Universal Health Care

[mr_whomp]

What does everyone think about universal healthcare?

I'll give it a go first. I'm a big supporter, but I also think that a two tier system makes sense with regards to non-essential services.

Also out of curiosity, let's say I'm in the US and I'm a poor intercity type character, with no health coverage or money to pay out of pocket for treatment. I get in a car crash and need to go to a hospital, what happens to me?

[hmkpoker]

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let's say I'm in the US and I'm a poor intercity type character, with no health coverage or money to pay out of pocket for treatment. I get in a car crash and need to go to a hospital, what happens to me?

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Well for starters, you don't post things like this anymore...

[Richard Tanner]

Universal health care is great on the surface but underneath is filled with problems like doctor swapping (the overall lessening of personal services because doctors are so busy and often suffled) and the the overall disinterest in becoming a doctor due to the lack of pay.

I love the idea if we did away with money and lived in a perfectly communist society, but in the real world, nope sorry to many negitives for me.

As for your question, you die on the street (or recover from your injuries). That's a little harsh, actually you are taken to a hospital, stabilized, released, then die in the steps, which are much nicer then the street.

Cody

[Myrtle]

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What does everyone think about universal healthcare?

I'll give it a go first. I'm a big supporter, but I also think that a two tier system makes sense with regards to non-essential services.

Also out of curiosity, let's say I'm in the US and I'm a poor intercity type character, with no health coverage or money to pay out of pocket for treatment. I get in a car crash and need to go to a hospital, what happens to me?

[/ QUOTE ]

What does the report card of how it's working in Canada say?

[Olof]

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Universal health care is great on the surface but underneath is filled with problems like doctor swapping (the overall lessening of personal services because doctors are so busy and often suffled) and the the overall disinterest in becoming a doctor due to the lack of pay

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I don't think this is true. A Swedish doctor has about a third of the purchasing power of an American doctor, yet entry to medical school is more competitive here than in the US.

[bdk3clash]

I'm sure that most people who oppose universal health care in the United States would be surprised to learn that under the current hodgepodge of private insurance and health care providers the United States "does not have anywhere near the best health in the world." (Journal of the American Medical Association, July 2000), even though our per-capita medical spending is quite high compared to other countries.

[Myrtle]

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I'm sure that most people who oppose universal health care in the United States would be surprised to learn that under the current hodgepodge of private insurance and health care providers the United States "does not have anywhere near the best health in the world." (Journal of the American Medical Association, July 2000), even though our per-capita medical spending is quite high compared to other countries.

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Gee whiz.....I wonder what kind of conclusions can be drawn from that?

[bdk3clash]

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I'm sure that most people who oppose universal health care in the United States would be surprised to learn that under the current hodgepodge of private insurance and health care providers the United States "does not have anywhere near the best health in the world." (Journal of the American Medical Association, July 2000), even though our per-capita medical spending is quite high compared to other countries.

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Gee whiz.....I wonder what kind of conclusions can be drawn from that?

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A lot of Americans assume that we have the best health and the best health care system in the world, so the debate over universal health care often starts off with a false premise.

I think it's important to know how Americans' health and the American health care system compare to other major industrialized countries' health and health care systems (all of them have universal health care, by the way), but I could be wrong.

[Myrtle]

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I'm sure that most people who oppose universal health care in the United States would be surprised to learn that under the current hodgepodge of private insurance and health care providers the United States "does not have anywhere near the best health in the world." (Journal of the American Medical Association, July 2000), even though our per-capita medical spending is quite high compared to other countries.

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Gee whiz.....I wonder what kind of conclusions can be drawn from that?

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A lot of Americans assume that we have the best health and the best health care system in the world, so the debate over universal health care often starts off with a false premise.

I think it's important to know how Americans' health and the American health care system compare to other major industrialized countries' health and health care systems (all of them have universal health care, by the way), but I could be wrong.

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OMG!!!! Really??

Damn! How can they ALL be so WRONG!

Stupid damned foreigners...what the hell do they know?

Hey, pass me another Bud lite, willya?

[bobman0330]

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A lot of Americans assume that we have the best health and the best health care system in the world, so the debate over universal health care often starts off with a false premise

[/ QUOTE ].

The best health-care system does not always lead to the best heath. There are a number of reasons that Americans would have a lower life expectancy: more driving, more eating, less exercise, etc. For an argument that the US system is indeed better than most others, link (http://www.marginalrevolution.com/marginalrevolution/2004/04/where_is_health.html)

[bdk3clash]

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There are a number of reasons that Americans would have a lower life expectancy: more driving, more eating, less exercise, etc.

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This is incorrect.

From John Abramson, MD's book "Overdosed America: The Broken Promise of American Medicine":

"In a comparison of 13 industrialized nations...the health of Americans is close to the worst on most measures and overall ranked second to last. Contrary to popular wisdom, the poor ranking of the United States cannot be attributed to our rates of smoking, drinking, or consumption of red meat. Surprisingly, Americans rank in the better half of the 13 countries on these measures, and have the third lowest cholesterol level. (Deaths due to violence and car accidents were not included in the data.)"

(Emphasis mine.)

[bobman0330]

I'm still not sold. What about overall obesity, which is definitely higher in the US?

[bdk3clash]

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I'm still not sold. What about overall obesity, which is definitely higher in the US?

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I doubt that adjusting for obesity levels would have a significant effect on the overall rank of the United States, but this is just a hunch.

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What does everyone think about universal healthcare?

I'll give it a go first. I'm a big supporter, but I also think that a two tier system makes sense with regards to non-essential services.

Also out of curiosity, let's say I'm in the US and I'm a poor intercity type character, with no health coverage or money to pay out of pocket for treatment. I get in a car crash and need to go to a hospital, what happens to me?

