Pigou Tax, Yes or No?

A small community sits on the outlet of a small river and uses the river water exclusively for unheated, unbuffered showers. The community has 50 homes, each with a single shower. The river flow is always sufficient to supply up to 60 showers in use simultaneously, so showers are not scarce goods, in terms of demand with respect to supply, and have no economic value.

After ten years of growth, the community now has 100 homes and showers, and it is no longer true that the unchanged river flow can supply all of the showers in use simultaneously.

Question :

In principle, would a supporter of a Pigou tax on road use to reduce traffic congestion support a tax on water use to reduce shower congestion? If not, why not?

Despite all my rage I am still just a...

(A funny parable)
A Rat is shocked when he touches a wall with his nose and so he stops touching it. Why did he do this? One guess might be that the rat either thinks that (or uses a mechanism that relies on the theory that) the future will resemble the past; if he touches it again he'll get shocked again. Well that seems reasonable, but another person (a Popperian) suggests that perhaps the rat had a former theory about the wall that was just falsified (the wall will not shock me) and he has moved on to a new theory which is- by the sheerest coincidence, of course -"Don't touch the wall" instead of a million other unfalsified theories like "Touch it only with your ear and you'll be fine." Curious, they try it again and again and always the rat the touches the wall once or twice and then ceases to. The Popperian- his master's voice perhaps ringing in his ear- unfailingly exclaims "Why you see- the rats are simply holding their first "Wall won't shock me" theory tentatively, changing it to the next random unfalsified theory (coincidentally it's always "I shouldn't touch the wall") and then maintaining and acting on the new "I shouldn't touch the wall" theory."
A dialogue starts:

Achilles: Wow, so it looks as if he hits upon the correct theory quickly, and you think that's always a function of chance?
Popperian: WOAH WOAH! "Correct theory" you say? Nonsense- his theory that the wall will shock him is no more likely to be true than any other theory (save, perhaps for his falsified theory "The wall is okay to touch")
Achilles: Well but right there we can see the voltage running through...
Popperian: Voltage? (he tentatively licks the place where the wire and electrified wall meet, he's painfully shocked and draws back) eeeeggghhhh!
Achilles: (grabs Popperian) What in the hell do you think you're doing?
Popperian: Oh it's aww in a days wowk. From my random bed of unfalsified theories I drew "The wire/wall connection tastes of delicious chocalate and will not hurt you."
Achilles: Well which new randomly unfalsified theory have you settled on now?
Popperian: Oh, um... "That wall will hurt me every time I touch it and never touch it again."
Achilles: Do you believe that's more likely than not to be true?
Popperian: Why..., er, of course not. It's- by the sheerest of coincidences- the new theory I've settled upon from my stack of possible theories.
Achilles: Why not "The wall wire/connective area will give me a hand massage if I touch it with my hand"? Is your theory better than that one?
Popperian: Oh not at all, they're just two unfalsified theories. No better, no worse.
Achilles: Well give that one a try then- there's no reason to keep your present theory (it's no more likely to be true after all) how about switching?
Popperian: Oh, er, hmmm... Well, I'm not quite certain that it would be er, rational to do so.
Achilles: interesting, but you're certain that your reluctance to touch the area isn't because you think it's more likely than not that you'll be shocked?
Popperian: (indignantly) not in the slightest.
Achilles: You think that the "hand massage" theory is just as likely to be true as you theory that the wall will shock you?
Popperian: Of course {this guy needs to read some Popper, sheesh...}
Achilles: And that you, and the rat, and everyone else who would almost immediately adopt the theory that "the wall will shock you"- they are all doing by the most random of selections? Simply finding a new unfalsified theory and then, for no apparent reason, dogmatically sticking to it even though (as you say) it's no more likely to be true than any other?
Popperian: Well you see, any other way would be irrational.
Achilles: Well in that case I have to ask something. You're obviously quite skilled in ex post facto justification. But your theory, falsification: is it really falsifiable?
Popperian: ...

