Socialized Health Care in the USA

[DeeBye]

I have no idea why you are so resistant to the idea of Universal Health Care when it has been proven to be less expensive and more effective than what you have going on in the USA.

[--Pete]

Hi,

I have no idea why you are so resistant to the idea of Universal Health Care when it has been proven to be less expensive and more effective than what you have going on in the USA.

In the fifties there was a popular slogan, "Better dead than red." If you can understand that mentality, you'll have achieved enlightenment on this topic. Note, 'understand' not 'accept'.

--Pete

[Jester]

In the fifties there was a popular slogan, "Better dead than red." If you can understand that mentality, you'll have achieved enlightenment on this topic. Note, 'understand' not 'accept'.

The comedy of all this is that the US *government* already spends more money per person on health care than nearly all fully socialized systems. That's just the commie part, not even counting private costs, which are also overwhelmingly higher. So, the American system is already redder than the Reds, in one sense.

-Jester

[kandrathe]

The comedy of all this is that the US *government* already spends more money per person on health care than nearly all fully socialized systems. That's just the commie part, not even counting private costs, which are also overwhelmingly higher. So, the American system is already redder than the Reds, in one sense.

Absolutely. And, theoretically, central planning and distribution should be more efficient than one based on a profit motive. But, in practice, these least cost, most efficient profitless systems lack the one thing humans need. Motivation to keep pressing the food bar.

[Taem]

This has got to be one of the biggest threads I have ever seen on the Lounge before. I followed the first three pages then grew tired of the dialog, but trying to catch up now is difficult when my four kids have just entered school this week. I have a few things I'd like to add but am not sure if they have already been mentioned before. Basically, here is my prediction:

Obama's "Plan America" health care reform plan [narrowly] passes both parties. It goes mainstream within a year of being passed. Several uninsured jump onto the plan immediately. Scared of the competition and cheaper costs, Private Insurers raise their rates. More people begin to overlook the "socialist" aspect of the Plan America and convert because of the rising costs of PI. The more people that convert, the more the PI companies have to "downsize" to stay afloat, eventually breaking down into smaller entities that offer comparable services on a local level only - good luck if your out of state and need surgery. Eventually after a decade or so, Plan America becomes THE health care provider for all of Americans with people getting local PI's only when they can't afford Plan America.

As for socialist health care being cheaper in other countries - it won't happen here! The insurance companies get huge payouts from drug companies to carry and offer specific brands that you cannot get in most places. To carry these expensive drugs and offer the same coverage, Plan America will have to be the more expensive socialist health care provider in the world, not to mention the doctors who will get completely screwed over if offered a flat rate compared to what they make now... They simply will not work unless paid a certain premium of what they get now, almost guaranteeing Plan America will be expensive to have, if not an outright failure. Is your doctor part of a union right now? Probably not, but he will be soon.

This isn't so much a problem of "socialist health care is cheaper than private insurers" to me, but more of, "if we pay a comparable rate to what is given now, a socialist system will go bankrupt." How exactly is Obama's plan going to compensate for all this costs? I've seen his re-re-re-revised plan, heard is rhetoric, and I for one and still not convinced that we [Americans] will be better off and paying less in the long run than if we had stayed course.

Just my 2-cents; I'll forward it to my health-care provider.

[Jester]

Absolutely. And, theoretically, central planning and distribution should be more efficient than one based on a profit motive. But, in practice, these least cost, most efficient profitless systems lack the one thing humans need. Motivation to keep pressing the food bar.

Hunh? Hasn't all the data pointed in exactly one direction: that whatever the disadvantages of the various single-payer models, they provide levels of care that are on average better, for much less money?

How does your criticism make any sense in that context? Are you saying that a universal health care plan will stop people from working for a living? Because that's just bonkers.

