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Old 03-08-2020, 07:03 AM
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...convince me to not support Universal Healthcare


...I'm self employed and I live in New Zealand.

I pay up to a maximum of $50.00 if I need to see the local GP but if my income were below a certain bracket I'd get a substantial discount. Each individual prescription cost me $5.00 each to a maximum of 20 prescriptions per year, then after that its no charge.

In 2016 I had a pulmonary embolism. The doctor told me "the good news is: you are not dead." But it was a close thing. They kept me in hospital for five days, treating me with blood thinners and for a bout of pneumonia. When I left the hospital the only bill that i had to pay was for the taxi home.

I got issued a CPAP machine to help me deal with issue with some of the effects of the PE. Cost out of pocket? 0. I have yearly catch ups with Respiratory doctors and nurses, cost out of pocket? 0. I met with a cardiologist every three months, then as I got better it became every six months, and now I see them once a year. Cost out of pocket for each of those visits? 0.

Last year I started to feel unwell again. On doctors advice I went to get a blood test: cost out of pocket: 0 . It was late Friday afternoon. When the results got faxed to the doctors surgery they were read by the duty doctor (not my personal doctor) who called me immediately and said the test showed an elevated level of somethingIdon'tunderstand and he recommended I got straight to the hospital to get further testing. He asked if he could call an ambulance for me, but I said I'd be fine to drive in. (The cost of the ambulance in Wellington would have been 0 )

I got to the hospital and I got a voucher to park my car overnight. (Cost of carparking out of pocket? 0 ) They admitted me immediately and started to run me through a barrage of tests including an MRI. Cost out of pocket, including an overnight stay in hospital, dinner and breakfast? 0. After they finished the testing the concluded that the elevated levels of somethingIdon'tunderstand was probably just a false positive, that this sometimes happened, but it was better to be safe than sorry. Cost out of pocket for me to spend a night in hospital just in case? 0.

It doesn't matter what flavour of Universal Healthcare we are talking about, the basic principle is the same. The goal is healthcare for all. Nobody misses out. I won't pretend that every country gets it right every time, that there aren't flaws or problems and that we all couldn't do better than we are. But we pay less per head than you do in America for (arguably) better outcomes overall.

So the Great Debate here is a simple one: convince me that we've got this one wrong. Convince me that we should switch to the American system, and explain to me how being self-employed in such a system would make me better off. I am at a loss on how to fund the American system here. The costs are sure to be staggering because adding an entirely new infrastructure of insurance companies whom add absolutely nothing of medical value and only exist to make a profit will surely just exponentially increase our costs. Major minus.

But I'm willing to be convinced. So tell me why countries with Universal Healthcare are doing it wrong, and what we should be doing instead. And while you are at it, convince me that the American Healthcare system isn't an absolute clusterfuck, a literal dystopian nightmare and one that the coronavirus is going to expose all of the failings in one horrible swoop.
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Old 03-08-2020, 08:33 AM
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I can't convince you, nor would I try. It seems like NZ's health system works quite well.

The debate we're having in the US is how to go from the shoddy, patchwork system we have now that works for people who don't get too sick too often or for too long...to one that reliably gives more people access to the health system without fear of bankruptcy. It's more politically challenging than it looks.
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Old 03-08-2020, 11:08 AM
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Let's see...the usual cases are dumb shit like wait times are shorter, I'll get to choose my plan/doctor that's right for me, the feds are too incompetent and fuck everything up. But what it all really is is the smug moral superiority of being able to say "I got mine, Jack."
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Old 03-08-2020, 11:20 AM
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Let's see...the usual cases are dumb shit like wait times are shorter, I'll get to choose my plan/doctor that's right for me, the feds are too incompetent and fuck everything up. But what it all really is is the smug moral superiority of being able to say "I got mine, Jack."
I thinks it's more that they're afraid they'll lose choice (of doctor, of treatment, etc.). They have visions of being treated the way we would hear about veterans being badly treated at poorly run VA hospitals. Seems like nothing will change their minds.
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Old 03-08-2020, 11:27 AM
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I thinks it's more that they're afraid they'll lose choice (of doctor, of treatment, etc.). They have visions of being treated the way we would hear about veterans being badly treated at poorly run VA hospitals. Seems like nothing will change their minds.
They’re delusional if they think they have “choice” now.
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Old 03-08-2020, 02:34 PM
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So the Great Debate here is a simple one: convince me that we've got this one wrong. Convince me that we should switch to the American system, and explain to me how being self-employed in such a system would make me better off. I am at a loss on how to fund the American system here. The costs are sure to be staggering because adding an entirely new infrastructure of insurance companies whom add absolutely nothing of medical value and only exist to make a profit will surely just exponentially increase our costs. Major minus.
Seems kind of silly and pointless. You obviously like your system. It does what you want it to do. You aren't bothered by the costs and think it's a good cost to benefit balance for you and, presumably, for your fellow New Zealanders. You certainly wouldn't want to enact a cluster fuck system such as ours in the US...no one would, since our system evolved over the last 100 years of changing needs and political shifts at all levels. Is there even any sort of push in your country for change?

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Originally Posted by asahi
The debate we're having in the US is how to go from the shoddy, patchwork system we have now that works for people who don't get too sick too often or for too long...to one that reliably gives more people access to the health system without fear of bankruptcy. It's more politically challenging than it looks.
Pretty much this. I assume this OP is yet another 'but we do it, so you can too!'. The problem is, we have a huge amount baggage and history in our system, and it's going to be a monumental task for us to shift direction, involving large billion or even trillion dollar corporations, political footballery, preconceptions, fears, and the fact that the new system will have to suddenly bring on 10's of millions of people who don't currently have full time healthcare. We have decades, nearly half a century of medical price fixing, basically, and a system and process that is completely entrenched. There isn't any easy fix, no magical silver bullet so that we can suddenly have UHC just like 'everyone else'...hell, looking at the various ways other countries do health care, there isn't even one model for us to go too, meaning that here in the US we have different people, sometimes in the same political party, who are looking at different potential solutions and fighting each other on which way we should go.

I get that folks from other countries don't understand why the US can't just be like them, and get frustrated when people tell them that it's not that easy. I also get that people want to pretend the US isn't unique and could be just like them, if only the Republican's or the Democrat's or whatever would just stop getting in the way. But we ARE different, our voters are different, our healthcare issues are different, our history is different, and if we were going to do this the easy way we needed to start down that path 70 or so years ago. Doing it today is going to be a major undertaking, and getting the voters on board is just one of the issues. You have to also get the various siloed and quasi-monopolistic regional healthcare providers on board, the hospitals and suppliers on board to change the various fixed pricing, the political parties on board, etc etc. It's going to be rough.

