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  #101  
Old 12-06-2018, 05:02 PM
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Originally Posted by DrDeth View Post
Originally Posted by Broomstick
It's that "Denmark does it better" or "Germany does it better", it's that Denmark AND Germany AND France AND the UK AND Australia AND New Zealand, and Etc., and Etc., all do it better.

You have to wonder why the US is the only one that doesn't... and it's not because we're getting better results because we aren't.


So tell me how the rest of your post changes you claim that the USA is the only nation that doesnt have UHC?
If you re-read what I wrote (and I know you can because this time you actually quoted the post) I did not, actually, name EVERY COUNTRY ON THE PLANET. Most people can figure out where I'm going with that - developed countries, what we used to call "first world". I'm not sure why you, personally, didn't grasp that.

So tell me - why can Denmark, Germany, France, the UK, Australia, and New Zealand manage to pull off UHC for less money and better results than what we have in the US? And why can't the US do the same?
  #102  
Old 12-06-2018, 05:12 PM
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If you can't figure out that from context, I am at a loss.
...well thanks for bringing everything full circle.

Context is important. We can deduce that Broomstick was probably talking about UHC, even though UHC was not explicitly mentioned in that particular post.

But we can also deduce that when Broomstick said " the US is the only one that doesn't" that she didn't mean "literally every country/nation in the world" even though she didn't explicitly state that.
  #103  
Old 12-06-2018, 06:05 PM
Railer13 Railer13 is online now
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You said this:

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Originally Posted by DrDeth View Post
I have several times said that UHC is a good idea.

I show them the facts, without resorting to the ridiculous and counterproductive argument that Denmark has it so should we.
I asked you for these facts, and you responded with this:

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Originally Posted by DrDeth View Post
It's cheaper.

It's more fair.

Fewer people go bankrupt from medical bills.

It's the Right thing to do.
But these are 'facts' that are obviously unproven in this country. However, these facts are in evidence in countries that have UHC.

So instead of saying that 'Denmark has it, so should we', I should say 'It works in Denmark, so it will work here'?

That's not exactly a huge distinction in arguments, is it?
  #104  
Old 12-06-2018, 06:08 PM
DrDeth DrDeth is offline
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So instead of saying that 'Denmark has it, so should we', I should say 'It works in Denmark, so it will work here'?

That's not exactly a huge distinction in arguments, is it?
No, you shouldn't use either.

Americans dont like to be compared to other nations.

So any comparison is counterproductive.
  #105  
Old 12-06-2018, 06:13 PM
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Americans dont like to be compared to other nations.
...surely this is part of the problem.
  #106  
Old 12-06-2018, 06:21 PM
DrDeth DrDeth is offline
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...surely this is part of the problem.
So basically the ONLY argument you have is that "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden!".

A argument that has never worked, that alienates those you are trying to convert and is a specious illogical argument anyway. What is the definition of insanity?

It doesn't work for Gun control, for higher taxes, for UHC, for ANYTHING.

and then of course, you attack someone on your side, for pointing out that it's a stupid argument that has never worked. because you cling to it.

But you can't argue that's it's the right thing to od, it's actually cheaper, and it's more fair.

All you got is a argument that works opposite from the way intended.

And of course- that's "part of the problem".

But go ahead, keep doing it- and then we'll never have UHC.

Last edited by DrDeth; 12-06-2018 at 06:24 PM.
  #107  
Old 12-06-2018, 06:27 PM
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Originally Posted by DrDeth View Post

But you can't argue that's it's the right thing to od, it's actually cheaper, and it's more fair.
Of course I can argue that it's the right thing to do, and it's cheaper, and it's more fair.

But then the counter-argument will be that I cannot prove these assertions.

Which I cannot, unless I point to Denmark or Sweden or Canada.

And we're right back where we started, no?
  #108  
Old 12-06-2018, 06:30 PM
DrDeth DrDeth is offline
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Originally Posted by Railer13 View Post
Of course I can argue that it's the right thing to do, and it's cheaper, and it's more fair.

But then the counter-argument will be that I cannot prove these assertions.

Which I cannot, unless I point to Denmark or Sweden or Canada.

And we're right back where we started, no?
No, you can point out the math like I did earlier showing that it is cheaper for Americans.

And you can't argue it's more fair, or it's the right thing to do without saying "It works in denmark?" wow. UHC has lost then, it has no chance.
  #109  
Old 12-06-2018, 06:34 PM
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So basically the ONLY argument you have is that "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden!".
...what the fuck are you going on about? How the fuck do you go from " 'It works in Denmark, so it will work here" to "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden?"


Quote:
A argument that has never worked, that alienates those you are trying to convert and is a specious illogical argument anyway. What is the definition of insanity?
Nobody is making that argument in this particular thread, and I very rarely see them making that argument anywhere else on the internet (although I have no doubt that it occasionally happens.)

This is Great Debates. We debate here. We aren't trying to get "world peace." We are fighting. With words. My job here isn't to "convince the American people that UHC would be a good thing." People in the real world can take care of that.

Quote:
It does work for Gun control, for higher taxes, for UHC, for ANYTHING.

But you can't argue that's it's the right thing to od, it's actually cheaper, and it's more fair.
America is unique. Its unique in its stubborn refusal to listen. To deflect. To pretend that it is somehow "exceptional", and that there is a reason why the things that other nations find ways of doing is impossible to implement "in the land of the free." And you exemplify that attitude.

Quote:
All you got is a argument that works opposite from the way intended.

And of course- that's "part of the problem".

But go ahead, keep doing it- and then we'll never have UHC.
Yep. The deliberate (and at this stage it has to be deliberate) conflation of a position with a strawman is a big part of the problem. And if you don't get UHC it won't be because people ask entirely reasonable questions like 'It works in Denmark, why can't we make it work here" but because of the intentional over-reaction to questions like that which appear to have the singular purpose of shutting down the debate.
  #110  
Old 12-06-2018, 06:52 PM
DrDeth DrDeth is offline
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Originally Posted by Banquet Bear View Post
...what the fuck are you going on about? How the fuck do you go from " 'It works in Denmark, so it will work here" to "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden?"




Nobody is making that argument in this particular thread, and I very rarely see them making that argument anywhere else on the internet (although I have no doubt that it occasionally happens.)