[/ QUOTE ]

I've been out of college for about a year and a half and haven't not been able to find a decent job, or even one having to do tangentially related to my degree (polital science). Needless to say I haven't had insurance and I haven't had any money. I've suffered through a broken rib and a bad illness without medical care. On a side note, my girlfriend and I can't afford to see a doctor about, nor would we be able to afford, her ADHD medicine.

I can't get a credit card to pay for any medicine or care because of a nasty credit card fraud incident, with Bank of America denying my fraud claim on account of a ridiculous loophole, and therefore my credit is [censored] and I'm in debt. And it was my mother that committed the fraud, something that has caused me major depression, about which I cannot afford to see a doctor.

This can be a harsh place. Better health care could make a huge difference in the lives of some people.

[BadBoyBenny]

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I'm in the US and I'm a poor intercity type character, with no health coverage or money to pay out of pocket for treatment. I get in a car crash and need to go to a hospital, what happens to me?

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You get treated in the emergency room just like everyone else. Hospitals can't turn you down.

[BadBoyBenny]

Hot chicks will still want doctors if they make less than they do now, and their mothers will want them to marry them.

I think it is more likely that you might end up with doctors working less hours if they are less paid, which could result in the need for more doctors, which could result in medical schools lowering acceptance standards... you know where I'm going with this.

On the other hand, if I;m in a major emergency, maybe having someone who couldn't quite get into medical school under the current system is better than having someone who has worked for 16 hours straight.

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I'm still not sold.

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It's always hard when facts get in the way of ideology.

[mr_whomp]

Canadian doctors make really good money. Not as much as in the states but still decent. And its not like all doctors are payed the same, some are salaried, but others are on fee for service plans where they bill (in ontario at least) OHIP for the services they do. This means that they make more money depending on which types of patients they see and how often. The problem is that some problems that take longer amounts of time (like mental health/addiction) do not pay more money then straight checkups, so doctors are less likely to accept new patients to their practice who have complicated problems (IE drug addict/and smoker/With mental health problems)

This may be a lil biased since i was volunteering this spring in an addiction medicine clinic and so got their point of view on the issue.

[renodoc]

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all doctors are payed the same, some are salaried, but others are on fee for service plans where they bill (in ontario at least) OHIP for the services they do.

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Is this sort of like billing for SIIHP ? I'm confused. Maybe I should move North, eh?

[mr_whomp]

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all doctors are Not payed the same, some are salaried, but others are on fee for service plans where they bill (in ontario at least) OHIP for the services they do.

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Is this sort of like billing for SIIHP ? I'm confused. Maybe I should move North, eh?

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FYP

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What does everyone think about universal healthcare?

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Most Americans above the poverty line reject socialism, and therefore reject the idea of universal healthcare simply by its name.

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I'll give it a go first. I'm a big supporter


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Are you poor? Rich people from other countires often fly in to America for any significant surgeries or procedures. The best doctors in the world often come to America because they make loads of more money as well. Of course, Medicaid ain't that great but neither are Ramen Noodles and powder grape "drinks".

Americans have the decision to accept universal healthcare and reject capitalism every year - all they need to do is cast a vote. We pay over $5000 per capita on healthcare because thats what we are willing to pay, and if we aren't satisfied then we pay more until we aren't willing to pay anymore. To transfer all of these costs to the Government doesn't mean that the costs magically disappear and that healthcare becomes better though. If anything, the cost becomes much greater due to the welfare loss of the massive bureaucratic grinder that is the government, and the premium healthcare that rich people demand disappears, along with the best doctors in the world because they no longer make the most loot.

[cardcounter0]

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... the premium healthcare that rich people demand disappears ...

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I don't see how poor people can sleep at night with the worry of rich people not getting their permium healthcare.
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[bdk3clash]

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Most Americans above the poverty line reject socialism...

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I'm not quite sure what this has to do with the topic in question--universal health care doesn't have anything to do with socialism.

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...and therefore reject the idea of universal healthcare simply by its name.

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This is a ridiculous statement. Universal healthcare is simply the notion that all of our citizens should have access to adequate health care--government should provide health care to those unable to pay for it themselves. I doubt that "most Americans above the poverty line" (or below it) reject this idea.

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Are you poor? Rich people from other countires often fly in to America for any significant surgeries or procedures. The best doctors in the world often come to America because they make loads of more money as well.

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I don't think anyone would argue that the United States doesn't have the best trauma care in the world. However, actual benefits to public health primarily come from sources other than cutting-edge procedures and newer, expensive medications. As Abramson (see my post above) states:

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According to the United States Centers for Disease Control and Prevention, 'Since 1900 the average lifespan of person in the Unites States has lengthened by greater than 30 years; 25 years of this gain are attributable to advances in public health.' These include improvements such as sanitation, clean food and water, decent housing, good nutrition, higher standards of living, and widespread vaccinations."

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(Emphasis mine.)

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Of course, Medicaid ain't that great but neither are Ramen Noodles and powder grape "drinks".

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As Malcolm Gladwell points out in this "New Yorker" article (http://www.newyorker.com/fact/content/articles/050829fa_fact),

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Medicare, too, is based on the social-insurance model, and, when Americans with Medicare report themselves to be happier with virtually every aspect of their insurance coverage than people with private insurance (as they do, repeatedly and overwhelmingly), they are referring to the social aspect of their insurance. They aren’t getting better care. But they are getting something just as valuable: the security of being insulated against the financial shock of serious illness.

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(Emphasis mine. Although in this quote Gladwell discusses Medicare and not Medicaid specifically, his general argument--if not specific facts--remains applicable to both.)