New SF Book Alert

Rollback by Robert J. Sawyer

Life Extension, First Contact, Philosophy, Ethics, Robotics, Evolution, Sink-Kitchen

Pan Critical Rationalism

A few of us have been having a contentious debate in the comments section after I claimed that it wasn't true that everyone uses induction in their lives.

I do hold that some people might use philosophical induction with the intention of achieving absolute truth but that this is invalid. There are people who say, "The sun rose in the past so it must rise today."

It certainly is a method you could use to take a stab at the truth but it is so prone to error that it is likely to fail. Popper called this psychological induction. I say it's likely to fail because it is prone to error. Just because the sun rose yesterday and the day before does not mean it will always rise. I'm sure most people who would agree with this solar statement are smart enough not to use the method in this case although they may be mistaken in thinking they are in fact using it anyway. This is the error that Popper believed Hume made.

Now I feel the opposition has so far even failed to understand my position. I cannot even get him to the point where he understands Popper. Sometimes I'm just not sure how to get another person to see things correctly. I'm not saying that he must see that I'm right but that he at least understands my position. Then I might accept his claims as valid criticism, true or not.

In that spirit I went out to try and find a worthy opponent. Someone who I feel understands Popper and has a criticism I accept as valid. I had heard arguments in the past that were, I thought, acceptable criticisms of Popper. I thought I'd show one to move the argument up to the point where I am, and not remain stuck on the failure to even understand Popper.

So why then do I still maintain my position? The answer is that I didn't. I'm not a strict Popperian in the sense of being a believer in everything Popper says. I never was since I disagreed with him on some issues. I was however accepting of part of his beliefs. I was a critical rationalist but had to abandon that when I found arguments that showed critical rationalism to be false. I modified my beliefs to more in line with Bartley. I'm currently a variety of Pancritical Rationalist.

Does that help? Well, yes and no. I no longer have to deal with the prior criticism that worked on Popper but there are new criticisms that work on Bartley's position. I also accept that criticism. We'll get into why I continue to believe in a modified Pancritical Rationalism later.

The criticisms of Popper and Bartley that I accept are expounded upon in an article by Armando Cíntora titled "Miller's Defence of Bartley's Pancritical Rationalism ". You can read it here. Here's a google in case that link goes bad.

Here is the criticism of Bartley that I accept:

"W. W. Bartley thought it was possible, however, to reform Popper's critical rationalism into a consistent and comprehensive theory of rationality («pan critical» rationalism: PCR, also called comprehensive critical rationalism: CCR.) Bartley claimed that it was possible to reform critical rationalism into a theory that allegedly does not lead into a fideism of ultimate commitments. Bartley proposed a new rational identity one that allegedly does not lead into conflicts of rational integrity. Bartley's pan critical rationalist can be characterized as one,

... who is willing to entertain any position and holds all his positions, including his most fundamental standards, goals, and decisions, and his basic philosophical position itself open to criticism; one who protects nothing from criticism by justifying it irrationally; one who never cuts off an argument by resorting to faith or irrational commitment to justify some belief that has been under severe critical fire; one who is committed, attached, addicted, to no position. (Bartley, p. 118; emphasis added.)

This pan critical rationalist justifies nothing and allegedly criticizes everything, even his own rational attitude or position, he is not committed to any position, not even to a belief in the value of argument. This doesn't mean that the PCrationalist is without convictions, but only that he is willing to submit his convictions to critical consideration. PCR, however, leads to logical paradox, thus consider the following argument, due to Bartley himself and inspired by a critique of J. F. Post, an argument that Bartley finds unobjectionable:

(A) All positions are open to criticism.

