Really? There are only perceived benefits? Might you concede the possibility of any actual ones?
Let me explain one thing; once you have UHC, the fact of it disappears as a political issue completely - no politician in their right mind would campaign on the platform of changing the basic principle.
Lets take the 30 leading industrialized countries and suggest an average of 50 years of UHC in each - that would be about 200 elections in which politicians and people had the opportunity to change the system: It’s not imposed, it’s a choice like any political policy, and the policy is reviewed at each election.
I have no idea how many non-Americans are on this messageboard but do you see any others urging Americans to save themselves from this awful system?
On this point Sam Stone is beyond whistling in the dark, it’s the most bizarre position I have ever seen from someone who claims to live in a country with UHC.
Except, of course, you’re overlooking the fact that the US system, by force of law, already requires you to pay for other people’s health care, through the tax system, while you yourself may not get the same level of public health care. Odd to argue that makes you more free.
According to this report published by the US Department of Health & Human Services, US health care spending is 15% of the GDP; of that, approximately 46% is paid for by the public sector.
So Americans are not “free” from having their tax dollars used to pay for health care, and are not “free” from having their tax dollars being used to pay for other people’s coverage, through public plans such as Medicare, state plans, and of course the health coverage of members of Congress.
So if you’re not eligible for any of those public plans, you have less freedom than those of us in countries with UHC - you are required to pay your taxes to pay for other people’s health care, without getting the benefit yourself.
But that’s to be expected of any large-scale program - especially an entitlement program - where huge numbers of entrenched constituencies are created and voters are fearful of any change. Don’t you agree?
That’s why free-marketeers and libertarians are so loathe to create any new government program. Because once it gets started, it’s only going to grow. It will never go away. Hell, ACORN had that as one of their primary governing philosophies.
Medicare and Social Security are primary examples. They’ve trapped entire generations of voters into dependency. They know the program is headed towards bankruptcy, but they have too much invested (whoops: strike that…taken from them) over the years to back out.
Can you name any large scale government program (something that runs into the many $10s of billions) that serves a large number of constiuents, that voters have chosen to eliminate in the past 50 years?
I can think of only a few in the G-8 countries, and only if you really stretch the definition of ‘program’. But they were accompanied by a hell of a lot of rioting and such.
Yes, it does appear democracy entrenches redistribution when so permitted that choice by the feudal Lords. It’s a funny thing that.
I’d be able to say more if you were clearer on a definition of ‘grow’; if we assume you’re not taking cheap shots then I should say healthcare in the USA is projected to rise from 15.4% of GDP in 2008 to 19% of same within 10 years.
The two most comparable economies - France and Germany - are currently running at 11% and 10.4 % respectively.
There is no record of which I’m aware in any indistrialized country of healthcare running out of control - instead, the mechanism is that expenditure reflects economic growth (or decline). Indeed, the electoral debate becomes (a) how much do you want to pay for this? and (b) value for money. In times such as now, the debate becomes more charged. Borrowing in the bad times is also an option.
I can’t agree either program has trapped “generations of voters into dependency”. Social policy has trapped those people. Medicare and Social Security ‘dependency’ are symptons of poor policy, they are not causes of dependency. Education poverty, housing poverty, etc. cause disenfranchisment. I don’t think you need me to explain that.
Of course I concede that there are actual benefits. To the uninsured person who has to pay $120 out of pocket that he can’t afford to see a doctor, or more likely, not pay it and suffer with his sickness, UHC would be a godsend. That doesn’t mean that it is good for the already insured Americans.
The only question is whether the overall pitfalls are worse than the actual benefits, and me and others feel that LESS government and more market participation would open these channels to allow for more access to care.
I feel that the reason health care is so expensive is precisely because the government already guarantees it for the poor and the elderly.
With most of the rest of the younger people having insurance that shields them from the true cost of the care, the medical professionals can feel free to ignore the uninsured and have a “pay the money or get lost” attitude.
If we were all participating in a market system where we cared what each item cost and shopped among competing providers, the system would operate much more efficiently.
I’ll ask you: (all of you UHC proponents really) If government intervention is so good for health care, then why not everything else? Why NOT implement total socialism?
Why not, for example, nationalize farms and have taxes taken out to pay for food that people can get for “free” at the local government commissary? Instead of paying the SDMB $15 per year, why don’t we subsidize message boards through taxes and make all of them “free” to use?
As someone living in Canada, I also don’t get this. I’ve lived under the US system, and I would not go back without a fight.
