Conservatives, under what conditions would you allow universal coverage?

[WildCat]

Nobody in the converstaion I'm part of in this thread made the specific claim that money paid to hospitals translates to research money for pharmaceuticals.

Beerina has been spouting this nonsense for years now. He/she claims that having a UHC system somehow takes money away from pharmaceutical research.

 

[RecoveringYuppy]

Beerina has been spouting this nonsense for years now. He/she claims that having a UHC system somehow takes money away from pharmaceutical research.

Well that's a good bit different from what you said earlier but it still isn't exactly the claim he/she made in this thread.

But, if you like, go ahead and explain why that is obviously nonsense. On what basis can you automatically assert that pharmaceutical research won't be affected if we make a major change in the way money flows?

More specifically to the exchange between Rustypuch and Beerina that I jumped in to: Rustypouch claims that the US can adopt a plan similar to Canada's and save money on health care (which I don't generally dispute). Now, since spending less money is a key part of that scenario how can you assert that pharmaceutical (or any other medical) research won't be affected?

 

[Neally]

Yeah, because that's exactly what I said. Use all the resources of the entire Earth, no, the whole solar system to cure one kid with Ultrarare-Hypothetical Syndrome.

I never said that you claimed unlimited resources should be spent. I asked a simple question and you got all hyperbole on me. My point again was that lines have to be drawn, and your critique of the private sector and praise for government funding didn't acknowledge this. Both face funding limitations on medical research.

 

[WildCat]

Well that's a good bit different from what you said earlier but it still isn't exactly the claim he/she made in this thread.

But, if you like, go ahead and explain why that is obviously nonsense. On what basis can you automatically assert that pharmaceutical research won't be affected if we make a major change in the way money flows?

More specifically to the exchange between Rustypuch and Beerina that I jumped in to: Rustypouch claims that the US can adopt a plan similar to Canada's and save money on health care (which I don't generally dispute). Now, since spending less money is a key part of that scenario how can you assert that pharmaceutical (or any other medical) research won't be affected?

Neither you nor Beerina have shown any link at all between UHC and pharmaceutical funding, nor even bothered to explain yourselves.

Medical research and health care are completely different animals, and funded differently. They are seperate budget items. There is no reason whatsoever to claim that spending on one affects the other.

And it's not up to me to disprove your claim, it is up to you to show evidence for it.

 

[MarkCorrigan]

Well that's a good bit different from what you said earlier but it still isn't exactly the claim he/she made in this thread.

But, if you like, go ahead and explain why that is obviously nonsense. On what basis can you automatically assert that pharmaceutical research won't be affected if we make a major change in the way money flows?

More specifically to the exchange between Rustypuch and Beerina that I jumped in to: Rustypouch claims that the US can adopt a plan similar to Canada's and save money on health care (which I don't generally dispute). Now, since spending less money is a key part of that scenario how can you assert that pharmaceutical (or any other medical) research won't be affected?

Because healthcare funding and medical research are totally different things?

That's like asking how Mercedez-Benz can make money if Pirelli tyres raise their prices. Sure, the first uses the products of the second, but they are funded in two totally different ways and have practically nothing to link them money wise.

Healthcare research and pharmaceutical companies get funding from a vast variety of sources, none of which are terribly dependant on healthcare provision. If having UHC caused the healthcare research companies of the nations that implement it to go into decline how come these guys are the world's third biggest pharma company?

 

[keale]

Per-capita we generate a lot more cures than your system does.

See, somebody has to invent the things your government hands out for free, and it ain't you and it ain't Europe. Oh, you invent stuff, just not half the stuff, which is the US's fraction of total planetary invention in the medical field.

You know, the 6% of world population that is the US? I know you know that fraction because leftists are always blowing how the US, "only 6% of the world's population", uses half the oil. Or produces half the greenhouse. Or some asinine irrelevancy.

This also puts the lie to the idea the government can make up the difference. Or that, as one nameless poster suggested, the "good will" of scientists will be happy to make up the difference. Of course, a big chunk of the lower production rates may be due more to generally business-unfriendly climates than socialized medicine per se, but that's a different issue.


Imagine how much better life would be, with or without socialized medicine, for everyone, if the rest of the world put out the 94%, proportional to the US's current 50%, such that the US's fraction was it's proper 6%, if you follow that. In other words, the rest of the world's invention rate increased over 8-fold what it was.

If the entire planet was that way, with rude, uncaring, for-profit medicine, but spitting out roughly 8x as many inventions, everyone would be living better, healthier, longer lives than if everyone had socialized medicine with it's current, attendant slower rates of technological development.


