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Medical Anarchy

chrispacia.wordpress.com

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Re: Medical Anarchy

#2
I'm quite torn about this. In some ways, it seems massively irresponsible, but framed another way, it makes some sense.

I think it's important to distinguish here between "screw experts they don't know anything" and "I've taken your professional opinion into account, and will be making my decision." The second has a long, long history in anarchist thought:

  > Does it follow that I reject all authority? Far from me such a thought. In
  > the matter of boots, I refer to the authority of the bootmaker; concerning
  > houses, canals, or railroads, I consult that of the architect or the
  > engineer. For such or such special knowledge I apply to such or such a
  > savant. But I allow neither the bootmaker nor the architect nor the savant to
  > impose his authority upon me. I listen to them freely and with all the
  > respect merited by their intelligence, their character, their knowledge,
  > reserving always my incontestable right of criticism and censure. I do not
  > content myself with consulting a single authority in any special branch; I
  > consult several; I compare their opinions, and choose that which seems to me
  > the soundest. But I recognise no infallible authority, even in special
  > questions; consequently, whatever respect I may have for the honesty and the
  > sincerity of such or such an individual, I have no absolute faith in any
  > person. Such a faith would be fatal to my reason, to my liberty, and even to
  > the success of my undertakings; it would immediately transform me into a
  > stupid slave, an instrument of the will and interests of others.
  > 
  > - Bakunin, "What is Authority" http://www.panarchy.org/bakunin/authority.1871.html

Re: Medical Anarchy

#3
> The AMA, which is little more than a union for doctors, doesn’t allow any policy changes that threaten to increase competition and reduce their monopoly profits

That's like saying that Comcast/Time Warner are a "union for Internet users".

If the AMA were "little more than a union for doctors", doctors would have a lot more respect for it, instead of the great contempt that they currently do.

If anything, you could argue that, because power follows the money, the AMA is an advocate for the insurance companies that the doctors are beholden to (essentially every doctor in the country must pay their fees to the AMA in order to process billing, because the AMA has a monpoly on that[0]). One of the big disadvantages of dissociating with the AMA (yes, a provider can do this) is losing the ability to use these insurance codes.

I don't think that that characterization is quite fair either, but it's a lot more correct than saying that the AMA is a union for doctors.

If you want to know more about CPT codes and billing, my startup[1] works with hospitals and outpatient providers to handle the billing process - I am happy to tell you far more about CPT codes than you ever wanted to know. :)

[0] The AMA owns and controls the CPT codes - the billing codes that payers use. The providers don't always pay them directly (especially if they're not independent practitioners), but they do end up paying them in the end.

[1] https://www.boardrounds.com/ (plugging shamelessly because it's relevant).

Re: Medical Anarchy

#4
This article is for real? Am I missing something? Sure, people want a diagnosis and other services from an unregulated, anonymous doctor with a reputation built by what? Amazon-like reviews? Come on!

Re: Medical Anarchy

#5
Time for a reality check.

Okay, so I like the idea of CoinMD. It's a nice way for people with medical knowledge to get paid for their tips, but so far that's really about it. It's just yet another forum for medical advice, but with a gimmick. It's not even an original gimmick. The whole "integrate Bitcoin into everything" appears to be motivated by more of a cargo cult to appear modern and countercultural than anything rational.

However, it does offer an alternative payment system and in this case it works, so I won't complain about that.

But can we please let go of these childish fantasies that Bitcoin will overthrow all government and usher us into an anarchist utopia of voluntaryism and global human liberation? Those kinds of libertarian/anarchist pipe dreams were excusable during the very beginning of Bitcoin, when the protocol was still being sharpened and everyone was enthusiastic about this new idea.

I don't know what kind of world the author lives in where he thinks people posting textual descriptions of their conditions on the Internet, backed by a digital currency, will revamp the healthcare system into an anarcho-capitalist institution and turn government irrelevant? What bullshit. Do I seriously need to explain that writing about your condition isn't enough to get diagnosed with anything beyond the most rudimentary of advice ("This might be that, but I'm not sure. Go see a doctor and try this herb in the meantime to see if it stops.")?

Bitcoin will not render government irrelevant. You see, the thing is that even if the concept of Bitcoin theoretically can allow financial independence from the state, it's completely meaningless when your ecosystem is a mess. The Bitcoin ecosystem, as we have witnessed so many times, is absolute chaotic mayhem that can ironically only be controlled through state regulation, which many hardcore Bitcoiners are advocating for.

Homeschooling is opting out of the state? Uh, last I checked, homeschooling requires one to be registered with the state, as well as offer vigorous and regular checks with it to ensure you're in line.

The Silk Road isn't any different from your standard drug dealing market, only it's online and just as volatile and unreliable as the physical thing.

