Socialized Health Care in the USA

[--Pete]

Hi,

. . . I don't think I have the ability to talk you out of it.

Did you ever really think you would? The reason for these discussions is for both sides (all sides?) to air their views. At most, it might persuade some people who had no strong opinion to support one side or another. But the principals in the discussion usually already have formed their strong opinions, have heard the opposing arguments, and have made up their minds. Seldom will one of them change their mind as a result of these discussions.

Do it for fun, for intellectual stimulation. Realize that the world will little notice.;)

--Pete

[Jester]

Seldom will one of them change their mind as a result of these discussions.

I have, on a couple of occasions. Although usually not until long after the thread has passed, and doubts have gotten the chance to gnaw at me.

But, yes. You're right.

-Jester

[kandrathe]

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.

I'm not convinced it's actually cheaper, and I fail to see how the system would have incentives to improve or be innovative. Who pays for new and maintaining infrastructure? In a capitalist endeavor, the corporation invests in new infrastructure when it makes fiscal sense and then repays that cost over time. While government tends to build whatever they want, where ever they want, when ever they want without regard to any cost/benefit analysis what so ever. When has OUR government ever done anything in a more efficient way than the private sector? Just because you believe it sort of works in some OECD nations (contrary to much of my own research), doesn't mean that any flavor of single payer universal health care must taste equally sweet. And... So far, every "good" point I've raised you dodged or ignored. Such as, Mr. Krugman's own admission that Hillary Clinton, John Edwards, and Barrack Obama's plan were all basically equivalent, and he called them "Democare". And, he went on to say that it would ultimately usher in a single payer universal health care system by driving private insurance out of business.

Cheaper? Well, in one respect yes, in that I won't have to open up my wallet to buy the service since the government is giving it away for "free". So there is your choice. You can pay high taxes and buy private insurance out of your own pocket, or you can pay high taxes and use the government option since you can no longer afford private insurance.

I object to the government using the force of law to reach into every workers pocket to pay for health care whether the worker uses it or not, and they have little to say about it other than to vote in different people.

<blockquote></blockquote>

[DeeBye]

I'm not convinced it's actually cheaper, and I fail to see how the system would have incentives to improve or be innovative. Who pays for new and maintaining infrastructure? In a capitalist endeavor, the corporation invests in new infrastructure when it makes fiscal sense and then repays that cost over time. While government tends to build whatever they want, where ever they want, when ever they want without regard to any cost/benefit analysis what so ever. When has OUR government ever done anything in a more efficient way than the private sector? Just because you believe it sort of works in some OECD nations (contrary to much of my own research), doesn't mean that any flavor of single payer universal health care must taste equally sweet. And... So far, every "good" point I've raised you dodged or ignored. Such as, Mr. Krugman's own admission that Hillary Clinton, John Edwards, and Barrack Obama's plan were all basically equivalent, and he called them "Democare". And, he went on to say that it would ultimately usher in a single payer universal health care system by driving private insurance out of business.

Cheaper? Well, in one respect yes, in that I won't have to open up my wallet to buy the service since the government is giving it away for "free". So there is your choice. You can pay high taxes and buy private insurance out of your own pocket, or you can pay high taxes and use the government option since you can no longer afford private insurance.

I object to the government using the force of law to reach into every workers pocket to pay for health care whether the worker uses it or not, and they have little to say about it other than to vote in different people.

<blockquote></blockquote>

Are you Glenn Beck?

[NuurAbSaal]

Are you Glenn Beck?

Let's hope not! From the Wikipedia entry on Beck (which I had to check, clueless European that I am):

Glenn Beck has suggested that Obama's Health Care reform agenda is a means by which he can effect reparations for slavery.

<_<

take care
Tarabulus

[kandrathe]

Are you Glenn Beck?

Are you Rick Mercer?

[Jester]

I'm not convinced it's actually cheaper...

As Pat Moynihan once said, you're entitled to your own opinion, but you aren't entitled to your own facts. Look at health care expenditures per capita. The statistics are diligently collected by every developed country. Compare them. Unless you have some funky math for making five thousand less than three thousand, every developed country enjoys cheaper health care than the US does.

Just because you believe it sort of works in some OECD nations (contrary to much of my own research)...

It has maintained the populations of Canada, Australia, Europe and New Zealand at lower prices for decades. What more do you want to prove that it more than "sort of" works. It actually works. What research exactly shows otherwise? Because I've lived in a couple of these countries, and, while no system is perfect, I can assure you they are fully functioning, and have been for a long time. I have relatives whose lives have been saved, seen kids whose sniffles have been looked after, my own flesh and bones treated. It works.

