Universal Health Care in the US. Yea or Nea?

[Toke]

I totally see the benefits.

The forum is running slow for me. I also have to be at work like 4 minutes ago. It's been awesome learning from you guys/gals and I look forward to getting off work and continuing to get schooled. Until then, Peace Out JREF!

That is one of the great things here.
There are people who go out of their way to educate others.

I have been learning about economics.
Marx´s was a bit more wrong that I throught.

 

[Corsair 115]

I might come to the conslusion that GOVERNMENT might be bad at running a health care system.

and a mortgage company

and a social security agency

Based on what's happened in the financial industry of late, it seems private mortgage companies might be bad at running at mortgage companies.

 

[Rolfe]

I'm sure people in here mean well, but how many of you grew up around people that get free medical care and entitlements?

I know everybody in the thread at the moment means well. Including you. But I really wish you would try to see where your ideology may be blinding you to the disadvantages of your present system, and the advantages of some other ones.

I want to expand a bit on what Darat said.

Unless we have some very privileged Brits posting in this thread every single one of us will have grown-up and live today with and among people who get "free medical care and entitlements". [....]

Darat, we are all "people who get free medical care". And so is everyone we grew up with (unless we grew up abroad), and so are all those we live among (unless we live abroad). Even the most privileged Brits are entitled to free medical care! Some may choose not to access it, but even if they don't use it, they're still entitled.

Now Dan has in one post accused Europeans of being "lazy", because of this. I just wonder how long he's spent in Europe, and how many Europeans he knows. Dan, it's true that we work fewer hours a week than Americans, but that has absolutely bugger-all to do with having access to free health-care. It's to do with life-work balance, and the knowledge that we only get one life so we'd rather not spend all of it working.

I just don't get the concept that not having to worry about where our medical treatment is going to come from makes us worse people, or lazy, or freeloaders, or moochers. It just doesn't come into it. Oh, I ought to do a bit more overtime this weekend. But the hell with it, I know that I'm entitled to be treated no questions asked if I get appendicitis, so I'll just take the kids to the park instead! Why would that ever be anyone's line of thinking?

Again, Dan, I think you're confusing healthcare with social security, welfare, whatever you want to call it. That's actually where the potential for mooching or freeloading or fraud comes in. I think, because you're so used to a system where entitlement to healthcare and entitlement to social security payments go together, you think of them in the same terms. Please try to separate them, because they're two entirely different things.

As I said, social security/welfare is always going to be means-tested. This is the area where the moochers operate, and probably always will. Others have explained the difficulties here. The more you try to clamp down on the frauds, the more likely it is that some genuinely needy person who's just lost a bit of paper or something is going to be denied assistance. The moochers are masters at playing the system - the genuine claimants struggle.

Now this is an area where our two systems don't differ a grear deal. And yes, I was brought up in a mining village where my father was the minister. About a third of the other children in my primary school class were dirt-poor. And most of these came from free-loading or even criminal families. Yes, there are people who will just relax in the safety net and make no effort to climb out.

But this has absolutely nothing to do with healthcare. People only access healthcare when they're sick. They don't go out of their way to access healthcare they don't need, just to get something for nothing! Yes, in a system where there is no universal access to healthcare and that is means-tested in the same way as social security, the social security freeloaders are likely to freeload their way into the free healthcare system as well when they get sick. But it's really just a side-effect of the means-test connection between the two systems in the USA. It's practically an irrelevance.

Now, try to disconnect the two systems. Social security is means-tested, and freeloading will happen, and you do the best you can to minimise this while not excluding the genuinely deserving. We can agree on this, wholeheartedly. But that's not the subject of the thread.

Where healthcare is not means-tested, freeloading simply stops applying! You can't mooch your way into benefiting from something you're automatically entitled to anyway! It really doesn't have any bearing on laziness, or dependency, or feeling that one is owed a living. It's simply how we deal with medical need, and everyone benefits according to their individual need.

