Want to rescue rural America? Bust monopolies • Hacker News Board

Re: Want to rescue rural America? Bust monopolies

#121

Post by MichaelBurge » Sun, Apr 23, 2017, 7:10 PM UTC

maxerickson wrote: post #96

MichaelBurge wrote: post #61

They need to deregulate the entire medical industry, so anyone can start a medical practice. Right now, doctors control the supply of new medical licenses, and they're incentivized to restrict the supply so their own wages go up. The official line is that they can ensure high-quality medical treatments this way, but that's just something they tell themselves to feel good about it. One of the consequences is that doct…

There's an awful lot of middle ground between what we have now and "anyone can start a medical practice".

If I'm reading you right, you're worried about e.g. some crackpot calling himself a doctor who rubs moonstones on an infection to make the evil spirits go away. An unfortunate consequence of "anyone can start a medical practice" is that the crackpot would be allowed to operate, but the negative aspects could be mitigated by:

* Somebody starting a "Yelp for doctors"

* The government could give some approval stamp to doctors using all the existing restrictions, and you could always ask a doctor "Are you XYZ-approved?" It would be a very serious crime for a moonstone-carrying crackpot to lie about his governmental approval, and his status could be verified on a government website. People who solely use government-approved doctors would still benefit, since licensed doctors would still be competing against unlicensed doctors, so there'd be a limit to how much the government policy could distort the market.

* People who repair your sidewalk or furnace often advertise "licensed, bonded, and insured". A furnace can burn your house down, which seems a similar risk to medical malpractice. You could ask your doctor if he's licensed by the government, has put his personal capital into a bond, and is insured.

Re: Want to rescue rural America? Bust monopolies

#122

Post by neuland » Sun, Apr 23, 2017, 7:12 PM UTC

trafficlight wrote: post #46

MichaelGG wrote: post #41

Earlier quoted context omitted.

Awesome. Do you actually have to sell telegram services?

Legally, I don't think so. But we did build a little Raspberry Pi based machine with a telegraph key. It needs some more work, but there are people who are legitimately wanting to buy the service.

There are people that want to buy telegraph service?

Re: Want to rescue rural America? Bust monopolies

#123

Post by bluejekyll » Sun, Apr 23, 2017, 7:13 PM UTC

whopa wrote: post #82

rndmize wrote: post #31

Earlier quoted context omitted.

Not the GP, but these are social issues largely, and while I care about them, I consider them less important than economic issues (for a multitude of reasons). And on economic/business issues, the two parties seems to have minimal differences.

Health care is squarely an economic/business issue that affects nearly everybody, and there are clear, meaningful differences between the two parties here.

AHCA, Obamacare is definitely better than before, it guarantees open access to many who didn't have it before. A good thing.

But it didn't go far enough. It played in to the corporate healthcare system demands by not offering a competitive public option. The so called Blue Dog democrats blocked that, which is such a shame.

Far better than anything the Republicans have put on the table. The problem is that we basically have one sane party which is backed by corporate interests, and another party backed by the same or similar corporate interests which plays off fear for support.

I believe the only fix to this is to weaken party entrenchment, and have ranked choice voting in place; but who in these two parties would actually support that?

[Edit: typo]

Re: Want to rescue rural America? Bust monopolies

#124

Post by enraged_camel » Sun, Apr 23, 2017, 7:13 PM UTC

JackFr wrote: post #92

skummetmaelk wrote: post #28

Earlier quoted context omitted.

That's the thing though, that is exactly what a late stage "free market" looks like. What you need is a heavily regulated market that prevents exactly this behaviour. People need to stop wishing for the "free" market. The term is abused by orators and manipulators who prey on peoples desire for a market which is free in the spirit of the word, and deliver to them a market which is technically "free" and horrible.

> What you need is a heavily regulated market that prevents exactly this behaviour. That seems like the opposite of a solution. For such a system to work one has to believe that that the regulatory apparatus is staffed with monks who are unaffected by the temptations of wealth, power and vanity that other humans are subject to and that 'regulatory capture' isn't a real thing. Further that the price mechanism as an in…

Don't let perfect be the enemy of good.

Yes, regulations aren't perfect. Yes, regulatory capture is a problem. Neither of those things is a reason to not have regulations.

