# Devil's advocate: saving America from socialized medicine. **URL:** \ **Category:** Great Debates\ **Created:** [January 26, 2009, 7:39am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032 "2009-01-26T07:39:12Z")\ **Posts on this page:** 20\ **Page:** 8
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [January 29, 2009, 3:58am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/141 "2009-01-29T03:58:24Z")
> [@curlcoat](#): > > . > People in the US are spread out much more, yes, but they are not as far from big cities as some Canadians are. OTOH, I haven’t been up there past Toronto or Vancouver in years, so perhaps Prince George, Yellowknife and White Horse have grown by quite a bit? It used to be that even in the prairies there would be 100’s of miles between cities - no longer true? You all don’t have the big sweeping wheat fields anymore? But _we don’t provide health insurance to wheat fields_. Canadians being “spread out” has nothing to do with the effectiveness of the health insurance system. Nobody, when it was set up, was thinking, “We really need to create a system so people in remote places get health care.” People in isolated areas _don’t_ get the same health care as they do in the cities - and since Canada is a very urbanized nation, with more than half the country living in around ten or so big cities, why _would_ that be the reason we have such a system? Does the USA not have people in isolated spots? Just how densely populated are Alaska, North Dakota, and Wyoming these days? ---
**Author:** ![Raygun99](https://avatars.discourse-cdn.com/v4/letter/r/6f9a4e/32.png) [@Raygun99](https://boards.straightdope.com/u/Raygun99)\ **Post date:** [January 29, 2009, 4:08am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/142 "2009-01-29T04:08:11Z")
> [@RickJay](#): > > But _we don’t provide health insurance to wheat fields_. A regrettable oversight in the latest Harper budget. ---
**Author:** ![Spoons](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spoons/32/3141_2.png) [@Spoons](https://boards.straightdope.com/u/Spoons)\ **Post date:** [January 29, 2009, 4:08am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/143 "2009-01-29T04:08:56Z")
> [@curlcoat](#): > > I don’t think that northern Canada is why UHC got started up there, but I think it is why it ended up being nationwide. If I remember correctly from what I read, it started in BC and then another provinence (I think Ontario) and then more or less ended up nationwide. You are either remembering incorrectly or you were reading incorrect information. It started in Saskatchewan in 1946 and was followed by Alberta in 1950. [Cite.](http://en.wikipedia.org/wiki/Health_care_in_Canada) ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 29, 2009, 5:27am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/144 "2009-01-29T05:27:03Z")
> [@curlcoat](#): > > Logically, a low populated area is not going to be profitable enough to support more than one GP doctor, if that. So the only way the government can assure that people living in the NW Territories or the plains got at least basic health care would be to subsidize it. And, yes, because that would cost a lot, the next logical step is to make it nationwide to spread out the cost. 😃 Aaand we have a winner! You just gave an argument _for_ nationwide socialized medicine in the USA! Alaska, Wyoming, parts of the Dakotas, are the kind of territory you describe. Ergo, if it must be socialized, & then a socialized system must be nationwide, the USA must have nationwide socialized medicine! Of course, that’s not true. There are plenty of ways to subsidize care in a particular region without building a national system. But really, subsidized care & directed investment make sense in urban areas as well, where there may be relatively little natural wealth for the population in the area, & it’s very hard for doctors to make as much money as they could in a less densely populated area. And then there aren’t enough doctors to treat everyone, & the doctors become overworked. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 29, 2009, 5:57am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/145 "2009-01-29T05:57:21Z")
> [@curlcoat](#): > > As I said way back someplace upthread, I personally think it is because Canadians tend to be more responsible and less entitlement minded than those in the US. And this is based on a sociological study, right? 😛 Look, if it were just what brazil84 calls the underclass, & getting out of the underclass were really more accessible for everyone, I might not expect any American to take the idea of socialized medicine seriously. But there’s a reason this idea is on so many lips now. Responsible working people who aren’t being paid living wages–in states that are more right-wing (Texas), poorer (Michigan), or both (Oklahoma) than what you know in California, or Washington state, or BC–are facing a pricing system that doesn’t work for them. The lower availability of money in those states interacts badly with the national pricing of medical services & supplies. But even in states that are both rich & “liberal,” the pricing system is out of whack because the distribution of wealth is so unbalanced. Our country still thinks being a doctor is a way to be respectably rich, but since our economy is turning third-world, that’s no longer true. It depends in a third-world economy which clientele you serve. If you serve a rich clientele, you can be moderately rich. If you only serve the poor, you have to accept it as a mission not a living. Unless we force doctors to share the wealth from across society, perhaps by making the rich share doctors with the poor, some doctors will be pampered & others live like monks. (Of course, the Hippocratic Oath is supposed to help this.) > [@the Oath](#): > > To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 29, 2009, 6:04am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/146 "2009-01-29T06:04:01Z")