Rolfe.

 

[Porkpie Hat]

Darat, we are all "people who get free medical care". And so is everyone we grew up with (unless we grew up abroad), and so are all those we live among (unless we live abroad). Even the most privileged Brits are entitled to free medical care! Some may choose not to access it, but even if they don't use it, they're still entitled.

Rolfe.

With all due respect Rolfe this statement niggles at me a little. There is no such thing as "free" health care. As many here have pointed out, we all pay unless we don't have the means to contribute.

I think this concept of "free" may be what scares some Americans off from supporting universal heath care.

 

[quixotecoyote]

free-at-point-of-service is annoying to type every time, and since no one's trying to pretend that health care fairies zap it into existence, why bother with it?

 

[Rolfe]

With all due respect Rolfe this statement niggles at me a little. There is no such thing as "free" health care. As many here have pointed out, we all pay unless we don't have the means to contribute.

I think this concept of "free" may be what scares some Americans off from supporting universal heath care.

free-at-point-of-service is annoying to type every time, and since no one's trying to pretend that health care fairies zap it into existence, why bother with it?

Well, yes. If it's an issue in a thread, I try to type "free at point of need" every time, or publicly-funded, or something like that. (Though that still hasn't stopped the odd US poster snipping a quote to remove the "at-point-of-need" part and then go on and on about how it wasn't free and everyone who accessed it was a thief and a freeloader....)

But it's not been an issue in this thread at this point, so I didn't take the trouble. Especially since I was basically replying to Darat, who had used that form of words himself. When you've just lost a long and thoughtful post to a database error, you tend to take a bit less care with the next one.

Rolfe.

 

[Porkpie Hat]

free-at-point-of-service is annoying to type every time, and since no one's trying to pretend that health care fairies zap it into existence, why bother with it?

How about "previously-paid via federal taxation-at-point-of-service" then?

 

[Porkpie Hat]

Well, yes. If it's an issue in a thread, I try to type "free at point of need" every time, or publicly-funded, or something like that. (Though that still hasn't stopped the odd US poster snipping a quote to remove the "at-point-of-need" part and then go on and on about how it wasn't free and everyone who accessed it was a thief and a freeloader....)

But it's not been an issue in this thread at this point, so I didn't take the trouble. Especially since I was basically replying to Darat, who had used that form of words himself. When you've just lost a long and thoughtful post to a database error, you tend to take a bit less care with the next one.

Rolfe.

I think its psychological, maybe its just me?

 

[Rolfe]

Or I could just find out whats wrong here and fix it. Either way.

What if "what's wrong" strikes to the very heart of the system? What about if it's really nothing to do with "moochers", and everything to do with the way it's funded? What if the real problem isn't a few people trying to buck the system round the edges, but the way it sets up even the prudent, hardworking guy to fail if he or his family have the misfortune to be struck down by serious illness?

Remember, the universal systems treat everybody, including those you'd class as moochers, for about the same as the US spends to treat only the minority entitled to Medicaid or Medicare. How you can imagine that simply removing the few people you see as not entitled to benefit from your present system can address such a fundamental problem?

More on the differences between social security and healthcare, and why we should take care not to confuse the two. Social security is about providing for the daily essentials of life for those who can't afford them - food, warmth, shelter. We all need these things, and the quality and quantity of what we need doesn't vary much from person to person. There's no need to save up enormous quantities of cash in case you suddenly find that you can't live without a five-star restaurant meal every day, or to take out insurance against the possibility that your very life will depend on your being able to acquire a Beverley Hills mansion! If people want the five-star feast, or the mansion, we quite rightly decide that they should pay for it themselves. Even if they can afford only the very basic essentials of life, we don't agree they should have these provided for them - assistance is rightly provided only to those who fall below this threshhold. And you have deep contempt for people who abuse this system, and rightly so.