-Jester

[Jester]

It goes mainstream within a year of being passed. Several uninsured jump onto the plan immediately. Scared of the competition and cheaper costs, Private Insurers raise their rates. More people begin to overlook the "socialist" aspect of the Plan America and convert because of the rising costs of PI. The more people that convert, the more the PI companies have to "downsize" to stay afloat, eventually breaking down into smaller entities that offer comparable services on a local level only - good luck if your out of state and need surgery. Eventually after a decade or so, Plan America becomes THE health care provider for all of Americans with people getting local PI's only when they can't afford Plan America.

I know I've been arguing against treating health care as a normal good or service, but let's do that now, just to simplify.

I sell donuts at my store, Jester's Donut Emporium. One day, because people are paying too much for their donuts, or can get no donuts at all, the government sets up its own store: the Bureau of Donut Procurement and Provision (BDPP). They offer cheap, standard donuts to everyone.

You're saying that my reaction will be to *raise* prices, because I'm scared of low prices? How does that make sense? You compete by cutting prices, not raising them! And if I wouldn't do it for donuts, why would insurance companies do it for insurance?

-Jester

[kandrathe]

I for one and still not convinced that we [Americans] will be better off and paying less in the long run than if we had stayed course.

The course now is bankruptcy for Medicare and Medicaid (which omits 60% of the poor who qualify). I've never liked my employer negotiating my health care plan, so while it's a nice benefit, it might be better to get the $12,000 raise and negotiate my own health care plan.

And, I've mentioned before that if you want to minimize costs, then you need to begin directly negotiating care with health care providers rather than insurance companies. Return the claim process to the person buying the insurance, and the bickering over paying for the care as well. If your insurance company won't pay your claims, then go shop for one that will. This is the crux of how every other product and service works, although, there is the special case that people tend to opt for the most expensive option in health care. It is made all the easier to opt for the most expensive option when payment is masked by health insurance premiums split between you and your employer, or worse yet between you and your federal government.

[kandrathe]

How does your criticism make any sense in that context? Are you saying that a universal health care plan will stop people from working for a living?

Probably doctors and nurses, and of course, those people employed by health insurance providers. There will be a boom of government jobs and bureaucracy though to offset what used to be a highly competitive business model.

[Jester]

Probably doctors and nurses, and of course, those people employed by health insurance providers. There will be a boom of government jobs and bureaucracy though to offset what used to be a highly competitive business model.

Competitive? Are you joking? Businesses of any kind provide a good at a price. If they provide less or less quality of the good (evidenced by lower life expectancy, higher infant mortality, etc...) at a higher price (massive spending on health care) than even the much-reviled socialism, how on earth is that a "highly competitive business model"? It's a bloated, rent-generating monster.

Every developed country on earth manages to hire doctors and nurses. Are you expecting them all to retire or something? Or throw away a decade of education and retrain? Or move to the Cayman Islands?

-Jester

[kandrathe]

Competitive? Are you joking? Businesses of any kind provide a good at a price.

Yes, and then a competitor offers a better service or finds a more efficient method and lowers the price.

If they provide less or less quality of the good (evidenced by lower life expectancy, higher infant mortality, etc...) at a higher price (massive spending on health care) than even the much-reviled socialism, how on earth is that a "highly competitive business model"? It's a bloated, rent-generating monster.

Lower life expectancy and slightly higher infant mortality (6/1000 vs 3/1000) does not correlate to less health care, or poorer health care. The US infant mortality statistics are skewed due to two factors, a) more attempts to save midterm premature births and b) the larger influx of emigrants than any other nation in the world.

People in the US are less healthy, but that might be because we've automated, or shipped away all our strenuous labor and can't pull ourselves away from the idiot box to exercise.

Every developed country on earth manages to hire doctors and nurses. Are you expecting them all to retire or something? Or throw away a decade of education and retrain? Or move to the Cayman Islands?

Let's see 4 years of pre-med, plus 4 years med school, then barely paid residency to earn the same as an engineer who gets a degree in 4 years. I think I'll go the engineer route and cut down the student loans, and the 16 hour shifts.