It is, literally, murderous on a scale Hitler and Stalin did not imagine. Yes, you, dear believer, are killing far more than you save, by slowing down medical development. Take a good, hard look at yourself in the mirror.

Evidence?? As others have stated we are still waiting. Its real easy to make stuff up and to this point im thinking your making stuff up on the fly.

 

[RecoveringYuppy]

Because healthcare funding and medical research are totally different things?

The answer to your question here is no, they are not totally different.

That's like asking how Mercedez-Benz can make money if Pirelli tyres raise their prices. Sure, the first uses the products of the second, but they are funded in two totally different ways and have practically nothing to link them money wise.

Huh? That's completely wrong. You just told me they are related. One is the customer of the other. How is that not a financial relationship???

Healthcare research and pharmaceutical companies get funding from a vast variety of sources, none of which are terribly dependant on healthcare provision.

Again, huh? How is it not by definition health care funding?

If having UHC caused the healthcare research companies of the nations that implement it to go into decline how come these guys are the world's third biggest pharma company?

No, that is not the claim, at least not mine. Money and merchandise can cross borders.

The claim I'm trying to evaluate is very simple. If we implement a plan to save money on healthcare then which part of the healthcare industry is that money going to come from? If we want a plan that contols costs but doesn't stifle medical progress then how do we guarantee that medical research is not one of the costs that will be affected?

 

[MarkCorrigan]

The answer to your question here is no, they are not totally different.

In terms of funding? Yes, yes they are. I admit I was almost totally out of it when I wrote that post, so I got my own wires crossed and was unclear what I meant, and I apologise for that, but while I made my point very badly (and wrote errors into it) your "point" is still worthless. This gets explained time and time again and people always ignore it, Beerina especially.

Huh? That's completely wrong. You just told me they are related. One is the customer of the other. How is that not a financial relationship???

Well, yes (and this is one of those major errors I copped to above), but it doesn't really work in the way you seem to think. One isn't a customer of the other in quite the same way that I'm the customer of a store. The healthcare provider uses products made by Glaxo or Pfizer or Unilever (or whoever you want really) but while they do buy products from them, they buy in bulk.

A healthcare insurance provider buys in bulk smallscale from Pfizer, but a UHC system, particularly a single payer system, buys for the whole nation. If random company A buys 5000 of something for $5 each and UHC provider B buys 500 000 for 50 cents each, which makes more money for the company that makes it? Neither. Buying in bulk like this means that the providers, who probably produce that item for about a fifth of a penny will be more inclined to give deals on other items, much like buying at wholesale.

In fact, although I admit I don't know the breakdown of costs exactly, I'd be absolutely amazed if the NHS or Canadian system didn't pay roughly the same amount per capita for healthcare products as the whole of the US healthcare system does, resulting in little to no drop in profits, and as such little to no drop in R&D money for the companies that discover and patent medicines.

"But wait!" I hear you cry, "If we pay the same for our drugs and machines and all that useful healthcare-y stuff, how come UHC supporters constantly talk about how CHEAP UHC is?! Surely this is an admission it isn't?"

Well, no. No it isn't. It's not even slightly that. Let's say that Jim grows oranges and they are, for the sake of simplicity, $1 each at cost. Tommy offers to buy me an orange and says that because he wants to ensure everyone who wants an orange gets one, he charges at cost price, I buy one from him for a dollar. Simon on the other hand wants to make a profit out of the orange selling business, so he charges $1.50. He still buys the oranges from Jim at $1, he's just added a cost to the end result. It's oversimplified yes, but that's essentially how UHC differs from...well the US system.

If I wanted to be even more accurate with my oranges tale, I could say that since they are buying these things, Tommy buys 5 million oranges and hands them out to people for a dollar each, a dollar these people are already paying him as part of a fruit and veg deal he's given them whereby whenever they want to get some fruit or veg, they just go and ask him for it. They all pay in a set amount on a regular basis, and while this means some people might be paying more than what they get out in fruit and veg actually costs, it means their friends and relatives can always get fruit and veg, and if they find themselves desperately needing some, they can just get it without paying Tommy when they pick it up.

Simon on the other hand decides that he's not going to pay the full amount at cost for his oranges anymore. He's decided that since people generally don't buy oranges all that often, he's going to let them pay into a pool as well. They pay more into the pool than Tommy charges people, but that's because Tommy is non profit, and gets a better deal on his oranges from Jim.
Because Simon won't pay full cost, he puts an 80% coverage system in place, whereby if someone wants an orange, he pays 80 cents of the money to Jim, but the person who wants the orange must pay the other 20 cents.

