Conservatives, under what conditions would you allow universal coverage?

[leftysergeant]

Well we do know that some people will be remarkably philanthropic, there are still many hospitals in the UK that were originally built with money from a rich individual or company and look at the Gates foundation today.

Lucky you. Many hospitals here that were orginally built by government entities and charities are being sold by "cost-cutting" idiots to for-profit hospital corporations.

Sucks.

 

[leftysergeant]

Government can pay more because it has the power to take money from those to whom it rightfully belongs without giving them a choice.

It does not rightfully belong to you until you have paid your utility bills. How many times need I remind you of that?

 

[3point14]

Just to ask again, in case it was missed:

In response to this:

The Constitution does not delegate the power to Congress to create one.

I wrote this:

Just a couple of hypothetical questions.


If the constitution didn't exist, and you had to make one up, would you think it would be a good idea to include universal health coverage.


If the constitution didn't exist and the US had muddled through without one till now, would you support universal health coverage.


IOW: Taking the constitution out of it, what's your actual opinion on if it's a good idea or not?

I was wondering, if you're about, Grizzly, what your response is. Or indeed the response of anyone who holds this view.

 

[Rolfe]

Well we do know that some people will be remarkably philanthropic, there are still many hospitals in the UK that were originally built with money from a rich individual or company and look at the Gates foundation today. Unfortunately for those against UHC that evidence also shows that the level of charitable giving will not provide anything like good health care for all of those that can't afford to pay for their medical needs.

That's very true. Some people are very philanthropic. But then others aren't, or else they give what they think is a nice donation, but when it's compared to their income or net wealth, it's derisory.

This is why I say that funding such services through taxes prevents freeloading. It prevents the phenomenon of stingy Daddy Warbucks turning away all the charity collectors with a flea in their ear, leaving it to others to make up the difference.

If you rely on voluntary giving to fund healthcare for those whose needs are greater than their resources, it's inevitable that some people will under-contribute. So either you come up short, or others have to over-contribute. The situation will be made worse by people's natural fear for their own well-being, in that the anticipation of perhaps incurring a big-ticket healthcare need themselves in the future is likely to stay their hand when the collecting tin comes round.

It's a terrible way to fund healthcare.

Rolfe.

 

[Mobyseven]

A private company has to obtain money by selling goods and/or services that consumers will buy of their own free choice.

Except we're not talking about the kinds of goods and services that one buys out of some free choice, at least not as we'd normally conceive it.

People don't go to the doctor for fun. They can't buy antibiotics without a prescription, and most wouldn't want to get them unless they were sick anyway. Conversely, if you are sick, your choices are often limited to 'go to the doctor' or 'get sicker' -- hardly a 'free choice'.

Sure, the USA has created a system whereby people DO have to choose -- cases like Travis -- but that's because you have a system that's, frankly, inhumane.

 

[3point14]

It's a terrible way to fund healthcare.

Rolfe.

But on the plus side, it does give those who have become rich within the system an opportunity to feel all charitable and glowy and the chance to look down at those who clearly didn't work as hard (the only reason not to be rich) and bestow upon them benevolence so that they can look upwards and be grateful for the scraps from the rich man's table.

Why would you take that away from them, Darat, Why

 

[TragicMonkey]

Government can pay more because it has the power to take money from those to whom it rightfully belongs without giving them a choice.

And when it then spends that same money to provide those same people a service, they're getting the benefit of it. Do you complain about your taxes paying for the military? The interstates? Schools? If not, then why is healthcare not like those? If you do, then what is the function of government if not to provide the group what it cannot obtain as individuals?

A private company has to obtain money by selling goods and/or services that consumers will buy of their own free choice.

And subtract a profit. By its very nature a private company will always give out less in services than it takes in as charges. Always. That's not a problem if you're dealing with luxuries that people can go without, but healthcare isn't a luxury. It's a necessity.

 

[TraneWreck]

Government can pay more because it has the power to take money from those to whom it rightfully belongs without giving them a choice.