...doesn't mean that any flavor of single payer universal health care must taste equally sweet.

Truth. However, the experience is that, from the Canadian private single payer system, to the British socialism-on-the-cheap NHS, to the Norwegian cradle-to-grave, they're all cheaper than the current American system by a country mile. Take your pick of flavours, and unless you think that the American government has some special distinction as being uniquely incompetent, it ought to at least save you a bundle of money, both on taxes and insurance.

And... So far, every "good" point I've raised you dodged or ignored.

I believe the word is "rebutted," although I certainly plead guilty to ignoring some points on the basis that I only have so many hours in a day. Whatever good points you have made, they have been surrounded by pages of ideological assertion: I believe in the free market, therefore somehow it must be right, even if the data all point the other way. Others do not necessarily share your gut feelings and suspicions.

Such as, Mr. Krugman's own admission that Hillary Clinton, John Edwards, and Barrack Obama's plan were all basically equivalent, and he called them "Democare".

Yes, during the *democratic primary*. We're now a couple years past that, and dealing with actual proposals before the actual congress, which have a very different cast than ideas by, of, and for Democrats exclusively.

And, he went on to say that it would ultimately usher in a single payer universal health care system by driving private insurance out of business.

Yes. That's the whole idea. Show people how the new system can be better than the old one, which will soften the bizarre, implacable opposition to any proposed government health program (accompanied, ironically, by a staunch defense of the ones that already exist.)

Cheaper? Well, in one respect yes, in that I won't have to open up my wallet to buy the service since the government is giving it away for "free". So there is your choice. You can pay high taxes and buy private insurance out of your own pocket, or you can pay high taxes and use the government option since you can no longer afford private insurance.

Cheaper *per capita*! Less money spent per person, public or private! This is not a difficult concept. It's not just taking from the right pocket instead of the left pocket. It's taking less from *any* pocket.

Or, visually, THIS is your curernt health care system, in context.



You aren't going to become Cuba, but maybe you might at least move the purple line a little bit closer to sanity? Perhaps even move up a notch or two in the rankings? It's not like the countries above you have some special magic. Greece? Come on, surely the mighty USA can do better than Greece.

-Jester

[eppie]

I believe the word is "rebutted," although I certainly plead guilty to ignoring some points on the basis that I only have so many hours in a day. Whatever good points you have made, they have been surrounded by pages of ideological assertion: I believe in the free market, therefore somehow it must be right, even if the data all point the other way. Others do not necessarily share your gut feelings and suspicions.

-Jester

I have seen this kind of reasoning on some other forum/blogs where there were discussions between Americans and others.
I am happy that this discussion started with Obama becoming president. Maybe it is because of the economic crisis that many Americans who lost there jobs now realize that some social behaviour in politics is not so bad, while many with jobs still let the 'I don't want to pay for healthcare of others' feelings prevail.

Although I don't agree with everything Jester says (eg with the same lifestyle of its citizens the US will still have more expensive health care than other countries), but most of it is just solid facts.
Kandrathes libertarian world is a far bigger (difficult to obtain) Utopia than even a working communist state is.

[Jester]

Although I don't agree with everything Jester says (eg with the same lifestyle of its citizens the US will still have more expensive health care than other countries), but most of it is just solid facts.

I'm not sure what you mean by this. Did I say that the US will not have more expensive health care than other countries'? Because I believe the opposite: even a very effective health care reform would probably still cost more than all but the most lavish cradle-to-grave Scandinavian plans. But, since the US is already paying something like half-again what anyone else pays, single payer would shrink the difference by cutting down on the stunning inefficiencies of the current model. It wouldn't transform one of the most unequal, unhealthy countries in the developed world into Denmark overnight.

-Jester

[eppie]

I'm not sure what you mean by this. Did I say that the US will not have more expensive health care than other countries'? Because I believe the opposite: even a very effective health care reform would probably still cost more than all but the most lavish cradle-to-grave Scandinavian plans. But, since the US is already paying something like half-again what anyone else pays, single payer would shrink the difference by cutting down on the stunning inefficiencies of the current model. It wouldn't transform one of the most unequal, unhealthy countries in the developed world into Denmark overnight.

-Jester

I agree fully with you. Sorry for the confusion.

