single-payer system ... singled out

[Rolfe]

So, if that's the case, do you think it's preferable that the care they can't get is limited to a few new, very expensive treatments of equivocal or as-yet-unproven value, or everything?

Rolfe.

 

[garcia<3]

Hmmm. Silence for several hours.

It seems to me that ideological objections to that last system of funding, which frankly seems to me to be the only method of ensuring that the system is funded, may be an insurmountable hurdle for universal healthcare in the USA.

So often, when such a system is described, the main reaction comes down to, "but then the stupid and the lazy and the feckless and the reckless will benefit!" Well yes, they will. Along with everybody else.

Is this right? Well, what's the alternative? Either the people who are better off, more provident and generally luckier pay more (one way or another) so that these people can be treated, or they are left to suffer and die for want of treatment. Insisting that no, you don't want these people to suffer, but at the same time you don't want to pay anything towards their treatment, is simply irrational.

Nevertheless, this method of funding seems deeply unpopular. It's described as communism, slavery, confiscation, theft, loss of liberty, oppression, a threat of violence and I don't know what else. Well, so how come nobody seems to be rioting because the roads and the rubbish collection and the public libraries and the fire service and the foreign embassies are funded in that way?

But somehow, medical care is different. There seem to be a lot of people who will accept this method of funding medical care for the population only over their own dead bodies. And this seems to be fundamentally unrelated to objections about efficiency and choice and quality of care. No matter how often these issues are discussed, it almost always seems to come back to, but it's wrong for the stupid and the lazy and the feckless and the reckless to receive medical care they can't pay for. And it's wrong that the wealthy should be obliged to pay disproportionately more so that low-income people can benefit (disregarding the fire service and the libraries and the embassies and the schools and the roads and all the rest of it).

Experience in just about every other developed country demonstrates that everyone benefits from universal healthcare - even the very wealthy, who get to inhabit their own swanky private hospitals without any interference from the Great Unwashed banging on the doors. But it does have this terrible downside. That same Great Unwashed are provided with medical care. Whether they "deserve" it or not. This seems to be the great dealbreaker for a distressingly large segment of the US population.

I asked Dan Stanley this. Suppose your fairy godmother came along and said, "Dan, you can have anything you want in the world. Your one great dream, the thing you've always wanted, you can have it. There's only one catch. Your worst enemy will also be granted his dearest wish. Do you accept the offer?"

It does seem to me as if the naysayers to universal healthcare in America, at bottom, are in the camp that would decline that offer.

Rolfe.

I know it's just a personal anecdote but from what I have experienced living in the USA all you have to do is slap the communist, socialist sticker on something and most people will oppose it, even if it might benefit them. I do recall being taught in history class that socialism and communism were bad thing. LOL, we learned all this at a public school, how ironic. So although I am for universal health care, I think because of our mind set and the way we vote, it would never work here. The system would have to completely change and people here like to vote based on religious and ideological views, not financial ones. Of course this is just my point of view, nothing else.

 

[Professor Yaffle]

This is simply false. Care is available to everyone regardless of their ability to pay. What level of care is available to all may differ, but that's not the same thing at all, and it is not uniform outside the US either.

What level of care do you think we have on the NHS? Do you think my sister was told - "No, sorry we can't afford the several operations your daughter will need - especially if it doesn't work and she need a heart transplant. You will have to go private if you want that"? And if you think the level of care in the NHS doesn't meet your standards, you can always get private insurance, and for reasons Rolfe has already laid out, it will cost you a lot less than US insurance.

 

[Ivor the Engineer]

<snip>

My practice just decided to write off several dozen million dollars of costs because we don't want to pass them on to the patients. But we are still mercenary, and evil, and corrupt, and have vested interests.

<snip>

Would those costs exist if the healthcare system was funded by the government? For example, would you be required?

 

[Ziggurat]

What level of care do you think we have on the NHS?

Irrelevant to my point. You can't rescue a false argument by changing to a different one. You were wrong, Yaffle.

