn’t allow the provision of free care via religious groups. Not Marxist enough. You and your ilk HATE solutions to problems which don’t involve guns. You have to ram your nonsense down the collective throats of the producers, the volunteers, and the freedom-lovers.

Anonymous November 3, 2009 at 5:25 am

The insurance company is going to keep me on their plan because if they don’t, they’ll be in violation of their contract and I’ll sue their sorry asses into the ground (again, a result which is specified by the contract). Or else it won’t because the contract doesn’t cover that rare form of cancer.

Let’s assume you have a government health care plan and suddenly come down with a rare form of cancer. The government decides that it can’t afford to cover your treatment. You die.

At least in a free market health care system costs will be lower so there’s a chance you can buy the treatment. When the government buys all health care, entrepreneurs (who are the ones who create new forms of cheaper health care) go away in search of more profitable fields. When the government buys all health care, the only kinds provided are the kinds the government chooses to buy.

The problem, muirgeo, is that you assume that because you are a smart person, that OF COURSE your choice of government program will be run by people like you. More likely it’s going to be run by the same people who beat you up in high school.

Anonymous November 3, 2009 at 5:50 am

Can one of you free market health care proponant please explain to me just what the hell you are thinking? – Yasafi

No.

There is no amount of explaining, no magic formula for teaching, and no amount of patience great enough to penetrate the fog that passes for your brain.

You barely have the intellectual capacity to understand that one-plus-one-equals-two, and rarely understand the difference between, to, too, and two, and have never figured out that, then, and than are not interchangeable words.

So, no. There is no one here who can explain our thoughts to you, because you are incapable of comprehending anything beyond, See Spot Run

Anonymous November 3, 2009 at 7:27 am

Sure one plus one equals too and to is more then one but than again it takes one two know one. So what’s your point?

Anonymous November 3, 2009 at 8:18 am

My point is that, Sure one plus one equals too and to is more then one but than again it takes one two know one, is the most coherent sentence you’ve ever written.

louh November 2, 2009 at 11:08 pm

Absolutely, what people expect is to live a profligate life, and when the shit hits the fan have someone else pick up the tab. It’s the perfect prisoners dilemma.

Anonymous November 3, 2009 at 12:51 am

“Actually, the listener might have a point, but not the one she intends to make. If s/he meant that people are willing to spend any amount someone else’s money to save their own lives…then she would be correct.”

No, that is not correct, either. I’ve been around enough dying persons to know that very few of them want the hospital and the health care team to pull out all the stops and give them every bit of care possible to save their lives. Because the costs aren’t just monetary. With present medical technology, saving an almost doomed life requires intensive care: intubation, catheterization, central lines, IV lines, constant monitoring, no privacy, a noisy room, drugs with uncomfortable side effects, drugs that alter mental status, etc. Subjecting a debilitated person to another week (or two or three) of this will put him through hell, physically and psychologically. And, because we cannot guarantee success despite the massive effort, many patients would go through this and still die. That’s why most patients choose to accept the standard of care and its somewhat higher risk of death.

Note, however, that some physicians always recommend maximum intervention to avoid death. These physicians believe that death is the enemy; they fail to understand that some patients come to welcome death.

Anonymous November 3, 2009 at 1:51 am

It’s complicated. I’m a skydiver. Skydiving lowers my life expectancy in some mathematical sense, but I love it, so I pay the price in life expectancy. On the other hand, if I had no other priorities, I suppose I’d pay most any price for one more day of healthy, active life, and I might spend the day lowering my life expectancy further by skydiving.So the WWL listener has a point. People do choose between increments of life expectancy and other things, but they’ll still pay most any price for another day of life, ignoring other priorities like children.I hope someday to die a little earlier than I might otherwise to give my children a bit more than I could otherwise, and I don’t consider this hope particularly noble. It’s a genetic emotion. Individual human beings clearly are not perfectly self-interested, economic Man. Nature doesn’t design beings this way.After correcting for lifestyle choices like smoking and obesity, wealth presumably makes little difference in life expectancy within the U.S. I’d be surprised if the top and bottom quintiles differ by more than ten percent. I don’t expect this difference to increase a lot any time soon, but if it does increase a lot, I expect some change in forcible propriety to follow.