And because of PCR's intended comprehensiveness it then follows,

(B) A is open to criticism. And,

Since (B) is implied by (A), any criticism of (B) will constitute a criticism of (A), and thus show that (A) is open to criticism. Assuming that a criticism of (B) argues that (B) is false, we may argue: if (B) is false, then (A) is false; but an argument showing (A) to be false (and thus criticizing it) shows (B) to be true. Thus, if (B) is false, then (B) is true. Any attempt to criticize (B) demonstrates (B); thus (B) is uncriticizable, and (A) is false. (Bartley, p. 224.) (Emphasis added.)

Hence, PCR is refuted and this conclusion is a result of the self-referential character of PCR -- a theory that intends to be a theory of all theories itself included, and it recalls the logical difficulties of classical rationalism, which also wanted to be comprehensive. Bartley claims that the paradoxical nature of PCR could be dealt, type and language-level solutions, Zermelo-type solutions, category solutions, radical exclusion of all self reference... (Bartley, pp. 219-20.)

But, this is too vague, mere possibilia. "

I agree with this and I also agree that Miller was not able to resolve the issue to my satisfaction.

So, you might ask, "If I accept this criticism of Bartley then why do I continue to claim to be a Pancritical Rationalist?" The answer is that I have a solution in mind that is not in this list of "possibilia".

I leave it to the reader to see if they can come up with a solution. Remember to always consider the possibility that the problem was improperly stated.

If the problem is misstated then this would not be an excuse for Bartley since he was the one who formulated the precise statement based on a critique by J. F. Post. If any error was made it was certainly Bartley's.

So what's the solution?

Also, who the heck spells Defense as Defence? Is that a British thing?

The Cart of Public Opinion

Is it wrong to fantasize about hanging out in the parking lot in front of a grocery store, waiting for someone to leave a shopping cart in the middle of a parking space, and then rolling it into his car as he drives away?

For extra credit (redeemable for absolutely nothing), is it wrong to do this when I should be finishing the follow-up to this post?

For extra extra credit, devise a market-based solution to this problem.

Economics, not even a two-bit science

Fundamentally, economics traces its foundation to a matter of choice, selection or comparison, or to an iterative ordinal ranking of alternatives. In each case, the result can be completely expressed as A or ~A, yes or no, higher or lower, 0 or 1.

In other words, economics is a one-bit science, with only a sign or direction bit needed, and no additional magnitude bits.

Sexual Orientation Affects Orienteering Skills

The results of this study are exactly what would be expected if homosexuality and map reading were both influenced by genetics and in the same direction. Sexual attraction to women apparently hones your ability to find them. The opposite and you can just let the men find you.

"For instance, in mental rotation -- a task where men usually perform better -- they found the best performance to worst was: heterosexual men, bisexual men, homosexual men, homosexual women, bisexual women and heterosexual women."

So apparently it also affects your ability to visualize different sexual positions. No wonder men spend more time thinking about sex.

Of course this post is entirely in jest and it's sad I had to write that.

Destined to Legislate

House Antigouging Bill

"The legislation's sponsor, Rep. Bart Stupak, D-Mich,..."

The Abacus and Chinese Interest rates

Inequality of Income, Rhetorical Question

Why do discussions of the inequality of income never seem to get around to government workers, university professors, public pensions, public and private union members and officials?

Dawkins and Instrumental Unreason

Instrumental unreason is when you say "I can't prove x, but I'm going to believe it anyway so that I can do y." The question of whether you actually need x to do y is a separate question, but it seems to me that this is an important concept to deal with in the great atheist debates of the late 2000s. Why? Well because Atheists use it just as religious people do and accordingly it's one of the few arguments that religious people make that Dawkins doesn't just demolish. As I always do when talking about this, let me say that I'm a secular atheist but not a militant atheist. I like Dawkins, am ambivalent toward Dennet (he gets credit by association from Hofstadter), and hate Hitchens and Harris with little restraint.

