Because those who are worried about that particular thing are just plain ignorant about the current state. If you think it doesn’t happen right now you need to go and find out more about the AMA. They have been doing this for years.

Can you, or anyone, give a good reason why limiting the number of doctors (I am not saying anyone should be admitted into a medical school, just that there is a lot of smart people who can’t make it in because of the caps) is a good thing for anyone except the doctors themselves?

There are several scenarios here: the government could (1) raise the cost of their insurance by shifting costs from one group to another (in the absence of demand signals!) (2) or conversely, tempt employers to cancel private options by undercutting prices with taxpayer-subsidized insurance, (in the absence of cost signals!) (3) reduce coverage for seniors in Medicare in order to pay for young uninsured people, (4) reduce the quality of medical care by trying to control doctors’ salaries by fiat, thereby driving doctors out of the market, or (5) introduce market distortions by trying to mandate the mix of specialties in which doctors are allowed to train, and so on.

Or… none of them could happen. You seem to be sure that at least one of those scenarios will actually happen. And that they are necessarily bad. What is wrong with doctors not making soooo much money for example? Or why would they be driven out of the market? Physicists, for example, do not make that much money; can you really say that they have been driven out of the market? Point 5 is related to my response above. For some reason you seem to think that there are no market distortions in the medical field right now. AMA is a huge distortion. Obama is not proposing limiting the number of doctors, he is proposing making family-care doctors more available.

I come from a country where public medical schools are essentially free for the medical students. Schools do have a yearly quota, but that is due to availability of physical space, not to drive doctor’s salaries up by controlling the supply. Specialties are also effectively free, and actually the government pays you a stipend (like a graduate student sort of thing) if you join their medical training program: We pay for your education, but when you are done you have to work for some years (the number depends on the specialty) in an economically-hit community. During this time they keep receiving the government’s stipend, which is not a lot but it’s enough for them to start a family if they want. You don’t have to take the government’s money though. If you can/want to pay out of your pocket that is fine. And you don’t have to do that community time.

Here’s food for thought: Law Bar Associations usually recommend a certain number of pro-bono hours although there is no penalty for falling short. Would it be so bad if the AMA implemented pro-bono medical work and makes it mandatory? Maybe 3-5 days/year/doctor in a community clinic? I am not talking about extremely expensive procedures necessarily but those are also welcome.

http://www.maths.tcd.ie/pub/HistMath/People/Fourier/RouseBall/RB_Fourier.html

Well, since you’ve been unable to produce any evidence to support your thin argumentation on health care, I suppose you consider your retreat a “success”. You remind me of the French army.

BBB

I expected that you would go this route.

There is no functional difference between the terms equivalence and equilibrium. What you are arguing is about a particular contextual use of the terms. Are you saying that terms on opposite side of an equation are out of balance? Too bad you still can’t figure that out. Since you chose this direction it shows me that you are incapable of actually learning anything and that you are just a tool, as stated before.

In any case, I have successfully diverted you away from the focus of this thread and have demonstrated that you are in no way capable of having a reasonable opinion on the subject matter.

However, I know at some point the owners of this blog will be forced to intervene and stop comments, so until that happens I am more than happy to continue this back and forth.

http://www.youtube.com/watch?v=DKhnmUdmz74

That’s it? You’re confused about the difference between equivalence and equilibrium?

Let me see if I can cure just a little bit of confusion today.

Look, fundamentally, “equilibrium” means a balance of fluxes. The word itself comes from the Latin and means “equal balance” or “equal scales” — like when a beam balance comes to rest, the net forces and moments on the balance are zero, which allows us to infer something about the quantities of matter on either side of the scale. Apparently you are misled by this paradigm, because the act of measurement has come a long way since the time of Caesar. We now know how to measure many things happening very fast. In mechanical systems, for example, we can very easily measure pressure changes happening over a fraction of a millisecond [and probably can do orders of magnitude better if we try hard -- I'm not sure what the current state of the art is]. In radiative systems, well, friends of mine measure the tracks of elementary particles with femtosecond lifetimes. Measurement does not require any sort of equilibrium.

Mechanical equilibrium occurs when net momentum fluxes are zero and the system is in steady state. Chemical equilibrium, ditto for net flux of chemical species. Radiative equilibrium, ditto for net flux of electromagnetic radiation. You might as well start with the Wikipedia article on thermodynamic equilibrium if you want to learn more. These are all idealizations. (For the most part, thermodynamics itself isn’t correct except in the thermodynamic limit ‘N goes to infinity’.) This all has nothing to do with equivalence relations except in the trivial sense that equivalent outputs from a calibrated measurement device can be trusted to measure equivalent physical parameters. That equivalence has nothing to do with whether the object or system being measured is in any kind of equilibrium. In fact, if EVERYTHING was in equilibrium, there would be no point in measuring temperature, would there?

