Universal Health Care in the US. Yea or Nea?

[DaN K. StAnLeY]

quoting to bypass ignore:
(sorry Dan...don't be a wuss)

I'm pretty sure you aren't allowed to do that.

 

[kellyb]

Actually, your post helps make my case. How do we know which study/rankings are accurate and which aren't? I must have read 20 papers in the last couple of weeks and almost none of them had the same information on them. It doesn't even seem like anyone can agree on exactly how many people don't have HC. We just need to cut wasteful spending and we'll be fine. Contrary to what Volatile thinks, people aren't dying in the streets by the millions.

You suss out the truth by digging into original research. Not watching John Stossel videos OR blindly believing WHO analyses.
You learn about it and then think about it and then argue about specific points with the smartest of those who disagree.

With only a 3 million population, no, we're not dieing by the millions daily over here from this healthcare system. But people do die because of it, and it's not so rare.

 

[kellyb]

I'm pretty sure you aren't allowed to do that.

Report me.

 

[kellyb]

See, you kow it's a myth but then I have industry experts saying that government is only responsible for about 4% of avaiable drugs on the market. Who should I believe?

Here's another person saying your facts are wrong and theirs are right: http://www.cato.org/pub_display.php?pub_id=9981

What I'm saying is that "pharma" is independent of both insurance companies and UHC systems. Replacing insurance companies with UHC has no effect upon pharma whatsoever (well, for the most part, but that's complicated)

But we're not talking about killing Merck to set up gov pharma plants. The "government is only responsible for about 4% of avaiable drugs on the market" thing does not matter at all because we're only nixing INSURANCE companies. Not pharmaceutical companies. Merck does research in Canada in the UK every day, the same as it is here now. And Merck selld their drugs there, as well. And Merck partners with their universities to buy technology from bright scientists there, just like here.

 

[DaN K. StAnLeY]

Report me.

No, I'll just ignore you.

 

[kellyb]

Whatever.

 

[Earthborn]

See, you kow it's a myth but then I have industry experts saying that government is only responsible for about 4% of avaiable drugs on the market. Who should I believe?

Why not believe both? There'd be no contradiction.

 

[Rolfe]

Dan, last night, way past my sleepy-time, I tried to address some of the things you'd posted. It seems to me that your replies only dealt with deficiencies you perceived in my posting style, that I was being "sarcastic" or something. I assure you that I had no such intention.

I'm reposting these comments, hopefully omitting anything that might annoy you, in the hope that you'll address the actual points I was trying to make.

Dan, which is your main objection to universal healthcare? Is it that you don't get to opt out of contributing?

No, you don't. Just as you don't get to opt out of contributing to Medicare and Medicaid right now. We merely observe that for the same level of contribution, in countries with universal healthcare, you get to ACCESS the system you're paying for. What's not to like?

In the dog-eat-dog world you seem to desire, you'd have to cancel Medicare and Medicaid, so that you wouldn't be compulsorily paying for anyone else's care. So that's the real, grinding poor and the elderly who can't work any more just denied access to healthcare. Nice world, this one.

You'd also have to cancel the legal requirement that hospitals treat everyone who shows up needing emergency care. In case you forgot, the way that gets paid for is by hospitals jacking up their prices to insured and self-funding patients.

There are going to be an awful lot of people dying in the streets in this brave new world.

[Dan]
But that's OK, they're lazy wasters who didn't get ahead like I have. Everybody is perfectly able to afford to fund their own healthcare if only they quit slacking and work hard enough.
[/Dan]

Which brings us to your second objection, that you don't want anyone to get anything they haven't paid for.

Why is it that you constantly focus on the Rab C. Nesbitts of this world? There really aren't so many of them as you seem to think. Yes, there are people who are lazy and who play the social security system. And who get access to policing and the fire brigade and education for their children and roads to drive their very very cheap cars on, without contributing.

But why focus on these people, and not on the people who simply haven't been born with your advantages? Those not bright enough to hold down much more than a minimum wage job? Those with chronic medical conditions who aren't well enough to work full-time? Those whose employers went bankrupt, taking their insurance coverage with them, the week before they were diagnosed with Hodgkins disease? Those who worked hard all their lives and saved what they could, but who had insufficient savings to pay for the quadruple bypass they needed when they had their heart attack, aged 70?

Is it really OK by you that these people are left to suffer and die, just so that
1. You do not compulsorily pay for anyone else's care
2. Nobody who has possibly not worked quite as hard as they might have done every day of their lives receives any benefit?