I might also point out the Americans pay for evil socialized medicine* through their tax dollars for the brave men and woman in the military fighting for freedom. And yet, those military types have not, in general, become Trotskyites, or Maoists.
- It’s free, it’s provided by the government, it’s pretty much all inclusive, and it’s funded by the taxpayer.
Because developed capitalist nations don’t do that.
There is no nation more against socialism or communism than Taiwan and yet:
So, the point still stands.
The opponents of UHC are fighting to limit freedoms like Americans being free from bankruptcy for health reasons, and to limit the freedom for small companies or individuals to start their own companies.
I would argue the following:
Some things are not that expensive, and not everyone needs them, or, not everybody needs the same things exactly. If you want or need it, you should buy it yourself - Steak, golf clubs, sports cars, bicycles. This also applies to clothes and haircuts. These things are also subject to the vagarities of fashion or taste.
Some things most all of us need and the infrastructure is too big for any one of us to buy ourselves. For these things we band together and form committees, working groups and yes, governments to get these things for us: Highways, dams, aircraft carriers, state departments.
I may never need to drive to Maine, but if I do, the government has made a highway there, because a lot of us do need to eventually drive there. I have no beef with the Argentina, but we have armed forces, so that I don’t have to retake the Falklands myself. I’m feeling pretty good today, but most people eventually need some sort of healthcare, so I would argue that it falls into the ‘band together’ catagory.
Farm poduce is cheap, and subject to the whims of picky eaters, much like clothing. It is fine to let farmers do their thing and sell the produce as they see fit. One guy buys mac and cheese, another buys organic free range beef. But when they have their heart attacks, what they’re going to want is medicine, now, and lots of it, with no discussions about what is and isn’t covered.
Why do we need to be so dogmatic that it becomes an all-or-nothing choice?
It’s great to have guiding principles, but what’s wrong with saying this is one particular area where it would be good for some kind of government involvement or oversight? I think conditions merit such an action.
And me personally, I won’t be very sympathetic to a slippery slope argument.
We don’t have to give in to the slippery slope; I am only asking.
Why is food so different from health care that we can have a free market for the one, but not for the other?
I would also ask, “Why does health care have to be lumped together”?
Why does a heart surgeon have to be in the same system with a country bumpkin doctor who writes Xanax scripts for nervous old ladies? Why does the guy who churns out antibiotics to sick kids with snotty noses get compensated in the same system with a brain surgeon who comes up with an earth-shattering new procedure? We all don’t need heart or brain surgery. Those are extraordinary risks, but are “insured” like everything else.
I view doctors visits and routine tests like normal food. Cancer and heart surgery are the extraordinary that we should insure against. In my perfect world, it would be privately, but perhaps a government solution would be good there…and there only.
We can find compromise or solutions in all of this, but our arguments are always national health care vs. what we already have
There isn’t a reason for these unchangeable positions.
A point - Sam Stone is wise about many things, but here in Calgary, doctors do indeed chose who their patients will be. Jim and I interviewed with three different doctors before finding our current family doctor (that is the process here now - you go to an interview with a family doctor, and he decides if he will consent to add you to his family practice). There is some room in the billing practices for them to receive payment, too.
Your question cuts both ways. Why is the mail so different? Why are schools so different? Why are national parks so different? Why are roads so different? Why is the military so different? Why are fire departments so different?
If anything, precedent leans more towards government involvement than against it.
Food is diverse. We all need it, but we can reasonably predict what we will want, and there is no upper limit of what food is appropriate - witness civet cat shit coffee. I can pretty much guarantee that I will never again eat sardines, and I have no need to pay for your sardines. Pretty much all food is in some sense optional - I need food, but the exact kind of food is up to my tastes.
You are welcome to waste your money on civet cat shit coffee. I am happy not too. Health care is different in that we all need it, we can’t afford to buy it by the piece, and nobody knows which piece they will need. It is not fundamentally a consumer-opinion-driven process.
We don’t know who will or won’t need heart or brain surgery. It’s great for you to have this opinion, but when you get a thunderclap headache at the moment of orgasm, you have suddenly become someone who does need brain surgery. Do you know you don’t have an aneurysm? Perhaps a silent congential defect of the heart? A slowly clogging coronary artery? Maybe you’re developing a deep vein thrombosis sitting in front of your monitor, and a pulmonary embolism is minutes away*. You never know what part of the system is going to break down, or what part of the health care system you may need.
