Stossel Solves the Health Crisis with Capitalism

[Rolfe]

No, I said I'd be less free than if I could opt-out without being punished. Does it completely escape you that some people may not want anything to do with others?

OK. But you wouldn't be any less free under a universal healthcare system than you are at the moment. In fact you'd be more free.

Now please watch what you're saying about not wanting anything to do with others. Any minute now someone is going to annoy you by accusing you of being perfectly relaxed about the idea of people dying in the street, so long as you aren't compelled to contribute anything to their care. Now we know you don't really feel that way, because you've told us so. But it does rather sound as if the system you seem to desire might end up having that effect.

Care to explain yourself a bit better?

Rolfe.

 

[Darat]

Oh, I think it is. Remember the poll tax protest? Didn't those people go to jail for refusing to pay that? Or some of them anyway.

But there was another choice for those people - they could have left the UK.... No one forces us to stay in the UK. (And no snarky comments Rolfe! )

...snip...

I just don't see where the US and the US are so different here. Dan already pays a proportion in tax to fund other people's healthcare, and I suspect he'd end up in jail if he persistently refused to hand that over. So what's different about the UK?

Oh yes, that in that situation the tax he's objecting to is being spent on something he is actually entitled to benefit from.

I'm trying to find out why he sees that as a loss of freedom, but I'm not getting an answer.

Rolfe.

I don't disgaree - it was one of the questions I asked him hundreds of posts ago, one he still can't answer.

 

[DaN K. StAnLeY]

As the article linked to above shows, non-insured babies are more likely to die. Since MarkCorrigan's parents did not have him insured under your system his probability of dying would have been higher than under the NHS (never mind some of the other UHC systems around which have even better statistics than the UK's NHS has managed to achieve).

You're assuming now, and you know what happens when you assume don't you??

 

[Rolfe]

Mark Corrigan tells us a personal story not entirely dissimilar to Abigail's. I haven't ever had an answer about whether there's any possible care Abigail might have received if she'd been a US citizen instead of a little Scottish girl. Or whether Abigail would have been guaranteed to receive that care if her parents had been American, even if they'd been on a low income or unemployed.

Thanks for sharing that story. It is very probable that you would have also survived in the US, and you're family could keep their house.

Dan, would you explain the mechanisms through which this outcome could have been achieved in the US?

total: 4.93 deaths/1,000 live births UK

total: 6.3 deaths/1,000 live births US

Not much of a difference.

My God, I might be going to say something I'd regret here. Not much difference????? This is a staggering 28% higher infant mortality in the USA. I honestly had no idea. Given that there is inevitably an irreducible number of neonatal deaths that no amount of care can save, this is absolutely appalling.

One extra death for every 730 live births.

Sorry, I have to go away and calm down for a bit.

Rolfe.

 

[Francesca R]

No one forces us to stay in the UK.

I don't tend to like this argument much. At some point you have to consider the system "closed", in that you can't get out of it. If no country offers you immigration and the conditions you want, short of setting yourself adrift in international waters equipped for 70 years or so (avoid the East African coast and a lot of other places though), you're stuck. I prefer admitting that if you don't like the system and you can't change it, then too bad.

 

[Rolfe]

But there was another choice for those people - they could have left the UK.... No one forces us to stay in the UK. (And no snarky comments Rolfe! )

No. No snarky comments. I support NHS Scotland and I support NHS England and I support NHS Wales and I support NHS Northern Ireland. Wholeheartedly. And I support full reciprocity between them, as now, irrespective of any political or constitutional outcome.

However, I don't think it's helping this discussion to point out the bleedin' obvious that if you don't like the way we do things you can leave. That's not a reasonable option for most people for many reasons.

And you're just confusing Dan.

Rolfe.

 

[DaN K. StAnLeY]

OK. But you wouldn't be any less free under a universal healthcare system than you are at the moment. In fact you'd be more free.

Now please watch what you're saying about not wanting anything to do with others. Any minute now someone is going to annoy you by accusing you of being perfectly relaxed about the idea of people dying in the street, so long as you aren't compelled to contribute anything to their care. Now we know you don't really feel that way, because you've told us so. But it does rather sound as if the system you seem to desire might end up having that effect.

Care to explain yourself a bit better?

Rolfe.

I DO care if people "die in the streets", but I also recognize someone elses right to not care. Soc-HC forces people under law to pay and assumes that if there weren't a law everyone in need would be left to die.

 

[Darat]

You're assuming now, and you know what happens when you assume don't you??

Assuming what?

 

[Professor Yaffle]

So if there were a system in your country in which contributions towards the healthcare of the uninsured were entirely voluntary, you would contribute (and be happy to pay a much higher portion of your income, as volunteers would also be covering the share of those who have opted out).

 

[DaN K. StAnLeY]

My God, I might be going to say something I'd regret here. Not much difference????? This is a staggering 28% higher infant mortality in the USA. I honestly had no idea. Given that there is inevitably an irreducible number of neonatal deaths that no amount of care can save, this is absolutely appalling.

One extra death for every 730 live births.

Sorry, I have to go away and calm down for a bit.

Rolfe.

Yes, and the only reason these numbers are different is because those babies didn't have insurance. I think you DO need to go calm down. Maybe not sit by your computer everyday and wait for someone to argue about UHC with.

