Universal Health Care

[bdk3clash]

[ QUOTE ]
[ QUOTE ]
I guess if you consider universal health care "socialism" . . .

[/ QUOTE ]

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

[/ QUOTE ]
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."

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


[/ QUOTE ]

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]

[ QUOTE ]

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


[/ QUOTE ]

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

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 [img]/images/graemlins/grin.gif[/img]

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

[/ QUOTE ]

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

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


[/ QUOTE ]

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

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

[/ QUOTE ]

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?


[ QUOTE ]
As Malcolm Gladwell points out in this "New Yorker" article

[/ QUOTE ]

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

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


[/ QUOTE ]

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

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

[/ QUOTE ]

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]

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


[/ QUOTE ]

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.

[/ QUOTE ]

The first paragraph of the Wikipedia entry on "socialism" does a good job explaining the various ideologies and beliefs that can be lumped under such a vague term:

[ QUOTE ]
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.

[/ QUOTE ]

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]

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

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

[/ QUOTE ]
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?

[/ QUOTE ]

In this way:

mr_whomp said:

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

[/ QUOTE ]
To which you replied:

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

[/ QUOTE ]
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.)

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

[ QUOTE ]
[ QUOTE ]
As Malcolm Gladwell points out in this "New Yorker" article

[/ QUOTE ]

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

[/ QUOTE ]

I specifically acknowledged that Gladwell mentioned Medicare and not Medicaid in the quote I gave. I suppose I should have been clearer and written:
[ QUOTE ]
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.

[/ QUOTE ]

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

[snip more socialist/communist(?) debate]

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

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

[/ QUOTE ]
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.

[/ QUOTE ]

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:

[ QUOTE ]
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 ]

[ QUOTE ]
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/Canadia...stems_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.