single-payer system ... singled out

[Rolfe]

Single-payer is not about helping people. That's a meme for the common man. It's about entrenching people to be dependent on government. The only thing this has shown in other countries is how well it works for that purpose.

This very place is loaded with emotional defenders of removing freedom in exchange for the hot air of memes, which downplay or ignore the problems caused, such as slowing technological growth which will cause more deaths and suffering in the long run. Magnitudes more. Hundreds of economic experiments last century with billions of "test subjects" showed an unambiguous correlation in this area.

And the mantra of "single-payer" puts the complete lie to it. In some European countries, the government provides a base level of care, but you are free to pursue your own, superior care beyond that.

If this were about quality of medical care, the government would not be in the business of outlawing this.

It is exactly identical to the ludicrous proposition that, say, for retirement, you get your Social Security, but are not allowed to live off any other money. The government, and only the government shall provide for you. Got bank accounts? Tuff. Your kids inherit that someday. Or more likely we'll just seize it for you for the general good.

I now sit humbly awaiting the meme defense mechanisms of single payer to arrive. I will "have no evidence" or "am wrong", in spite of the hundreds of experiments done last century. Or medical people will "still work just as hard", a response that cynically turns them into slaves to be taken advantage of because of their desire to help, which is one of the most truly sickening positions I've ever heard, and won't be enough anyway. Or that the government "will make up the difference", which, completely neglecting the politics involved in directing money, nevertheless reduces profits (or what's the point) and it doesn't have enough money, anyway, to induce research on that level.

I think you are confusing two things here. I have not encountered anyone defending a system where nobody was allowed to purchase any healthcare other than that provided by the government. I entirely agree with you that this idea is oppressive, and what's more it won't work. Those of us who point out the advantages we enjoy in our universal systems are not insisting that citizens be prevented from spending their money on any damn thing they like.

If the US government is suggesting such a thing I'd be very surprised indeed, in fact I'd be astonished. For one, as I said, I think it won't work, and for another, I think it is something likely to be particularly resisted by the American people.

So, are you sure you're not attacking a straw man here?

Second, please tell me those freedoms you have at present which those of us living in countries with universal healthcare don't have? You can use the British NHS is you like, as that is regarded as one of the most centralised of all the universal systems.

Rolfe.

 

[Toke]

This is wishful thinking.

These treads does tend to boil down to a claim of the US goverment as the only one in the western world that is unable to organise a healthcare system.

I have yet so see anyone back up the claim of unique US incompetence.

Therefore I choose to belive it is a result of insurance company propaganda, and some ingrained american phobia of goverment.

Come on, cast off your fear and come over to the red side.

 

[Ziggurat]

What’s wrong with that? Seriously, what’s wrong with that?

Dependency is bad for people, and can create behavioral pathologies. If people view government entitlements, rather than individual achievement, as the route to a better life, then democracy becomes unstable. "Sooner or later, you run out of other people's money."

Do we as citizens of the US get a good deal out of the current private healthcare system compared to those of other industrialized countries with more government intervention?

Given that the system as it is now is hardly free from government intervention, is more government intervention the only alternative we should be considering?

And if other countries are getting similar or better healthcare outcomes for less money, why not copy them?

Better by what metric? Not everybody has the same ideas about what constitutes a better outcome.

 

[Ziggurat]

These treads does tend to boil down to a claim of the US goverment as the only one in the western world that is unable to organise a healthcare system.

Strawman. I didn't claim that the US government can't organize a health care system. But where's the evidence that we would achieve such savings? It's no-existent. The fact that other countries may pay much lower doesn't demonstrate that we would, because the demands we would place on any government system are almost certainly NOT the same demands that those other systems meet.

Therefore I choose to belive it is a result of insurance company propaganda, and some ingrained american phobia of goverment.

In other words, you dismiss anyone who disagrees with you as an idiot of one stripe or another. Way to elevate the debate.

 

[Toke]

In other words, you dismiss anyone who disagrees with you as an idiot of one stripe or another. Way to elevate the debate.

You overlooked this sentence.

I have yet so see anyone back up the claim of unique US incompetence.

 

[Ziggurat]

You overlooked this sentence.

No I didn't. In fact, the first paragraph in my previous post addressed that issue directly.