Anonymous November 3, 2009 at 2:51 am

Does sky diving even effect your health insurance premium? It’s not like you’ll need any medicine or doctors services after you auger in at 100 mph.

Anonymous November 3, 2009 at 5:17 am

Ahhhh, like everything else you comment on, suddenly you’re an expert on skydiving accident mortality rates.

You don’t know anything, George, but you think you know everything. It’s called the “Fatal Conceit”.

Anonymous November 3, 2009 at 7:28 am

Wow is it a requirement to have no sense of humor when you become a libertarian?

Anonymous November 3, 2009 at 8:25 am

Maybe it’s the performer rather than the room.

Anonymous November 3, 2009 at 3:00 pm

The trouble is that you’re not joking. As far as I can tell, you actually believe your bullshit to be true.

Anonymous November 3, 2009 at 10:06 am

It doesn’t affect my premium, because I’m usually covered by a corporate policy. It probably should. Non-fatal injuries are very common. I’ve dislocated both of my elbows. Skydiving injuries are practically the only medical care I’ve had in the last decade or so. Many health insurance policies exempt extreme sports injuries, but doctors often ignore the exemptions. The joke is that skydiving injuries appear on insurance claims as “Tripped and fell stepping off of a plane.”

Mathieu Bédard November 3, 2009 at 7:50 am

I must be a special case because I will spare no costs to ruin my health with foie gras…

Anonymous November 3, 2009 at 11:08 am

You are doing in an obnoxious goose at the same time so you get credit for a twofer.

Matt November 3, 2009 at 10:36 pm

I think it’s more like “people are willing to incur any cost ON OTHERS to save their lives.”

Anonymous November 3, 2009 at 3:10 am

Typical pathetic try muirduck, but the man just has to stay with the Cafe for a couple of days and your participation will make it clear, especially that there is no “we”, on this Cafe you stand alone at the head of the line of reviled idiots.

Cheap food subsidized by taxpayers, well yeah you have been stupid enough to claim Walmart is subsidized by government, but you missed Kroger’s and HEB. LOL.

Health care free? I can only dream, since that was another of the corrupt congress’s lies. I pay for my healthcare plan every quarter.

Anarchist, oh yeah…yawn.

Military penision, yes, and most of it comes out of your taxes, muirduck, a situation that pleases me immensely as I know the socialist in you loves it.

Anonymous November 3, 2009 at 5:20 am

It’s not immoral to consume resources you were forced to buy.

MWG November 3, 2009 at 3:37 am

Yea, if they can survive long enough. Your comment is even more hilarious in light of last night’s 60 Minutes.

http://www.cbsnews.com/video/watch/?id=5486399n&tag=contentMain;cbsCarousel

Anonymous November 3, 2009 at 4:57 am

I understand that. I do believe that there should be some sort of public option for the extremely poor. It should be so basic that anyone who can afford it should want to get something private. That’s what happens in India. There are civil hospitals which provide free treatment. There are private charities too, which means that people who want to donate to help the unfortunate can do so. Government run healthcare makes non-smokers pay for lung cancer treatments and lung transplants…and so on.
Also I checked…the kidney transplant in India costs about $14000-$18000, much lower than the US cost…mainly because it is market adjusted. It would be even lower if organ sales were legal and documented. If we had websites running which are constantly updated with names of people who want to sell their organs for whatever reason, we would find that transplant costs would come down. Also, the black market for organs (which is a thriving illegal business) would be shut down as customers would get stuff for less the legal way. But I digress.
Also please don’t beat the old leftist drum that other countries have universal health care and spend less. The truth is, they depend on the US for quality innovation in the pharmaceutical industry and the biomedical research. If stem cell research had not been impeded for so long, the US would have been a world leader in that too. It is not a coincidence that despite other countries being so wonderful as liberals love to put it, immigrants want to come here and nowhere else.

