Universal health care- what's the problem?

Great Debates
1

Boy-Who-Cried-“Death Panel!”-types aside, why exactly are people opposed to universal health care?

From what I understand, everyone should be happy:

-The people who don’t want government health care can stay with their current insurance.
-The people who trust the government more than the insurance companies can get covered by the feds.
-The people who can’t afford insurance can get some protection. This is what people fail to understand, I think. Partial coverage is still better than no coverage. Forget about taking Grandma of the respirator, with what they have now they can’t get Grandma on the respirator in the first place.

I’m not seeing a downside. If you don’t want politicians in your policies, you can continue on as before. If you like Obama’s plan, you can opt in. If you’re poor, at the very least you’ll be slightly better off than before. So who loses out here?

Is it financial? I can understand that people would be cautious about a plan that costs a lot of money, but from what I’m hearing it sounds like the opponents are trying to take some sort of moral high ground. What am I missing here?

2

I think the opponents fear the “slippery slope.” If the government is only wetting a toe now, they may ultimately take over, and private options may evaporate. Will this happen in reality? Nobody knows at this point. But the fear is not wholly unjustified; the private options for people eligible for Medicare are far fewer than for those too young to be eligible.

3

Like most issues in the States, it’s been shaped by the media and politicians to be a great ideological caged death match: The Right Way vs. the Dark Side.

All rational debate is then eschewed in favour of clutching your chest as the national anthem plays, lots of flag-waving and chilling reportage of Godwin proportions, entirely supported by a politcal class in hock to the lobbyists who fund them.

At no point will the issue be permitted to be debated honestly and openly on its merits.

4

Yes. I do not for a second buy the silliness that we will somehow expand coverage AND decrease costs. That’s a fantasy, one that has already been debunked. The Feds are horrible at cost-effective design and execution of massive programs. Additionally, I see no magical reason why insurance costs will decrease because the Feds are the ones writing the check, not unless they’ll be rationing coverage. The health insurers, those evil profit-mongers, currently enjoy about a 3% profit margin. What, then, will this option actually do to decrease costs? What? How will a program that does not exclude for pre-existing conditions–a notion that defies the very essence of insurance–lead to lower costs?

And what leads anyone to think the Feds will run this program efficiently? This will be another SSN, a program that cannot sustain itself but that will run by virtue of the endless supply of “free” money at those idiots’ disposal, right up until the point that the machine explodes, causing horrible collateral damage. Or, if we’re lucky, it will die a quick death when it becomes crystal clear that insurance reform, without any material change in the health care system itself, did NOTHING to contain costs.

Plus, there’s that trivial little notion that this is NOT a power of the Federal government, though I know it’s whistling in the wind to even bring that up. That’s a ship that has long since sailed–the government does what it wants, it gets bigger and bigger, and this administration is now the poster child for such expansion. And to say that the financial collapse was caused to any extent–and now requires–health insurance reform? Please! It’s lies and pet projects, more of the same, with no real debate permitted. “Change” you can predict.

This has boondoggle written all over it. And I’m going to pay for it.

5

Most people don’t.

Taxpayers.

Costs.
Look at all the bullet points you’ve listed. They all have something in common: they only list “benefits.” No mention of the costs and incurred debt. This is typical of an unsophisticated one-sided argument.

6

It’s all about Freedom™. If people are allowed to choose, then that takes their Freedom™ away. The only way to protect our Freedom™ is to ensure the fewest possible options!

7

the real issue isn’t in theoretical questions about freedom…
the real issue is that it’s just plain ol’ human nature to resist change.

I have American friends who have good insurance from their work, but are locked forever into a shitty job because they need the insurance. They openly admit that they are working for the insurance, not the salary. They hate their boss, but it never occurs to them to look for another job.
I asked them why in America it is the employer’s obligation to provide health insurance. (After all, nobody asks their employer to provide car insurance or house insurance, or life insurance or travel insurance–only health insurance. )
And they just looked at me blankly, saying “well that’s the way it’s always been”. These are educated professionals…But they are simply so used to the system they know and have experience with, that they are terrified of any change to a new system that they don’t have any experience with.