 

[DaN K. StAnLeY]

Assuming what?

A whole lot.

 

[DaN K. StAnLeY]

So if there were a system in your country in which contributions towards the healthcare of the uninsured were entirely voluntary, you would contribute (and be happy to pay a much higher portion of your income, as volunteers would also be covering the share of those who have opted out).

If we didn't want to have Medicare/aid we could vote it out at any time and start discharging people tomorrow. What makes you think a significant number of people would opt out? Are Americans more evil than other people?

 

[Rolfe]

Yes, and the only reason these numbers are different is because those babies didn't have insurance. I think you DO need to go calm down. Maybe not sit by your computer everyday and wait for someone to argue about UHC with.

I make no assumptions as to the reason for this astoundingly higher neonatal mortality rate in the US. I merely observe that this is the nation which is regarded as being the most technologically advanced and indeed the most "civilised" in the world, and wonder what the hell is wrong.

Rolfe.

 

[Darat]

I don't tend to like this argument much.

...snip...

I pretty much agree with you, but in my experience ideologues accept these types of extremes in their arguments so I can't see how they can refute the fact that we do have this fundamental choice.

 

[Rolfe]

If we didn't want to have Medicare/aid we could vote it out at any time and start discharging people tomorrow. What makes you think a significant number of people would opt out? Are Americans more evil than other people?

Nope. But they're not a bunch of plaster saints either. In every single developed first world country, there is compulsory taxation of the better off in order to fund the healthcare of the poor and needy. Because it is recognised that if this is left to private charity, the funding will firstly be insufficient, and secondly will be diverted to "cuddly" causes away from the nastier ones.

You seem to be assuming that the vast majority of Americans are saints. I suggest the evidence is that they're no different from anybody else.

Rolfe.

 

[Professor Yaffle]

If we didn't want to have Medicare/aid we could vote it out at any time and start discharging people tomorrow. What makes you think a significant number of people would opt out? Are Americans more evil than other people?

So if only evil people would opt out of paying their fair share in a voluntary system, what's wrong with a compulsory system. Why should I care if a vanishingly small number of evil people are forced to do something they don't want to do. Not doing it makes them evil right?

 

[Rolfe]

I pretty much agree with you, but in my experience ideologues accept these types of extremes in their arguments so I can't see how they can refute the fact that we do have this fundamental choice.

OK, point has been put. Now can we continue the discussion on the assumption that people have the right to remain in their native country and still disagree with its policies?

Rolfe.

 

[Darat]

OK, point has been put. Now can we continue the discussion on the assumption that people have the right to remain in their native country and still disagree with its policies?

Rolfe.

Of course, unless someone brings up "freedoms" again....

 

[MarkCorrigan]

If we didn't want to have Medicare/aid we could vote it out at any time and start discharging people tomorrow. What makes you think a significant number of people would opt out? Are Americans more evil than other people?

....I don't understand.

You would personally contirubute, yes or no?

Some people would not contribute, yes or no?

In order for the (not entirely up to standard) level of healthcare available to those on medicaid/care to be continued under your proposed system then those who do contribute would have to pay more, yes or no?

Why is this situation better?

Also, please descibe by what mechanisms that my parents, in my situation (remember, I have to have continual healthcare and will do for the rest of my life. In fact, I'm due another operation in 5-10 years dependant upon how well the last one went and will be in that situation for the rest of my life, meaning assuming I live to 80 I will need an aditional 3-6 operations, all of which would be exceedingly costly despite the increasingly commonplace nature of these operations meaning no insurance company would touch me with a bargepole) would be able to continue their standard of living without being driven onto another form of government assistance at the very least.

Do keep in mind, the operations that saved my life were not available for the brother of someone I knew in school who was born a mere 6 months before me.

 

[Rolfe]

Hmmm, totally charity-funded system.

Never generates sufficient cash for this sort of need. People who would pay a small amount in a tax-based system, pay nothing because they are strapped for cash and see it as the responsibility of the rich people. Rich people think they're some sort of bloody saint if they make a big, flashy donation, get their name engraved on the neonatal cot or whatever it is, but in fact the amount of the donation still might be less than they'd have paid on their large income if it had been taxed.

People choose which healthcare charity they donate to, and they want their money to go to the neonatal cots or the MRI scanner, and geriatric psychiatry ends up with nothing.

Healthcare competes with other charities, so one day a lot of people decide that they're going to give the money to the Somalia appeal, or the Pakistan earthquake appeal, or maybe the dog and cat home.

And there are people who won't donate at all. In any system. If you allow them to opt out, they will. So everybody else's contributions have to be higher to make up for that.

The only vague possibility that I could see would be to send people an optional tax bill. You would be told the total amount of tax the government thinks you should pay, all broken down and hypothecated to different purposes. Healthcare, education, policing, defence and so on. You would tick the boxes of the things you wanted to contribute to, and send a cheque for only that proportion (which will of course be higher than in a compulsory system, as the government will have figured out what proportion of the population won't pay, and hiked the nominal amount accordingly). And there would be no comeback if you didn't pay anything.

Sounds great. I wonder why no country actually follows this system?

Rolfe.