But healthcare needs aren't predictable. Some people can go through life needing little healthcare. Others are dealt a rotten hand. Some people may need to spend only peanuts on healthcare, while others may literally die if they can't access treatment of a similar monetary value as the Beverley Hills mansion. Compounding this is the unfortunate fact that it is the very person who needs the large amount of resources who is likely to be in the worst position to make that sort of money.

What if this is the real "what's wrong"? What if "what's wrong" isn't just that a few people who are scamming your social security system are also able to panhandle medical treatment they aren't entitled to? What if it's actually the whole principle that what one is expected to pay in should be based entirely on perceived risk, and not at all on ability to afford the payments?

Rolfe.

 

[Rolfe]

Another thing I should say is, I'm not completely ignoring what uni-health has managed to do for other countries. I would just prefer to avoid going that route if we can find a better way that fits in with my morals and work ethic.

I can also take more responsibility by reporting abuses in the system (thats the hard part) that I see. Once we get a better mindset going, people will realize that their friends/relatives cheating the system costs us all more, they'll be more likely to report abuses.

I've never said I will turn down the needy or desperate. Just so long as they contribute if they can.

I'm not talking about the people who can't contribute. I'm talking about the people who can but don't. These people are way too common and would rather get free medical care and rims for their car instead of paying into the system they constantly take from.

Just think what would happen to the uni-health system if more people start just taking and not contributing.

I admire your work ethic, even if I feel you haven't explained your morals very well so far. (Apparent willingness to see those without resources abandoned to their fate isn't pretty, even if you later say that this isn't what you meant.)

But once again, I think you're applying it to the wrong target. Yes, for social security, for the basic essentials of food, shelter and warmth, abuse is wrong, taking what you're not entitled to is wrong. Taking with no intention of paying in is fraudulent. We agree on this. And when it comes to reporting abuse, social security abuse that is, then I don't disagree. Shame the freeloaders and reduce the drain on the system.

But where does the work ethic and the morals come into it, in the unpredictable area of healthcare need? It's not moral that a work-shy layabout never gets sick even though he spends the cash he scams on beer and cigarettes. But it happens. It's not moral that a diligent hard-working technician gets systemic lupus. But it happens.

Can you even out these inequities? Can you redistribute fate so that the diligent and the deserving don't get sick? Of course you can't. So where does that leave the morals and the work ethic?

Your main (if not only) objection to a universal system is that the people you see as freeloaders will continue to get healthcare. Well, yes. Only they won't be freeloaders in that respect any more, they'll be entitled just like you and everybody else. Go away and concentrate on preventing them from scamming the welfare system proper.

YOu don't mind if people who genuinely can't pay get treatment, so long as it's genuine, and they would be prepared to contribute if they could. Good. You just don't like the possibility that people might be able to avoid paying into the system when they can in fact afford it, and then take advantage of it. Well, no objections to that from me, either.

So what is your problem with a tax-based system? The only people who won't pay in are those who genuinely do not make enough money to pay tax. And these people surely are the genuine needy. And yes, the tax-dodgers. Fine, get the Inland Revenue to go after them!

I don't hear anyone saying that you shouldn't have publicly-funded schools because some people might dodge tax and still send their children to these schools. I don't hear a complaint that you shouldn't have a public fire brigade, because tax dodgers' house fires might be put out. And so on.

People can't, on the whole, avoid paying into a universal healthcare system, because the tax authorities make pretty damn sure they don't get away with it. And as a result, and also because you do away with the real parasites - the insurance companies - there is enough money in the pot to treat everyone.

I don't like communism either. But not for idealistic reasons, but because it doesn't work and has been shown not to work right back to biblical times. It runs counter to the whole human desire to "have our own things". And the central control in entails is grossly inefficient.

Universal healthcare though, is no more communism than a publicly-funded fire brigade. And it's impossible to scam, because everyone is entitled in the first place.

Save your indignation about the moochers for their fraudulent take from the social security system, and think seriously about healthcare itself without all that baggage.