This is just silliness. How much money would you make in a world without roads, electrical grids, police, firemen, armies to protect borders, people to inspect food, water, and goods, a court system to enforce your rights...etc.?

Nonsensical glibertarianism. This is a democracy, "The Government" is us. We got together and decided these are the things we should collectively provide. If you think it sucks, start a movement to change things. If it's popular, that will be the new government.

Not so scary.

A private company has to obtain money by selling goods and/or services that consumers will buy of their own free choice.

I love this canard. Show me the "choice" in the healthcare industry. The vast majority of people who are able to obtain coverage do so through their employer. They rarely have much choice in that situation. Most states only have three or four insurers that provide coverage.

But to the broader point, profit-motive can be a powerful force, but it can also be damaging. Profit motive drives people to develop clever ways to generate that surplus. When we're discussing Apple or Google or biotechs or care companies, this is a very good thing. It generates innovation, has a general effect of driving down prices and creating efficiency, and spurs creativity. Of course, it has to be regulated lest we arrive at "economic breaches" (cheaper to settle lawsuits from wrongful deaths than build safe cars, for example).

But what good is profit motive in private health insurance? What innovations does that incentive generate? I'd be curious to hear the free market advocates explain what the benefit of that is.

We know it hasn't created efficiency, which is why Medicare has such intensely lower administrative costs, and the only innovation in the market is to develop new ways to deny people the coverage they're paying for. The only way to increase profit is to take in more and pay out less. That does not benefit individuals or the nation as a whole.

I would challenge any free market advocate to explain why profit motive is at all a good thing for the health insurance industry without reference to vague, inchoate "principles."

 

[kmortis]

Keep it civil, keep it on topic. The topic is not the other posters. The topic is generally included in the thread title, so if you're having issues remembering what it is, look at that.

Replying to this modbox in thread will be off topic  Posted By: kmortis

 

[rustypouch]

This is just silliness. How much money would you make in a world without roads, electrical grids, police, firemen, armies to protect borders, people to inspect food, water, and goods, a court system to enforce your rights...etc.?

Nonsensical glibertarianism. This is a democracy, "The Government" is us. We got together and decided these are the things we should collectively provide. If you think it sucks, start a movement to change things. If it's popular, that will be the new government.

Not so scary.



I love this canard. Show me the "choice" in the healthcare industry. The vast majority of people who are able to obtain coverage do so through their employer. They rarely have much choice in that situation. Most states only have three or four insurers that provide coverage.

But to the broader point, profit-motive can be a powerful force, but it can also be damaging. Profit motive drives people to develop clever ways to generate that surplus. When we're discussing Apple or Google or biotechs or care companies, this is a very good thing. It generates innovation, has a general effect of driving down prices and creating efficiency, and spurs creativity. Of course, it has to be regulated lest we arrive at "economic breaches" (cheaper to settle lawsuits from wrongful deaths than build safe cars, for example).

But what good is profit motive in private health insurance? What innovations does that incentive generate? I'd be curious to hear the free market advocates explain what the benefit of that is.

We know it hasn't created efficiency, which is why Medicare has such intensely lower administrative costs, and the only innovation in the market is to develop new ways to deny people the coverage they're paying for. The only way to increase profit is to take in more and pay out less. That does not benefit individuals or the nation as a whole.

I would challenge any free market advocate to explain why profit motive is at all a good thing for the health insurance industry without reference to vague, inchoate "principles."

From my point of view, I think the "free market" breaks down with regards to health care.

The basic reasoning is that the supply and demand relation is messed up. With most products and services, there comes a point where if they get too expensive, people won't get them. No matter the cost, people need health care. Is there a price point where a parent says to a kid " sorry about the cancer son, but we don't have the money for the treatment so you'll have to die in agony?"

Appeal to emotion, maybe.

But it all comes back to the same few points: the US is the only "Western" country without UHC. UHC systems same equivalent or better outcomes. Americans spend significantly more on health care than people in other industrialized nations, with the very real risk of bankruptcy or suffering if they can't afford care they need.