> [@curlcoat](#): > > Not reject it, don’t have the option due to their own irresponsibility. Such as not finishing high school (we have a lot of that out here) so they never end up in a job that offers group plans, and they are so underemployed they cannot afford a private policy. So an 8th-grade education doesn’t qualify anyone for a union job in your world? > [@](#): > > Perhaps the Germans don’t sit around waiting for someone else to take care of them. Perhaps the Germans have a sense of community. Can you imagine Americans agreeing to cut the standard work week to 30 hours rather than just laying off a quarter of workers? ---
**Author:** ![Strassia](https://avatars.discourse-cdn.com/v4/letter/s/e8c25b/32.png) [@Strassia](https://boards.straightdope.com/u/Strassia)\ **Post date:** [January 29, 2009, 6:53am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/147 "2009-01-29T06:53:43Z")
> [@curlcoat](#): > > What would be logical would be to not allow people to move into the test area and skew the results. I agree it would be logical, but Massachusetts cannot prevent people from crossing the border the way Canada can. My point still stands that a failure in a system set up in only one part of a federation is only evidence against piecemeal adoption, not general adoption. > [@](#): > > No it doesn’t, it just means that you might have to - gasp! - put off the gratification of working for yourself until you have enough saved to pay for a private policy. Or, only one of you quits the job with group coverage. If the only thing keeping you from starting this business is the triple cost of insurance, what are you going to do if your great idea doesn’t bring in money quickly, or even semi-quickly? It doesn’t sound like this has been thought thru, tho it is a great example of how too many people think these days. Apparently, it’s ok to take all kinds of risks because the government will tax the non-risk takers and save your butt. Unfortunately, it seems that the non-risk takers are getting more and more rare. > > As for subsidizing CEOs, two wrongs don’t make a right. If it is true that there are folks makin money for no work, deal with that. Without creating more government waste. You are missing my point. Think in terms or market distortions for a minute. As the system stands, the government is subsidizing large businesses. That creates a market distortion discouraging entrepreneurship. Individual cases are not that important, thing about the effects on the system. The manager of a Starbucks pays less for insurance than the owner of an independent coffee house. Therefore the government is distorting the market for coffee in favor of the large chains. Is that a libertarian policy? UHC puts both on an equal footing. Jonathan ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 7:32am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/148 "2009-01-29T07:32:23Z")
> [@RickJay](#): > > But _we don’t provide health insurance to wheat fields_. Canadians being “spread out” has nothing to do with the effectiveness of the health insurance system. Nobody, when it was set up, was thinking, “We really need to create a system so people in remote places get health care.” People in isolated areas _don’t_ get the same health care as they do in the cities - and since Canada is a very urbanized nation, with more than half the country living in around ten or so big cities, why _would_ that be the reason we have such a system? I didn’t say anything about the effectiveness of the health insurance system, I was talking about the financial aspect. Your UHC is not new. Do you have any cites for the reason(s) why it was set up back when? > [@](#): > > Does the USA not have people in isolated spots? Just how densely populated are Alaska, North Dakota, and Wyoming these days? Alaska I don’t know. ND and Wyoming are not that much different than Alberta and Saskatchewan if you factor in the difference in sizes. I suppose that Alaska is a lot like northern Canada, but I’m not sure how many people live in northern Alaska. OTOH, what is pertinent here is Canadian population when the UHC started, not now. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 7:35am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/149 "2009-01-29T07:35:50Z")
> [@Spoons](#): > > You are either remembering incorrectly or you were reading incorrect information. It started in Saskatchewan in 1946 and was followed by Alberta in 1950. [Cite.](http://en.wikipedia.org/wiki/Health_care_in_Canada) I’d kinda like to see something other than a Wiki entry. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 7:37am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/150 "2009-01-29T07:37:59Z")
> [@foolsguinea](#): > > 😃 [COLOR=“SeaGreen”]Aaand we have a winner! You just gave an argument _for_ nationwide socialized medicine in the USA! Actually, no I didn’t but I realize how much you want to have this so you can believe that Canada in the 50’s is the same thing as the US now all you want. 🆒 ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 29, 2009, 7:43am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/151 "2009-01-29T07:43:54Z")
