Baiting you. I can't stop myself.
Ezra linked that last post, and I was nervously waiting to get slammed for my cavalier approach to my health care. Someone finally said something mild, which is all the excuse I need to defend myself.
I don't take charge of my health care. I don't want to. I am mostly injured-but-healthy; my health care bores me. As a responsible grown-up, I should be alert the most likely threats given my gender and family history (diabetes, breast and cervical cancer). I'll watch for those. Beyond that? I can't get interested without some new diagnosis.
But I don't think this makes me irresponsible. It shows that I am not interested. I am interested in other things. Things like floods. I study flood maps in my area. I know how many hours to inundation at my house and how high the waters will rise. I store emergency water and food for me and my cat. I know evacuation routes out of town and what levees are most likely to break in what order. I know where the city flood gates are. I have seen them, to verify they look maintained and operable. I care and I am interested in emergency response. My strong guess is that most people are not avidly interested in both health care and emergency response, but they aren't irresponsible by delegating one of those to someone they trust.
This is the other thing I don't get about small government types. You protest so vociferously that government takes choices away from you. But a whole lot of choices are BORING. If I never once think about car bumper safety standards for 25mph crashes, I will never miss it. I do not want to carefully match my car safety standards to my most likely driving patterns and save two grand in the process. I would not enjoy that process. (Perhaps you would, and you would rather have the money.) I've never been a comparison shopper or a meticulous consumer. Maybe my model of the individual is too biased by my experience. But I don't want to figure out how much coliform bacteria I can tolerate on my spinach, given my health. I don't want to do that even if it saves me money. I don't want to figure out what goes into paint in nephews' toys. I don't even want to handle my health care.
People talk about being rational health care consumers, but they are maximizing some combination of health outcomes and money. I want to maximize my utility. My utility is optimized by going outside to play while someone who is interested in health care gets paid to balance my health care and money. I'll pay a little extra to cover that person. I come out well ahead in that deal*.
*I can hear you already: "But you are FORCING me to take that deal too.". Yes. But right now our system FORCES me to comparison shop. Either way, someone gets FORCED to do something, and I don't see a justice interest on one side or the other. Absent a justice interest, we might as well just go with the system that creates the most utility overall.
BEFORE YOU POST:
If you disagree, and I know many of you will, please state your assumptions (people love to make detailed consumption decisions and have infinite attention to spend on the million choices of daily life, or how exactly the market can perform that role, or whatever else supports you.). I don't want to argue with your conclusions until I know your biases.
I don't take charge of my health care. I don't want to. I am mostly injured-but-healthy; my health care bores me. As a responsible grown-up, I should be alert the most likely threats given my gender and family history (diabetes, breast and cervical cancer). I'll watch for those. Beyond that? I can't get interested without some new diagnosis.
But I don't think this makes me irresponsible. It shows that I am not interested. I am interested in other things. Things like floods. I study flood maps in my area. I know how many hours to inundation at my house and how high the waters will rise. I store emergency water and food for me and my cat. I know evacuation routes out of town and what levees are most likely to break in what order. I know where the city flood gates are. I have seen them, to verify they look maintained and operable. I care and I am interested in emergency response. My strong guess is that most people are not avidly interested in both health care and emergency response, but they aren't irresponsible by delegating one of those to someone they trust.
This is the other thing I don't get about small government types. You protest so vociferously that government takes choices away from you. But a whole lot of choices are BORING. If I never once think about car bumper safety standards for 25mph crashes, I will never miss it. I do not want to carefully match my car safety standards to my most likely driving patterns and save two grand in the process. I would not enjoy that process. (Perhaps you would, and you would rather have the money.) I've never been a comparison shopper or a meticulous consumer. Maybe my model of the individual is too biased by my experience. But I don't want to figure out how much coliform bacteria I can tolerate on my spinach, given my health. I don't want to do that even if it saves me money. I don't want to figure out what goes into paint in nephews' toys. I don't even want to handle my health care.
