EG: in a free market, if someone has a healthcare emergency, yet cannot afford to pay for the service required, the free market would say -- dump this person in the street. Not exactly a morally pleasing choice. Free markets assume a rational and informed consumer; a person having a medical emergency is not always going to be a rational and informed consumer.
Not to say there is plenty of scope for a competitive marketplace in healthcare (there is, particularly for less critical care and wellness etc.), but certain portions really don't fall in scope in my opinion.
The problem with the US healthcare market is that it kind of pretends to be this "free market healthcare" system, while in reality being a half-baked socialized medical system built in bits and pieces over time. Some people are covered by the government (Medicare and Medicaid). The government relies on companies to provide much of the remainder (with tax incentives), but heavily regulates the type of health care that can be offered (eg HMOs). Since not everyone is employed by a large company, this leaves many gaps where people have no de facto health coverage at all. Except for emergency rooms, which (thanks to some notorious emergency street dumping instances in the 1980s) will accept anyone these days.
It's a mess. "Obamacare" merely plugged a couple of gaps. Much greater reform is needed, IMHO.
But there does seem to be a chorus of people who, with their strong belief in free markets, believe that the US healthcare system is a free market one (it's not) and consequently believe that the US healthcare system is the best in the world (anyone who has traveled knows how laughable this statement is). It's hard to get meaningful reform as long as this belief persists.
So before the EMTALA was passed in 1986 people were dying in the street? https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
(In practice: some private hospitals refused to accept poor uninsured patients, so these patients would be shuffled around in an attempt to find a hospital that would accept them. Sometimes patients would die before a hospital was found.)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1346189/pdf/canm...
I understand one of the reasons EMTALA was passed was due to public outrage caused by reports within newspapers, 60 Minutes, etc. on patient dumping.
From what I can Google, there are still patient dumping cases raised, even though the EMTALA exists. (12 settlements in 2013 for instance: http://www.beckershospitalreview.com/legal-regulatory-issues...)
Healthcare is not a fungible good. If you have aggressive cancer you can't just switch to a phsychiatrist because he/she is a "cheaper good" than your oncologist. Delaying purchase of your heart surgery may mean death.
"Excuse me sir, I know I might be having a heart attack, but can you please provide me a quote for this ambulance ride? I'd like to do some due diligence." Said exactly no one.
Metcalfe's Law only kicks into high gear when everyone is capable of joining the same network. If there are three or four proprietary networks with limited and expensive communications between them, growth is hobbled.
Or, to take another tack, how much has access to clean water done for you? How much has access to a house that isn't burgled done for you?
Just because you personally never received a check doesn't mean the government hasn't given you benefit.
Why do you think other networks wouldn't have grown global?
> If there are three or four proprietary networks with limited and expensive communications between them, growth is hobbled.
I agree, and there was tremendous pressure to interconnect them. The "inter" part of internet is the result of that, it's why it's called the internet rather than Arpanet. Numerous packet switching networks were developed in the 1960s, not just Arpanet.
Because privately-run networks have to turn a profit by the end of the fiscal year, if not sooner. It's too easy for a company to engage in profit-seeking behavior which harms long-term growth, like demanding fees to interoperate with it. The core Internet protocol suite, OTOH, is completely specified by RFCs which are free to read and implement.
Local and federal governments need developers to write software and will use contractors, but that's not really a subsidy.
The NSF will occasionally fund research that may or may not use software. For example, I see that the Sage math software has a few grants listed:
http://www.sagemath.org/development-ack.html
I don't know that any of this really supports the grandparent's comment, though. McDonald's is closer to being government-subsidized than anything in the software industry.
Consider also that the DEC's 1967 TOPS-10 operating system led to RT-11 to CP/M to MS-DOS to NT to Windows 10. I'm not aware of government subsidy having any role in that.
I get saying that Windows was a better user environment (maybe) than what existed in UNIX at the time, though I was fine in FVWM.
But I don't think I can take someone seriously that thinks DOS is better than UNIX.
Also, Edison invented the vacuum tube upon which it is all based. I read a biography of him, and he never got a subsidy. Shouldn't he get all the credit?
Also I would call most of the government projects that Oracle is on subsidies considering how little value they deliver and how much they cost.
Selling to the government is not a subsidy.
There are probably many companies that make your point much better is all.
Or do you mean we don't need copyright protection, limited liability and bankruptcy protection allowing entrepreneurs to take risks, laws protecting investors and corporations, public education system, and so forth?
Why would Edison want all the credit? Newton said he only saw as far as he did by standing on the shoulders of giants. We are all inheriting the accumulated wealth and knowledge of all the people who came before us. Why not the people around immediately before us who built the society we live in?
> Why would Edison want all the credit?
Why indeed.
Existing in a country where a private company is a profit center as opposed to something for bandits to loot?
The lesson from this is not "free markets are bad," it's "simplistic ideologies are useless."
We know that private actors are bad at some things, like funding basic research and building roads and utilities. We also know that governments are bad at some things, like making consumer products. So let the government build the roads and let GE make the washing machines.
The worst alternative is to have the government do half of something. This is the US healthcare system. Single payer has problems, but it works. The complete absence of government in healthcare would have different problems but would also work. What we have doesn't work. It's a corrupt mechanism for funneling public money into drug companies.
Here's the test for whether the government should do something: Does it make sense for the government to pay for this and then give it away for absolutely no money whatsoever to every citizen of the country? If not, the government shouldn't do it. Notice that the answer for healthcare is then not obvious, but the thing we have is not a valid answer.
Cards on the table, I do think that more freedom in the market would be good for the entire system, from top to bottom. But I can find myself in total agreement with those who think it should be more socialized that what we have now is a really crazy, chaotic system that seems to manage to combine the worst of both worlds. As a result, it's every bit as valid to claim that socialized health care is a disaster because the US health care system proves that it doesn't work... which is to say, an entirely invalid and fallacious claim.
On the other side, check the software business. It's a powerful engine for growth and wealth in this country, despite having driven prices for software literally to zero. And the software business in the US is the most free market industry in the country - no licenses, permits, subsidies, tariffs, regulations, etc.