Look, Bitcoin is certainly capable of great things, but these here are just naive pipe dreams.

Re: Medical Anarchy

#6

This article is for real? Am I missing something? Sure, people want a diagnosis and other services from an unregulated, anonymous doctor with a reputation built by what? Amazon-like reviews? Come on!

That's not like that at all. As far as I understand all answers doctors give are open to the public on the site, so everyone else on the internet, including other doctors, can read them and say if it's a good answer or a bad answer. I imagine if this sites starts issuing bad advice, no one would want to go there. However, as of right now, it appears you are wrong and answers are getting paid for by willing customers.

Now, this idea may be far from perfect. But comparing it to the existing system while having a blind faith in it is wrong. In our existing system patients don't have many options of checking what their doctor tells them; they are referred to doctors by other doctors and very often have no way of checking on the reputation (% of successful operations this doctor conducted, for instance). The current system is very inflexible and not consumer oriented at all. Consumer interests are sacrificed in the name of their supposed safety, without first giving said consumers options to decide what they actually want and consider safe.

Re: Medical Anarchy

#7

Time for a reality check. Okay, so I like the idea of CoinMD. It's a nice way for people with medical knowledge to get paid for their tips, but so far that's really about it. It's just yet another forum for medical advice, but with a gimmick. It's not even an original gimmick. The whole "integrate Bitcoin into everything" appears to be motivated by more of a cargo cult to appear modern and countercultural than anythi…

So, do you think that if enough people want to peacefully live without government interference at all (e.g. without a government) they don't deserve to do so and they don't deserve, for example, to be sold a piece of land to completely secede from state?

Re: Medical Anarchy

#8

> The AMA, which is little more than a union for doctors, doesn’t allow any policy changes that threaten to increase competition and reduce their monopoly profits That's like saying that Comcast/Time Warner are a "union for Internet users". If the AMA were "little more than a union for doctors", doctors would have a lot more respect for it, instead of the great contempt that they currently do. If anything, you could…

>"That's like saying that Comcast/Time Warner are a "union for Internet users"."

Comcast and Time Warner are most comparable to hospital chains in the medical context (or perhaps insurers, depending on what parameters you choose for the comparison).

>"If the AMA were "little more than a union for doctors", doctors would have a lot more respect for it, instead of the great contempt that they currently do."

Many rank-and-file union members hold their organizations in contempt.

>"If anything, the AMA is an advocate for the insurance companies that the doctors are beholden to"

The AMA's members are physicians, and other medical personnel; you may look at the AMA as a union, lobbying group, or a professional association, but it is certainly not advocating for the interests of the insurers.[1]

[1] http://www.ama-assn.org/ama/pub/membership/faqs.page?

Re: Medical Anarchy

#9
post #7

Time for a reality check. Okay, so I like the idea of CoinMD. It's a nice way for people with medical knowledge to get paid for their tips, but so far that's really about it. It's just yet another forum for medical advice, but with a gimmick. It's not even an original gimmick. The whole "integrate Bitcoin into everything" appears to be motivated by more of a cargo cult to appear modern and countercultural than anythi…

So, do you think that if enough people want to peacefully live without government interference at all (e.g. without a government) they don't deserve to do so and they don't deserve, for example, to be sold a piece of land to completely secede from state?

That's a very loaded (but easy) question.

In the United States, we fought an entire war over the question of whether or not a state had the authority to secede from the federal government (the Union). The seceding states lost that fight.

It would be very hard to argue that individuals have that right when the states do not.

You may wish that it were different, but the fact is that individuals do not have this right, according to virtually any constitutional interpretation since the mid-19th century.

Re: Medical Anarchy

#10
post #7

Time for a reality check. Okay, so I like the idea of CoinMD. It's a nice way for people with medical knowledge to get paid for their tips, but so far that's really about it. It's just yet another forum for medical advice, but with a gimmick. It's not even an original gimmick. The whole "integrate Bitcoin into everything" appears to be motivated by more of a cargo cult to appear modern and countercultural than anythi…

So, do you think that if enough people want to peacefully live without government interference at all (e.g. without a government) they don't deserve to do so and they don't deserve, for example, to be sold a piece of land to completely secede from state?

The idea of "owning" a piece of land yet seceding from the state is itself a totally ridiculous concept. Without the state, you "own" what you can defend. God won't come down and defend your "natural right" of property ownership. If you can defend a piece of land against the established states, then good for you. Set up whatever anarchist utopia you want in there. But if you find that a voluntarist society doesn't allow you to defend yourself from aggressive outsiders, then you have to concede the failure of the concept, because one of the most fundamental tasks of being a human, right up there with eating and breathing, is defending your tribe against other tribes. If your model of society doesn't allow you to do that, then talking about it makes about as much sense as talking about a utopia in which people don't need to eat or breathe.
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