People talk about being rational health care consumers, but they are maximizing some combination of health outcomes and money. I want to maximize my utility. My utility is optimized by going outside to play while someone who is interested in health care gets paid to balance my health care and money. I'll pay a little extra to cover that person. I come out well ahead in that deal*.
*I can hear you already: "But you are FORCING me to take that deal too.". Yes. But right now our system FORCES me to comparison shop. Either way, someone gets FORCED to do something, and I don't see a justice interest on one side or the other. Absent a justice interest, we might as well just go with the system that creates the most utility overall.
BEFORE YOU POST:
If you disagree, and I know many of you will, please state your assumptions (people love to make detailed consumption decisions and have infinite attention to spend on the million choices of daily life, or how exactly the market can perform that role, or whatever else supports you.). I don't want to argue with your conclusions until I know your biases.
posted by Megan at 1:23 PM
44 Comments:
Your assertion that an absence of government regulation would force you to do your own painstaking comparison shopping is incorrect. In all sorts of areas that the government doesn't regulate, people outsource their decisions to experts. They hire interior designers, they buy well-known brands, they look for accreditation by professional societies, they follow "Consumer Reports" recommendations.
Germany's giant, highly regarded safety testing organization, TUV, is a private corporation. Since the mid-19th century, it has been meeting a market demand for independent evaulation of many classes of products. In some areas, for example car safety, rather than establishing its own agencies and regulations, the German government piggy-backs on TUV's work by simply requiring a TUV seal-of-approval. In many other areas, for example consumer electronics, there are no laws requiring it, but people still look for the TUV seal-of-approval.
I have little doubt that, in the absence of, say, the FDA, similiar private organizations would arise, and drug manufacturers would seeks their independent seals-of-approval to advertise to consumers.
You managed to buy yourself a car, right? Do you really have any interest in cars? Do you really know what makes one car more reliable than another? Do you even really care?
So, how did you manage to decide which car to buy? Did you check consumer reports? Maybe a car magazine? Talk to friends who might know?
Your assumption is that all of this information goes away without the government.
How do I choose a dentist? I just call that 1800dentist number. They've got all kinds of information, but generally all I care about is, takes my insurance, close to where I work. For other people they offer more information.
How about climbing ropes. As far as I know there are no regulations on climbing ropes, or climbing gear in general. But there is the UIAA. I buy UIAA certified gear, I have a vague idea of what the different numbers mean, and what I'm looking for. But, again, no government involvement, and all the information, and certification is there.
Now, would I be concerned about 25MPH bumpers? Well, no, those aren't really a safety feature to begin with, and I think you mean 5MPH bumper. But, general car safety. Most cars surpass federal guidelines. So, consumers want safe cars, manufacturers provide them. Air bags were in cars long before they became mandatory, same goes for seat belts.
Would i want to know all the details of all the safety features in cars? No, but someone would be interested, some publication would sum it up for you in a paragraph or 2, and I could go on not caring.
Justin
In the presence of governmental regulation, there can be no toys that have lead in their paint. All cars will meet some minimum standard. All potable water will have certain maximum arsenic and nitrate standards. I can do better if I want, but I do not have to worry about the bottom end. That is one less burden for me.
*I can hear you already: "But you are FORCING me to take that deal too.". Yes. But right now our system FORCES me to comparison shop.
So, you're upset that you don't have the choice to not have a choice? Nice.
I can do better if I want, but I do not have to worry about the bottom end.
Isn't that true of the current health care situation too? Each of those emergency rooms has a whole bunch of regulations that require it to meet a minimum standard to stay open. They don't have to be owned by the government for that to happen.
Of course, in the prior post you were concerned about not knowing which of the 4 emergency rooms was the best. How would you expect a government expert to solve this problem for you? Would they close down the 3 worst? Would they improve the 3 worst to match the performance of the best?