Rolfe.

 

[ServiceSoon]

This thread is slowly dying and I don't want to see that happen!!!

Well, according to this poll/thread, it is official that the non-Americans want America to have universal health care (UHC). Right-O! I would love to start an argument 

I voted no because:
1) I prefer to promote liberty. This is very important to me.
2) I despise the idea of a person in Washington controlling more and more aspects of my everyday life. I feel powerless when this happens. Politics make me vomit a little in my mouth. Many American’s feel this way about government (gov). This coincides with number 1.
3) I have seen first hand how the gov has screwed up social security. The promises made by the administration trying to get it passed as law and then those promises broken later by another administration. The sad truth that the gov is taking my money and then has the testicular fortitude to tell me that social security should be a “part” of my retirement plan. That would be another deviation from the original plan.
4) If the gov is so great at running health care, what would prevent the government from running everything? This creates a slippery slope with no end in site. This coincides with number 1.
5) More erosions of personal freedom. If we get UHC I can see a national smoking ban, mandatory dieting, etc. This coincides with number 1.
6) The flip side is those who take the necessary steps to live healthy lives are punished by the high premiums of the lazy people.
7) I think you will see an increase of lazy people if a UHC plan becomes mandatory due to the "I don’t have to pay attitude."
8) Proponents of UHC who suggest that, “I can buy additional insurance if I don't care for the coverage that the UHC program offers,” is ridiculous. If UHC is incorporated, then I am already paying a certain amount in taxes to support this system. And now you are suggesting that I should spend additional money? This coincides with number 3. What good is a program that doesn't fit my personal need? Very similar to your question, "What good is health care if it isn't affordable?"

I am various curious why the same rather large groups of people automatically suggest solving various problems by seeking government intervention. There are other options. If health care is so expensive that people can't afford it then we have a responsibility to determine why. If many American's don't have health care because they would rather spend the money on something else then that is a separate issue.

America is a different country and we choose to live this way. If you really feel so bad for the people who can't afford health insurance in evil American, then ask your government to offer these people a visa to your country. That would solve their/your problem. Don't get me wrong...some people should be offered help...but there has to be restrictions and time limits on these services.

 

[Blue Mountain]

4) If the gov is so great at running health care, what would prevent the government from running everything? This creates a slippery slope with no end in sight. This coincides with number 1.

Once again, we are not proposing the government run the whole healthcare system! We are proposing the government take steps to ensure everyone has access to affordable health insurance and has a basic policy. I suspect the US would adopt a model similar to Germany's, where health insurance is private but there are regulations in place that make sure everyone can get (and has) insurance.

5) More erosion of personal freedom. If we get UHC I can see a national smoking ban, mandatory dieting, etc.

Well, neither Canada nor the UK have banned smoking, although maybe the US is crazy enough to try it. It will work just as well as Prohibition and the War on Drugs.

6) The flip side is those who take the necessary steps to live healthy lives are punished by the high premiums of the lazy people.

When everyone is insured to a basic level of protection, there are no freeloaders. Or, conversely, everyone is now a freeloader. And as has been pointed out innumerable times in this thread, you are already paying for the freeloaders, either in taxes or higher premiums on your health insurance.

8) Proponents of UHC who suggest that, “I can buy additional insurance if I don't care for the coverage that the UHC program offers,” is ridiculous. If UHC is incorporated, then I am already paying a certain amount in taxes to support this system. And now you are suggesting that I should spend additional money?

As has been pointed out many, many times in this thread, countries with UHC have much lower overall costs. Ergo, your basic policy may cost only half what you're paying now. You can put the other half to improved insurance.

Have you even read the other thirteen pages of this thread?

 

[Toke]

1-5, Americans are somehow unable to make goverment work (really?)

6-8, It´s too expensive. (wrong)

 

[quixotecoyote]

Apologies if some of these sound short. It seems as if you haven't read the whole thread. Nothing wrong with that, but most of these have already been addressed.

