• Security incident: ISF was recently accessed by intruders. Please change your password, and change it anywhere else you used it. Read more

Socialize Medicine

I had always thought Americans viewed "socialized medicine" as a single-payer system. Or one where government-run insurance systems were mandatory and facilities were publically owned and operated.

Thank you 1950s America.
Yeah--that's why I prefer to avoid the term "socialism". It's pretty loaded. For some people it only means "bad". At best it's ambiguous.

George Orwell even lists it as one of the words frequently misused this way in "Politics and the English Language" (my bolding):

Meaningless words. In certain kinds of writing, particularly in art criticism and literary criticism, it is normal to come across long passages which are almost completely lacking in meaning.

<snip>
Many political words are similarly abused. The word Fascism has now no meaning except in so far as it signifies "something not desirable." The words democracy, socialism, freedom, patriotic, realistic, justice have each of them several different meanings which cannot be reconciled with one another. In the case of a word like democracy, not only is there no agreed definition, but the attempt to make one is resisted from all sides. It is almost universally felt that when we call a country democratic we are praising it: consequently the defenders of every kind of regime claim that it is a democracy, and fear that they might have to stop using that word if it were tied down to any one meaning. Words of this kind are often used in a consciously dishonest way. That is, the person who uses them has his own private definition, but allows his hearer to think he means something quite different. Statements like Marshal Pétain was a true patriot, The Soviet press is the freest in the world, The Catholic Church is opposed to persecution, are almost always made with intent to deceive. Other words used in variable meanings, in most cases more or less dishonestly, are: class, totalitarian, science, progressive, reactionary, bourgeois, equality.

So I prefer using terms like single-payer system, universal healthcare system, and so on.

Back to the point in the OP, I would separate banning extraneous profit centers altogether from the idea of relying on them as the primary way we provide access to healthcare.
 
So I prefer using terms like single-payer system, universal healthcare system, and so on.
"Single payer" means fully or mostly publicly funded. Relatively few universal care systems are like that, so it's a too-narrow definition really. The government can regulate pricing and entitlement and enforce enrollment without paying all the bills from tax or social insurance (which is tax by another name)
 
3.4%...?

So for every $100 they take in, in premiums, they only keep $3.40...?

They pay out the other $96.60 in claims...???

I am sorry, but I just don't believe that. Where's that number within your link?
It was in the row marked "health care plans", in the column marked "profit margin".

Of course, I find it ironic... earlier you made a comment about how people shouldn't "assume" anything; yet from the looks of things, you've been "assuming" that insurance companies make huge profits, without actually looking up the figures.
I am going to concede to your second point, about government pay vs private sector pay. However, I am going to argue now, that there is a bigger 'difference' between private sector profit margins vs non-profit cost operations. Everybody has to pay employees, and a certain number of them. But at the end of the day, the corporation has to show 'profit', at the end of the day. Enough not only to pay the general middle management paper filer, keyboard puncher, or phone response person, but enough to pay a well funded CEO & Board. Our Congressmen make less than $200,000 a year...
So? As I've already pointed out, the people at the top (congressmen and top bureaucrats in public systems, CEOs and other board members in private systems) make up only a small amount of the pay structure.
Question: "Does the average government job require certification or a degree of some kind, or are most government officials 'unlicensed'?"
Depends on the job. I'm sure there are jobs that require certain diplomas/degrees. However, I know people here in Canada who have managed to get good paying jobs with just a high school diploma.

(Of course, if a particular job can be done successfully by a private sector employee without any special certification/degree, why would it be necessary to have the public sector employee "liscenced" (or with a degree) to do the same job?

Well, I'll make my point in this manner, since we are going to pay out "more" claims for all "valid medically ordered" ones, we are going to HAVE to increase our fraud and abuse wing. Today's medical insurance has a much easier time denying a claim, than my system would. I am sure in my system there'd be lots of "fly-by night" clinics pop up, and attempt to de-fraud the taxpayers. The law enforcement wings have never had to be profitable, to be justified. I may well concede that this would cost more in a government model than in a private sector model.

