Charles Koch wants to eliminate minimum wage

[paulclifford]

Re: Simplicity and uniformity:

http://oversight.house.gov/wp-conten...a-Hub-7-17.pdf

Download the above-linked PDF.

Scroll to Appendix I on pages 9-11. Study the diagrams and ask yourself if the schematic of the Affordable Care Act serves your values of "simplicity" and "uniformity."

[trish]

Regular care and maintenance of one's car is preventative medicine. But if I lose a windshield because it caught a stone on the highway and cracked, my insurance covers it. People who can't afford cars don't buy car insurance because they don't have a car to insure. People with bodies don't have the cost saving strategy available to them. If you're making $12000 a year and your teenage daughter is in pain because she broke a tooth on a fast food burger, the dentist's bill will break you.

[broncofan]

>>>

I doubt that. One reason medical care is expensive in this country is that many people who ought to put off trips to the doctor because it's unnecessary, do not do so. The additional demand "pull" on the supply of medical care — made possible by bureaucratically regulated insurance policies that mandate coverage for just about everything at taxpayer expense — has the perverse effect of raising prices.
.

What you're talking about is moral hazard, that people who are insured overuse those services for which they're insured. Those with car insurance might drive more recklessly, and those with health insurance might overuse medical care. However, there is a screening function performed by both doctors and insurance companies.

I have no idea why anyone should put off an appointment to go to the doctor. Someone in their 50's with chest pain should assume it's heartburn and not something worse? Someone with a torn ligament should assume that it's a minor strain? This is callous nonsense.

Do me a favor. Next time you think you need to see a doctor, ask yourself whether you would like to put it off.

I also love what you did with the demand function for healthcare. You are correct that if poor people are not served by doctors and not insured by their employers, and cannot afford healthcare, the price of healthcare in this country might be cheaper. Afterall, less demand for services does mean a lower equilibrium price. Some of us don't actually think that those in the lower income strata should be denied healthcare to lower the average cost of healthcare, or that access to healthcare should be limited to an elite segment of society. What you're describing works with filet mignon but is unacceptable to people of conscience when discussing cancer treatment or cardiograms.

Once you have one distortion in the market, and you have a number of built-in distortions in the market for both healthcare and health insurance, the de-regulation argument falls apart. Even the patent system is a distortion, given that it gives an innovator a monopoly for a length of time, allowing him to collect surplus profits for his innovation. I'm not saying there isn't a reasonable trade-off involved, but this argument about price wars and intense competition is something you simply don't see in a field characterized by strict licensure of providers, patents on drugs and technology, and insurance which almost by definition can't be left unregulated. When you leave insurance un-regulated, insurance companies end up forfeiting their obligations. Why? Because they have an incentive to invest premiums and not hold sufficient reserves. You just don't get anything like intense competition in either the delivery of healthcare services or the insurance markets.

[broncofan]

Is medical school an artificial barrier to entry? I can't open up a medical practice because I haven't gone to medical school. Do you know what this does to the supply function for medical services? With a lower supply of healthcare providers, the price of healthcare is now much greater than it would be if every third person were a doctor.

[Ben in LA]

Just ask yourselves this question: are YOU willing to work for less that $7.25 an hour...no matter the job? I'm pretty sure that with no restrictions on minimum wage, there'll be no restrictions on what fields can implement that.

Can you imagine a policemen or EMT making that?

[paulclifford]

>People come to the Mayo Clinic because they can afford care that most people cannot.

I never mentioned the Mayo Clinic, but in any case, you're repeating leftist-pop-mythology.

The Mayo Clinic has a high reputation for providing charity medical care for those unable to pay. It does this by using differential pricing: wealthy patients pay much more than middle-class patients; middle-class patients pay more than the poor. Thus, the Mayo Clinic uses payments from the wealthy to subsidize charity care for the poor. Most importantly, the OUTCOMES of the poor are better than they are at "free" clinics in the UK, Canada, and other countries that have socialized healthcare.

Additionally, since the clinic has long practiced "integrative care" — i.e., all specialists, all diagnostic facilities, all appointment-setting, etc., are integrated into one unit, under one "tent" — care in general can be provided at lower cost and in a timelier manner than at many other clinics or hospitals, even in the US. Recent studies, for example, even show that Medicare spent about 50% less-per-patient at the Mayo Clinic than at other places. So the Medicare Unit at the Mayo Clinic is easier on taxpayers than other hospitals and clinics.

Not sure why anyone would complain about this. Obviously, what we need, therefore, are MORE Mayo Clinic-type organizations (i.e., private, voluntary, integrative, and run by the doctors themselves).

See:
http://takingnote.tcf.org/2008/10/what-makes-the.html
"What Makes the Mayo Clinic Different?"

> This is not evidence that our healthcare system provides better care on average to the average person.

