# Plans for “free” college or “free” healthcare or anything of that sort **URL:** \ **Category:** Great Debates\ **Created:** [December 21, 2019, 9:14pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199 "2019-12-21T21:14:39Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 23, 2019, 7:03pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/21 "2019-12-23T19:03:36Z")
> [@2Bits](#): > > …will require MASSIVE cost cuts (IMO) resulting in LOTS of people making LOADS less money if there’s any hope of success and sustainability. > > Right? > > ``` > [I know nothing is “free.” Please ignore my choice of words.] > > ``` > > Sent from my iPhone using Tapatalk Pro In CA, Community colleges are more or less free. I think this should be nationwide. I think that the next two years should be subsidized, but not free for all. Means tested, etc. Too many kids go to a big 4 year college and drop out. Let’s have more go to a nice two year college, and if they find academics not for them, continue as a trade school. Lets bring Medicare to anyone up to 18 or over 55. _This is a start,_ then for everyone. And I mean REAL Medicare, with small premiums for parts B, C, D, etc. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 23, 2019, 7:05pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/22 "2019-12-23T19:05:34Z")
> [@Wesley\_Clark](#): > > Medicare for all will, but I don’t see why free public college will. > > … > > Medicare for all will cost a lot more. Plus because medicare has lower reimbursement rates, yeah a lot of medical providers will suffer. But sadly our health system is 2x as expensive as any other nation, so they are going to have to learn to do more with less. Our health care system isn’t sustainable, and it is starting to wreck our economy due to how much wealth it extracts and how inefficient it is. REAL Medicare for all can be paid for by a tax on business equal to about what they pay out in health premiums now. I mean REAL, not sanders crazy expensive plan. ---
**Author:** ![2Bits](https://avatars.discourse-cdn.com/v4/letter/2/e95f7d/32.png) [@2Bits](https://boards.straightdope.com/u/2Bits)\ **Post date:** [December 23, 2019, 8:27pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/23 "2019-12-23T20:27:16Z")
> [@DrDeth](#): > > REAL Medicare for all can be paid for by a tax on business equal to about what they pay out in health premiums now. I mean REAL, not sanders crazy expensive plan. Does it have to be crazy expensive? Can’t costs be significantly reduced? Can’t billions of profit dollars currently going into certain pockets be significantly reduced? Won’t there need to be cost controls to make MCFA or single-payer work? Sent from my iPhone using Tapatalk Pro ---
**Author:** ![BrickBat](https://avatars.discourse-cdn.com/v4/letter/b/ac91a4/32.png) [@BrickBat](https://boards.straightdope.com/u/BrickBat)\ **Post date:** [December 23, 2019, 8:57pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/24 "2019-12-23T20:57:51Z")
> [@2Bits](#): > > Does it have to be crazy expensive? Can’t costs be significantly reduced? Can’t billions of profit dollars currently going into certain pockets be significantly reduced? Won’t there need to be cost controls to make MCFA or single-payer work? > Sent from my iPhone using Tapatalk Pro Not only that, but the current system could be “crazy expensive” as well, perhaps more so. It’s just that the cost is being hidden by being borne by the public at large as discretionary spending, rather than taxes paid. ---
**Author:** ![Kimera757](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kimera757/32/3765_2.png) [@Kimera757](https://boards.straightdope.com/u/Kimera757)\ **Post date:** [December 23, 2019, 9:09pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/25 "2019-12-23T21:09:07Z")
> [@MandaJo](#): > > One way free health care and free college would work well together is to remove the massive student loans required to go into high paying medical professions, which is a large part of the reason salaries have to be high–not just to recoup the cost of the education, but to account for the risk of taking those loans long before you make any money, and with no confidence that you would be able to pay them back. It boggles the mind that we say to 22 year olds “Ok, here’s the deal. You take on a cool half million in debt, and then hopefully around 30 you’ll start making $250K a year and paying them back. If you aren’t good at this, don’t like it, or for any other reason can’t do this, you are pretty much screwed. Also, don’t specialize in any of the areas that people actually need–they pay the worst”. > > Doctors wouldn’t need to make “doctor salaries” if they started making real money earlier, and if they didn’t have such ungodly debt loads. Some European countries have, or in the case of the UK, had free higher education. I don’t know what the restrictions were, but I’ve read that they didn’t have that many students, and they had to perform well. > [@](#): > > French schooling is free and mandatory from ages six to 16, although the majority of French children start earlier. Another two years of study are required if a student is to sit the baccalauréat exam, which they must pass to enter university. > **[The French education system: a guide for expat parents](https://www.expatica.com/fr/education/children-education/french-education-system-101147/)** > > Learn how to navigate the education system and support options. This doesn’t sound very different than the American and British systems, though. In Canada, there isn’t such an exam, but when I was a kid, I was told I needed an average of 83 per cent to get into university. Many children could not reach such an average. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [December 23, 2019, 9:34pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/26 "2019-12-23T21:34:48Z")
> [@2Bits](#): > > I agree but if I were a middleman “efficiencied” out of a job I would not. Next time you want to buy a car, call me. I’ll find the car you want, and add 10% to the cost of it for my fees. Then if you complain that I’m charging you too much money and adding no value, I’ll remind you that you were once opposed to increasing efficiency at the cost of jobs. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [December 23, 2019, 10:04pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/27 "2019-12-23T22:04:12Z")
