Wikipedia says that it was opposition from the American Medical Association that killed public health care for FDR and Truman.
Atwater said no such thing. He said that appealing to racism no longer worked so they had to use appeals that did.
No he didn’t. Listen to the whole interview. eta- as** Puddleglum **sez.
So out of 115 posts you managed to find two which are vaguely insulting about the american public (on a site that frequently takes that tone), and you are taking that as a good enough reason to handwave the actual argument, that has been patiently explained many times in this thread?
The cognitive dissonance exhibited here, and on other topics like climate change, is fascinating.
How does one counter an argument, when no counter-argument is available? “You guys really shouldn’t use that argument: Here are two examples of people rudely-stating the argument, therefore it’s just plain rude”
Yes. But again Listen to the whole interview. Taken out of context it sure sounds like that. But if you actually read or listen to the whole interview you will see it is taken out of context, and Atwater means just the opposite.
No. You are currently wasting ~1.6 trillion dollars in the healthcare sector while having a national debt of 21 trillion, and running a deficit of ~800 billion. You cannot afford waste of that degree of magnitude. That is the bottom line, regardless of how it polls.
Further, US satisfaction with the US healthcare system is extremely weak. And has been for a long time.
What you are citing is that Americans satisfaction with their personal care, not their system, is over 75%. That is also not that good for a developed nation.
Also, people do not necessarily know if their healthcare or healthcare system is good unless they have something to compare it to.
Most people don’t know jack-squat about the healthcare system. It reminds me of the lady that once told her congressman to “keep your government hands off my medicare”, or when people were interviewed who had just bought a policy on a state exchange and were glad it wasn’t an “obamacare policy”.
But people are familiar with and do know their own healthcare. They know their doctors. They know how they’re treated. The 75% satisfaction is real, and it matters. And it’s one of the reasons Obama went with the ACA to begin with, as he didn’t want to change the overall system, but just part of it.
And it appears that some nutcase judge in Texas ruled the ACA unconstitutional.
I’m sure hoping this gets overturned.
Why don’t you stop talking about satisfaction with doctors and start talking about satisfaction with insurance companies.
For instance, this article does not give the satisfaction level, other than it being constant, but does say:
and
which doesn’t sound so great to me.
But this article gives more data - if a bit old.
Worse than airlines? That’s pretty bad.
Satisfaction with Medicare is well above this. So why don’t you focus on the real issue, not the strawman issue?
It may well be real but its also low. A pretty poor satisfaction rate compared to other first world systems. Also the rate of dissatisfaction, and the fraction that feels the US system needs a total overhaul is also pretty real, and matters. And once again: satisfaction with your personal doctor and healthcare is not the same thing as satisfaction with the system.
I mostly agree.
But where I really agree is that most people don’t jack-squat about the healthcare system in other countries.
Sweden’s system may be too localized for generalizations.
In Italy, people who need to go to a specialist can wait several months, or can have an American-style wait of a couple of weeks by going private. This does not sound to me like single payer!
Almost every country has competing payers and providers. When an attempt is made to establish one payer for all, what happens is that the non-affluent are stuck with the one payer, and the affluent choose from competing payers.
Maybe I don’t know jack squat about the universal care systems where competing payers make up the core of the system, as in Switzerland, Germany, and the Netherlands. However, this sounds to me much better than one system for the poor to lower middle class, and a bunch to choose from only for others. Is Swiss and Dutch medicine expensive? Well, yes, although not as expensive as in the US.
A respectable GOP should favor competition-based systems, such as Romneycare/Obamacare. Instead, ever since Reagan socialized American medicine, the Republicans have been facilitating health care freeloaders who refuse to take out affordable heath insurance and then receive multi-million dollar care, at public expense, when they get in a no-helmet motorcycle accident.
When you say “American-style wait” are you suggesting that the wait time for all Americans is only a few weeks?
Or are you saying anyone with health insurance has a wait time of only a few weeks?
Or are you saying that the wait time for people with a certain income level is only a few weeks?
Because those are three different situations, and it’s not appropriate, in my opinion, to use the term “American style wait” without clarifying which one you mean.
My understanding is that for Americans without insurance, the “American-style wait” can be infinite.
Is that not the case?
I am an American and this is the case as I understand it. The law gives us the right to emergency care, but cancer is usually not an emergency until the end of life so there is no guarantee you will get treatment if you are terminally ill. There is always medicaid, something which many Americans fall back on after they bankrupt themselves, but the care is not awesome.