For the OP, I'm happy you like your system and wish there was a magic wand that would give us something like that, or something like what Canada has, or other systems, but there isn't. Be thankful you have a system that works for you.
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Old 03-08-2020, 02:57 PM
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Originally Posted by needscoffee View Post
I thinks it's more that they're afraid they'll lose choice (of doctor, of treatment, etc.). They have visions of being treated the way we would hear about veterans being badly treated at poorly run VA hospitals. Seems like nothing will change their minds.
I like my VA healthcare. It is infinitely better than the private insurance horror stories I read about all the time.
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Old 03-08-2020, 04:03 PM
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Is there even any sort of push in your country for change?
...no need for the dubious smilie. Of course there has been. Just look at how the NHS is under assault in the UK. In the 80's we saw a solid push by the then Labour government to privatise health services and bring in insurance companies. We managed to stop it at the time but profit motive is a powerful thing. It would be a dangerous thing to simply think "it cannot happen here."

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Pretty much this. I assume this OP is yet another 'but we do it, so you can too!'.
We can do it here. What is so unique and special about America that you can't do it there? Elizabeth Warren even had a plan to get you there. A plan developed by Americans that was adapted to your unique situation that was costed and fundable and doable. So why can't you do it?

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The problem is, we have a huge amount baggage and history in our system, and it's going to be a monumental task for us to shift direction, involving large billion or even trillion dollar corporations, political footballery, preconceptions, fears, and the fact that the new system will have to suddenly bring on 10's of millions of people who don't currently have full time healthcare.
So you have tens of millions of people who don't have "full time healthcare." Whats the plan to fix that? Do you not think it needs fixing? I just don't understand how you can admit that 10's of millions of people don't have access to healthcare yet you don't seem to want to do anything about it. Why not?

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We have decades, nearly half a century of medical price fixing, basically, and a system and process that is completely entrenched. There isn't any easy fix, no magical silver bullet so that we can suddenly have UHC just like 'everyone else'...hell, looking at the various ways other countries do health care, there isn't even one model for us to go too, meaning that here in the US we have different people, sometimes in the same political party, who are looking at different potential solutions and fighting each other on which way we should go.
I'm not sure why you are giving me this lecture. I fully comprehend that its going to be an uphill battle. But at some point if you think the system needs to change then you are going to have to start somewhere. But do you want the system to change? Or are you happy that 10's of millions of fellow Americans don't have access to healthcare?

And you don't have to look to overseas to find a model of healthcare. The experts have already done that for you. There exists a model to transition the US healthcare system to a universal one. Warren had a comprehensive plan and she has said that anyone who wants to use it is welcome to do so. Sanders doesn't have as strong of a plan but still, its a plan that is better than what you have now.

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I get that folks from other countries don't understand why the US can't just be like them, and get frustrated when people tell them that it's not that easy.
Strawman. Nobody expects it to be easy. But you are already waving the white flag. You aren't even trying. Paragraph after paragraph telling me "we are so special!!! We can't do it!"

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I also get that people want to pretend the US isn't unique and could be just like them, if only the Republican's or the Democrat's or whatever would just stop getting in the way. But we ARE different, our voters are different, our healthcare issues are different, our history is different, and if we were going to do this the easy way we needed to start down that path 70 or so years ago.
You don't get to do it the easy way. We all know that already.

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Doing it today is going to be a major undertaking, and getting the voters on board is just one of the issues. You have to also get the various siloed and quasi-monopolistic regional healthcare providers on board, the hospitals and suppliers on board to change the various fixed pricing, the political parties on board, etc etc. It's going to be rough.
Of course its going to be rough. Its going to be hard. Its going to be painful. Its going to be nasty.

None of this is a good reason to abandon 10's of millions of people with no access to healthcare.

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For the OP, I'm happy you like your system and wish there was a magic wand that would give us something like that, or something like what Canada has, or other systems, but there isn't. Be thankful you have a system that works for you.
This isn't about me. This is really about people like you. You can see the obvious benefits of healthcare centred around universality. But you don't want to support it because "its too hard." I'm sure the 10's of millions of people with no access to healthcare appreciate your concern.
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Old 03-08-2020, 04:04 PM
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I grew up in a nation (Taiwan) with single-payer. The only few legit gripes I can see in the system are:

1. Doctors and nurses are often paid relatively little. Indeed, many hospitals have to make ancillary income off of restaurants, convenience stores, etc. American doctors and nurses wouldn't like to be low-paid - especially considering that many U.S. doctors graduate med school with over $250,000 in student debt.

2. Many patients exploit the cheap healthcare for really unnecessary things like the common cold, trying to get their money's worth out of the system. Abuse of the system is common, not only straining the system but also overworking the (low-paid) medical staff.

3. There can be very long wait times for some procedures.



Is it better than America's current system? For sure. But single-payer has legit problems.

Last edited by Velocity; 03-08-2020 at 04:07 PM.
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Old 03-08-2020, 04:18 PM
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But single-payer has legit problems.
...the thread isn't about single-payer, but about the principle of universality. And the OP concedes there are problems and that no system is perfect. The question was can you convince me that countries that have adopted universal healthcare are doing it wrong? Doctors aren't that underpaid (in comparison to other work in society.) Waiting times are often comparable to wait times in America with the added bonus that eventually (unlike in America) everyone will get treated.

As for exploiting the system: accessing the system to get treatment for the common cold isn't "abuse." Its what the system is set up and designed for.
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Old 03-08-2020, 04:32 PM
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The US has something like twice the number of CAT scanners per capita as any other country.

The end result of that is that, because of American obesity, our average life expectancy is lower than everywhere else that would be worth comparing the US to. But that's a different quirk of America that has no real relevance to the discussion other than that it corrupts the numbers.

If Americans weren't fat - and yes, I've done the math - we would have comparable life span to other countries. Not above, just comparable. But we would still have twice the number of CAT scan machines.

The American system allows bonus money to flow into the system and that allows for cutting edge technology to break in earlier and come into wider use. On the other hand, cutting edge technology, in the world of health, is currently more of a gimmick for most cases than it is a savior. CAT scans don't save enough lives to change the results very much. Basic sanitation, healthy lifestyles, and vaccines are so immensely successful for longevity that once you add in the free cures that we have discovered for a few big diseases (like diabetes and malaria), it's really hard to find something that moves the needle at a population scale. Until we can break cancer (properly) and "heart disease", we're probably not going to see any big wins through advancing technology. If you have a disease, a particular breakthrough might mean all the world to you, but you're not the population at large.

The thing is, though, future tech exists when people pay for it. It doesn't come into being through magic and wishes.

There's nothing, theoretically, to stop governments from financing future tech but, from a practical standpoint, governments tend to be cheap because people refuse to vote for increased taxes. Other countries don't have CAT scans because they don't feel like putting forward the extra money to support progress.