There's no way the cost of a quadruple bypass or surgery for a brain tumour or even for appendicitis is going to come down to where someone on the minimum wage or a retired person is going to be able to afford it, just by "free market". Laser eye surgery just doesn't begin to compare for too many reasons to type.

A couple of weeks ago I started to go through this and related threads for actual case reports of ordinary, non-freeloading Americans who were in real distress because of their inability to afford access to healthcare. I was going to ask how, in the system you're trying to advance, such people would be cared for. Unfortunately a computer crash lost the references, and I need to start again.

But just declaring that if there was no taxpayer-funded healthcare and nobody had insurance (except maybe for catastrophes, and even there you have to define catastrophe - might be Hodgkins disease for the well-off, might only be cystitis for the low-waged, where do you put diabetes by the way?) then the price would be as low as a can of beans, isn't going to convince anyone who knows anything about how much medical procedures actually cost in real terms.

Actually, I should maybe explain my perspective on the last point I raised.

I'm a vet. I'm right in there in a completely free-market healthcare system, and I had a lot of my experience in the days before pet health insurance was as widespread as it is today.

There are irreducible costs to complex medical and surgical interventions. Some of it is the cost of drugs, which are expensive to develop and manufacture. Some of it is the cost of equipment, which is often complex and expensive to manufacture. And unlike consumer electronics, the size of the market is never going to be big enough to bring these costs crashing down. Some of it is overheads. And a lot of it is manpower. You need professionals, who have undergone expensive training. And you need lots of other people, just to deliver the care.

So, a lot of this is about people. The people who develop the drugs and the people who make the anaesthetic machines and the MRI scanners and the people who do the actual surgery and the people who clean the kennels and load the washing machine.

You want all these people to take the minimum wage? Even the ones who spent five years doing a very expensive university course? So where does that leave them? Unable to afford their own healthcare, by the sound of it - because they didn't "work hard and get on".

I know what happens in healthcare when the price of the needed intervention is higher than the client can pay. The patient gets substandard care. And then when things get worse, and there is real suffering, we have a fairly cheap solution. It's a blue solution, and the commonest brand name is called "Euthatal".

That's what happens when you leave it entirely to the market. Is that how you want human healthcare to be organised?

I'm trying to imagine a change to your system that would make me even consider tolerating it (personally, I mean).

At the moment my taxes are by no means onerous. Even though I pay tax at the "higher rate", I still take home about 73% of my gross salary. For that, among other things I really, really hate having to contribute to (like nuclear submarines and invading other people's countries), I get stuff I really, really like having. This includes the ability, indeed right, to see a doctor any time I feel I need to. And to be treated in whatever way my doctors feel is right for any illness I might have, all without anyone asking for a single penny from me at the point of delivery.

This gives me an enormous amount of freedom. It means that I can change jobs any time I like, without having to worry about the effect on my healthcare provision. It means I can spend a while without a job, without having to worry about my healthcare provision. It means that I don't have to waste a single second of my time comparing different health insurance policies to get a good deal without being screwed. It means that there is no insurance company trying to disallow any treatment my doctor thinks I need. It means that if I was unlucky enough to get something really, really expensive (or a series of expensive conditions) that nobody is ever going to say to me, that's it, you've exceeded your lifetime coverage, no more chemotherapy for you.

And remember, I'm getting all this for less, pro rata, than you're currently paying just to support Medicare and Medicaid.

You seem to think that I should be outraged that I'm forced to pay this modest tax, which gives me such great benefits, just because I can't opt out. Well, I'm not. Of all the elements of my taxation, this is probably the best value for money of the lot. I'm 110% in favour.

You also seem to think that I should be outraged that people like Rab C. Nesbit get the same treatment I get, even though he's a work-shy scrounger. Well, I'm not. I save my outrage in that department for the social security benefits fiddle. If someone is sick, I think they should be treated, even if they are "scum", as Rab likes to describe himself. I'm getting a good deal from the system, and I'm happy to know that those of my compatriots who may work just as hard as I do but who don't have my advantages also will never find themselves without healthcare - why should I cut off my nose (and indeed everybody else's noses) just to spite a few bottom-feeders?

So, explain to me again why the small bits of tinkering you're proposing to your system make it so good that I might be persuaded it was better for me than what I've got already?

An American acquaintance recently reeled off to me just some of the things that are currently "socialised" in America.

• Schools
• Law enforcement
• the Military
• Firefighting
• Roadbuilding
• Rubbish collection
• Street lighting

And I'm sure that there are more. Now I don't doubt that you'd like to get rid of all of these tomorrow, "if there was a better way."