What is x for atheists? There are possibly a few examples, but it seems to me the most obvious one is something like the "problem of induction." That is to say, is there any principle by which we know that the floor will be there when we wake up tomorrow? Or that the Grue-Bleeners aren't right? There isn't. So why do we assume it, and why is the problem of induction really meaningless? I presume it's because we are willing to make the small leap (and it's important to stress "small") that in practice the problem of induction is only a problem of sample size and not theory. I fully embrace this, and in so doing I say "I can't prove that the floor will be there tomorrow when I get out of bed, but I'm going to believe it anyway so that I don't wake up every day scared, carefully prodding the whole floor for weak-spots using a stick." Everyone agree with this?

Well so let's take a look at a similar religious use: "If I didn't believe in God then I'd know I could never see my dead son again and I doubt I could go on living." If you say that Dawkins, he'll say two things:

1. Wanting it to be true doesn't make it true. Your desire doesn't prove anything.

2. Atheists deal with tragedies all of the time, and there is much meaning to be found in the beauty of rational life.

Did I miss anything? I think those are the two Dawkins responses, and I've listened to a lot of Dawkins. Always "that doesn't prove anything" and "There is meaning to life in a secular worldview." Well on the first point Dawkins is of course correct but he's either misunderstanding what's meant or just providing a caveat. That question doesn't say "I want to see my dead son therefore religion is true", it says "I'm willing to have an irrational belief to ease the pain from Life's tragedies." As for point 2, this is also true but the simply fact that you or I or Dawkins find consolation in secular rationalism doesn't mean that someone else will. Point two can only be an appeal to alternatives rather than some disproof. Suppose that our questioner doesn't find consolation in the secular worldview. What then?

It seems to me that we're dealing with two questions of the same type. One says "I'll believe in induction even though I can't prove it so I can continue building and admiring this tremendous edifice of science" and the other says "I'll believe in God even though I can't prove it because I want to have meaning in my life." They are both examples of Instrumental unreason. What distinguishes them then, aside from what I've already covered? It seems to me that the two major differencres are as follows:

1. Differences of goal: Is the ability to not spend 4 hours crossing 1 street because you can't be sure if you aren't stepping on illusory pavement this time superior to "finding meaning in one's life?" Possibly; I happen to think that "finding meaning" thing is rather overblown, though if not it's arguable.

2. Differences of reasonableness: This is the meat of it- is the jump from "it's EXTREMELY likely that the floor is there" to "it's true that the floor is there" much of a jump? No, especially when compared to the jump from "there probably isn't a bearded man in the sky who watches me and takes my soul to heaven" to "there is."

Okay, so it's a problem of reasonableness but... that's subjective and hard to pin down. So how do we make the distinction? I'd love to hear some thoughts. As for me, the best I have is "if possible one shouldn't have irrational beliefs." It seems to me that trying to eliminate induction from my life is not possible and yet finding meaning in my life without god is. Therefore I'm a secular atheist. However, I recognize that as a personal assessment that may be different for other people. That's why I'm tolerant of religious moderates. I'm not interested in defending religion from the militant atheist movement; I'm interested in defending pluralism.

Pernicious Perverse Incentives

How many people really think, "Gee, if only my open heart surgery were more like buying a dishwasher"? I'm guessing that's a pretty select group, butThe New York Times is betting that patients want an extended warranty on that new ticker.

Some hospitals are experimenting with a flat fee for surgery and recovery care, meaning that any unforeseen hospital visits will be gratis for the consumer. The theory here is that doctors have a perverse incentive to neglect patient care, since they get to bill for every extra problem that arises post-op. Under a flat fee system, that incentive vanishes, so doctors are more likely to give the best possible care.

It's an intriguing idea but one I don't think will work. First of all, the benefits are likely to be very marginal--better instructions with medications and so on--rather than structural. There's just no way that doctors are leaving sponges in people so they can later bill for their extraction (see the accompanying photo from the article). I can assure you that the fear of a malpractice suit is the only incentive an OR team needs to double check the sponge situation.

