How about socialized medicine?

Great Debates
41

I’ve got a question or two now that I’ve thought about this.

I’m on a motorcycle mailing list and we were just talking about insurance and a point came up that I had never known: that insurance companies can deny your claims if it comes from a “High Risk” activity such as motorcycling, SCUBA diving, or parachuting. Does this mean that if there is a national system I can be denied claims because of a motorcycle accident?

As it is now if I don’t like one insurance company I can get another one even if it costs more. However, if a national system says we’re not gonna pay for motorcycle accidents, do I have to then pay twice as much to get insurance in case of an accident? Plus who decides what is “high risk”?

We already see people complaining about smokers and insurance and how it costs millions of dollars each year to different states. this is the problem I see with a national health system, someone is gonna decide what I can and can’t do because it might cost money. it’s not their choice to make for me.

42

Thanks for the link London_Calling,
I have a ton of reading to do.

and for the record phantom I’m a man.
Zebra

43

Please provide an instance of a national health service that has ever said they will not cover certain activities.

44

Precisely. A proper NHS is required by law to provide health coverege to everybody.

45

Ed-Head - I said that an NHS was in essence nothing more than a nationwide insurance scheme. However in amongst my spiel I did make the point that one advantage a nationalised scheme has is that they will not have exceptions in their contracts - i.e. no refusal to treat based on certain causes. Everybody is covered for everything.

You could feel free to injure yourself via mad motorcycle stunts everyday of the week.

pan

46

One of the main arguments against private care is that it neglects prevention in the first place. Studies show that people without insurance wait until a disease of medical problem has progressed to an emergencey treatment phase. That’s when the fallacies of too much paperwork (to qualify to care) and substandard care for government plans are invoked. If a health system is substandard, it begins with preventive care.

47

Agreed. There is no small print with universal health care.

Another thing that struck me that’s different is that I can walk into a hospital anywhere in the EC (basically Western Europe) and get treated by signing a form. No limits, no cost. I believe there are also reciprical agrements along the same lines with Australia, Canada, NZ, etc, etc…

In effect, it’s evolved into a (first) world-wide system.

No problem, Zebra.

48

Sorry - didn’t fully answer the question.

Also note that the NHS takes their revenue from the treasury (UK terminology - i.e. from the tax base). It does not come from individuals paying premiums.

pan

49

Not exactly. I think it depends on the plan.

Here in Ontario, OHIP (that is, the Ontario Health Insurance Plan) covers most things, but there are certain items or procedures that it does not. We know the big ones: unnecessary cosmetic surgery, for example; and the usual ones, like dental work. But there are others that are less-well-known, and without asking or reading the OHIP Schedule of Benefits, you might not know until it is too late.

It’s been a long while since I’ve read the Schedule, but IIRC, one of the things that was not covered was a telephone conversation with a doctor. (But oddly, the same conversation was covered if it took place in the doctor’s office.) Another that was not covered was the cost of a physician’s certificate if a camp or school required one before admitting a child. The physician could bill the child’s parents for the certificate.

These are small things, true, and not the only ones, but if the physician doesn’t tell the patient (or the patient’s parents) up front, there will be a surprise when the bill arrives.

Of course, this is in Ontario; other provinces have their own health plans that may cover these things. But as with most things, there is fine print even in a provincially-run system.

Not that I’m aware of, but it’s been a while since I’ve been to the UK. Things may have changed though–anybody know for sure?

I do know that there is no reciprocal agreement between Australia and Canada; each time I head down there, I have to buy out-of-country health insurance. And my contacts down there have to do the same when they come to Canada.

