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Socialised Healthcare

CaptainManacles said:
But what if my doctor says they're medically neccisary. If I don't get my chakras aligned, toxins will build up in my body and I may die. Oh noes.

And if my doctor doesn't get to make that call then we're back to the bureaucrat again, though, as I pointed out before, he hides himself behind a few degrees of seperation, he's still there. It just requires a bit of thought to spot him.
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Does your HMO provide this? Or do you have to go out of pocket? You see chakra and crystals are not recognized medically. Even if I my doctor says I MUST see a spritual healer to remove a demon it will not be covered by the government because it is not recognized as a medical problem or a medical treatment.

Now before you say "OMG!! You see the government is making health decisions for you!!" think about what you are saying... The government provides medical services. Not spiritual service. If it isn't a recognized medical treatment it isn't covered.

Also people are free to obtain third party health insurance as well (most people get it through work) which can cover a lot of additional services not considered essential (orthodontics, cosmetic surgery, holistic or complimentary services), though you still pay taxes for Medicare.

Here is an overview of the Canada Health Act if you care to learn what it is actually about.

http://www.hc-sc.gc.ca/hcs-sss/medi-assur/cha-lcs/overview-apercu_e.html
 
Rolfe said:
Get real, it's not that much! And in fact there is still benefit. You'll find that your insurance costs are noticeably less because the insurance company knows that it won't have to fork out for an emergency, no matter how expensive.
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Exactly right! I have my free government healthcare which is a tax of about 1% of my income. I make $25000/year that's about $21 a month which covers all of my expenses for essential services no matter how much or how extensive the required care is (read my earlier post about my familly member who has had the government pick up an $80,000 tab for six months of cancer treatment). Now for everything else not essential to my staying alive I pay $36 per month (this includes $20,000 of workplace Life insurance as well). That is a total of $51 for nearly 100% coverage (I did opt out of orthodontics as I'm passed the age it's necessary).

How much does the average American pay for total health coverage?
 
Wildy said:
I don't really understand what it is you are trying to say.

Are you trying to say that universal healthcare is bad because don't don't get to choose what treatments you don't want to be able to choose?

As well as that wouldn't you prefer a bureaucrat that says "OK" all the time to suggested treatment then a bureaucrat telling you that certain life saving treatments will not be covered because it wouldn't be cost effective?
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Since I'm the one paying the cost, albiet indirectly, yes, I would like a bureaucrat who poo-poos certain procedures, if the benefit doesn't outweigh the cost.

And I'd like clarification on a point, does your system only support life saving treatments or do they almost never turn any treatment approved by a doctor down? Because it has to be one or the other, and you've been arguing both.
 
CaptainManacles said:
Since I'm the one paying the cost, albiet indirectly, yes, I would like a bureaucrat who poo-poos certain procedures, if the benefit doesn't outweigh the cost.
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So what is the cost of a life?

And I'd like clarification on a point, does your system only support life saving treatments or do they almost never turn any treatment approved by a doctor down? Because it has to be one or the other, and you've been arguing both.
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Well your chakra guy wouldn't be covered if that is what you are asking.
 
I suspect the chakra thingy was just an illustration, not a serious suggestion. It seemed to me that he was choosing something wildly expensive and of questionable benefit, and pointing out that he might not be allowed this under a universal healthcare system. Well, probably not, in this case. However, even under a universal system, he'd still be allowed to take out supplementary insurance for chakra-balancing if he could find anyone to cover him, so I still don't see that point.

Now, in a later post, he's changed to saying he might prefer a provider who does pooh-pooh certain interventions. Presumably because the premiums might be cheaper? (I'm guessing here, because he's really not being very clear.)

Now I know that there are whole university departments dedicated to the study of health economics, so anything we say here is likely to be pretty simplistic. But it seems to me there are two basic options.

1. Care primarily funded by non-compulsory insurance, with premiums set acording to perceived risk, and in addition the poor who have no insurance being cared for out of general taxation.

2. Care primarily funded by taxation, which is equivalent to having compulsory insurance with the premiums set according to ability to pay. While this covers everybody, and provides a full range of healthcare, individuals still have the option to take out more insurance to go above and beyond this provision if they so wish.

It seems to me that the chances of an individual being refused treatment on grounds of cost are greater in the former situation, where insurance companies are motivated to stall and find bits of small print to justify keeping hold of the money. It also appears that individuals above the povery line are paying, through their taxes, for a healthcare system they derive no benefit from (the care of the uninsured).

I can't seem to get it through to CaptainManacles that I'm perfectly aware that I pay towards the NHS through my taxes (strictly, National Insurance). I don't see this money as being "ripped from my wallet". I barely notice it. As I said, it's the bargain of the century. Yes, it's non-refundable if I decided to ignore the NHS and go private - just as my taxes for education are non-refundable if I decide to send my children to private school (or have no children at all). However, given that the NHS is the best place to be when you have an emergency, no question, that money cannot be seen as being wasted.