Keep in mind that the government has not done a stellar job of making sure all schools are of uniform quality--even within a school district.
So, you're upset that you don't have the choice to not have a choice? Nice.
There is always a flipside. If the Coasian exchange of money could go in both directions, then there is always an opposite.
Megan, those three lines after the asterisk will shortly be tattooed on my back. Pure consequentialist gold.
There is always a flipside.
Yeah, but your flipside is weird.
How often are you actually dealing with the bottom end? And, you're still operating under this assumption that without government regulation the information you want would disappear. And that these minimum standards are necessarily good.
How do you know the standards the government is setting are adequate? Why trust those minimum standards? If you had kids, would you really buy a new car that just met the minimum federal safety standards to haul them around in?
How much FDA regulation is there really on food you buy at a farmer's market? Or food from your own garden for that matter? Why is that risk acceptable? Why are you ok with those unknowns?
The reality here is in your normal life a minimum standard would evolve for everything you use without government intervention. As is the case with my climbing equipment. I don't need to know what the minimum requirements for my mountaineer's ax are to pass UIAA certification, I'm just happy to see it's certified.
You might ask, but how do I know that certification is good enough? I'm asking the same thing about these government regulations. If I don't know the standards, I can't know if they're really good enough, I'm just trusting some other body to make the decision for me.
Justin
A3:44,
I can't tell how you mean that. But it would be a long tattoo.
Bob V.,
You're judging me. I can feel you judging me.
Justin,
I know the process that bureaucrats went through to make them (better than most people, prolly). There was a law, a draft was issued, there was public comment, two revisions, adoption and notice in the Federal Register. Every piece of that is supposed to be transparent. If I got interested, I could request copies of every relevant document; it is my right to know as a citizen. I don't know that any particular reg is good, but I know how they are made. And I could find out the details on any reg. Those aren't proprietary or a competitive secret or anything. That information is mine as a citizen. I am trusting the process more than the outcome, for every standard I don't chose to investigate myself.
You're describing what (some) people want - not to have to make choices or take responsibility for various parts of their lives.
You're failing to describe WHY this desire on their part implies a duty on my part to pay for their laziness, or to accept generic choices that are wrong for me.
If they're willing to accept the consequences of letting others make those choices, great. but if they WANT to make better choices, I say they should be allowed.
Also, I find a large difference between the universe requiring choices by letting you be born, and humans imposing choices on other humans.
P.S. Thank you for switching to healthcare from water management. Not that I don't care about water, but health issues are much less zero-sum (as humans are both provider and consumer, so can scale at the same rate), and have fewer issues about ownership and property rights.
I suspect government, as a monopoly on violence, has a large role in water management. I can imagine it having a much lesser one in individual choices like food, excercise, allowable types of bicycles, how often one sees a doctor, etc.
Sorry, I forgot to state my biases - some may be apparent in my posts, of course...
I'm biased toward modeling humanity as a fractally-complex system of individuals (and sub-individuals, for that matter - we vary nonlinearly over time and topic), with much of the complexity caused by the recursion implicit in desires shaped by society shaped by desires shaped by society.
I have a fairly strong disbelief that any external rules-based system can control such a system. The only hope of success (to be defined later, but encompassing continued existence and diversity of experiences of billions of individuals) is for self-regulating structures to be allowed to emerge.
"Markets" is a general term for these self-monitoring spontaneous structures. Where many people are making choices based on self-referential feedback loops, structure emerges and (often) equilibria are reached.
Further, I'm biased against the idea that there's anything humans can make that's outside this system. "Government" isn't separate from "market", it's just a market that includes violent coersion - if you disagree we'll fine, jail, or kill you.
Dagon,
The focus on health care won't last. I've pretty much exhausted my knowledge of it. Water policy, though, holds infinite interest for all of us.
So, if it's just the process you believe in, couldn't that process be done privately? Couldn't you then choose to only use products certified under such a process? And the rest of us could choose what we trust?