My evidence was empirical/statistical, not anecdotal. If you remove suicides and high-speed automobile deaths (i.e., accidents in which the driver dies immediately upon crashing), the U.S. has the longest life-spans for its citizens; it has the highest survival rate of cancers and heart disease; it has the highest patient satisfaction with special surgeries like back surgery, hip-replacements, knee-replacements, heart-valve and bypass surgeries, etc. It also has the highest rates of colonoscopies and mammographies in the world — two reasons that Americans spend a higher percentage of their incomes on healthcare than citizens of other countries. It has the most access to new drugs, new medical devices, and new kinds of therapies (stem-cell, nano-technologies, prostheses, etc.). It has the lowest infant mortality. It's not just at the Mayo Clinic. It's a general characteristic of US healthcare. It can certainly be improvised, but not by following the European model of having the government pay for more things. When government pays for things, prices always go up and quality always goes down. Government can "mask" the price increases because it can always cover losses between the cost of something and its selling price with tax revenue. That doesn't change the fact that the REAL costs of something have risen.

>>>Insurance has always been regulated.

And marriage has "always" been one man and one woman. So? That's not an argument. We could also say, "There has always been slavery. Why abolish an institution that has existed for thousands of years?" So what if it has always existed?

Additionally, regulation of insurance only began in the 20th century — correlating strongly with things going awry for patients' easy access to high quality medical care.

>>>As a system it is almost unworkable if there are no regulations.

Says who? Might as well assert the same thing about the dairy industry or the consumer electronics industry or the bicycle industry or the shoe industry. It's all self-interested nonsense. The only two groups of people who believe such a thing are members of the insurance industry themselves (who benefit from regulation because it protects them from competition) and politicians (who also benefit from regulation because it allows them to buy votes). Consumers of medical care (patients) don't benefit, and neither do providers of medical care (doctors and nurses).

See:
http://www.cato.org/sites/cato.org/f...9/hb111-15.pdf

You'll find most of the arguments for freedom of choice in healthcare in the above-linked PDF from the Cato Institute, a thinktank that analyzes policy from a free-market perspective.

>>>You don't have a good system of healthcare if most people can't afford necessary procedures or are made bankrupt by illness.

You also don't have a good system of healthcare if most people spend most of their time waiting to get an appointment, are then given a 5-minute examination, and then have to wait months for their "free" necessary procedure. You don't have a good system of healthcare if most people cannot get the latest, most effective drugs, devices, and treatments because some "cost-efficiency" panel says, "It's too expensive. Our job is to keep the cost of medical care down, and we're doing that by DENYING you the latest, expensive treatment. Don't like it? Go to some other country and seek treatment there." Which is pretty much arrangement in the UK and Canada, to name but two single-payer systems that supposedly cater to the poor.

>>>I don't care how many wealthy people flock to our best institutions.

You also don't care how many poor people die waiting in lines in other countries' socialized institutions, or who die for lack of access to the latest drugs, devices, and treatments, or who die waiting months — sometimes years — for simple procedures like a hernia operation. You only seem to care about the rhetoric — the sales pitch — by the politicians who run these programs, that the system is "for the benefit of the poor", even though it guarantees the poor only two things: long waiting times and crappy care.

Are you really going to say, "But at least they get FREE crappy care!"?

[paulclifford]

>>>Is medical school an artificial barrier to entry?

No. But using government to close many medical schools throughout the US for the purpose of intentionally graduating fewer doctors — in order to keep the supply of doctors low and, thus, their rates and incomes high — IS an artificial barrier to entry. Doctors did precisely that through their lobby, the AMA, and something called "the Flexner Report", back in the 1920s or 1930s.

Additionally, state licensing of only "approved" doctors, with "approved" training, at "approved" medical schools, are all examples of artificial barriers to entry imposed by government and its special-interest lobby: the AMA.

State licensing of physicians with only a narrow, specific kind of training (which would NOT include age-old techniques such as homeopathy, naturopathy, etc.) was sold to the public with the rhetoric that it would "protect people from quackery". It has no such effect, and no studies have ever been done that show such regulation has such an effect. Ordinary laws against fraud and misrepresentation — which have long been in place in all states — can protect the public against that. The AMA/Flexner regulations on state licensure do nothing but artificially make the supply of physicians scarce in relation to the great demand for their skills. Obviously, this drives up their rates, and thus their incomes.

Prior to the AMA and the Flexner Report, most Americans preferred to see non-invasive homeopaths or naturopaths for their chronic conditions. Allopathic medicine allied itself with the chemical industries and the pharmaceutical industries with the discovery of anesthesia and asepsis, indispensable for surgeries. To force Americans away from their traditional therapies of choices, the AMA, the Flexner Report, and, of course, government, closed many medical schools, and instituted the state-licensing regulations.

Government licensure requirements also have the perverse effect of keeping older, less sophisticated doctors in practice, who should have perhaps retired long ago. Instead of keeping up with the breathless pace of medical advancements — including lots of new knowledge regarding "complementary" medical practices incorporating food supplements, vitamins, minerals, herbs, exercise, etc. — it tends to keep doctors in practice who know nothing about any of these, because "they have their licenses" and are thus "legit" practitioners of medicine, even if their knowledge and their treatments are 40 years out of date. Under a truly free market-driven system, the "branding" of such out-of-touch physicians would decline, as would their rates and practices.