Progress hasn't accomplished a ton (at a population level) for several decades, but it will eventually. And if the US ever goes single payer, it will throw the global medical industry into a crisis.

Ideally, all the countries would be splurging a little. The nice thing with open market usage is that the wealthy voluntarily spend for big medicine, where they won't pay for taxes.
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Old 03-08-2020, 04:33 PM
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Okay, here's one factor to consider: one aspect of New Zealand's universal health care policy is a "no fattys" immigration rule--if you are overweight, you aren't allowed to immigrate to New Zealand and if you are already there, you get kicked out. Does that ping your human rights radar?
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Old 03-08-2020, 05:18 PM
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I like my VA healthcare. It is infinitely better than the private insurance horror stories I read about all the time.
Yes, I was referring to the stories we used to hear about how bad it was in the recent past. We hear now about how much it's improved, and that's also what I hear from the people I personally know who are on it. To me, that's a pretty good indicator of how the system can make corrections when it's understaffed or mismanaged, which is what some people are so afraid of.

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Old 03-08-2020, 05:44 PM
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When is a New Zealander going to asks us why his nation’s gun banning is a mistake? Similarly, why doesn’t Eritrea stop being poor?

It’s complicated.
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Old 03-08-2020, 05:55 PM
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Okay, here's one factor to consider: one aspect of New Zealand's universal health care policy is a "no fattys" immigration rule--if you are overweight, you aren't allowed to immigrate to New Zealand and if you are already there, you get kicked out. Does that ping your human rights radar?
...several factors to consider: the New Zealand immigration policy is not "one aspect" of our universal healthcare system and policies, it is a separate and distinct system. You do not have a fundamental right to immigrate to another country, and it isn't a violation of human rights to refuse an application. There is plenty that myself and others disagree with about our immigration policy and we are working to make fundamental changes. If you want to start a thread to discuss this then you are welcome too and I would probably agree with a lot of what you said. But it has nothing to do with this discussion.

And for clarity: the person who (in 2013) was allegedly declined an extension to their work visa wasn't declined only because of their weight, but "the main reason Buitenhuis' application had been declined was due to the osteoarthritis in his knee." He still managed to get granted an extension to his work visa for an additional 23 months until what is described as a "new scuffle" occurred with immigration that prompted them to leave before they were deported. What that "new scuffle" was is entirely relevant to this particular case: but we don't know what that was.

As for fatties: I'm happy to say that I am a fattie, I've been a fattie most of my life, and being classified as a fattie has not restricted my access to the New Zealand healthcare system one bit, as can be demonstrated by what I wrote in the OP.
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Old 03-08-2020, 06:06 PM
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When is a New Zealander going to asks us why his nation’s gun banning is a mistake? Similarly, why doesn’t Eritrea stop being poor?
...most New Zealanders don't consider the gun banning to be a mistake.
And the ones that do are pretty vocal about it. And this thread is about universal healthcare. I'm sure you have strong feelings about Eritrea: but I don't know what it has to do with this thread.

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It’s complicated.
Whats complicated?
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Old 03-08-2020, 07:19 PM
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And while you are at it, convince me that the American Healthcare system isn't an absolute clusterfuck, a literal dystopian nightmare and one that the coronavirus is going to expose all of the failings in one horrible swoop.
Since you live in New Zealand, why are you so concerned about the healthcare system in America?
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Old 03-08-2020, 07:24 PM
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Since you live in New Zealand, why are you so concerned about the healthcare system in America?
...why wouldn't I be concerned at the plight and the suffering of 10's of millions of fellow human beings? I don't understand the question.
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Old 03-08-2020, 07:52 PM
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One interesting argument I got here from a poster (long since banned) could be summed up as:

"America is an exceptional place, in that there are many lazy, shiftless brown and black people who do not look after their health, and are not interested in pulling their own weight. Therefore, due to our exceptional situation with these lazy sick people who would probably go to a doctor every week for shits and giggles if it had no cost, we cannot possibly have Universal Healthcare."

As a bonus, he assured me that Canada would soon go completely bankrupt, as it was plainly evident that we could never afford Universal Healthcare, and also we were Godless Socialists.

I guess it's not too surprising that he got the ban-hammer.
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Old 03-08-2020, 08:11 PM
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Originally Posted by Banquet Bear
...no need for the dubious smilie. Of course there has been. Just look at how the NHS is under assault in the UK. In the 80's we saw a solid push by the then Labour government to privatise health services and bring in insurance companies. We managed to stop it at the time but profit motive is a powerful thing. It would be a dangerous thing to simply think "it cannot happen here."
There is approximately zero chance that the UK is going to dump the NHS...and your bio says you live in New Zealand. Has there been any serious attempt to change your system to something like the US?

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We can do it here. What is so unique and special about America that you can't do it there? Elizabeth Warren even had a plan to get you there. A plan developed by Americans that was adapted to your unique situation that was costed and fundable and doable. So why can't you do it?
People have tried and continue to try. I suspect that even if Bernie gets elected (note that Warren dropped out), he will try and maybe some progress will be made. But they will be baby steps. Kind of like what Obama had to settle for. The reasons boil down to what makes the US unique and one of the few western nations without some sort of single payer or universal healthcare.

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So you have tens of millions of people who don't have "full time healthcare." Whats the plan to fix that? Do you not think it needs fixing? I just don't understand how you can admit that 10's of millions of people don't have access to healthcare yet you don't seem to want to do anything about it. Why not?
There isn't one. There hasn't been one. What we do is we kick the can down the road, and we have a bunch of ad hoc methods to deal with it, which mainly boil down to emergency care being basically free, and any sort of supportive care being out of reach to anyone without a full time job with benefits. It's stupid, but it's what we've been doing for decades now. If it could be fixed easily by simply pointing out the failings we'd have collectively fixed it by now. Again, it's one of the things that makes us unique, since, pretty obviously, no one else does stupid shit like this.

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I'm not sure why you are giving me this lecture. I fully comprehend that its going to be an uphill battle. But at some point if you think the system needs to change then you are going to have to start somewhere. But do you want the system to change? Or are you happy that 10's of millions of fellow Americans don't have access to healthcare?
Do you though? Because your follow on questions seem to indicate you don't...not really. Again, if it was something we could just hear lectured to us for the millionth time by someone from another country and have a eureka moment, we'd have done that half a century ago. Or maybe 75 years ago.

Do I want the system to change? Absolutely. Do I want 10's of millions to not have healthcare? Nope, I definitely don't want that and think that the richest country on the planet SHOULD be able to figure this out. But we haven't so far, and I'm doubtful it's going to happen when/if a Democrat becomes president, any more than it will happen under the Republicans. I also think that the compromise system that will inevitably happen will be basically more like the ACA than UHS, and it will put in yet more baggage.

