Persuade me to switch to the US Healthcare Model

[volatile]

Yes, another healthcare thread, but with a twist. Rather than us benighted citizens of countries with UHC systems trying to convince the stubborn Republican / Conservative / Libertarian opponents of universal healthcare that ours is the right approach, I'd like to take the opposite tack.

Would anyone in favour of either the current US system, or even any hypothetical one in which universal provision is removed, like to explain to me why I would be better off under such a system? If you were trying to sell a non-universal healthcare system to the British people (imagine you're Daniel Hanan and you've just ceded control of the Tory Party, if you like), on what basis would you argue for the dismantling of the NHS?

So much of this debate is done in the negative. So, let's hear the "pro" argument for marketisted, non-universal healthcare.

 

[Rolfe]

This is actually a question I'd like to hear addressed. I don't think anyone would claim the NHS is perfect, for example. I know doctors who say they could do more for some patients if they had greater resources. There's a lot of internal waste attributable to the sheer hugeness of the system.

Government targets intended to improve care often distort its delivery. Public pressure to fund the cuddly stuff can lead to money being diverted away from things like geriatric psychiatry. It's a lot easier to park someone on a waiting list if they can't cross the road and be treated by your competitor immediately.

So there has to be room for improvement. What's working well in the USA, that we should adopt?

Unfortunately, when the Tory government decided that market forces would improve efficiency, we ended up with dirty hospitals because the cleaning contracts went to the lowest bidder. And other stuff. So we're not immediately embracing that uncritically.

Still, there's gotta be something.

Rolfe.

 

[Francesca R]

I'm not really addressing the question, but it would be a mistake to think that the UK has got health costs sorted, as per the chart below. (Yes, I know the US level of spending does not cover much of its population)

Source here and here. (the webmaster is an American small-government enthusiast but his numbers are legit)

And both Labour and Conservative promises to "ring fence NHS funding from cuts" (IE a spending freeze) will actually be the biggest squeeze on it since its inception.

I'd rather persuade folk in the UK to adopt a multi-payer universal system, but that's a different topic.

 

[Rolfe]

I can see that, and I don't have any huge arguments apart from the fact that wherever we're going we have to start from here and not stamp on too many people on the way there. A thread explaining why we might consider something like the French system would be interesting.

However, I think Volatile is specifically talking about advantages of the US system that we'd benefit from, and specifically why we should abandon universal coverage.

Rolfe.

 

[Dave Rogers]

I'm not really addressing the question, but it would be a mistake to think that the UK has got health costs sorted, as per the chart below. (Yes, I know the US level of spending does not cover much of its population)

Just for clarification, are the US figures in effect the cost of Medicare and Medicaid combined, and pretty much nothing else?

Dave

 

[Francesca R]

are the US figures in effect the cost of Medicare and Medicaid combined

I think so yes (and the military _{and Gitmo})

 

[Lothian]

Yes, another healthcare thread, but with a twist. Rather than us benighted citizens of countries with UHC systems trying to convince the stubborn Republican / Conservative / Libertarian opponents of universal healthcare that ours is the right approach, I'd like to take the opposite tack.

Would anyone in favour of either the current US system, or even any hypothetical one in which universal provision is removed, like to explain to me why I would be better off under such a system? If you were trying to sell a non-universal healthcare system to the British people (imagine you're Daniel Hanan and you've just ceded control of the Tory Party, if you like), on what basis would you argue for the dismantling of the NHS?

So much of this debate is done in the negative. So, let's hear the "pro" argument for marketisted, non-universal healthcare.

If you don't take out any health insurance and never ever get ill, a smaller proportion of your income (1/2% according to FR's chart) will go towards healthcare......
Easy

 

[Darat]

Derail moved to the thread that is already discussing that point: http://www.internationalskeptics.com/forums/showthread.php?t=150486.

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

 

[Beerina]

Very well, Darat.

So, let's hear the "pro" argument for marketisted, non-universal healthcare.

• It has faster medical tech development. Benefit: Yields a better overall outcome, as measured by actual deaths and quality of life, over the years and decades. However, tech sharing masks the general per capita tech lag of other, "universal" coverage nations. They do not hand out "free" 1990 or 2000-level care in 2010 because that's not how the world works.
• Rich people in universal-coverage nations, e.g. Linda McCartney, while still loving their system, come to the US when push comes to shove. While expensive, at least the option is available. Benefit: Under such a system, you don't have to flee to another country to get the best care.
• You can open your own clinic and charge whatever the market will bear. In some place, this is not "allowed", though it is often illegally, and openly, done anyway. Benefit: Profit for you and increased quality of care for your customers, as defined by them, not a bureaucrat.

 

[Leif Roar]

[*]It has faster medical tech development.

A baseless assertion, and one you've made repeatedly and repeatedly failed to back up in any way whatsoever.

[*]Rich people in universal-coverage nations, e.g. Linda McCartney, while still loving their system, come to the US when push comes to shove.

I'm not aware of an European version of this organisation.

[*]You can open your own clinic and charge whatever the market will bear. In some place, this is not "allowed",

It is, however, allowed in the UK, which was the example held up for discussion. So, not a valid reason.

 

[Lothian]

[*]Rich people in universal-coverage nations, e.g. Linda McCartney, while still loving their system, come to the US when push comes to shove. While expensive, at least the option is available. Benefit: Under such a system, you don't have to flee to another country to get the best care.

You killed Linda

Have you evidence that she went to the USA to get better care?

 

[Shalamar]

Very well, Darat.