America is unique. Its unique in its stubborn refusal to listen. To deflect. To pretend that it is somehow "exceptional", and that there is a reason why the things that other nations find ways of doing is impossible to implement "in the land of the free." And you exemplify that attitude.



Yep. The deliberate (and at this stage it has to be deliberate) conflation of a position with a strawman is a big part of the problem. And if you don't get UHC it won't be because people ask entirely reasonable questions like 'It works in Denmark, why can't we make it work here" but because of the intentional over-reaction to questions like that which appear to have the singular purpose of shutting down the debate.
That's how it comes across. See this line "America is unique. Its unique in its stubborn refusal to listen. "


No? Only in posts #1, 42, 47, 65, 69, 70, 76, 82, 84, 85, 96, 101, 103, ....

And see, you then add in "And you exemplify that attitude." even tho I am 100% in favor of UHC, but am just pointing out that one argument for it doesnt work and in fact is counterproductive.

It won't work in America because apparently, your one and only argument is 'It works in Denmark, why can't we make it work here" That's it, that all you got. And that has failed for decades.

Instead of showing we can afford it, that it is actually cheaper, like I have- you cling to
"It works in Denmark, why can't we make it work here".

And then you call other supporters of UHC names and insult them because they somehow can't see how marvelous your argument it.

Look, if I showed you that UHC was tried and failed in every other nation for decades, would you still still use that argument? Because that is exactly what you are doing- using a argument that has been tried and failed for decades.
  #111  
Old 12-06-2018, 07:11 PM
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That's how it comes across.
...nope. That is how it is portrayed. By people like you. You literally just did that now. People don't hear the original question. They hear how it has been mis-characterized.

Quote:
See this line "America is unique. Its unique in its stubborn refusal to listen. "
Am I wrong?

Quote:
No? Only in posts #1, 42, 47, 65, 69, 70, 76, 82, 84, 85, 96, 101, 103, ....
What about them?

Quote:
And see, you then add in "And you exemplify that attitude." even tho I am 100% in favor of UHC, but am just pointing out that one argument for it doesnt work and in fact is counterproductive.
"I'm 100% in favor of UHC, but I will willfully and intentionally mis-characterize arguments in support of UHC because...reasons?"

Arguments are things that we argue about. That it is "counterproductive" is only your opinion.

Quote:
It won't work in America because apparently, your one and only argument is 'It works in Denmark, why can't we make it work here" That's it, that all you got. And that has failed for decades.
Fortunately it isn't the "one and only" argument for UHC. That isn't all I've got, and it isn't all we've got. For decades the NRA have been "untouchable." But this year due to the actions of some very brave survivors of school shootings the NRA have finally taken a hit in the pocket-book. Sometimes it takes a while for the message to get through.

Quote:
Instead of showing we can afford it, that it is actually cheaper, like I have- you cling to
"It works in Denmark, why can't we make it work here".
I have no need to "cling" to anything. I do not "cling" to "It works in Denmark, why can't we make it work here."

Quote:
And then you call other supporters of UHC names and insult them because they somehow can't see how marvelous your argument it.
If someone has insulted somebody in this thread I hope you've reported it: because insults are bad.

Quote:
Look, if I showed you that UHC was tried and failed in every other nation for decades, would you still still use that argument?
Is that a serious question?

Quote:
Because that is exactly what you are doing- using a argument that has been tried and failed for decades.
You haven't demonstrated how the "argument has failed." You've shown how important propaganda is to be able to shape the narrative.
  #112  
Old 12-06-2018, 09:24 PM
DrDeth DrDeth is offline
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Originally Posted by Banquet Bear View Post

What about them?



"I'm 100% in favor of UHC, but I will willfully and intentionally mis-characterize arguments in support of UHC because...reasons?"



Fortunately it isn't the "one and only" argument for UHC. That isn't all I've got, and it isn't all we've got. For decades the NRA have been "untouchable." But this year due to the actions of some very brave survivors of school shootings the NRA have finally taken a hit in the pocket-book.....



.....


Is that a serious question?



You haven't demonstrated how the "argument has failed." You've shown how important propaganda is to be able to shape the narrative.
"Nobody is making that argument in this particular thread,", except as i said Only in posts #1, 42, 47, 65, 69, 70, 76, 82, 84, 85, 96, 101, 103, ....

No, it's ONE argument, and a argument that is hurting the push towards UHC. You said i was "mis-characterize arguments " (note your plural, a nice subtle dig and not true, is this how you debate?) and I am not doing so, I am telling why that argument doesnt work. And the reason is- I want UHC, and you are hurting the push for UHC by that bad counterproductive argument.

That's all you have said so far in this back and forth, and what does the NRA have to do with UHC?

Since you wont drop it, I guess not.

I have shown that your main argument, so far your ONLY argument, hasn't worked. Has it worked? Do we have UHC?
  #113  
Old 12-06-2018, 09:58 PM
Wesley Clark Wesley Clark is offline
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Preventative medicine is almost always a good idea, but it will not save money.
The biggest healthcare myth is that the US can easily save money on healthcare without large disruptions in care. If you look other country's systems they are all UHC but they vary alot by country. There is no one way to control costs. The best correlation is between how rich a country is and how much they spend.

For example, Greece spends 34% less than what Italy does per capita and has longer lifespans than Italy. They spend less than one third of what Switzerland, Norway, and Luxembourg does. The reason they spend so little is not because Greece has a hyper efficient medical system but because it is the poorest country in Europe and so spends much less than the rest of Europe. Rich countries spend more on services because of Baumol's cost disease which states that efficiencies in one area of the economy push up prices in other areas of the economy. So Luxembourg and Switzerland, the two richest countries in Europe spend the most on healthcare per capita and the most on education per capita. The US is much richer than the rest of the world, actual individual consumption in the US is 16% higher than in Luxembourg and 36% higher than in Italy which is average for Europe.