 

[Professor Yaffle]

Irrelevant to my point. You can't rescue a false argument by changing to a different one. You were wrong, Yaffle.

Then I'll be more precise and say all I ask for is a good level of care with access to drugs and procedures that are considered to have a reasonable chance of improving ones condition - for everyone regardless of their ability to pay. I'm happy to live in a country that has that and I really can't understand whyanyone wouldn't want that for their own country.

 

[Rolfe]

Irrelevant to my point. You can't rescue a false argument by changing to a different one. You were wrong, Yaffle.

Wrong, Ziggurat.

There is all the difference in the world between a system where the care that you can't get unless you pay is limited to a few very new and very expensive treatments of as-yet-unproven value, and a system where the care you can't get unless you pay is in fact almost anything you might ever need.

We have a system where the care we can't get without paying is so little that few people even bother to insure against that eventuality. You have a system where the care you can't get without paying seems to be just about everything available.

It's hardly rational to reject any idea of looking at the former system just because there are still small pockets of provision that aren't covered.

Professor Yaffle's point is absolutely hitting the nail on the head, sorry.

Rolfe.

 

[Ziggurat]

Wrong, Ziggurat.

There is all the difference in the world between a system where the care that you can't get unless you pay is limited to a few very new and very expensive treatments of as-yet-unproven value, and a system where the care you can't get unless you pay is in fact almost anything you might ever need.

Which doesn't describe the US system. Emergency care, which is the care most people are most likely to need, is available to everyone regardless of whether they can pay. Whether or not you consider that sufficient is irrelevant to my point. And I never claimed that there were no differences, or even no major differences. But that's still not what Yaffle had originally claimed, so this is really no defense of his statement at all. Hell, even Yaffle hasn't tried to reassert his original formulation.

It's hardly rational to reject any idea of looking at the former system just because there are still small pockets of provision that aren't covered.

Did I reject looking at any system in the post you replied to? No, I do not believe I did. In fact, did I do what you describe here in any post? I don't think so. Strawman.

 

[Praktik]

So although I am for universal health care, I think because of our mind set and the way we vote, it would never work here. The system would have to completely change and people here like to vote based on religious and ideological views, not financial ones. Of course this is just my point of view, nothing else.

Hmm - Americans have been using their well-known ingenuity to get around cultural objections though - why not simply dress it up in non-socialist clothing? Call it "America First Health Care" or "Freedom Care"?

From "enhanced interrogations" to "preventative war" to the "Patriot Act" it seems the well never runs dry when dressing up things that would seem unpalatable to the American public on first glance.

 

[Professor Yaffle]

In the UK, only 12.5% of people have any form of private medical insurance - many of these will be people who get it automatically through work. If our level of coverage in the NHS was really low, I imagine far more people would be taking out insurance.

 

[Professor Yaffle]

Which doesn't describe the US system. Emergency care, which is the care most people are most likely to need, is available to everyone regardless of whether they can pay. Whether or not you consider that sufficient is irrelevant to my point. And I never claimed that there were no differences, or even no major differences. But that's still not what Yaffle had originally claimed, so this is really no defense of his statement at all. Hell, even Yaffle hasn't tried to reassert his original formulation.

Emergency care is the care people are most likely to need? I have only been to A&E 4 times in my life. Most of my medical care has been routine, provided through my GP. Emergency care is only your most likely need if you have been denied access to routine care.

And of course it is relevant whether we consider emergency care is sufficient. That is precisely why we consider your system to be deficient. If the level of care everyone was entitled to was thought to be sufficient, then you would have, by definition, a universal health care system.

 

[Random]

Which doesn't describe the US system. Emergency care, which is the care most people are most likely to need, is available to everyone regardless of whether they can pay. Whether or not you consider that sufficient is irrelevant to my point. And I never claimed that there were no differences, or even no major differences. But that's still not what Yaffle had originally claimed, so this is really no defense of his statement at all. Hell, even Yaffle hasn't tried to reassert his original formulation.