 

[mhaze]

I was unemployed and briefly homeless (lived in a guy's garage for awhile) when I was 23 and they told me I wouldn't qualify for medicare unless I had children and had been homeless for.......I forget how many days it was. Even then only the children would be covered. Nonetheless I applied three times during that period hoping to qualify under different specialty programs which involved reams of applications and navigating a Kafkaesque type bureaucracy.

So you've experienced firsthand the harsh impersonal reality of "government assistance".

As I have. So I reject expanding those sectors, as per "universal health care".

To me it seems obvious that would expand the harsh impersonal realities, including the number and variety of insanities.

I don't want that and don't think it's a good thing.

You found the reality of "Government Assistance" was quite different than the concept of it you had initially. I suggest the same would be the case with "universal health care".

That's the problem.

 

[Darat]

All those problems were caused by trying to limit access to health care, make it universal and you remove all those steps.

 

[WildCat]

A private company has to obtain money by selling goods and/or services that consumers will buy of their own free choice.

How many people actually have a choice? Most have to accept whatever plan their company's HR yahoo decides they get, and it can change every year. And that HR guy's criteria for what constitutes a good plan probably varies wildly from what the employees would choose, if they actually had a choice.

 

[stokes234]

So you've experienced firsthand the harsh impersonal reality of "government assistance".

As I have. So I reject expanding those sectors, as per "universal health care".

To me it seems obvious that would expand the harsh impersonal realities, including the number and variety of insanities.

I don't want that and don't think it's a good thing.

You found the reality of "Government Assistance" was quite different than the concept of it you had initially. I suggest the same would be the case with "universal health care".

That's the problem.

He listed specific problems with a means-tested healthcare system that only covered a certain part of the population under very strict conditions, and then explained why UHC (more government cover) would solve those existing problems (i.e. through no means-testing). How exactly did you extrapolate that to mean that the government is bad?

 

[RecoveringYuppy]

Similarly, if you told us that we had to have private armies because otherwise there would be less defence research, we would all sit around in an equally confused manner waiting for you to elaborate.

Bolding mine. You're reading a point in to my posts that isn't there. I've been very specific about what my question is in my posts, let me clarify what my question isn't. None of my posts have said anything about public vs private. Maybe the link I posted said that, but I said I didn't think it settled the matter and later I said I was citing it for the evidence it cited. I'm not questioning nor opposed to public health care. I'm in favor of universal health care. Please just look at back at what you just quoted from me. It doesn't say public vs private, it's questioning cost savings. I'm questioning the restriction of money and looking for an assurance that medical research won't be impacted. I think it was this thread were I just posted last night that I'd be in favor of plans that simply subsidized health care.

So your questions about armies isn't analogous. A proper analogy would be if someone had a proposal to cut defense spending people would then want assurances that defense research was going to be spared. (not that that's my opinion on that matter, but it's a proper analogy).

Until you explain at exactly which point during the transition from private to public healthcare you believe the flow of money to big pharma research will be reduced, nobody can really analyse your claim.

As I hope you might understand now I'm not questioning the transition from public to private. I'm questioning the transition from our current spending levels to the proposed lower spending levels that some people in this thread have said we could have with certain plans. I'd have exactly the same concerns if private insurance companies announced they had a plan to save a trillion dollars in health care costs. I'd want assurance that they weren't going to impact medical research and quality of health care in that case too.

BTW You mention "Big Pharma" twice in your post to me. I'm not focused on drug research in particular. I'm concerned about medical research in general. There's more to medical research than drugs.

It's as if you think the funding for big pharma research and the funding for private or public healthcare is drawn from the same pool, but they aren't.

Investors in medical research companies aren't doing so in the hopes of revenue and profits?

I understand that medical research is also paid for with charitable donations and subsidies but all of it? Are you really claiming there is no connection between what people spend on health care and what gets spent on health care R&D?

 

[TraneWreck]

From my point of view, I think the "free market" breaks down with regards to health care.

The basic reasoning is that the supply and demand relation is messed up. With most products and services, there comes a point where if they get too expensive, people won't get them. No matter the cost, people need health care. Is there a price point where a parent says to a kid " sorry about the cancer son, but we don't have the money for the treatment so you'll have to die in agony?"