As far as I can make him out, it's about choice. However, apart from the irrelevant $17 million chakra alignment, I don't see what choices he has with the private system that would be denied to him in a universal system. The only thing, really, is the choice of which insurance company to patronise. Is that really such a great privilege?

Rolfe.
 
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The problem with the US health care system is that it is a failed market.

To read about specific problems associated with markets in health care, read this.

i. Market failure - an overview

In theory, markets produce the goods and services we want in the right quantities and at the lowest possible cost. This is why markets are so powerful. But in the real world markets do not always work in the way theory predicts. It is possible for a free market to produce a Pareto inefficient result - i.e. the market fails.

An information system

A market is an information system. We get the right goods at the lowest possible cost because the market is able to transmit all the information about benefits and costs between producers and consumers (Unit 2. 1. f.) 2If this information is less than perfect, then the market will fail.

Think about buying a CD. You know what a CD is, and you will also have a good idea of the kind of music on the disc.

So you are able to relate your benefit to the price of the CD. If we look at the market for CDs, people will go on buying CDs until the extra satisfaction from the last CD is exactly equivalent to the price of the CD. We have reached the situation where we as a society are consuming the 'right' quantity of CDs in the sense that we are gaining the maximum possible satisfaction from CDs given their price.

Why might markets fail?

But health care is rather different from CDs. We face very acute information problems which make rational purchasing decisions difficult if not impossible. For instance most people do not know the best way to treat a stomach ulcer so they would find it difficult to buy such treatment.

This analysis also assumes that the only people receiving benefit or satisfaction from the CDs are the people buying them. In other words, the price of a CD accurately conveys the level of satisfaction received. This ignores the possibility of externalities or 'spillovers'. Think about someone hearing your CD and enjoying it - they are also receiving satisfaction from the disc but the market is unable to provide any information about the benefits they are receiving unless they specifically share the cost of buying the CD. Whenever externalities occur, the market fails. Many economists believe that there are strong externality effects related to health care. For example caring for a sick person can impose financial costs on that person's family. We discuss externalities more fully in subsection vi of this Unit.

Perfect competition

An efficient free market requires producers to be operating under conditions of perfect competition. This requires a stringent set of conditions - perfect information, many buyers and sellers, a uniform product and freedom of entry and exit - which ensure that firms are price takers, producing for the lowest possible cost in the long run and only earning normal profits.

If producers do not operate in this way and, in particular, if they have a significant power to influence price or the total quantity being produced, then the market will fail. Doctors and other suppliers of health care often have this power.
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If the American health care system is so fantastic, why are Americans spending $2,000,000,000,000 (that's $2 trillion!) a year on it, while at the same time 45,000,000 Americans have NO health insurance?
 
Ivor the Engineer said:
If the American health care system is so fantastic, why are Americans spending $2,000,000,000,000 (that's $2 trillion!) a year on it, while at the same time 45,000,000 Americans have NO health insurance?
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Because as long as it's a free market it's good?
 
NoZed Avenger said:
I have spent between 20 and 30 minutes tracking down the liver transplant study that I mentioned, with no luck. It was referenced on a blog that I do not regularly read, but that was linked by one that I do in the last week to ten days. I do not remember what or wher, as I was only reading it because I took some upper level coursework in health economics prior to law school, and was interested in the study.
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Thank you for trying.

I don't want to spend any more time on it, because I suspect this thread will end up similar to the last few that I participated in on the subject. I don't mind people thinking that the American system is worse (as I have stated, reasonable arguments can certainly be forwarded); I simply am kind of tired of the tone that indicates that any American suspicious of handing over health care ot the government is an idiot, has been mislead, or is dishonest (or some combination thereof).
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I can understand that. I usually try to focus on whether there is a misunderstanding of what other systems entail, or try to get a more objective measure of some of the relevant characteristics (like innovation).

Linda
 
Ivor the Engineer said:
If the American health care system is so fantastic, why are Americans spending $2,000,000,000,000 (that's $2 trillion!) a year on it, while at the same time 45,000,000 Americans have NO health insurance?
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We Americans like to have it both ways you see, the worst of socialized health care and the worst of free market with the benefits of neither. Truman should have socialized health care when he had the chance in the wake of WWII with millions of veterans to care for and an abhorrent federal deficit anyway. I honestly don't believe we'll see change either way, towards socialization or free market until Medicare becomes totally insolvent and we are forced to take action. Until then we'll keep sapping away an ever increasing percentage of our incomes on overpriced care and the latest pharma wonder pills.
 
Wildy said:
Because as long as it's a free market it's good?
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It's called a "free market" - it is anything but "free" (in the sense of choice, not cost).

It's good for doctors.
It's good for lawyers. (What isn't good for lawyers?:))
It's good for insurance, pharmaceutical and medical companies' profits.
It's bad for everyone else.