Since Simon is trying to make a profit, he also tries to make sure that a lot of his customers don't get oranges when they want them. He insists on holding up orange provision until the patient can not only prove they need the orange, but that they can't be stopped from getting one some other way. Since this is a long and arduous process, Simon can delay on paying his 80% and often manages to find some way to refuse the orange to the person who wants it. Since he doesn't often pay for the oranges, and given he charges more for his fruit and veg provision, he makes huge profits.

He also refuses to accept people who have scurvy into his business pool, since they will likely need a lot more oranges than his other customers, and as such will make him less profit, or potentially a loss.

A stupid analogy? Yes, but it was fun, and the point still stands. UHC provides for everyone no matter what your wealth, it buys in bulk at cheaper (but still not exactly cheap given the huge profit margins) rates than individual insurance companies, and has fewer or even zero middle men creaming money for profit.

Interestingly enough, there are UHC systems which work with insurance companies, providing everyone medical care. These companies which provide for absolutely everyone are for profit, so they take money for their shareholders, so how does that still cost less?

Simple. They are universal, and so don't spend enormous amounts of money hiring people to prevent their customers getting medical care. If the company knows it will always pay out to all the customers, they don't have to have large legal bills from those who take them to court for refusing a drug (at least, nowhere near as often as happens in the US) they don't have to pay the exhaustive line of middlemen who exist only to obstruct those who need care. They don't need to fund the scrutinisers and lawyers and money grubbers who exist only to prevent those with "pre existing conditions" from getting medical care. They aren't paying all the useless frippery that comes from a system specifically designed to deny people care that they need at every opportunity.



Therefore when you said :

The claim I'm trying to evaluate is very simple. If we implement a plan to save money on healthcare then which part of the healthcare industry is that money going to come from? If we want a plan that contols costs but doesn't stifle medical progress then how do we guarantee that medical research is not one of the costs that will be affected?

The answer was very simple. Cutting out (or at the very least minimising) the middle men removes most of the additional financial burden without hurting the profits of Glaxo and co in the least.

 

[TragicMonkey]

I never said that you claimed unlimited resources should be spent. I asked a simple question and you got all hyperbole on me. My point again was that lines have to be drawn, and your critique of the private sector and praise for government funding didn't acknowledge this. Both face funding limitations on medical research.

And both my 96 year old grandfather and Mike Tyson are capable of throwing a punch. Does that mean there's no difference between getting punched by either?

A private company, which requires a profit, will have to have narrower limits on what acceptable expenditure is. Government can pay more because it only needs to cover the costs, not make a profit.

 

[3point14]

I think the answer to the OP seems to be 'Anything that means that I don't have to pay for anyone else'

It all sort of breaks down at that point.

 

[3point14]

I worked for Starbucks for a few years. I didn't make a lot of money but I did get full health coverage even working part time. There are other jobs like this. If people made their own well being a priority they would get a job (at least in the interim between better jobs) that offers health coverage, but people don't do that because it's too easy to get state funded healthcare paid for by others.

If you don't like your position in life, change it. Unless of course you believe that millions of Americans are invalids who can't help themselves. I tend to think this is true from your comments.

This one is absolutely my favourite argument against UHC, the 'I'm alright, Jack.' argument.

 

[3point14]

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

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?

 

[TraneWreck]

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?

Those are good questions, but I should point out that adopting a system like Germany's, where insurance companies are regulated, clearly falls under Congress's Commerce Clause powers.

"Insurance companies must be non-profit, they must accept XX% of high risk patients in order to be licensed, and they cannot deny coverage for pre-existing conditions" is perfectly consistent with the Constitution.

Additionally, Medicare is Constitutional. I don't see how "Medicare for all" would violate any law, nor is the VA (an actual socialist institution), unconstitutional. The argument against UHC by way of the Constitution is not a strong one.

 

[3point14]

Those are good questions, but I should point out that adopting a system like Germany's, where insurance companies are regulated, clearly falls under Congress's Commerce Clause powers.

"Insurance companies must be non-profit, they must accept XX% of high risk patients in order to be licensed, and they cannot deny coverage for pre-existing conditions" is perfectly consistent with the Constitution.

Additionally, Medicare is Constitutional. I don't see how "Medicare for all" would violate any law, nor is the VA (an actual socialist institution), unconstitutional. The argument against UHC by way of the Constitution is not a strong one.

Thanks for that.