[kandrathe]

As Pat Moynihan once said, you're entitled to your own opinion, but you aren't entitled to your own facts. Look at health care expenditures per capita. The statistics are diligently collected by every developed country. Compare them. Unless you have some funky math for making five thousand less than three thousand, every developed country enjoys cheaper health care than the US does.

I'm not saying that there is not a problem and a disconnect.

It has maintained the populations of Canada, Australia, Europe and New Zealand at lower prices for decades. What more do you want to prove that it more than "sort of" works. It actually works.

I have no doubt that your systems "work", but what I do question is the price you pay, both tangible and intangible. We have a basic disagreement in the purpose of government. I believe the US government was established to keep the citizens free, rather than be the caretaker of society. I want to make ALL the choices I can regarding me, my family, and my property (including my income).

Truth. However, the experience is that, from the Canadian private single payer system, to the British socialism-on-the-cheap NHS, to the Norwegian cradle-to-grave, they're all cheaper than the current American system by a country mile. Take your pick of flavours, and unless you think that the American government has some special distinction as being uniquely incompetent, it ought to at least save you a bundle of money, both on taxes and insurance.

I'm not disagreeing on it's brokenness, only on the remedy. You are saying... "Hey, do what we do, it works." To which I am replying, "I see, but I don't want to be a socialist who pays 60% of my income to a nanny state. I want to reform the free market, and get government out of the way."

Yes, during the *democratic primary*. We're now a couple years past that, and dealing with actual proposals before the actual congress, which have a very different cast than ideas by, of, and for Democrats exclusively.

How has the "public option" plan of the democrats changed since the primary? The demoplan was written and has been floated around and refined for the last two years.

Or, visually, THIS is your current health care system, in context.

I'm uncertain to how they are measuring costs. Is this a measure of health care costs, or health insurance costs? How does it factor in the 50% socialist + 50 % private system of the US? Is it comparing the same brain surgery operation across nations? The one thing that is clear from the graph is, that whatever the jagged line is, it does not have any correlation to life expectancy.

Again, its not so simple to just point at a graph and say, "See!"

The council on foreign relations has an interesting analysis which goes into great depth -- Healthcare Costs and U.S. Competitiveness.

It says what your graph says, that costs are higher. But also what I said above, for example, "[Elizabeth Olmstead Teisberg, a professor at the University of Virginia's Darden School of Business], in an interview, said part of the reason for this disconnect is that companies have traditionally focused their attentions strictly on direct costs rather than the root cause of the costs: poor health. Teisberg cites internal corporate reports that estimate the combined costs of these additional expenses to be two-and-a-half to three times higher than the direct costs of coverage."

We pay more because our system is fractured by laws into a complicated mess of public and private plans that do not mesh, and do not focus on "HEALTH" as an outcome. Only in the US can you get medical treatment to offset your poor health as a result of your 32 fast food meals in a week.

If we focus on minimizing the need for health care, the supply of care will increase and the overall costs will drop. I would also expect to see a dramatic rise in life expectancy and reduction in infant mortality. We are a sick society, mostly by our own bad choices.

[--Pete]

Hi,

I believe the US government was established to keep the citizens free, rather than be the caretaker of society.

OK. So, how about roads? Schools? Water, sewage? Dams and levies? In many places, electricity (rural electrification, TVA, Bonneville)? Police? Fire? EMS?

Why are so many of these now provided by the government if the free market can do it better? Could it be that the free market failed? That your model of how the free market works is based on a false assumption -- the assumption that the majority of people are reasonable, intelligent, informed, compassionate, responsible, etc. The Jeffersonian assumption. Indeed, the Marxist assumption. But history shows us, over and over, that Jefferson was wrong, Hamilton was right. The average person is a stupid, selfish, indifferent brute who cares only for his own desires and pleasures and that will allow the world to go to hell around him rather than give up one beer to save it.

I want to make ALL the choices I can regarding me, my family, and my property (including my income).

Or, in other words, you want to withdraw from our society (while still driving on the roads we supply).

I want to reform the free market, and get government out of the way.

Again, I ask you, why did the government get "in the way" to begin with? Was it because the free market was doing such a good job that everyone had access to high care low cost health services? Or was it a repeat of what happened with the police departments, the fire departments, the schools under the free market? Are only the wealthy to receive protection from theft, from fire, from ignorance, and from sickness?

Only in the US can you get medical treatment to offset your poor health as a result of your 32 fast food meals in a week.

Every time you say something like this, your credibility drops. This is the kind of inflammatory rhetoric used by politicians and preachers. It is insignificant to the topic, as well as being an outright lie -- obesity and its effects is treated in all the industrialized nations that have national health care.