MWG November 3, 2009 at 5:09 am

“lso please don’t beat the old leftist drum that other countries have universal health care and spend less. The truth is, they depend on the US for quality innovation in the pharmaceutical industry and the biomedical research. If stem cell research had not been impeded for so long, the US would have been a world leader in that too. It is not a coincidence that despite other countries being so wonderful as liberals love to put it, immigrants want to come here and nowhere else.”

Great point… though I think it’s been made to him many… many times.

MWG November 3, 2009 at 5:11 am

That respect will die over time.

MWG November 3, 2009 at 7:43 am

You ARE an idiot if you think Hayek was for universal healthcare.

“But there are strong arguments against a single scheme of state insurance; and there seems to be an overwhelming case against free health service for all. From what we have seen of such schemes, it is probable that their inexpediency will become evident in the countries that have adopted them, although political circumstances make it unlikely that they can ever be abandoned, not that they have been adopted. One of the strongest arguments against them is, indeed, that their introduction is the kind of politically irrevocable measure that will have to be continued, whether it proves a mistake or not.”
FA Hayek

“The conception that there is a an objectively determinable standard of medical services which can and ought to be provided for all, a conception which underlies the Beveridge scheme and the whole British National Health Service, has no relation to reality. In a field that is undergoing as rapid change as medicine is today, it can, at most, be the bad average standard of service that can be provided equally for all.. But since in every progressive field what is objectively possible to provide for all depends on what has already been provided for some, the effect of making it too expensive foremost to get better than average service, must, before long, be that this average will be lower than it otherwise would be.”
FA Hayek

“There are so many serious problems raised by the nationalization of medicine that we cannot mention even all of the more important ones. But there is one the gravity of which the public has scarcely yet perceived and which is likely to be of the greatest importance. This is the inevitable transformation of doctors, who have been members of a free profession primarily responsible to their patients, into paid servants of the state, officials who are necessarily subject instruction by authority and who must be released from the duty of secrecy so far as authority is concerned. The most dangerous aspect of the new development may well prove to be that, at a time when the increase in medical knowledge tends to confer more and more power over the minds of men to those who possess it, they should be made dependent on a unified organization under a single direction and be guided by the same reasons of state that generally govern policy. A system that gives the indispensable helper of the individual, who is at the same time an agent of the state, an insight into the other’s most intimate concerns and creates conditions in which he must reveal this knowledge to a superior and use it for the purposes determined by authority opens frightening prospects. The manner in which state medicine has been used in Russia as an instrument of industrial discipline gives us a foretaste of the uses to which such a system can be put.”
FA Hayek

I got my quotes from here:
http://www.qando.net/details.aspx?Entry=5176

What crazy socialist site did you get yours from?

Also, would you be so kind as to provide the whole quote? At least the part before the “nor”? Or should I cut and paste it for everyone to see how disingenuous you are?

Anonymous November 3, 2009 at 11:44 am

So, Muirgeo, does this mean that everyone now cannot make adequate provision? That we must all go on the state-run plan for assistance? Is this not the sort of thing that Medicaid and Medicare are for?

Of the approximate 2 Trillion that gets spent on health related medications and services in this country, nearly 800 Billion is spent by the federal government…and the individual states are doing their own governmental spending as well.

Anonymous November 5, 2009 at 4:05 am

>>There’s nothing left for you to say. ~ Muirgeo<<

Apparently you're wrong. So, what will you now say? Or do you continue playing duck, duck, goose step?

Anonymous November 5, 2009 at 4:05 am

>>There’s nothing left for you to say. ~ Muirgeo<<

Apparently you're wrong. So, what will you now say? Or do you continue playing duck, duck, goose step?

Anonymous November 3, 2009 at 11:04 am

Truth.

Anonymous November 3, 2009 at 8:40 pm

muirgeo, why do you personally bankrupt Americans?

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