[paulclifford]

>>>Just ask yourselves this question: are YOU willing to work for less that $7.25 an hour...no matter the job? I'm pretty sure that with no restrictions on minimum wage, there'll be no restrictions on what fields can implement that.

>>>Can you imagine a policemen or EMT making that?


Can you imagine a policemen or EMT making that?

No. Which is why in a free market — with employers bidding against one another competitively for the skills and experiences of potential employees — wages RISE, not fall.

You have a basic misunderstanding of how prices and wages are set on a free market. They are not "set" or determined by only one side of the economic transaction (the seller of a good, or the employer of labor). Prices and wages are always co-determined by both buyers and sellers, and both employers and employees . . . assuming, of course, the existence of competition.

Regarding minimum wage, here's another hypothetical that might make you think about it differently:

Suppose you're earning a $50,000/year salary. Your skill-set and your experience-level are worth $50,000/year both to you and to your employer. Then (God forbid!), you lose your job because of some sudden economic downturn. You are now unemployed, but you immediately start looking for another job: contacting friends, connections, head-hunting firms, etc.

Then the government enters the scene with the following regulation:

Although it's very happy to see you be proactive in your search for employment, it mandates that you can only accept new employment IF it offers a salary that is 23% higher than your previous salary of $50,000; i.e., you can only accept a new job on condition that the minimum salary offered to you is $61,500/year.

Even if you were to agree to an offer of $50,000/year or less, you would legally not be permitted to accept it. You can legally accept only an offer of $61,500/year or higher.

Question:

Would such a regulation — implemented for your benefit, don't forget — increase your chances of finding new employment? Or would it decrease them? Or would it not affect your chances of finding new employment at all?

[trish]

You have a basic misunderstanding of how prices and wages are set on a free market. They are not "set" or determined by only one side of the economic transaction (the seller of a good, or the employer of labor). Prices and wages are always co-determined by both buyers and sellers, and both employers and employees . . . assuming, of course, the existence of competition.

Ever hear of a buyer's market? Since the Great Bush Recession, here's been an over supply of labor. So how does the market respond? By lowering wages, contrary to something someone said recently.what was it...oh yes...

...in a free market... wages RISE, not fall.

In an unregulated market there is nothing to prevent a full time job from paying less than a living wage. At least in the U.S. we are beginning to recover. It would have been a stronger recovery had we had a more serious stimulus program. Europe's austerity strategy is failing miserably.

[paulclifford]

>>>So how does the market respond? By lowering wages, contrary to something someone said recently.what was it...oh yes...

But we don't have a free market, at least not in the entry-level labor market. We have minimum wage laws that make the market the opposite of free, remember?

We also have an unfree market in many skilled labor markets which demand that employers only hire union labor. Unemployment is highest in those states — all of them "blue" Democratic controlled — that have union-hire laws, and which do not have "right-to-work" laws.

It's an old story, all well understood in Econ-101 classes and textbooks.

As for everyone else:

When the left cries that "wages have not kept pace with productivity", they speak only of the nominal wage — the number printed on the paycheck — and not all those benefits workers get today: paid vacation (technically part of one's wage); paid sick-leave (technically part of one's wage); paid personal days (technically part of one's wage); paid health insurance (a benefit, not a "right", and technically part of one's wage); additional benefits like reductions in health club memberships (technically part of one's wage); etc.

Add all of these up, and it represents a big increase in wages.

Additionally — and more to the point — the way capitalism works to raise wages for everyone is not, necessarily, by guaranteeing them a larger "nominal" wage (that is, a larger number printed on their paychecks so that they have more money); but, rather, by lowering prices of everyday goods and services, so that the purchasing power of the paycheck increases: lower prices for food, clothing, transportation, communication, etc. This is true even today in spite of government-caused inflation and erosion of the dollar's purchasing power. Measured in terms of the number of hours one must labor in order to buy a mid-priced item such as a phone, a television, a washing machine, a new suit, a winter coat, a pound of beef, etc., prices have actually radically declined: in other words, most workers today spend a much smaller percentage of their incomes on these items than workers in the 1970s because they only have to labor for a few minutes to earn the requisite amount of money to make these purchases; whereas 30+ years ago, they had to labor several hours or several days to earn enough money for these kinds of purchases. Additionally, the quality of today's products is far, far higher than what was available back then. Televisions are better, coffee-brewers are better, and some things — like a MacBook Pro, for example — cannot even really be compared to an IBM electric typewriter, since the former does things that were simply impossible for the latter.

So I dismiss the claim that "wages have declined". They most certainly have not.

Where purchasing power really has declined is in precisely those areas that have the most government meddling: the housing market, public education, school loans for private higher education, insurance, and health care. This is obviously not a coincidence.