Thus in order to actually save money you either have to get healthcare professionals to to agree to be paid like people in a poorer country or get people to accept a standard of care of a poorer country. The good news is that much of healthcare spending is wasted so getting less healthcare won't necessarily mean worse health. But the bad news is that we don't know what parts of healthcare are waste and thus cutting healthcare will probably mean worse health.
What is this based on though? Several studies say we can cut 1/3 or more of health care spending without it negatively affecting health. That would free up a trillion dollars or more a year. Money we could use to pay down deficits, invest in renewable energy, invest in education, invest in infrastructure, etc.

https://www.healthaffairs.org/do/10....3.959735/full/

https://hbr.org/2015/10/how-the-u-s-...-by-1-trillion
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  #114  
Old 12-06-2018, 10:08 PM
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Originally Posted by DrDeth View Post
"Nobody is making that argument in this particular thread,", except as i said Only in posts #1, 42, 47, 65, 69, 70, 76, 82, 84, 85, 96, 101, 103, ....
...nope. Nobody in this thread has argued "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden?" Except in post 106, of course.

Quote:
No, it's ONE argument, and a argument that is hurting the push towards UHC.
I don't think it is.

Quote:
You said i was "mis-characterize arguments " (note your plural, a nice subtle dig and not true, is this how you debate?) and I am not doing so, I am telling why that argument doesnt work.
You haven't explained jack-shit. You've made an assertion, thats all.

You've intentionally and willfully micharacterized arguments such as " 'It works in Denmark, so it will work here" with "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden!"

Quote:
And the reason is- I want UHC, and you are hurting the push for UHC by that bad counterproductive argument.
I'm hurting the push? Really? By arguing with you on a messageboard? You flatter me. But I don't think I'm that important.

Quote:
That's all you have said so far in this back and forth, and what does the NRA have to do with UHC?
I never said the NRA had anything to do with UHC. If you didn't understand the point then I suggest you go read it again.

Quote:
Since you wont drop it, I guess not.
Drop what? Have I actually used the argument you are attributing to me in this thread? Are you actually reading my posts?

Quote:
I have shown that your main argument, so far your ONLY argument, hasn't worked.
You mean the argument, the one and ONLY argument, that I haven't made in this particular thread (yet)?

Quote:
Has it worked? Do we have UHC?
ROFL!

What a ridiculous standard to uphold. Lets close down Great Debates. LETS STOP ARGUING!!! IT DOESN'T WORK!

Yes: we do have UHC. Or to be quite precise: I have UHC. I think you should have it as well. If we can do it where I live then you can do it in the United States of America. And if me expressing that opinion "hurts the debate" then there are fundamental problems with your society bigger than anything that we've been discussing in this thread that needs to be sorted out.
  #115  
Old 12-06-2018, 10:11 PM
Wesley Clark Wesley Clark is offline
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So basically the ONLY argument you have is that "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden!".

A argument that has never worked, that alienates those you are trying to convert and is a specious illogical argument anyway. What is the definition of insanity?

It doesn't work for Gun control, for higher taxes, for UHC, for ANYTHING.

and then of course, you attack someone on your side, for pointing out that it's a stupid argument that has never worked. because you cling to it.

But you can't argue that's it's the right thing to od, it's actually cheaper, and it's more fair.

All you got is a argument that works opposite from the way intended.

And of course- that's "part of the problem".

But go ahead, keep doing it- and then we'll never have UHC.
American exceptionalism is a thing, sadly, but I don't think its as big a thing as it was maybe 40 years ago. In the age of the internet, I think a lot of people are realizing how fucked up our country really is, and that in many ways we are inferior to other nations, not superior. The US has undergone a lot of traumas and humiliations in the last few decades that keep reminding us that we aren't nearly as wise or strong as we think we are.

Having said that, the real reasons we do not have UHC basically come down to 2 things.

1. Plutocracy
2. Egotistical tribalism

for point 1, a lot of rich companies enjoy our broken, over priced system. They make a ton of money out of it. If we made our health care as efficient as europe, that would save 1 trillion a year or more. These companies will not take a trillion dollar cut to their business model and profit margins without a fight.

For point 2, a lot of people in America love to feel superior to someone/anyone. Usually they target these feelings at non-whites and the poor. So for them, UHC is just a way for 'hard working' white people to pay taxes so lazy people and non-whites can get medical care. Its a bullshit philosophy (some of the strongest proponents of this I've met in person were on programs like medicare or medicaid), but Americans love feeling better than someone/anywone, and we are a very tribalistic, racist nation.

So I don't think what you're worried about really matters. If someone could snap their fingers and get rid of plutocracy and egotistical tribalism, we'd have UHC within a year or two.

Also calling Americans stupid isn't wrong when we act stupid. And we can be a very stupid country.
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  #116  
Old 12-06-2018, 10:28 PM
Railer13 Railer13 is online now
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I have shown that your main argument, so far your ONLY argument, hasn't worked. Has it worked? Do we have UHC?
Of course, none of your arguments, or anybody else's, have worked either.

Speaking of your arguments:

It's cheaper. Yes, you presented a study that showed it would be cheaper than our current system. But until it's actually put into practice, we won't really know. But right now we can look at other countries and see that they provide better health care at a lower per-capita cost, and use them as an example that UHC would indeed be cheaper.

It's more fair. What is 'fair' is entirely subjective. You and I might think that UHC is more fair, but I would surmise that others do not hold that opinion.

Fewer people go bankrupt from medical bills. Again, until we put it into practice, this statement cannot be subjectively proven. The only evidence we have of this is what's happening in countries that already have UHC.

It's the Right thing to do. Again, you and I agree that it's right. Others may not hold that opinion...and it is, at this point, only an opinion.

Hey, we're on the same side of this debate. I just don't see what is so terrible about using other countries as examples to bolster our position.
  #117  
Old 12-07-2018, 07:11 AM
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.....2. Egotistical tribalism

......
For point 2, a lot of people in America love to feel superior to someone/anyone. Usually they target these feelings at non-whites and the poor. So for them, UHC is just a way for 'hard working' white people to pay taxes so lazy people and non-whites can get medical care. Its a bullshit philosophy (some of the strongest proponents of this I've met in person were on programs like medicare or medicaid), but Americans love feeling better than someone/anywone, and we are a very tribalistic, racist nation.
So, lack of UHC is due in part to racism. Do you have a cite for this? I've never seen this used as an argument against UHC.

If insulting groups of Americans was persuasive on this issue, then we need to get you in front of our congress to talk about how racist Americans are keeping us from UHC. I'm sure this argument will win the day and get us single-payer right away.