Well, at least you've admitted that in some cases there would be more overhead involved a the public system.
But I CAN'T afford $300 a month PLUS the huge deductible that came with that price...THAT's my point.
And do you think you'd be able to afford paying $5000/year more in taxes to pay for a government-run system (as they do in Canada)?
My complaint is the over billing that has to occur to keep Medical Insurers in business.[/quote[
Yes it does have to happen. But, you can still offer service at a lower cost (compared to a public option) and turn a profit if you manage to cut down on overhead.
I have no problem with hospitals operating for-profit. They are providing a real service. The insurer, is merely 'holding' our collective money, there's no nee for them to be profitable.

Actually, they aren't merely "holding your money". You yourself pointed out that they also have to investigate cases of fraud and determine what claims are valid (something which is a service and still has to be done.) Plus, it does require the efforts of file clerks to manage payments, statisticians to determine health care probabilities, etc. These are things that need to be done regardless of whether its a government-run or private system.

You almost make it sound like private insurance companies have some giant mattress that they stuff your insurance payments under.
 
"Single payer" means fully or mostly publicly funded. Relatively few universal care systems are like that, so it's a too-narrow definition really.

That's pretty much the point I meant to make: it's better to use specific terminology (single-payer if that's what you mean, insurance reform* if that's all you mean, universal health care--a more general term than the first two, but less problematic than socialism) rather than the term socialism.

*ETA: And here in the U.S. even the insurance reform bill we're likely to get is frequently characterized as the "government takeover of healthcare"--even by people in position to make these decisions (like Congresspersons).
 
Last edited:
Of course, I find it ironic... earlier you made a comment about how people shouldn't "assume" anything; yet from the looks of things, you've been "assuming" that insurance companies make huge profits, without actually looking up the figures.
I think that they make profits at all is a concern when so many people have limited or no access to healthcare and the costs for everyone are skyrocketing.

By the way, these extraneous profit centers (the ones not necessary for delivering healthcare goods and services) also spend money on sales and marketing. That money isn't typically counted as "profit" but it is money that's not necessary for providing healthcare.
 
But as I pointed out, they also score high in user responsiveness (dealing with patients, new technology, etc.) So, is it worth paying a little more per capita if it meant the system could deal with rarer cases?
Paying more per capita than we already do to have more expensive technology that a substantial portion of the population will never be able to benefit from? No.
Of course, your use of the phrase "substantial portion" is one of these fuzzy words that seems to be causing problems. What do you consider a "substantial portion"? 1% 5%? 50%?

Remember, we aren't just talking about top-of-the-line, cutting edge technology here. Here in Canada (where we have 'universal', publicaly funded care), the 2 cases that seem to get a lot of attention are the waiting lists for MRIs and Hip replacements. Granted, not everyone will need these procedures (and I do recognize that emergency cases will get priority for MRIs). However, they aren't exactly 1 in a million either; they're rather well established technology. Thousands of these procedures get done each year, and they can lead to an improvement in quality of life and can save lives. (And, in my opinion, the earlier they are done the better.)
 
Of course, I find it ironic... earlier you made a comment about how people shouldn't "assume" anything; yet from the looks of things, you've been "assuming" that insurance companies make huge profits, without actually looking up the figures.

I think that they make profits at all is a concern when so many people have limited or no access to healthcare and the costs for everyone are skyrocketing.

Keep in mind that the poster wasn't just discussing universality (something that could, in theory, be done keeping private companies), he seemed to be suggesting we should replace private companies with government-run insurance.

If that is done, you may not necessarily be saving society any money; Yes, you do eliminate the costs associated with profits (and executive pay), but it provides no benefit to society if you add more costs (in terms of unionized workers and higher overhead due to fraud investigations) than you save.

By the way, these extraneous profit centers (the ones not necessary for delivering healthcare goods and services) also spend money on sales and marketing. That money isn't typically counted as "profit" but it is money that's not necessary for providing healthcare.

You're right... marketing is an issue. But remember, even a government-run system will have a certain amount of "marketing" costs as well (although perhaps not as many).