I'd still like to know what Grizzly thinks. I'm not going to argue with him on points of constitutional scholarship, but I'd really like to know if he thinks that UHC is a good idea or not, not if his opinion on if it's constitutional or not. The constitution is subject to amendment, the people who wrote it were smart that way.

 

[TraneWreck]

Thanks for that.

I'd still like to know what Grizzly thinks. I'm not going to argue with him on points of constitutional scholarship, but I'd really like to know if he thinks that UHC is a good idea or not, not if his opinion on if it's constitutional or not. The constitution is subject to amendment, the people who wrote it were smart that way.

Yeah, sorry for butting in. It's a good line of inquiry, I'm curious to see the answer. The "UHC is unconstitutional" has always seemed like a means of avoiding substantive argument by hiding behind procedure.

 

[DrDave]

Dude, just do what I did and get a job that offers health coverage.

Even easier, he could just make sure he never gets ill

 

[3point14]

Yeah, sorry for butting in. It's a good line of inquiry, I'm curious to see the answer. The "UHC is unconstitutional" has always seemed like a means of avoiding substantive argument by hiding behind procedure.

No apology needed. If no-one ever 'butted-in', it'd be very boring.

I have always maintained that the first question should be 'is it a good idea?' not 'is it constitutional?'.

I have had people argue that they're one and the same thing, but I really don't subscribe to that notion at all.

 

[lomiller]

Well that's a good bit different from what you said earlier but it still isn't exactly the claim he/she made in this thread.

But, if you like, go ahead and explain why that is obviously nonsense. On what basis can you automatically assert that pharmaceutical research won't be affected if we make a major change in the way money flows?

More specifically to the exchange between Rustypuch and Beerina that I jumped in to: Rustypouch claims that the US can adopt a plan similar to Canada's and save money on health care (which I don't generally dispute). Now, since spending less money is a key part of that scenario how can you assert that pharmaceutical (or any other medical) research won't be affected?

The burden of proof here lays with Beerina since he made the claim the result would be less effective R&D. “This is what I believe and it’s true unless you can prove me wrong” is simply not a valid argument from.

As it turns out there are several elements to this argument that are suspect.
First, we have no particular reason to think drug companies will be unable to sell their products just because the US moves to a single payer model. In Canada for example prescription outside of direct hospital care drugs are still provided by private insurance so under this model nothing would change at all.
Second, we have no particular reason to think that if R&D diminished there would be a reduction in the effectiveness of treatment. Part of the problem with the US system is that it emphasizes catastrophic care which is a more expensive and less effective then early diagnosis and treatment. In such cases expensive drugs can yield small benefits but these are dwarfed by the potential benefits of not depending on catastrophic care to begin with.

Third, we have no evidence that a reduction in private research would significantly impact the development of new cures because a large amount of private research is spent on known mechanisms where there are existing drugs that already work. Drug companies spend most of their R&D to develop new patentable drugs that duplicate, perhaps with slight improvement, the effects of older drugs that are coming off patent and can be purchased cheaply as generics. Primary research is where it’s at in terms of new mechanisms and major advances but privately funded R&D has a number of issues performing this type of research.

As I said there are weaknesses in the argument, but it’s ultimately up to the people trying to advance the arguments that new treatments will suffer if the US went to a single payer system to address these issues, not the people challenging the claim.

 

[lomiller]

The claim I'm trying to evaluate is very simple. If we implement a plan to save money on healthcare then which part of the healthcare industry is that money going to come from? If we want a plan that contols costs but doesn't stifle medical progress then how do we guarantee that medical research is not one of the costs that will be affected?

One page back you linked to a site that claimed spending by US and European drug companies supported the notion that changing the US system would reduce R&D. Don’t you think it’s a little disingenuous to now claim it doesn’t matter where the drug companies are headquarters or do their R&D?

If we want a plan that contols costs but doesn't stifle medical progress then how do we guarantee that medical research is not one of the costs that will be affected?

Major sources of cost in the US healthcare system include massive administrative overhead compared to single payer systems, profit taking by private insurance companies, an emphasis on expensive catastrophic care, overuse of emergency rooms because that’s the only place some people can receive care, high dependence on expensive drugs that are only marginally more effective then generics, and high pay for doctors, particularly specialists.

 

[Wildy]

It never ceases to amuse me when those with government health insurance rail against government health insurance...

Perhaps they feel special because they get to belong to an exclusive little club who get their healthcare on the backs of those who aren't permitted to join and therefore believe that if a UHC system is created then they won't get to feel special.

What I don't understand is if they are so against government health insurance/care then why do they so willingly use it?