Last edited by survinga; 12-07-2018 at 07:12 AM.
  #118  
Old 12-07-2018, 07:19 AM
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So basically the ONLY argument you have is that "You stupid, ignorant Americans, you dont know what's good for you, you need to be more like Sweden!".
Posts #26 & #115 are textbook examples of people insulting groups of Americans as part of the argument, exactly in the spirit of what you're talking about. In one post #26, it's "morons" (crossed out for "Americans") who are healthy, and therefore they think we don't need UHC. In the other post #115, it's "tribalism", i.e. racists, who don't want non-whites who are lazy to get healthcare. I wonder how often insulting groups of people has worked to change millions of minds. I'm sure these insults will change the politics of America, and we'll get "Medicare for All" if we call enough people morons & racists.

Last edited by survinga; 12-07-2018 at 07:20 AM.
  #119  
Old 12-07-2018, 02:13 PM
Wesley Clark Wesley Clark is offline
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Originally Posted by survinga View Post
So, lack of UHC is due in part to racism. Do you have a cite for this? I've never seen this used as an argument against UHC.

If insulting groups of Americans was persuasive on this issue, then we need to get you in front of our congress to talk about how racist Americans are keeping us from UHC. I'm sure this argument will win the day and get us single-payer right away.
FDR wanted to pass uhc but southern whites were afraid it would lead to integrated hospitals.

Also you have to listen to keywords and dog whistles. Concepts like 'illegal immigrants' and 'poor people from the inner city' come up as resistance factors to universal health care. Lee Atwater, referencing the the southern strategy, admitted that the GOP's resistance to statism and a welfare state is just an abstract form of racism.
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  #120  
Old 12-07-2018, 03:26 PM
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What is this based on though? Several studies say we can cut 1/3 or more of health care spending without it negatively affecting health. That would free up a trillion dollars or more a year. Money we could use to pay down deficits, invest in renewable energy, invest in education, invest in infrastructure, etc.

https://www.healthaffairs.org/do/10....3.959735/full/

https://hbr.org/2015/10/how-the-u-s-...-by-1-trillion
I don't think those studies go far enough. If there was perfect knowledge I bet we could cut at least 50% of health care spending without negatively affecting health. The problem is we don't know how to do that.

In 2009 part of the Affordable Care act was to go after Medicare Fraud, yet in 2015 a report estimated that Medicare Fraud cost the government $60 billion. That is for outright fraud which no politician in the world thinks is a good idea and no voter would be mad if we completely eliminated it. Yet every year the GDP of Luxembourg is wasted on this.

Cutting healthcare spending is a problem for every country. I am sure Canada would love to cut its healthcare spending one third to the level of Spain while improving life expectancy to Spain's number. They just are unable to do so.
  #121  
Old 12-07-2018, 03:29 PM
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FDR wanted to pass uhc but southern whites were afraid it would lead to integrated hospitals.

Also you have to listen to keywords and dog whistles. Concepts like 'illegal immigrants' and 'poor people from the inner city' come up as resistance factors to universal health care. Lee Atwater, referencing the the southern strategy, admitted that the GOP's resistance to statism and a welfare state is just an abstract form of racism.
Wikipedia says that it was opposition from the American Medical Association that killed public health care for FDR and Truman.

Atwater said no such thing. He said that appealing to racism no longer worked so they had to use appeals that did.
  #122  
Old 12-07-2018, 05:22 PM
DrDeth DrDeth is offline
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Also you have to listen to keywords and dog whistles. Concepts like 'illegal immigrants' and 'poor people from the inner city' come up as resistance factors to universal health care. Lee Atwater, referencing the the southern strategy, admitted that the GOP's resistance to statism and a welfare state is just an abstract form of racism.
No he didn't. Listen to the whole interview. eta- as Puddleglum sez.
  #123  
Old 12-07-2018, 09:48 PM
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Posts #26 & #115 are textbook examples of people insulting groups of Americans as part of the argument, exactly in the spirit of what you're talking about. In one post #26, it's "morons" (crossed out for "Americans") who are healthy, and therefore they think we don't need UHC. In the other post #115, it's "tribalism", i.e. racists, who don't want non-whites who are lazy to get healthcare. I wonder how often insulting groups of people has worked to change millions of minds. I'm sure these insults will change the politics of America, and we'll get "Medicare for All" if we call enough people morons & racists.
So out of 115 posts you managed to find two which are vaguely insulting about the american public (on a site that frequently takes that tone), and you are taking that as a good enough reason to handwave the actual argument, that has been patiently explained many times in this thread?

The cognitive dissonance exhibited here, and on other topics like climate change, is fascinating.
How does one counter an argument, when no counter-argument is available? "You guys really shouldn't use that argument: Here are two examples of people rudely-stating the argument, therefore it's just plain rude"

Last edited by Mijin; 12-07-2018 at 09:50 PM.
  #124  
Old 12-08-2018, 03:04 PM
Wesley Clark Wesley Clark is offline
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No he didn't. Listen to the whole interview. eta- as Puddleglum sez.
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Originally Posted by puddleglum View Post
Wikipedia says that it was opposition from the American Medical Association that killed public health care for FDR and Truman.

Atwater said no such thing. He said that appealing to racism no longer worked so they had to use appeals that did.
https://en.wikipedia.org/wiki/Southern_strategy

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Atwater: Y'all don't quote me on this. You start out in 1954 by saying, "Nigger, nigger, nigger." By 1968 you can't say "nigger" that hurts you. Backfires. So you say stuff like forced busing, states' rights and all that stuff. You're getting so abstract now [that] you're talking about cutting taxes, and all these things you're talking about are totally economic things and a byproduct of them is [that] blacks get hurt worse than whites. And subconsciously maybe that is part of it. I'm not saying that. But I'm saying that if it is getting that abstract, and that coded, that we are doing away with the racial problem one way or the other. You follow me because obviously sitting around saying, "We want to cut this," is much more abstract than even the busing thing, and a hell of a lot more abstract than "Nigger, nigger."
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  #125  
Old 12-08-2018, 05:39 PM
DrDeth DrDeth is offline
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Yes. But again Listen to the whole interview. Taken out of context it sure sounds like that. But if you actually read or listen to the whole interview you will see it is taken out of context, and Atwater means just the opposite.
  #126  
Old 12-11-2018, 09:17 AM
Grim Render Grim Render is offline
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You're just tap-dancing around real polling on a real issue. People don't have to believe in crazy stuff to know if their own healthcare is good or not. And the numbers I quoted on the very strong consensus on the real issue of our own healthcare is fact.

