# Could a government run healthcare system compete **URL:** \ **Category:** Great Debates\ **Created:** [October 21, 2013, 9:25pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869 "2013-10-21T21:25:37Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 26, 2013, 12:58am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/81 "2013-10-26T00:58:38Z")
> [@HoneyBadgerDC](#): > > Oh, I did think about that. I have a feeling some of these hospitals might sign contracts with the goverment for shared use. The whole system would have to be revamped which is no small feat but the owners of these hospitals would still be able to make good money. > > ``` > I honestly believe this country is spending twice what is hould be on healthcare when all costs including present taxes subsidizing county hospitals. > > ``` > > If we ever get this right all this money could be going back into the economy buying goods and services. It might amount to 5% of the conomy that could be saved. I agree with you in principle. But government owned healthcare is not the only solution. While England has NHS, the rest of Europe has private doctors with government insurance and single payer plans. And when the government is paying the bills they can wring a lot of inefficiency out of the system, for instance by saying they will pay for the use of only one MRI machine in a square mile (there seem to be more of them than Starbucks sometimes) and reducing the incentive for expensive tests. Even the recent publication of prices across hospitals is going to help, since it will give insurance companies and patients a lot more clout. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [October 26, 2013, 1:17am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/82 "2013-10-26T01:17:17Z")
> [@Voyager](#): > > Do you really want a government or a company knowing exactly where you are driving at every minute. That is far worse than 1984. Hmm. I just installed Waze – Google’s traffic-enabled GPS acquisition – on the FreedomPop smartphone that came in today’s mail. So, when we go out driving tomorrow, it’s going to be worse than having our faces ravaged by rats? A million people a year, worldwide, die in vehicle accidents. Given likely technical advances in the next decade or two, most could be saved if Google servers not only knew where each car was, but also had the power to keep them from getting too close to one another. Such a great boon to mankind shouldn’t be equated with Orwell’s depiction of war, mind control and torture. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [October 26, 2013, 10:30am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/83 "2013-10-26T10:30:30Z")
> [@Der\_Trihs](#): > > That’s nonsense. The health of the populace affects society in general; the sick and the dead don’t contribute much to the economy or the rest of society. And our present system is a major economic burden; we’re costing ourselves enormous amounts of money thanks to our hatred of helping people. > > And I think that human life is more important than economic dogma. As I said earlier, I have no interest in dying in order to satisfy some abstract point of political or economic dogma. No, what you’re saying is content free righteous claptrap. You may think you’re helping people, but you’ll only end up harming more in the long run. The US system may well beflawed and require a fix, but the fix should not be using tax money to pay for a private good. You and whoever else feels strongly about the healthcare costs of others should voluntarily and directly bear those costs, instead of demanding that it be Borne by everyone ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [October 26, 2013, 10:38am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/84 "2013-10-26T10:38:33Z")
> [@bldysabba](#): > > The US system may well beflawed and require a fix, but the fix should not be using tax money to pay for a private good. We have been doing that for over two hundred years; why should healthcare be any different? ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [October 26, 2013, 12:49pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/85 "2013-10-26T12:49:33Z")
> [@bldysabba](#): > > No, what you’re saying is content free righteous claptrap. You may think you’re helping people, but you’ll only end up harming more in the long run. The US system may well beflawed and require a fix, but the fix should not be using tax money to pay for a private good. There IS no other fix. Nor is there any reason to think that people will be harmed. All the evidence is that it’s America’s hostility to spending money to help people that’s causing harm. > [@bldysabba](#): > > You and whoever else feels strongly about the healthcare costs of others should voluntarily and directly bear those costs, instead of demanding that it be Borne by everyone In other words, we should die, after being driven into utter poverty. I have no interest in suffering and dying for your principles. ---