Here in Canada, we regularly get TV adds for the "Canadian Deposit Insurance Corporation" and the "Parole board", both government departments, and both things that really don't need to be advertised. I've also seen various ad campaigns to remind people of services offered by "OHIP" (the government health insurance plan here in Ontario).
 
By the way, these extraneous profit centers (the ones not necessary for delivering healthcare goods and services) also spend money on sales and marketing. That money isn't typically counted as "profit" but it is money that's not necessary for providing healthcare.
I fail to see the opposition to profit in itself. Ethical breach, crime, whatever is different. But opposition to profit is pretty wrong-headed. As is viewing it as something that worsens the delivered output as though everything was tit-for-tat (zero-sum)

By that logic, primary care holding companies or trusts should be non-profit either. Doctors should not earn above the median cost of living. Ambulances should not be purchased from private profit-seeking companies but made out the back by co-operatives. After all the private manufacturers have sales and marketing overheads.

Stepping outside healthcare, roads shouldn't be build by private contractors, train operators and airlines should be re-nationalised, etc etc etc.
 
I fail to see the opposition to profit in itself. Ethical breach, crime, whatever is different. But opposition to profit is pretty wrong-headed. As is viewing it as something that worsens the delivered output as though everything was tit-for-tat (zero-sum)

By that logic, primary care holding companies or trusts should be non-profit either. Doctors should not earn above the median cost of living. Ambulances should not be purchased from private profit-seeking companies but made out the back by co-operatives. After all the private manufacturers have sales and marketing overheads.
I specifically said this is about extraneous profit centers (and even defined it as those not necessary for providing healthcare goods and services).

Stepping outside healthcare, roads shouldn't be build by private contractors, train operators and airlines should be re-nationalised, etc etc etc.
First, we have got strict profit controls on some of these things. For example, even though most utility companies in the U.S. are for-profit companies, the profits they make aren't really dependent on market forces. Around here, profits are set by the Public Service Commission.

Most roads are paid for by the government and available for public use. To make that analogous to something like healthcare you'd have to consider a privately-funded road that is built in order to make a profit off of toll fees or some such. (I think even where toll roads exist, their purpose is not to make a profit. Even if I'm wrong on this point, toll roads comprise an infinitesimally small part of our roads.) Our inter-city rail system in the U.S., Amtrak, is a government owned corporation that has not even broken even in a long time (if it ever has).

So the airline industry is your only example that is a for-profit industry. If air travel were an essential part of a basic developed world life, I might be arguing that it should be subsidized or nationalized, but it's not really the same as these other things.

ETA: Stepping back, though, I agree with your overall point. I don't think I'd consider these profit centers extraneous to the delivery of healthcare to be problematic if the U.S. didn't have such an expensive system that provides relatively low access to healthcare.
 
Last edited:
If that is done, you may not necessarily be saving society any money; Yes, you do eliminate the costs associated with profits (and executive pay), but it provides no benefit to society if you add more costs (in terms of unionized workers and higher overhead due to fraud investigations) than you save.
Even if that's so, I'd consider it an improvement. I'd rather clerical workers or whatever to get paid better wages than see the money go to corporations or stockholders. I'd rather a system that has oversight than allow an industry to go relatively unregulated (and even enjoy legislation that gives it antitrust exemptions).
 
Profit is not a bad thing. Economic transactions are not zero-sum.

Competition and profit motive drive prices DOWN, not UP.

Why does it seem that in the world of academia and critical thinking, do otherwise smart people have absolutely no economic understanding?
 
I specifically said this is about extraneous profit centers (and even defined it as those not necessary for providing healthcare goods and services).
Yes and I discarded that since when I brought up Marxian theory in post 12 you didn't really accept you were using it. But it appears that you are.