Justin
I'd rather not. Then I'd have to know the processes of a million different certifiers. As it is now, I can learn what sunshine laws require of every governmental regulatory body and know that every single agency is are bound by those laws to that process. One process is why I trust them and not different companies.
(And the fact that companies have the goal of making a profit. The Cal Dept of Pesticide Regulation has the mission to protect me. Those are different goals. Sometimes they coincide and that is awesome. Sometimes they conflict and I do not trust companies to always choose protecting me when faced with that conflict.)
Then, there could be a standard for certifications, like companies get ISO9000 certified. And you could choose to only trust those certifiers that claim whatever equivalent of ISO9000 comes about. Right?
Justin
Wait, why would you trust your government to always protect you? Michael Nifong reported to prison today, you know.
Justin
I came here to comment only to find that dcw said it for me. I'd like to add the example of Underwriter's Laboratories as a pretty useful private certification organization.
I went to the UL wikipedia page to double check that they were private, and I noticed that they also do water quality testing! I'm so excited.
On the other hand, we have the nasty example of the bond ratings agencies and how they mis-handled subprime debt and especially CDOs containing subprime debt. In the case of bonds, we've literally got an agency problem, if you'll pardon the pun--the raters are paid by the bond issuers.
If the rating agencies were somehow paid by the bond insurance people instead, maybe we would have had a different experience. I've no idea how to get there from here, though; I'll just note that UL got it right to start with and hasn't been a problem.
I'm not a true libertarian, and I don't want to think about my bumpers either. I think you're right that the first order effects of a lot of this type of regulation is good for most people.
But you also need to consider the downside: the cost of dealing with that regulation. There are certainly all sorts of potential cool products that never even get produced at all because of the expense of dealing with mountains of regulation. Those are the choices that I lose that I care about.
So if I'm reading this right... Megan, it seems like you believe that The Government [whatever subset it is] has your best interests in mind, and private Corps. don't, because their profit needs are at odds with yours. On the other hand sit people who think The Govt. DOESN'T have their best interests in mind, and so should not be givien more power, because they never give it back...
Is that the crux of the argument?
Also? While your interest in floods in your vacinity is commendable, it doesn't apply to me in the rain shadow of the rockies, 1200 miles away. But a national health service WILL apply to me even if I don't want it... I would be much more inclined if there were any human services program that was working correctly on the national scale. If we could point to anything and say 'this is the model' I'd be happy. But I don't know of one. But right now there may be another person using my SSN and the administration is prohibited by law from telling me, or doing anything about it, and there is a young woman in the UK who is fighting to keep a baby that hasn't been born yet, because a doctor who has never met or interviewed her, has decided she is a danger. and she has no real recourse to fix that, except suing the government.
maybe I just don't have the faith...
Megan,
completely agree.
Oh, and in my subjective impression the "yeah, but bureaucrats have their own interests" argument is mostly, though not completely, bunk, because most of the time, bureaucrats simply seem to be doing their job, sometimes better, sometimes less so.
Megan, if you choose not to decide, you still have (been FORCED to) make a choice. Even if you choose not to decide which government to live under, you still have (been FORCED to) make a choice. Since you have to choose, then if your government doesn't FORCE your choice on something, then you are free to pick some socialist government's decision, and then do whatever you would be FORCED to do if you had moved to that country.
Megan, what do you think of Would-Have-Banned Stores? You couldn't go into such a store accidentally, and so for you government would be protecting everything you deal with. Do you object to other people going into such stores?
What the free marketeers don't mention when they suggest private testing and certification, is that those are industries prone to natural monopoly. Underwriters Labs and TUV are both monopolistic in the US and Germany respectively.
If we must have monopolies, better that they are publicly run or regulated, with open processes, as Megan suggested.
