Is socialized healthcare a good idea?

There is a serious justice issue here as well. When we all get dumped in the same insurance pool by fiat, suddenly the free choice of one person imposes costs on other people.

For instance, let’s say a person who wants to eat lots of junk food.

Now, obviously, there is a moral hazard problem: if he doesn’t bear the full cost of the medical care required to fix his clogged arteries, then he might start consuming even more junk food, requiring even more medical care. This is always a problem with better medical technology: it allows you live more recklessly. That’s actually a GOOD thing: but when coupled with a form of nationalized coverage, it’s way too much of a good thing.

But that’s not primarily what I’m interested in here. The overlooked problem is that, because the nationalized system artificially makes this man’s consumption an externality on others, suddenly the government has a “rationale” for intruding in markets. Suddenly, the government is going to think it a great idea to tax or otherwise regulate junk food. More generally, to regulate everyone’s lifestyle so as to keep it within whatever it considers the “proper” behavior to avoid excessive medical cost to others. That’s another hidden danger oft forgotten. I want to be able to live my life without imposing extra costs on others, which is precisely why I don’t want to be forced to buy into an insurance pool I don’t belong in, or give the government an excuse to regulate my lifestyle choices that LOOKS like it’s just good public economics, but only because it was forced upon me to begin with.

Now don’t get me wrong, I’m no right winger. But at this point in timem universal healthcare is economicaly one of the worst things we can do. Let us not forget that Canada has socialized healthcare, and the income tax there is a whopping 45%.

Thats better than it being decided by God, who came up with the bright idea of putting me in a dirt poor family.

And let us not forget that Canada has a higher quality of life than us.

If you are ‘dirt poor’, maybe. Otherwise, you are just taxed more.

The correct measure is, “do Canadians live longer ONCE THEY ARE PART OF THE HEALTH CARE SYSTEM”. And that answer is no. More Canadians may have access to health care, but that health care is inferior to that available in the U.S. Probably the main reason is because Canadians have to wait longer for diagnosis and initial treatment, and for diseases like cancer, that’s deadly.

I think there are probably workable models. A good SDMB friend and great poster kabbes once turned me on to the idea and I must admit I haven’t thought about the issue the same since.

The problem with insurance is one of hedged bets: you want more people paying in than are paying out. The way we currently do this in the US is through rate variation based on different criteria (life insurance of course works similar). This has the effect we desire, but in doing so it also ensures not everyone can get health care… even if they are in a good risk group!

The alternative is to broaden your risk group by taking on more clients. As things stand, insurance companies desire the most clients in the best risk group, thus giving us the worst of the solutions: affordable health care for those who need it least.

So perhaps we would seek a different solution: a sort of semi-nationalized insurance program. Perhaps two or three insurance groups that must insure everyone at the same price (internal standard, company x charges the same price for all it insures). We would retain some elements of competition in pricing, and we would obtain some elements of diversified risk taking, and we would obtain more coverage (and I hardly think anyone will claim that a healthy population is not a good thing).

AFAIK no country does this exactly. Some do have nationalized insurance, but there is no competition within the geopolitical region so it is a monopoly. I’d be interested in hearing people comment on this.

45%? Cite please.

My income tax is at 16% federal and 11.25% provincial, and that’s not counting any deductions. Of my gross income, I’m actually paying a whopping 6.5% in income taxes this year (roughly - I don’t have all the forms yet, but that will drop a few tenths, not go up, since the missing forms are for some smallish deductions). Granted, I didn’t make a whole lot of money this year, but being single, I don’t have many deductions either.

Wrong wrong wrong.

Years of healthy life expectancy from birth (men)
USA 66.4
Canada 68.2

  • Canadians live almost two years longer than Americans *

Years of remaining healthy life expectancy at age 60 (men)
USA 14.9
Canada 15.3

Percentage of population that is overweight:
USA 22.6%
Canada 14.6%
http://fitfat.ctvnews.com/copy/copy_livinglong.html

Calc:

It’s unclear from reading your post what problem you are trying to solve. What, specifically, is wrong with the US health care system? Then ask yourself: What properties of socialism help solve that problem.

I’m somewhat guessing here, but you are probably concerned with 2 things:

  1. High cost of medical insurance.

  2. Large numbers of uninsured people.

Socialism would certainly fix #2. But there are so many examples in this world that free markets are the best way to keep prices low, that I can’t imagine socialism would help #1. Unless it lowers the overall quality.

It really surprises me how many people who would never advocate socialism as the best economic system for a country still think it is the best system for certain aspects of the economy. Ask yourself this: A large number of Americans cannot afford to buy a house. Shouldn’t we socialize the housing industry to fix that? Now take another look at health care and see what you think.

Apos: Great point you made on the secondary effects of socializing health care (i.e., gov’t intrusion into lifestyle choices). I couldn’t agree with you more.

Like whether I can be gay or not? The government has always invaded on lifestyle choices.

FranticMad said:

You didn’t read very carefully. I’m well aware that Canadians have a higher life expectancy. But is there a good correlation between that and our socialized health care system? That’s a hard case to make. For example, your own cite shows that Americans are more obese than Canadians. Unless you think that our socialized medicine system somehow keeps us thinner, it should be clear that there are significant lifestyle differences which may be the reason why Canadians live longer. Our cities are smaller, we have less pollution, less street crime, etc.

That’s why I said a better measure of the efficacy of the health care system is to measure the lifespan of people ONCE THEY HAVE BEEN TAKEN INTO ITS CARE. For example, the five-year survival rate for prostate cancer in Canada is 87%. In the U.S., it’s 93%. For Colorectal cancer, Canada is at 56%, the U.S. 62%.