It is simply fear of the unknown–fertile breeding ground for spreading panic, on all sides.
Liberals panic that “they’ll take away our freedom to choose our doctor, they’ll start a huge bureacracy”.
Conservatives panic that “they’ll create death panels”, “They’ll tax us unfairly”.

But their real panic is not fear of the new taxes or bureacrcacy–it is fear of change, fear of the unknown.

8

Which is why I’m asking.

9

The biggest reason: Republicans hate it, and spread lies instead of reasoned arguments.

10

Why the apples and oranges comparison to something completely unrelated? Why not approach the possibility of the public option and compare it to the already extant government-run medical programs, the insurance that covers civilian government employees and their families (including all the members of Congress out there denying the ability of government to provide health care appropriately at all) or Medicare which has transformed life for America’s seniors, or TriCare which provides coverage to our military families?

11

I’ve certainly heard Repubs argue that the potential cost of UHC raises grave concerns. You don’t think that’s reasonable?

12

I’m not sure Medicare is a good program to cite in support of the long-term financial viability of Govt-run medical programs.

13

Although just about every other country in the developed world manages to provide universal coverage for its citizens, at a comparable or higher standard than most insured people get in the U.S., and at a fraction of the cost? Do you really think that the American government is so very much more incompetent than those of other countries? (If so, maybe you should go live in Cuba - where, incidentally, they have excellent universal health care, comparable in quality to that available in the U.S., and costing a tiny fraction of the amount: wicki.)

To respond to the OP, however, there is a huge downside to effective healthcare reform, not for the American people or economy (for whom it is almost entirely upside), but for insurance companies and other institutions that make enormous profits out of the current system. All the so-called waste is actually going into someone’s pockets, after all. In the case of the health insurance companies, in particular, we are looking at large, powerful and very wealthy institutions that are literally fighting for their lives. Of course they are going all of the vast resources at their disposal, including (but by no means limited to) spreading lies and confusion, to stop it happening.

(And, of course, they have many politicians - apparently all congressional Republicans and quite a few Democrats - and much of the media, in their pockets.)

Conservatives tend to be more susceptible to being being taken in by the bullshit being spread around because a lot of it appeals to their general ideological viewpoint, but note that the vast majority of conservatives in countries that do have UHC fully support it, and recognize that it is good for business, the overall economy, and the public purse (except the private health insurance business, of course). Single payer UHC is actually entirely consistent with good, prudent fiscal conservatism. I do not think Republicans, for the most part, oppose UHC because they are Republicans (or conservatives), but either because they are corrupt, or, as I said, for ideological reasons more easily bamboozled on this issue than progressives are, or perhaps because they see the political danger of the Democrats being able to take credit for achieving it.

14

So, so far, the rational arguments mentioned are (A) the cost and (B) the possibility of the goverment messing up royally. As I understand it, the consequences of B would be financial disaster- essentially the same argument as A- and an inefficiant medical system. As I wrote in the OP, though, even a badly-run system is better than no coverage at all, and those that are happy with the current system don’t need to change. So the only practical objection is still the high cost.

Either that, or I need to work on my reading comprehension skills (a very real possibility).

15

Obama’s plan is lifted from the commonwealth fund, which found that implementing changes like a public option and insurance exchange can cut the rate of medical cost inflation from 6.7% down to 5.5% a year.

http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Feb/The-Path-to-a-High-Performance-US-Health-System.aspx

Over the course of a decade, that is 3 trillion in lower medical spending. Since most plans being promoted cost 1 trillion, and are funded in half by improvements to medicare and medicaid, that is a 3 trillion savings from a $500 billion investment.

As far as your statement that government can’t do anything right, medicare has lower overhead and higher satisfaction than private insurance.

16

There are downsides. Insurance companies and pharmaceutical companies would lose tons of money. Doctor and people in the health industry may see lower wages if a public option is tied to medicare rates.

Naturally they want to protect their income, which I can understand. However they aren’t being honest about it. Instead we are getting tons of lies about death panels, socialism, communism, and other fear tactics.