The point I am making is that opponents of UHC in the US often point to wait times in Canada (or Italy in this discussion) as an indicator of the flaws in UHC.
However, the unexamined premiss of that critique is that there are no wait times in the US, or they are very short.
But if you don’t have good insurance, or any insurance at all, in the US the wait times can be very lengthy, stretching to infinite.
Comparisons should be apple to apple, not apple to kumquats.
The latter. Now, in 2018, going without insurance is illegal in the sense that there is a national tax penalty. For 2019, that penalty goes away nationally but a few states will have their own insurance mandate (I believe, Massachusetts and New Jersey – maybe more).
One thing I’ve wondered about – what happens in countries, like Germany, Switzerland, and the Netherlands, where there is universal coverage based on a mandate that almost everyone pay affordable premiums? If someone doesn’t pay, do they go to jail? Or it the idea of not paying so idiotic than the mandate barely requires enforcement?
I am against attempting single-payer but for affordable universal coverage.
Your article – I wouldn’t exactly call it a study – accepts the myth of single payer. In reality, attempts to get to single payer result in multiple payers, with the best ones patronized by the upper middle class and above. Under the proposed 2017 Bernie Sanders law reviewed in your link, I think that large numbers of primary care docs – already in short supply here – would withdraw to concierge practices. The article completely ignores this, and a lot else that actually happens after a country tries to go single-payer. Now, the Sanders plan could be improved, and probably would be if something like it ever got close to passage. But I think we’d be better off using the Affordable Care Act (which also needs a great deal of improvement) as the starting point.
That’s not what the Wikipedia article on health-care coverage in the US says. It states that in 2016, there were 27 million uninsured Americans. The source for that cite is a US federal government report: “Federal Subsidies for Health Insurance Coverage for People under 65”, put together by the Congressional Budget
Office.
That’s 27 million Americans for whom wait times are infinite.
And, you note, now that the tax penalty has been removed, that number is likely to go up.
Sure, you can get to UHC without it being a single-payer system. Germany, Switzerland, France and Australia all offer multi-payer UHC examples.
However, it’s not the case that single-payer results in multi-tier systems like you’re mentioning. In Canada, a prohibition on multi-tier is one of the basic principles of our single-payer systems. Doctors can’t charge more than the set rates, so no point to trying to set up a concierge clinic, or charge more to well-heeled clients to jump the queue.
The only way that’s permitted is if doctors opt out of the single-payer system entirely, which would mean their clients (one hesitates to call them patients, when money is the main distinguishing feature) have to pull the full freight.
And in Canada at least, there’s not enough people willing to forego our terrible socialist system and pay full freight.
So, do you have a cite to support your assertion that multi-tier is an inevitable result of all single-payer systems?
I was thinking of this:
Top court strikes down Quebec private health-care ban
Googling, I also found this:
Why private health insurance coverage in Canada needs a review
I’m not saying your system, either as it is currently, or with modest improvements, is wrong for Canada. I just don’t think it’s right for the more individualistic* U.S. ethos.
- The idea that Canadians tend to be orderly followers of the official way, and that Americans insist on individualistic choices, may be a ridiculous overgeneralization I’m picking up from wildly outdated Pierre Berton history books. But, well, it’s only the internet, so I’ll risk it
Sure, but neither of your cites support your assertion that multi-tier health care inevitably develops under single-payer.
The Chaoulli decision of the Supreme Court said that the province could not prohibit private health insurance. However, 13 years on, the decision’s had little to no effect. There simply aren’t enough people who want to pay insurance premiums on the off-chance it may help them get health care faster than the public system. Pay insurance premiums and taxes, and maybe get faster care at some point in the future, or pay taxes and use the publicly funded health care system at no additional cost? There’s not been any market for private insurance.
With respect to your second cite, yes, there are some health care matters that are not covered by Medicare. The big ones are dental and pharmaceuticals. But that’s not the same as a multi-tier system, as you said inevitably develops under single-payer. If something isn’t covered by Medicare, paying for those matters by other means isn’t a new tier of Medicare.
Where the premiums are to a national system, not paying counts as tax evasion: translate “don’t mess with the IRS, 'cos they fersure can find holes in your accounting” into any language you care and serve au jus.
And where they’re to insurance companies yes, there are penalties. What the exact penalties are will, as any legal question, vary by location. Proof that every worker (employed or subcontractor) is indeed insured is one of the things auditors look for (both the tax fellows and the safety fellows).