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Can a 'masses' think for itself? Can a 'masses' act? Does this 'masses' possess a unitary consciousness? And if not, who dares speak for this entity, this 'mass'?
Anyway, let's analyze this.
You say that there should not be some 'profit-maximizing force' between the doctor and the patient.
Let's define profit, shall we? I hope we can all agree that profit is a mutual increase of value resulting from an exchange of goods or services of mutually and relatively lower perceived value. Example: Person A has Thing 1. Person B has Thing 2. Person A values Thing 2 more than Thing 1, which he possesses. Person B values Thing 1 more than Thing 2, which he possesses. So the two decide to exchange. They both profit from the exchange because they both now have more value in their possession.
That is profit.
Doctor wants his profit. Patient wants his profit. They want to maximize their profit. Doctor values the Patient's dollars more than his expertise, which he is full of. Patient has dollars, but no expertise. He values the expertise more than the dollars. So the two make the exchange. They both profit as a result.
But do they want to maximize their profit? The original poster somehow thinks that maximizing profit is bad. Such a blinkered mind.
The Patient is interested in maximizing his profit. He doesn't want to spend his dollars on the Doctor's areas of expertise that he does not need. Doctor may be great at golf, but Patient isn't interested in spending his money at the Doctor's office for golf tips. Nor does the patient want to spend his money on treatment that has nothing to do with his complaint. In fact, the Patient wants the best expertise he can get for the specific ailment that bothers him.
The Doctor likewise wants to maximize his profit. The Doctor is not going to waste time measuring the Patient's shoelaces with tongue depressers. He isn't going to waste time - time is money - on unnecessary things. He will see the patient, get a diagnosis, prescribe a treatment, and move on to the next patient. But he also wants to maximize future profit by ensuring return visits, so he will deliver the best service he can.
So, what is profit but a very important medium of communication? Socialism is a swear word because it removes any possibility of communication between producers and consumers. Producers must guess what the consumer wants, and how much. This is why countries with heavy socialism tend to maintain modes of production that never advance; they only tend to produce the same shoddy goods they were producing when they became socialist. Socialism, because there is no communication of wants and desires between producers and consumers, leaves producers in the dark, producing the same things of the same quality with no new information to guide them on what comsumers want. This is why socialist countries always have a stodgy, outdated feel to them. Once they go socialist, they become stuck in time, innovation dies.
The original author thinks it is wrong for an insurance company to make profit-maximizing decisions. What he doesn't understand is that the insurance company is acting as proxy for the patient. The patient, if faced with the costs of their own medical care, would likely decide between this test or that, this treatment or that, based on efficacy. But because he chose to use insurance instead, that insurance company will do that. Why do they have to do that? Because the doctor is also a profit-maximizer. Without SOMEONE to stand in and say, "No, I don't want this," the doctor will try to sell anything from sugar pills to Talbott's Magical Energy Elixir. There are many medical pocedures out there whose efficacy have not been well-established. There are many procedures that will not work under some circumstances, there are experimental treatments that haven't been proven effective at all. But doctors will, whether for profit or for other reasons, throw everything at a problem, hoping something works, regardless of whether it is likely to do any good. I have seen it first hand.
Lastly, the sentiment that everyone should get the same care is great if we lived in a unicorn and fairy universe where things can materialize out of nothing, born of pure thought. Problem is, that is not our universe. Everything requires someone to create it. To create requires effort, requires energy. And that effort and energy, spent on creating one thing, cannot then be used to create another thing. Additionally, once something is consumed, it cannot be consumed again. This guy probably has a problem with the concept of money. But money is nothing more than stored effort and energy. A person creates something through their effort and they turn that energy into a universal medium, money. Medical care is also something that does not trickle out of the tip of a unicorn's horn. It too must be created, using effort and creative energy. If the total balance is to remain, if the system is to remain in balance, then the consumer must replace that energy spent on creating that medical care that he uses for himself, with his own energy stored within the universal medium of money.
In other words, nothing is free.
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