And single-payer is not necessary for sustainability of a healthcare system.
No. You are currently wasting ~1.6 trillion dollars in the healthcare sector while having a national debt of 21 trillion, and running a deficit of ~800 billion. You cannot afford waste of that degree of magnitude. That is the bottom line, regardless of how it polls.

Further, US satisfaction with the US healthcare system is extremely weak. And has been for a long time.

What you are citing is that Americans satisfaction with their personal care, not their system, is over 75%. That is also not that good for a developed nation.

Also, people do not necessarily know if their healthcare or healthcare system is good unless they have something to compare it to.

Last edited by Grim Render; 12-11-2018 at 09:18 AM.
  #127  
Old 12-15-2018, 07:24 AM
survinga survinga is offline
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No. You are currently wasting ~1.6 trillion dollars in the healthcare sector while having a national debt of 21 trillion, and running a deficit of ~800 billion. You cannot afford waste of that degree of magnitude. That is the bottom line, regardless of how it polls.

Further, US satisfaction with the US healthcare system is extremely weak. And has been for a long time.

What you are citing is that Americans satisfaction with their personal care, not their system, is over 75%. That is also not that good for a developed nation.

Also, people do not necessarily know if their healthcare or healthcare system is good unless they have something to compare it to.
Most people don't know jack-squat about the healthcare system. It reminds me of the lady that once told her congressman to "keep your government hands off my medicare", or when people were interviewed who had just bought a policy on a state exchange and were glad it wasn't an "obamacare policy".

But people are familiar with and do know their own healthcare. They know their doctors. They know how they're treated. The 75% satisfaction is real, and it matters. And it's one of the reasons Obama went with the ACA to begin with, as he didn't want to change the overall system, but just part of it.
  #128  
Old 12-15-2018, 07:26 AM
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And it appears that some nutcase judge in Texas ruled the ACA unconstitutional.

I'm sure hoping this gets overturned.

https://www.vox.com/2018/12/14/18065...l-texas-ruling
  #129  
Old 12-15-2018, 04:11 PM
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Originally Posted by survinga View Post
Most people don't know jack-squat about the healthcare system. It reminds me of the lady that once told her congressman to "keep your government hands off my medicare", or when people were interviewed who had just bought a policy on a state exchange and were glad it wasn't an "obamacare policy".

But people are familiar with and do know their own healthcare. They know their doctors. They know how they're treated. The 75% satisfaction is real, and it matters. And it's one of the reasons Obama went with the ACA to begin with, as he didn't want to change the overall system, but just part of it.
Why don't you stop talking about satisfaction with doctors and start talking about satisfaction with insurance companies.
For instance, this article does not give the satisfaction level, other than it being constant, but does say:
Quote:
The JD Power 2018 Commercial Member Health Plan Study found that consumer satisfaction with the health plan industry still lags behind other industries in terms of convenience, helpfulness, and the availability of user-friendly purchasing experiences.
and

Quote:
Only 47 percent of health plan members fully understood how their plan works. Respondents said that they have significant trouble understanding certain administrative processes, such as when pre-approvals are needed for medical services or treatments.
which doesn't sound so great to me.

But this article gives more data - if a bit old.

Quote:
Overall satisfaction with health insurance fell 1.4% to a score of 69 in the 2015 American Customer Satisfaction Index, released Tuesday.
Quote:
The health insurance industry as a whole scores poorly, delivering satisfaction levels below that of the airline business and tying with landline phone providers and the U.S. Postal Service. Only the dreaded pay TV and Internet service providers score lower as an industry.
Worse than airlines? That's pretty bad.
Satisfaction with Medicare is well above this. So why don't you focus on the real issue, not the strawman issue?
  #130  
Old 12-15-2018, 06:06 PM
Grim Render Grim Render is offline
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Most people don't know jack-squat about the healthcare system. It reminds me of the lady that once told her congressman to "keep your government hands off my medicare", or when people were interviewed who had just bought a policy on a state exchange and were glad it wasn't an "obamacare policy".

But people are familiar with and do know their own healthcare. They know their doctors. They know how they're treated. The 75% satisfaction is real, and it matters. And it's one of the reasons Obama went with the ACA to begin with, as he didn't want to change the overall system, but just part of it.
It may well be real but its also low. A pretty poor satisfaction rate compared to other first world systems. Also the rate of dissatisfaction, and the fraction that feels the US system needs a total overhaul is also pretty real, and matters. And once again: satisfaction with your personal doctor and healthcare is not the same thing as satisfaction with the system.
  #131  
Old 12-15-2018, 07:40 PM
PhillyGuy PhillyGuy is offline
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Most people don't know jack-squat about the healthcare system.
I mostly agree.

But where I really agree is that most people don't jack-squat about the healthcare system in other countries.

Sweden's system may be too localized for generalizations.

In Italy, people who need to go to a specialist can wait several months, or can have an American-style wait of a couple of weeks by going private. This does not sound to me like single payer!

Almost every country has competing payers and providers. When an attempt is made to establish one payer for all, what happens is that the non-affluent are stuck with the one payer, and the affluent choose from competing payers.

Maybe I don't know jack squat about the universal care systems where competing payers make up the core of the system, as in Switzerland, Germany, and the Netherlands. However, this sounds to me much better than one system for the poor to lower middle class, and a bunch to choose from only for others. Is Swiss and Dutch medicine expensive? Well, yes, although not as expensive as in the US.

A respectable GOP should favor competition-based systems, such as Romneycare/Obamacare. Instead, ever since Reagan socialized American medicine, the Republicans have been facilitating health care freeloaders who refuse to take out affordable heath insurance and then receive multi-million dollar care, at public expense, when they get in a no-helmet motorcycle accident.
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  #132  
Old 12-15-2018, 07:53 PM
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Here's a new study that concludes that M4A will save us money.