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Americans have the decision to accept universal healthcare and reject capitalism every year - all they need to do is cast a vote.

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Logical fallacies and factual inaccuracies abound in this statement alone. You've somehow analogized universal healthcare and a rejction of capitalism. Americans, as far as I know, have yet to be offered a vote on this issue ever, let alone "every year."


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We pay over $5000 per capita on healthcare because thats what we are willing to pay, and if we aren't satisfied then we pay more until we aren't willing to pay anymore. To transfer all of these costs to the Government doesn't mean that the costs magically disappear and that healthcare becomes better though. If anything, the cost becomes much greater due to the welfare loss of the massive bureaucratic grinder that is the government, and the premium healthcare that rich people demand disappears, along with the best doctors in the world because they no longer make the most loot.

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Oy. Read me. (http://www.newyorker.com/fact/content/articles/050829fa_fact) Medicare and Medicaid operate tremendously efficiently and have much lower administrative costs than private insurance does. To quote wholesale a large portion of Gladwell's article:

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Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations.

Doctors here perform more high-end medical procedures, such as coronary angioplasties, than in other countries, but most of the wealthier Western countries have more CT scanners than the United States does, and Switzerland, Japan, Austria, and Finland all have more MRI machines per capita.

Nor is our system more efficient. The United States spends more than a thousand dollars per capita per year—or close to four hundred billion dollars—on health-care-related paperwork and administration, whereas Canada, for example, spends only about three hundred dollars per capita.

And, of course, every other country in the industrialized world insures all its citizens; despite those extra hundreds of billions of dollars we spend each year, we leave forty-five million people without any insurance. A country that displays an almost ruthless commitment to efficiency and performance in every aspect of its economy—a country that switched to Japanese cars the moment they were more reliable, and to Chinese T-shirts the moment they were five cents cheaper—has loyally stuck with a health-care system that leaves its citizenry pulling out their teeth with pliers.

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[TomCollins]

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Quote:
Most Americans above the poverty line reject socialism...


I'm not quite sure what this has to do with the topic in question--universal health care doesn't have anything to do with socialism.

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You are serious? It has nothing to do with socialism? That's entirely the purpose.

[bdk3clash]

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Quote:
Most Americans above the poverty line reject socialism...


I'm not quite sure what this has to do with the topic in question--universal health care doesn't have anything to do with socialism.

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You are serious? It has nothing to do with socialism? That's entirely the purpose.

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Can we define our terms? Do you consider Social Security and/or progressive taxation socialistic?

[The Don]

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Quote:
Most Americans above the poverty line reject socialism...


I'm not quite sure what this has to do with the topic in question--universal health care doesn't have anything to do with socialism.

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You are serious? It has nothing to do with socialism? That's entirely the purpose.

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Can we define our terms? Do you consider Social Security and/or progressive taxation socialistic?

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Obviously.

[bdk3clash]

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Quote:
Most Americans above the poverty line reject socialism...


I'm not quite sure what this has to do with the topic in question--universal health care doesn't have anything to do with socialism.

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You are serious? It has nothing to do with socialism? That's entirely the purpose.

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Can we define our terms? Do you consider Social Security and/or progressive taxation socialistic?

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Obviously.

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I guess if you consider universal health care "socialism" and therefore something to be avoided entirely then you're not really interested in discussing it at all, really.

If you are, maybe you could respond to some of the other points in my post, which, by the way, happen to be given after the first sentence.

Of course, you might want to get hung up on whether universal healthcare is socialism or not, which I think is a separate debate.

[TomCollins]

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Quote:
Most Americans above the poverty line reject socialism...


I'm not quite sure what this has to do with the topic in question--universal health care doesn't have anything to do with socialism.

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You are serious? It has nothing to do with socialism? That's entirely the purpose.

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Can we define our terms? Do you consider Social Security and/or progressive taxation socialistic?

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Absolutely.

[natedogg]

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I've been out of college for about a year and a half and haven't not been able to find a decent job Needless to say I haven't had insurance and I haven't had any money.

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As a young single male in good health you can purchase personal coverage for under $100 month. Maybe you weren't aware of this, but the fact is that anyone who isn't disabled or has an expensive pre-existing condition can get insurance for an affordable price. They CHOOSE not to.

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I can't get a credit card to pay for any medicine or care because of a nasty credit card fraud incident, with Bank of America denying my fraud claim on account of a ridiculous loophole, and therefore my credit is [censored] and I'm in debt.

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All you have to do is file with the credit reporting agencies. You can go to their websites and request to file a statement with your credit that explains why you have a default or collection that you haven't paid. It doesn't make your credit perfect but it mitigates the black marks. If this really did happen fraudulently, you can get a police report and include that in your addendum to your credit report.

Also, you may not have found a job that fits your degree, but unless you are physically unable to work, you can certainly find a job. It's just a matter of what you're willing to do to pay bills while you're getting your career started. If you live in an urban area and you know how to type, you can get up to 15 or even 20/hr just doing office temp work. That's what I did when I first graduate. It was no fun and the lawyers treat you like crap.

Good luck.

natedogg

[Borodog]

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I guess if you consider universal health care "socialism" . . .

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I'm curious. What exactly is your definition of "socialism" ?

[bdk3clash]

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I guess if you consider universal health care "socialism" . . .

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I'm curious. What exactly is your definition of "socialism" ?

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It's a very loaded term--its definition varies by individual, and it seems to generally be used pejoratively by critics of social programs. My working definition is something like a government which strives to create a classless society.

I don't think that programs like Social Security, Medicare/Medicaid, public transportation, public education, progressive taxation (were it to actually exist), and universal healthcare (were it to exist), really fit this definition because they appear to me to exist not to eliminate class distinctions or dramatically transfer wealth, power, or the means of production but to ensure that even the least among is granted "life, liberty, and the pursuit of happiness."

