But what happens if a majority of people supports the idea? Is it really fair to call the Canadian Health System a tyranny of the majority?
Socialised Healthcare
- Thread starter Wildy
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But what happens if a majority of people supports the idea? Is it really fair to call the Canadian Health System a tyranny of the majority?
Rolfe
Adult human female
Well this seems to have turned into a rant against the Canadian system in particular, and since the particular aspects of the Canadian system being ranted about do not apply to the British system, I'll retire to the peanut gallery for now.
Secure in the knowledge that should I happen to want one, I can indeed pay a private institution to give me an MRI scan. Also secure in the knowledge that if I can't pay, and I still need one, I will get it, even if not quite as quickly as I might have wished.
Rolfe.
Secure in the knowledge that should I happen to want one, I can indeed pay a private institution to give me an MRI scan. Also secure in the knowledge that if I can't pay, and I still need one, I will get it, even if not quite as quickly as I might have wished.
Rolfe.
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Having just read through this thread for the first time, it's interesting to see the division of attitudes on both sides of the debate.
The people in favor of universal healthcare are very pragmatic and focused on results. Universal healthcare is good because it results in decent care for a large percentage of the population at a reasonable cost.
Most of those against it are more idealistic. Universal healthcare is bad because it violates a basic principle of personal liberty: the ability to decide how to spend your own money. The fact that it may provide better care on average is irrelevant because maintaining principles is more important.
I can see merit (and flaws) in both sides of this debate. It's also interesting to see both sides talking past each other: the pro-universals asking "What do you want from your healthcare system?", not understanding that that isn't even the issue for the idealists; and the anti-universals saying "How can you justify ripping money out of my wallet?" without realizing that the pros are thinking in terms of lives saved by democratically obtained tax money. That's not a slight against the idealists, by the way -- lives are saved by defending ideals, too.
Then there's the third camp: the pragmatic anti-universals. These people claim that the inevitable price-fixing which accompanies universal healthcare stifles innovation. I've felt that way myself at times, and I think it's something we need to investigate more thoroughly.
As I get older, I think there's something to the innovation argument, but I also think it's too simplistic. Innovation depends on competition for profits, yes, but a free market isn't the only factor there; there's also overall wealth to consider. An affluent nation with price-fixing may well outperform a poorer free-market nation in the innovation department, and that opens up a whole new can of worms. It seems reasonable to me that having a healthier population may lead to a healthier economy, with fewer people missing work or being wiped out financially by crippling medical bills. Also, the 15% of the GDP that Americans spend on healthcare can't be helping the economy, either. On the other other hand, that 15% probably is stimulating innovation directly, so you can't ignore that either.
Anyway, there's one major issue here that's been touched on in this thread, but not (in my opinion) given the weight it deserves, and that's the fact that the U.S. already has an expensive and highly suboptimal universal healthcare plan in the form of emergency treatment. By law, American hospitals can't refuse emergency medical care to anyone, regardless of their ability to pay. As a result, poor people still get medical care, of a sort, except they have to wait until it develops into an emergency.
Conditions which may have cost $100 to prevent, or treat at an early stage, now require thousands of dollars of expensive (and less effective) emergency care. Since it's unlikely the hospital will see any of that money, they pass the cost on to those who can pay, which means rich patients, insurance companies, and, yes, government bailouts. The money is already being ripped from our wallets. On top of that, it wouldn't surprise me in the least to learn that this was the principal cause of the high cost of healthcare in America.
It's this last issue that's finally swung me back in favor of universal healthcare. My inner geek can't stand to see such an inefficient and broken system, which is, as others have stated, a combination of the worst aspects of both the free-market and universal systems. We can do better by just embracing the universal aspects, at least a little.
The people in favor of universal healthcare are very pragmatic and focused on results. Universal healthcare is good because it results in decent care for a large percentage of the population at a reasonable cost.
Most of those against it are more idealistic. Universal healthcare is bad because it violates a basic principle of personal liberty: the ability to decide how to spend your own money. The fact that it may provide better care on average is irrelevant because maintaining principles is more important.
I can see merit (and flaws) in both sides of this debate. It's also interesting to see both sides talking past each other: the pro-universals asking "What do you want from your healthcare system?", not understanding that that isn't even the issue for the idealists; and the anti-universals saying "How can you justify ripping money out of my wallet?" without realizing that the pros are thinking in terms of lives saved by democratically obtained tax money. That's not a slight against the idealists, by the way -- lives are saved by defending ideals, too.
Then there's the third camp: the pragmatic anti-universals. These people claim that the inevitable price-fixing which accompanies universal healthcare stifles innovation. I've felt that way myself at times, and I think it's something we need to investigate more thoroughly.
As I get older, I think there's something to the innovation argument, but I also think it's too simplistic. Innovation depends on competition for profits, yes, but a free market isn't the only factor there; there's also overall wealth to consider. An affluent nation with price-fixing may well outperform a poorer free-market nation in the innovation department, and that opens up a whole new can of worms. It seems reasonable to me that having a healthier population may lead to a healthier economy, with fewer people missing work or being wiped out financially by crippling medical bills. Also, the 15% of the GDP that Americans spend on healthcare can't be helping the economy, either. On the other other hand, that 15% probably is stimulating innovation directly, so you can't ignore that either.