But furthermore, the article totally neglects the new set of perverse incentives created by the warranty system. To wit:

Since Geisinger began its experiment in February 2006, focusing on elective heart bypass surgery, it says patients have been less likely to return to intensive care, have spent fewer days in the hospital and are more likely to return directly to their own homes instead of a nursing home.

Call me a cynic, but I'm not surprised that fewer people are getting hospitalized when the cost of that stay suddenly starts falling on the doctors. What the Times reports as evidence of success could just as easily mean that these patients are receiving a lower standard of care than they would have if their insurance companies were footing the bill. Suddenly Grandpa's post-op pain doesn't seem so pressing--get some pills in him and get him out that door! Now maybe this is just good sense and a smart way to keep soaring medical costs down, but it's ridiculous that the article fails to mention the trade off being made at all.

Unintended consequences are a bitch.

It's a Bad Thing

Sweeping CO2 under the mat

By Aeon McNulty in: Environment •

It's not just a question of putting out less CO2, but of removing that already there. Whether it's causing the earth to warm, or is the result of the earth's warming, it's a bad thing and we want rid of it because CO2 molecules hold back the heat from the surface and warm the atmosphere....

Governmental Innovation and The Wisdom of Crowds

I've been reading James Surowiecki's The Wisdom of Crowds, and I think it must be really good, because I've already encountered a section supporting my political ideas :). Discussing the early automobile industry, he writes:

In the first decade of the twentieth century, there were literally hundreds of companies trying to make automobiles. And because there was no firm definition of what a car should look like, or what kind of engine it should have, those companies offered a bewildering variety of vehicles, including the aforementioned steamers and battery-powered cars...At one point, a third of all cars on the road in the US were electric-powered. Similarly, steam-powered engines were seen by many as the most logical way to propel a vehicle, since steam obviously worked so well in propelling trains and boats...As the decade wore on, though, the contenders began to fade...By the time of WWI, there were still more than a hundred automakers in America. But more than four hundred car companies had gone out of business or been acquired.

He also explains how the best innovations from this wide variety were eventually taken up by the winners, and goes on to generalize:

The story of the early days of the US auto industry is not an unusual one. In fact, if you look at the histories of most new industries in America, from the railroads to television to personal computers to, most recently, the Internet, you'll see a similar pattern. In all these cases, the early days of the business are characterized by a profusion of alternatives, many of them dramatically different from each other in design and technology. As time passes, the market winnows out the winners and losers, effectively choosing which technologies will flourish and which will disappear. Most of the companies fail, going bankrupt or getting acquired by other firms. At the end of the day, a few players are left standing and control most of the market.

Why do things this way? Isn't it inefficient to have so much failure? Surowiecki explains that this process is a response to a situation when you not only have to choose between many possibilities, but you don't even know what the possibilities are! Now you can't just choose, you have to first explore to determine your choices, which requires diversity and experimentation. He says:

One key to this approach is a system that encourages, and funds, speculative ideas even though they have only slim possibilities of success. Even more important, though, is diversity, not in a sociological sense, but rather in a conceptual and cognitive sense. You want diversity among the entrepreneurs who are coming up with the ideas, so you end up with meaningful differences among those ideas rather than minor variations on the same concept.

Because of the high barrier to entry in the governing industry, such an explosion of innovative and diverse firms has passed us by. Without experimentation, how can we find more effective means of organizing and governing societies? And because the cost of switching countries is so high, the current large firms don't even do much innovation to compete with each other. (And what competition there is is to attract businesses, not people, since businesses are more mobile). As a result, the field is moribund, slow-moving, and inefficient, with business models ("Monarchy", "Democracy") lasting for hundreds of years - the diametric opposite of a thriving industry. This is especially bad because government is currently the largest industry. Furthermore, one of its most important aspects, generating laws, is a knowledge industry of the type which has been revolutionized by modern communications - at least, in the private sector - so there is reason to think the technology could be improved.