Emergency care is not free. You show up, you get treatment, and then they send you a bill. If you can’t pay it, they send you to collections. The collections agency will harass you, trash your credit rating, and try to dock your paycheck. If you still can’t pay, the hospital takes the money they lost treating you and transfer it to patients who can pay. It’s a bad form of Socialized Medicine.

And this is only for a broken leg or something. What happens if you have leukemia? Are you supposed to show up at an emergency room twice a week for free chemotherapy?

 

[Ziggurat]

Emergency care is not free.

I never said it was free. I said it was available regardless of ability to pay.

 

[garcia<3]

Hmm - "Freedom Care"?
.

 

[Random]

I never said it was free. I said it was available regardless of ability to pay.

Never said you thought it was. I was just listing the consequences of someone showing up at an emergency room without money and pointing out how this type of medical access was basically a form of Socialized Medicine.

It’s like a medical student saying, "I never got a handout from anyone. I worked hard and got a scholarship!"

Frankly, the "emergency care" mantra is just another way to dodge responsibility for the consequences of the "everyone for themselves" attitude towards healthcare. If you think people have no fundamental right to medical care, fine. That is your opinion. But when someone talks about poor children who get sick, you don’t get to spout something about how charity/Medicaid/emergency care will handle it to make it sound better. Those things are in place in spite of your position, not because of it.

 

[Ziggurat]

If you think people have no fundamental right to medical care, fine. That is your opinion. But when someone talks about poor children who get sick, you don’t get to spout something about how charity/Medicaid/emergency care will handle it to make it sound better. Those things are in place in spite of your position, not because of it.

This is a completely false representation of my position. I do not think that I have a fundamental right to have a city park near my house. But that doesn't require that I therefore oppose having one. I don't. It's a nice perk, and I'm glad to have it. There is no conflict between wanting government to provide some service and thinking that it's not a fundamental right. But thanks for trying to tell me what I believe.

 

[Random]

This is a completely false representation of my position. I do not think that I have a fundamental right to have a city park near my house. But that doesn't require that I therefore oppose having one. I don't. It's a nice perk, and I'm glad to have it. There is no conflict between wanting government to provide some service and thinking that it's not a fundamental right. But thanks for trying to tell me what I believe.

But there is a conflict. You are not saying that poor sick children have a right to medical care. You are not saying poor sick children have no right to medical care. You are saying poor sick children have no right to medical care, but they’ll probably get it anyway somehow.

And who would provide that medical care? People who believe poor sick children have a right to medical care.

Your position is dependant on other people rejecting your position.

 

[Ziggurat]

But there is a conflict. You are not saying that poor sick children have a right to medical care. You are not saying poor sick children have no right to medical care. You are saying poor sick children have no right to medical care, but they’ll probably get it anyway somehow.

This is getting quite tiresome. No, this is NOT what I'm saying. I'm saying that it's not a fundamental right, but I'd like to see them get it. I don't need to think something is a fundamental right in order to want it provided. Is that really too hard a concept to grasp? Apparently so.

And who would provide that medical care? People who believe poor sick children have a right to medical care.

No. It is provided by people who want sick children to have medical care. Whether they think it's a fundamental right is rather incidental to that.

Your position is dependant on other people rejecting your position.

No, it is not. But keep on poisoning that well, Random.

 

[Random]

This is getting quite tiresome. No, this is NOT what I'm saying. I'm saying that it's not a fundamental right, but I'd like to see them get it. I don't need to think something is a fundamental right in order to want it provided. Is that really too hard a concept to grasp? Apparently so.



No. It is provided by people who want sick children to have medical care. Whether they think it's a fundamental right is rather incidental to that.



No, it is not. But keep on poisoning that well, Random.

Maybe I just can’t see it. I think healthcare is a right, and I just can’t understand someone saying its not, and then saying that it would be nice. If you don’t think people have a right to healthcare, why would you care?

 

[Ziggurat]

Maybe I just can’t see it. I think healthcare is a right, and I just can’t understand someone saying its not, and then saying that it would be nice. If you don’t think people have a right to healthcare, why would you care?

Other than ones you are opposed to, is there really no government-provided service that you don't consider a fundamental right?