I don't need a primer in Hardin's Commons work, thank you. It very clearly applies here and is substantiated by significant research on the affects of copays on use of medical services.

If as the poster suggested, medical care was available on an as-wanted basis without additional costs as policing is today, people would overconsume care. This is plain as day and ANY economist would agree. If you need evidence, look to any country where there is socialized medicine.

And being deliberately obtuse is not a valid way to win an argument. 17% of our GDP is dedicated to health care. How about you come up with an equivalent figure for law enforcement before we continue discussing the validity of your points?

If you claim that "any country where there is socialized medicine" provides evidence for your position that patients will overconsume care, then go ahead and provide that evidence. Facts and figures, with citations to peer-reviewed publications. Otherwise you're just blowing hot air. FWIW, my experience working with "socialized medicine" systems abroad (the NHS) and in the US (military medicine, county safety-net hospitals) suggests that there's little merit to the claim, but I'm willing to consider the evidence ... if you have any.

Also, be very careful with statements like "ANY economist would agree." Truth is, you can take just about any position you can think of, and you'll be able to find an economist to take the contrary position. Economists are funny that way.

I laughed till I cried.

it must be pointed out that such a system is not without its flaws. I'm actually part of a socialized medical system myself: the VA. It was great when I needed surgery to repair a hernia. The hernia was detected fairly early, before it got really bad, and I was able to get it repaired by a very professional staff at almost no cost ($8 co-pay for pain meds). On the other hand, I suffer from a chronic skin rash which comes and goes (and which started around the time they shot me up with a bunch of vaccines to guard against Saddam's fictional biological weapons, but I digress) and I can never get treatment for it. Every I get the rash, I call up the VA and can't get an appointment until a month later, by which time the condition has gone away, only to return again later. So I just have to deal with it. Yes, we need to reform healthcare, but I think examples like this go to show that socialized medicine is not some kind of flawless panacea.

ramoncreager: thanks for the succinct summary of the principle of the "tragedy of the commons."

But that isn't how the hard-right economic Libertarians and Republicans view it.

For them, the "tragedy of the commons" consists of the fact that "the commons" might be deemed to exist in the first place.

Every I get the rash, I call up the VA and can't get an appointment until a month later, by which time the condition has gone away, only to return again later. So I just have to deal with it. Yes, we need to reform healthcare, but I think examples like this go to show that socialized medicine is not some kind of flawless panacea.

If I'm not mistaken: under single-payer universal health care, you could simply visit any primary care physician at the onset of the rash. Not just VA doctors, anyone.

But the fact is that even under the present status quo of private insurance-mediated health coverage, in many regions of the country, it's very difficult for a patient to obtain an appointment to be seen for a non-emergency condition in less than around 3 weeks.

If it were me, I'd go to a VA Urgent Care Clinic at the first sign of the rash's reappearance (presuming your local one hasn't been closed, that is- although even in that case, you should still be able to find an emergency treatment option for which you can bill the VA.)

You''ll be down the list for triage, which means you'll most likely have a wait in store, but I seriously doubt that they'll turn you away.

The points you've attempted to make about the excessive expense of publicly funded health care have already been addressed- and, according to the material, refuted- by the reference links I appended to a previous post in this discussion.

http://letters.salon.com/opinion/feature/2009/06/30/police/permalink/ca7a5431c7ab615b89f27a55c1385c15.html

[linked at my highlighted screen name, "cabdriver"]

If you care to contest them, I invite you to provide references of your own.

The fact is, I'm open to having my mind changed on this issue. But only by facts, logic, and ethically presented persuasive arguments.

Yeah, you're right. I could go into the emergency room. But, I feel bad about going to the emergency room for something that isn't an emergency. The emergency room is for people with traumatic brain injuries, not itchy elbows, and I don't want to distract the staff from helping people who really need it. Maybe I'm overdoing it there. The VA shrink told me my feelings of guilt over participating in the war come from having an over-active superego. lol. "I'm afraid you're very ill, sir. It seems you have . . . a conscience . . ." I know, I'm digressing. But isn't one of the arguments for socialized medicine that it will alleviate the overuse of emergency rooms?

I have a great deal of firsthand experience at giving various hospital emergency rooms a once-over...they're right up there with bars and grocery stores as passenger pickup points for cab drivers, especially in the hours after the buses stop running.

Hospital ERs aren't always crowded. That's just your imagination talking. I recommend staying away on weekends. Fri, Sat, Sun., holidays- that's often a mess. The rest of the days/evenings aren't nearly as bad. Early morning hours are the best- like 4am. You may even find yourself with only one or two other patients in the waiting room.

Above all, remember that the staff is in charge of triage. Crowded or not, it's their professional duty to make sure that the most serious cases get seen first. You don't have to worry about the possibility that you're cutting in front of somebody who needs treatment more than you do. The doctors and nurses won't let you do it.

Nothing the matter with having a strong empathetic conscience, as far as I'm concerned. But I'd rest easy on that score, and try to have it looked at asap if the symptoms flare up again. After all, when it comes to diagnosis of an intermittent medical condition, the time to get seen by a physician is when you have the symptoms.