I mean, this is a really trivial point. The fact that measuring a pound of sugar and a pound of flour on a kitchen scale gives the same number has nothing to do with whether the sugar and the flour are in equilibrium. I’m starting to think you’re toying with me, writing outrageously stupid things to see if you can get a rise out of me. But I’ll refrain from any further flaming, because I really suspect you may just be honestly ignorant.

Seether/Fake It

Heh. I know you are, but what am I?…. But seriously, you’re circling the drain of juvenile irrelevance. Get a grip. I’m sensing some doubt on your part, but cowardice, too, about directly accusing me of lying about myself. My advice is for you to knock it off before you embarrass yourself. And do a little research.

BBB

http://www.youtube.com/watch?v=7j2DHUw8SZg

as far as this comment is concerned:

http://www.youtube.com/watch?v=muP9eH2p2PI

Since that statement indicates to me that you are very nearly capable of correcting your incorrect understanding of everything, let me repeat:

You can not perform a measurement or make an observation if there is not some sort of equilibrium.

http://en.wikipedia.org/wiki/Zeroth_law_of_thermodynamics

Under the zeroeth article itself you can find:

“It is often claimed, for instance by Max Planck in his influential textbook on thermodynamics, that the Zeroth law implies that we can define a “temperature function” or more informally, that we can “construct a thermometer.” ”

There is actually a good link for the philosophy of the zeroeth law on wikipedia:

http://en.wikipedia.org/wiki/Philosophy_of_thermal_and_statistical_physics

it contains this statement:

“Hence thermal equilibrium between systems is an equivalence relation, and this is the substance of the zeroth law of thermodynamics. According to Max Planck, who wrote an influential textbook on thermodynamics, and many other authors, this empirical principle shows that we can define the “temperature function” central to our everyday conception of heat. ”

that leads you to this:

http://en.wikipedia.org/wiki/Equivalence_relation

There is a great statement there that you should read:

“An ubiquitous equivalence relation is the equality (“=”) relation between elements of any set. ”

Another great wiki article is this one:

http://en.wikipedia.org/wiki/Conservation_law

This article contains a good quote:

“One particularly important physical result concerning conservation laws is Noether’s Theorem, which states that there is a one-to-one correspondence between conservation laws and differentiable symmetries of physical systems. For example, the conservation of energy follows from the time-invariance of physical systems, and the fact that physical systems behave the same regardless of how they are oriented in space gives rise to the conservation of angular momentum.”

(Note: it says one-to-one!!!)

It is very important now to review what is meant by “temperature function”, or more specifically “function”:

http://en.wikipedia.org/wiki/Function_(mathematics)

From here we get:

“In mathematics a function is a relation between a given set of elements (the domain) and another set of elements (the range), which associates each element in the domain with exactly one element in the range. The elements so related can be any kind of thing (words, objects, qualities) but are typically mathematical quantities, such as real numbers.”

and

“In pure mathematics, functions are defined using set theory, and there are theorems that show the existence of uncountably many different functions, most of which cannot be expressed with a formula or algorithm.”

From here it should be very clear that for someone to perform a measurement or make an observation, one must first define a function that is expressible by some formula or algorithm that utilizes the equivalence principle. Without the ability to do such, one can not make an observation or take a measurement, since any attempt to do so would be meaningless (and any device that one tried to construct would most likely output random numbers).

Combined with the fact that there are empirically verified symmetries in the universe, we are thus able, and in some way guaranteed, to be able to observe the world around us; specifically, there are invariable scalar quantities that are measurable by all observers.

Thus in essence:
You can not perform a measurement or make an observation if there is not some sort of equilibrium.

I’m trying to imagine you being a little less unhinged… but it’s just not coming to me….

Of course I enjoy helping people. I’m helping to bring you to enlightenment, but your ego keeps getting in the way. “Snatch the pebble from my hand, Grasshopper”.

