Universal Health Care

[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.

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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.

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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,

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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. 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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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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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.

[TomCollins]

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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.

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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]

[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...[insert logical argument here]...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 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 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.

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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.

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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.

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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.

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Hacker says it best:
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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.

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