Dynamic geography and market anarchy both offer the potential to dynamize the industry by knocking the entry barrier down to size. Dynamic geography is what you get in places like the ocean where you can build a new country one floating house at a time. Market anarchy is a system where each function of government is performed by many competitive, private firms. In these systems, a new competitor doesn't have to win an election, a revolution, or a war to enter the market, just have a new and appealing product - just like the industries Surowiecki describes.

It is important to note that these new and appealing products should not be restricted merely to libertarian systems. A competitive market can serve many niches - including ones that you never would have predicted in advance. Which is a good thing - we want to see the product of diverse viewpoints about what makes a good, just society and how to get it. The lack of governmental innovation doesn't just hurt libertarians - it hurts everyone.

Now, its not clear that either of these systems will ever become reality - they are clearly speculative ideas. But slim though the possibilities are, the potential payoff is gigantic. If either of them comes into being, government will finally have its Cambrian explosion, a dot-gov boom of experimentation and exploration, and the world will be a different and better place. Seems worth shooting for - which is why I'm back to trying to finish my seasteading book.

I Against I

The worst thing about a police state is that the police become a weapon in the petty disputes of citizens. Law per se isn't what keeps us out of a Hobbesian war of all against all: It's having institutions that minimize the number and importance of disputes and mechanisms that settle them quickly. Too much law is just as bad (if not worse) for a society as not enough.

Narrow conceptions of determinism

Still haven't had a chance to read Taleb's Black Swan as my local bookshop hasn't received it yet but I did read, last week, his earlier (and entertaining) Fooled By Randomness which is pretty eye-opening by itself. In passing, I was reminded of Popper's stance on determinism - one of the few things I reckon Popper got wrong - and it occurred to me that much of the discussion around determinism is hampered by the fact that the popular conception of determinism, including that of Taleb and Popper, is overly narrow. Taleb makes the correct point that we often mis-identify predictable patterns in mere "randomness". But one needn't posit "true" randomness under indeterminism for this to be true. Even under determinism, any complex system is going to be "functionally" random with causes "effectively" (but not "in principle") impossible to identify. It seems to me that Taleb and Popper try (and fail) to establish an "in principle" objection to determinism but an "in principle" objection to determinism is not necessary to show that "naive determinism" - the idea that simple cause and effect are easy to identify and can be used to make accurate predictions - is wrong. In other words, the problem with Laplace's Demon is not that it would be impossible for such a "vast intellect" to predict the future but that naive determinists vastly underestimate (and misunderstand) just how (unimaginably!) vast that intellect would have to be to process the amount of information required.

Active Insurance

I've been thinking about a potential business idea for seasteads (although it would work elsewhere as well) which my friend Daniel called "Active Insurance". It came out of daydreaming about what I'd want to do with lots of money if I made it.

One answer is "buy healthcare which gives me a long and happy life", which made me wonder how someone with lots of money would turn money into health. If you have enough money, just buying healthcare won't soak up enough. What I would really want to do is to sponsor medical research into the things which were going to kill me.

So imagine an organization you could join, and give whatever amount of money you want to devote to your health problems. The organization starts out with a full risk assessment to figure out what causes are most likely to kill you. The organization then allocates your money to its research funds in proportion to their risk. So each medical problem is funded in proportion to the sum of risk it contributes to the membership pool weighted by the contributions of the at-risk members. (Even better would be to add an estimate of the difficulty of addressing a given problem, and thus the benefit of marginal dollars).

The larger a fund and the more obscure the health problem, the more likely the organization would start an in-house effort. For smaller funds and more common problems, it would instead give research grants, donations, and venture capital to other organizations. Any breakthroughs or products would be first available to members, then either sold to other medical companies (to increase funds available for solving more problems) or given away, depending on the cost structure, demand structure, and goals of the membership.

I suppose that a truly efficient regular insurer would render such a system less useful. The insurer would have incentive to research medical breakthroughs that would reduce their costs by more than the cost of the research. But they don't have the sliding cost structure, where people are willing to pay more because they know the money is going directly towards figuring out how to extend their life, solve their problems. And in practice, while they fund some such research, they don't fund much.