Let’s return to the notion of equilibrium for a moment. Meditate on this: there is no equilibrium. “Equilibrium”, like “steady flow”, like “isolated systems”, is just a model we use to try to make sense of the things we see around us. Physical systems can be approximately in equilibrium, but it is more usually the case that they are changing their state of motion due to an imbalance of forces. Equilibrium is only one paradigm among many. For example, the equilibrium paradigm is not very useful for modeling oscillatory systems, where energy flows back and forth between two modes of storage (in the idealized paradigm). Equilibrium is not a useful paradigm for understanding systems that are characterized by growth, be it the inflationary universe or inflation in an economy.

In the meantime I’ll leave you with the famous quote from Robert Heinlein:

“Anyone who cannot cope with mathematics is not fully human. At best he is a tolerable subhuman who has learned to wear shoes, bathe and not make messes in the house. ”

Now, it could be that you have some mathematical skills, but for some reason you are just choosing not to display them in this thread. Humility is a good thing. But I suspect that advancing any argument about health care will require something more, oh, analytical. Just tossing insults back and forth is fun, but something of a diversion, don’t you think? But if that’s all you can do, I’ll play along until a serious commenter drops by.

BBB

Math skills are nice, but all that means is that you get to be a tool in a toolbox. At some point in your life, if your lucky, you might stop and wonder what you can do to help the people around you. If your really lucky you might actually find a way to do it. Your existence in the universe, and all your skills don’t amount to a hill of beans except in the present.

So the question I ask you is whether you want to be a tool for the rest of your life?

Good Will Hunting

Heh. Great movie. Did you know it was fictional? That wasn’t even MIT.

On the other hand, this movie was based on a true story. And it was at least filmed near MIT. As for me, I beat the house at the Grand Casino in Monte Carlo by using a highly sophisticated strategy for placing bets on roulette. Maybe I’ll tell you about it sometime….

BBB

http://www.youtube.com/watch?v=Zx3m4e45bTo

http://www.youtube.com/watch?v=nQezXbiroiE

LOL. I’ve got a bachelor’s and a master’s in mechanical engineering and a doctorate in theoretical physics, all from the little tech school where Sean Carroll did his postdoc. And I’ve taught thermodynamics more times than I can remember.

But I can always use more learnin’, JL. Can you recommend a good math textbook?

BBB

You need a good course in math. You might also want to check out some books on conservation laws. Thermodynamics might be a good place to start as well.

Nonsense. We do it all the time. What do you think we measure when we use an accelerometer? What do you think economists are measuring when they measure growth in GDP?

In any case, it was very clear from the conversation that the choice to perform the procedure did not rest with the patient or her daughter

Boy, that’s not how I hear it. The patient and her daughter wanted the procedure, their doctor wanted the procedure, the first specialist said no, so they went to find another specialist, who said yes.( If that isn’t the patient choosing to perform the procedure, who chose?) THAT’S THE POINT OF THE STORY. When patients have the freedom to choose doctors, and doctors have the freedom to help (or not help) patients, everyone benefits. What everyone is worried about is the imposition of a system where the government controls the supply of doctors, and the government chooses which procedures meet their criterion for cost-effectiveness, and no one has a choice. And the fact that this plan is being pushed by someone who doesn’t even know that YOU DON’T PRESCRIBE PAINKILLERS FOR ARRHYTHMIA fills no one with confidence.

Obama was very correct in stating that in many cases, a specialist may make a decision that a patient may live a longer and happier life without the procedure.

In this country, doctors and patients make these kinds of decisions jointly. You seem to be fixated on a top-down, dictatorial form of health care. I’m sorry if that’s been your relationship with your doctor. You should speak up and participate in the decision-making about your health. While you still can.

Sicko

So this is MM’s great indictment of private health care? Nixon on tape? LOL.

This is the same Nixon who gave us wage and price controls? The same one who pushed quotas for affirmative action? Who abandoned the gold standard? Who imposed the 10% tax on imports? Whose advisor, Herbert Stein, bragged about the unprecedented amount of regulation imposed by the Nixon administration?

The last thing Nixon was right about was Alger Hiss. But what makes you think Nixon knew anything about the free market system? Bizarre.

BBB

I found the specific reference:
http://wizbangblog.com/content/2009/07/21/sophistry-obama-painkillers-and-pained-words.php

Any invasive procedure is very dangerous, and as you get older there is a higher risk of complications. Obama was very correct in stating that in many cases, a specialist may make a decision that a patient may live a longer and happier life without the procedure. In any case, it was very clear from the conversation that the choice to perform the procedure did not rest with the patient or her daughter, so to argue that the public option would take choices away from patients is incorrect.