Here’s an interesting cite about the U.K’s cancer survival rates: U.K. Cancer survival rates worst in Europe.

This is instructive, because the primary effect you see in countries with socialized medicine is long waiting lists for diagnostic services. So illnesses that rely on early detection have lower cure rates in Canada and the U.K. than in the U.S.

Eris:

Yes, the gov’t has invaded our lifestyle choices a lot. We need to lessen that, not increase it.

I was almost going to disagree with you about homosexuality, but I guess you could claim that PRACTICING homosexual sex is a choice even though I don’t believe BEING homosexual is a choice.

I think the overall tax burden might be 45%, which would include things like prov. sales taxes, the GST, various fees, etc…

But yes, a claim of a 45% income tax rate is absurd. Mine’s about 20% all told and I’m neither rich nor poor.

I don’t think I’d venture to say that it would be a good thing. But I’m willing to go on record as saying that it’s a coming thing.

This year alone we’ve had short term strikes in 3 states (WV, NJ, MS) by doctors protesting the cost of malpractice insurance. In addition, healthcare is becoming so expensive that insurers no longer wish to insure healthcare for anyone who has any risk whatsoever. The deductibles on healthplans are now becoming expensive enough to justify having supplement insurance to afford them.

There’s even a side issue regarding whether skyrocketing health care costs have been caused by 40 years of health insurance. If no one can afford a $40K operation and enough people need it then the entrepreneurial set among us will figure out how to supply it at an affordable cost. But with certain health care plans there hasn’t been a desire to control costs (until recently).

In short, the health insurance industry is that water flowing downhill. It’s a matter of when, not if, it reaches the bottom and the current system is no longer viable in any way.

Wrong. Though it seems it’s the case in the UK and Canada, there are no waiting list here. Posters froms Norway and Germany already said they were very happy with their socialized healthcare system, and I’m too with the french one. There are waiting lists and similar issues when the founding is insufficient (or possibly the organization ineffective). Obviously, you have what you paid for.

You’d have a hard time finding people supporting the end of the socialized healthcare sytem (assuming that some official would be ready for a political suicide by proposing such a thing) here, and I suspect in most other european countries…

How old are the socialized medical systems in Germany and Norway?

Problem with vouchers and subsidies alone … cherry picking and differnetial rates. If you are buying for yourself your rates are much higher than if you are buying as part of a large company, let alone if your are buying with a known medical condition, in which case you may be uninsurable.

Solution: mandate health insurance just like mandated auto insurance, and mandate that insurance companies offer one rate for the same product to all comers (with the exception of contrallable behaviors like smoking). Sure you can always buy an insurance that covers more than what is mandated, just like you can install a security systemn to supplement your local police station. Then subsidize based on income by tax credits and the like.

Socialized medicine is just DOA, whether it would work or not is moot, it aint goin to happen here.

Not all forms of universal health care involve single-payer care (like Canada or the UK). We can do something like the Clinton plan or something like the Dutch, who use a mandatory insurance scheme, IIRC.

Sam: 1) Health care decisions are decided by bureaucrats in the US as well. We call them, “insurance companies”.

  1. The resource allocation angle is an important one. Let’s not forget though that the US spends the largest share of GDP on health care of any industrialized nation, and receives mediocre life expectancy as output. (We can break out these stats, if you wish).

  2. True, lifestyle choices are an important confounding factor. But they cut both ways: there are fewer smokers in the US. (This issue could be addressed with more rigor).

  3. Frankly, the US health care system seems geared towards less cost-effective health care. High profile organ replacement attempts are given oodles of money while anti-tuburculosis schemes are dependent upon a Democratic administration.

Having numerous insurance companies, each with their own forms, leads to an administrative nightmare.

  1. The issue is not merely treatment for a given disease. The issue is also funneling resources (and research dollars) towards more cost-effective treatments, even if they are for different illnesses.

  2. My speculation: Refusing to guarentee health care and a safety net for the disabled has pernicious unintended consequences. Juries know that if somebody is crippled by malfeasance, that no big government is going to step in and provide a minimal standard of living and care. Thus, they look favorably in reaching into the pockets of any fat cat who is even vaguely implicated in the cause of injury.

In short, it is no coincidence that the industrialized country with the most out-of-control tort problems is also the country with the shoddiest health care guarentees.

And we both know that (not unrelated) high malpractice costs feed back into medical care costs.

Uh, no, it isn’t.

I make well above the average income in Canada, and I pay less than thirty percent. In all I pay about 33% if you also include CPP and EI (sort of the Canadian equivalents of Social Security and that other deduction I never remember the name of.)

Sam Stone:

I’d like a cite. And frankly, you’ll need quite a bit of citing, because that’s not an easy or simple thing to measure.

Furthermore, your assertion that that is the correct measure is obviously not true, since the percentage of the population given the opportunity to enter the health care system is obviously a relevant issue here.

On the plus side, the US Healthcare system provides some rather substantial subsidies for European and Canadian citizens.

Under socialized medicine, there is one purchaser of prescription drugs, who therefore has a great deal of monopsony power (monopsony=one buyer, as opposed to monopoly=one seller).

Lower prices for prescription drugs feeds back into lower research and development.

Not a problem. Drug companies know that the US Healthcare system permits substantially higher markups on prescription drugs and correspondingly high profits. This allows them to price discriminate, selling to aggressive buyers at a low price and to sorry (but wealthy) collective saps at a higher price. Everybody wins except the US consumer, who doesn’t care since he prefers astronomically higher insurance premiums over marginally higher taxes.