I agree completely. It's a miserable failure and the rest of the world is aware of this. Look at the statement by conservative David Cameron:

"We will not be selling off the NHS, we will not be moving towards an insurance scheme, we will not introduce an American-style private system," Prime Minister David Cameron emphatically told a group of healthcare workers in a nationally televised address last week.

In case they didn't hear it the first time, Cameron repeated the dreaded "A"-word in a list of five guarantees he offered the British people at the end of his speech.

"If you're worried that we're going to sell off the NHS or create some American-style private system, we will not do that," he said. "In this country we have the most wonderful, precious institution and also precious idea that whenever you're ill … you can walk into a hospital or a surgery and get treated for free, no questions asked, no cash asked. It is the idea at the heart of the NHS, and it will stay. I will never put that at risk."

http://www.latimes.com/health/la-fg-britain-health-care-20110613,0,1237142.story

What's that about "American exceptionalism" again? The rest of the civilized world views us as a comedy act.

I agree with you that American-style health care has failed on a practical level, but it also makes no sense on a conceptual level. We can consciously decide how and when profit motive is allowed as an incentive. It's often a very powerful force in developing innovation.

But again, what innovation do health insurance companies develop? New drugs? New treatments? More efficient treatments?

No, they merely come up with new ways to deny claims. Other than raising premiums, that's the only way they have been able to increase their profit.

And interestingly, allowing insurance companies to seek profit has had a stunting effect on free market incentives for other industries. Employers cannot take the same level of risk within their fields because they're constrained by health care costs. Employees cannot freely seek to maximize their potential for fear of losing health care, nor are they as able to become entrepeneurs and start new businesses because of health care costs.

I don't know about you, but I would rather have the free market working to reward people who take a risk, start a small business and try to develop a new drug, a new technology, a new service...etc. then just allowing some insurance company to concoct convoluted arguments for why they don't have to pay for your medical care.

Free market incentives for health care companies are hampering free market incentives in more beneficial fields. This is idiotic both from a health care perspective (low-quality, highly expensive) and from an economic perspective (restricts business ventures, contrains employees, inhibits employers). There is no criteria under which our system is a good one.

 

[Rolfe]

He listed specific problems with a means-tested healthcare system that only covered a certain part of the population under very strict conditions, and then explained why UHC (more government cover) would solve those existing problems (i.e. through no means-testing). How exactly did you extrapolate that to mean that the government is bad?

Seems to work just great here. For certain definitions of "great" anyway, and certainly minus the horrors Travis has encountered.

Rolfe.

 

[WildCat]

So you've experienced firsthand the harsh impersonal reality of "government assistance".

As I have. So I reject expanding those sectors, as per "universal health care".

To me it seems obvious that would expand the harsh impersonal realities, including the number and variety of insanities.

I don't want that and don't think it's a good thing.

You found the reality of "Government Assistance" was quite different than the concept of it you had initially. I suggest the same would be the case with "universal health care".

That's the problem.

Travis would have encountered none of those issues if there was UHC.

 

[WildCat]

Investors in medical research companies aren't doing so in the hopes of revenue and profits?

There you go again, confusing "medical research" with "health care".

They are not the same thing.

 

[stokes234]

I understand that medical research is also paid for with charitable donations and subsidies but all of it? Are you really claiming there is no connection between what people spend on health care and what gets spent on health care R&D?

Where you're getting confused is assuming that the savings would come from reduced spending on healthcare. That's not the proposal in UHC. The reduced spending would come mainly from no spending on advertising, no means testing, and no insurance company middle-men (ETA: and ofc. no administrative costs from billing people and chasing them up).

Actual spending on R&D under UHC will be determined by what the government wants to spend on R&D. If this is less than before, then your issue is with the government choice of low spending on R&D, not with the UHC system, and you should vote in a new government that spends more on it.

Basically, the switch isn't a cut in healthcare spending, it's a cut in wasted spending that is related to healthcare.