Quote:
Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents.
  #133  
Old 12-15-2018, 08:23 PM
Northern Piper Northern Piper is offline
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In Italy, people who need to go to a specialist can wait several months, or can have an American-style wait of a couple of weeks by going private.

When you say "American-style wait" are you suggesting that the wait time for all Americans is only a few weeks?

Or are you saying anyone with health insurance has a wait time of only a few weeks?

Or are you saying that the wait time for people with a certain income level is only a few weeks?

Because those are three different situations, and it's not appropriate, in my opinion, to use the term "American style wait" without clarifying which one you mean.

My understanding is that for Americans without insurance, the "American-style wait" can be infinite.

Is that not the case?
  #134  
Old 12-15-2018, 08:38 PM
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I am an American and this is the case as I understand it. The law gives us the right to emergency care, but cancer is usually not an emergency until the end of life so there is no guarantee you will get treatment if you are terminally ill. There is always medicaid, something which many Americans fall back on after they bankrupt themselves, but the care is not awesome.

Last edited by Happy Fun Ball; 12-15-2018 at 08:39 PM.
  #135  
Old 12-15-2018, 09:09 PM
Northern Piper Northern Piper is offline
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Healthcare Myths in America

The point I am making is that opponents of UHC in the US often point to wait times in Canada (or Italy in this discussion) as an indicator of the flaws in UHC.

However, the unexamined premiss of that critique is that there are no wait times in the US, or they are very short.

But if you don't have good insurance, or any insurance at all, in the US the wait times can be very lengthy, stretching to infinite.

Comparisons should be apple to apple, not apple to kumquats.

Last edited by Northern Piper; 12-15-2018 at 09:09 PM.
  #136  
Old 12-15-2018, 09:25 PM
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When you say "American-style wait" are you suggesting that the wait time for all Americans is only a few weeks?

Or are you saying anyone with health insurance has a wait time of only a few weeks?
The latter. Now, in 2018, going without insurance is illegal in the sense that there is a national tax penalty. For 2019, that penalty goes away nationally but a few states will have their own insurance mandate (I believe, Massachusetts and New Jersey -- maybe more).

One thing I've wondered about -- what happens in countries, like Germany, Switzerland, and the Netherlands, where there is universal coverage based on a mandate that almost everyone pay affordable premiums? If someone doesn't pay, do they go to jail? Or it the idea of not paying so idiotic than the mandate barely requires enforcement?

I am against attempting single-payer but for affordable universal coverage.

Your article -- I wouldn't exactly call it a study -- accepts the myth of single payer. In reality, attempts to get to single payer result in multiple payers, with the best ones patronized by the upper middle class and above. Under the proposed 2017 Bernie Sanders law reviewed in your link, I think that large numbers of primary care docs -- already in short supply here -- would withdraw to concierge practices. The article completely ignores this, and a lot else that actually happens after a country tries to go single-payer. Now, the Sanders plan could be improved, and probably would be if something like it ever got close to passage. But I think we'd be better off using the Affordable Care Act (which also needs a great deal of improvement) as the starting point.
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  #137  
Old 12-15-2018, 09:51 PM
Northern Piper Northern Piper is offline
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The latter. Now, in 2018, going without insurance is illegal in the sense that there is a national tax penalty. For 2019, that penalty goes away nationally but a few states will have their own insurance mandate (I believe, Massachusetts and New Jersey -- maybe more).
That's not what the Wikipedia article on health-care coverage in the US says. It states that in 2016, there were 27 million uninsured Americans. The source for that cite is a US federal government report: "Federal Subsidies for Health Insurance Coverage for People under 65", put together by the Congressional Budget
Office.

That's 27 million Americans for whom wait times are infinite.

https://en.wikipedia.org/wiki/Health..._United_States

And, you note, now that the tax penalty has been removed, that number is likely to go up.


Quote:
I am against attempting single-payer but for affordable universal coverage.





Your article -- I wouldn't exactly call it a study -- accepts the myth of single payer. In reality, attempts to get to single payer result in multiple payers, with the best ones patronized by the upper middle class and above. Under the proposed 2017 Bernie Sanders law reviewed in your link, I think that large numbers of primary care docs -- already in short supply here -- would withdraw to concierge practices. The article completely ignores this, and a lot else that actually happens after a country tries to go single-payer. Now, the Sanders plan could be improved, and probably would be if something like it ever got close to passage. But I think we'd be better off using the Affordable Care Act (which also needs a great deal of improvement) as the starting point.


Sure, you can get to UHC without it being a single-payer system. Germany, Switzerland, France and Australia all offer multi-payer UHC examples.

However, it's not the case that single-payer results in multi-tier systems like you're mentioning. In Canada, a prohibition on multi-tier is one of the basic principles of our single-payer systems. Doctors can't charge more than the set rates, so no point to trying to set up a concierge clinic, or charge more to well-heeled clients to jump the queue.

The only way that's permitted is if doctors opt out of the single-payer system entirely, which would mean their clients (one hesitates to call them patients, when money is the main distinguishing feature) have to pull the full freight.

And in Canada at least, there's not enough people willing to forego our terrible socialist system and pay full freight.

So, do you have a cite to support your assertion that multi-tier is an inevitable result of all single-payer systems?
  #138  
Old 12-15-2018, 10:23 PM
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In Canada, a prohibition on multi-tier is one of the basic principles of our single-payer systems.
I was thinking of this:

Top court strikes down Quebec private health-care ban

Googling, I also found this:

Why private health insurance coverage in Canada needs a review
Quote:
Canadians must insure or pay out-of-pocket a whopping 30 percent of health costs with only around 70 percent covered by our publicly funded health system.
I'm not saying your system, either as it is currently, or with modest improvements, is wrong for Canada. I just don't think it's right for the more individualistic* U.S. ethos.

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  #139  
Old 12-15-2018, 10:58 PM
Northern Piper Northern Piper is offline
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Sure, but neither of your cites support your assertion that multi-tier health care inevitably develops under single-payer.

The Chaoulli decision of the Supreme Court said that the province could not prohibit private health insurance. However, 13 years on, the decision's had little to no effect. There simply aren't enough people who want to pay insurance premiums on the off-chance it may help them get health care faster than the public system. Pay insurance premiums and taxes, and maybe get faster care at some point in the future, or pay taxes and use the publicly funded health care system at no additional cost? There's not been any market for private insurance.