 

[Blue Mountain]

(snip)Which is why you can buy supplemental insurance or even your own individual policy.

And what do you do if the only jobs you can find pay a measly $7.00 to $10.00 per hour and you're trying to raise two kids?

Which is what COBRA is for.

Wait ... you have no income, yet you're expected to pay both your own part of your health insurance place AND your employer's? Not everyone who finds himself jobless got laid off from a $75,000/year job and had thousands in the bank just so he can burn through it propping up some private insurer's bottom line.

Also:

What Plans Are Not Subject to COBRA?
Small Employer Plans: Small employer plans are entirely exempt from COBRA. If all employers maintaining the plan normally employed fewer than 20 employees on a typical business day during the preceding calendar year, the plan falls within the "small employer plan exception".

There are a lot of small employers in the USA.

And people who thought they had universal health care find themselves fighting government bureaucrats tooth and nail to get what they need.

Those are the stories that make the headlines. Ones that don't are like my father's: he had a mild heart attack in his mid-70s. He received a triple bypass and excellent care at a first rate hospital 120 miles from home. Ditto for a mild bout of prostate cancer. His costs? For the heart attack, it was $300 for an ambulance ride from home to the city, because that wasn't covered by the provincial plan.

Welcome to the reality of rationing: whether it gets done by an insurance company or by the government, it gets done, and never perfectly.

The reality is healthcare in the USA is rationed by ability of the individual to pay, and is inefficiently subsidized by those who can.

And many people in the US are uninsured because they don't think it's worth the cost because they're young and healthy. And when they find out they were wrong, they get sob stories in the newspaper.

All too true. That's where a universal system can help: you're covered regardless of your belief of need. I didn't need the universal healthcare system in my province for years and years. But I was glad for it when I suddenly and unexpectedly ended up in hospital.

 

[Toke]

No I didn't. In fact, the first paragraph in my previous post addressed that issue directly.

I see, my mistake.
You did not claim unique incompetence, but rather unique demands of a healthcare system.
So unique that you cannot use any of the models used in the rest of the western world with good results.

It does not sound that convincing to me.

 

[balrog666]

I have yet so see anyone back up the claim of unique US incompetence.

Amtrak.
Fannie Mae.
Freddie Mac.
Government Motors.

More specifically:
The Indian Health Care System
The VA Hospital System
MediCare
MedicAid

 

[Random]

Dependency is bad for people, and can create behavioral pathologies. If people view government entitlements, rather than individual achievement, as the route to a better life, then democracy becomes unstable. "Sooner or later, you run out of other people's money."

"Yes sir, your daughter is going to die a slow and agonizing death without this expensive surgery, but surely that is better than becoming dependant on the government!"

Better by what metric? Not everybody has the same ideas about what constitutes a better outcome.

Pick a metric. Chose any objective measure of health care quality you want, we will look up the statistics, and we will see who gets the best deal.

 

[Praktik]

I'm pretty sure there's more than few fellow skeptics here who check out the blog Denialism (prominently linked to by Novella and others), but he's had a few posts on health care in America and given we were talking about satisfaction with health care in different systems around the world I thought this recent post would be useful for our discussion:

 

[Ziggurat]

You did not claim unique incompetence, but rather unique demands of a healthcare system.
So unique that you cannot use any of the models used in the rest of the western world with good results.

Again, this is a strawman. I never said we could not adopt any part of any other system without getting good results. But this notion that we would have giant cost savings of 30-50% if only we would adopt government-run health care is just not supported. That's more than just a good result, that's too good to be true. And you haven't even attempted to support it in your responses.

 

[Ziggurat]

"Yes sir, your daughter is going to die a slow and agonizing death without this expensive surgery, but surely that is better than becoming dependant on the government!"

Because nothing says you're right like a blatant appeal to emotion.

 

[Toke]

Amtrak.

? Are they loosing money faster than european railroads?

Fannie Mae.
Freddie Mac.

Not enough goverment regulation?

Government General Motors.

Not your best examble of private efficiency.

More specifically:
The Indian Health Care System
The VA Hospital System

?

MediCare
MedicAid

Last I heard they made good use of what money there were.

All countries have horror stories of goverment waste.
That is not something unique for the US.

