Trump Thread

[Seamus Fermanagh]

"Medicare for All" is a neat slogan, but to actually achieve single-payer care and universal coverage would require several layers of brand new institutions and years of graduated transition. If people complained that the ACA bill was very long or complex, then the bill ushering in the new system would be at least an order of magnitude more so. What needs to happen is for Congress to establish a commission to return with some plans in 2 or 3 or 5 years. Of course, who's to say that future government or the People have the patience or commitment to follow through once the time comes? So if it comes, it comes haphazardly. That's the 'democracy tax'.



Government expansion via workplace coverage was a compromise, and workplace coverage only emerged in the first place because healthcare and health insurance as we know it did not yet exist. Today the product and service that needs to be provisioned is totally different, and we need to change how we do it once again. As with adaptation to climate change, the thing that wants central administration has to be transformed because it is no longer sustainable in its present state under any administration. This is two problems at once, economic and metaeconomic, and they're inseparable. We can't and shouldn't expect a mere reduplication of current practices with a different set of paperwork.



This is an important point that follows from what I said about metaeconomics and sustainability. Even with a single-payer paragon established in the United States soon enough new crises in quality and absolute costs will emerge that can only be addressed by transnational governance of healthcare -and probably more. But, one step at a time.



I think these "medical tourists" to America can be generalized as economic elites, with a small proportion of non-elites being sponsored for experimental treatments or purposes of research into rare conditions. There is medical tourism out of the United States as well, but the profile is inverted: those are lower or middle-class people who cannot afford treatment locally.

I know what metaeconomics means in general, but how do you use the term here?

[HopAlongBunny]

One difference.
For the individual the provision of x may be a life or death choice; you will pay the maximum given that choice.
For the gov't, x is a bulk good (life and death are not at issue); the gov't gets a better rate.

As a patient with complete kidney failure, I have seen how this plays out first-hand.
A drug I needed was $5,000 a pop if I bought it as a person; buying through blue cross the price magically drops to ~$50.
It is a rather dramatic example of "market power" at work.

[Montmorency]

I know what metaeconomics means in general, but how do you use the term here?

The economics of healthcare are the narrow questions of how actors from individuals to firms to governments are exchanging money and other resources to provision and consume certain sets of fixed services and products with respect to some predetermined indicators like access, outcomes, efficiencies and expenditures of GDP and so on...

The metaeconomics of healthcare go to the root of societal organization, of what healthcare is supposed to be, or what is possible, what is needed or should be needed in the context of all the other economic sectors and their principles as well as philosophical and political-sociological questions on the human condition including, "What is or should be the overall focus of economic activity?".

Here's one take:

[T]his website argues for a paradigm shift in the substance, rather than the form of economics, a move which will, paradoxically, take economics back to its origin in the field of moral philosophy. I hope to convince the viewer that when the existing paradigm is examined for it appropriateness to humanity’s needs, it will be seen to be so inadequate, dysfunctional and socially destructive that a new economic paradigm is called for. When the current economic upheavals have run their course, and rebuilding is being planned, it must start from a clear vision of the kind of social community we desire, and this website will argue that it cannot be profit-driven.

...

[B]ut what distinguishes metanomics from informed orthodox economics is its rejection of two even more fundamental assumptions. The first of these is that the aim of economics of whatever kind is to increase “wealth”, which is taken to be material possessions or comforts or the money to obtain them. The second is the assumption that the natural economic group is the nation state. The latter is already being questioned in the drive to globalism which has been intensified by the rise of China, with all its many economic consequences, and of the transnational business corporation, which actively seeks to escape from regulation by the nation state and whose ideal would be a totally borderless world.

Metanomics redefines the aim of economic theory and practice , so that wealth is not a measurable financial quantity, but a function of human well being, albeit this is not separable from a minimum level of income. “Human welfare” or “human prosperity” might initially be taken to be something akin to Aristotle’s euphoria, which meant something much less dramatic and intoxicating than commonly understood today.

...

One thing we can be sure of is that the economic problems that humankind now faces cannot be solved by the same kind of economic thinking that caused them in the first place.