50

Man, nothing like debating with 50 people at once :wink:

Phantom
I am not arguing from an ideological stand. I am arguing from an economic/technological-advancement one. Though, I suppose, one might say my economics are my ideology. Say what you will.
The question becomes where do we want the money to go? It is posited that a nationalized health care package is more economically efficient because it accomplishes the same for less. This is from the receiver’s side. I am arguing that a private health care system generates more funds. This is from a supplier’s side.
My argument is in a large part based on the advancement of drug and medical technologies. I find a private, competitve market has continually shown it usefulness in promoting technological growth.
The case against me is one of ideology (everyone needs health care so we should provide it; health care is a right) and/or one of user efficiency. They are obviously mutually exclusive. Thus I argue ideologically against an ideological argument for one poster and economically to another. :smiley:

[sub]paragraph break for gadarene ;)[/sub]

Zebra
OF COURSE I benefited personally from public education. that is not in dispute. That I would also benefit from a socialized medical plan is ALSO not in dispute.

I didn’t say I think it absolutely necessary for the government to handle road building. I said it was practical. Government roads do not stop toll bridges and toll roads. Privatized roads would not make them free. As well, the task of building a road itself is largely formulaic (apart from the design aspect) while technological development is not. Teaching students is also not formulaic. The state’s means of control is formalism. Private enterprise is not so formal…rather, it is sometimes more formal but in more ways (since there are more companies).

Education isn’t a plug and play event. And the government cornered the market on education, worse than any monopoly could hope to do. We don’t like to think of that, and I’m not saying public education (the education received itself) is necessarily bad, either.

I will not continue to hijack my own thread. I didn’t make the comparison to education and I will no longer support it.

“If you want to live a free as a caveman please move to a cave.” Don’t give me that shit! If you want socialism move to a socialistic country. :wink: I am not going to deal out those kind of arguments, and I’d ask not to receive them.

Gary
“I hope you’d appreciate the sheer sense in not wasting money in this fashion.”
I don’t find it wasteful. I feel the growth and benefits gained technologically outweigh the other inefficiency. If it weren’t for these people in the first place we wouldn’t have the technology to begin with. I am not so quick to force them to perform a service.

“We could also discuss why a healthy workforce is in the economic interests of your country…”
Yes, I did address that. I said that the growth of society would increase, but not in comparison to the number of medical practicioners due to lack of incentive. We’ve been dealing with socialized medicine for only a few generations. This argument is not accessable from any standpoint other than an ideological and hypothetical one.

I would like to further address the incentive issue. The fact that a person has a right to health care vs the profit motive for becoming a practicioner in some respect. Profit is quantifiable; respect for rights is not. That is, we are largely relying on an uncontrolable sense of duty to maintain the field. Not that doctors still don’t make decent wages, I’m sure they do, but the prospect of profit here is better, thus we should have more doctors. Controlling a sense of duty is acheived through propoganda.

Kabbes
“A government insurance plan does not need to include margins for profit or contingencies in their premium prices (i.e. taxes). This means that the charge to the consumer is lower, so capital investment in the private markets can be higher.”{emphasis removed}
In private markets in general. The concern is that this money will not return in the same quantity toward the advancement of medical technologies.

Let us consider this as it stands in the discussion between you an I. It is, as far as America largely stands, a problem of distribution, not demand or supply. There is an unequal distribution, or in some cases a complete lack of it. Socializing insurance will indeed largely solve the problem of distribution. So will a semi-monopolistic insurance group. Were a semi-monopolistic insurance group, an oligarchy of sorts, to run the insurance there would still be a large amount of profit. Companies do not store their profit in a vault, they store it in the form of investments. Thus, in either regard, the extra monies are being reinvested in the economy. Private companies generate profit for reinvestment, government simply spends money.
You might even consider, as well, a sort of quasi-public institution like The Federal Banks are an institution…a sort of non-profit insurance company for insurance companies. This seems to be about as far as I am willing to stretch, honestly. Perhaps this seems ideological. I’m sorry.

“countries with nationalised health spend less money as a % of GDP on greater coverage.”
Yes, I know! :wink: This isn’t theoretical, but it again uses practicality and/or efficiency as an ideological standard…that is, “It is more efficient so it MUST me the correct solution.”
American health care is largely inefficient with respect to distribution, I agree. This problem should be addressed, I just find the potholes of socialization to bring its own problems.