But is it possible that there isn't? Is it possible that having publicly-funded schools is the best way to ensure that the next generation is at least tolerably educated? Is it possible that having a publicly-funded police force is the best way to fight crime? And so on.

If there were "a better way" in these areas, why is it that the USA hasn't got rid of these dreadful "soc" provisions and embraced this better way?

Now personally, I don't have any great ideological preconceptions here. I just want good and affordable healthcare for me, and for everyone else in the society I live in. Because, you see, I don't believe that anyone should be allowed to die of a treatable illness even if their lifestyle is not one I approve of, and even if that lifestyle may have brought on their illness. And I don't mind in the slightest that this is funded from taxation, because I get great benefits from it.

To screw up such a beneficial system because of ideological objections to paying taxes, or to treating the illnesses of my neighbours who may be unlucky or even foolish and improvident seems to me to be completely senseless.

Remember, I'm a vet. I see in great detail the consequences of a client being unable to afford the costs of necessary healthcare in a completely free-market system. And it isn't lower prices.

If I have misunderstood you, I apologise. I see what appear to be contradictory posts from you, some praising the limited "socialised" healthcare you have in the US at the moment, but others appearing to deplore the principle of compulsory contributions to maintain this system. I realise you're throwing out ideas to see if they fly, but without a coherent proposal it's difficult to see what you're getting at sometimes, and I get confused.

Rolfe.

 

[macdoc]

 

[DaN K. StAnLeY]

If I have misunderstood you, I apologise. I see what appear to be contradictory posts from you, some praising the limited "socialised" healthcare you have in the US at the moment, but others appearing to deplore the principle of compulsory contributions to maintain this system. I realise you're throwing out ideas to see if they fly, but without a coherent proposal it's difficult to see what you're getting at sometimes, and I get confused.

Rolfe.

I see where you are confused by my posts. What I was saying was in response to all the posters (you included) that suggest we want people to die who can't afford medical care. It's crazy to say that because I don't want UHC, that I must want people to die and I was just pointing out that we do have a system in place to make sure that doesn't happen. Those posts don't seem productive and sound like borderline flame posts.

I appreciate you going through all the trouble of the edit and repost. Unfortunately, I'm not as articulate as most people and I just don't think I know enough about UHC (or just the medical system in general) to put forward a proposal that wouldn't get me laughed out of here. It's also not the obligation of posters on JREF to school me on these things so I've just decided to limit my posts to specific questions and articled related to threads. Throwing around ideas seems to become counterproductive pretty fast for me.

Again, this website is awesome, because everyone gets held accountable for what they say by really smart people. Thanks again Rolfe.

 

[Rolfe]

No, I don't think that you necessarily want the poor and the old to be left without healthcare because you don't want universal healthcare. But sometimes what you say seems to imply that, if you take it to its logical conclusion. So, I enquire what you actually mean.

It comes back to the question I've asked several times. Why don't you want universal healthcare? You say it's not unthinking blind ideology. So you must have some reasons you can articulate.

I've tried to find these from your posts, and come up with two possibilities. One is that you object in principle to being compelled to contribute towards other people's healthcare. If that is the case, I think you have to explain your position with regard to your tax contributions towards Medicare and Medicaid. These are undoubtedly compulsory contributions towards the healthcare of other people. So, if you don't want to contribute in this way, and yet you don't want these people left without healthcare, how do you see their healthcare being funded?

You also have to consider your position as a paying patient, whether insurance-funded or self-funded. The way your system works at present, hospitals are legally obliged to treat emergency presentations even if these people have no means of paying. They cover their costs for this by overcharging the paying patients. So really, if you have insurance, you also can't avoid paying for the healthcare of the uninsured, because the insurance companies inflate their premiums to compensate for this overcharging.

The only way you can avoid being forced to pay for other people's healthcare is not to carry any insurance of your own, and then never get sick. Because the minute you enter the system as a paying patient, again you're going to face inflated charges to cover the uninsured emergency presentations.

So, it's not just in a universal system that you are forced to contribute towards the healthcare of others. You have to do it at the moment. So, if that's your reason for not wanting universal healthcare, forgive me, but I don't think you're thinking it through.

The main difference between us is not that I have to contribute towards the healthcare of others and you don't. We're both in about the same boat there. In fact the real difference is that I get to access the healthcare system I'm "forced" to pay for - so it no longer seems like an imposition to me, more like a very good deal indeed.

Can you see why I'm completely confused by this objection?

Your other objection seems to be that you don't want "undeserving" people to "get something for nothing".