Watch this and then tell me that private insurers are less draconian; it is from Sicko, but has been edited down to remove any commentary (no, I’m not a great fan of Michael Moore, so please refrain from the inevitable inane comments)
http://www.youtube.com/watch?v=RmHTte8jRLk

You can not perform a measurement or make an observation if there is not some sort of equilibrium. Go back to school when you have the opportunity.

Well, JL, your posts are getting rather thin on substance, and increasingly erratic in your reading of my commentary. so like I told gopher: Come back anytime, maybe after you graduate.

In the meantime, I’ll comment on your observations.

there is always an equilibrium of some sort being maintained

Why do I get the impression that you didn’t do any better in your economics classes than in your physics classes? Not everything is in equilibrium.

Maintaining the current status quo also has serious unintended consequences.

I thought you just said we were in equilibrium? Now I’m confused.

In any case, I favor changes that favor the free market. Some of these are oft-stated, such as allowing health insurance policies to be sold across state lines. I just pointed out in the previous post that we should move to a system with more individual stake in health care expenditures. We could do this with a system that allowed employers to create tax-free incentives for saving money — for example, imagine a system where employers were allowed to put $2000 in an employee’s health care account, from which you were required to cover your first $2000 of health care expenditures, but from which you were allowed to keep any unspent money, tax-free, at the end of the year. Contrast this with the current system of health care benefits accounts, where employees can put their own pre-tax money, but lose any balance at the end of the year.

But you see a problem with this? The problem is that although we don’t live in a dictatorship, we sure as hell live in a one-party state, and any proposals coming from conservatives are immediately disregarded by the folks in power.

I think that the government can and should legitimately require insurers to cover pre-existing conditions — part of HR3200 [sec 111, Subtitle B of Title I, Div A]. Isn’t that like requiring insurers to sell fire insurance on burning buildings? some people ask. No, not really. People really do burn down buildings to collect insurance, but as far as I know, no one has ever deliberately developed cancer — or even broken a bone — to collect payments from insurance companies. Doesn’t that interfere with the free market? others remark. Well, what we have now is a system where people are afraid to change jobs because their new insurance might exclude them from covering their diabetes or gout. The market power of private insurers, containerized into state markets, allows them to impose this distortion on the free market. Let’s get rid of it and enjoy the benefits of freeing up the labor market.

What I don’t believe is that I should have to pay for a government option to compete with private insurers just to have that particular market distortion fixed. But “evil” (your word) politicians who want us to move toward a single-payer system refuse to sever that provision, because they want to use it as a carrot to coerce us into accepting their massive scheme.

If you insist on maintaining the position that the US government is evil and its only intent is to screw old people out of their health care and send them to their early deaths…

You really need to break that habit of using weasel words (“only”). If your argument is weak enough that you require that kind of conditional scaffolding to make your statements sound reasonable, you need to step back and reformulate.

Anyway, in this regard I am concerned about two things. First, some of the people pushing this scheme really do understand that the system they want to implement will trade lives to save money. Telltale signs: they hint at the need for “very difficult democratic conversations” when talking about providing care for sick people [Obama]. They talk about prescribing painkillers instead of pacemakers for cardiac arrhythmia. [Obama]. They write about the “tough technical decisions” that their plans will enable [Daschle].

Second, I’m concerned that other people pushing this scheme have no idea that it will (or “could”) lead to the rationing of care. Telltale signs: they dismiss unintended consequences, and bring up non sequitur straw men about dictatorship and evil government when responding to intelligent commentary.

BBB

These arguments are specious. No organization can arbitrarily remove itself from following basic economic principles, there is always an equilibrium of some sort being maintained. Your point about unintended consequences might sound intelligent until one realizes that every action has unintended consequences and no one entity is immune to them. Maintaining the current status quo also has serious unintended consequences.

I absolutely agree that central planning of entire economies ultimately fails, simply because there is no mechanism that can keep up with shifts in peoples preferences, needs and wants. This is why every dictatorial country is forced to tolerate a healthy black market…central planners simply can’t keep pace with irrational changes in culture and values.

The U.S. is not a dictatorship, nor is the proposal on the table horribly unreasonable. You are presenting a series of false choices as being the only logical ones that present themselves. That simply isn’t true, and it simply isn’t true that group choices (like democratic ones) have no place in the free market. If you are happy with your Blue Cross/Blue Shield, good for you, but I have had equally bitter experiences with the same organization, so I can assure you that your confidence in private insurers is greatly misplaced.

If you insist on maintaining the position that the US government is evil and its only intent is to screw old people out of their health care and send them to their early deaths, then I simply can no longer entertain any further dialogue.