# Conservatives and health care rationing **URL:** \ **Category:** Great Debates\ **Created:** [December 10, 2009, 3:31am UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686 "2009-12-10T03:31:30Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [December 14, 2009, 12:25am UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/81 "2009-12-14T00:25:43Z")
> [@yorick73](#): > > Those without insurance would get care through the government (either medicaid, medicare, or the charity system of hospitals) and would probably have to wait quite some time. That medicaid is widely available to those of us without insurance is a myth. [The eligibility rules vary by state](http://www.cms.hhs.gov/medicaideligibility/02_areyoueligible_.asp) but for the most part, if you are a working adult, you won’t get covered unless you have a high-cost emergency (cancer doesn’t count), and often not even then. In Pennsylvania, as a single woman without any children and, thankfully, without a qualifying disability, I am automatically ineligible for non-emergency coverage, regardless of my income, so long as I **own a car** , regardless of the age or value of the car, if someone else co-owns the car or if how much money may be owed against my interest in said car. If I lose my job tomorrow, and have $0 income, until I sell my only means of transportation and have no more than $250 (I believe) in the bank, I won’t even get beyond the initial screening. The idea that Medicaid is universally available to the uninsured, even the low income uninsured, is feel-good nonsense passed around by those who have a vested interest in pretending that the “safety net” is stronger and wider than it really is or ever was. But 80% of uninsured Americans are in families where there is at least one wage-earner, and often more than one. If there is income, there is no Medicaid. 14,000 Americans are losing their health care coverage every single **day** because of job losses and COBRA expirations, and the majority will never have Medicaid coverage. ---
**Author:** ![Dunkelheit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dunkelheit/32/248_2.png) [@Dunkelheit](https://boards.straightdope.com/u/Dunkelheit)\ **Post date:** [December 14, 2009, 12:34pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/82 "2009-12-14T12:34:37Z")
> [@Euphonious\_Polemic](#): > > Call it rationing or some other word, but it still remains that access to a limited pool of medical resources is limited in the US by a person’s ability to pay (either directly or through expensive private insurance). In Canada, access to the limited pool is (mostly) limited by medical decisions, triage and necessity. True. And having spent 28 years with the US system and 11 years with the Canadian, I’d take the latter over the former any day. I’d much rather live where medical decisions, triage and necessity trump wealth when it comes to health care. ---
**Author:** ![Dunkelheit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dunkelheit/32/248_2.png) [@Dunkelheit](https://boards.straightdope.com/u/Dunkelheit)\ **Post date:** [December 14, 2009, 12:45pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/83 "2009-12-14T12:45:13Z")
> [@villa](#): > > I think few people deny that America has some of the absolute best health care in the world. It’s the method of allocating that care that people think is bat shit crazy. Exactly. And what opponents to “government run” health care don’t seem to realise is that the government in places like Canada doesn’t RUN the health care, it just pays for it. ---
**Author:** ![monavis](https://avatars.discourse-cdn.com/v4/letter/m/e0b2c6/32.png) [@monavis](https://boards.straightdope.com/u/monavis)\ **Post date:** [December 14, 2009, 12:49pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/84 "2009-12-14T12:49:34Z")
> [@Wesley\_Clark](#): > > Medicare covers everyone over 65 and is government run. And since the majority of people who die in this country are over 65, they have been dying in a public plan for over 40 years. So far no death panels. I don’t see why that would change. > > There are death panels in private industry though. There are many examples of private, for profit health insurance companies depriving needed care from people on technicalities. Either they refuse to cover people due to pre-existing conditions, or they deny coverage for a medical event, or they rescind policies after someone gets sick. > > So the concept of ‘death panels’ doesn’t really scare me. We know that private health care has death panels, and we know most people who die have died in a public medicare plan w/o death panels. It is my understanding that the so called “Death Panels” we so named because it gave a person to decide what they wanted to have done at the end of their life. The person decided it him or her self, not the Government, that was just a suggestion for them to decide? Did they want an operation etc. or not. No matter what is proposed some will object. ---
**Author:** ![Dunkelheit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dunkelheit/32/248_2.png) [@Dunkelheit](https://boards.straightdope.com/u/Dunkelheit)\ **Post date:** [December 14, 2009, 1:01pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/85 "2009-12-14T13:01:42Z")
> [@yorick73](#): > > I’m not here to defend insurance companies. We all know their purpose is to make a profit for shareholders. I’m in favor of social saftety nets (as are most Americans). I’m also in favor of insurance reform. What I am NOT in favor of is the complete dismantling of a system that the overwhelming majority of Americans are content with. There are other ways to achieve the goal of making sure everyone has adequate care. Such as? How can the insurance system be reformed without being dismantled? Under the current system, you can pay an insurance company for years for the privilege of denying you needed services. ---