I vaguely remember when the government (I think NY State--no fed mandate) first mandated turn signals on cars (dad had to retrofit our 49 chevy). I also remember the brief McNamara reign at Ford--he pushed safety, and it flopped (recessed steering wheel hubs was one item I believe)--consumers were more interested in sex appeal and fins than safety.
Having said that, my bias is that you all generalize too freely about "people"--we're too various to wrap up in comfortable libertarian (or bureaucratic) labels.
"yeah, but bureaucrats have their own interests" argument is mostly, though not completely, bunk" -lemmuslemmus
Yes... and no. They have their own biases and agendas. Whitness the FDA's dissembling on planB. The biggest thing that I can point to is that it will be politicians making the laws. They have such a track record of doing right by everyone...
in their own district.
They are also the kings and queens of unintended consequences...
When it comes to taking charge of one's health and safety, the key is to take reasonable precautions without getting obsessive. An example? Keeping one's kitchen reasonably clean is fine. Constantly wiping every surface with antibacterial wipes is obsessive.
Expanded from my comment on bobvis:
There's naive paternalism, which is:
"90% of people are idiots. The government should make decisions for them."
Here's the obvious problem here:
So those 90% of people vote, resulting a government that is approximately 90% idiots. We then give those idiots in the government of people the power to run our lives. Somehow, now they'll make wise decisions! PROFIT!
Right.
I compare the efficiency of FedEx to the USPS, a 401(k) to Social Security, Wal*Mart to a Soviet bread line, and so on, and come to this conclusion:
The average idiot, making decisions for himself, will do better than some other idiot making decisions for him.
There's also "evil paternalism"
"90% of people are idiots. Thus elites in government should make all the decisions."
This one's even easier to debunk:
I'm not of the elite socioeconomic class - never was, never will be. I don't think the elites have my best interests at heart.
I think the average idiot has a better chance making decisions for himself than he would having the Bushes, Kerrys, and Deans of the world making them for them.
This is the core of libertarianism: Saving us, idiots or not, from other idiots at best, or venal elites, at worst.
Hello.
My assumption is that it is wrong to force someone to do something (when he is not forcing something on you) to make life better for you.
- Jan
Yeah! Health care policy! I finally have a reason to link to you!
One point: it seems you have two theories of the individual.
* One is that people are busy, don't have the ability/expertise to self-triage, and don't usually have the opportunity or means to comparison shop in health care.
* The second is distrustful of the profit motive for something like health care.
The first blows away the theories of individual vouchers, Health Savings Accounts, and other efforts, and leads you to support group (rather than individual) coverage, where you share risk with a larger group, and which can negotiate the best deal for you.
The second leads you away from for-profit insurance companies to administer the group coverage, and toward government--at least as a referee, if not directly as the financer, or even the provider.
-Anthony
http://www.health-access.org/blogger.html
Safety standards are one thing but many people are not aware of the other forms of regulation there are and just how many are used by existing businesses to keep new businesses from competing with them.
An example can be found here.
I Hate the Liquor Licensing Process
But one universal impression I have is that the whole liquor licensing process has long ago ceased to serve its original purpose and has instead become either become captive to rent-seekers or has become a bureaucratic jobs program or both.
minuscule errors, such as abbreviating "Boulevard" in an address to "Blvd" can cause the application to be rejected and have to be resubmitted.
TJIT
1. If the government provides your health care, then they will inevitably get a say in what that health care is. I do not want politicians getting involved in my reproductive rights any more than they are. I do not want people who overdosed to be more afraid to go an emergency room. I do not want the government to know who has chlamidia(SP?) or erectile dysfunction or depression.
2. I want doctors to be paid well, so there is incentive for the best and brightest to try to go out there and cure disease. It is not a coincidence that a lot of the best places to get treated for life-threatening diseases are in the US, which does not have socialized health care.
3. I personally want choice. Choice to go to a specialist if I want to, not if some general physician says I can. Choice to pick my doctor, or midwife. Choice about the type of care I receive. I do research my health options and stay abreast of new studies that may effect my family. I do not want to give up those rights.
