single-payer system ... singled out

[Rolfe]

He's scarier than Dan Stanley, who came out with the same stuff but didn't really seem to have thought it through. Ziggurat seems to be holding this as a considered position. Cold, hard, unsympathetic, and thinks that appealing to emotion automatically invalidates an argument.

But since he seems to have stopped talking to me, I'll go away again.

Rolfe.

 

[Ziggurat]

He was a politician and he was trying to convince the populous

Yes, and I understand that politicians act like, well, politicians. But that doesn't explain why it was mentioned in this thread. The efficacy of a fallacy among the general electorate is irrelevant here.

This system costs more than it should and is fundamentally inefficient.

True. But I do not think government intervention will change that. Some people think it will, but current experience with medicare suggests this is unlikely. If advocates of government-run health care think they can make the system work for everyone, they should demonstrate that by making medicare work first.

You are willing to put your ideology, that government is bad, before what is best for the overwhelming majority of the population.

Uh, no. Rather, I believe that government interference will NOT be "what is best for the overwhelming majority of the population". But thanks for poisoning that well.

People like you scare me to be honest. .

Bite me.

 

[tomwaits]

Guys, seriously. This was an interesting discussion until people started making accusations of being ideologues and how they were "scary". Couldn't we just discuss the issues, and not try to find hidden motives?

 

[Cleon]

Because I think everyone needs it, going without has massive externalities, and it's needed at a point in life where they cannot possibly provide it for themselves.

Only the last of these ever applies to healthcare.

Nonsense.

Everyone needs health care; from the moment you're born, until the moment you die. Going without has massive detriments on both your individual health and the health of other people.

Three out of three.

 

[Ziggurat]

Nonsense.

Everyone needs health care

Nope. Healthy people can do just fine without it. We did for thousands of years. It is prudent to get coverage, but that's a separate issue.

Going without has massive detriments on both your individual health and the health of other people.

Nope. Certain infectious diseases have large externalities (and so you can add vaccinations to the list of things I'm OK with government taking over), but if you have a heart attack, the impact on me of whether or not you've got health care coverage is pretty damned small.

 

[Architect]

Nope. Healthy people can do just fine without it. We did for thousands of years. It is prudent to get coverage, but that's a separate issue.

 

[balrog666]

Yes, and I understand that politicians act like, well, politicians. But that doesn't explain why it was mentioned in this thread. The efficacy of a fallacy among the general electorate is irrelevant here.



True. But I do not think government intervention will change that. Some people think it will, but current experience with medicare suggests this is unlikely. If advocates of (US)* government-run health care think they can make the system work for everyone, they should demonstrate that by making medicare work first.



Uh, no. Rather, I believe that government interference will NOT be "what is best for the overwhelming majority of the population". But thanks for poisoning that well.



Bite me.

Nicely said.




And Medicaid. And the Veteran's Affairs Hospital System. And the Indian (USA Native Americans for whose without Google) Health Care System.

* - added by balrog666

 

[Rolfe]

Now you're here, are you going to get round to telling is what "freedoms" you have that us poor benighted souls who have access to universal healthcare are denied?

Or are you just going to keep asserting that the mighty USA can't run the proverbial piss-up in a brewery?

Rolfe.

 

[garcia<3]

Wow!!! I just read this whole thread and as an American I couldn't disagree more with Ziggurat. The only thing that I was able to get from his posts is that he is out of touch with most Americans. I tried, I really did, I read them carefully, I really wanted to understand his point of view. The reason I was trying to understand him is because my experience with my health insurance has been nothing but a nightmare. So I am curious to see how people like him come the these conclusions. He has failed. I also find it very insulting that he thinks the only reason people have problems with their health insurance is because their lazy

 

[Rolfe]

I've been quite shocked by some of what I've come across in this forum relating to US insurance company behaviour and policies. Some of the shocking material has been from links to press reports, but a surprising amount has been personal stories from posters themselves - often not posted with any intent to influence a healthcare debate. Before reading that stuff I'd always assumed that while it was expensive, and you could well be screwed if you didn't have it, at least the insured American really did live in this utopia of immediate treatment with the best medical science has to offer, no expense spared.

Of course, one has to take individual anecdotes with a pinch of salt. It's also easy to find press reports criticising the NHS. If people feel they have been badly treated then they can get very vocal about it, and the newspapers love a good story. So maybe these insurance horror stories are the US equivalent of the six-month waiting list - not exactly a lie, but very much not the experience of the average patient.

However, a very important difference strikes me between the two types of horror story. In Britain the narrative is virtually always, "I should be entitled to this treatment, and I'm not getting it." In the USA the narative however reads, "I'm not getting the treatment I need because someone has decided I'm not entitled to it." So it does seem as if the US patient has no more certainty of being treated than the British patient. The mechanisms are just a bit different, that's all.

Rolfe.

 

[mr rosewater]

Hey Rolfe, Question for you, how bad is your country's debt due to all your free ponies. Without health care we in the US have a 12 trillion debt not including our obligation to SS and medicare about 50 trillion the Chinese own us how about you?