If we focus on minimizing the need for health care, the supply of care will increase and the overall costs will drop. I would also expect to see a dramatic rise in life expectancy and reduction in infant mortality. We are a sick society, mostly by our own bad choices.

You make that claim against all evidence. It's pure BS.

--Pete

[Thecla]

Only in the US can you get medical treatment to offset your poor health as a result of your 32 fast food meals in a week.

Not to mention the effect of gun freedom on life expectancy, which would of course also have to be factored out.;)

If we focus on minimizing the need for health care, the supply of care will increase and the overall costs will drop. I would also expect to see a dramatic rise in life expectancy and reduction in infant mortality. We are a sick society, mostly by our own bad choices.

But seriously, you seem to have little regard for the importance of preventative medicine and the availability of routine medical treatment for everyone, including people who are too poor to afford adequate health care, whether they are pregnant mothers-to-be or the uninsured who eventually wind up in the ER rooms at enormous and avoidable expense to the entire system.

[Jester]

Don't like the other graph? Think there's no correlation? Fine. Try this one.

Plain as day.

The one other country that seems to be a major outlier on the bad side is South Africa, the only other developed country with largely private care. The notable outlier on the good side is Cuba, the most socialized system around. I'm not going to make the crude argument that it's as easy as free market bad, socialism good, but the graph isn't lying to you.

If we focus on minimizing the need for health care, the supply of care will increase and the overall costs will drop.

Hey, here's an idea. Maybe if you let people see the doctor on a regular basis, for free, then maybe they might get good medical advice, helpful hints on improving their health, and early diagnosis of disease while it's still treatable or controllable!

How could a society possibly accomplish such a thing? Hm.

-Jester

[Chesspiece_face]

Why are so many of these now provided by the government if the free market can do it better? Could it be that the free market failed? That your model of how the free market works is based on a false assumption -- the assumption that the majority of people are reasonable, intelligent, informed, compassionate, responsible, etc. The Jeffersonian assumption. Indeed, the Marxist assumption. But history shows us, over and over, that Jefferson was wrong, Hamilton was right. The average person is a stupid, selfish, indifferent brute who cares only for his own desires and pleasures and that will allow the world to go to hell around him rather than give up one beer to save it.

--Pete

There are some social research studies which demonstrate this wonderfully. Unfortunately I cannot recall who originally did these studies but the general framework of the research went like this:

The study participants are assigned to either group A or B then they are given an array of options of how to assign resources between the two groups. There is never a definition of what the groups are or what the resources are they are just told they are in a group and to pick how they would like the resources assigned. Resource totals are abstracted on a scale of 1-10 so that some assignment options would be like Group A: 3, Group B: 6. Or Group A: 8, Group B: 5. Interestingly in all of the questionaires there was an option for Group A: 10, Group B: 10. If the participants chose to they could have given both groups all the resources the highest possible allocation, or in other words chosen an "Everyone Wins" option. Subjects pretty much never chose that option, however. They would choose to hurt their own group by choosing options which offered less resources for them only to make sure that the other group ended up with less resources than their group. The subjects would consistently and constantly chose a more harmful option for themselves instead of allotting "resources" to a group outside of their own or one they felt undeserving.

[kandrathe]

Not to mention the effect of gun freedom on life expectancy, which would of course also have to be factored out.;)

Or, the drinking alcohol and killing other people freedom... But as far as epidemic... "Alcohol-related causes of death include accidents, violence, poisoning, mouth and throat cancer, colorectal cancer, breast cancer, suicide, stroke and many others."

But seriously, you seem to have little regard for the importance of preventative medicine and the availability of routine medical treatment for everyone, including people who are too poor to afford adequate health care, whether they are pregnant mothers-to-be or the uninsured who eventually wind up in the ER rooms at enormous and avoidable expense to the entire system.

Why would you draw that conclusion? I believe at least 4 times in this thread I've advocated more Federal attention to health and fitness (ala JFK, presidential physical fitness award). I think I still might have that patch in my childhood treasure box. Talk about your low cost, viral advertising campaigns...

[kandrathe]

OK. So, how about roads? Schools? Water, sewage? Dams and levies? In many places, electricity (rural electrification, TVA, Bonneville)? Police? Fire? EMS?

