Motor Vehicles handles your immigration papers?!?! Really?!?! OK if you say so. Feel free to come to my tiny part of the world where you can walk into the DMV office, get served, and get gone, pretty much like that.
As for the rest, we really aren’t comparing two extremely shitty systems. We are comparing one extremely shitty system, the privatized system the US is being crushed by right now, to a theoretical new system crafted from the best features of the diverse systems already in place in other countries. The problems and issues known to occur in each of those systems should serve as cautionary and instructive details that can help us to avoid committing the same errors.
Thanks for explaining your definition of right-to-life. I understand that’s what you believe, and I don’t want to argue back and forth about it as that seems like it would be an entirely new, long debate.
I would say though, that as long as we continue to have our health care system based on a fee-for-service model, where each procedure completed and test ordered is how the vast majority of MDs are paid, there is a huge problem achieving effective cost-efficient treatment.
In addition, even now, death panels exist- they are just based on who has the money to pay vs. who does not.
A lot of the health care we’re talking about moves beyond simply letting people die. Through EMTALA, which makes emergency medical care mandatory, we’ve reached the point as a society that we agree that letting someone die when they can be prevented from dying is bad. I think it’s just much harder to extend that particular argument to non-emergency treatment.
I also have seen little to indicate that costs will actually go down from health care reform- although they might stop rising as fast as they currently are. But the point of health care reform- and the right to medical care- should be discussed in terms of better health outcomes (ie. a healthier population).
Compared to other modern, industrialized nations, the US spends the most for the least. That is really shameful.
Of course there is no “right” to health care. Its not a natural law.
There is no more right to health care than there is a right to education.
But as a society we have determined that everyone should have access to a certain level of education regardless of ability to pay. Part of this is ethical and moral but part of it is very pragmatic. An educated populus leads to higher productivity and a more enlightened society. Every year of education up to about the second year of college provides more in additional tax revenue than it costs, never mind all the other benefits of an educated populus.
Health care might similarly be considered something that everyone should have a certain level of access to for moral as well as pragmatic reasons. Pragmatically, a healthier population is more productive and a governmentally run program is cheaper than a privately run program. I don’t know what level of health care the government should provide to all regardless of ability to pay but there must be some non-zero level of health care where it makes sense.
I think a high deductible health care system that covers preventative care and catastrophic care is reasonable. You can quibble about the copays, deductibles and which medical treatments will be covered but we have never progressed to this level because some people can’t admit that there is at least SOME level of health care taht it makes sense for our government to pay for, frankly because we are ALREADY paying for it.
Under the new rules put in place since 9/11 immigrants are required to prove legal residency in order to get a driver’s license, the expiration on the license then matches the expiration on the visa.
So for those in the country–legally–on a TN visa, their license expires yearly on the same day the visa expires. But here’s the rub, you won’t get your renewal notice until about two months before expiration. You take THAT piece of paper to the DMV to prove that you’re allowed to stay another year, and they issue a new license with a new expiration. You’ll do this again for every year that you have a TN visa. Your spouse with a TD visa also goes through this.
Problem is that when you take the piece of paper to the DMV they know NOTHING about immigration because they are after all people that work in the DMV. Why would they know anything about immigration? They know as much about immigration as the people in immigration know about the DMV. What they do know is that when someone presents this piece of paper they are to fax it to a number listed on a wall. Then they are instructed to tell you everything is set and to expect your new license in 4-8 weeks, in the mean time you can carry around a stupid piece of paper with a stamp on it.
Here is the fun part. Where does that faxed piece of paper go? Is there any record of it? Nope.
So four days before your license expires you will receive a computer generated notice indicating that you failed to provide immigration documents and your license will expire. This will arrive on a Saturday, and your license will expire on Tuesday. But it’s okay because who needs a license.
Thankfully one of the DMVs is open on Saturday, so you stop everything to go out there, wait in line, only to be told nothing about that can be done on the weekend, but he faxes the piece of paper again just to be sure.
So you take work off Monday morning to go back in line, and here is where it gets good: You talk to the same clerk that helped you the two times before, who is certain he faxed it right, but he faxes it again. Then he makes a couple of calls and finally gets the desk of the person whose job it is to look at the date then hit “okay” on her computer. She claims she didn’t get it. So we fax it again. Now she won’t answer her phone. The guy says there isn’t much more he can do, but to try calling later.
Eventually my wife gets through to someone who finally admits she has the paper, but that she’s got a big stack of them and it will take a few weeks to process. We mention the deadline and she says, “you should have submitted it sooner.”
Some tears are shed, harsh words exchanged, and when we go back to the DMV the next day it’s been sorted out.
We went through this again the next year. And then again when we had H1-Bs that expire every three years. Then again when we switched to a green card.
You’re kidding yourself if you think you can avoid those issues. Not to say you shouldn’t try, but it’s the nature of the system, and even with all of its problems it is still way better than the mixed up mostly-private-mostly-public system the US has now.
That’s exactly it. I recall reading a summary of preventative medicine and the expected cost savings – the surprise was that there are a bunch of things for which preventative medicine simply isn’t cost effective. But, on the other hand, there are also a bunch of things for which it really is.
Preventative care is tricky. There have been a number of studies finding that it doesn’t save money. Problem is that preventative care costs a lot, it means things like daily blood glucose monitoring, insulin injections, etc. Control of diabetes is expensive over 10 years, amputating someone’s foot isn’t. And although it is usually preventive, quite often it’s more about delaying the inevitable.
But what is harder to quantify is that preventative care increases quality of life and extends life expectancy. Those two things are the point of health care. Cost shouldn’t be the determining factor.
Fixing potholes is expensive. If you run a cost benefit analysis it will tell you to let them accumulate for a couple of years then re-surface. But having messed up roads sucks, our quality of life improves if we fill in potholes.
Then you would predict that rates of obesity etc. would be worse in countries with UHC than in countries like ours without it. Care to find evidence for that?
I agree with everything you wrote just about 100%. Emergency health care is right to life - all else is efficiency.
The only extremely minor quibble is calling rationing by ability to pay a death panel. Death panels would at least look at some other factors. However, if we could convince the public that these are death panels, we might be able to improve things, so I won’t quibble further.
Smallpox has been eliminated. It used to be one of the major killers, if not the major killer, of people all over the world. During the 20th century alone, smallpox accounted for 300 million to 500 million deaths worldwide. Tell me that prevention was not worth it.
Yes, I am well aware. But we’re not talking about the right to FREE health care and treatment. We’re talking about the right to health care and treatment.
There is no such thing as free health care. Nor is there a such thing as free police or fire protection. Two are paid for mainly by taxes. In the more civilized countries all three are paid for by taxes.
How about the vaccine for a disease is a penny, and the disease is one where you eat hundred dollar bills or die. (I can create five even more absurd examples than any of yours before breakfast.) I clearly said that some prevention is worth it, and some isn’t. Saying prevention is too expensive is a meaningless statement, since it doesn’t define what type.
Actually, the dead can cost quite a lot, in lost productivity to be crass about it. How much did Mozart’s early death cost in social and artistic terms?