 

[ARubberChickenWithAPulley]

Of course, one has to take individual anecdotes with a pinch of salt. It's also easy to find press reports criticising the NHS. If people feel they have been badly treated then they can get very vocal about it, and the newspapers love a good story. So maybe these insurance horror stories are the US equivalent of the six-month waiting list - not exactly a lie, but very much not the experience of the average patient.

However, a very important difference strikes me between the two types of horror story. In Britain the narrative is virtually always, "I should be entitled to this treatment, and I'm not getting it." In the USA the narative however reads, "I'm not getting the treatment I need because someone has decided I'm not entitled to it." So it does seem as if the US patient has no more certainty of being treated than the British patient. The mechanisms are just a bit different, that's all.

Well, the UK doesn't cover everything that people think they are entitled to either. Your last point might be generally true, but it also may be that people in the UK have a different expectation regarding care. Because there is a national standard, they -- and the doctors -- know what treatments they can use, and which treatments are inappropriate because they are too expensive with too little benefit.

For example, one 'grain of salt' you should probably look at insurance company anecdotes with is a fairly common scenario:
- The doctor recommended an expensive treatment and the insurance company wanted to try a less expensive one first; Hence, they denied payment (from the POV of the patient). This goes back to the issue I mentioned earlier: we complain about cost, we do a terrible job of containing cost, we use expensive procedures more often than any country in the world, but hate hate hate the idea of any "bean counter" overruling our doctor on anything to contain cost. Everyone wants to contain cost, as long as the cost containment isn't used on them.

I don't claim there is a black and white resolution there: bureaucracies can't know the nuances of a specific patient like a doctor can; I don't want an insurance company overruling my doctor. Yet, clearly in the U.S., our doctors use very expensive treatments with little to show for the extra cost, so somebody has to try to stop it. And chances are, whoever does it is going to be the bad guy.

To be clear, there have been some odious actions by insurance companies in the past (finding excuses to drop people when they get sick, etc.) that are not worthy of defense, but there is still a major problem with expectations in the U.S.: purely anecdotal, but a lot of people tend to think that health insurance means (or should mean) carte blanche on medical procedures: if I get sick, my insurance company had better pay for whatever procedure my doctor demands. If he demands the most cutting edge, expensive procedure out there, then darn it, it should be paid for! And the reality is, neither a public nor a private system will be that.

 

[garcia<3]

Well, the UK doesn't cover everything that people think they are entitled to either. Your last point might be generally true, but it also may be that people in the UK have a different expectation regarding care. Because there is a national standard, they -- and the doctors -- know what treatments they can use, and which treatments are inappropriate because they are too expensive with too little benefit.

For example, one 'grain of salt' you should probably look at insurance company anecdotes with is a fairly common scenario:
- The doctor recommended an expensive treatment and the insurance company wanted to try a less expensive one first; Hence, they denied payment (from the POV of the patient). This goes back to the issue I mentioned earlier: we complain about cost, we do a terrible job of containing cost, we use expensive procedures more often than any country in the world, but hate hate hate the idea of any "bean counter" overruling our doctor on anything to contain cost. Everyone wants to contain cost, as long as the cost containment isn't used on them.

I don't claim there is a black and white resolution there: bureaucracies can't know the nuances of a specific patient like a doctor can; I don't want an insurance company overruling my doctor. Yet, clearly in the U.S., our doctors use very expensive treatments with little to show for the extra cost, so somebody has to try to stop it. And chances are, whoever does it is going to be the bad guy.

To be clear, there have been some odious actions by insurance companies in the past (finding excuses to drop people when they get sick, etc.) that are not worthy of defense, but there is still a major problem with expectations in the U.S.: purely anecdotal, but a lot of people tend to think that health insurance means (or should mean) carte blanche on medical procedures: if I get sick, my insurance company had better pay for whatever procedure my doctor demands. If he demands the most cutting edge, expensive procedure out there, then darn it, it should be paid for! And the reality is, neither a public nor a private system will be that.

I'm usually happy getting the cheap version of what ever treatment or pills I need to get. It's still going to cost me though. Of course this is a personal anecdote and should be taken with a grain of salt.

 

[ARubberChickenWithAPulley]

Incidentally, I have been under both types of systems: I left the military 18 months ago. The military health system is essentially socialized: I could walk in and get medical care any time I needed it, without any worry about cost.

Moving to the private sector, I now have a "high deductible health plan." I actually like it. I have some incentive to question cost with my doctors, because the initial chunk of money comes out of my pocket. It also enables me to save and plan ahead.

That said, the HDHP is a dollar amount, not an income %. I'm lucky enough to make a high enough salary to fund it fully and save into my health savings account. Not everyone makes that much, so the execution of it is an issue. I'm also lucky enough to have a job to begin with. But I like the principle of the HDHP. I save to my deductible every year. If I don't use it, I keep the money in case I need it next year. When we had our child this year, it was very simple: I paid the deductible (about $3,000), the insurance covered every single thing after that (over $15,000). No hassles, no issues. For me, it's a good balance. I have some responsibility and even reward for planning well.

On the other hand, I also want to know, if I were to lose my job, that I would have decent coverage. Right now, I'm not sure that exists very well in our system -- and that is a major problem.