Water quality is a pretty black and white thing. We are all equal in our needs of clean, poison-free water. And there is no choice about what comes through your tap. So this is an area where government regulation is brilliant. But you can't apply that system to everything. Health care is one of the most personal services we require, everyone has different needs and beliefs and preferences.
-dithers
Awesome post Hon. Really well put.
If Megan and Schwartz here are unwilling to make choices for themselves, why don't they let me make their choices for them. I am above average IQ (135 or so), speak several languages, have technical background (including several patents in thin film materials), and have lived in various places around the world. I am also very knowledgable of the current biotechnological efforts to cure aging within the next 20 years.
As such, I feel that I am way more qualified and capable to make other people's choices for them. So, I feel very strongly that I should be the one to make your choices for you rather than these bozos in Washington D.C. sho call themselves a "government".
I am sure than Megan and Schwartz would agree with me here.
I think Megan has a point here. many people are incapable/unwilling to make their own choices. Likewise there are many other people (like myself) who insist on making all of their own choices themselves. Megan complains that it is unreasonable that she should be forced to make her own health care and other choices. Other people may complain that they are not allowed to make these choices for themselves. The only positive-sum solution that ensures fairness to both sides would be to create parallel systems of governance. One system who want to have their choices made for them, the other for those who want to make their own choices.
Malaysia has an analogous system in that they have parallel legal systems, one for muslims and one for everyone else. I spent time in Malaysia from 1997-2001 and saw that, generally speaking, this system worked well for the Malaysians. I think a similiar system should be setup in the U.S. as well.
You already have both options. You can sign up for an HMO if you don't want any control over your health care.
Justin
"In the presence of governmental regulation, there can be no toys that have lead in their paint."
This is laughable. There are regulations by the government on lead in paint, otherwise why would they be recalled?
In addition, the stores and importers require testing certificates, and their contracts will state they only want safe products. They may even require a test before shipment.
The problem is that unless you actually test each individual toy, the manufacturer can deceive the importer and store and ship toxic products. Yes, you could do random batch inspections and require your factory to have test machinery on site (as the one factory did) but test reports can be forged, inspectors can be bribed, etc.
My bias is that people are different, and if left to their own devices they will make choices that maximize their effort to satisfaction ratio. Megan cares a lot about floods, so she considers it less effort to learn about floods than health care, so she learns more about floods.
I'm sure no one wants to do all their own analysis on every topic, but the topics on which we want help vary from person to person. I like the idea of optional standards. The government can institute flood standards that I can follow, but if Megan with her superior interest and knowledge wants to ignore them she can.
I know that you are happy to pay the government to make your choices, but why must I also pay for them to make your choices if I choose to make my own, or pay someone I trust more?
I envy those slaves who, prior to the Civil War, were unburdened by having to choose anything. How nice it must have been to wake up every day knowing that every important decision was going to be made FOR you. All you had to do was pick cotton.
The Master will decide what you eat, what you wear, how you live, and what health care (if any) you need. How kind of him to free the slave of those decisions! How cruel it would have been to FORCE the slave to make those decisions for himself!
We need more Masters in this country. I want someone to tell me what (they think) I should eat, what (they think) I should wear, and where (they think) I should live.
On second thought, no I don't. I'll accept the "burden" of choice instead of the "freedom" of slavery.
I will add my own example of why I'm generally distrustful of governmental certification/decision making.
Once upon a time, when the Internets were new, those that sought to use those Internets for commercial applications required a method of authenticating and securing transactions. Otherwise, you'd have no way to protect credit card transactions online, and buyers would have no incentive to trust that you would protect their vital information. The government made a request for encryption algorithms that could be used to solve this problem. A little company named IBM submitted an algorithm that eventually came to be known as the data encryption standard, or DES.