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My working definition is something like a government which strives to create a classless society.


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This is simply wrong. Socialism very simply put means public (read: government) control of industry and banking. One of these industries, of course, is healthcare.

As an aside, socialism in theory prevents a classless society and rather maintains the status quo of the elite. This theory was promoted by even Karl Marx (who suggests that socialism was merely originally promoted by the elite to throw the working class a bone so as to prevent revolution). Because so long as the vast majority of people's income is taxed, then no one can ever become rich (or bourgeoisie). Meanwhile the bourgeoisie don't need to have income, because they still possess land and wealth that they can perpetually live off of.

[wmspringer]

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A lot of Americans assume that we have the best health and the best health care system in the world


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I would also assume that America has the best health care in the world....for the rich /images/graemlins/grin.gif

Disclamer: I'm quite happy with my health care. Been with the same HMO all my life...although since I now work for the state, the premiums are paid by the government /images/graemlins/grin.gif

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universal health care doesn't have anything to do with socialism

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Completely false, as it has everything to do with socialism. Government control of an industry = socialism.

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I doubt that "most Americans above the poverty line" (or below it) reject this idea.


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If most Americans didn't reject the idea, we would have it, because we vote. We prefer capitalism.

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However, actual benefits to public health primarily come from sources other than cutting-edge procedures and newer, expensive medications

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This is true across the entire globe. Health education (sanitation, nutrition etc) goes a lot further than expensive medical technology. In what way did this address anything I posted?


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As Malcolm Gladwell points out in this "New Yorker" article

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Medicaid and Medicare are two different things. How is that you just apply what he said to Medicaid as well?

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Americans, as far as I know, have yet to be offered a vote on this issue ever, let alone "every year."


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Socialist and communist parties exist in America. They are on the ballot because I see them there. I don't vote for them however.

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Medicare and Medicaid operate tremendously efficiently and have much lower administrative costs than private insurance does.

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Your quote displays incredible ignorance to the issues at stake. First of all, the $5000 per head we pay includes spending on Medicare and Medicaid. Money from Medicare and Medicaid is spent on hospitals, doctors, drugs, etc, and this is what is tallied in our total health spending. The reason we spend so much more on healthcare is because there is no check on our prices. Most Americans can afford their health insurance premiums, and so the doctors and hospitals and drug companies charge as much as humanly possible, without the threat of competition (because their is no freedom of choice in our healthcare industry). Our extra administrative costs are due to our third party payment system. When someone else pays the bill, no one cares how much something costs or if something is necessary. However, when you spend your own money, you are much more careful and responsible in your spending decisions. The model for the Federal Employees Health Benefits program proves this thoroughly, that with a little bit of choice there is competition and therefore lower prices and better quality.

I'm simply in shock that you would even begin to believe that government, especially the American government, can operate more efficiently and more effective than a private firm. Really, I am in shock. This is so completely the opposite of truth, that even simple microeconomics 101 graphs can prove it.

In America, if state barriers to choice over private health firms fell, we would see even greater price and quality competition and our spending would deflate significantly. Furthermore, the creation of private savings account for the elderly would foster even more competition for MSA dollars for which doctors and hospitals would have to compete over, further deflating our spending.

The problem isn't private firms here. The problem is government.

[bdk3clash]

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My working definition is something like a government which strives to create a classless society.


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This is simply wrong. Socialism very simply put means public (read: government) control of industry and banking. One of these industries, of course, is healthcare.

As an aside, socialism in theory prevents a classless society and rather maintains the status quo of the elite. This theory was promoted by even Karl Marx (who suggests that socialism was merely originally promoted by the elite to throw the working class a bone so as to prevent revolution). Because so long as the vast majority of people's income is taxed, then no one can ever become rich (or bourgeoisie). Meanwhile the bourgeoisie don't need to have income, because they still possess land and wealth that they can perpetually live off of.

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The first paragraph of the Wikipedia entry on "socialism" (http://en.wikipedia.org/wiki/Socialism) does a good job explaining the various ideologies and beliefs that can be lumped under such a vague term:

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Socialism is an ideology with the core belief that a society should exist in which popular collectives control the means of power, and therefore the means of production. In application, however, the de facto meaning of socialism has changed with time. Although it is a politically-loaded term, it remains strongly-related to the establishment of an organized working class; created through either revolution or by social evolution, with the purpose of building a classless society. Socialism had its origins in the ideals of the Enlightenment, during the Industrial Age/Age of Industrialization, amid yearnings for a more egalitarian society. It has also increasingly become concentrated on social reforms within modern democracies. This concept and the term Socialist may refer to a group of ideologies, an economic system, or a state that exists or has existed.

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The definition of socialism is hardly as precise, as simple, or as universal as you're claiming. It's absolutely a "politically-loaded term" and means different things to different people, depending on what's being said (or interpreted) and who's interpreting it.

Specifically, on this forum the term "socialist" or "socialism" seems to be used mainly by right-wingers to discredit social programs and policies as unworthy of consideration or debate, or antithetical to the American way of doing things.

Personally, I don't think debating whether a given program or policy is "socialist" or not isn't particularly interesting or enlightening to anyone, but to each his own.

[bdk3clash]

[socialism "debate" snipped because we're just running around in circles]

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However, actual benefits to public health primarily come from sources other than cutting-edge procedures and newer, expensive medications

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This is true across the entire globe. Health education (sanitation, nutrition etc) goes a lot further than expensive medical technology. In what way did this address anything I posted?

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In this way:

mr_whomp said:

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I'm a big supporter [of universal healthcare].