> [@MandaJo](#): > > One way free health care and free college would work well together is to remove the massive student loans required to go into high paying medical professions, which is a large part of the reason salaries have to be high–. No costs is being removed here - just shifted from the med student to the taxpayer. So you aren’t saving any money overall. If more doctors go into lower paying specialties, you would lose money, because they would not repay the loans in the form of higher taxes. There is no free college, and TANSTAAFL. Regards, Shodan ---
**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\ **Post date:** [December 23, 2019, 10:47pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/28 "2019-12-23T22:47:53Z")
> [@2Bits](#): > > I agree but if I were a middleman “efficiencied” out of a job I would not. Yup, and nobody spoke up for the poor gravediggers who were out of a job when they invented antibiotics. ---
**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\ **Post date:** [December 23, 2019, 10:51pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/29 "2019-12-23T22:51:24Z")
> [@2Bits](#): > > …[I know nothing is “free.” Please ignore my choice of words.] The correct wording is that a sensible primary healthcare system is free _at the point of service_, and funded out of general taxation. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [December 23, 2019, 11:48pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/30 "2019-12-23T23:48:47Z")
> [@Shodan](#): > > No costs is being removed here - just shifted from the med student to the taxpayer. So you aren’t saving any money overall. If more doctors go into lower paying specialties, you would lose money, because they would not repay the loans in the form of higher taxes. There is no free college, and TANSTAAFL. Whoa, I never considered that we should keep EVERY aspect of our failed heath care system because they are all interdependent. We can’t trim the number of millionaire doctors because student loans are too expensive; we can’t make college more affordable because what about all those debt collectors who might be out of a job; we can’t make health care like fire and police service because there are struggling bankruptcy attorneys out there. I mean, knock any leg out of that pyramid of malevolence and the whole system might get better! ---
**Author:** ![Flyer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/flyer/32/7298_2.png) [@Flyer](https://boards.straightdope.com/u/Flyer)\ **Post date:** [December 24, 2019, 3:33am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/31 "2019-12-24T03:33:41Z")
> [@DigitalC](#): > > Cutting out middlemen is a benefit of single payer, not a drawback. But you’re NOT cutting out middlemen with government-run healthcare. All you’re doing is replacing one set of middlemen (private corporations) with another set (government bureaucrats). At least the private ones have a reasonable chance of actually being fired from their jobs if they’re not adding value somewhere to the equation. The government ones, not so much. ---
**Author:** ![snfaulkner](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snfaulkner/32/433_2.png) [@snfaulkner](https://boards.straightdope.com/u/snfaulkner)\ **Post date:** [December 24, 2019, 3:56am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/32 "2019-12-24T03:56:47Z")
> [@Flyer](#): > > But you’re NOT cutting out middlemen with government-run healthcare. All you’re doing is replacing one set of middlemen (private corporations) with another set (government bureaucrats). > > At least the private ones have a reasonable chance of actually being fired from their jobs if they’re not adding value somewhere to the equation. The government ones, not so much. Except governments are (supposed to be) looking out for your well being while corporations are definitely looking out for their bottom line. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [December 24, 2019, 4:25am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/33 "2019-12-24T04:25:50Z")
> [@Flyer](#): > > But you’re NOT cutting out middlemen with government-run healthcare. All you’re doing is replacing one set of middlemen (private corporations) with another set (government bureaucrats). > > At least the private ones have a reasonable chance of actually being fired from their jobs if they’re not adding value somewhere to the equation. The government ones, not so much. So, Medicare is less efficient than private insurance companies? Really? And you would consider it more efficient for doctors to have to hire staff to navigate the many different billing policies for each insurance company? Explain to me how having to deal with a dozen or more different billing practices in order to get paid is better than one. Shit, maybe merchants would be better served if Visa demanded that a hundred different conditions apply to any sale; MasterCard can have a very different set of 150 conditions; AmEx could have a random number of new policies; and Discover could just randomly demand proof that its customer needed to buy groceries otherwise refuse to pay the merchant. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 24, 2019, 6:14am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/34 "2019-12-24T06:14:19Z")
> [@2Bits](#): > > Does it have to be crazy expensive? Can’t costs be significantly reduced? Can’t billions of profit dollars currently going into certain pockets be significantly reduced? Won’t there need to be cost controls to make MCFA or single-payer work? Pretty much, every expert sez sanders plan is too damn expensive. One reason why Warren dropped it, she was trying to come up with some way of paying for it, and concluded it wouldnt work. ---