With respect to your second cite, yes, there are some health care matters that are not covered by Medicare. The big ones are dental and pharmaceuticals. But that's not the same as a multi-tier system, as you said inevitably develops under single-payer. If something isn't covered by Medicare, paying for those matters by other means isn't a new tier of Medicare.
  #140  
Old 12-15-2018, 11:08 PM
Nava Nava is online now
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Originally Posted by PhillyGuy View Post
One thing I've wondered about -- what happens in countries, like Germany, Switzerland, and the Netherlands, where there is universal coverage based on a mandate that almost everyone pay affordable premiums? If someone doesn't pay, do they go to jail? Or it the idea of not paying so idiotic than the mandate barely requires enforcement?
Where the premiums are to a national system, not paying counts as tax evasion: translate "don't mess with the IRS, 'cos they fersure can find holes in your accounting" into any language you care and serve au jus.

And where they're to insurance companies yes, there are penalties. What the exact penalties are will, as any legal question, vary by location. Proof that every worker (employed or subcontractor) is indeed insured is one of the things auditors look for (both the tax fellows and the safety fellows).
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Last edited by Nava; 12-15-2018 at 11:11 PM.
  #141  
Old 12-16-2018, 08:27 AM
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The Chaoulli decision of the Supreme Court said that the province could not prohibit private health insurance. However, 13 years on, the decision's had little to no effect. There simply aren't enough people who want to pay insurance premiums . . .
According to page 4 of this three year old industry link, 24 million Canadians have supplementary health insurance. That's two-thirds. I tried to find something from Statistics Canada as a tie-breaker between your post and the industry source I found googling, and didn't. However, this from Statistics Canada shows, on page 16, that Canadians, nine years ago, were paying about the same for supplemental insurance as for dental and prescriptions combined. So I'm going to say that the industry source is plausible and Canada is multi-payer with signficicant disparities.

Every country has health care disparaties between rich and poor. I'm for lowering them. I'm not for jumping to the conclusion that slapping the words "single payer" on a bill, and passing that, automatically does it.

I think the US is rich enough that we can have good competing payers that will satisfy even affluent consumers. My experience with non-profit Blue Cross plans says this is possible. My family's experience with US Medicare -- where roughly half the seniors have supplemental insurance and roughly half don't, is otherwise.
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  #142  
Old 12-16-2018, 08:54 AM
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Sure, but neither of your cites support your assertion that multi-tier health care inevitably develops under single-payer.
Here's a good link that compares systems of all types all over the world.

https://www.commonwealthfund.org/sit...rofiles_v5.pdf

It's very common to have private insurance as either a supplementary type, or to get you into a "higher-tier" facility, private room, quicker access to service and so forth.

I'm not going to say that multi-tier develops inevitably under single-payer. But it is very common in single-payer systems for a portion of the population to also have some type of private insurance which either supplements on co-pays (Japan for example has a very large market for this, US medicare supp also) or for "better cadillac healthcare service" (In England, 11% have this). Some portion of the population will always want more than what the basic single-payer provides, and is willing to spend to do so. I think it's very fair to say that single-payer systems often end up with companion or supplemental private systems around them. I tried to make this point, backed up with cites, on other threads, and I'm not sure why something that's so obviously true creates angst among some.

This is a good reference link, btw. The commonwealth fund has some good info.
  #143  
Old 12-16-2018, 10:50 AM
Northern Piper Northern Piper is offline
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According to page 4 of this three year old industry link, 24 million Canadians have supplementary health insurance. That's two-thirds. I tried to find something from Statistics Canada as a tie-breaker between your post and the industry source I found googling, and didn't. However, this from Statistics Canada shows, on page 16, that Canadians, nine years ago, were paying about the same for supplemental insurance as for dental and prescriptions combined. So I'm going to say that the industry source is plausible and Canada is multi-payer with signficicant disparities.
Except that what is covered by supplemental health insurance is things that are not covered by the medicare system. So no concierge practices, no quicker access to treatment, which is what you seemed to be suggesting in your earlier posts. What is covered by medicare is single-payer, and supplemental health insurance doesn't change that.
  #144  
Old 12-16-2018, 07:04 PM
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Why don't you stop talking about satisfaction with doctors and start talking about satisfaction with insurance companies.
For instance, this article does not give the satisfaction level, other than it being constant, but does say:


and



which doesn't sound so great to me.

But this article gives more data - if a bit old.





Worse than airlines? That's pretty bad.
Satisfaction with Medicare is well above this. So why don't you focus on the real issue, not the strawman issue?
It's not a strawman to talk about someone's view of their own healthcare. But people are also fairly satisfied with their employer-provided coverage.

This article, even though critical of the system, notes that a 2016 Kaiser poll found that 83% of employees either think their employer-sponsored health insurance is good or excellent. That's 5 out of 6:

https://www.vox.com/policy-and-polit...alth-insurance

AHIP pegs the number at 71% (not 5 out of 6, but still not bad):