Well, according to this poll/thread, it is official that the non-Americans want America to have universal health care

Since you don't know how many people on either side are Americans/non-Americans there's no way to tell what proportions of what groups support/oppose it "according to this poll"

I prefer to promote liberty. This is very important to me.

So do I. My personal liberty is constrained my my reliance on employer funded healthcare. In order to maintain an adequate degree of saftey, I have to remain an employee longer before amassing enough capital and credit to afford private health insurance in additional to the normal funding self-employment costs.

2) I despise the idea of a person in Washington controlling more and more aspects of my everyday life. I feel powerless when this happens. Politics make me vomit a little in my mouth. Many American’s feel this way about government (gov). This coincides with number 1.

Except this aspect is already controlled by someone else, an insurance company bureaucrat. My choice would be someone who isn't working under a set of policies designed to deny me health care funding. In practice, government funded healthcare means doctors get to decide what's necessary for your health, not the insurance agents whose job is to provide you as little care as possible.

I have seen first hand how the gov has screwed up social security. The promises made by the administration trying to get it passed as law and then those promises broken later by another administration. The sad truth that the gov is taking my money and then has the testicular fortitude to tell me that social security should be a “part” of my retirement plan. That would be another deviation from the original plan.

Assuming you started being politically active and aware of social security at age 16 (not unreasonable) I'm impressed. There aren't that many 90 year old people on the internet.

If the gov is so great at running health care, what would prevent the government from running everything? This creates a slippery slope with no end in site. This coincides with number 1.

Not just a slippery slope, but a slippery slope fallacy. Issues of necessity, asymmetric information, and empirical examples have been discussed already in this thread. There are reasons why government funded health-care makes sense. If you want to pick an argument made about this and dissect it you'll probably get a warmer response than asking people to rehash.

More erosions of personal freedom. If we get UHC I can see a national smoking ban, mandatory dieting, etc. This coincides with number 1.

More slippery slope fallacies.

6) The flip side is those who take the necessary steps to live healthy lives are punished by the high premiums of the lazy people.

Non-unique. Problem exists in the status quo. Insurance is already a pooled risk. Any unhealthy people covered by your insurance company are causing you to be "punished"

I think you will see an increase of lazy people if a UHC plan becomes mandatory due to the "I don’t have to pay attitude."

Unsupported speculation and factual error. If you fund this through taxes, everyone is paying. I also challenge the speculation. Why would having medical care make people lazy?

Proponents of UHC who suggest that, “I can buy additional insurance if I don't care for the coverage that the UHC program offers,” is ridiculous. If UHC is incorporated, then I am already paying a certain amount in taxes to support this system. And now you are suggesting that I should spend additional money? This coincides with number 3. What good is a program that doesn't fit my personal need? Very similar to your question, "What good is health care if it isn't affordable?"

Non-unique. Problem exists in the status quo. You are already paying taxes to support the health care system. As it stands you get no benefit from that and have to purchase your own coverage. The complaint you have is happening now and would not occur in the new system. The extra coverage is largely perks and elective procedures, not necessary care, so it will fit your personal needs

 

[Mitchell314]

Since it seems there's a lacking of solid arguments against UHC, I'll play devil's advocate:

1) Right now, we can't afford to implement such a system. We need to focus on rebuilding the economy, and if the stimulus packages get through, well, add 2 & 2

2) We would need to be dedicated. The switch over won't happen over night, and changing any system so drastically will lead to short term problems. If elections come around and people are thinking about the immediate pinch, will they vote in the feel-good politicians who say to revert back? And all that trouble would be for nothing and people would be more convinced to not try to implement a UHC system. We shouldn't try it until enough people are behind it.

3) Regardless if you say yea or nay, if we make as decision to change, we stick to it in the long haul. Cold feet will do nothing but make things worse.

I had more, but I need to turn in.