**Author:** ![cornopean](https://avatars.discourse-cdn.com/v4/letter/c/8c91f0/32.png) [@cornopean](https://boards.straightdope.com/u/cornopean)\ **Post date:** [October 26, 2013, 12:58pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/86 "2013-10-26T12:58:51Z")
> [@Der\_Trihs](#): > > Or by deception or by force. The only reason they don’t use force on a regular basis is because the government stops them; in places and times where it doesn’t, they have no problem with profiting using force and coercion. Two things: First, some private companies do deceive but such companies will have only a limited, short-term success. Very quickly (especially in our information age) the jig is up, and they have to pay the price. The really big successful companies have to make something that people really want. and if private companies, then yes…this is a time for govt to step in. You look at the really rich people and you see that they did FAR more for civilization than any govt ever did. Rockefeller cut the price of oil and kerosene by 80%. The Vanderbilts lowered the price of transport. Bill Gates and Steve Jobs gave us some operating systems that people couldn’t even have imagined long ago. Miley Cyrus gave us…wait cancel that. ☹ > [@](#): > > No. It’s called paying what you owe; “Taxes buy civilization”. People who call taxes theft want the benefits of living in a civilized society without paying for it. I agree that taxation is paying for certain services that only govt can perform. the problem is that govt officials rarely stick to there assigned responsibilities. they have such good intentions that they soon see all the good they can do with other people’s money. so Thomas Jefferson said, the natural progress of things is for govt to gain ground and for liberty to yield. that is why so many of us do regard taxation in the US as theft and robbery. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [October 26, 2013, 1:01pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/87 "2013-10-26T13:01:25Z")
> [@bldysabba](#): > > You and whoever else feels strongly about the healthcare costs of others should voluntarily and directly bear those costs, instead of demanding that it be Borne by everyone Whoa! Medicare started the business of costs being borne by everyone. Then Ronald Reagan signed the [Emergency Medical Treatment and Active Labor Act](http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act), which required everyone to pay for the most expensive sorts of care for those too young for medicare. As a result, we have masses of unhappy freeloaders who get seriously ill or injured, receive the world’s most expensive treatment, and have to go bankrupt – thus socializing the costs of their medical care to everyone else. For decades, Republican health care analysts wanted to make these freeloaders pay for their care by getting private insurance at rates they could afford. Now, they got it, but because a Democrat was in office at the time, it is socialism. Health care policy in a normal democracy is more in the realm of wonkery than ideology. The differences between GOP plans, over the years, and the Affordable Care Act, have to do with what gets covered, not the essence. Solving America’s health care financing mess should be no more a left-right issue than is the difference between the well-working Affordable Care web site in pure-Democratic California, and the broken one that people in states not cooperating with the Act are forced to use. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [October 26, 2013, 1:09pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/88 "2013-10-26T13:09:39Z")
> [@cornopean](#): > > Two things: First, some private companies do deceive but such companies will have only a limited, short-term success. Very quickly (especially in our information age) the jig is up, and they have to pay the price. Because governments (sometimes) punish them. > [@cornopean](#): > > You look at the really rich people and you see that they did FAR more for civilization than any govt ever did. That’s not true at all. Not only have governments done an enormous amount of useful things directly, none of those rich people could have done much of anything without govenrment, including being rich in the first place. > [@cornopean](#): > > I agree that taxation is paying for certain services that only govt can perform. the problem is that govt officials rarely stick to there assigned responsibilities. they have such good intentions that they soon see all the good they can do with other people’s money. It’s not “other people’s money”. And so what if they do? > [@cornopean](#): > > so Thomas Jefferson said, the natural progress of things is for govt to gain ground and for liberty to yield. that is why so many of us do regard taxation in the US as theft and robbery. Nonsense. People think that because they don’t want to pay what they owe, and because they’ve been manipulated by rich parasites who hate having to pay taxes at all. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [October 26, 2013, 1:24pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/89 "2013-10-26T13:24:08Z")
> [@cornopean](#): > > but people are going to choose to use the streets that are best maintained. and for the private company to keep their contract, they are going to have to do a good job or the local govt can fire them and hire another contractor. There is one and only one road that leads to my house. How do I have any choice which street to drive on in your scenario? I have to drive on that road. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [October 26, 2013, 1:36pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/90 "2013-10-26T13:36:14Z")