No political party has the power in the US to just junk the old system and bring in something like what you have...what the Brits have...even what the Germans or Japanese have. Instead, we have basically a dystopian system more like what China has.

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Strawman. Nobody expects it to be easy. But you are already waving the white flag. You aren't even trying. Paragraph after paragraph telling me "we are so special!!! We can't do it!"
Again, this gets back to your assertion you understand, when clearly you don't. It's not that it's not easy...of course it isn't easy. It wasn't all that easy for Canada to bring in it's current system, and they had far less baggage than we do. But their political system is nothing like ours. Another one of those things that make us unique that you clearly don't get or don't agree is unlike any other.

That said, people HAVE and CONTINUE to try. Several Democrats ran on healthcare reform. Our former president ran on it. He actually had a majority in the house as well. And what we got was STILL a compromise system that didn't really please anyone, didn't really fix anything major. If Bernie can do it, fine by me. I plan to hold my nose and vote for ANYONE but Trump. But I don't see it happening, and it's not ME that is the problem.

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This isn't about me. This is really about people like you. You can see the obvious benefits of healthcare centred around universality. But you don't want to support it because "its too hard." I'm sure the 10's of millions of people with no access to healthcare appreciate your concern.
Well, I get that...you didn't really expect or want to be convinced. Nor do the majority of your countrymen. For good reason...you aren't idiots. But, again, you really don't grasp the core issues of WHY the US hasn't gone to UHS or a single payer, or even something like Medicare for all....or anything else remotely like that. You don't really understand the dynamics or why it's more than simply 'too hard'.
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Old 03-08-2020, 08:56 PM
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There is approximately zero chance that the UK is going to dump the NHS...and your bio says you live in New Zealand. Has there been any serious attempt to change your system to something like the US?
I can tell you that there is zero chance of abolishing the single-payer system in Canada. Various provinces are always talking about relatively minor kinds of tweaks and reorganizations to improve efficiencies and the provinces are always arguing with the feds about the amount of health care transfers, but no sane politician with any hope of being elected -- of any political stripe including the most staunch conservative -- has ever said "let's go to a US-style of private insurance". If one did, he might be the first politician in history to get exactly zero votes.

As a side note, under the Canada Health Act and the general principle of provincial autonomy, any province is free to ignore the CHA and go it alone with a system of fully private US-style insurance companies. They would then lose federal health subsidies but since private insurance is so wonderfully efficient they'd get a net benefit, right? Guess how many provinces have done this? Guess how many have even considered it? If you astutely guessed zero and zero, congratulations. Remember that single-payer UHC was not forced on the provinces; it started in Saskatchewan, and was adopted by the provinces one by one in response to its performance and public demand. The Canada Health Act was just a later initiative to enshrine its principles as national values and establish a baseline of uniform national standards.
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Old 03-08-2020, 09:02 PM
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There is approximately zero chance that the UK is going to dump the NHS...
...with Brexit and the lack of any substantial trade deals on offer the odds that the fundamental nature of the NHS will be changed beyond recognition are not "at zero." There have already been substantive changes in the UK and over a decade of austerity hasn't helped.

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and your bio says you live in New Zealand. Has there been any serious attempt to change your system to something like the US?
Not only does my bio say I live in New Zealand: the very first sentence in the OP says "I'm self employed and I live in New Zealand." And as I said in my original response to you:

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In the 80's we saw a solid push by the then Labour government to privatise health services and bring in insurance companies. We managed to stop it at the time but profit motive is a powerful thing. It would be a dangerous thing to simply think "it cannot happen here."
So yes there was a serious attempt to change our system. In 1984 David Lange's government introduced "rogernomics", a raft of reforms that deregulated industries and shifted many different government agencies to "user pays."

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People have tried and continue to try. I suspect that even if Bernie gets elected (note that Warren dropped out), he will try and maybe some progress will be made. But they will be baby steps. Kind of like what Obama had to settle for. The reasons boil down to what makes the US unique and one of the few western nations without some sort of single payer or universal healthcare.
It doesn't matter that Warren dropped out. You are arguing that America and Americans are so different and so unique that what works in other countries could not possibly work in America. But Warren had a plan that was drafted by Americans, unique to America, it was costed, fundable and doable.

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There isn't one. There hasn't been one. What we do is we kick the can down the road, and we have a bunch of ad hoc methods to deal with it, which mainly boil down to emergency care being basically free, and any sort of supportive care being out of reach to anyone without a full time job with benefits. It's stupid, but it's what we've been doing for decades now. If it could be fixed easily by simply pointing out the failings we'd have collectively fixed it by now. Again, it's one of the things that makes us unique, since, pretty obviously, no one else does stupid shit like this.
Nobody is expecting an easy fix. And this thread really isn't about pointing out "the failings" of the US system. There is another thread on the front page titled "Convince me to support single-payer" and this thread is the corollary to that. This thread asks the question "convince me not to support Universal Healthcare." If you aren't interested in convincing me then there really isn't a lot more to discuss.

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Do you though?
Yep.

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Because your follow on questions seem to indicate you don't...not really. Again, if it was something we could just hear lectured to us for the millionth time by someone from another country and have a eureka moment, we'd have done that half a century ago. Or maybe 75 years ago.
Maybe you don't need the lecture. But people in this thread obviously do. Feel free to tune out, if you must.

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No political party has the power in the US to just junk the old system and bring in something like what you have...what the Brits have...even what the Germans or Japanese have. Instead, we have basically a dystopian system more like what China has.
Yep. If you want universal healthcare it is going to take a lot of hard work. Better roll up your sleeves. You need to win the House, the Senate and the Presidency just for starters. You've got a lot of hard work ahead of you.

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Again, this gets back to your assertion you understand, when clearly you don't.
I understand it much better than you think.

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It's not that it's not easy...of course it isn't easy. It wasn't all that easy for Canada to bring in it's current system, and they had far less baggage than we do. But their political system is nothing like ours. Another one of those things that make us unique that you clearly don't get or don't agree is unlike any other.

That said, people HAVE and CONTINUE to try. Several Democrats ran on healthcare reform. Our former president ran on it. He actually had a majority in the house as well. And what we got was STILL a compromise system that didn't really please anyone, didn't really fix anything major. If Bernie can do it, fine by me. I plan to hold my nose and vote for ANYONE but Trump. But I don't see it happening, and it's not ME that is the problem.
You have done nothing but agree with me. You concede its going to be hard. I accept its going to be hard. What is it do you think I don't understand?

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Well, I get that...you didn't really expect or want to be convinced. Nor do the majority of your countrymen. For good reason...you aren't idiots. But, again, you really don't grasp the core issues of WHY the US hasn't gone to UHS or a single payer, or even something like Medicare for all....or anything else remotely like that. You don't really understand the dynamics or why it's more than simply 'too hard'.
And you've done an exceptionally poor job of explaining why you haven't gone to UHS.