Anyway, there's one major issue here that's been touched on in this thread, but not (in my opinion) given the weight it deserves, and that's the fact that the U.S. already has an expensive and highly suboptimal universal healthcare plan in the form of emergency treatment. By law, American hospitals can't refuse emergency medical care to anyone, regardless of their ability to pay. As a result, poor people still get medical care, of a sort, except they have to wait until it develops into an emergency.
Conditions which may have cost $100 to prevent, or treat at an early stage, now require thousands of dollars of expensive (and less effective) emergency care. Since it's unlikely the hospital will see any of that money, they pass the cost on to those who can pay, which means rich patients, insurance companies, and, yes, government bailouts. The money is already being ripped from our wallets. On top of that, it wouldn't surprise me in the least to learn that this was the principal cause of the high cost of healthcare in America.
It's this last issue that's finally swung me back in favor of universal healthcare. My inner geek can't stand to see such an inefficient and broken system, which is, as others have stated, a combination of the worst aspects of both the free-market and universal systems. We can do better by just embracing the universal aspects, at least a little.
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Segnosaur
Penultimate Amazing
But, we don't know what criteria they used to do sort though the lists, what exact criterion they used to include or reject an article, etc. True, they may not have known the exact results of each study before hand, but there are ways that the selection can be skewed. (For example, if they know MRI wait times are longer in Canada than the U.S., they may purpously exclude any articles about MRIs even if they haven't seen the final results.) I'm not saying that's exactly what they did, but such tampering is always a risk when dealing with meta-articles such as this.
If it takes longer? There are long line ups for basic diagostic services (like MRIs). There are addition wait lists to see specialists. There is definitely a delay in getting diagnoses.
http://www.cbc.ca/news/story/2001/06/18/scan010618.html
Would it really make the U.S. look better? First of all, some people will die while waiting for treatment and/or diagnoses (and not even get counted in the studies). Secondly, from what I've seen, there's nothing in their analysis to account for Canadians being (on average) at a more advanced stage in their illnesses due to slow diagnoses times.
Before you mentioned him, I had no idea who he was. Now, I did a quick search, and found out that while he is very well qualified as a physician, he also ran as a member of the NDP party, a political party which sits on the political left wing in Canada and is the party most opposed to any privatization of Canadian health care.
Segnosaur
Penultimate Amazing
Yes, it is... the people who support the system aren't really fair judges on whether the system is somehow oppressive to people who don't share their same views. Much like people who want to censor TV, movies and music aren't exactly fair judges on laws that restrict free speech.
Once again, I do want to point out that I am not totally opposed to public health care. I do think that there should be services in place for people who cannot afford to pay for needed medical care (or who just don't consider it a priority). But, I also think that private health care can and should play a part. I just don't like the fact that people automatically jump in and say "Private health care is automatically bad, public health care is good".
Beerina
Sarcastic Conqueror of Notions
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There are two issues:
1. Immediately poorer care. This is somewhat subtle, but is manifesting itself in longer lines and wait times and these illegal clinics where officials look the other way.
2. A general slow down in per capita production of cures.
It's point 2 that, cumulatively, year after year becomes more of a problem.
It's somewhat more nebulous than even issue 1 because the modern world shares cures and treatments. Hence most people will (to the extent hampered by issue 1) always have the latest treatment available.
Of coures, this immediately suggests the testable theory that the US should be leading the world in producing, per capita, new treatments and cures, and that other western nations (Canada, England, France, etc.) should do better than, say, China or India, which should do better than some dictatorship in Africa or South America.
I note a "hands off" socialist system, where patented cures and treatments, which were open to full, free market price setting for the duration of the patent, would definitely somewhat offset this. Perhaps some countries are like this.
Abe_the_Man
Thinker
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I think this article should have caused a little more of a stir when you posted it. It says the average Canadian pays $2210 in taxes for healthcare and elsewhere in the article the total per capita spending (including private insurance) is about $3100. This is an average of $3100 for full coverage for 100% of the population. In this same link it also states that the average american pays $2700 in health related taxes to the government but elsewhere in the link it also states that the total per capita spent on healthcare averages $7100. That's $4000 more per year to partially cover only 85% of the population.
I think the numbers speak for themselves. And the fact that nobody in Canada or UK, or AU or anywhere else they have universal healthcare would want the government to get rid of it speaks volumes.
On that note, I don't see this discussion going anywhere as all participants hold their oppinions too strongly and are not likely to budge (me included
). So at this point I will be bowing out and I would thank everyone for an entertaining and informative debate!On that note, I don't see this discussion going anywhere as all participants hold their oppinions too strongly and are not likely to budge (me included
Don't assume it's futile.
My opinions on a lot of important topics (including universal healthcare) have been changed because of information from JREF threads. You might not convince the other vocal posters, but there are other people lurking, too.Segnosaur
Penultimate Amazing
I have already pointed your mistake out to you TWICE, yet you still keep repeating it.
