- Capitalism and Alternatives -


Posted by: Red Deathy ( Socialist Party, UK ) on September 10, 1999 at 00:06:47:

In Reply to: baskets or splints posted by Gee on September 09, 1999 at 15:02:52:

: Thats a possibility, leads us to....

A rather important possibility.

: You seem to be avoiding the logical conclusion of what you are saying. "no-one should be denied, or have restricted access to health care because of poverty" requires that it takes precedent over *anything* else - including the fellow who buys a washing basket for he must be, in principle, as wrong and as 'denying' as the fat lady because his $10 could have also contributed to some healthcare somewhere or other. The same goes for any activity undertaken by any person which at first has not been passed through the test "will this in some way deny an impoverished person access to medical care". Clearly buying washing baskets does. Unicef regularly inform us that $4 buys a quick fix to dysentry etc.

No, the logical conclusion is that everyone in society should have equal access to health care. Nothing more nor less, just as they should have equal access to everything else.

: It also requires that other people attend to supplying the attentiona regardless of whether they wish to. It seems to indicate that poverty must not be a factor in any choice regarding whether or not to offer meidcal care whilst other things might be. Such as? perhaps the practitioners preferences?

The only factor worth consideration is medical need, in comparison to the ability of the practitioners to treat it.

: This is a good point, in that the 'medical treatnebt market' consists of thosands of sectors in which different profits are realised, different motivations and morals can be applied and so forth. My argument was that medical resources are not a static pot, it is ofcourse correct to point out how resources can become somewhat focussed on activities which may not seem essential. Although these are self defined needs expressed through effective demand, actual demand has no expression save the self defined extend of the 'need', so lipo suction might be expressed as more important than leg fixing in a competition between resources with no arbiter except subjective opinion.

Possibly- although, I should state, Q in my argument is a constant, so its Q leg breaking, or Q plastic surgery. Poor people are denied access to plastic surgery they may need (after accidents, etc.).

Further, as per your market model of doctors. You neglect the nature of doctor production-

The number of doctors we can produce at any given time is:
The number of people capable (in themselves) of doing teh work, the number of people willing to do such work, the number of people of suffice socio-economic/personal circumstances to train to do that work: a declining scale at each stage.

Should demand for doctors head towards the effective demand of the rich, this will mean that wages in other fields may well rise, making it actually more difficult to attract doctors to those fields.

If we compare pocket elasticity, we'll see the rich have more elastic pockets, so they'll be able to up wages to keep their doctors, and poorer communities will have to nmake do with trainees, teh recently graduated or the failed.

A similar pattern can be seen in public defenders.

: yes thats a myth too. No one really says works at....., just that it works. it delivers uneven medical care and as the link demonstrates - in many cases its well below the commonly believed standards.

1:In an unequal society access to health care will always be unequal.
2:In an unequal society need will be unequal.
3:I'll clarify, I had someone else's arguments in my mind- Von Evil's monetary calculation stuff about socialising destroying the capacity to rationally judge- the NHS delivers most things well.

As for the link:
1;its clearly out of date, we haven't had free eye tests for over ten years.
2;its arguments are erroneous, it says paying for pills is a waste of resources, however, if people cannot actually afford that medicine then that is a good use. Further, prescription charges are, last I recall, 5.26(?).
3:It compares CAT scan ratios:
i)It does not account for medical fashion (.e. that doctors in one area may or may not use CAT scanners excessively, etc.- as comparing England with germany, where Doctors were Hot on Low blood pressure, where ours didn't bother.It made no odds.
ii)It made no account for access to CAT scanners, and need. A Simple comparison of numbers.
iii)Made no account for Charity fashions, and the possibility that it became fashionable to endow a CAT scanner, etc.
iv) this applies more generally- it did not set out an overall framework, it consistantly chose areas where America had good figures, for all we know there may well be other figures that change the story.
v)a further on that, that in Britain refusals and 'rationing' are active and documented, no account is made of the silent rationing of private health care, where people just don't go to a doctor coz they can't afford it.
4:Rhetoric- they mention that at some point up to 9,00 people in britain PA were refused kidney treatment, 'presumably they died', this presumption, not an entirely simple one, taking into account:
i)deferals of treatment from one financial year to the next.
ii)actually treatability and refusal on medical grounds.
became later the certain assertion of '9,000 p.a. dying annually.'
5:Death in the north- no account was made of specific poverty in the north, or the concentratiuon of heart and lung diseases cause by drink, diet and smoking in this region.
6:Private hospitals: the bizzarre assertion was made that if the NHS was there to direct to need, then where private hiopsitals are least, the NHS should spend most, as in the North- again. However, this doesn't take into account;
i)that only a relatively small number of people can actually sustain private hospitals.
ii)in areas, such as london, where there are some very rich people, some very poor communities can exist side by side.

That said, I don't challenge the charges of unequal treatment, but I think its less uneuqual than the alternatives, specifically less unequal than America.

Further, as I have mentioned to you before, the dependance on Charity in the American system demonstrates accute market failure. Noticably you do not challenge my supply demand model, in its specific point that poor people will receive sub-standard care.

Nationalised health care is not an answer, it demonstrates that socialised treatment is workable, but that in teh end, the damaging health effects of poverty and inequality cannot be met by any patch-up system.

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