**Author:** ![Horatio\_Hellpop](https://avatars.discourse-cdn.com/v4/letter/h/e5b9ba/32.png) [@Horatio\_Hellpop](https://boards.straightdope.com/u/Horatio_Hellpop)\ **Post date:** [December 24, 2019, 7:05am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/35 "2019-12-24T07:05:35Z")
All the (western) countries that have free or heavily subsidized healthcare and college–how many of them have the US footing the bill for their national defense? Is it possible that you can have a robust national defense or free healthcare/college, but not both? I think “free” college is going to mean free _community_ college. The states will cover your first two years, then you’ll transfer to a four-year college and will be responsible for the final leg of your Bachelor’s degree and graduate school (with Pell grants and such). I don’t see any proposals that guarantee a free Ivy League education for everyone. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [December 24, 2019, 11:37am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/36 "2019-12-24T11:37:30Z")
Except all of the western countries that provide universal health care spend less, as a percentage of GDP, than does the US, with better results: universal coverage for all residents, and better indicators of health. Here’s the wiki article health care spending by GDP. The US spends more public money on healthcare than other OECD countries, but doesn’t achieve universal coverage. As well, the public spending by US governments is roughly in line with government spending on health care in other OECD countries; again, without achieving universal coverage. Providing “free” universal coverage is less costly than the US model, freeing up more public money in those countries for other purposes. Tying the health care spending to defence spending is a meaningless way to look at the issue. > **[List of countries by total health expenditure per capita](https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita)** > > This article includes 2 lists of countries of the world and their total expenditure on health per capita. Total expenditure includes both public and private expenditures. > The first table and bar chart lists member countries of the Organisation for Economic Co-operation and Development (OECD). It shows each country's total spending (public and private) on health per capita in PPP international dollars. > The next table lists nearly all countries. It uses data from the World Health Organization (... > **[How does health spending in the U.S. compare to other countries? -...](https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-u-s-health-spending-growth-higher-1980s-similar-since)** > > In this chart collection, we examine how U.S. health spending compares to health spending in other OECD countries that are similarly large and wealthy, based on median GDP and median GDP per capita. For this analysis, we reviewed the OECD Health... ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [December 24, 2019, 11:47am UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/37 "2019-12-24T11:47:52Z")
> [@Flyer](#): > > But you’re NOT cutting out middlemen with government-run healthcare. All you’re doing is replacing one set of middlemen (private corporations) with another set (government bureaucrats). > > At least the private ones have a reasonable chance of actually being fired from their jobs if they’re not adding value somewhere to the equation. The government ones, not so much. Yes, you are, at least in a single-payer system like Canada. You go to a doctor, get treatment, the doctor bills the Medicare system and gets paid. The doctor doesn’t need to have a large staff to bill a great number of insurance plans, each with their own billing system. It’s a single billing system. And, more significantly, there are no bureaucrats scrutinizing the doctor’s bill and substituting their views in whether it was medically necessary treatment. Cost control is handled globally, by negotiations between the Medicare officials and the doctors to establish a payment schedule. Doctors then bill for treatment provided, and get paid. They don’t have to justify their treatment choices to government bureaucrats, unlike a system of private insurance. The only time i’ve run into a bureaucrat second-guessing my treatment is my dental insurance, which is private insurance, not part of Medicare. A single-payer system of this type does eliminate a large bureaucracy, compared to a private insurance system where insurance bureaucrats scrutinize and question the doctor’s treatment decisions, for cost control reasons. ---
**Author:** ![Balthisar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/balthisar/32/2825_2.png) [@Balthisar](https://boards.straightdope.com/u/Balthisar)\ **Post date:** [December 24, 2019, 12:01pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/38 "2019-12-24T12:01:00Z")
> [@Northern\_Piper](#): > > And, more significantly, there are no bureaucrats scrutinizing the doctor’s bill and substituting their views in whether it was medically necessary treatment. Cost control is handled globally, by negotiations between the Medicare officials and the doctors to establish a payment schedule. Doctors then bill for treatment provided, and get paid. They don’t have to justify their treatment choices to government bureaucrats, unlike a system of private insurance. I’m not sure about the other provinces, but [Ontario](https://www.hqontario.ca/System-Performance/utm_medium/Referral?utm_source=Ontario.ca&utm_campaign=WT%20Referral) has some pretty dismal waiting times for things that are pretty important. Because I don’t have USA data, I can’t claim an advantage, but looking at some things like “imaging,” I can’t imagine have a wait time at all. Anecdotally, I’ve met multiple Canadians who cross into Buffalo or Detroit for expedited services. I get it, our system is fucked up, albeit in in a different way. At least I can visit radiology same-day. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [December 24, 2019, 12:10pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/39 "2019-12-24T12:10:50Z")
If you have the money to pay for it. For individuals in the US without money or insurance, the wait time can be infinite. ---
**Author:** ![Urbanredneck](https://avatars.discourse-cdn.com/v4/letter/u/ea5d25/32.png) [@Urbanredneck](https://boards.straightdope.com/u/Urbanredneck)\ **Post date:** [December 24, 2019, 12:47pm UTC](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199/40 "2019-12-24T12:47:38Z")
Those countries with free healthcare and all also dont have the open borders being proposed. [Previous page](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199.md?page=1) [Next page](https://boards.straightdope.com/t/plans-for-free-college-or-free-healthcare-or-anything-of-that-sort/845199.md?page=3)