• It has faster medical tech development. Benefit: Yields a better overall outcome, as measured by actual deaths and quality of life, over the years and decades. However, tech sharing masks the general per capita tech lag of other, "universal" coverage nations. They do not hand out "free" 1990 or 2000-level care in 2010 because that's not how the world works.
• Rich people in universal-coverage nations, e.g. Linda McCartney, while still loving their system, come to the US when push comes to shove. While expensive, at least the option is available. Benefit: Under such a system, you don't have to flee to another country to get the best care.
• You can open your own clinic and charge whatever the market will bear. In some place, this is not "allowed", though it is often illegally, and openly, done anyway. Benefit: Profit for you and increased quality of care for your customers, as defined by them, not a bureaucrat.

[citation needed]

 

[McHrozni]

Yes, another healthcare thread, but with a twist. Rather than us benighted citizens of countries with UHC systems trying to convince the stubborn Republican / Conservative / Libertarian opponents of universal healthcare that ours is the right approach, I'd like to take the opposite tack.

Would anyone in favour of either the current US system, or even any hypothetical one in which universal provision is removed, like to explain to me why I would be better off under such a system? If you were trying to sell a non-universal healthcare system to the British people (imagine you're Daniel Hanan and you've just ceded control of the Tory Party, if you like), on what basis would you argue for the dismantling of the NHS?

So much of this debate is done in the negative. So, let's hear the "pro" argument for marketisted, non-universal healthcare.

The way I see it it offers the benefit of choice. You yourself can decide what do you want, rather than having the state decide for you what is in your best interest.

In many other fields, this is a given. I believe (nearly) everyone would agree they're better off choosing their own jobs, based on what they believe they can do, or that it is our right to choose where to live (within our means). We also get to decide by ourselves what to eat and wear, for example. Why would the state decide none of these, but it should decide in what way should we take care for our health?

Note that I do think there are major problems with the US health system. However, you asked for a reason why it is better, and this is such a reason. It's fairly difficult to deny.

McHrozni

 

[Shalamar]

The way I see it it offers the benefit of choice. You yourself can decide what do you want, rather than having the state decide for you what is in your best interest.

In many other fields, this is a given. I believe (nearly) everyone would agree they're better off choosing their own jobs, based on what they believe they can do, or that it is our right to choose where to live (within our means). We also get to decide by ourselves what to eat and wear, for example. Why would the state decide none of these, but it should decide in what way should we take care for our health?

Note that I do think there are major problems with the US health system. However, you asked for a reason why it is better, and this is such a reason. It's fairly difficult to deny.

McHrozni

why do you assume the state decides your health care for you? Is that better, or worse than having a corporate bureaucrat deciding on your heath care?

In the health Care system in Canada, the 'state' does not decide what care you get. Your Doctor does. You can even get a second or third opinion if you so wish. the 'state' acts as your insurance provider, ensuring that your health care provider is paid.

 

[Francesca R]

The way I see it it offers the benefit of choice. You yourself can decide what do you want, rather than having the state decide for you what is in your best interest.

Incorrect, the state merely pays for it. You have more choice of care under the UK system than the US (In the UK, more hospitals and more doctors are on the platform that you're eligible to use).

Try again

 

[volatile]

The way I see it it offers the benefit of choice. You yourself can decide what do you want, rather than having the state decide for you what is in your best interest.

You don't know a thing about how my current system operates, do you? I have all the same freedoms of choice you do, but amplified. I can go private, should I want. I can select my GP, even within the NHS.

What choices do you have in the US that are not available to me in the UK? Name one choice you are able to make in regards to your healthcare that I am unable to make.

"The state" does not decide anything to do with my health. My doctor does. This, as I understand it, is markedly different to the US system, wherein insurance companies can decline to pay for physician-mandated treatment, force you to choose specific hospitals, can refuse to pay for "pre-existing" conditions and also decide not to pay you if they think you've had enough care. None of this is in any way preferable to the system I currently live under, even in the narrow terms of "choice" you claim the US system offers you.

You're simply mistaken about how UHC systems operate, I'm afraid. It seems you've bought into the mendacious rhetoric rather than understood the facts.

 

[volatile]

A baseless assertion, and one you've made repeatedly and repeatedly failed to back up in any way whatsoever.



I'm not aware of an European version of this organisation.



It is, however, allowed in the UK, which was the example held up for discussion. So, not a valid reason.

Exactly what I was going to say. Point 3 shows, yet again, that you haven't even the first clue about what it is you hate so much. It's just empty rage, isn't it Beerina? You're tilting at windmills.

 

[McHrozni]

why do you assume the state decides your health care for you? Is that better, or worse than having a corporate bureaucrat deciding on your heath care?

You will notice I didn't say which is better overall. It may be that the Canadian (or European) system is better. However, that does not mean it is better in every single way.

In the health Care system in Canada, the 'state' does not decide what care you get. Your Doctor does. You can even get a second or third opinion if you so wish. the 'state' acts as your insurance provider, ensuring that your health care provider is paid.

I said this:
Why would the state decide none of these, but it should decide in what way should we take care for our health?

I'll try to state it a bit differently.

By take care I mean how to pay. If the state doesn't decide how will you pay for your groceries, why should it decide how will you pay for your health?

McHrozni

 

[volatile]

By take care I mean how to pay. If the state doesn't decide how will you pay for your groceries, why should it decide how will you pay for your health?

What do you mean by "decide how to pay"? In what way do you have an extra choice, that I do not have. Spell it out for me, not in generalities but in specificities. What exactly do you mean by this? What do you imagine the UK government does, that the US government does not?

 

[Francesca R]

If the state doesn't decide how will you pay for your groceries, why should it decide how will you pay for your health?

In order to cover those whose income is too low to reach society's preferred threshold level of cover*, and in order to circumvent the failure of markets to price themselves efficiently under self-selection.

*For people too poor to afford society's preferred level of grocery consumption, the state decides how this is paid for too. (Selection bias does not arise with grocery purchase.)