So, how to you refine your system so that only the truly deserving can access free healthcare? Who decides who is deserving and who isn't? Just how blameless does someone have to be? And what about the children of the improvident and the feckless? Are they excluded along with their parents?

And how proportionate do you want the punishment to be for bad choices, a bit of risk-taking, the fatal gamble that serious illness is something that only happens to other people? Do you really want to sentence these people to death from untreated diabetes, or heart disease, or liver failure?

I would hesitate a long time before I presumed to judge my fellow human beings like that. And make no mistake about it, declarations that you oppose someone "getting something for nothing" do in the end boil down to exactly that.

So while I accept that you don't explicitly wish ill on the poor, the old and the feckless, a lot of what you say actually does imply that these people should be left without access to healthcare. If indeed I've correctly divined your reasons for not wanting universal healthcare.

Of course, if your reasons are something else, you still have to explain them.

Rolfe.

 

[DaN K. StAnLeY]

I think its a mix of being forced to pay for people who expect handouts that bothers me the most.

 

[kellyb]

I think its a mix of being forced to pay for people who expect handouts.

How is this different from the insured paying for the uninsured in the ERs presently?

 

[DaN K. StAnLeY]

How is this different from the insured paying for the uninsured in the ERs presently?

Didn't say it was different, just said that it bothers me.

 

[kellyb]

Didn't say it was different, just said that it bothers me.

Do you feel that UHC is more "wrong" morally than the (same) situation we have now where the uninsured are mooching off those with insurance?

 

[Rolfe]

I think its a mix of being forced to pay for people who expect handouts that bothers me the most.

Honestly, this is a very minor point in my opinion.

I've said before, and I'll say it again, I really do think you're conflating undeserved handouts of social security (food stamps, housing benefit and so on) with healthcare. I agree with you, social security scroungers should be ashamed of themselves. And forced to pay back what they've fraudulently claimed. And made to live strictly within their entitlements.

Well, that's how it works in Britain. We have TV advertisements encouraging us to shop people who might be claiming handouts they're not entitled to. We have whole posses of social security investigators to trap these people and get the money back.

But nobody, nobody, would even think of suggesting that even these bottom-feeders should have medical treatment withheld if they needed it.

I have tried to explain the advantages of universal healthcare. Flexibility of employment. Reduction of burden on employers. Absence of the insurance skim-off of healthcare expenditure. Empowerment of patients as a consequence of entitlement. Healthcare needs of the elderly, children and the low-waged looked after along with everyone else. The sheer relief and freedom of not having to worry about where the money might come from if you get ill. The cost savings produced by bulk buying (the USA could have a huge advantage here). The incentive to drug companies to produce new drugs, knowing that in these systems all the potential consumers will be actual consumers. The fact that nobody has any lifetime ceiling on healthcare spend.

Oh yes, and the fact that we get all that for the price of slightly less tax take as you already pay just to support Medicare and Medicaid.

And the reason you'd turn down all this? Because you don't like "being forced to pay for people who expect handouts". Don't you think you're being a little short-sighted here?

Do what we do, and save that outrage for the social security cheats. And be happy that nobody in your society is denied medical treatment, no matter how poor or how unlucky or how stupid or how reckless they've been. It's not that hard.

Rolfe.

 

[Rolfe]

Do you feel that UHC is more "wrong" morally than the (same) situation we have now where the uninsured are mooching off those with insurance?

Actually, she put it better. Why do you reserve your "botheration" for universal healthcare? You're already forced to pay for people who expect handouts - as you see it.

Rolfe.

 

[Rolfe]

What is the frayser institute?

Is your Google broken?

Results for: "frayser institute"

Your search - "frayser institute" - did not match any documents.
Suggestions:

• Make sure all words are spelled correctly.
• Try different keywords.
• Try more general keywords.

Did you mean to search for: "fraser institute"

Sorry, only posting this because I was confused, and wondered if there was something I was missing.

Rolfe.

 

[macdoc]

For the uninformed and vulnerable...the Fraser Institute is a right wing mouthpiece where neo-con economists without qualifications in the field they are writing about make pompous pronouncements about various and sundry topics in an attempt to influence public opinion....

Think CATO et al...

 

[Rolfe]

For the uninformed and vulnerable...the Fraser Institute is a right wing mouthpiece where neo-con economists without qualifications in the field they are writing about make pompous pronouncements about various and sundry topics in an attempt to influence public opinion....

Think CATO et al...

Er, thanks. I now realise I REALLY wasn't getting it.

Rolfe.