But you don't have to explain it to me. I understand exactly what the problem is. America is a country that began with the subjectation of the original indigenous population, it was built off the backs of slavery, its a nation full of hypocritical values and is currently in the grips of a white supremacist regime that doesn't want to let go of any power. Most of the population has been effectively "brainwashed" by decades of propaganda that "greed is good" and "socialism is bad". There isn't any rational reason why America hasn't gone to UHS.

And healthcare is just a mere part of this. But the reality is that things are going to have to eventually start falling apart. You've got a system where people who work in the most vulnerable industries like food service can't afford to go to the doctor, can't afford to take time off work, who for decades have historically gone to work sick because if they didn't they would lose their job. And with a pandemic looming around the corner what options are going to be available for these people to self-quarantine?

You act like you've got all the time in the world to fix this but you really don't.
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Old 03-08-2020, 11:30 PM
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...why wouldn't I be concerned at the plight and the suffering of 10's of millions of fellow human beings? I don't understand the question.
It comes across as a little odd to be so concerned about something happening thousands of miles away, which doesn't affect you at all. Just saying.
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Old 03-08-2020, 11:32 PM
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It comes across as a little odd to be so concerned about something happening thousands of miles away, which doesn't affect you at all. Just saying.
So you want him to explain empathy to you?
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Old 03-09-2020, 12:03 AM
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It comes across as a little odd to be so concerned about something happening thousands of miles away, which doesn't affect you at all. Just saying.
1. It's an important debate about a major socioeconomic issue. Why does it matter where someone lives, if they can contribute useful information?

2. I myself live close to the US border and worry about the constant attempts by US private clinics and private insurers to try to insinuate themselves back into Canada after being kicked out circa 1960s. Think in terms of thousands of Mexicans and Central American migrants at your Mexican border clamoring to get in, and you begin to get the idea, except that most of these immigrants would likely productively contribute to the economy, whereas health insurers would steal from it, like parasitic leaches. Except instead of poor Central American migrants they would be white men in suits driving Porsches.

3. I find most posts defending the US health care system to be entertaining, a lot like opening the Saturday morning newspaper and turning to the comics section.
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Old 03-09-2020, 12:26 AM
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Having lived under both systems, both US and Australia - UHC is superior in every single way.
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Old 03-09-2020, 12:31 AM
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Universal healthcare is a no brainer in a high trust society like New Zealand.

On the other hand, the USA has far more corruption, incompetence, dysfunction, and indifference. We see how our public schools function and extrapolate from there to imagine what universal healthcare will look like. Once universal healthcare comes to the USA, the doctors and nurses will unionize and make more money than ever before. The same with drug companies and medical equipment manufacturers. Have you ever heard of a public school system bragging about saving money? All we ever hear is that public schools are underfunded. I live the highest taxed state in the union and yet in the last election there was a bond measure for 15 billion dollars because the schools are unsafe with asbestos and lead paint. How could this be in a Democrat utopia? The students and their parents are all hot messes, and the teachers and administrators are as greedy as any CEO.
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Old 03-09-2020, 01:20 AM
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But do you want the system to change? Or are you happy that 10's of millions of fellow Americans don't have access to healthcare?
How do I approach this thread? It's very similar to my own thread. I can't object to health insurance in New Zealand, as you have described it. I cannot convince you to "not support Universal Healthcare", and thus will not attempt to do so.

You seem to want to understand Americans who do not support Elizabeth Warren's plan. I have not looked at Elizabeth Warren's plan, therefore I cannot support it. Senator Warren dropped out of the race before appearing on any ballot I might cast a vote on, as such, I haven't had the occasion to take a good look at her plan - despite my recent attempt to find and understand details about "Medicare-for-All". I probably should look at her plan, at some point.

My default position is status quo: until I am convinced that some proposal will make things better, I will prefer what we have now, even if it is unfair or inefficient, because in my uninformed opinion it works well enough for most people. At the same time, I am not happy that "10s of millions" of fellow Americans don't have access to healthcare. As far as I know, these two opinions are compatible - you have framed your questions much like a false choice.

In conclusion, I think you underestimate the pure apathy of Americans such as myself. I really don't care that much about politics, and it doesn't get much more political than some Democratic Senator's dead-on-arrival bill.

~Max
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Old 03-09-2020, 01:46 AM
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Universal healthcare is a no brainer in a high trust society like New Zealand.

On the other hand, the USA has far more corruption, incompetence, dysfunction, and indifference. We see how our public schools function and extrapolate from there to imagine what universal healthcare will look like. Once universal healthcare comes to the USA, the doctors and nurses will unionize and make more money than ever before. The same with drug companies and medical equipment manufacturers. Have you ever heard of a public school system bragging about saving money? All we ever hear is that public schools are underfunded. I live the highest taxed state in the union and yet in the last election there was a bond measure for 15 billion dollars because the schools are unsafe with asbestos and lead paint. How could this be in a Democrat utopia? The students and their parents are all hot messes, and the teachers and administrators are as greedy as any CEO.
Exuding ignorance there, there are already unions for doctors and nurses in the US. Although as The New Yorker notices, balkanized an in need to counter the dastardly corruption seen in the USA.

https://www.newyorker.com/culture/an...hould-organize

And yes, schools are underfunded, especially when one takes into account that we do not do much into helping the families of the students, past discussions and evidence have made me realize that it is a crucial thing that has very little funding in poor schools.

https://www.cbpp.org/research/povert...n-succeed-over

-Ed (who has worked in public and charter schools.)
  #30  
Old 03-09-2020, 01:53 AM
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My default position is status quo: until I am convinced that some proposal will make things better, I will prefer what we have now, even if it is unfair or inefficient, because in my uninformed opinion it works well enough for most people. At the same time, I am not happy that "10s of millions" of fellow Americans don't have access to healthcare. As far as I know, these two opinions are compatible - you have framed your questions much like a false choice.
Sorry, but in that opinion, there is a real false choice.

-Ed, (who is currently without health insurance and under self quaranteen as I have the flu, that I hope is the common one, and not something worse.)

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Old 03-09-2020, 03:03 AM
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I would actually really like to know what happened to healthcare, because when I was younger it seemed fine, at least where I was (Denver). There was a charity hospital, Denver General, that provided care to any city resident. You did not have to be a charity case, it was ANY RESIDENT, on a sliding scale. It had clinics for various things, and of course if you came into the emergency room they'd fix you up no problem. You did have to jump through a few hoops, like bring in your check stub or your tax return, and that determined how much you were charged on their sliding scale. For instance at the time, mid-70s, I, a really underemployed 20-something, was on the next to the lowest tier, so when I went in to get my eyes checked it cost $1. When I went in with a UTI it cost $1. When I went in to the emergency room to see if I had a broken arm (I didn't) it cost $1. Show your card, pay $1. People making more money could pay more, but still not a lot. However, people with more money went somewhere else, usually.