https://www.ahip.org/majority-of-ame...-survey-shows/

I think if you want single-payer, you're going to have to deal with the real (not strawman) view that people have of their insurance that they already have, and of the healthcare that they have. I have employer-based, and I use it, and like it. Don't take away my doctors and my coverage....that's a common view, and shrug it off at your peril.
  #145  
Old 12-16-2018, 07:30 PM
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According to page 4 of this three year old industry link, 24 million Canadians have supplementary health insurance. That's two-thirds. I tried to find something from Statistics Canada as a tie-breaker between your post and the industry source I found googling, and didn't. However, this from Statistics Canada shows, on page 16, that Canadians, nine years ago, were paying about the same for supplemental insurance as for dental and prescriptions combined. So I'm going to say that the industry source is plausible and Canada is multi-payer with signficicant disparities.
This is misleading. The main reason so many Canadians have supplementary insurance is that it's pretty much a standard employee benefit, and the main reason it's pretty much standard is that it's a cheap benefit, which in turn is because it doesn't pay for much except common prescription drugs and dental. When I took early retirement nearly two decades ago, the thought of getting my own supplemental insurance never even entered my mind. Since then I've had a few doctors' visits, a few prescriptions, and never spent more than a few tenners on the drugs and nothing on the medical care. But then a few years ago I had a major cardiac event, with hospitalization, surgery and ongoing drug treatment. None of it cost a cent except for $100 deductible for the drugs every year. Why the hell would I pay for supplemental insurance?
Quote:
Originally Posted by PhillyGuy View Post
I think the US is rich enough that we can have good competing payers that will satisfy even affluent consumers. My experience with non-profit Blue Cross plans says this is possible. My family's experience with US Medicare -- where roughly half the seniors have supplemental insurance and roughly half don't, is otherwise.
Medicare is so far removed from full-coverage unconditional and unlimited single-payer that there is no comparison.
  #146  
Old 12-16-2018, 07:38 PM
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I think if you want single-payer, you're going to have to deal with the real (not strawman) view that people have of their insurance that they already have, and of the healthcare that they have. I have employer-based, and I use it, and like it. Don't take away my doctors and my coverage....that's a common view, and shrug it off at your peril.
Why do people persist with the view that it's either one or the other? Here in the UK we have private health insurance on top of the NHS.
  #147  
Old 12-16-2018, 10:56 PM
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It's not a strawman to talk about someone's view of their own healthcare. But people are also fairly satisfied with their employer-provided coverage.

This article, even though critical of the system, notes that a 2016 Kaiser poll found that 83% of employees either think their employer-sponsored health insurance is good or excellent. That's 5 out of 6:

https://www.vox.com/policy-and-polit...alth-insurance

AHIP pegs the number at 71% (not 5 out of 6, but still not bad):

https://www.ahip.org/majority-of-ame...-survey-shows/

I think if you want single-payer, you're going to have to deal with the real (not strawman) view that people have of their insurance that they already have, and of the healthcare that they have. I have employer-based, and I use it, and like it. Don't take away my doctors and my coverage....that's a common view, and shrug it off at your peril.
If everyone had good employer provided coverage as you have and as I have we wouldn't be having this discussion. But\ only 55.7% of Americans who have health insurance have this (8% have no insurance) and 16% direct purchase, which is often expensive or inadequate. So we might expect that those with direct paid insurance or no insurance are not going to be quite as satisfied. Not sure about Medicaid, but Medicare gets higher ratings.
I liked the insurance I already had. I like Medicare more. Satisfaction with one does not mean you won't be satisfied with a new plan.
And the plan won't take away your doctors. If we are dumb enough to get insurance companies too involved, maybe. If a doctor wants to quit, maybe. But the Medicare network is bigger than any single insurance company network. And it would be even bigger if it is the only game in town.
  #148  
Old 12-16-2018, 11:30 PM
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Originally Posted by Quartz View Post
Why do people persist with the view that it's either one or the other? Here in the UK we have private health insurance on top of the NHS.


I think it's because the Canadian single-payer system does not allow for a private system in addition, for various reasons. The Canadian system is the one most Americans are familiar with.
  #149  
Old 12-17-2018, 06:10 AM
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I think there was a typo in the following, which I've corrected in Red.
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Originally Posted by XT View Post
,,, There is also a difference between Americans and a lot of other people in other nations, that being an almost innate distrust of big government wrt doing a good job at things. While I know this isn't universal, it's something I've seen a lot of examples of with friends from other countries and those in the US. And to a lot of people it would be a huge leap of faith that we could get such a system implemented, that it would cost less or even the same and that they, personally, would get as good or better healthcare than they currently get. Because, again, for the majority of Americans it is good enough and, again, what they know. So, instead of large systemic changes to bring us to single payer UHC type service, paid for by taxes instead of by deductions from your pay stub and payed for mainly by your employer, we get small changes that often actually muck things up worse. Part of the reason we pay so much for hospital stuff stems from this happening, and it's not now so entrenched that just changing that one thing would be a monumental undertaking.

I am totally for a new system, and freely acknowledge that the one we have is broken. I believe pretty much everyone agrees on that second part anyway. But I think it's not so simple as the OP or others on this board, pointing at what other countries do and saying we could just do that.
I agree with this completely. It sums up the big problem. Getting from the present system to a single-payer UHC is hugely difficul. Obamacare was touted as a first step in the right directiont towards a goal that can only be achieved incrementally. (Obamacare with a public option would have been better it might have had 59 votes but was vetoed by the Senator from Insurancicut.) But the mandate was essential to ACA, and it was maliciously repealed by the very party that first explained its necessity.

If the Democrats treated the country the way the Republicans do, they would destroy the health insurance companies as soon as the forces of sanity defeat the Dark Lords of Mordor.
Quote:
Originally Posted by DrDeth View Post
Health care in America, for those that have it- is pretty darn good.
Slavery was pretty darn good for those who owned the slaves. When will the U.S. grow up and understand that Democracy is not supposed to be a device for the 51% to exploit the 49%?

Quote:
Originally Posted by JcWoman View Post
We should NEVER have an interruption in our medical care simply because we change jobs.
[sarcasm] Job Creators would suffer if employees were not motivated by fear to stay despite better prospects. Without the threat of insurance cancellation, employers would have to divert shareholder profits to compensating employees. Why do you hate Job Creators? Why do you hate America?
  #150  
Old 12-20-2018, 10:32 PM
survinga survinga is offline
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Quote:
Originally Posted by septimus View Post


I agree with this completely. It sums up the big problem. Getting from the present system to a single-payer UHC is hugely difficul. Obamacare was touted as a first step in the right directiont towards a goal that can only be achieved incrementally. (Obamacare with a public option would have been better it might have had 59 votes but was vetoed by the Senator from Insurancicut.) But the mandate was essential to ACA, and it was maliciously repealed by the very party that first explained its necessity.

Amazingly, even with all the sabotage that Trump has tried on the ACA, the exchanges are still standing. All counties in America have at least one insurer willing to sell. And the numbers signing up are still respectable.

http://acasignups.net/18/12/20/hcgov...ive-comparison

About 11.4 million expected to sign up. States that run their own exchanges are doing better at keeping their numbers up than states that are at the mercy of healthcare.gov. It looks to me like even without a functioning mandate, there's still an ability to keep the exchanges going and for companies to make money. I think we need a real mandate at some point. But glad the Trump sabotage isn't working so far.
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