> [@cornopean](#): > > that is why so many of us do regard taxation in the US as theft and robbery. Conservatives have pointed out for decades that taxes are not just what the legislature makes us pay the government directly, but also the costs of complying with laws. And the largest unfunded mandate ever is the Reagan-signed Emergency Medical Treatment and Active Labor Act. See: [The Law That Changed Everything—and It Isn’t the One You Think](http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=4770007463) If there is theft and robbery, it isn’t in the above-board taxes passed by legislators that I can vote for for against. It’s the uninsured guy, in intensive care, who wasn’t wearing a helmet when he flew off his motorcycle and whose care people who have insurance wind up paying for. Starting March 15, 2014, this problem isn’t solved, but it will be better. Repeal of the Affordable Care Act wouldn’t just be a blow against the poor. It also would be one more unfunded mandate. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [October 26, 2013, 2:25pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/91 "2013-10-26T14:25:06Z")
Correction for last post: Date of March 15, 2014 was in error. To avoid getting into unnecessary detail, I should have said “Next year.” ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [October 26, 2013, 10:36pm UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/92 "2013-10-26T22:36:13Z")
> [@Fear\_Itself](#): > > We have been doing that for over two hundred years; why should healthcare be any different? Which private goods have been funded by tax money in the US for the past two hundred years? > [@PhillyGuy](#): > > Whoa! > > Medicare started the business of costs being borne by everyone. > > Then Ronald Reagan signed the [Emergency Medical Treatment and Active Labor Act](http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act), which required everyone to pay for the most expensive sorts of care for those too young for medicare. > > As a result, we have masses of unhappy freeloaders who get seriously ill or injured, receive the world’s most expensive treatment, and have to go bankrupt – thus socializing the costs of their medical care to everyone wise. > > For decades, Republican health care analysts wanted to make these freeloaders pay for their care by getting private insurance at rates they could afford. Now, they got it, but because a Democrat was in office at the time, it is socialism. > > Health care policy in a normal democracy is more in the realm of wonkery than ideology. The differences between GOP plans, over the years, and the Affordable Care Act, have to do with what gets covered, not the essence. > > Solving America’s health care financing mess should be no more a left-right issue than is the difference between the well-working Affordable Care web site in pure-Democratic California, and the broken one that people in states not cooperating with the Act are forced to use. I’m neither democrat nor republican. Heck I’m not even American. My concern is the poor policy examples that you set will cascade to my corner of the world. They already show signs it’s doing so. Medical insurance for insurance, is a terrible model for healthcare, and it was government interference through tax benefits that has so badly entrenched a bad model into your system. Medical insurance too is socialisation of healthcare. It artificially expands the pool of those making payments while the population is young, reducing the incentive to cut costs. Because the pool of people making payments is large, and the pool needing treatment is small, it just drives up costs. This is where you are now, and unfortunately where my country is headed. Later, as the population ages (as is bound to happen), this situation reverses itself - the pool of people needing healthcare becomes larger, and those able to pay for it becomes smaller. And this comes back to bite you in the ass, because governments are NOT good at providing private goods. This has been emphatically proven, again and again. And it will be, with healthcare too. A far better model is healthcare savings accounts. I don’t know how or if America can transition to it, but the principle is important. Don’t use tax money to pay for something that is a private good.(including subsidising medical insurance through tax breaks). It distorts incentives in ways that are highly inefficient and leads to extremely sub optimal outcomes, even if it does provide some temporary salve to bleeding hearts. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [October 27, 2013, 2:28am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/93 "2013-10-27T02:28:40Z")
> [@bldysabba](#): > > My concern is the poor policy examples that you set will cascade to my corner of the world. What corner is that? As for your concern, I think it is exaggerated. The US health care financing model is not an infectious disease other nations catch. > [@](#): > > A far better model is healthcare savings accounts. I don’t know how or if America can transition to it, but the principle is important The Affordable Care Act is, on balance, neutral concerning those, according to a source consistent with your POV: > **[Health Savings Accounts Will Survive ObamaCare -- At Least For Now](https://www.forbes.com/sites/merrillmatthews/2013/03/27/health-savings-accounts-will-survive-obamacare-at-least-for-now/)** > > Health Savings Account plans will qualify under ObamaCare's coverage standards, which might help counter the health care spending explosion created by ObamaCare. > [@](#): > > It appears that Health Savings Accounts (HSAs) will slip under the Affordable Care Act’s threshold for qualified coverage—although just barely. > > It would be ironic if HSA plans, which most ObamaCare supporters really dislike, ended up becoming the favorite option among employers and individuals—and significantly slowing health care spending. If that happens you can bet those supporters will take credit for the slowdown, even though most of them never wanted to include HSAs in the first place. Since we can take out that kind of high deductible health insurance and avoid Affordable Care Act penalties, there’s no reason there for you to oppose it. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [October 27, 2013, 4:21am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/94 "2013-10-27T04:21:09Z")
> [@PhillyGuy](#): > > What corner is that? > > As for your concern, I think it is exaggerated. The US health care financing model is not an infectious disease other nations catch. India, and on the contrary, we’ve made many of the same missteps that have gotten you into your mess, particularly tax deductions for medical insurance, and encouragement for medical insurance in general. That medical insurance exists as a powerful market force in the world at all, I will choose to blame on the American government, perhaps wrongly 🙂 > [@](#): > > The Affordable Care Act is, on balance, neutral concerning those, according to a source consistent with your POV: > > [Health Savings Accounts Will Survive ObamaCare -- At Least For Now](http://www.forbes.com/sites/merrillmatthews/2013/03/27/health-savings-accounts-will-survive-obamacare-at-least-for-now/) > > Since we can take out that kind of high deductible health insurance and avoid Affordable Care Act penalties, there’s no reason there for you to oppose it. Let me clarify, I’m not opposing the ACA, since I know too little about it. If I came across as doing so, I am guilty of poor expression. I’m opposing the idea that healthcare costs, particularly tertiary care costs, should be socialised. Tertiary healthcare brings a lot of resources to bear to improve the lot of one individual. The benefit goes almost entirely to that individual, with few externalities, if any. There is absolutely no reason that others should bear the cost, unless they desire to do so. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 27, 2013, 5:40am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/95 "2013-10-27T05:40:21Z")
> [@PhillyGuy](#): > > This is a smart idea, but I doubt it works quite like that. If it did, the growth of Kaiser Permanente, often pointed to as a model for humane cost containment, instead would have made California health care more inefficient. I find this hard to accept. > > Phillip Longman’s proposal for gradual creation of a civilian clone of VA’s system calls for taking over financially distressed hospitals. Without such a VA clone option, there is political pressure to keep such hospitals open at taxpayer expense. I know that such campaigns rarely prevent an individual distressed hospital from closing – all they do is [drag it out](http://www.brooklynpaper.com/stories/36/26/dtg_lichviolation_2013_06_28_bk.html). But distressed hospitals, as a class, cost money in that they are a strong argument for keeping medicare reimbursement high. The proposal in the OP was to build a duplicate healthcare system. Kaiser did not plop down all their hospitals at one time. Growing capacity with market share is a far different thing than just building capacity. Financially distressed hospitals are probably in underserved locations, so “nationalizing” them would seem to make sense. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 27, 2013, 5:42am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/96 "2013-10-27T05:42:56Z")
> [@PhillyGuy](#): > > Hmm. > > I just installed Waze – Google’s traffic-enabled GPS acquisition – on the FreedomPop smartphone that came in today’s mail. So, when we go out driving tomorrow, it’s going to be worse than having our faces ravaged by rats? > > A million people a year, worldwide, die in vehicle accidents. Given likely technical advances in the next decade or two, most could be saved if Google servers not only knew where each car was, but also had the power to keep them from getting too close to one another. Such a great boon to mankind shouldn’t be equated with Orwell’s depiction of war, mind control and torture. You can get a discount on your insurance by letting the insurance company track you also. If you want that, fine. The suggestion was to force people to report their positions or not drive - and the only benefit is getting the roads out of the hands of government. The two way TVs in 1984 were not optional. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 27, 2013, 5:58am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/97 "2013-10-27T05:58:15Z")