There was a similar program for people who weren't residents of Denver but were residents of Colorado, Colorado General. The problem was, CG was also in Denver, so anyone using it had to get here and Denver is not the center of the state. CG did have some outposts but rural residents were pretty much SOL.

Now here's a little tale (TLDR warning!) In something like 1974 I was playing soccer in the park with some friends and I attemped to kick the soccer ball and instead tripped over it and fell. I threw out my right arm to catch myself and hurt my wrist. Was it broken? It really hurt, and it was swelling pretty badly, so off I went to DG to see if it was broken, or what. Not broken, but sprained. They x-rayed it, then wrapped it in an Ace bandage, then gave me a prescription for painkillers (which I could not open because I only had one hand. $1

In 2012 I did pretty much the same thing, having learned nothing about proper kicking technique over the years. This time it was one of those construction sandbags, which was lying on the sidewalk and blocking it. I intended to use my foot to nudge it out of the way and instead, you guessed it, I tripped on it. Once again I tried to break my fall using my arm, the left one this time because I had my dog's leash in my right hand. And once again that was the wrong move and it hurt like hell. In addition, this time I banged my face into the street, too. It went numb and my lip bled like crazy.

In 2012 I had health insurance, and yet I was too afraid of the cost to go to the ER and get it checked out. I figured if it still hurt after a week or so I might go in. Why didn't I go in? BEcause the last time one of my family members went to the ER for something (six months or so before) it cost us $1200, which was 20% of the total bill, and what was done? Well, my son had had a bicycle misfortune resulting in a very deep gouge in his leg. It was ugly and it was deep. I called his pediatrician and described it, and the doc said take him to the ER, so I did. They did not x-ray it, and they did not put in stitches. They did power-scrub it and apply antibiotics and a really nice bandage. If $1200 was 20% then that little outing, which took about an hour, most of which was waiting, cost $6000. So, in short, I wasn't going to risk it for some trifle like a possibly broken wrist, even though (a) the first time I did it I was 40 years younger, and (b) the first time I did it I fell on grass, not concrete. This $1200 bill was still very fresh in my mind and yet it hadn't made much of a dent in my deductible. So, I passed.

So what happened between 1974 and 2012 that made a pretty routine health-care thing so out of reach? Obviously I did not really require any care in either instance--both times my wrist hurt for awhile, then got better. But that's, like, 95% of doctor visits, things would improve with or without a doctor. You go in to make sure you're not in the 5%.

(In retrospect I would still have taken my son in, because that WAS a nasty-looking wound, and they expertly applied the butterfly bandage so he wouldn't need stitches, but sheesh, why the hell would that cost $6000?)

So, what happened in Denver to make health care out of reach? Not that it was out of reach but, you know, I'd rather have a broken bone than lose my house. If it was a heart attack I might think, hmm, my money, or my life? And I'd probably call the squad.

Did I ruin the system by going in for something that turned out not to be all that serious? Well okay, now the system is fixed; I will not be going in for something I don't think is all that serious. Or pretty much anything.

I have heard people say the system was ruined because of all the illegal immigrants, or actually what those people call them is, "the illegals." I DON'T BELIEVE THAT. Why would they be any more unhealthy than legal Colorado natives? Why would they make more trips to the ER and the various clinics? Answer, they would not. If they're really here illegally they are trying to stay under the radar. Going through the hoops to get a clinic card could very well expose them to deportation. I guess if someone was going to argue that they overtaxed the ER, which has to take you if you're about to die and no card required, I could probably refute that argument too. Unless you're in active labor or in danger of losing life, sight, or limbs, the ER does NOT have to take you.

I did ask my kids' doctor why one of them got his full first year of health care including shots, well child visits, and sick child visits, for $88 (for the whole year) and, 16 years later, it cost $128 for his little brother to have ONE appointment. She said, "Insurance--we used to have our receptionist do it, now we have to have three people, full-time to keep up with it." I don't buy that that's the whole story but I'm sure it's part of it. I've also heard that transplant surgeries have caused costs to go up; medical equipment has caused costs to go up; and I know that all the hospitals in Denver (including the charity hospital) were building, building, building, continuously, all those years when costs were going up. (Including CG, which kept building, building, building, and remodeling, right up until the very actual day it moved to another location.)

Oops, guess I failed at convincing the OP to oppose UHC.
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Old 03-09-2020, 09:29 AM
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I get that folks from other countries don't understand why the US can't just be like them, and get frustrated when people tell them that it's not that easy.
Speaking as a foreigner, I totally understand why it isn't easy. It would be the biggest, most complex government-driven policy change in American history that did not involve a war. It's DOABLE, but no one said it would be easy.

Speaking as a Canadian, I'd point out that the USA also has constitutional issues, concerning the split of powers between Washington and the states. Canada has a similar issue, which is why Canada does not in fact have a national health care system; it has provincial health care systems, which the federal government funds on certain conditions but cannot directly control. It is a system that has to meet Canada's federally organized nature, as would the USA's, and even then I would not suggest Canada's system be adopted wholesale; it's not perfect and is almost certainly not the best one around.
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Old 03-09-2020, 09:56 AM
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Sorry, but in that opinion, there is a real false choice.
What do you mean when you write "a real false choice"?

~Max
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Old 03-09-2020, 10:37 AM
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It's the difference between 'convince me to quit my well paid and mostly satisfying job', and 'convince me to quit my underpaid job and take a leap into the unknown in the hope of getting a better one'. Only one of those is going to spark a serious discussion.

Banquet Bear, you're in the best position to say what the downsides of the NZ system are. I could list some for the NHS - shortage of doctors and nurses, shortage of beds, waiting times, the postcode lottery, local hospitals closing or offering fewer services to save money, various scandals of substandard treatment. All mostly caused by chronic underfunding. Even then, it doesn't mean that switching to a private system would be the best way to solve them, or would necessarily solve them at all.

Do you think there would be any benefits at all to moving to a US-style system? For you or NZ in general.
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Old 03-09-2020, 12:03 PM
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But I'm willing to be convinced.
Sure, buddy
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Old 03-09-2020, 12:54 PM
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What do you mean when you write "a real false choice"?

~Max
For this message board, going for "in my uninformed opinion" is not only choosing ignorance as way of life, but also to support others that also willfully ignore that having a population living in fear of treatment due to costs leads to a population were a health issue like a pandemic can become disaster rather than a just a serious problem.