The $7100 spend per capita also includes spending by people who have decided to pay for health care out of their own pocket. So, it covers more than just 85% of the population.
Molinaro
Illuminator
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Are you suggesting that your correction invalidates the point being made?
Segnosaur
Penultimate Amazing
Yes it does.
I have never denied that the American system is more expensive. (In fact, I doubt even people who want no part of health care have denied that.) But arguments that large sections of the population "just aren't covered" is false.
People do have financial hardships due to medical costs in the U.S. But that 15% that Abe claims are suffering still (for the most part) gets treated.
Earthborn
Terrestrial Intelligence
What is still missing from your argument:
- An explanation on how exactly socialised medicine would reduce the rate of development of new cures.
- A way to assess the effect of government grants and subsidies in medical research and how it relates to the rate of development of new cures.
- A good definition of what constitutes a new cure. Are the "me-too" medications that pharmaceutical companies develop to compete with already existing medications, and that basically work the same way as things already on the market, actually new cures?
- A good way to quantify how important a new cure is. A system that produces a lot of new profitable cures against minor discomforts may not be preferable to a system that produces fewer new cures, but more lifesaving drugs.
Funny that you mention China and India as probably producing fewer new cures as some fully socialised medical systems, even though they have extensive for-profit medical (and research) centers.
In many European countries, the prices are negotiated between pharmaceutical companies and insurance companies, though the government is involved as well to make sure people are covered for all the medications they may need and not just the ones that the insurance company chose to buy. I am not quite sure how you imagine a fully free market of pharmaceuticals is supposd to work; wouldn't it mean a system where everyone can freely buy any medication without prescription?
It should also be noted that while public insurance systems try to negotiate lower prices for pharmaceuticals, they also tend to subsidise their development.
I don't think you've quite put your finger on it. It isn't that I don't understand that choice isn't an important ideal. It's that lack of choice is not a necessary component of a universal health care system.
Linda
Abe_the_Man
Thinker
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I know I bowed out but since this was directed specifically to me I thought I would jump back in for just a moment. The figures I quoted include people covered by government programs and people with their own private insurance. 15% of US citizens do not have any coverage be it private or through a government program.
http://en.wikipedia.org/wiki/Universal_healthcare#United_States
*bolding mine
Earthborn
Terrestrial Intelligence
What some of the anti-universals fail to realise is that money is already ripped from their wallets, and that a universal or socialised system may in fact rip less money from their wallets. They fail to realise that while an equivalent amount of money is ripped from their wallets they are not protected from being bankrupted by their healthcare system, while people in countries with universal health insurance are.
The inclusion and exclusion criteria were listed in the methods section.
Which is why multiple people were involved at each step.
That presupposes that one needs a specialist or an MRI for a diagnosis. And that the timing of the diagnosis has an impact on the course of the disease.
That's what a lead-time bias is. And it would have the effect of making the US look better, since it would increase the length of survival from the time of diagnosis. If the normal course is death after 10 years and you diagnose the disease at year 2, you will find that people live 8 years after diagnosis. If the diagnosis is delayed to year 5, you will find that people live 5 years after diagnosis. People in the first group will appear to live 3 years longer than people in the second group, even though the underlying process is unchanged.
This, as well as other analyses, are discussed in the article.
He and others are well aware of how bias can even subconsciously influence results. Which is why they took steps to remove the possibility of influence (such as blinding).
Linda
I've found the arguments in favor of this position very unconvincing. Universal healthcare is paid for, in part or in whole, by increased taxation. I might be willing to believe that extra taxes are an acceptable price to pay, but the assertion that they don't qualify as the government taking money from its citizens against their will -- or at least unconcerned with their will -- is frankly ludicrous. That's what taxation is. It's not optional, at least around here.
Whether or not taxation is against anyone's will is not an issue specific to healthcare.
Universal healthcare is not necessarily based on public spending.
Since every other country with universal healthcare actually pays less in taxes toward health care than the US, how do you know your taxation wouldn't decrease?
Linda
True, and I imagine you'll find that a lot of the people who object to universal healthcare also object to many other tax-funded programs.
Can you name a system where it isn't? I'm not sure how that would work.
I don't. Like I said, I'm not opposed to the idea of universal healthcare, or at least I've become mostly convinced that it's the lesser evil. I was just describing my perceptions of the attitudes I saw from both sides in this thread.
However, if I were to play devil's advocate and take the side of those who object to tax money being used to pay for healthcare, I suppose I would say that we should try to reduce the amount of tax spending rather than adopt a system which embraces it. However, that's the attitude that made me veer away from that position to start with, since it inevitably results in turning poor people away to die on the streets.
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A quick, dumb question for those who live in countries with universal healthcare:
If someone has injuries which are clearly caused by another person (for example, I punch someone and break his jaw), do the taxpayers have to pick up the tab, or is the person at fault made to cover the costs?
What if I break my wrist in addition to his jaw? Is my own injury covered?
If someone has injuries which are clearly caused by another person (for example, I punch someone and break his jaw), do the taxpayers have to pick up the tab, or is the person at fault made to cover the costs?
What if I break my wrist in addition to his jaw? Is my own injury covered?
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