Wait, what? Canada is “sparsely populate”–actually just mainly populated in a strip along the south–& has Medicare for all in each province. The UK is densely populated, & has an even more socialized National Health Service. Each country has areas of great population density & sparsely populated rural areas. Yet the same NHS serves Yorkshire as serves London, & a similar system serves Orkney. Canadian Medicare works in Montreal as well as in Labrador. What are you hoping to derive from this population density argument? ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 8:10am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/152 "2009-01-29T08:10:54Z")
> [@foolsguinea](#): > > And this is based on a sociological study, right? 😛 No, as I said it is based on my interaction with Canadians for decades. I really doubt anyone is going to do a sociological study to determine whether Canadians on average can be as big assholes as those in the US…:rolleyes: > [@](#): > > Look, if it were just what brazil84 calls the underclass, & getting out of the underclass were really more accessible for everyone, I might not expect any American to take the idea of socialized medicine seriously. But there’s a reason this idea is on so many lips now. Responsible working people who aren’t being paid living wages–in states that are more right-wing (Texas), poorer (Michigan), or both (Oklahoma) than what you know in California, or Washington state, or BC–are facing a pricing system that doesn’t work for them. The lower availability of money in those states interacts badly with the national pricing of medical services & supplies. But even in states that are both rich & “liberal,” the pricing system is out of whack because the distribution of wealth is so unbalanced. I suppose all of that depends on what you consider to be “responsible” working people. It also depends on what a “living wage” is, and why these folks are in jobs that don’t pay it. For example, we have a lot of Mexicans that come here with very little in the way of skills and education, and most of them are probably not making what would be considered a living wage, and here I am paying big taxes to give them medical care and educating their children. Why am I responsible for all of these (mostly) Catholic overbreeding third world folks? Yes, most of Mexico is a pretty awful place to live (at least the border towns, and Mexico City was a huge mess last I was there), and yes I should be grateful that at least these folks are working but my god! I don’t have the money to keep paying these taxes! I worked for almost 40 years - isn’t that enough? If you have to make me pay more taxes, balance it by stopping all of the money going to pay people to have children. If the government would quit that, maybe some people would wait to have them until when they can actually afford them (and health insurance). Start teaching fiscal responsibility at all levels in the schools (and real birth control). Quit celebrating teen pregnancy. I’m sure there are others but I’m getting sleepy. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 29, 2009, 8:16am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/153 "2009-01-29T08:16:06Z")
**I don’t want to raise your taxes.** I want to raise Warren Buffet’s taxes. Sheesh! ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 8:27am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/154 "2009-01-29T08:27:04Z")
> [@foolsguinea](#): > > So an 8th-grade education doesn’t qualify anyone for a union job in your world? No idea - I’ve never worked in a union shop, nor have I known anyone that does. But, does an 8th grade education get you a union job that you can still do in your 40’s and 50’s? Do you learn a skill that you can take elsewhere if you get laid off or have to move? > [@](#): > > Perhaps the Germans have a sense of community. Can you imagine Americans agreeing to cut the standard work week to 30 hours rather than just laying off a quarter of workers? I asked this before - how will the folks losing those 10 hours a week pay their bills? You think it’s better to leave everyone making less than they need instead of kicking the quarter off to get other jobs? ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 8:32am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/155 "2009-01-29T08:32:56Z")
> [@Strassia](#): > > I agree it would be logical, but Massachusetts cannot prevent people from crossing the border the way Canada can. My point still stands that a failure in a system set up in only one part of a federation is only evidence against piecemeal adoption, not general adoption. However, Mass could prevent people who move in and don’t pay taxes from signing up for UHC coverage. > [@](#): > > You are missing my point. Think in terms or market distortions for a minute. As the system stands, the government is subsidizing large businesses. That creates a market distortion discouraging entrepreneurship. Individual cases are not that important, thing about the effects on the system. The manager of a Starbucks pays less for insurance than the owner of an independent coffee house. Therefore the government is distorting the market for coffee in favor of the large chains. Is that a libertarian policy? UHC puts both on an equal footing. 😕 You are going to have to explain how the government is subsidizing large businesses translates into UHC is a good thing. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [January 29, 2009, 8:36am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/156 "2009-01-29T08:36:13Z")
> [@foolsguinea](#): > > **I don’t want to raise your taxes.** > > I want to raise Warren Buffet’s taxes. Sheesh! How are you going to create and manage this UHC without tax money? If you can do UHC without me paying for it, go for it. I don’t care what is done as long as I don’t have to pay for it. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 29, 2009, 9:03am UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/157 "2009-01-29T09:03:36Z")