Last edited by GIGObuster; 03-09-2020 at 12:57 PM.
  #37  
Old 03-09-2020, 01:09 PM
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...convince me that we've got this one wrong. Convince me that we should switch to the American system, and explain to me how being self-employed in such a system would make me better off. I am at a loss on how to fund the American system here. The costs are sure to be staggering because adding an entirely new infrastructure of insurance companies whom add absolutely nothing of medical value and only exist to make a profit will surely just exponentially increase our costs. Major minus.

But I'm willing to be convinced. So tell me why countries with Universal Healthcare are doing it wrong, and what we should be doing instead. And while you are at it, convince me that the American Healthcare system isn't an absolute clusterfuck, a literal dystopian nightmare and one that the coronavirus is going to expose all of the failings in one horrible swoop.
There are plusses and minuses to the health care model that distributes health care based on ability to pay rather than need. It's hard to see how the plusses outweigh the minuses but if you're asking for an argument...

If you are wealthy, then distributing health care based on ability to pay can be very good for you. Our high end health care is in general much better than the high end of universal health care plans. But it will cost you How successfully self-employed are you?

Drug companies will spend more money dealing with the health issues affecting Americans than those affecting the health issues of countries that provide less profit. America is full of fat fuckers like me and we need diabetes and heart medication. And drug companies know they can make more money coming up with ways to treat me than coming up with ways to treat malaria. Are there health issues that are unique to New Zealand that is not getting sufficient attention because universal health care reimbursement formularies do not encourage research in those areas?

The downside is lower average lifespans, higher morbidity, lower productivity, higher total health care costs.

As the saying goes, universal health care is the system you want for your country, the American system is the system you want for your family (if you can afford it), espcially if you're fat rich and impotent..
  #38  
Old 03-09-2020, 01:11 PM
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For this message board, going for "in my uninformed opinion" is not only choosing ignorance as way of life, but also to support others that also willfully ignore that having a population living in fear of treatment due to costs leads to a population were a health issue is easier to become a disaster rather than a just a serious problem.
Boy, that is a sentence to unpack.

I wrote, "My default position is status quo: until I am convinced that some proposal will make things better, I will prefer what we have now, even if it is unfair or inefficient, because in my uninformed opinion it works well enough for most people."

I won't argue with your description of me as being ignorant, although I wouldn't say I choose ignorance. But you are wrong to suggest that I "willfully ignore" the chilling effect a medical bill has on personal health. You mentioned having flu symptoms yourself - not seeking treatment during a pandemic could have negative impacts on a societal level. I am not ignoring these impacts.

It would appear that you see some sort of contradiction here, but I do not. You will have to be more specific.

~Max
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Old 03-09-2020, 01:23 PM
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I actually agree that the US should eventually adopt UHC but to the OP, quite frankly you and other non-Americans ask this question often with an attitude of like "stupid Americans".

I dont think you get it. You just cannot see how big and complex the US is compared to places like NZ. We are not stupid. We see the benefits.

Many if not most of us WANT UHC. It's just the complexity that's holding us back

We are working on it.
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Old 03-09-2020, 01:26 PM
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Boy, that is a sentence to unpack.

I wrote, "My default position is status quo: until I am convinced that some proposal will make things better, I will prefer what we have now, even if it is unfair or inefficient, because in my uninformed opinion it works well enough for most people."

I won't argue with your description of me as being ignorant, although I wouldn't say I choose ignorance. But you are wrong to suggest that I "willfully ignore" the chilling effect a medical bill has on personal health. You mentioned having flu symptoms yourself - not seeking treatment during a pandemic could have negative impacts on a societal level. I am not ignoring these impacts.

It would appear that you see some sort of contradiction here, but I do not. You will have to be more specific.

~Max
Sure there is, stop choosing ignorance or stop posting in a message boards where that is not kosher.
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Old 03-09-2020, 02:59 PM
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Sure there is, stop choosing ignorance or stop posting in a message boards where that is not kosher.
One does not simply "stop choosing ignorance"... We aren't talking about willful ignorance here, I don't know what it is that you think I am ignorant of...

~Max
  #42  
Old 03-09-2020, 03:39 PM
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One does not simply "stop choosing ignorance"... We aren't talking about willful ignorance here, I don't know what it is that you think I am ignorant of...

~Max
Well, for starters you unpacked what I said the wrong way, I was responding to your seemingly way of responding in treads like this in a 'devil's advocate way'. It does not magically make the argument that I'm making here to be an invalid one.

So, besides your argument from ignorance being contradictory to what this message board is, there is then the reality that the system we have now is not only inefficient, with fewer liberties and more barriers for new entrepreneurs or business to appear, but created almost made to order to fall apart if a pandemic shows up.

The logical thing is not to then "claim to not ignore those impacts" and then for all intents and purposes act as if they can be ignored.

Last edited by GIGObuster; 03-09-2020 at 03:40 PM.
  #43  
Old 03-09-2020, 07:29 PM
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Well, for starters you unpacked what I said the wrong way, I was responding to your seemingly way of responding in treads like this in a 'devil's advocate way'. It does not magically make the argument that I'm making here to be an invalid one.
I'm not being a devil's advocate, at least not in this thread or the other thread about healthcare. The only problem I have with your posts is that I don't see where you have made an argument. "Willful ignorance" argument aside, you have presented plenty of premises along the lines of, the U.S. system is bad. I haven't contested those premises. Yet, I get the distinct feeling that you and I disagree about something. I have a pretty good guess as to what it is, too.

Look, I don't want to clog up Banquet Bear's thread with a duplicate of my own. We have a thing going on over there. I stopped by in this thread to concede defeat to the challenge in the original post, to point out my own apathy for change, and perhaps provide the perspective of some subset of Americans who think like me. You say this is an argument from ignorance, because it is - I put the burden of proof on he who is against the status quo. Being altogether undecided on the best system of health insurance, I am in no position to convince someone to abandon their present system. I cannot convince Banquet Bear to oppose universal healthcare.

~Max
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Old 03-09-2020, 07:39 PM
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Being altogether undecided on the best system of health insurance, I am in no position to convince someone to abandon their present system.
...this thread has absolutely nothing to do with health insurance. It has everything to do with healthcare. Perhaps if you could understand the distinction you would be in a much better place to understand what other people are saying to you in your own, parallel thread.
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Old 03-09-2020, 07:42 PM
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...this thread has absolutely nothing to do with health insurance. It has everything to do with healthcare. Perhaps if you could understand the distinction you would be in a much better place to understand what other people are saying to you in your own, parallel thread.
Apologies, the two terms (as used) are synonyms in my book.

~Max

Last edited by Max S.; 03-09-2020 at 07:44 PM. Reason: as used
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Old 03-09-2020, 07:46 PM
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Banquet Bear, you're in the best position to say what the downsides of the NZ system are. I could list some for the NHS - shortage of doctors and nurses, shortage of beds, waiting times, the postcode lottery, local hospitals closing or offering fewer services to save money, various scandals of substandard treatment. All mostly caused by chronic underfunding. Even then, it doesn't mean that switching to a private system would be the best way to solve them, or would necessarily solve them at all.
...the obvious solutions to the problems with the NHS would be to stop the chronic underfunding, wouldn't you agree?