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To which you replied:

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Are you poor? Rich people from other countires often fly in to America for any significant surgeries or procedures.

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You didn't elaborate any further, so I took this statement to mean something along the lines of: "We have the best care available for cutting-edge procedures and techniques that wealthy people all over the world come to the United States for......therefore I disagree with your being a 'big supporter' of universal healthcare." (Feel free to correct me.)

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As Malcolm Gladwell points out in this "New Yorker" article

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Medicaid and Medicare are two different things. How is that you just apply what he said to Medicaid as well?

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I specifically acknowledged that Gladwell mentioned Medicare and not Medicaid in the quote I gave. I suppose I should have been clearer and written:
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Although in this quote Gladwell discusses Medicare and not Medicaid specifically, his general argument [i]that the true benefit of programs like Medicare is that they provide social insurance, that is, "the security of being insulated against the financial shock of serious illness" remains applicable to both.

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[snip more socialist/communist(?) debate]

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Medicare and Medicaid operate tremendously efficiently and have much lower administrative costs than private insurance does.

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I'm simply in shock that you would even begin to believe that government, especially the American government, can operate more efficiently and more effective than a private firm. Really, I am in shock. This is so completely the opposite of truth, that even simple microeconomics 101 graphs can prove it.

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This article (http://www.prospect.org/web/page.ww?section=root&name=ViewPrint&articleId=9549 ) by Jacob S. Hacker does an excellent job outlining exactly why you're wrong (although I'm sure your economics 101 graphs are quite nice). I urge others to read the article itself, but for you I'll paste some relevant passages:

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Remember those bumper stickers during the early-1990s fight over the Clinton health plan? “National Health Care? The Compassion of the IRS! The Efficiency of the Post Office! All at Pentagon Prices!” In American policy debates, it’s a fixed article of faith that the federal government is woefully bumbling and expensive in comparison with the well-oiled efficiency of the private sector. Former Congressman Dick Armey even elevated this skepticism into a pithy maxim: “The market is rational; government is dumb.”


But when it comes to providing broad-based insurance -- health care, retirement pensions, disability coverage -- Armey’s maxim has it pretty much backward. The federal government isn’t less efficient than the private sector. In fact, in these critical areas, it’s almost certainly much more efficient.

[/ QUOTE ]

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When the issue is health insurance or retirement security, allocational efficiency is really not what’s under discussion. Nearly everyone agrees that the private market won’t distribute vital social goods of this sort in a way that citizens need. Before we had Social Security, a large percentage of the elderly were destitute. Before we had Medicare, millions of the aged (usually the sickest and the poorest) lacked insurance. If we didn’t subsidize medical care -- through tax breaks, public insurance, and support for charity care -- some people would literally die for lack of treatment. Market mechanisms alone simply can’t solve this problem, because private income is inadequate to pay for social needs. This is one of the chief reasons why government intervenes so dramatically in these areas by organizing social insurance to pay for basic retirement and disability, medical, and unemployment coverage, and by extensively subsidizing the cost of these benefits, especially for the most vulnerable.

What’s usually at issue, instead, is technical efficiency: Are we getting the best bang for our necessarily limited bucks in these areas? The notion that the private market is, by definition, better at delivering such bang for the buck is the main rationale offered for increasing the already extensive role of the private sector in U.S. social policy. Thus, Medicare vouchers or partly privatized Social Security would supposedly engage the discipline of competition and lead to more efficient use of resources.

[/ QUOTE ]

[ QUOTE ]
The typical private health insurer spends about 10 percent of its outlays on administrative costs, including lavish salaries, extensive marketing budgets, and the expense of weeding out sick people. Medicare spends about 2 percent to 3 percent. And Social Security spends just 1 percent. Even low-cost mutual funds have operating costs greater than that.

[/ QUOTE ]

*****************************

[ QUOTE ]
In America, if state barriers to choice over private health firms fell, we would see even greater price and quality competition and our spending would deflate significantly. Furthermore, the creation of private savings account for the elderly would foster even more competition for MSA dollars for which doctors and hospitals would have to compete over, further deflating our spending.

The problem isn't private firms here. The problem is government.

[/ QUOTE ]

Hacker says it best:
[ QUOTE ]
The real issue in the big-ticket areas of U.S. social policy isn’t public versus private services. It’s public versus private insurance. Medicare buys essentially all its services from the private sector, and no one wants that to change. What some want to change is the degree to which Medicare is in the insurance business, and it’s here that all the efficiency advantages of the public sector become clear.

[/ QUOTE ]

[Matty]

[ QUOTE ]
What does the report card of how it's working in Canada say?

[/ QUOTE ]The report card is very good, while costing a lot less than what America pays.

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

There is a major concept here that you continue to misunderstand:

*** Currently there is little to no competition among private health insurers. This is because government currently prevents them from competing. I am calling for the introduction of competition into these private firms. So saying that they are not as efficient as government is irrelevant and misleading, because it is government that is intervening to prevent this from happening.

Also, the article you cite is very misleading. Private health insurance did not even come into prominence until the 1940's when medical and especially hospital care began to grow very expensive. So saying that prior to Social Security (1935) people died because they were destitute, and that this was the private firm insurance market failure is incredibly misleading. The author, after making this factually false statement even then goes on to say that this is the reason government had to intervene, which is chronologically impossible. Market hadn't had the opportunity to succeed or fail, given that most people into the 1930's felt that private health insurance was completely unneseccary (since most surgeries were not done in hospitals and most medical care wasn't outrageously expensive).

This author obviously has you pretty fooled.