However, under the vetting process for DES, the key length was shortened, which makes the cipher considerably more vulnerable to being broken. Most people at the time had no understanding of encryption or ciphers, didn't know the key length had been shortened, and if they did know, wouldn't have understood the consequences of shortening the key length anyway. However, a few mathematicians that were interested in cryptography questioned the decision and were met with little or no response as to why the decision was made. Some speculate that it was weakened to keep communications mostly secure, while still allowing the NSA to crack communications that might be important.
I guess what I'm trying to demonstrate with this example is that governments, just as individuals and private companies, are prone to make decisions that benefit their own interests. In this case, the government was not interested in actually providing an uncrackable cipher, so when they were given one as the potential standard, they weakened to suit their own purposes, adopted it as the government standard, and allowed numerous banks and businesses to use it, thinking that it had been certified secure by the government.
This means little to anyone that doesn't really care about encryption standards, but if government applies the same standards to, for example, securing levees and canals to prevent flooding, it might be a little more obvious how a lack of understanding government's incentives might lead to problems in the future. While you have gone to verify the flood gates work the way they're supposed to, I think we can mostly agree that obviously there was not a New Orleans equivalent of Megan, ensuring that government's incentives were aligned with the incentives of the people living in a flood plain. I know very little about flood plains or water allocation, so I'm a little out of my depth when I attempt to make comparisons with standards and technology that I understand.
Also, if you think the DES example might be isolated, the government attempted to do the very same thing nearly a decade later with the Clipper chip.
--mith
"You already have both options. You can sign up for an HMO if you don't want any control over your health care.
Justin"
Poor/unemployed people can't just sign up for an HMO. Doesn't part of the problem have to do not only with models of the individual, but ideals about what individuals owe to one another in a society? For example, I think we owe it to our fellow members of society to provide everyone with good health care. Discussions of free choice don't mean much to poor people who can't afford to choose, and I think this is a much bigger problem (and reason that we need the government) than whether or not we like making health care choices, and whether they are boring/interesting to us.
-sarah
I've got the same question
Where do you draw the line with this? Why not have the government choose a diet for all of us, maybe even provide us all with weekly government meal packages, so we don't have to worry about our nutrition?
Or government mandated exercise programs, with government provided gym memberships?
It's hard to work without a car, especially in the less urban areas of this country, some people can't afford cars, why not have the government provide every citizen of legal driving age with a car?
Certainly proper nutrition is no less tricky, personal, or important than health care.
The same goes for a generally healthy lifestyle.
Why are so many of you hung up on this one thing, and not the others? And, let's say you do get your free government health care, what would then start demanding for free next? Where do you stop? Do you want full on communism? What would you leave to people to take care of themselves? And why those things, and not others?
Justin
Sarah,
You are correct, but there are much better, and cheaper ways to give poor people health care than a single payer system. Like a tax break, or tax credit for people to buy insurance, or a program that provides discounted or free health care for poor and unemployed.
Underwriters Labs and TUV are both monopolistic in the US and Germany respectively.
Only if you define the market as "Providers of UL certification." UL develops standards (copies of which you can buy) and also provides 3rd party certification of those standards. Similarly, Consumer Reports, Road & Track, Car & Driver, J. D. Power, IIHS w/r/t cars; NFPA, IEEE, ISO, and ANSI w/r/t electronics and other products; Fitch, Standard and Poor's, Moody's w/r/t financial instruments; and many other groups in many industries publish standards, and some of them test against those and publish results. They are all in the business of providing third party certification of reputation.
(To the extent that UL is well-known, it is worth considering how much of that is the result of the state mandating the use of UL standards over others. UL is a Nationally Recognized Test Lab (NRTL).)
And it doesn't stop there: you can also poll friends, read online reviews, use things such as Angie's list, and use other heuristics, all of which you can weight or ignore as you wish.
The state, however, has a tendency to eliminate the dynamic search for better standards. See, for example, how the USDA is driving meaning from the word "organic" (link).
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