You have people who want to protect their income on one hand (insurance companies, pharma companies, health workers) and you have grassroots conservatives who are enraged that a black liberal from the north is the president and has a supermajority in congress, and they are scared to death of what that means for ‘their’ country. So they will believe every conspiracy theory they come across.

If it was an honest debate and honest criticism, that’d be fine. But it isn’t. It is mostly scare tactics and misinformation.

As far as the public option, many conservative media pundits who condemn it say ‘it will drive private insurance companies out of business’. The reason they say that is it has been shown the public option might be 20-30% less expensive than private insurance. So private insurance may spend 20% on overhead whereas a public option might spend 5%. Plus private insurance may not be able to get the negotiated rates of a strong public option.

So the argument isn’t that health reform involving a public option won’t work, it is that it’ll provide such high quality care for such a low cost that people will abandon their private plans and choose the public option. The central crux of the conservative argument against hte public option is that it will work too well, and given freedom of choice the public would pick it instead of private plans.

So ideology also plays a battle, tons of conservatives don’t want the government to work well, and they are opposed to anything ‘public’. So an efficient public plan is as anathema to them as private corporations are to communists.

17

I think you’re looking at the situation wrong. There are serious downsides to meaningful health reform
Powerful corporations would lose tons of money

If (heavy on the if) a public option is tied to medicare rates, medical professionals will see pay cuts

A strong public option is ideologically poisonous to conservatives. If it actually provides high quality care for 20-30% less money than private plans, then it is doubly poisonous as it destroys their entire worldview that ‘government can’t do anything right’.

Meaningful healthcare reform will be a major political victory for democrats which they can campaign on for a decade, and which will push the GOP further into minority status. That is why they opposed reform in 1994, and why they oppose it now.

Grassroots right wing authoritarians (aka wingnuts) are terrified of having a black, democrat liberal as president, are terrified of any change he might implement whatsoever (it has only been half a year and they are already calling for assassinations, military coups and things like that) and are believing any conspiracy theory thrown their way.
The real resistance to health reform comes from those things. Xenophobia, corporate profits, attempts to win/lose future political elections and ideological hangups. It has nothing to do with whether reform will help average Americans. That part is obvious.

18

You also conveniently left out the fact that Medicare is insolvent. The government’s own officials have already published this fact numerous times and it is not in dispute.

You also left out the fact that Medicare budget estimations in 1967 were wildly off the mark. They calculated/forecasted that Medicare would cost $12 billion in 1990 (EVEN WHEN FACTORING INFLATION) and the reality was that it cost $107 billion.

That’s damning evidence of your government Intelligence Quotient right there folks.

“higher customer satisfaction” … LOL! What a typical amateurish cherry-picked metric!

Yes, and omission of facts (such as Medicare insolvency) is also “misinformation.”

19

Medicare insolvency is not caused by bad management. It is caused by the ever escalating costs of health care in the US. It also is a collection of the old people who are not profitable for insurance companies. Insurance companies refuse to cover anybody who might possibly cost them money. Many of the people who are rejected by insurance companies are likely to apply for Medicade and later Medicare. Medicare , if it could cover everybody would also be providing coverage for people who are profitable and do not use the system very much at all.

20

… which by definition is bad management.

As health care costs rise, good management is to regularly respond to reality and re-adjust the program by changing the benefits or changing the tax funding. The incompetent government of politicians did not have the brains or the backbone to do either.

Please look up the defintion of management and you’ll see that yes, the government did mismanage Medicare (nevermind the childish “customer satisfaction” metric.)

The “gigantic risk pool of 300 million” fallacy?

Nope. Since most folks will die of old age and geriatric care is the most expensive, that nullifies the gigantic risk pool mathematics. If the government institutes forced euthanasia for anyone over the age of 60, then the gigantic risk pool might work.

The problem is that people are not using the word “insurance” in its classical “risk” based defintion of which you’re covered for only for UNEXPECTED costs. We have extended the meaning of “insurance” to ALSO cover EXPECTED and ONGOING costs. One of those expected costs is old-age care. Adult diabetes is ONGOING costs (and also somewhat expected).

Once you throw EXPECTED costs into the mix, the phrase “gigantic risk pool” becomes meaningless.