**Author:** ![monavis](https://avatars.discourse-cdn.com/v4/letter/m/e0b2c6/32.png) [@monavis](https://boards.straightdope.com/u/monavis)\ **Post date:** [December 14, 2009, 1:10pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/86 "2009-12-14T13:10:47Z")
I was born in 1930, I had no health care until I was in my 30’s. I cut my foot off at age 8 the doctors and hospital made it so my parents could pay a little at a time. We saved ahead for our first 3 children, we payed the doctor a few dollars each visit until it was payed for, when our child was sick the doctor came to our home if the child had a high fever. After we had Insurance the doctor would put us in the hospital for a test because the Insurance would only pay if one was in the hospital. that caused the insurance to go up. When some of my children were born, the hospital padded the bill (like charging $150 dollars for medication which was 2 aspirins) when I called the hospital on it they said they needed the money to pay for those who had no insurance! Now the cost of health care has soared because people use any excuse to sue, as a result the rates go up, the docotrs have to pay a lot for insurance and the lawyers advertise to get people to sue. Doctors charge a lot so they can pay their insurance, plus make money, it is a domino effect. Sadly it seems, there are many people who want to get rich either by winning the lottery or sueing some one. The American dream used to be that a person could work hard and get ahead, now, the one’s who do work are asked to pay for the ones who want to get rich quick. Each time a person sues the cost is added to the rest of the public in one way or another. ---
**Author:** ![Evil\_Captor](https://avatars.discourse-cdn.com/v4/letter/e/f17d59/32.png) [@Evil\_Captor](https://boards.straightdope.com/u/Evil_Captor)\ **Post date:** [December 14, 2009, 3:16pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/87 "2009-12-14T15:16:01Z")
The simple fact of the matter is that our health care system is clearly and obviously wildly inefficent – we pay more than twice what Canada does for health care, and that means that _those of us who are insured_ get less effective health care than people in Canada. Now if you factored in the American _uninsured_ and calculated the quality of their health care (only fair, since all are covered in Canada) the figures would be even more skewed in favor of Canada. The reason for that is that insurance companies are doing a VERY poor job of managing health care. They deny coverage for pre-existing conditions, they refuse treatment on technicalities, they spend huge amounts on executive compensation and stockholder payouts that could be spent on health care, and in general do everything they can to profit off the suffering of their clients. The post about the poor coverage offered by Medicare is also true. I have read many stories about people being forced to live like paupers to satisfy Medicare requirements. (The problem here of course is that conservatives who don’t like Medicare in some states have done everything they can to create it as a system that covers virtually no one.) I have ALSO read many stories of financially comfortable people with catastrophic illnesses who have been driven to bankruptcy by the present system of coverage. Guys, the system is broke. It doesnt’ work at all well. Fixing it will be easy – deep-six the insurance companies, create a single-payer system where ALL are included in the insured pool (thus spreading the risk instead of concentrating on coverage of only those who don’t need it, as insurance companies presently attempt to do (see, denial of pre-existing conditions) and get everybody covered. Do you conservatives really LIKE to see hard-working, decent Americans being driven to bankruptcy by catastrophic illness? YOU might be next … if so, please don’t bother us by complaining … it’s what you wanted, after all. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [December 14, 2009, 3:44pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/88 "2009-12-14T15:44:06Z")
> [@Euphonious\_Polemic](#): > > My original point stands then; Look to the north, where your neighbouring country has a single payer system that cost a LOT less, and leads to significantly better health outcomes (at least according to my meta-study cite) Even if we do have wait lists, they do not lead to poorer health outcomes for the population (this is because the waitlists are prioritized by the severity of the condition, not by how much money the patient has) Again, you cannot discount the health disparities between the people of two different nations. A better comparison may be to look at cost and outcomes of individuals who live in states that have tried a state version of UHC. Even then, you cannot discount the health disparity between people living in Mississippi versus those in Vermont. > [@Euphonious\_Polemic](#): > > And, even though you can say that “the overwhelming majority of Americans are insured or can afford their own insurance”, you must know that your insurance is horribly overpriced. In addition, you are simply dismissing those who don’t have (and can’t afford) insurance, as well as those who are denied claims. These people would love to be on a wait list. Is insurance overpriced? Look at what is covered in the highest markets. We, as a country, have somehow bastardized the term “insurance” with regard to health insurance. Health insurance is no longer about covering risks and is much more about having a third party pay for any checkup or medical procedure performed. Maybe some reform in this area would benefit those who cannot afford insurance. Also, I am not dismissing those without insurance. I don’t see a point, though, is dismantling our entire system. There are ways around this problem without putting us on the road to UHC. If the Liberals were honest about the public option the bill could have been 20 pages instead of 2000. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [December 14, 2009, 4:09pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/89 "2009-12-14T16:09:48Z")