The concept of social necessity ("not extraneous" to you) is arbitrary and not really resolvable without recourse to dicatorship. And resolving it via Marx's labour theory of value (were you to use that) contradicts itself unless you accept that labour has value only to the extent that people are willing to pay for it (which is what Marxian theory sets out to avoid, but finds sneaking in through the back door*). And since people are willing to pay in respect of private insurance services (even for medical cover in universal systems) I really don't see where you get "extraneous" from except your imagination

Incidentally this has been brought up in many health care threads--where lots of posters seem tempted to make caricatures of the various services involved in health care, forming a camp of "saints" (physicians and frontline medical staff) and "evil parasites" (insurance companies, sometimes governments). It is kind of fun to do, but wrong.

* Marx: Capital (Abridged) page 67-8 "suppose that every piece of linen in the market contains no more labour time than is socially necessary [ . . . ] "

ETA: Stepping back, though, I agree with your overall point. I don't think I'd consider these profit centers extraneous to the delivery of healthcare to be problematic if the U.S. didn't have such an expensive system that provides relatively low access to healthcare.
I understand this, but you're shooting the wrong target. The inefficient incentive structure in the US system causes the high cost, not insurance being extraneous.
 
But there's no need to 'risk' anything anymore, since there'd be no need to seek huge profits from the premiums collected
Insurance companies "huge profits" are in the 3-4% range. This isn't where the problem lies folks.

Savings occur because of mandatory screenings that will catch diseases before they become financially untreatable.
This isn't actually true. Screenings and tests actually increase costs.
 
Last edited:
Quality of health results should be the #1 priority,followed then by costs.
For the large publicly-owned health care providers in the US legally the number one priority is increasing shareholder value.
 
Why should we pay the 3-4%...?

That's 3-4% MORE you could be paying actual health care providers.
It's also 3-4% more that could be gobbled up by government inefficiency and waste.

And there's gobs of that in my county's county-owned and run hospital.
 
If that is done, you may not necessarily be saving society any money; Yes, you do eliminate the costs associated with profits (and executive pay), but it provides no benefit to society if you add more costs (in terms of unionized workers and higher overhead due to fraud investigations) than you save.
Even if that's so, I'd consider it an improvement. I'd rather clerical workers or whatever to get paid better wages than see the money go to corporations or stockholders.
Again, not exactly that simple...

Yeah, the "poor" unionized workers may see an increase in their salary (of course, there is every chance that they would have still been earning a living wage before... sometimes unionization doesn't just take from the rich and give to the poor, sometimes it takes from the rich and gives to the relatively well off.) But you know those "huge profits" going to stockholders? Many of those shares are held in retirement plans. So by eliminating those profits, you might end up making the elderly at least a little worse off.

And of course, it seems like you are assuming that the costs would remain exactly the same. Would you be in favor of a government plan/increased pay if it lead to an overall increase in the overhead of dealing with health care?
I'd rather a system that has oversight than allow an industry to go relatively unregulated (and even enjoy legislation that gives it antitrust exemptions).

You do realize we do have a court system... if an insurer makes certain promises and breaks them, they would still be subject to lawsuits.
 
Why should we pay the 3-4%...?

That's 3-4% MORE you could be paying actual health care providers.

Because, in our society, we probably don't have a middle ground... its either:
- Pay to cover the overhead associated with profits
- Pay to cover the increased cost of employee salaries associated with implementing a "government-run" system.
If you can convince all the unions covering government workers to just "go away" it might solve the problem, but I doubt that will happen any time soon.

Now, you might assume that there is a 3rd way... non-profit health insurance companies. And yes indeed, those do exist. However, a couple of things must be kept in mind:
- a "non-profit" company may still earn profits... just that the profits get plowed back into the company rather than distributed to shareholders
- If a non-profit company gets into financial trouble (as can happen during economic downturns, or management problems) they will have a more difficult time recovering. This can end up putting customers of the non-profit company at risk
(Just to note: I'm not a U.S. citizen, so I'm not necessarily an expert on U.S. financial laws; this is just from what I've read.)

http://usgovinfo.about.com/b/2009/08/17/what-are-nonprofit-health-insurance-cooperatives.htm
 

ISF - Join now!

Every member here is approved by hand. No bots, no spam, just people who care about evidence and honest debate.

Membership is free!

Create your free account

Back
Top Bottom