Things may have changed since the crash, but a couple of years ago, about 50% of private wealth was in the hands of 1% of households. I’m not kidding when I say we don’t need your money. ---
**Author:** ![Foxy40](https://avatars.discourse-cdn.com/v4/letter/f/a9a28c/32.png) [@Foxy40](https://boards.straightdope.com/u/Foxy40)\ **Post date:** [January 29, 2009, 2:26pm UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/158 "2009-01-29T14:26:19Z")
> [@curlcoat](#): > > ( > If this is happening somewhere, you should hope that the state has an elected insurance commisioner and that person should be contacted. It is illegal for an insurance company to not pay for something that is in the policy. OTOH, surgeries that are outside the bounds of the policy can sometimes be approved given a lot of time and energy from the doctors - _those_ would take hours. Of course it is happening…it is happening all over the country with all private insurance companies. If there is an expensive procedure, they start looking for preexisting…followed by finding any other entity that may get them off the hook. (Was it an accident? Can we blame work, auto, a slip and fall?) Precertification doesn’t mean anything other than this particular procedure is covered under the policy. There is always the disclaimer that precert doesn’t guarentee payment. Of course Medicare doesn’t require this. If you have Medicare and you need the surgery, you get it. What a concept. I am on the fence on UHC. But it not running efficiently isn’t one of my concerns. Medicare is run very well and there are far less hoops. Most private insurance contracts base their rates on Medicare. The office enters the charges, the bill goes electronically and the funds get deposited in the bank directly. It is a beautiful thing compared to the denials and delays of private companies. ---
**Author:** ![Spoons](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spoons/32/3141_2.png) [@Spoons](https://boards.straightdope.com/u/Spoons)\ **Post date:** [January 29, 2009, 2:35pm UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/159 "2009-01-29T14:35:34Z")
> [@curlcoat](#): > > I’d kinda like to see something other than a Wiki entry. Wikipedia is good for basic facts like this one, but Saskatchewan as the birthplace of Canadian medicare is such common knowledge that I suppose I could have posted pretty much any cite. For example, [here’s one](http://www.mta.ca/about_canada/study_guide/doctors/delivery.html) from the Centre for Canadian Studies at Mount Allison University: > [@the above link](#): > > In Saskatchewan, the CCF administration of Douglas became the first provincial government to enact hospital coverage (in 1947) and medical coverage (in 1962). ---
**Author:** ![Strassia](https://avatars.discourse-cdn.com/v4/letter/s/e8c25b/32.png) [@Strassia](https://boards.straightdope.com/u/Strassia)\ **Post date:** [January 29, 2009, 3:33pm UTC](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032/160 "2009-01-29T15:33:16Z")
> [@curlcoat](#): > > No idea - I’ve never worked in a union shop, nor have I known anyone that does. But, does an 8th grade education get you a union job that you can still do in your 40’s and 50’s? Do you learn a skill that you can take elsewhere if you get laid off or have to move? > > I asked this before - how will the folks losing those 10 hours a week pay their bills? You think it’s better to leave everyone making less than they need instead of kicking the quarter off to get other jobs? I am not positive about Germany, but in France when they went to a 32 hour work week, part of the law stipulated that with few exceptions people would make the same amount for 32 as they were previously making for 40. I remember that truck drivers went on strike because they were one of the exceptions. > [@curlcoat](#): > > However, Mass could prevent people who move in and don’t pay taxes from signing up for UHC coverage. Well, then it wouldn’t be Universal. Seriously, part of the point of UHC is that it is actually cheaper to care for the indigent this way then our current system of only providing emergency care. Deny care to those who don’t pay taxes would defeat the purpose of the system. So they would have a choice between putting in a waiting period during which recent immigrants to the state would cost the system more, or not and potentially becoming a magnet for those out of work who need health care. > [@](#): > > 😕 You are going to have to explain how the government is subsidizing large businesses translates into UHC is a good thing. Well, let me put it this way, if you rule out the possibility of UHC then the only ways to remedy this issue is to either eliminate the tax break (which would increase most peoples out of pocket costs by more than a third) or extend to all people in all situations, which would require more of your tax dollars. Either way you pay more. From where I stand, UHC will probably cost me less and it also has the advantage of freeing U.S. from burden of providing health care through our current inefficient system. That is part of the ironic thing about our current system: it favors established companies over entrepreneurs, stifling innovation, while at the same time burdening all U.S. companies with a costly system that puts them at a disadvantage to places with UHC. Jonathan [Previous page](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032.md?page=7) [Next page](https://boards.straightdope.com/t/devils-advocate-saving-america-from-socialized-medicine/483032.md?page=9)