“Also note that the NHS takes their revenue from the treasury (UK terminology - i.e. from the tax base). It does not come from individuals paying premiums.”
kabbes, come on, you know better than this. The taxes are increased to help medical coverage. The premiums are still there. Stuff doesn’t become free just because the government takes it over. :wink:

Brian
“One of the main arguments against private care is that it neglects prevention in the first place. Studies show that people without insurance wait until a disease of medical problem has progressed to an emergencey treatment phase.”
Now that is a damn fine argument. I trust you see that I agree that a national-style medical plan is probably in our best interest, just, again, not a socialized one.

51

arl: Did you even bother to read the rest of what I said? To summarize: we already have subsidized health care for what probably amounts to a majority of our population. We’re already halfway to a national plan, except that we have the injustice that who’s in or who’s out depends on chance more than it depends on anything else (as does what gets covered, too, now that I think about it).
As of right now, the government probably spends more on health care than on any other single item save the national defense. (I’ll look up the actual figures when I get home.) SO you’re arguing against something that already exists for a majority, and will exist for all if we have the will to make it so.

52

I didn’t say that they would have some sort of fine print, I said that they COULD, or at least they might think about it. And someone above said that Canada has some small print about getting health certificats signed so right there is one example.

You can also look to the smoking suits where the states sued, at least this is what I understood, because they were having to pay for the medical bills of some people and it was costing millions of dollars for the state. That right there to me says that the state doesn’t want to pay for smokers so the tobacco companies should. Who’s to say that the next thing will not be motorcycles, or scuba diving, or anything else that can get someone hurt.

I’ve also heard complaints about how bad some doctors/service can be in places like Canada and I’ve been to a dentist in Ireland when I lost a crown. He wasn’t very nice and when I told him that my normal dentist wanted a non-permante cement to hold in my crown because the tooth still damaged. That dentist told me my normal dentist was an idiot and gave me all sorts of crap about it. Gee sorry dude but you haven’t even looked at my teeth.

I still don’t like the idea of National Health care and there are places that will help out the people who do not have insurance.

53

OK, here are the last figures for what the government spends that I have at my fingertips. These are really old, from 1994, but for some reason my last edition of the American Almanac isn’t updated for these figures past that time. Here goes:

Medicare - 145 billion
Other health - 107 billion
Total of these two items: 252 billion.

The “Other” includes Medicaid, health care for the armed forces and other federal employees, federally financed research, and other health spending. It doesn’t include Veterans’ health benefits.
The tax expenditure for subsidizing corporate health plans, which I don’t include in the above because it’s not actual spending, only forgone revenue, amounted to 56 billion in 1994, while the deduction for medical expenses cost another 3 billion. So just health alone commanded, in total, 311 billion dollars in either actual spending or forgone revenue on the part of our national Treasury (NOT including Veterans’ benefits), and that was six years ago.
As a practical matter, consolidating everything, Medicaid, Medicare, Veterans’ care, and all the private plans (by getting rid of the tax expenditure) and simply taxing all employers and employees at some to be determined rate to finance the consolidated plan, has got to turn out to be cheaper overall for our society than this improvised patchwork we’re living with now. It would certainly be an order of magnitude fairer.
I pointed this out in another thread, and I’ll point it out here: prior to 1993, there was steadily building support in the business community for a national health plan. The overly bureaucratic plan Bill & Hillary came up with at that time evaporated that support. But the logic was simple: those corporations that have a plan are paying more than they would under a national plan, because they’re insuring smaller, riskier groups, whereas a national plan would spread the risk to everyone, which is what kabbes has been trying to point out.

54

Concern is not fact. In economics it is always better to have the choice as to where capital should be invested rather than being forced. The spare capital available due to an NHS can be quite happily invested in research, if so desired. I’ll agree though that it becomes a murky area to see the best way of melding free-enterprise initiative with state-centric efficiency.