>>that corrupting it with noise will have negligable effect on efficiency and technological development

What really hurts efficiency and technological development is monopolies. A company that is a monopoly has very little reason to innovate. We see this all over America with Internet Service Providers. They only improve their service levels if they fear competition (like what happened with Google Fiber).

Re: Want to rescue rural America? Bust monopolies

#125

Post by LoonyBalloony » Sun, Apr 23, 2017, 7:14 PM UTC

noir_lord wrote: post #119

skummetmaelk wrote: post #28

Earlier quoted context omitted.

That's the thing though, that is exactly what a late stage "free market" looks like. What you need is a heavily regulated market that prevents exactly this behaviour. People need to stop wishing for the "free" market. The term is abused by orators and manipulators who prey on peoples desire for a market which is free in the spirit of the word, and deliver to them a market which is technically "free" and horrible.

> That's the thing though, that is exactly what a late stage "free market" looks like. What you need is a heavily regulated market that prevents exactly this behaviour. I've joked for years that the end stage of capitalism is "one company selling you oxygen". Turns out someone else had that idea back in the 1920's and there is a 'sci-fi' book based on the premise.

https://m.youtube.com/watch?v=SiabeNR_q0U

Re: Want to rescue rural America? Bust monopolies

#126

Post by charlieflowers » Sun, Apr 23, 2017, 7:16 PM UTC

This is behind many (maybe most) of our problems in America. For example, this is the biggest source of what's wrong with our healthcare system.

Businesses have built up "moats" throughout the system, leading to high prices and poor service. This is the source of the "cost disease" that makes our healthcare too expensive.

Competition is part of the very foundation of capitalism. Without it, capitalism itself doesn't work. So we better figure out some answers.

Re: Want to rescue rural America? Bust monopolies

#127

Post by WalterBright » Sun, Apr 23, 2017, 7:19 PM UTC

cs702 wrote: post #4

"I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public health officials, a major grant from the National Institutes of Health and robust private investment. But when my partn…

The medical industry, including the medical device industry, is the most heavily regulated industry in the US. It's far from free market.

Re: Want to rescue rural America? Bust monopolies

#128

Post by WalterBright » Sun, Apr 23, 2017, 7:20 PM UTC

cs702 wrote: post #4

"I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public health officials, a major grant from the National Institutes of Health and robust private investment. But when my partn…

> 80 percent of the market

What about the other 20%? what about the international market? what about the non-hospital market (i.e. people who inject themselves, such as diabetics, at home)?

Re: Want to rescue rural America? Bust monopolies

#129

Post by maxerickson » Sun, Apr 23, 2017, 7:20 PM UTC

MichaelBurge wrote: post #121

maxerickson wrote: post #96

Earlier quoted context omitted.

There's an awful lot of middle ground between what we have now and "anyone can start a medical practice".

If I'm reading you right, you're worried about e.g. some crackpot calling himself a doctor who rubs moonstones on an infection to make the evil spirits go away. An unfortunate consequence of "anyone can start a medical practice" is that the crackpot would be allowed to operate, but the negative aspects could be mitigated by: * Somebody starting a "Yelp for doctors" * The government could give some approval stamp to d…

I'm not terribly worried about literal crackpots.

I'm skeptical that "Yelp for doctors" will in practice be more efficient than up front regulation about who can provide certain services.

I certainly think there are impediments that should be removed, just not all of them.

Re: Want to rescue rural America? Bust monopolies

#130

Post by sanderjd » Sun, Apr 23, 2017, 7:22 PM UTC

skummetmaelk wrote: post #28

cs702 wrote: post #4

"I started a manufacturing company in Little Elm, about 35 miles north of Dallas, to produce the first-ever automatically retracting syringe to eliminate the risk of nurses contracting HIV through accidental needle sticks. The syringe received rave reviews from nurses, hospital executives and public health officials, a major grant from the National Institutes of Health and robust private investment. But when my partn…

That's the thing though, that is exactly what a late stage "free market" looks like. What you need is a heavily regulated market that prevents exactly this behaviour. People need to stop wishing for the "free" market. The term is abused by orators and manipulators who prey on peoples desire for a market which is free in the spirit of the word, and deliver to them a market which is technically "free" and horrible.

This is just one of those definition things where the common amateur usage of terms differs from their meaning amongst professionals in the relevant field. The common understanding of "free market" seems to be synonymous with "unregulated market", but that's not how economists use the term.