You really need to wake up if you think Medicare is efficient. Again I will say, when people aren't spending their own money, they don't care about cost or quality. Someone else is simply writing the checks. Welcome to the third party payer system of America. If someone is spending their own money, and furthermore, choosing what to spend it on, they will choose the health care that costs the least and offers the most. This forces firms to be price efficient and offer the best quality if they wish to stay in business.

[bdk3clash]

I'm fine with competition among private healthcare insurance providers. However, as Hacker writes, the existence of markets alone doesn't provide or distribute healthcare in the United States in an equitable or, dare I say it, efficient manner:

[ QUOTE ]
But “markets” for social insurance don’t work like [traditional markets]. In particular, information in these markets is both scarce and unequally distributed. This leads, in turn, to all sorts of familiar distortions on both sides of the transaction. Consumers, for example, can saddle private insurers with “adverse selection,” which occurs when only high-risk folks buy insurance. The “moral hazard” problem crops up when people are insured against costs that are partially under their control, and then engage in risky behavior. On the producer side, health-insurance companies can take steps to avoid costly patients, and purveyors of retirement products can gull unwary retirees in order to enrich insiders. All of this is why insurance aimed at achieving broad and necessarily social objectives has never worked well, or indeed at all, without some government support and regulation. And it’s also why it often makes sense for that support to take the form of public insurance.

[/ QUOTE ]
No one rationally discussing universal healthcare wants to abolish private insurance providers. Universal healthcare, in the form it would likely take in the United States, would probably be a system of public insurance available to all citizens, since the market doesn't tend to allocate social services like health care particularly equitably or, yes, efficiently. Private healthcare insurance providers would still be free to operate and compete with one another and, indeed, with government-provided healthcare insurance as well.

I'm curious as to exactly what you disagree with about Hacker's concluding paragraphs, particularly the sections I've bolded:
[ QUOTE ]
And this is simply to focus on efficiency. As noted already, the public sector runs circles around the private sector in terms of equity, the other major rationale for social insurance. If the current functions of social insurance were just turned over to the private market, vast numbers of people simply wouldn’t be able to afford anything as good as Social Security and Medicare. Conservatives like to argue that everything provided in the Social Security package -- the annuity, disability, and life-insurance coverage -- could just be purchased in the private market. It could, but at far greater cost for most Americans, and many applicants would be deemed “uninsurable.” All of which suggests that the claim that social programs are “inefficient” is often just a politically correct way of saying that they don’t follow the usual market logic of giving the most to those with the greatest means.

Liberals frequently stress the equity argument but buy into the efficiency critique because they recognize, correctly, that the market is usually tremendously efficient. But they shouldn’t accept that premise when it comes to social insurance. Well-functioning markets are indeed efficient for ordinary commerce, but well-designed social insurance is almost always more efficient than its market counterparts when it comes to dealing with the basic social risks that capitalism invariably produces. It’s high time for liberals to say what logic, evidence, and the lived experience of citizens all show: The efficiency attack on social insurance, far from a self-evident truth, is usually an attack on the ideal of social insurance itself -- the notion that everyone, regardless of income or likelihood of need, should be covered by a common umbrella of protection. And, ultimately, social insurance is good for the efficiency of society as a whole, not just because it provides much-needed protections at a reasonable cost, but also because it allows people to deal with what FDR once called the “hazards or vicissitudes” of modern capitalism without draconian restraints on the free play of the competitive market.

So the next time someone complains to you about the compassion of the IRS, the efficiency of the post office, all at Pentagon prices, tell them you’d be happy with the efficiency of Social Security, the compassion of Medicare, all at Medicaid prices.

[/ QUOTE ]

[ QUOTE ]
the existence of markets alone doesn't provide or distribute healthcare in the United States in an equitable or, dare I say it, efficient manner:


[/ QUOTE ]

Remove the words provide (since the market absolutely would provide) and the word efficient (since market is always more efficient), and I think you are right, and I don't believe Medicaid or Medicare should be abolished, but rather that freedom of choice and ownership of private accounts should enter the fray, which currently the government does not allow, and is the root of the problem of our ballooning costs.

[ QUOTE ]
As noted already, the public sector runs circles around the private sector in terms of equity, the other major rationale for social insurance. If the current functions of social insurance were just turned over to the private market, vast numbers of people simply wouldn’t be able to afford anything as good as Social Security and Medicare.

[/ QUOTE ]

This is false. It isn't a matter of eliminating Medicaid and Medicare. Its about choice and competition, which this author is deceptively trying to show as inefficient all while omitting the fact that the government has not and does not allow it. If the elderly people had the choice to use a private health account from which they spend their own money to choose what medical care they needed, then we enter cost competition, which currently does not exist. According to most MSA proposals, catastrophic coverage would be available for expenses over $3,000 and Medicare would still contribute $1500 a year to your overall expense account. You keep in your account what you don't spend, which encourages you to make economical spending decisions, which then creates a competition which does not currently exist. This system would align similarly to the same amount of money Medicare currently spends, and distributes the care 100% evenly. Of course the elderly could opt to remain in the current Medicare program if they chose.

[ QUOTE ]
the market is usually tremendously efficient. But they shouldn’t accept that premise when it comes to social insurance.

[/ QUOTE ]

Again, the author's logic fails by omitting the fact that government does not allow for competition, which demands efficiency and cost effectiveness for survival.

[ QUOTE ]
well-designed social insurance is almost always more efficient than its market counterparts when it comes to dealing with the basic social risks that capitalism invariably produces.

[/ QUOTE ]

Same as above.

[ QUOTE ]
The efficiency attack on social insurance, far from a self-evident truth, is usually an attack on the ideal of social insurance itself -- the notion that everyone, regardless of income or likelihood of need, should be covered by a common umbrella of protection. And, ultimately, social insurance is good for the efficiency of society as a whole, not just because it provides much-needed protections at a reasonable cost, but also because it allows people to deal with what FDR once called the “hazards or vicissitudes” of modern capitalism without draconian restraints on the free play of the competitive market.