Your family doc is not a bag of rice. He or she is the person who diagnoses you, and sends you off the the appropriate specialist. The visits and routine tests are what are determining the rest of the process. Cancer and heart disease are extremely ordinary, and the whole point of insuring against something is to try and protect yourself from the UN-expected.
- God forbid!
Good examples.
Why is the mail so different?
- Because I don’t want to row to Hawai’i every time it’s my mother’s birthday, so we organize a collective method.
Why are schools so different?
- Because I don’t want to home school my kids myself, so we organize a collective method.
Why are national parks so different?
- Because I can only protect my yard, but if we organize a collective method we can all visit nature.
Why are roads so different?
Because paving my driveway is expensive. If I pave all the way to Florida it’ll be a pain, so we organize…
Why is the military so different?
Still don’t want to retake the Falklands alone, so…
Why are fire departments so different?
This is the best example. Health care is exactly like the FD. We don’t know who is going to get sick, we don’t know which house will catch fire. Instead we work together.
Steak, on the other hand, I am happy to take care of by myself, buying, cooking and eating.
But without socialized health care, you have more people dying, and therefore more people to eat, which lowers food costs.
True. Maybe we should organize some sort of government run scheme to deal with rendering the corpses.
The loss of freedom is one of the cost of regulation. The aim of regulation is to make life better and more secure and therefore more free. There is in theory cost benefit.
P1. It shouldn’t be. There is absolutely no reason for the government to be in the business of letter delivery. It could all be privatized tomorrow.
P2. A fuzzier case, at least IMHO.
Providing resources for basic primary and secondary education passes the externality test, as I’ve postulated in other posts. That doesn’t mean that the government should be the delivery mechanism, via a unionized public school system.
Straight cash to the poor, or vouchers, would be a better option. Along with simply returning all the tax money taken for education from the rest of the citizenry, and abolishing the public school system.
P3. Another fuzzy case. You’ve picked some good ones.
The key point with national parks and wilderness areas is that there is less margin for error in ‘mistake-and-correction-loops’ if something goes wrong. That is one of the areas where libertarian theory starts to break down…also IMHO, of course.
By comparison (and example) that is not the case with ordering a hamburger, buying a new car, or choosing to watch a crappy TV program. You will choose not to watch it next week, the advertisers will suffer, and the program will get cancelled. The free market works.
P4. Good one! You’ve picked some good ones! There is also no reason for the government to get involved in road construction (or other large infrastructure projects) other than to overcome significant transaction costs on the front end. But then the government should privatize the operation of the roads later.
In fact, it should signal this up-front…for example,
‘We will build a new highway here, but it’s operation will be privatized in 10 years. Bids will be accepted tomorrow’.
That way the government overcomes the front-end transaction costs of eminent domain lawsuits and such, but commits to get out of the business of maintaining infrastructure, a task at which it sucks and is horribly inefficient.
P5. Because its a fundamental, basic function of government.
P6. There’s no reason why it needs to be. There are many rural areas where fire protection is provided by volunteer forces, and other public services (like trash collection) are privatized. If a locality wants to pool resources to tax the citizenry and engage fire protection, that seems reasonable to me.
Please note the large difference between a local program and a federal program, which I feel is often understated…it’s a huge, huge difference. There is much tighter accountability, and more ‘choice’, in local programs.
But good, challenging objections nonetheless. Well played! Extremely well played, sir. (Or Ma’am)
This seems like a horrifically bad idea to me. No way in hell I want a bunch of warring, for-profit enterprises to be involved in major travel routes. Perhaps I’m misunderstanding your argument, but I want the biggest thing on the minds of my bridge-maintenance crews to be “public safety”, not “profit margin”.
I’ve got a healthy streak of libertarian in me, but there are a handful of things I want a state- or national- collective looking out for: national wilderness, national defense, transportation, education, and health are on my list. I think these are all things that we have a huge stake in, on a national level. Fire safety? That one I can easily discard as best served on a municipal level with some backup from the state and/or military in a crisis… but the others, not so much.
If every state was equally capable of caring for their own the way California might be, I’d generally agree with you on the issue of leaving it to state-by-state solutions. The problem I see is, that’s just not true. That being the case, I am willing to pitch in some tax bucks from a relatively prosperous state toward a national plan which benefits me and in turn serves to help folks in, say, Alabama. I think a wholly healthier population benefits me both directly and indirectly in a lot of ways.