BTW, it is not profit which drives innovation, it is competition for profit.
 
ZenFountain said:
Truman should have socialized health care when he had the chance in the wake of WWII with millions of veterans to care for and an abhorrent federal deficit anyway.
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That's the rub, isn't it? I don't see how you could do today what Bevan did in 1947, essentially nationalising all the private providers of medical services. Even though he "stopped their (the consultants) mouths with gold", I can't see that being possible today.

You have publicly funded schools. You have a publicly funded firefighting service. You have a publicly funded police force. I don't see anybody demanding the choice of which fire engine turns up if their house goes on fire, or which police force should investigate the possible arson. I don't see citizens who choose to send their children to private schools (or childless citizens) having their share of education taxes returned to them. So, I don't see that the concept of a universal healthcare system paid for by taxation is really foreign to US thinking or philosophy.

Nevertheless it would be a huge undertaking in the teeth of certain vitriolic opposition from large, well-funded and influential groups of doctors, lawyers, insurance companies and so on. I don't see it happening.

As a result, discussion of how the present system can be made better is probably more fruitful for the US than philosophical discussion of whether or not a universal healthcare system is really superior or desirable. Similar discussions are happening all the time in countries with universal systems, of course.

What is not fruitful is a back-to-the wall defence of the present system on spurious grounds, simply because you're stuck with it.

Rolfe.
 
Wildy said:
And if medical treatment is more then you can afford?
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Well, first I would look to friends and family for financial support. Maybe private charity but that's a wing and a prayer. Other then that, the same thing that happens in Canada or anywhere else if there aren't the doctors/resources/technology to save my life. I die. It happens. Socializing medicine doesn't change that fact. It just takes away my ability to choose how much I value my survival compared to other things in my life.

As has been said, you can get your own insurance that covers that. But then a better question is why would you even consider chakra guy to be a doctor?
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I said no, not yes. As in no, that's not what I was asking, so why do you continue to act like that's what I was asking. In fact, why did you even originally ask if that's what i was asking when that's clearly not what I asked.
 
CaptainManacles said:
Socializing medicine doesn't change that fact. It just takes away my ability to choose how much I value my survival compared to other things in my life.
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On the other hand, it allows those without large incomes or coverage by private insurance to get the health care they need to survive without worrying about being bankrupted by the costs.

Personally, I consider that benefit very valuable and worthwhile

If I recall correctly, one of the leading causes for personal bankruptcy in the U.S. is unexpected health costs..
 
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Corsair 115 said:
On the other hand, it allows those without large incomes or coverage by private insurance to get the health care they need to survive without worrying about being bankrupted by the costs.

Personally, I consider that benefit very valuable and worthwhile..
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Then feel free to donate part of your income to a private charity that helps with health care costs of lower income people. If the rest of the world agrees with you then there should be no problem. Why you feel the need to compel this value on people like me who disagree with you is beyond me.
 
Rolfe said:
I don't see anybody demanding the choice of which fire engine turns up if their house goes on fire, or which police force should investigate the possible arson. .
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there have been people on these very forums arguing for just that.
 
CaptainManacles said:
Then feel free to donate part of your income to a private charity that helps with health care costs of lower income people. If the rest of the world agrees with you then there should be no problem. Why you feel the need to compel this value on people like me who disagree with you is beyond me.
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I don't know the exact figures, but if you're a US taxpayer you're definitely paying money (or having it "ripped from your wallet" if you like) to help with the healthcare costs of lower income people. And, unless you are in fact a low income person, getting nothing back for it (other than some quiet satisfaction, I presume). At least I'm getting something for my contribution to my country's healthcare system!

Now, I thought we were having a conversation. A discussion. Why do you feel the need to characterise other people expressing different views from your own as trying to compel their values on you? Do you want no views expressed but your own? Did you notice me complaining about you trying to compel your values on me? No? Well, do continue with the conversation like a grown-up.

I'm still trying to figure out what it is you like about the system you're supporting. You want a choice of insurance providers, is that it? You get that with universal systems as well, if you opt for additional insurance. (And don't retort that you want to opt-out of contributing to the healthcare costs of poorer people, until you can show that the US tax system lets you do that as things stand.)

Or do you simply want to choose to remain uninsured, and trust to your current means to pay your way if and when you do get ill?

I'm genuinely confused about what it is you want and are getting from the system you're so keen on. Unless of course it's simply that you prefer a choice between several bad options rather than having a single good option imposed on you. (No, it can't be that either, because universal healthcare systems also allow choices, including insurance, and pay-as-you-go when you need the treatment.)

Just try to state your preference and desire in the healthcare market.

By the way, what would your game plan be if you happened to have a child affected with cystic fibrosis (remember, this one is lifelong care and often involves a heart-lung transplant)? Or your dearly beloved father needed a quadruple bypass? Or you yourself broke your spine in an accident which was your own fault?

Just curious.

Rolfe.
 
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