 

[garcia<3]

Incidentally, I have been under both types of systems: I left the military 18 months ago. The military health system is essentially socialized: I could walk in and get medical care any time I needed it, without any worry about cost.

Moving to the private sector, I now have a "high deductible health plan." I actually like it. I have some incentive to question cost with my doctors, because the initial chunk of money comes out of my pocket. It also enables me to save and plan ahead.

That said, the HDHP is a dollar amount, not an income %. I'm lucky enough to make a high enough salary to fund it fully and save into my health savings account. Not everyone makes that much, so the execution of it is an issue. I'm also lucky enough to have a job to begin with. But I like the principle of the HDHP. I save to my deductible every year. If I don't use it, I keep the money in case I need it next year. When we had our child this year, it was very simple: I paid the deductible (about $3,000), the insurance covered every single thing after that (over $15,000). No hassles, no issues. For me, it's a good balance. I have some responsibility and even reward for planning well.

On the other hand, I also want to know, if I were to lose my job, that I would have decent coverage. Right now, I'm not sure that exists very well in our system -- and that is a major problem.

I currently have a very good job as well and I definitely don't mind having to pay what I do for my insurance, they are a bit of a nightmare to deal with at times but I manage. Now if I were to lose my job things would get really though for me, it's not cheap being a female even if I'm healthy I can't avoid seeing my gyno.

I think people should still be able to purchase insurance if they can but at the same time I wish we had something that would insure any citizen, not just children, if they found themselves without a job. I am all for paying higher taxes to achieve this.

 

[balrog666]

Now you're here, are you going to get round to telling is what "freedoms" you have that us poor benighted souls who have access to universal healthcare are denied?

Or are you just going to keep asserting that the mighty USA can't run the proverbial piss-up in a brewery?

Rolfe.

You talkin' to me, punk? /Dirty-Harry-mode

How 'bout ...

1. The freedom to buy whatever medical services I want from whomever I want whenever I want without interference from the US government bureaucrats.

2. The freedom to not have my assets confiscated to pay for the medical service requirements of foreigners here illegally.

and

3. The USA government bureaucrats, as contrasted with real people who work for a real living in the real world, can't run the proverbial piss-up in a brewery as demonstrated every year by Amtrak, the VA Hospital System, the Indian Health Care System, Medicare, Medicaid, Government Motors, et al. Jeez, the US government bureaucrats even went broke running a brothel for Dog's sake! Buy a clue someday!




So, what businesses do you see the US government bureaucrats running to your satisfaction for the benefit of people everywhere??

Other than the US Military, of course. And NASA some forty years ago.

 

[Matthew Best]

How 'bout ...

1. The freedom to buy whatever medical services I want from whomever I want whenever I want without interference from the US government bureaucrats.

But the question was what freedoms do you have that we don't have. You just listed a freedom we both share.

2. The freedom to not have my assets confiscated to pay for the medical service requirements of foreigners here illegally.

You object to paying taxes?

and

3. The USA government bureaucrats, as contrasted with real people who work for a real living in the real world, can't run the proverbial piss-up in a brewery as demonstrated every year by Amtrak, the VA Hospital System, the Indian Health Care System, Medicare, Medicaid, Government Motors, et al. Jeez, the US government bureaucrats even went broke running a brothel for Dog's sake! Buy a clue someday!

Er, that's not even a freedom.

But this is basically the famous American "can't do" attitude again. Why do you think American government bureaucrats are so much more inefficient than British government bureaucrats? Would you perhaps like the British National Health Service to run health care in the US, since we are apparently much more capable of doing it than you?

 

[ARubberChickenWithAPulley]

But the question was what freedoms do you have that we don't have. You just listed a freedom we both share.

The freedom that Americans could have that you don't is the freedom to decide who will administer their health benefits -- just like choosing a supermarket, or car company, or anything else, we could have real competition and the choice of "do we want company A, B, or C to administer health benefits for us."

The problem is, the status quo "system" isn't even that. Most competition for insurance is between large employers, not by individuals. Individual insurance is a pricey -- and dicey -- proposition. And while it would be easy to blame insurance companies for that, the simple fact is, the way our "system" is set up essentially ensures that there is a shoddy individual market (e.g. it is fragmented by state, we give a tax break for employer-paid benefits but not for individual benefits, people can "opt out" if insurance altogether which ensures that a lot of healthy people won't be paying into the system to help pool risk, etc. etc.). I can't just go and tell my insurance company to take a hike and get a new one. My company can -- but then, if it's a self-funded plan, chances are my company isn't on my side anyway.

 

[Cleon]

Nope. Healthy people can do just fine without it. We did for thousands of years.

Ah. So apparently you are completely unaware of what the population's general health was like during those thousands of years.

Hint: The Black Death was not a metal band.

Nope. Certain infectious diseases have large externalities

...So nope, but yep.

 

[Ziggurat]

Ah. So apparently you are completely unaware of what the population's general health was like during those thousands of years.

Primarily a difference of hygiene and nutrition. Followed by vaccination (already addressed my position on that).