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Do you think there would be any benefits at all to moving to a US-style system? For you or NZ in general.
As I've already said: they tried in the 80's. The only thing that changed was that people had to pay more money out of pocket. The taxes didn't go down, the waiting lists didn't go down, the level of service at the hospitals didn't go down. They abandoned the reforms because they didn't make anything better and made things worse and harder for the average patient.

What is it do you think would be improved with the US style system?
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Old 03-09-2020, 08:10 PM
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Apologies, the two terms (as used) are synonyms in my book.

~Max
...its a fundamental difference between what you find in most parts of the world and what happens in America. Do you really not understand that the two terms are not interchangeable?

I don't have to pay any health insurance premium at all to access the healthcare system here. As outlined in the OP I pay my taxes, I pay for my GP and I pay for prescriptions. If my income was lower I'd get discounts, and there are additional layers of safety net in case my income was lower still.

I can choose to pay additional money for private health insurance. If I did this it would mean that I would probably be able to get a private room. I might be able to jump the queue for non-urgent care. But having health insurance isn't a matter of life or death here. I'm self-employed and I didn't have to liquidate my businesses to spend a week in hospital. No co-pays. No minimum payments. No bills after the fact.

There are some universal systems that do rely on mandatory insurance. But those systems, unlike America, are very tightly controlled.

America spends more on healthcare yet has less Doctors than the rest of the OECD. America spent $9,892 per person (in 2016) in comparison to $4,033 for OECD countries and the American system isn't even universal. 10's of millions of people miss out. You have to pay taxes and then you have to pay insurance and at best you get the same level of care as other countries while millions of your fellow citizens can't access the healthcare system at all.

This isn't apples and oranges. This is apples and a great big container of rotting, festering fruit. You have HUGE gaps in your knowledge. I would suggest that you stop arguing so authoritatively over in your own thread about something you know so little about.
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Old 03-09-2020, 08:57 PM
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I'm not sure why you are giving me this lecture. I fully comprehend that its going to be an uphill battle. But at some point if you think the system needs to change then you are going to have to start somewhere. But do you want the system to change? Or are you happy that 10's of millions of fellow Americans don't have access to healthcare?
This is going to sound heartless, but I suspect that what is most likely to compel a lot of us to have a paradigm shift is something like...COVID-19. An epidemic *could* (not necessarily would) expose some of the problems of having a health system that people are afraid to use because they might incur expenses they can't pay back, and that when you have thousands of people who avoid health clinics during a pandemic, that eventually bites everyone in the ass, regardless of income or wealth.

But honestly, Americans are so individualistic, so brainwashed to embrace individualism and clannishness that I'm skeptical that we'll ever change unless there's a shock event so major that it fundamentally terrifies the shit out of all of us - and in those situations there's absolutely no guarantee that people collectively experience a Eureka moment; they could just as easily strip themselves of grey matter and go back to their inner caveman. This is what scares me right now. I don't see COVID-19 as necessarily the end of Trumpism; I see it as something that could push European and the American governments - in France, in Germany, in anywhere - into the arms of right wing extremists. The initial reaction may be critical of a Trump, but the real reaction will be that globalism is the problem. COVID-19 was introduced by 'furriners'. The economic impact is 'global'. I could easily see people going deeper and deeper into the cave.

Last edited by asahi; 03-09-2020 at 09:00 PM.
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Old 03-09-2020, 09:28 PM
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...this thread has absolutely nothing to do with health insurance. It has everything to do with healthcare. Perhaps if you could understand the distinction you would be in a much better place to understand what other people are saying to you in your own, parallel thread.
But health insurance is a key part of health care. It's important to understand that to have an intelligent discussion about this.

It's why it drives me a little nuts when people talking about Canada having a "universal health care system." It does not. It has a universal health insurance system (well, a number of systems) which enables Canadians to access health care. This isn't unique to Canada; Germany has universal (multi payer) health insurance. France has national health insurance, too.

Max S's "the two terms are interchangeable in my bnook" comment is... well, amazing, to put it kindly. Confusing health insurance with health care is like confusing car insurance with a car. But that's not to say the concept of health insurance is useless here.
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Last edited by RickJay; 03-09-2020 at 09:28 PM.
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Old 03-10-2020, 02:58 AM
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But health insurance is a key part of health care. It's important to understand that to have an intelligent discussion about this.

It's why it drives me a little nuts when people talking about Canada having a "universal health care system." It does not. It has a universal health insurance system (well, a number of systems) which enables Canadians to access health care. This isn't unique to Canada; Germany has universal (multi payer) health insurance. France has national health insurance, too.

Max S's "the two terms are interchangeable in my bnook" comment is... well, amazing, to put it kindly. Confusing health insurance with health care is like confusing car insurance with a car. But that's not to say the concept of health insurance is useless here.
Health "insurance" is not a key part of health care.

In the first place insurance is a business, and it's the business of maximizing returns, or in other words, making money. One really good way to do that is to get millions of people to pay a set amount every month, or quarterly, or yearly. Insurance companies do that. The second thing is not to pay out too much, and insurance companies, particularly health insurance companies, are also very good at that, too. If they take in a lot more than they pay out--and they always do--their owners and executives get bonuses. The top people almost always get bonuses, along with country club memberships, company cars, and expense accounts.

Insurance is not intrinsically a great thing that lots of people want, which is why millionaire lawmakers create laws requiring people to have it (i.e., auto insurance, which almost every state mandates). Insurance is a thing that insurance companies work very hard to make sure people think they want it and need it, and the insurance industry has been very successful. That industry is spending your money to make you think you need its product.

But it has nothing to do with health care. That's, like, almost a Maguffin, for an insurance company. The health care is not the product. The money is the product. The ROI is the product.

Universal health care (or single-payer as it gets referred to) would cut out most of the hierarchy of people standing by to collect small fortunes by virtue of the money people send in to insurance companies.

You can certainly have universal health care without "insurance." Sure, there will have to be a few non-health-providers in the system who do things like figure out how much staff to hire and obviously there should be some actual health-care providers in the mix--doctors, nurses, technicians--to inform the decision making. What you don't need is hospital executives whose only function is to be taken to lunch by insurance company executives to discuss how much they can charge for a given procedure.

ETA: What you particularly do not need in universal health care is gatekeepers who decide whether a procedure is necessary and whether it is covered. It is the health-care providers who decide whether it's necessary and also (I would hope) whether the patient is likely to survive it and whether it's likely to be beneficial.

Last edited by Hilarity N. Suze; 03-10-2020 at 03:01 AM.
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