Focusing on the Federal level, I would omit roads with the exception of rare cases where interstate commerce requires the federal government to negotiate between states (who should pay for the projects based on per capita ratios). School we've beat to death, but there are only mandates and little money at the Federal level. Water, sewage, garbage are local problems, except to protect its quality (EPA). Dams and levies funding would be better left to those areas who are willing to invest and maintain them. When you build below sea level, you need to either be tolerant of flooding, or invest in your levies. Electricity (except again for coordinating and planning State level integration) is a local problem. Same with Police, Fire, and EMS. And... Actually, I'm not as opposed to a some State level services, although this one is pretty over the top in being high tax, and high service. We could garner some efficiencies with more public/private partnerships. I've seen great strides in efficiencies where the local and state government enter into 2 year contracts for services with private companies based on clear requirements.

The average person is a stupid, selfish, indifferent brute who cares only for his own desires and pleasures and that will allow the world to go to hell around him rather than give up one beer to save it.

Maybe I see a different caliber of people where I live. When people are indifferent here, other people freeze to death (in a broken car, or homeless on the street). We send all those brutish, stupid, selfish, indifferent people out west. :)

You make that claim against all evidence. It's pure BS.

55.8% of Americans have chronic illness-- obesity is the highest-- and teen pregnancy is highest (infant mortality) --and deaths due to diabetes.

We seen to run in the middle of the OECD pack on many other common killers like Cancers, but our obesity rates and well above the norm.

[eppie]

If we focus on minimizing the need for health care, the supply of care will increase and the overall costs will drop. I would also expect to see a dramatic rise in life expectancy and reduction in infant mortality. We are a sick society, mostly by our own bad choices.

In a system with privatized healthcare there is no incentive whatsoever to decrease the need of health care. The more obese people the better because the more business there is for medical personell, and of course the insurance people make sure they don't loose out on their piece of the pie.


If health care and insurance is arranged by the government, finally there is an incentive to cut costs. Maybe not on the admin part (because those great insurance companies are far better in firing excess personell) but for sure on the education and legislation part. That would than actually work in two ways......cheaper health care (total) and healthier people.


An extreme free market system as you advocate is never going to work. We have been talking about is so much here on the lounge. Apart from health care also the roads (etc) mentioned by Pete will never be there in a 100% free market society. Social security builds wealth. If in the US there hadn't been workers unions or there hadn't been an army, then you wouldn't have the wealth that you have now. It is all very easy to say that you want to pay for everything you use and not for what other people use, but you would not be saying that if you didn't live in a 1st world country.

Please try to imagine how other people live, people from different social classes or people in different countries. So I am not saying look at the facts; Jester is saying that already 10 pages in this thread (while he also presents these facts) because they are clear. (example of Holland.....since healthcare is privatized it is getting more expensive every year, the only thing we get back is very expensive TV commercials from insurance companies).

Let's just stop this thread. Will you cooperate or should I write down some profanities so that Bolty will shut it down the hard way.:)

[kandrathe]

In a system with privatized healthcare there is no incentive whatsoever to decrease the need of health care. The more obese people the better because the more business there is for medical personell, and of course the insurance people make sure they don't loose out on their piece of the pie. If health care and insurance is arranged by the government, finally there is an incentive to cut costs. Maybe not on the admin part (because those great insurance companies are far better in firing excess personell) but for sure on the education and legislation part. That would than actually work in two ways......cheaper health care (total) and healthier people.

There is no evidence of that either. For example, Netherlands has the highest incidence of cancer in the world and climbing.

Let's just stop this thread. Will you cooperate or should I write down some profanities so that Bolty will shut it down the hard way.:)

Would you swear in Dutch? :) The thread has been a good thread, and its not just shouting and aimless. We've talked about substantive issues, and presented opinions in a reasonable way. But, reasonable people can disagree.

[kandrathe]

Don't like the other graph? Think there's no correlation? Fine. Try this one.

Plain as day.

You'd look at that and think so, but the people who built the graph are trying to make the same argument as you. In order to draw the conclusion that you do, you would need to examine if the hypothesis of applying more money per capita actually increased the "life expectancy". And, conversely, that in reducing the amount of money spent actually reduced the "life expectancy".

So for example, does Japan have a higher life expectancy due to the people there spending more dollars per year going to the doctor? Where is the control group? Could we measure the number of visits, and the incidence of disease for comparison? Are there life style (healthy eating and exercise), and genetic factor differences that are measurable for comparison?

I would examine Cuba as an outlier and determine what they do then that keeps them healthy without spending much money on health care at all. How much health care do they get, and who provides it?