 

[Policenaut]

I suspect the US would adopt a model similar to Germany's, where health insurance is private but there are regulations in place that make sure everyone can get (and has) insurance.

I believe this is how it works in Massachusetts. There is some kind of monetary penalty if you don't buy insurance.

 

[quixotecoyote]

I believe this is how it works in Massachusetts. There is some kind of monetary penalty if you don't buy insurance.

And you can get it through your job or a subsidized program.

I worry a little that by taking a politically acceptable half-step they're going to get the worst of both sides. Since the subsidy comes from taxing/fining employers who don't offer healthcare, I worry about the effects this will have on businesses and unemployment.

 

[Darat]

This thread is slowly dying and I don't want to see that happen!!!

Well, according to this poll/thread, it is official that the non-Americans want America to have universal health care (UHC). Right-O! I would love to start an argument 



I voted no because:
1) I prefer to promote liberty. This is very important to me.

...snip...

What liberty would you lose if you had a universal health care system compared to the system you currently have?

4) If the gov is so great at running health care, what would prevent the government from running everything? This creates a slippery slope with no end in site. This coincides with number 1.


...snip...

I never understand this objection - surely you want your society to function as effectively as possible? If so what does it matter if some services are provided by a group we label "the government" (i.e. you and me) or by a group we label "a private company" (i.e. you and me)?

5) More erosions of personal freedom. If we get UHC I can see a national smoking ban, mandatory dieting, etc. This coincides with number 1.

...snip...

Certainly in countries like the UK and the rest of the EU the universal health care systems have no powers to implement anything like this so why do you assume that a USA universal health system would be given such powers (even if it was possible within your legislative framework)?

6) The flip side is those who take the necessary steps to live healthy lives are punished by the high premiums of the lazy people.

...snip...

Yes that is how your system is currently fundamentally flawed - see the links FrancescoR provided that explains what happens in a system like the USA system.

7) I think you will see an increase of lazy people if a UHC plan becomes mandatory due to the "I don’t have to pay attitude."

Since there are dozens of universal health care systems that have been running for decades and even over half a century I presume you can find evidence to support this opinion?

However I think you may be misunderstanding what ill-health is - people do not "get" cancer from being lazy, they do not suffer cataracts from being lazy, they do not break their legs from being lazy.

8) Proponents of UHC who suggest that, “I can buy additional insurance if I don't care for the coverage that the UHC program offers,” is ridiculous. If UHC is incorporated, then I am already paying a certain amount in taxes to support this system. And now you are suggesting that I should spend additional money? This coincides with number 3. What good is a program that doesn't fit my personal need? Very similar to your question, "What good is health care if it isn't affordable?"

Please go back to the beginning of the thread - you will find that currently you pay more for less now. You could implement a universal health care system like the UK has that would cover everyone for less than you pay in taxes to support your current state provided health care system. Therefore even if you then wanted additional cover you wouldn't be any worse off than you are now and everyone would have a very good standard health care.

I am various curious why the same rather large groups of people automatically suggest solving various problems by seeking government intervention.


...snip...

What is automatic about looking at the evidence and coming to a conclusion that leads from the evidence.

 

[Francesca R]

Streamline our records, lower spending on all the admin costs, stop giving illegals free care, get rid of friv suits against docs, etc....

The first two of those are possible regardless of the method of funding and distribution of health services. The second two are political and cultural choices made in your country which are even more unrelated to it.

So this is a smokescreen for some other opposition to a universal health service

 

[volatile]

My morals don't advocate that.

I've never said I will turn down the needy or desperate. Just so long as they contribute if they can.

I have a great idea on how this can be achieved. I'm sure you'll like it! How aboyut we tax people for their healthcare directly from their paypackets, so that everyone pays an affordable percentage of their earnings? That way, people automatically contribute if they can!

It seems, yet agaun, that the universal system provides exactly what you want. Why do you still oppose it?