> [@sqweels](#): > > But what this thread is about is that many of the same people who think a public option will be so generous it will quickly put the private insurance industry out of business have been going on about how nightmarishly stingy and rationed it will be. Obviously it would have to be very generous at first. But, when it is the only option left it can then be as nightmarishly stingy and rationed as it pleases. > [@sqweels](#): > > But the more unpleasant it would be to be on the public plan, the more of a selling point the private insurers would have to help them stay in business–and the less it would cost the taxpayers. And there would also be such a thing as “gap” insurance, wouldn’t there? You are assuming that the government is willing to let the plan fail. I submit that government would not want their brand damaged any more than a company would and, therefore, will spare no expense to make is successful at the start. > [@sqweels](#): > > And if employers do manage to pass off the cost of their employees’ coverage in large numbers, won’t that create jobs and stimulate the economy? That’s a rather simplistic view of economics. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [December 14, 2009, 4:23pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/90 "2009-12-14T16:23:05Z")
> [@Jeneva](#): > > Such as? > > How can the insurance system be reformed without being dismantled? Under the current system, you can pay an insurance company for years for the privilege of denying you needed services. What kind of question is that? I should ask how can we reform insurance by dismantling it? You DO realize that reforming something does not requre destroying it…don’t you? Many people never consider the regulations placed on insurance companies in certain states. Deregulating and/or allowing people to buy coverage across state lines would be a start. Limiting medical malpractice amounts would lower the price of insurance and reduce the cost of care by removing a huge incentive for doctors to use defensive medicine. ---
**Author:** ![The\_Tao\_s\_Revenge](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@The\_Tao\_s\_Revenge](https://boards.straightdope.com/u/The_Tao_s_Revenge)\ **Post date:** [December 14, 2009, 4:24pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/91 "2009-12-14T16:24:03Z")
> [@yorick73](#): > > Again, you cannot discount the health disparities between the people of two different nations. A better comparison may be to look at cost and outcomes of individuals who live in states that have tried a state version of UHC. Even then, you cannot discount the health disparity between people living in Mississippi versus those in Vermont. What common thread links Canada, Britain, Japan and various other countries? They all have UHC, lower costs and better outcomes then the US. It works in every other rich industrial democracy. Why do you feel Americans are soley incompetent in that regard? ---
**Author:** ![Dunkelheit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dunkelheit/32/248_2.png) [@Dunkelheit](https://boards.straightdope.com/u/Dunkelheit)\ **Post date:** [December 14, 2009, 4:27pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/92 "2009-12-14T16:27:23Z")
> [@yorick73](#): > > Prices rise for private insurance as more people move to the public option. The ability of the government plan to bleed red ink in order to undercut private insurance and attract more people until private insurance companies go out of business. How do you explain the fact that this hasn’t happened in Canada, a single payer system? > [@yorick73](#): > > Barney Frank was honest enough to admit that offering a single payer bill would be suicidal but that a public option would be a backdoor to a single payer system. This really isn’t difficult to understand. Could you describe some specific aspects of actual existing single payer systems that you particularly object to, and explain why the concept in general is not a viable alternative to the current insurance mess? And offer alternative solutions if you have any in mind? ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [December 14, 2009, 4:36pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/93 "2009-12-14T16:36:43Z")
> [@yorick73](#): > > Again, you cannot discount the health disparities between the people of two different nations. A better comparison may be to look at cost and outcomes of individuals who live in states that have tried a state version of UHC. Even then, you cannot discount the health disparity between people living in Mississippi versus those in Vermont. This is simply an American Exceptionalism argument; The US is exceptionally in poor health, and nothing can be done about it. Did you ever stop to think that the health disparities you mention may be DUE TO the single payer system in Canada, and the fact that it does not cost a Canadian money to get preventative health care (checkups, shots, pre-natal care, etc) Also, Canada is not a monolithic culture either. People in Quebec smoke more, People in BC drink more. ---
**Author:** ![DanBlather](https://avatars.discourse-cdn.com/v4/letter/d/f4b2a3/32.png) [@DanBlather](https://boards.straightdope.com/u/DanBlather)\ **Post date:** [December 14, 2009, 4:40pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/94 "2009-12-14T16:40:45Z")
> [@Jeneva](#): > > Could you describe some specific aspects of actual existing single payer systems that you particularly object to, and explain why the concept in general is not a viable alternative to the current insurance mess? And offer alternative solutions if you have any in mind? It might lead to dancing. ---