Nursing Shortage Expected To Grow Annually Through 2016, According To U.S. Bureau Of Labor Statistics

[Taem]

You're saying that my reaction will be to *raise* prices, because I'm scared of low prices? How does that make sense? You compete by cutting prices, not raising them! And if I wouldn't do it for donuts, why would insurance companies do it for insurance?

I respect what your saying but think your comparing apples to oranges here. To keep doing business "as usual", they [private health-coverage insurers] will have to raise their rates to provide the same level of service. If they lower their rates as you suggest, they will have to offer a lower level of service to compete else go bankrupt. This lower level of service will eventually loose customers in the long-run to 'Plan America'.

Currently, my mother-in law works for Health Net and they recently (within the last year) raised their rates once they got a solid taste of what was to come. Perhaps they are setting the bar to a higher standard that the American health coverage plan will have to compare to? I think they are preparing for the future by putting away money they already know they'll need to keep their business afloat. FYI, Health Net is currently downsizing any and everywhere it can in preparation for such event, but how much can they do against 'Plan America' at competitive rates and still offer the services they do? They can't IMO.

[kandrathe]

I respect what your saying but think your comparing apples to oranges here. To keep doing business "as usual", they [private health-coverage insurers] will have to raise their rates to provide the same level of service. If they lower their rates as you suggest, they will have to offer a lower level of service to compete else go bankrupt. This lower level of service will eventually loose customers in the long-run to 'Plan America'.

Currently, my mother-in law works for Health Net and they recently (within the last year) raised their rates once they got a solid taste of what was to come. Perhaps they are setting the bar to a higher standard that the American health coverage plan will have to compare to? I think they are preparing for the future by putting away money they already know they'll need to keep their business afloat. FYI, Health Net is currently downsizing any and everywhere it can in preparation for such event, but how much can they do against 'Plan America' at competitive rates and still offer the services they do? They can't IMO.

I wonder what Paul Krugman thinks?

Public Option Will Kill Private Insurance -- Check out at minute 2:20.

[Jester]

I wonder what Paul Krugman thinks?

Public Option Will Kill Private Insurance -- Check out at minute 2:20.

The key point being they would kill the private plans though *competition*. People would find the public plan cheaper and better. They would switch to that plan for the same reason any consumer switches products in a free market.

Then, you'd be getting better health care for cheaper, which is exactly what single-payer advocates have been saying, and what other developed countries have been experiencing. Better health care for half the price. What a concept.

-Jester

(The video is about Hillary's plan from 2007, by the way. Krugman has written reams about the current plan; perhaps we should be looking at that instead?)

[Jester]

...how much can they do against 'Plan America' at competitive rates and still offer the services they do? They can't IMO.

Couldn't have put it more succinctly myself.

-Jester

[Jester]

Lower life expectancy and slightly higher infant mortality (6/1000 vs 3/1000) does not correlate to less health care, or poorer health care.

Read that sentence over a couple times. Are you seriously claiming that there is no correlation between the two most obvious health care outcomes and the quality of health care? Because that would be crazy.

The US infant mortality statistics are skewed due to two factors, a) more attempts to save midterm premature births andB)the larger influx of emigrants than any other nation in the world.

I highly doubt that US doctors attempt to save so many more preterm babies than their Canadian, Australian, New Zealander or European counterparts that it doubled your infant mortality rate.

As for immigration, I'm sure that plays a role, but as part of a larger picture: you have very high inequality for a developed country, and no public health care! So, the worst off get worse nutrition, have poorer health care, and their babies are therefore at greater risk when they're preterm. Critically, *this is a problem that public health care fixes.*

People in the US are less healthy, but that might be because we've automated, or shipped away all our strenuous labor and can't pull ourselves away from the idiot box to exercise.

Follow the argument. This is about comparing the US to other OECD countries which have experienced the same automation, the same "shipping away" of strenuous labour, and mostly the same move to a sedentary culture. This isn't just bicycle-loving Holland. This is Britain, Canada, Australia, countries every bit as fat 'n lazy as the US.

Let's see 4 years of pre-med, plus 4 years med school, then barely paid residency to earn the same as an engineer who gets a degree in 4 years. I think I'll go the engineer route and cut down the student loans, and the 16 hour shifts.