> [@bldysabba](#): > > India, and on the contrary, we’ve made many of the same missteps that have gotten you into your mess, particularly tax deductions for medical insurance, and encouragement for medical insurance in general. That medical insurance exists as a powerful market force in the world at all, I will choose to blame on the American government, perhaps wrongly 🙂 > > Let me clarify, I’m not opposing the ACA, since I know too little about it. If I came across as doing so, I am guilty of poor expression. I’m opposing the idea that healthcare costs, particularly tertiary care costs, should be socialised. Tertiary healthcare brings a lot of resources to bear to improve the lot of one individual. The benefit goes almost entirely to that individual, with few externalities, if any. There is absolutely no reason that others should bear the cost, unless they desire to do so. [Story from JAMA on how Indian health care workers do not have medical degrees.](http://jama.jamanetwork.com/article.aspx?articleID=1557743) I don’t think you guys are models we want to emulate. Insurance of any type is spreading the risk so that others bear the cost. Car insurance works the same way. For health care, the alternative is that sick people get sicker and die. Is that what you want? In the US (and in Western Europe) we can afford care for everyone. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [October 27, 2013, 6:05am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/98 "2013-10-27T06:05:28Z")
> [@cornopean](#): > > Two things: First, some private companies do deceive but such companies will have only a limited, short-term success. Very quickly (especially in our information age) the jig is up, and they have to pay the price. The really big successful companies have to make something that people really want. and if private companies, then yes…this is a time for govt to step in. You look at the really rich people and you see that they did FAR more for civilization than any govt ever did. Rockefeller cut the price of oil and kerosene by 80%. The Vanderbilts lowered the price of transport. Bill Gates and Steve Jobs gave us some operating systems that people couldn’t even have imagined long ago. Miley Cyrus gave us…wait cancel that. ☹ You seem to be confusing private companies and the people who run them. Those who cook the books legally get the big bonuses, and of fired have to make do with their $50 million severance packages. Some incentive to be honest! As for operating systems, Jobs stole from Xerox PARC and Gates stole from Jobs. (Probably the Woz, actually.) And I was teaching operating systems before Gates was even writing BASIC interpreters, and I assure you he could have done a lot better with Windows. You do know he bought MS-DOS, right? He was quite a good monopolist, though. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [October 27, 2013, 6:38am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/99 "2013-10-27T06:38:17Z")
> [@Voyager](#): > > [Story from JAMA on how Indian health care workers do not have medical degrees.](http://jama.jamanetwork.com/article.aspx?articleID=1557743) I don’t think you guys are models we want to emulate. > Insurance of any type is spreading the risk so that others bear the cost. Car insurance works the same way. For health care, the alternative is that sick people get sicker and die. Is that what you want? In the US (and in Western Europe) we can afford care for everyone. Strange you should want to bash the Indian model when I’m already saying that it’s picking up the worst aspects of the American . Nor have I at any point made any comparisons between the Indian system and the American one. I normally respect your debating style, so I’m surprised at this post. The attempt to couch the problem in such emotive terms is not useful. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [October 27, 2013, 7:18am UTC](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869/100 "2013-10-27T07:18:55Z")
[QUOTE=Voyager;1679389 9] Insurance of any type is spreading the risk so that others bear the cost. Car insurance works the same way. For health care, the alternative is that sick people get sicker and die. Is that what you want? In the US (and in Western Europe) we can afford care for everyone. [/QUOTE] As for insurance - I’m well aware how it works and why it exists. It involves small payments made by a large pool to hedge against a small percentage of them suffering a large payout. This is NOT how health insurance works. With the advances in medical technology, almost everybody is going to require large payouts from the system. The math simply doesn’t hold up. Not to mention that the industry quickly starts running on insurance payouts for every transaction. This is sustainable only as long as the pool of healthy people is growing faster than those requiring medical care. As soon as demographics shift, which they inevitably will, healthcare insurance won’t work at all. This is why I suggested healthcare savings accounts instead. Everybody part for their own medical care out of funds they’ve saved up for that purpose. The people that care deeply about the sick and dying supplement these funds. If it is as much of a human imperative as people claim, there will be no shortage of these supplemental funds. If it isn’t, then people do not care about their fellow man as much as some think, and there’s no reason to force them to. Tertiary care does not have externalities. Sanitation-everyone benefits, people should be forced to pay tax to provide it. Law and order, same. Vaccination, same. Pollution control, same. Advanced healthcare is NOT in that category though. [Previous page](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869.md?page=4) [Next page](https://boards.straightdope.com/t/could-a-government-run-healthcare-system-compete/671869.md?page=6)