**Author:** ![DanBlather](https://avatars.discourse-cdn.com/v4/letter/d/f4b2a3/32.png) [@DanBlather](https://boards.straightdope.com/u/DanBlather)\ **Post date:** [December 14, 2009, 4:44pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/95 "2009-12-14T16:44:48Z")
> [@Euphonious\_Polemic](#): > > This is simply an American Exceptionalism argument; The US is exceptionally in poor health, and nothing can be done about it. Did you ever stop to think that the health disparities you mention may be DUE TO the single payer system in Canada, and the fact that it does not cost a Canadian money to get preventative health care (checkups, shots, pre-natal care, etc) > > Also, Canada is not a monolithic culture either. People in Quebec smoke more, People in BC drink more. Actually, it turns out that instances of many diseases are higher in Europe; they smoke more for instance. But with UHC the outcome is better. In fact the only demographic in the US that has comparable or better outcomes than Europe are those over 65 which have UHC through Medicaire. It must be frustrating that all the facts are against you, I know you’d love your argument of “government is bad” to be supported by reality, but it just isn’t so. ETA: Sorry **EP** I quoted the wrong person. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [December 14, 2009, 4:48pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/96 "2009-12-14T16:48:04Z")
> [@The\_Tao\_s\_Revenge](#): > > What common thread links Canada, Britain, Japan and various other countries? They all have UHC, lower costs and better outcomes then the US. It works in every other rich industrial democracy. Why do you feel Americans are soley incompetent in that regard? How often do you hear of someone going to Japan for cutting-edge medical treatment? How often do you hear, “The best specialists in X are in Canada?” On the other hand, I often hear about people from Canada coming to the U.S. for medical treatment. Japan, too, seems to send people here. Why is that? ---
**Author:** ![Evil\_Captor](https://avatars.discourse-cdn.com/v4/letter/e/f17d59/32.png) [@Evil\_Captor](https://boards.straightdope.com/u/Evil_Captor)\ **Post date:** [December 14, 2009, 5:21pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/97 "2009-12-14T17:21:58Z")
> [@Bricker](#): > > How often do you hear of someone going to Japan for cutting-edge medical treatment? How often do you hear, “The best specialists in X are in Canada?” > > On the other hand, I often hear about people from Canada coming to the U.S. for medical treatment. Japan, too, seems to send people here. Why is that? People go to Mexico and Costa Rica for various surgeries, and for dentistry, they go to Canada to buy prescription drugs. Why is that, Bricker? ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [December 14, 2009, 5:28pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/98 "2009-12-14T17:28:33Z")
> [@Euphonious\_Polemic](#): > > This is simply an American Exceptionalism argument; The US is exceptionally in poor health, and nothing can be done about it. Did you ever stop to think that the health disparities you mention may be DUE TO the single payer system in Canada, and the fact that it does not cost a Canadian money to get preventative health care (checkups, shots, pre-natal care, etc) > > Also, Canada is not a monolithic culture either. People in Quebec smoke more, People in BC drink more. No culture is monolithic but averages are used within countries to get a snapshot of that culture. It’s very difficult to compare two different countries. Have you considered the higher homicide rate and traffic fatalities in the US. How about all those war fatalities. It is overly simplistic to to list life expectancy as proof that UHC results in a longer life. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [December 14, 2009, 5:34pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/99 "2009-12-14T17:34:06Z")
> [@DanBlather](#): > > Actually, it turns out that instances of many diseases are higher in Europe; they smoke more for instance. But with UHC the outcome is better. In fact the only demographic in the US that has comparable or better outcomes than Europe are those over 65 which have UHC through Medicaire. This statistic should tell you something. When you look at an older cohort they fare as well or better in the US. This number is important because most homicides, war related deaths, traffic fatalities ect. have already occurred. > [@DanBlather](#): > > It must be frustrating that all the facts are against you, I know you’d love your argument of “government is bad” to be supported by reality, but it just isn’t so. What’s frustrating is the simplistic arguments and supposed correlations that are trotted out with no understanding of what they really mean. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [December 14, 2009, 5:36pm UTC](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686/100 "2009-12-14T17:36:26Z")
> [@Evil\_Captor](#): > > People go to Mexico and Costa Rica for various surgeries, and for dentistry, they go to Canada to buy prescription drugs. Why is that, Bricker? [Medical tourism](http://en.wikipedia.org/wiki/Medical_tourism) is especially popular for Americans who can get adequate treatment for far less in Thailand or India than at home, even with travel costs. [Previous page](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686.md?page=4) [Next page](https://boards.straightdope.com/t/conservatives-and-health-care-rationing/520686.md?page=6)