How then do you explain that single-payer Europe has far more doctors per capita than the market USA? There isn't a shortage there.

Nursing Shortage Expected To Grow Annually Through 2016, According To U.S. Bureau Of Labor Statistics

Economists long ago figured out the secret of ending a worker shortage: more carrots. If you're not giving enough incentive to work, you get less workers. This is true in any system, capitalist or socialist.

-Jester

[kandrathe]

Read that sentence over a couple times. Are you seriously claiming that there is no correlation between the two most obvious health care outcomes and the quality of health care? Because that would be crazy.

Right crazy. Is it incongruous to understand the relationship between life style and health? What are factors in life expectancy? Genetics, life style, health care, environment, etc. So, like education, pumping more money into health care will not automatically drive up life expectancy. A better idea would be a leadership of a national healthy easting and exercise program.

I highly doubt that US doctors attempt to save so many more preterm babies than their Canadian, Australian, New Zealander or European counterparts that it doubled your infant mortality rate.

"In 2005, more than 68 percent of infant deaths occurred among preterm infants, up from more than 65 percent in 2000. In November, the March of Dimes released its first annual "Premature Birth Report Card," giving the nation an overall "D" grade and noting that preterm birth — birth before 37 weeks of gestation — is the top cause of death in an infant’s first month of life." -- March of Dimes

As for immigration, I'm sure that plays a role, but as part of a larger picture: you have very high inequality for a developed country, and no public health care! So, the worst off get worse nutrition, have poorer health care, and their babies are therefore at greater risk when they're preterm. Critically, *this is a problem that public health care fixes.*

You've nailed the description of the problem, neonatal health and other environmental factors that result in a much higher rate of preterm births and low birth weights. The US system is also fractured by State. Some states have very low taxes and very low levels of service. The answer to helping the poor is not Universal Health Care for the rich, and middle class. Although, since the one program designed for the poor, Medicaid, is an abysmal failure, any change would probably be better for them. Why not fix the system that is broken?

Follow the argument. This is about comparing the US to other OECD countries which have experienced the same automation, the same "shipping away" of strenuous labour, and mostly the same move to a sedentary culture. This isn't just bicycle-loving Holland. This is Britain, Canada, Australia, countries every bit as fat 'n lazy as the US.

But, look at the rates of heart disease, diabetes, and other "sedentary" illness.

How then do you explain that single-payer Europe has far more doctors per capita than the market USA? There isn't a shortage there.

Canada's doctor shortage to worsen without changes: Fraser report

Economists long ago figured out the secret of ending a worker shortage: more carrots. If you're not giving enough incentive to work, you get less workers. This is true in any system, capitalist or socialist.

Yes, motivation to press the food bar.

[kandrathe]

The key point being they would kill the private plans though *competition*. People would find the public plan cheaper and better. They would switch to that plan for the same reason any consumer switches products in a free market.

The government plan will be cheaper, while running the red ink to the tax payers. Let health insurance companies run a business model where they pay out billions more than they take in, and then you might be able to compete with a government run program.

[eppie]

Right crazy. Is it incongruous to understand the relationship between life style and health? What are factors in life expectancy? Genetics, life style, health care, environment, etc. So, like education, pumping more money into health care will not automatically drive up life expectancy.

Well, you should look at the right 'more money'. Pumping more money in a private health clinic in order for them to get the best doctors will indeed not help a lot. Giving people who otherwise have difficulty getting basic a good national insurance so that they can go to the doctor when they have a bad flu, stomach pain or headache (things that somebody poor who has to pay his own care directly would not go to the doctor for) will drive up life expectancy.

[Jester]

I think I'm exhausted.

I don't get it. Single-payer is cheaper, it's been shown to work, it seems to produce better outcomes by almost any metric. If you find your reasons why the US must be exceptional here valid, I don't think I have the ability to talk you out of it. Best of luck with reform, I can only hope it passes with something vaguely resembling a public option still attached.

-Jester