Harvard Pilgrim HMO Premiums, debriefing myself

In a previous post that I don't seem to be able to reference, I noted that the new mandatory Massachusetts health care law had forced Harvard Pilgrim to drop my existing non-group HMO policy (single, 60, male, non-deductible, with drug benefits) and offer a new spectrum of plans that comply with the new law. I also noted that I had had some expectation that the resultant plans would cost less than the $900 per month that a renewal of my plan would likely cost.

Given that healthcare insurance plans are almost unique for every individual, at least in terms of price, I will list the prices of all the HMO plans offered for reference and note some other tidbits that I picked up in multiple calls to the insurer.

For 7/01/07 thru 6/30/08, single, male, 60, with drug benefits, per month

Plans with copays only:

Premier HMO 10 $812.96
Value HMO 15 $700.30
Affordable HMO 20 $654.55 ** compare
Affordable HMO 25 $603.15
Tiered Copay HMO 20 $601.74

Plans with copays and deductibles:

Best Buy HMO 500 $625.70
Best Buy HMO 1000 $591.92
Best Buy HMO 2000 $538.42 ** compare

The details of these plans are here on page 2.

Comparing the two **-marked plans above, the major differences are that the $2000 deductible plan has an ER copay of $100 vs $50 and no inpatient and day surgery copay of $500. Note that copays are not counted against calendar year deductible liabilities.

Ignoring the copays, the non-deductible plan has a total premium of $7854.60 and the $2000 deductible plan has a total premium of $6461.04. This means that a relative annual saving of up to $1393.56 could result for the deductible plan if no such liabilities were incurred and the relative loss would be limited to $606.44 if the full $2000 liability was incurred.

Nuggets stumbled upon (some may well be specific to Harvard Pilgrim):

1. Deductible liabilities incurred are the highly discounted contract prices, not the full invoice prices. This was a pleasant surprise. For a hypothetical example, the deductible paid for a $600 MRI would be the same contracted $240 or so that Harvard Pilgrim itself pays.

2. Fourth quarter deductible carry-over. Any deductible payments made for services supplied in the fourth calendar quarter are applied to start satisfying the next calendar year's deductible amount.

3. Harvard Pilgrim apparently has a substantial advantage over competitors in terms of placing drugs in Tier 2, as opposed to the much more expensive Tier 3. This is said to be the result of a benefits manager organization in Ohio with strong bargaining power.

4. Surprisingly, mail order prescription fulfillment of three months' supply of drugs only costs two months of copays for Tiers 1 and 2.

5. if I remember anything else.

Non-economic quota-filling entry

From here

...The superstate will glide onward in its steel and vinyl splendor, tagging and numbering us with its scientific tests, conscripting us with its computers, swaggering through exotic graveyards which it filled and where it dares to lay wreaths, smug in the ruins of its old-fashioned, man-centered promises to itself.

Uninsured Prices for Healthcare Products and Services

It is often claimed that drugmakers and other healthcare providers raise prices for the uninsured to make up for the profits lost when selling to insurance companies, for example, here.

This is almost certainly a mistaken belief, as I note in the following comment :

The high prices for the uninsured are the inevitable result of the insurance companies as a group being the dominant customer for both drugs and other medical services.

If the uninsured could get the same discounts as the insurance companies, the insurance companies would have no real reason to exist in anything like present forms.

So if a drug company or other provider wants insurance company business, it must agree to not sell to the uninsured at a discount. As long as the business of the insurance companies is of vital importance to the providers, they can only get adequate prices from the insurance companies by raising the pre-discount price for the uninsured, EVEN IF THAT PRICE IS SO HIGH THAT IT PRODUCES NO SALES AT ALL.

If healthcare were a normal market without third party payments, the market prices would be much closer to the discounted prices that the insurance companies currently pay.

Regards, Don