[/ QUOTE ]

The efficiency attack on social insurance is due to the fact that Medicare spending is growing at a rate twice that of our GDP. The cost of Medicare is ballooning and our ability to pay is drifting very very far apart from our willingness to pay. The author continues to fool you when he implies that attacks on social insurance are those conservatives up to dirty tricks again, rather than the self-evident truth that our government's ability to pay for Medicare is dwindling fast and that this is because there is nothing to control prices.

[sam h]

Universal health care is something every wealthy society should have. The question is how you achieve it. There has never been a country that has achieved universal or near universal coverage of its citizens that hasn't relied heavily upon the state to do so. There is no empirical evidence that a heavily market oriented system is going to ever be able to provide decent coverage to poor people. Health care is just too expensive. In many instances, these marekt-oriented systems run very inefficiently anyway. This is the case with the American system. We probably get less bang for our health care buck than any other advanced industrial country.

[QuadsOverQuads]

Well, I'd be in favor of it, but that would probably make me a communist or a Muslim or something ...


q/q

[vulturesrow]

[ QUOTE ]
Universal health care is something every wealthy society should have.

[/ QUOTE ]

Agreed. It may very well be that we have the best system going. Anecdotally speaking, most of the Canadians I know hate their system. I find it somewhat repugnant that a nation as powerful as ours can let people miss out on needed health care because they cant afford. There are a lot of smart people in this country, on both sides of the political divided. Maybe if people would quite clinging so hard to their beloved ideologies we could come up with the right answer.

[ QUOTE ]
Anecdotally speaking, most of the Canadians I know hate their system.

[/ QUOTE ]

Really? That's fascinating, because my anecdotal experience is quite the opposite. What are the demographics of the Canadians you know? The ones I know are generally lawyers or executives in the telecommunications industry.

[vulturesrow]

[ QUOTE ]
[ QUOTE ]
Anecdotally speaking, most of the Canadians I know hate their system.

[/ QUOTE ]

Really? That's fascinating, because my anecdotal experience is quite the opposite. What are the demographics of the Canadians you know? The ones I know are generally lawyers or executives in the telecommunications industry.

[/ QUOTE ]

Honestly, not sure of their demographics, other than the fact that when I knew them all they were all around their mid 20s. I played rugby in the BC rugby union and thats where I met them. I was also very friendly with a French Canadian lass when I was a freshman in college and she probably had the strongest negative feelings in general toward the system. She as a uni student at the time, came from a solid middle class family.

As for anecdotes, I've been to an emergency room following a burst appendix here in the States and I've been to, well, where you go when you break your leg an hour north of Montreal. One of the places was awesome, the other was absolutely horrible. I think if my appendix had burst in Canada I would have died for certain.

[Myrtle]

[ QUOTE ]
[ QUOTE ]
What does the report card of how it's working in Canada say?

[/ QUOTE ]The report card is very good, while costing a lot less than what America pays.

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

[/ QUOTE ]

.....thanks much for the link, Grey.

I must advise you, however, to be very careful with things like this, or you will be in danger of being branded as one of those radicals on this board who let facts get in the way of today's popular, revisionist horseshit opinions....

/images/graemlins/wink.gif

[ QUOTE ]
[ QUOTE ]

Really? That's fascinating, because my anecdotal experience is quite the opposite. What are the demographics of the Canadians you know? The ones I know are generally lawyers or executives in the telecommunications industry.

[/ QUOTE ]

Honestly, not sure of their demographics, other than the fact that when I knew them all they were all around their mid 20s. I played rugby in the BC rugby union and thats where I met them. I was also very friendly with a French Canadian lass when I was a freshman in college and she probably had the strongest negative feelings in general toward the system. She as a uni student at the time, came from a solid middle class family.

[/ QUOTE ]

Interesting. Perhaps the people I've talked to are well off enough to supplement the Gov't provided care with private care when they want/need it. (I don't really know, it's not as if I've had any in-depth discussion about it). Thanks for the response.

[frizzfreeling]

The efficiency attack on social insurance is due to the fact that Medicare spending is growing at a rate twice that of our GDP. The cost of Medicare is ballooning and our ability to pay is drifting very very far apart from our willingness to pay


This has to do with the aging baby boomers, not efficiency in government programs. One way or another, you and I are going to pay for these peoples well-being for many years to come, and its going to get a lot worse than it is right now.

[theweatherman]

[ QUOTE ]
As for anecdotes, I've been to an emergency room following a burst appendix here in the States and I've been to, well, where you go when you break your leg an hour north of Montreal. One of the places was awesome, the other was absolutely horrible. I think if my appendix had burst in Canada I would have died for certain.

[/ QUOTE ]

Ive always been told that if you are injuried in Cancada to make a run for the States (if you can of course) since the Canadian system is terrible. That said I am still a staunch supporter of universal health care in the US. I believe that it can work and that it is the moral obligation to provide all citizens with health care, not just the ones who can afford it.

[mr_whomp]

I'm a little confused by some of the posts in this thread.

1) Several posters mention that cost of healthcare in the US should be cheaper than in other industrialized countries because governments are more inefficient than companies, and their healthcare is offered by companies.
2) Several posters show that cost of healthcare in the US is more expensive than in other industrialized countries and also ranks lower in terms of effectiveness.
3)In rebuttal first posters say it is because people aren't spending their own money on healthcare, that they are spending other peoples money. They also mention that because there isnt much competition between healthcare providers prices go up.

I think opinion #3 is poop.