Hurray! We’ve achieved some more common ground.

Right - here is the last great misunderstanding I think. Insurance company financing doesn’t work in the same way as manufacturing or service-based financing due to the unpredictable nature of the liability. You can’t just take your money and invest it in the optimal way, because you don’t know what you’re going to end up paying out. Instead you essentially do have to shove your backing assets in a vault - or at least into non-risk assets that match your liabilities, such as government bonds. In many ways private insurance becomes public insurance since the liabilities are being backed from government debt! While it may be healthy for the economy to have a ready market for government bonds, it would be healthier for this capital to be invested in capital projects instead.

Health insurance is an extreme example of this due the the extreme volatility and unpredictability of the liability. You end up sitting on easily twice as much capital as is necessary “just in case”. An NHS however doesn’t need to worry about this “just in case” scenario because governments can’t go bankrupt. The excess wealth is therefore retained in the economy in the hands of private individuals (via tax-premia being lower than the equivalent insurance-premia), who can invest it in the free-market as speculatively as they like.

Ah yes, in the end it does come down to ideology. I spout my economic-based arguments and you spout your research-based ones but I strongly suspect in the end I just like the idea of everybody in the country being able to get free-at-point-of-contact medical care whilst you don’t like the idea of, in a direct way, paying for others.

As I said…

I never meant to imply that it is free! I was rather assuming that the extra tax was implicit in the statement! Sometimes my rigour slips - it’s not easy to try to not leave holes you know.

pan

55

Well, the company I work for has strong ties to Europe. We have two of our friends from the UK here this week and my boss is from Denmark. So of course I feel the need to bring up the angle of economics that we are discussing right here.

As is usual over beers, the conversation was wandering all over the place. We came to people suing McDonalds (for instance) because they slipped on a recently mopped floor. To which my boss replied: “Yes, but how was I supposed to know the floor was wet?” ; “Well, there was a wet floor sign.” ; “Yes, but because you won’t have public schools I couldn’t go and I can’t read.”

Well, {i]I* thought it was amusing anyway. [sub]“Yeah,” said a Brit, “but that’s what the picture of the guy falling is for.” Vindication![/sub]

So kabbes we’ve seemingly reached an impasse. One thing I wanted to address.
“In economics it is always better to have the choice as to where capital should be invested rather than being forced. The spare capital available due to an NHS can be quite happily invested in research, if so desired.”
Er… It is better to have choice so create a tax (forced) based health care plan? Eh? As well, I am still a little tenuous on the NHS reinvsting…is this assuming some surplus?

phantom
“As of right now, the government probably spends more on health care than on any other single item save the national defense.”
Yeah, and IIRC if current spending trends continue the government is going to go bust between social secrity and health expenditure. This leads me to more strongly dislike a socialized plan, of course.

56

To my regret I sense that this thread is dying. Ah well.

Anyway - to answer your question ARL, I merely note that choice is better than no choice all else being equal. To my mind the economic arguments I have presented in favour of an NHS clearly outweigh the “choice”* that would be present in its absence.

And by extra wealth I mean the extra money which would otherwise have been spent on more expensive insurance premiums compared to the tax needed to support an NSH. If NHS costs X and private insurance costs Y then by chooising NHS we have an extra Y-X to spend on capital investment.

Last few questions mopped up I think. Shall we discuss public education instead?

pan

*I put the quotation marks in because the above arguments indicate that the choice of private companies is not quite that which it may appear, what with exclusions and lack of suitable suppression to volatility of experience.

57

Again, you are looking at once specific of a general case. We need a reasonably large insured base to develop lower costs. In a country like America this could easily be accomplished through two or three large insurance companies. There is no need to turn to socialized medicine as a rule since the problem is simply covering a large number of people.
Now, common sense will show us that this isn’t going to happen without a government shove, but the government doesn’t need to run the thing either.