 

[Ziggurat]

I'm pretty sure there's more than few fellow skeptics here who check out the blog Denialism (prominently linked to by Novella and others), but he's had a few posts on health care in America and given we were talking about satisfaction with health care in different systems around the world I thought this recent post would be useful for our discussion:

Most of those statistics are of limited use. Public opinion is shaped in large part by the press. In the US and Europe, the press leans left, and in a number of countries the same government which runs healthcare also plays a major role in delivering news, both about their own health care system and about alternatives. While people don't need the press to know something about their own health care system, that's most people's only source for information about alternative systems, and so we should not be surprised if it has a significant effect on shaping consumer satisfaction with existing systems.

Factors like out-of-pocket expenses are also not very useful since the systems being compared are so fundamentally different in their models of how costs get covered. If one were to include taxes paid for health care, for example, one would also find considerable differences. Also missing is any statistics on access problems due to any cause (such as a lack of available services). What is not being included is as telling as what is being included.

Lastly, there are other issues which get swept under the rug in most of these analyses. For example, Americans do not have particularly healthy lifestyles. This has a number of effects, including increased health care costs, higher disease rates, and increased mortality. And that shows up in many health care system comparisons, but it's not really an issue of the health care system we use. Adopting socialized medicine won't make people start eating healthy diets. And for good or ill, Americans don't want (and won't put up with) a government health care system that tries to force them to adopt healthy lifestyles. So we could adopt a system identical to France's, for example, and we wouldn't get identical results, in terms of cost or in terms of disease rates and mortality.

 

[Toke]

Again, this is a strawman. I never said we could not adopt any part of any other system without getting good results. But this notion that we would have giant cost savings of 30-50% if only we would adopt government-run health care is just not supported. That's more than just a good result, that's too good to be true. And you haven't even attempted to support it in your responses.

I did not realise it needed specific support in my posts, everyone else is getting it cheaper with some version of goverment run/backed system.

I admit it sounds fantastic, and it is one of the reasons I and others have a very hard time understanding many americans resistance to the idea.

Do you understand why suspicion of less than rational motives crop up?

Insurance companies have a duty to their stockholders, and alot to lose. Lobbying against UHC is an expected reaction from them. And it would be foolish not to try to affect the public debate as well as politicians.

 

[boooeee]

Again, this is a strawman. I never said we could not adopt any part of any other system without getting good results. But this notion that we would have giant cost savings of 30-50% if only we would adopt government-run health care is just not supported. That's more than just a good result, that's too good to be true. And you haven't even attempted to support it in your responses.

Just to amplify on that point, if you look at Praktik's graph, you can see that the US and State Governments already spend more per capita on health care than any of those countries. And that's just to cover Medicare (65+) and Medicaid (low income). To assert that we would actually spend less in aggregate, by covering more people (everybody under 65) in a government plan makes no sense.

Can somebody spell out exactly how we would spend less by covering more?

 

[Ziggurat]

everyone else is getting it cheaper with some version of goverment run/backed system.

Therein lies the problem: the assumption that "it" (the healthcare we would be receiving under a government-run system) will be the same thing. But there's just no reason to think that will be the case.

 

[NoZed Avenger]

Well, what standards would you like to go by? Life expectancy, infant mortality, average wait times for specific procedures, cost per capita? Choose an objective measure for determining the best healthcare and we can see how the US measures up.

I am interested in seeing if there is any way of factoring in medical innovation. New technologies, new techniques, new drugs.

Does anyone know of links to studies that compare where the new medical "stuff" gets generated or created?

 

[Ziggurat]

And what do you do if the only jobs you can find pay a measly $7.00 to $10.00 per hour and you're trying to raise two kids?

Medicaid.

Wait ... you have no income, yet you're expected to pay both your own part of your health insurance place AND your employer's? Not everyone who finds himself jobless got laid off from a $75,000/year job and had thousands in the bank just so he can burn through it propping up some private insurer's bottom line.

It's called planning. You don't need to be making $75k a year in order to save enough to pay for COBRA coverage, or even individual insurance. I saved enough when I was a grad student to do exactly that sort of thing. Hell, I still don't make that kind of money, and I've always made sure I could cover my own health insurance if I ever lost my job.

Those are the stories that make the headlines.

Exactly. So why would you think that the stories which make headlines in the US are any more representative?