1) US system involves earning profit for services, Canadian/International system offers services at cost.

2) In Canada/Internationally it's not like we are spending our own money on healthcare either and trying to shop for the cheapest price. If anything we are spending someone else's money just like in the states, this time, it's the governments money not an HMO's.

3)While increasing competition would drive prices down, the duplication of services which is inherent to creating that competition would be more inefficient then the Canadian/international system.

Please discuss...

Also saying that canadian's are unhappy with our healthcare system would be untrue. It's often said that us canadians define ourselves as "not being american", and along with kicking your buts in hockey, not having guns everywhere (though this summer in toronto was pretty violent), we hold up our public health care system as one of the reasons canada is better than the states.

[sam h]

[ QUOTE ]
They also mention that because there isnt much competition between healthcare providers prices go up.

[/ QUOTE ]

This is key. There will never really be a competitive "market" for healthcare for a variety of reasons, and this is partly why free-market fixes are not going to work. It is a sector that lends itself toward oligopoly for a variety of reasons. The US system is incredibly wasteful, offers huge rents to privileged players like HMOs, doctors, and drug companies that conspire to maintain their privilege, and does a poor job overall in safeguarding the health of Americans, especially poor ones.

Many of the smaller European countries have demonstrated that the health system can be run more efficiently with a larger government presence. However, they are countries that have a history of competent public administration. This is not really something can be said of the United States, so its not clear that we would be better off at all by creating a large health bureaucracy. Despite what the ideologues on either side say, the ability of government to perform bureaucratic tasks efficiently is not some intrinsic property of governments per se, but differs greatly across countries.

[vulturesrow]

[ QUOTE ]
I'm a little confused by some of the posts in this thread.

1) Several posters mention that cost of healthcare in the US should be cheaper than in other industrialized countries because governments are more inefficient than companies, and their healthcare is offered by companies.
2) Several posters show that cost of healthcare in the US is more expensive than in other industrialized countries and also ranks lower in terms of effectiveness.
3)In rebuttal first posters say it is because people aren't spending their own money on healthcare, that they are spending other peoples money. They also mention that because there isnt much competition between healthcare providers prices go up.

I think opinion #3 is poop.

1) US system involves earning profit for services, Canadian/International system offers services at cost.

2) In Canada/Internationally it's not like we are spending our own money on healthcare either and trying to shop for the cheapest price. If anything we are spending someone else's money just like in the states, this time, it's the governments money not an HMO's.

3)While increasing competition would drive prices down, the duplication of services which is inherent to creating that competition would be more inefficient then the Canadian/international system.

Please discuss...

Also saying that canadian's are unhappy with our healthcare system would be untrue. It's often said that us canadians define ourselves as "not being american", and along with kicking your buts in hockey, not having guns everywhere (though this summer in toronto was pretty violent), we hold up our public health care system as one of the reasons canada is better than the states.

[/ QUOTE ]

How much would you like to wager on my ability/inability to find five Canadians that dont like their healthcare system?

[mr_whomp]

how much would you like to wager i can find 5 americans that believe that no one ever landed on the moon?

[etgryphon]

[ QUOTE ]

Interesting. Perhaps the people I've talked to are well off enough to supplement the Gov't provided care with private care when they want/need it. (I don't really know, it's not as if I've had any in-depth discussion about it). Thanks for the response.

[/ QUOTE ]

Actually it isn't until recently that you can buy private health insurance to suppliment the government insurance. There was a Supreme Court case in Canada that ruled that by preventing private health care you are infringing upon the Charter rights of people who can afford better health care.

As for my opinion, I think that the only agreeable position is to have basic universal health care up to a certain point like $2000 per year and that takes care of prenatal, ER visits and the like. Then you can supplement your healthcare above that with your own funds.

I think basic healthcare is needed in todays modern society to keep the peace and increase productivity, but call me insensitive I do not think Healthcare is a basic right.

Also, I think if we do go to a universal healthcare system, you shouldn't get full medical treatment if you abuse your body with cigarettes, alcohol, obesity and anything that is detrimental to your health. I think you can be on a continuum, like there are a 60% more likely to get disease A from smoking and if you get that disease and you smoke the health care only covers 40% of the bill.

-Gryph

[ QUOTE ]
[ QUOTE ]

I've been out of college for about a year and a half and haven't not been able to find a decent job Needless to say I haven't had insurance and I haven't had any money.

[/ QUOTE ]

As a young single male in good health you can purchase personal coverage for under $100 month. Maybe you weren't aware of this, but the fact is that anyone who isn't disabled or has an expensive pre-existing condition can get insurance for an affordable price. They CHOOSE not to.

[/ QUOTE ]

Would you please provide the name/contact info for where this $100 healthcare coverage can be purchased? I wonder what the deductibles/co-pays/limits are for this $100/month policy? When I was laid off, it cost me over $300/month to continue my current coverage (Aetna) using COBRA. My sister has shopped around and has not found anything affordable for her family (her, husband, & 3 kids) -- everything has been over $1,000/month for the family. They are self-employeed, so they don't get the group-rates that bigger companies get.

Anyway, I'd sure like to know where this $100/month coverage is... and how good it is. Thanks.

[jthegreat]

The insurance system in the US is a key factor in our ballooning health care costs. Hospitals/doctors charge more because people don't pay the bills themselves, they only tend to pay a small percentage.

[ QUOTE ]
The insurance system in the US is a key factor in our ballooning health care costs. Hospitals/doctors charge more because people don't pay the bills themselves, they only tend to pay a small percentage.

[/ QUOTE ]

You aren't answering my question are you? Just making sure...

Anyway, I agree with what you said.

[jogger08152]

Re: your car crash scenario, presumably the police return the car to its original owner.